Health A to Z

Vaginitis Vibrio Parahaemolyticus

Vascular Disease

 

Vaginitis

 

Definition:

Vaginitis refers to the swelling, itching, burning or infection in the vagina that can be caused by several different germs. The most common kinds of vaginitis are bacterial vaginosis (used to be called Gardnerella vaginitis) and yeast infections. Trichomoniasis, also a kind of vaginitis, is also caused by a parasitic protozoa called Trichomonas vaginalis.

The healthy vagina has a balance of many different kinds of bacteria. "Good" bacteria help keep the vagina slightly acidic. This keeps "Bad" bacteria from growing too fast. When the balance between the "Good" bacteria and the "Bad" bacteria is upset, "Bad" bacteria grow too fast and cause infections.

 

Who is at risk?

• Women who have any injury to the vagina;
• Women who are taking antibiotics;
• Pregnant women;
• Women who practice douching;
• Women who wear underwear, which is damp, or tight pants;
• Women who use vaginal products (sprays, lubricants, birth control devices);
• Women who have low immunity (e.g. diabetes).

 

Symptoms:

1. Related to bacteria: A strong fishy smell, with whitish foamy discharge
2. Related to yeast: A smell like baking bread and thick, white "cottage cheese" discharge with pain, itching or burning sensation
3. Related to parasite: A strong odor, with green, yellow or grey discharge ; itching in or around the vagina; and pain during intercourse or urination

Treatment:

1. Bacterial vaginitis: Treatments include antibiotic such as Metronidazole or Clindamycin.
2. Yeast infection: Topical antifungal cream such as miconazole or clotrimazole. Sometimes oral anti-fungal medications such as ketonazole or itraconazole would be given in persistent cases.
3. Trichomona vaginitis: Treatments include the antibiotic Metronidazole. Both partners should be treated for the elimination of parasites.

 

Prevention:

• Wash vaginal area every day. Use mild soap. Rinse well and pat dry.
• Wipe vagina and anus from front to back.
• Don't douche as this can upset the natural balance of the vagina; consider using natural yoghurt for douching, if required.
• Take antibiotics only when needed. Antibiotics can kill "Good" bacteria.
• Practice safe sex
• Wear cotton or cotton-lined underpants.
• Avoid tight pants and panty hose in hot weather.
• See your health care provider if you notice any unusual discharge or smell from the vagina.

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Vascular Disease

 

Definition:

Vascular disease is a broad term referring disease processes in the blood vessels that can impair proper circulation. It is closely related to the cardiopulmonary system (the heart and lungs) and can impair the proper function of these and other organs of the body. Among the subtypes of vascular disease are Arterial Disease and Venous Disease.

 

Common diseases affecting the arteries (arterial diseases) include:

1. Peripheral vascular disease (PVD) is a condition where the arteries that carry blood to the legs or the arms become narrow or clogged.
2. Carotid artery disease is a condition in which the arteries in the neck that supply blood to the brain become clogged and may cause a stroke.
3. Abdominal aortic aneurysm (AAA) is an area in the main artery of the heart (the aorta) that is weakened and bulges like a balloon. If it grows large enough, the aneurysm can rupture and cause life-threatening bleeding.
4. Abdominal vascular disorder such as renal artery stenosis (narrowing) and mesenteric artery stenosis leading to pain and mesenteric ischemia.
5. Vasospastic syndrome such as Rayaund phenomenon.

 

Common diseases affecting the veins (venous diseases) include:

1. Superficial Thrombophlebitis refers to a clot and inflammation formed in a superficial vein near the surface of skin.
2. Varicose vein refers to the incompetence of the valves within the veins of the leg.
3. Deep Vein Thrombosis (DVT) refers to the development of a blood clot, which can cause partial or total blockage of blood flow in a deep vein.
4. Pulmonary embolus (PE) refers to a clot in lower limb broke off and travel to the lung and become lodged in one of the pulmonary arteries.

 

Who is at risk?

1. Smoking;
2. Diabetes;
3. Obesity;
4. Pregnancy;
5. Hypertension, diabetes & high cholesterol;
6. A family history (arterial occlusive or venous disease);
7. Deficiency of protein C, protein S and antithrombin III (increase risk of DVT & PE);
8. Increasing age leads to a loss of elasticity in the veins and their valves;
9. Prolonged inactivity (e.g. prolonged period of sitting, standing or bed rest).

 

Symptoms:

 

Symptoms of arterial diseases include:

• Cerebrovascular disease: Inability to move (paralysis) of face, arm, or leg, especially on one side of the body associated with transit loss of eyesight
• Abdominal aneurysm: Back pain associated with absence of femoral pulse in the groin

 

Symptoms of PVD include:

• Persistent coldness or numbness in the feet or hands
• Pain, abnormal coloring or lack of pulse in portions of the extremities
• Leg pain worse with exercise & relieved by rest
• Ulcers and sores at foot/ankle with poor healing and leads to gangrene

 

Symptoms of DVT may include:

• Pain, swelling or tenderness in the limb
• A bluish discoloration of the skin
• An abnormal flush or redness of the skin

 

Symptoms of a pulmonary embolism (PE) may include:

• Sudden onset of chest pain or collapse
• Unexplained shortness of breath
• Unexplained rapid heart rate
• Unexplained low-grade fever

 

Treatment:

Treatment programs are tailored to each individual and take into account the needs of the patient and family. The treatment will depend on factors such as the severity of the symptoms, the degree of arterial or venous narrowing and the patient's overall health.

1. Controlling risk factors through lifestyle changes: Low fat low calorie diet. Exercise helps in weight loss and in improving blood flow.
2. Medication: Cholesterol lowering medication, anti-platelet and anticoagulation.
3. Endovascular therapy or surgery to reopen arteries to the legs or arms (angioplasty and stents).
4. Surgery such as endarterectomy (cleans out the plaque buildup inside the artery) and graft/bypass.

 

Prevention:

1. Stop smoking.
2. Control diet & maintain a healthy weight.
3. Control high blood pressure.
4. Exercise daily.
5. Avoid immobilization.
6. Manage diabetes and high cholesterol.
7. Know the warning signs for stroke that could be brief and recurrent.

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Vibrio Parahaemolyticus

 

Definition:

Vibrio parahaemolyticus is a bacterium thrives in brackish environment and naturally inhabits coastal waters especially in the summer. According to the Centre for Health Protection, it is the most common agent causing food poisoning in Hong Kong.

 

Who is at risk?

• The usual sources of food poisoning by Vibrio parahaemotyicus include inadequately cooked marine products, or food items cross-contaminated by seafood with improper handling.
• Raw or undercooked shellfish and oysters are especially risky.

 

Symptoms:

• Vibrio parahaemolyticus causes watery diarrhea, often with abdominal cramping, nausea, vomiting,fever and chills.
• Usually these symptoms occur within 24 hours after ingestion.
• The disease is self-limiting and lasts about 3 days. Severe disease is rare, except in persons with weakened immune systems.

 

Treatment:

• Patients should drink plenty of fluid to replenish that lost through diarrhea.
• Treatment is not necessary in most cases.
• There is no evidence that antibiotic treatment decreases the severity or the length of the illness.

 

Prevention:

• Most infections caused by Vibrio parahaemolyticus can be prevented by cooking seafood thoroughly.
• The public should only patronize licensed and reputable food premises, especially when eating high risk food items.
• Of course we should all observe personal hygiene. Wash hands thoroughly with soap and water after using the toilet, before handling food or before eating.

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