Health A to Z

E. Coli O157:H7 Endometriosis

Eczema Esophagitis

 

E. Coli O157:H7

 

Definition:

E. Coli is a bacterium that normally lives in the intestines of humans and animals and contamination of the meat may occur in the slaughtering process. Although most strains of these bacteria are harmless, several are known to produce toxins that can cause diarrhea. Infection with E. Coli O157:H7 can be acquired by eating contaminated food or water and by contact with fecal material from infected persons or animals. Person-to-person spread of the bacteria is possible and has occurred in family settings, in day care centers and in nursing homes. O157:H7 infection can be complicated by severe diarrhea and kidney damage and is associated with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP).

 

Who is at risk?

1. Anyone of any age can become infected with E. Coli O157:H7;
2. Children are more likely to develop serious complications;
3. Food handlers;
4. People working at abattoir.

 

Symptoms:

• People infected by E. Coli O157:H7 can develop a range of symptoms
• Some infected people may have mild diarrhea or no symptoms at all
• Most identified cases develop severe diarrhea and abdominal cramps
• Blood is often seen in the stool
• Usually little or no fever is present

 

Treatment:

• Most people recover without specific treatment in 5 to 10 days.
• Antibiotics should not be used for the treatment of E. Coli O157:H7 Infection.
• Treatment with antibiotics has not been shown to be effective. Antibiotic treatment does not alter the severity or duration of diarrhea, or shorten the period of time someone has E. Coli O157:H7 in his/her stool.
• More importantly, antibiotic treatment does not reduce the risk of developing complications of E. Coli O157:H7 infection and may, in fact, increase the risk of developing hemolytic uremic syndrome.
• It is important to prevent and treat dehydration and transfusions and kidney dialysis might be required in patients with Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP).

 

Prevention:

Primary prevention

• Parents should stress proper hand washing habits to their children.
• Avoid eating raw or undercooked beef (steak or rare hamburgers, for example).
• Avoid drinking unpasteurized (raw) milk or unpasteurized milk products.
• Avoid drinking unpasteurized fruit juices (e.g., apple juice or apple cider).
• Drink municipal water that has been treated with chlorine.
• Avoid swallowing public swimming pool water.
• Always carefully wash your hands with plenty of soap and water after bowel movements, and before and after food preparation.
• Avoid spreading harmful bacteria in your kitchen. Keep the raw from the cooked food.
• Wash the utensil with soaps after they touch the raw meat.
• Wash the fruit thoroughly.
• Never put cooked hamburgers onto an unwashed plate that held raw patties.
• Avoid petting zoos and other animal exhibits.
• Wash hands following contact with cattle and cattle fecal material including manure used for farming or domestic gardening practices.

Secondary prevention

Infected persons with diarrhea and those who are unable to control their bowel habits, particularly those children in day care centers and individuals in nursing homes, should be isolated until symptoms have resolved.

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Eczema

 

Definition:

Eczema is an inflammation of the skin which may cause redness, dryness, flakiness, heat, and itchiness of the skin. Eczema is ususally caused by allergy.

 

Who is at risk?

1. Young babies who may be associated with cradle cap (a lay term for infantile seborrhoeic dermatitis of the scalp in babies, characterised by greasy, yellow, scaly patches on the skin of the scalp);
2. People with asthma and hay fever (atopy);
3. People in contact with chemical (irritants) such as detergents, soaps, diesel or engine oils, strong chemicals, cleaners, etc.;
4. People allergic to nickel, rubber, etc.;
5. People with varicose vein (dilated and tortuous veins, most commonly in the legs).

 

Symptoms:

1. Patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs. In children, the inner creases of the knees and elbows are often involved.
2. Skin lesions, patches of redness, scaling, and in dark-skinned people, changes in skin colour.
3. Sometimes, the itch would come before the rash.

 

Treatment:

The treatment plan will be made based on the type and severity of the eczema, age, and medical history as well as history of any previous treatment.

1. Lifestyle modification and avoidance of irritants.
2. Emollients for moisturizing.
3. Topical steroid: In cases not responsive to the moisturizing cream.
4. Antihistamine: To relieve severe itching.
5. Antibiotic: For secondary bacterial skin infection.
6. Antifungal cream or shampoo: For secondary fungal infection.
7. Phototherapy: Useful in only certain types of severe eczema.
8. Oral corticosteroids and immunosuppressive drugs (e.g. cylcosporin and methotrexate): May be prescribed in some severe cases.
9. Immunomodulators e.g. (Elidel and Protopic): Non-steroidal treatment but an increased risk of skin cancer and non-Hodgkin's lymphoma (a type of malignant tumor of lymph nodes).

A combination of treatments may be appropriate. You should discuss the options with your doctor to develop a treatment plan.

 

Prevention:

• Doctors advise continuing breast milk for at least up to six months (preferably one year) as you introduce your baby to solid food. This would also reduce the risk of developing eczema.
• Babies should also be protected from allergens such as tobacco smoke, and airborne irritants such as mites and molds.
• Soothe your skin with regular applications of moisturizer to prevent itching and dryness.
• Limit contact with anything that irritates the skin. Stay away from extreme temperatures, dry air, harsh detergents, harsh chemical cleaners, jewellery, perfumed soaps, bubble baths, and heavily fragranced lotions that tend to irritate the skin and trigger eczema.
• Find out what irritates your skin and limit contact with all that does. Avoiding personal-care products that contain alcohol and not washing hands too frequently also will help reduce irritation.
• If you wear makeup, look for brands that are free of dyes and fragrances that can aggravate eczema.
• Take short, warm showers and baths. Prolonged shower would dry up the skin.
• Try wearing rubber gloves to avoid hands soaked in water for too long.
• Avoid sweating and overheating. The most common triggers of the scratch/itch cycle are sweating and overheating.
• Use a humidifier in the home to help prevent skin from drying out.
• Dress in loose-fitting cotton clothes. Use blankets and clothing made of cotton instead of wool or polyester.
• Removal of excess dyes by washing new clothes before wearing them.
• Keep stress down to reduce eczema flares. Try activities like walking and aerobics after a long day to keep your stress levels low.
• Find out if any food(s) triggers the eczema. Avoid those food and consider seeking an opinion from a dermatologist.

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Endometriosis

 

Definition:

Endometriosis is a progressive, often debilitating disease that affects 10-35% of women during their reproductive years. It is most common in women in their thirties and forties, especially in women who have never been pregnant. It occurs when endometrial tissue begins to grow on the outside of the uterus and on nearby organs. This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation.

 

Who is at risk?

1. Caucasian women;
2. Women who have a first-degree relative (mother, sister, daughter) with the disease;
3. Women who give birth for the first time after age 30;
4. Women with an abnormal uterus.

 

Symptoms:

• Infertility
• Fatigue
• Pain before and during periods
• Pain during sex
• Painful urination during periods
• Painful bowel movements during periods
• Gastrointestinal upsets such as diarrhea, constipation, nausea
• Unexplained regular breathlessness at roughly every 28 days (pleura involvement leading to pneumonthorax (meaning: free air in the chest outside the lung))

 

Treatment:

1. Pain relief: Over-the-counter pain relievers include aspirin, paracetamol and prostaglandin inhibitors such as ibuprofen, naproxen and diclofenac.
2. Hormonal therapy: Hormonal treatment aims to stop ovulation for as long as possible and includes oral contraceptives, progesterone drugs, a testosterone derivative (danazol), and gonadotropin releasing hormone drugs.
3. Surgery: Conservative surgery seeks to remove or destroy the growths and allows pregnancy to occur in some cases. Conservative surgery involves laparoscopy surgery or laparotomy (full incision on the abdomen). Radical surgery, which may be necessary in severe cases, involves hysterectomy (surgical operation to remove the uterus), removal of all endometrial tissues, and the removal of ovaries.

A combination of treatments may be appropriate. You should discuss the options with your doctor to develop a treatment plan.

 

Prevention:

Research suggests that frequent and early pregnancy and daily exercise may help decrease the incidence and severity of endometriosis. Since the causes of Endometriosis are unknown, advice on prevention is difficult to provide. If you think you may be at risk, watch for symptoms and consult your doctor early.

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Esophagitis

 

Definition:

Esophagitis is a sort of Inflammation or irritation of the esophagus. The common causes of esophagitis include:

1. Reflux of acid from the stomach.
2. Infections in the esophagus. Organisms that can cause infection in the esophagus include candida, a yeast that normally lives in the oral cavity and the skin, and herpes, a virus.

 

Who is at risk?

Acid irritation causing esophagitis is common in patients with GERD (Gastroesophageal reflux disease). Candida and herpes infect the esophagus only when the body's immune system is weak. Extensive candida infection of the esophagus can be an early sign of AIDS.

 

Symptoms:

Symptoms of esophagitis include:

• Difficult and/or painful swallowing
• A feeling of something of being stuck in the throat
• Heartburn
• Mouth sores
• Nausea and vomiting

 

Treatment:

Treatment for esophagitis depends on its cause as well as the nature and severity of symptom. Possible treatments include:

• Medications that block acid production, like heartburn drugs.
• Medications that soothe pain, which include those that are gargled or swallowed.
• Medications to reduce inflammation, such as corticosteroid preparations.
• Antibiotics, antifungals or antivirals to treat specific infections.
• Supplements and nutritional support. Those who cannot swallow at all would require intravenous (by vein) nutrition.

 

Prevention:

Prevention should be focused on avoiding risk factors of diseases that can lead to esophagitis, such as GERD and AIDS. Patients with symptoms of esophagitis would be better off symptomatically if they can:

• Avoid spicy foods such as pepper, chili and curry.
• Avoid hard foods such as nuts and crackers.
• Avoid acidic foods and beverages such as tomatoes, oranges and grapefruits.
• Add more soft foods such as applesauce, cooked cereals, congee and mashed potatoes.
• Eat slowly, take small bites and chew food thoroughly. Allow plenty of time for meals.
• Drink liquids through a straw to make swallowing easier.
• Avoid alcohol and tobacco.

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