Healthpedia

Imperforate Anus Impetigo Influenza

Impotence Insanity Insomnia

 

Imperforate Anus

 

Definition:

Imperforate anus is a birth defect, where the baby is born with no anal opening. The congenital abnormality can appear in many different forms, with different implications on prognosis. Treatment options would vary accordingly.

 

Who is at risk?

Imperforate anus is one of the more common varieties of congenital malformation of the anus and rectum. The latter can occur in one out of every 5,000 newborns. Approximately 50% of babies with these malformations have other coexisting abnormalities in the spinal vertebrae, limbs, kidneys, heart, trachea and esophagus.

 

Symptoms:

The condition is often picked up by the first routine physical examination by nurses or doctors. The anus is either absent or misplaced. If not noticed, the patient would suffer from vomiting, abdominal distension and constipation. The bowel would not open even 1 to 2 days after birth due to obstruction. In some cases, there may be a connection between the gastrointestinal tract and the urinary tract or the genital tract, and stool would be passed by way of vagina, base of penis or scrotum, or urethra.

 

Treatment:

Imperforate anus usually requires immediate surgery to open a passage for feces. The infant should also undergo evaluation for other abnormalities, especially the spine and the genital as well as the urinary tract.

Treatment recommendations will depend on the anatomy of the malformation, the presence and type of associated abnormalities, or the child's overall health. In simple cases, a one-stage operation may be adequate. Some patients would need a "colostomy", which is a surgery that creates an opening in the abdomen that allows the passage of intestinal wastes. This may be done temporarily in complicated cases while awaiting definitive reconstructive surgery later.

 

Prevention:

There is no way to prevent this birth defect. Doctors are still working on ways to diagnose the condition before birth with techniques such as antenatal ultrasound.

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Impotence

 

Definition:

Impotence is an erectile dysfunction referring to a man's consistent inability to get or maintain an erection sufficient to have sexual intercourse. It does not mean a lack of sexual interest or desire. Most adult men have probably experienced a short period of temporary impotence at some occasions in their life. It affects at least 1 in 20 males at age 45 and 1 in 3 males at age 65.

 

Who is at risk?

• People with physical diseases and disorders. e.g. atherosclerosis and diabetes. The accumulation of deposits (plaques) in your arteries (atherosclerosis) also can prevent adequate blood from entering the penis;
• People with low level of testosterone;
• People who had past surgery or trauma to the pelvic area. e.g. After prostatic surgery (permanent) and prolonged bicycle riding (temporary);
• People taking medications. e.g. antidepressants, antihistamines and medications to treat high blood pressure, pain and prostate cancer. Tranquilizers and sleeping aids may also pose a problem;
• People with substance abuse. e.g. Chronic use of alcohol, marijuana or other drugs. Excessive tobacco use also can damage penile arteries;
• People with stress, anxiety or depression.

 

Symptoms:

1. Complete inability to achieve an erection
2. Inability to maintain an erection throughout intercourse
3. Occasional inability to obtain a full erection

 

Treatment:

1. Lifestyle: Reduce stress and alcohol, quit smoking.
2. Foreplay and the right environment: Increase ability to have an erection.
3. Counselling for psychological causes.
4. Hormone treatment: For those who are lacking male hormone (rare).
5. "Viagra" type drugs: e.g. Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). Precaution must be taken for people with heart diseases. Viagra is generally not recommended for men who already have retinal diseases. The most common vision side effect related to Viagra involves seeing a bluish tinge that may be accompanied by light sensitivity.
6. Prostaglandin E (alprostadil): The hormone helps relax smooth muscle tissue in the penis: needle injection directly into the spongy part of penis or self-administered intraurethrally via a disposable applicator.
7. Vacuum devices: Use of an external vacuum and one or more rubber bands (tension rings). The erection typically lasts long enough for a couple to have adequate sexual relations. You remove the tension ring after intercourse.
8. Vascular surgery: It is reserved for men whose blood flow to the penis has been blocked by injury. Surgery may also be used to correct erectile dysfunction caused by vascular blockages.
9. Penile implants: This treatment involves surgically placing a device into the two sides of the penis, allowing erection to occur as often and for as long as desired. These implants consist of either an inflatable device or semi-rigid rods made from silicone or polyurethane. This treatment is often expensive and is usually not recommended until other methods have been considered or tried first.

 

Prevention:

• Careful treatment of medical problems and avoidance of "social drugs".
• Discuss the effects of medication with doctors (e.g. diurectic).
• Cut down both alcohol and cigarettes.
• Promote sexual feelings by having good communications and a good atmosphere for lovemaking.

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Influenza

 

Definition:

Influenza is a common contagious respiratory infection caused by the influenza virus. After exposure, it takes 1-2 days to develop symptoms of the flu. There are three main types of the influenza virus: A, B, and C, and they frequently mutate (change) into different "strains". Different strains produce outbreaks almost every year, most frequently in winter.

 

Who is at risk?

1. People who are 65 years old or older;
2. Children 6 to 23 months old;
3. Adults and children with a chronic condition such as heart disease, diabetes, kidney disease, asthma, cancer or HIV;
4. Women who will be pregnant during flu season;
5. Residents of nursing homes and long-term care facilities;
6. Children aged 6 months to 18 years on chronic aspirin therapy;
7. Healthcare workers involved in direct patient care;
8. Out-of-home caregivers and household contacts of children younger than 6 months.

 

Symptoms:

The flu usually starts suddenly and may include these symptoms:

• Fever (usually high)
• Headache
• Tiredness (can be extreme)
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Diarrhea and vomiting also can occur but are more common in children
• Body aches including muscle ache, backache, and headache

 

Treatment:

In most healthy people, flu will go away in 7 to 10 days. Resting and symptomatic treatment with paracetamol and decongestants might be all that is required.

Antiviral medications such as Relenza and Tamiflu can be taken to:

• Reduce the severity and duration of symptoms caused by influenza virus.
• Shorten the length of the illness.
• Control outbreaks of the flu in nursing homes.
• Reduce the spread of the virus to high-risk groups to reduce complications.

 

Prevention:

Always

• Avoid contact with persons with upper respiratory infections (e.g., colds, sore throat, bronchitis).
• Wash the hands often with soap and water: Especially after they cough or sneeze. If water is not near, use an alcohol-based hand cleaner.
• Remind them not to touch their eyes, nose, or mouth. Germs often spread this way.
• Cover the nose and mouth with a tissue when coughing or sneezing: Should throw the tissue away after using it and wear a mask to prevent the cough droplets spreading to other people.
• Flu shot yearly and especially if you are over 65 years old or have chronic heart or lung disease.

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Insanity

 

Definition:

There is no medical definition for "insanity" as the term is seldom used by medical professionals.

A patient may be committing a crime because he is mentally confused, and hence "not guilty by reason of insanity". A doctor may be summoned to give evidence on the patient's medical history, or experts called to provide knowledge on specific diseases. But the definition of "insanity" here is a legal one, and may vary among jurisdictions. In civil proceedings, medical opinions are sometime required to decide if a person's mental condition is competent enough to sign a contract or a will, or to testify in court.

People behaving strangely in a social setting may be suffering from a psychiatric disease, but not always. If the behaviour is threatening to the community and the suspicion for a psychiatric disorder is strong, the patient may be compulsorily admitted to psychiatric hospitals. Usually an application must be made by a relative or local authority, based on the written recommendation by at least two doctors.

 

Who is at risk?

Severe psychiatric disorders are only one of the causes for strange behaviors. Other possible causes are mental deficiency and personality disorders. Unusual behavior can be an early sign of dementia, or degeneration of brain. Other organic diseases affecting the brain such as brain tumors or infection may also present in this way. Patients with severe liver diseases cannot get rid of nitrogen from their body, and these may be affect their brain cells and cause strange behaviors. People under the influence of drugs or alcohol, or their withdrawal, are also at risk of performing unsocial or anti-social behaviors.

 

Symptoms:

Patients with psychiatric diseases often present with strange behaviors. Actions that are violent and threatening to others are more often called into attention. Those close to the patient may notice strange behaviors and disturbed thoughts much earlier on, such as unexplained mannerism, hearing voices, sudden change in religious outlook, or a sense of persecution. Sleep problem is common. There is often a sudden deterioration in performance in job or at school.

 

Treatment:

Most psychiatric diseases can be treated with drugs and psychotherapy. The difficulty often lies in persuading patients to receive treatment, and rehabilitating them to their families and jobs.

 

Prevention:

Patients severely affected by psychiatric diseases seldom seek treatment voluntarily, and even offered, would not comply. Therefore we should all pay close attention to early symptoms of psychiatric diseases in our family members and friends so that professional help can be offered early.

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Insomnia

 

Definition:

Insomnia can mean having difficulty in falling asleep, maintaining in sleep, sustaining a quality sleep, or a combination of the above. A person is suffering from insomnia if he or she wakes up feeling unrefreshed with impairment in his or her daytime activities despite adequate time and opportunity for sleep. It is not defined by a specific number of hours of sleep that one gets.

 

Who is at risk?

• Travelers
• Women, especially around menopausal age
• Elderly
• Shift workers
• Patients with psychiatric disease or mental health problems

 

Symptoms:

• Difficulty falling asleep at night
• Awakening during the night
• Awakening too early
• Not feeling well rested after a night's sleep
• Daytime fatigue or sleepiness
• Irritability, depression or anxiety
• Difficulty paying attention or focusing on tasks
• Increased errors or accidents
• Headaches and gastrointestinal symptoms
• Ongoing worries about sleep

 

Treatment:

Insomnia is a symptom, not a diagnosis. Almost everyone has experienced transient insomnia, but chronic insomnia lasting more than 3 weeks should be evaluated by a doctor, since this may be symptomatic of an underlying medical or psychiatric condition. Although there are different kinds drugs to help relieve insomnia, sleep problems are better dealt with by behavioral modification since any drug can be habit forming.

 

Prevention:

• Make your bedroom quiet and comfortable. Hide the clock.
• Stick to a good daily schedule, keep your bedtime and wake time consistent day to day
• Create a bedtime ritual, such as reading, praying, relaxation exercise etc. Many find a warm bath before bedtime helps.
• Avoid forcing yourself to sleep. If you cannot fall asleep after 20 minutes or so, get out of bed and do something relaxing, such as reading, listening to music.
• Avoid or limit coffee, tea, tobacco or any stimulant drugs. Do not take alcohol. If you are on any medications, discuss your sleep problem with your doctor.

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Impetigo

 

Definition:

Impetigo is a contagious skin disease caused by bacterial infection, most often by Staphylococcus aureus or sometimes Streptococcus pyogenes. These bacteria normally live on the surface of the skin, but can find their way into the skin through scratching, minor abrasions or insect bites.

 

Who is at risk?

• Infants and children
• Patient with atopic eczema
• Children living in crowded and unhygienic environment
• Direct contact with a patient with impetigo, or contaminated clothing or towels
• Hot humid weather
• Patients with weak immune system, such as diabetics or elderly

 

Symptoms:

Impetigo commonly affects the face and limbs in children, which can spread rapidly over other parts of the body. The lesion starts off as a small red patch that grows into blisters that rupture and ooze a yellowish fluid, which dry into a sticky crust that covers the sores. The disease is highly contagious. Scratching or touching the sores is likely to spread the infection to other parts of the body and to other people.

 

Treatment:

Since the disease is caused by bacterial infection, the condition usually responds to antibiotic treatment, applied as creams or ointments on the lesions. For patients severely affected or those with underlying diseases, antibiotics may need to be given orally or sometimes as injections. Treatment can be more complicated if the disease is caused by a drug resistant bacterium called MRSA or Methicillin Resistant Staphylococcus Aureus which is increasingly reported from the community.

 

Prevention:

• Infected children should not go to school until adequately treated. Wash their clothes and towels daily and do not share them with others. Affected patient should avoid scratching or touching the skin lesions. Cut the affected child's nail short and wash their hands often
• Keep the skin clean, especially in children and the elderly. Take bath daily with soap and water
• Take good care of minor wounds or insect bites first by thorough cleansing followed by application of antiseptic creams

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