Corneal diseases

Cornea - a front part of an external fibrous envelope of an eyeball; nonvascular, high-sensitivity, transparent, an optically homogeneous envelope with smooth, a smooth surface. Except for protective and basic function the cornea is the main refracting surface of optical system of an eye.

Diseases of a cornea makes about 25 % of the general number of diseases of eyes, and quite often are the reasons of blindness and lowering of vision.

Diseases of a cornea are rather various. Most often there are inflammatory diseases of a cornea (keratitis), differing greater variety of forms and being one of principal causes of decrease in sight and blindness, and also keratikonus. The Most frequent reasons of keratitis and keratoconjunctivitis are virus and bacterial infections.

Keratikonus - a condition of an eye at which the normal spherical form of a cornea is broken, the cornea is bent. On a surface of an eye the camber similar to a cone that leads to strong easing of sight develops.

Dystrophies and degenerations of a cornea happen primary and secondary. In a basis primary local and general infringements of a metabolism with adjournment in a cornea of products of a pathological exchange lay. Secondary dystrophies develop after transferred keratitis, traumas, burns of eyes.

For the prevention of heavy complications of diseases of a cornea are required: proper diagnostics, duly and active treatment. Various medicinal substances are applied to local treatment in the form of drops, injections. Methods of electrophoresis, phonophoresis, treatment by laser radiation are used also.

For carrying out of purposeful treatment bacterial keratitis definition of sensitivity of microflora to antibiotics by crop of defeat separated from the center is necessary.

Instruction to the patient after change of a cornea

To you the microsurgery of change of a cornea is lead. The thin seam keeping a donor fabric, can long-standing time (about one year) to remain in a cornea. It allows you to start to work with the moderate physical activity earlier. At the same time, it is necessary to remember the periodic medical control over a condition of a seam.
Durable healing of a wound after change of a cornea comes only in 6-10 months after operation. Therefore after an extract from a hospital it is necessary for you to continue the recommended treatment in house conditions. Instilling drops or loading ointments can be made the purest hands before a mirror or in a prone position, as well as by means of relatives, using those receptions with which you have got acquainted in a hospital.

During the first month to sleep it is necessary on a back or on the party opposite to the operated eye. The food can be usual, it is necessary to exclude alcoholic drinks. Surplus of sweets is not desirable. Easy gymnastic exercises without jumps, run and inclinations are useful. During rest and walks during the first year after operation it is necessary to avoid stay on the bright sun. It is impossible to sunbathe. It is possible to use the blacked out glasses. The replaced cornea during several months, and sometimes several years, has the lowered sensitivity. Therefore it is impossible to rub sharply an eye a scarf or a hand, it is necessary to be cautious at washing, to cover the operated eye during a strong wind and to avoid walks in frosty days even on the second or the next years after operation. It will help to save a cornea from damages and freezing injury.

You can watch TV, go to museums, cinema and theatre if it is not connected with difficult and close moving to transport. It is possible to start the usual or limited work in 2-4 months depending on a condition of the operated eye and working conditions. Expansion of the general mode should be carried out one step at a time, however during the first year work with a slope of a head downwards, outdoor games, run, heavy physical work is absolutely counter-indicative. After an output for work do not forget to show to the oculist each 2-3 months within the first year after operation, especially if it is not removed an encircling stitch.

In case of occurrence of reddening and an ache in an eye, and blear-eyedness to you it is necessary for photophobia to see a doctor promptly. Only early the begun treatment can prevent deterioration of vision.

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Dystonia and Botox Injections

The first thing you notice about "Joey" is that his head is turned and tipped to one side; his left ear rests on his hunched-up left shoulder. He has to turn his whole upper body to look at you. Joey has torticollis, also known as cervical dystonia, meaning that his neck muscles are in an involuntary spasm that forces his head into its painful, abnormal position.

Can affect any part of the body
Dystonia--those painful muscle spasms--can affect any part of the body including:

• eyelids (blepharospasm)
• face (oromandibular)
• vocal cords (dysphonia)
• arms, legs, or trunk

"Writer's cramp" is dystonia in the hand or arm muscles.

Causes
Dystonia affects people of all ages and ethnic backgrounds. Some forms of it can be inherited; researchers have identified more than 10 genes or chromosome locations associated with the disorder. Dystonia may also occur due to birth injury, traumatic injury, toxins (such as manganese), certain medications (such as haloperidol), stroke, or be part of another disorder such as Parkinson's disease. It generally develops gradually, and symptoms can appear at any age.

Diagnosis
There is no specific test for dystonia, so it is usually diagnosed based on the symptoms. Dystonia can come and go, so some people who experience it may have a hard time convincing health care providers that it exists. The spasms may change significantly with different actions. For example, hand dystonia may occur when trying to write but not during other activities.

Treatment
For most people with dystonia, the disorder does not shorten life, but it does cause pain and discomfort, and may interfere with basic activities such as walking, dressing, or eating.

There are a number of medications that can treat dystonia, either alone or in combination. One of the most common treatments is Botox (botulinum toxin) injections (marketed as Vistabel in Europe). Dysport is another brand available in Europe. Another formulation of botulinum toxin used is called Myobloc (U.S.) or Neurobloc (Europe).

Botox injections
Although most people in the U.S. know Botox as a vanity treatment for facial lines, it was originally developed in 1989 as an orphan drug to treat dystonia and muscle spasms. Injection of the drug causes weakness in the targeted muscle, thus relaxing the spasm and relieving dystonia.

Information for this article was taken from:
- Molloy, F. M. (2002). Botulinum toxin (Botox): Dystonia treatment. eMedicine, accessed at http://www.emedicine.com/neuro/topic585.htm
- Dystonia Medical Research Foundation

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Shigellosis

What Is It?

Shigellosis is an infection of the colon (large intestine) caused by Shigella bacteria. Shigellosis is also called bacillary dysentery because it can cause severe diarrhea. However, the infection often causes only mild symptoms.

Shigella can be found in water polluted with infected sewage. Bacteria commonly enter the body through a contaminated drinking supply. Shigella bacteria also can be found on food that has been rinsed with unclean water, grown in fields contaminated with sewage, or touched by flies that have touched feces. Shigella bacteria can reach the mouth on dirty fingers that have touched items soiled with feces, including dirty diapers, toilets and bathroom fixtures. Outbreaks of shigellosis are most common in areas where sanitation is poor, and in places where people live under confined or crowded conditions. Shigella also can be passed from person to person during anal-oral sex.

Worldwide, an estimated 140 million people develop shigellosis each year, and about 600,000 die. Most of these deaths occur in developing countries among children under age 5. In the United States, only 20,000 cases are reported each year, but the actual number of infections is probably more than 200,000 per year. Shigellosis is more common among children ages 1 to 4. Children of this age are especially at risk because they are starting to use the toilet and often forget to wash their hands. Infants are at the highest risk of becoming seriously ill from a Shigella infection.

Symptoms

Although health experts don't know why, some people take in Shigella bacteria without becoming ill. Others develop only a brief fever, or a brief fever with mild diarrhea that goes away on its own. About 25% of patients, however, develop high fever, abdominal cramping and severe diarrhea that can contain blood, mucus and pus. These people can have 10 to 30 bowel movements each day, along with a persistent urge to have a bowel movement that can lead to rectal prolapse (an abnormal protrusion of the rectum). Rarely, Shigella bacteria can affect other parts of the body far from the digestive tract. When this happens, there can be seizures, confusion or coma, kidney failure, arthritis, rashes or other symptoms.

Diagnosis

Your doctor will ask about your symptoms and about the appearance of your bowel movements. He or she will ask if you have recently traveled to developing countries, been in contact with people who have severe diarrhea, or might have been exposed to contaminated pools, lakes or food.

Your doctor will diagnose shigellosis based on a physical examination and the results of laboratory tests. These tests include taking a swab of your rectum or a sample of your stool (feces). If you have signs of dehydration (excessive loss of body water) or significant blood loss, additional blood tests may be necessary.

Expected Duration

In most otherwise healthy people with mild shigellosis, diarrhea goes away on its own within five to seven days. However, in very young children, the elderly or people with chronic illnesses, shigellosis can be severe and can lead to life-threatening dehydration and other complications within a few days.

Prevention

There is no vaccine to protect against shigellosis. To prevent the spread of Shigella bacteria, you should:

• Practice good hygiene, especially frequent handwashing.
• Wash your hands immediately after changing a child's diaper, especially if the child has diarrhea.
• Dispose of soiled diapers in closed-lid garbage cans.
• Swim only in lakes and pools whose water quality is monitored by local health officials.
• When traveling to developing countries, drink only water that has beeb treated or boiled eat only foods that have been cooked thoroughly. Never eat unpeeled fruits, and always peel fruits yourself immediately before eating them.

Treatment

If you have a mild case of shigellosis, you probably won't need treatment because your symptoms will probably go away on their own. Sometimes, doctors may prescribe antibiotics if there are very young or very old members in a household who could get the infection.

If you have a severe case of shigellosis, your doctor will prescribe fluids to treat dehydration and an antibiotic based on how you became infected. For example, if you became infected with shigellosis in the United States, your infection probably will respond to common antibiotics such as ampicillin (Polycillin, Totacillin, Omnipen), trimethoprim-sulfamethoxazole (Bactrim, Septra and other brand names), tetracycline (sold under many brand names), or ciprofloxacin (Cipro). However, if you became infected during travel to a developing country, the infecting strain of Shigella is more likely to be resistant to these common antibiotics, and you may need a newer or less common antibiotic.

The use of antidiarrheal medicines to slow bowel movements is controversial. It can take longer to clear the bacteria from the lower intestine and the illness caused byt he infection could become more severe.

When To Call A Professional

Call your doctor if you develop severe diarrhea, especially if the bowel movements contain blood or mucus. Call your doctor whenever you have a fever and severe diarrhea. Seek immediate attention if you have signs of dehydration, such as very dry mouth and lips, and lightheadedness when you stand, whether or not you are thirsty.

Prognosis

In developed countries, most people with shigellosis recover completely. In underdeveloped countries, the risk of complications, including death, is signifcantly higher.

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Factors and the conditions causing irritation of a dental pulp

The irritation of a pulp of a tooth can arise owing to caries of a teeth, as a result of preparation of a tooth and carious cavities, under influence a filler material, owing to penetration of microorganisms at not tight seal, at an exposure dentin.

Caries of a tooth serves as a principal cause of changes in a pulp and its inflammations. Already at initial damage dentin fibrilloblasts react adjournment secondary and formation of a layer scleroid dentin (adjournment of salts of calcium on walls of dentinal canaliculus) down to full occlusion of dentinal canaliculus. These processes should be considered as display of protective mechanisms of a pulp on action of a cue.

At processing of a caries and destruction of enamel of a bacterium get in dentin, however the inflammation of a dental pulp does not arise. It is established, that first signs of an inflammation come, when carious the cavity is separated from a pulp by a layer of 1,1 mm [Reeves R., Stanley H. R., 1996], i.e. the pulp practically is not infected up to an instant of penetration of microorganisms in secondary dentin [Massler, Pawlak J., 1977].

Preparation of a cavity without use of a water spray leads to its damage. Thus probability of damage of the in direct proportion area of preparation and depth of damage. Thus, preparation of a tooth under vinirs or artificial crownwork without due cooling serves a serious risk factor for a pulp.

Filler materials. There are the numerous data specifying irritating influence various of filler materials. From cements the most expressed adverse action renders silicate though specify, that it is shown at formation of a clearance between edge of enamel and dentin as microorganisms nestle close in dentin [Brannstrom, 1979].

Composites also are considered as irritating materials. First of all, toxicity of composites of the first generation was marked. Materials let out now as specify numerous supervision, render insignificant influence on a pulp.

During many years use of bondings was studied at sealing. It is proved, that improvement of a compounding bondings has allowed to achieve favorable reaction of a pulp to used composites.

Regional permeability as considers a number of researchers, is a principal cause of irritation of a pulp after sealing. The leading part thus belongs to microorganisms. With the purpose of the prevention of the specified changes in a pulp it is recommended to spend padding fabrics of a tooth and use bonding systems.

The exposure of dentin can occur after loss of a seal, as a result of deleting fabrics, at erosion, etc., that is accompanied by sensitivity action of irritating factors. Sensitivity can arise also at an exposure cervical dentin because canaliculus of dentin become opened.

The sheeting (direct) provides:

1) clarification of a surface of a pulp;

2) drying of a cavity;

3) imposing on the naked pulp of medical paste;

4) a seal from zinc oxide eugenic acid cement;

5) imposing of a constant seal.

Most widely used materials for protection of a pulp contain all calcium hydroxide. As a result of it above a site of an exposure it is postponed secondary dentin, forming the dentin bridge. Consider, that formation of a barrier occurs not due to the calcium containing in a material, closing a pulp.

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Colitis - a problem of intestines

Very often at people the wrong opinion concerning such disease as colitis is created. They assume, that colitis is a gripe. However, this incorrect assumption. The word colitis has occurred from the Greek word "kolon" which is translated as a large gut. Actually colitis is an inflammatory disease of a mucous membrane of thick intestines.

Colitis in sharp forms pass very violently, but during too time it is very fast. Chronic colitis in turn proceed very long and languidly. Sharp colitis are very often accompanied by an inflammation of thin guts and a stomach. The medicine knows some types of colitis. Among them: ulcer, infectious, ischemic, medicinal, radiating and some other types of colitis. Ulcer colitis it is accompanied by occurrence of chancres in paries of intestines. At ischemic prick blood badly reaches intestines.

There is a big number of the reasons of occurrence colitis. It can be intestinal infections, an infection in a bilious bubble or a pancreas, long application of antibiotics, infringement of blood supply of a gut. If to speak about a wrong feed it also influences formation of colitis. More often this abusing flour and animal food, also a spicy food and alcohol. If at you a dysbacteriosis of intestines, worms, a bad heredity or a food allergy, quite probably, that you become "hostage" of colitis. One more very frequent factor of occurrence of colitis is the wrong mode of day, a frequent mental or physical overstrain.

The basis of any colitis includes damage of a mucous membrane of a gut. If colitis is caused by an intestinal infection then disease passes with rough influence on an organism. During the moment of disease various bacteria and parasites get on a mucous membrane of a gut and start it to damage. During this moment in a gut of the patient there is an inflammatory process. Because of it the wall of a gut swells. The gut cannot normally function any more. The wrong operating mode causes desires on defecation, a diarrhea and painful sensations in a stomach. At the patient at prick constantly the temperature raises.

First attributes of colitis are a pain in the field of a stomach and a unstable chair. Rumbling and a swelling of a stomach can disturb the patient. In a dung there can be a slime or blood. The person with colitis feels slackness, weakness. The given disease proceeds more often, approximately, some weeks.

If happens you got a colitis, it is necessary for you to address necessarily to the gastroenterologist. Only him can put you the correct diagnosis. Also you should hand over the analysis кала and to pass some researches on various devices.

Treatment of any kind of colitis requires a special diet. All other treatment is appointed depending on the reasons of disease. If at you has appeared colitis because of an intestinal infection then to you will necessarily appoint antibiotics. In case of if you became the owner of this disease because of application of a plenty of medicines then all medical products are canceled.

Medicinal therapy, physiotherapy, psychotherapy – all this methods of treatment colitis. Sanatorium treatment of this disease very well helps.

Colitis, as well as all other diseases, requires duly treatment. For this reason leave all businesses on then and engage for the beginning in the health. Visiting of the gastroenterologist will help you to get rid from colitis and to feel far more confidently and better.

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How is Down Syndrome Diagnosed?

How is Down's Syndrome Diagnosed?

Down syndrome is diagnosed one of two ways, either during pregnancy or shortly after birth. The diagnosis is always based on the presence of an extra number 21 chromosome on a karyotype (a picture of an individual's chromosomes).

At Birth

The diagnosis of Down's syndrome is usually made soon after birth because of some subtle differences in the baby's appearance. Children with Down syndrome have some distinctive facial features and physical characteristics that may lead your doctor to suspect that your baby has Down syndrome.

Some of the features include:

• A flat facial profile, flat nasal bridge and somewhat small nose
• Almond shaped eyes with epicanthal folds
• A small mouth with a slightly enlarged tongue
• A big space between the first and second toe
• Small broad hands with short fingers and a little finger that curves inwards.
• A single palmar crease on their hand
• Reduced muscle tone (hypotonia) which results in floppiness

If the doctor suspects that the baby has Down syndrome, a chromosome test called a karyotype, will be ordered. It usually takes a few days to get the results of this blood test. It is almost always a shock when a baby is diagnosed with Down syndrome but there are some things that you can do to get through the first few months.

During pregnancy

Screening versus Diagnostic Testing

There are two kinds of testing that can be done during a pregnancy - diagnostic testing such as amniocentesis and chorionic villi sampling (CVS), and screening testing such as ultrasound (sonogram) and maternal serum screening tests. A screening test can never give you a firm diagnosis - a screening tests simply tells you if you have a slightly higher risk to have a baby with Down syndrome. A diagnostic test on other hand, gives you a firm diagnosis.

Down syndrome can be diagnosed in pregnancy by diagnostic tests such as amniocentesis or chorionic villi sampling (CVS). These are considered optional tests during pregnancy which means that it is your choice whether or not to have this testing. It is recommended that women considering testing speak with a genetic counselor to review their risks and to discuss risks and benefits of these procedures before making their decision about testing

The results of amniocentesis and CVS will give you a picture of the fetus’s chromosomes and the diagnosis of Down syndrome is very straightforward. Infants with Down syndrome have an extra number 21 chromosome for a total of 47 chromosomes rather than 46.

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Dermatitis

Dermatitis is an inflammatory process arising in integuments. Its reason can become various physical or chemical factors of an environment. The degree of influence of the harmful agent sometimes depends on individual sensitivity of an organism, in this case it is a question of the allergic nature of disease. It takes place both at external contact with cue, and after its hit inside of an organism. Depending on it, distinguish contact forms of illness and toxicoderma.

Ordinary contact reactions result from hit on a leather of caustic chemical substances, for example, acids or alkalis. Depth and the area of defeat thus neatly depends on concentration, area and time of influence of the negative factor. At long-standing contact to small dozes of toxin pathological process gets chronic character, and at lots — immediately there is a sharp reaction. It is accompanied by reddening of a leather, formation of bubbles, a suppuration, occurrence of hypostases, pains, burnings and an itch.

As a rule, its reason are solar burns, significant differences of temperatures, toxic substances of a vegetative or animal origin, cosmetic and perfumery means, medicinal creams and ointments. As most often meeting form sharp dermatits the attrition and the water callouses formed on a leather owing to mechanical friction serves. Usually on palms of hands it is observed after heavy physical work, and on stops — as a result of long carrying close footwear. At people with excess weight quite often attritions arise on a body between folds of a leather.

For chronic process bluish painting of integuments, occurrence of cracks, a thickening of a horn layer and a peeling is characteristic. The reason of similar reactions can become various fungoid, bacterial or virus infections, strong diaphoresis, especially in a combination to synthetic clothes. To cause the allergic form of disease some foodstuff are capable. At children such condition has received the name of a diathesis. More often it is connected with the use in food of dairy products, citron, nuts, eggs.

Constant stay in a condition of stress provokes occurrence or strengthening of negative symptoms of dermatitis. It is necessary to comply with caution to people with a dry leather, especially in cold and windy weather. During this period for protection of the open sites of an integument it is necessary to use special creams. For preventive maintenance of disease it is necessary to adhere strictly to the safety precautions at the reference with dangerous substances on work and houses, in time to eliminate activators of infections, with caution to approach to use of medical products.

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