AtoZ Diseases

The sinuses are air spaces in the bones behind your nose. Sinusitis is an inflammation of the mucous membranes of the sinuses. It is caused by bacterial or viral infection. The frontal sinuses, which are in the forehead just above the eyes, and the maxillary sinuses, which are in the cheek-bones, are the ones that are most likely to be affected.The organisms that cause sinusitis spread to the sinuses from the nose. This occurs easily because the mucous membranes of the main nasal cavity extend into and line the sinuses. Sinusitis usually occurs after a common cold, which is a viral infection, is complicated by the occurrence of a secondary bacterial infection

What are the Symptoms?

After the first few days of a cold, when you would expect it to get better, the blockage in your nose may worsen and the greenish discharge may increase. Later, because the passages between the nose and the sinuses also become blocked, the discharge may stop. Your nose then becomes more stuffed up than ever. You have to breathe through your mouth, your speech becomes nasal, and you feel generally ill. If the frontal sinuses are affected, you may have a headache over one or both eyes. It is most painful when you wake up in the morning, or when you bend your head down and forward. The under surface of your forehead just above the eyes may feel tender.

If the maxillary sinuses are affected, one or both cheeks may hurt. You may feel as if you have a toothache in your upper jaw. Occasionally, sinusitis may follow dental treatment, because infection can spread from the roots of your tooth into one of your sinuses .

Sinusitis is common, but susceptibility varies. Some people never get it, while others get it every time they have a bad cold. Others may get sinusitis by jumping into water feet first without holding their noses. Damage to your nasal bones, or even a foreign body caught in your nostril, may make you more susceptible to infection and, thus, bring on an attack. A deformity of the nose, such as a deviated septum , may increase your susceptibility to sinusitis by obstructing the nasal airways.

What are the Risks?

The risks of sinusitis are minimal if it is treated with antibiotics. Before the availability of antibiotics, the infection sometimes spread through the mucous membrane of the sinuses into the bones and even to the brain. Such serious complications of sinusitis almost never happen today.

What should be done?

Try the self-help measures recommended below. If the symptoms persist after three or four days, consult your physician, who may confirm the diagnosis of sinusitis by examining X-rays of your sinuses. The physician may also gently press the floor of the sinuses from inside your nose and mouth.

What is the Treatment?

Self-help: Stay indoors, in a room with an even temperature. Add moisture to the air with a vaporizer or humidifier. Blow your nose gently with tissues. To relieve the pain, inhale steam from a basin of hot water, or the spout of a kettle, but be careful not to burn yourself; steam is very hot.

Professional help: Your physician may prescribe a broad spectrum antibiotic and also suggest that you use decongestant tablets, nose drops, or a nasal spray. Decongestants shrink the swollen mucous membrane, which widens the airways, but for sinusitis they should be used only as prescribed by a doctor. If they are used incorrectly, decongestants can do more harm than good.

Further treatment should be unnecessary, but if the sinusitis persists, your physician may advise a minor operation under local anesthetic. In this procedure, the physician or surgeon pierces a bone between the nose and the sinuses to open an extra passageway, and washes the sinuses out with sterile water. This procedure relieves the obstruction. Material that is removed from the sinus can be analyzed to identify the cause of the infection and determine the best way to combat it. You may discover that you will need additional minor surgery to improve drainage if the infection becomes chronic, but this complication rarely happens.

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The disease we call the common cold is really a group of minor illnesses that can be caused by anyone of almost 200 different viruses. Usually a common, or head, cold is confined to the nose and throat, but the same viruses can also infect the larynx and the lungs . These viral infections sometimes are followed by more serious bacterial infections of the throat, lungs, or ears.All of us get colds. Most people have their first cold during their first year of life. Most children are extremely susceptible to nasal viral infection between the ages of one and three. Then they gradually become immune to many of the viruses that are common in their environment. The frequency of colds increases again during early school years, because the school environment contains new types of viruses. Most people acquire more immunity as they grow older, and catch fewer and less severe colds.

What are the Symptoms?

To some extent the symptoms depend on. In you If you have recurrent attacks of bronchitis or frequent case, an antibiotic may be useful, since it will give you some protection against the bacteria-caused complications to which you are prone. Thus, in your case, the benefits of the drug will probably outweigh the possible drawbacks. Consult your physician who can explain your individual situation and recommend appropriate treatment.

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What is this Condition?

When bacteria or viruses invade the body, they may attack the thyroid and cause it to become inflamed. Thyroid gland inflammation occurs in several forms: as a long-term autoimmune inflammation, as a self-limiting subacute granulomatous inflammation, or as several miscellaneous disorders (acute suppurative, chronic infective, and chronic noninfective inflammations). A postpartum form strikes women within I year after delivery. Inflammation of the thyroid is more common in women than in men.

What Causes it?

Autoimmune inflammation of the thyroid results from the immune system’s response to thyroid antigens that occur naturally in the blood. Subacute granulomatous inflammation of the thyroid usually follows mumps, influenza, coxsackievirus, or adenovirus infection.

Miscellaneous forms may result from a variety of causes. Acute suppurative thyroiditis may be caused by bacterial invasion of the gland. Chronic injective thyroiditis may be caused by tuberculosis, syphilis, actinomycosis, or other infectious agents. Chronic noninfective thyroiditis may be caused by sarcoidosis or amyloidosis.

What are its Symptoms?

The autoimmune form usually does not produce symptoms. It commonly occurs in women, with peak incidence in middle age. It’s the most prevalent cause of spontaneous hypothyroidism.

In subacute granulomatous inflammation, moderate thyroid enlargement may follow an upper respiratory tract infection or a sore throat. The thyroid may be painful and tender, and the person may have difficulty swallowing.

Clinical effects of miscellaneous inflammation are characteristic of pus-forming infection: fever, pain, tenderness, and reddened skin over the gland.

How is it Diagnosed?

Lab tests are the key to accurate diagnosis. Test results vary according to the type of thyroid inflammation.

How is it Treated?

Appropriate treatment varies with the type of thyroid inflammation. Drug therapy includes Levoxine for accompanying hypothyroidism, pain relievers and anti-inflammatory drugs for mild, subacute granulomatous inflammation, Inderal for transient hyperthyroidism, and steroids for severe episodes of acute inflammation. Suppurative inflammation requires antibiotic therapy.

What can a Person with Inflammation of the Thyroid do?

Watch for and report symptoms of hypothyroidism (sluggishness, restlessness, sensitivity to cold, forgetfulness, dry skin).

Be aware that you’ll need lifelong thyroid hormone therapy if hypothyroidism occurs. If you’re taking this medication, watch for signs of overdose, such as nervousness and palpitations.

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What is this Condition?

In hyperparathyroidism, one or more of the four parathyroid glands (pea-sized organs located behind the thyroid) are overactive, causing excessive secretion of parathyroid hormone. This results in bone loss and leads to excessive calcium and a shortage of phosphates in the blood. Consequently, the kidneys and gastrointestinal system absorb more calcium.

What Causes it?

Hyperparathyroidism may be classified as primary or secondary. In primary hyperparathyroidism, one or more of the parathyroid glands become enlarged. The most common cause is an adenoma, a type of benign tumor. Other causes include genetic disorders or multiple endocrine neoplasia (a rare disorder that causes the endocrine glands to become overactive). Primary hyperparathyroidism usually occurs between ages 30 and 50 but can also occur in children and the elderly. It affects women two to three times more often than men.

Secondary hyperparathyroidism is marked by excessive production of parathyroid hormone. This type of hyperparathyroidism results from a condition outside the parathyroid glands that decreases the level of calcium in the body. Such conditions include rickets, vitamin D deficiency, chronic kidney failure, or osteomalacia (softening of the bones).

What are its Symptoms?

Symptoms of primary hyperparathyroidism may include:

• kidney: excessive urination (one of the most common effects)

• bones and joints: chronic lower back pain and easy fracturing due to bone degeneration; bone tenderness; pain associated with calcium buildup in joints, erosion of joint surfaces, and cartilage fractures

• digestive tract: severe epigastric pain radiating to the back caused by pancreatitis; abdominal pain, appetite loss, and nausea caused by peptic ulcers

• muscles: marked muscle weakness and wasting, particularly in the legs

• nervous system: psychomotor and personality disturbances, depression, overt psychosis, stupor and, possibly, coma

• other: skin destruction, cataracts, anemia, and calcification under the skin.

In secondary hyperparathyroidism, decreased levels of calcium in the blood may produce the same features of calcium imbalance, with skeletal deformities of the long bones (rickets, for example), as well as symptoms of the underlying disease.

How is it Diagnosed?

A diagnosis of primary disease is confirmed by lab tests revealing high levels of parathyroid hormone and calcium in the blood. X-rays typically show diffuse demineralization of bones, bone cysts, outer cortical bone absorption, and subperiosteal erosion of the phalanges and distal clavicles. Microscopic examination of the bone typically shows increased bone turnover. Lab tests show elevated urine and blood calcium, chloride, and alkaline phosphatase levels and decreased blood phosphorus levels.

In secondary disease, lab findings show normal or slightly decreased serum calcium levels and variable serum phosphorus levels, especially when hyperparathyroidism is due to rickets, osteomalacia, or kidney disease. The person’s history may reveal a family history of kidney disease, seizure disorders, or drug ingestion. Other lab studies and physical exam findings identify the cause of secondary hyperparathyroidism.

How is it Treated?

Treatment varies, depending on the cause of the disease. Treatment for primary hyperparathyroidism may include surgery to remove the adenoma or, depending on the extent of hyperplasia, all but half of one parathyroid gland (necessary to maintain normal parathyroid hormone levels). Such surgery may relieve bone pain within 3 days. However, kidney damage may be irreversible.

If surgery isn’t feasible or necessary, the following treatments can decrease calcium levels:

• forcing fluids

• limiting dietary intake of calcium

• promoting sodium and calcium excretion through forced diuresis using normal saline solution, Lasix, or Edecrin

• administering sodium, potassium phosphate, calcitonin, Mithracin, or biphosphonates.

Treatment of secondary hyperparathyroidism must correct the underlying cause. It consists of vitamin D therapy or, in the person with kidney disease, administration of an oral calcium preparation for hyperphosphatemia. In the person with kidney failure, dialysis is necessary to lower calcium levels and may have to continue for life. In the person with chronic secondary hyperparathyroidism, the enlarged glands may not revert to normal size and function even after calcium levels have been controlled.

What can a Person with Hyperparathyroidism do?

Be sure to receive periodic medical follow-up through lab tests. If your condition wasn’t corrected surgically, make sure you avoid calcium-containing antacids and thiazide diuretics (such as Diuril).

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What is this Condition?

Premature rupture of the membranes (”breaking water”) is a spontaneous break or tear in the amniochorial sac before onset of regular contractions, resulting in progressive cervical dilation. This condition occurs in nearly 10% of all pregnancies over 20 weeks’ gestation . Labor usually starts within 24 hours after the membranes rupture, and more than 80% of these infants are mature.

The latent period (between membrane rupture and onset of labor) is generally brief when the membranes rupture near term; when the infant is premature, this period is prolonged, which increases the risk of death from maternal infection and fetal infection.

What Causes it?

Although the cause of this condition is unknown, malpresentation and a contracted pelvis commonly accompany the rupture. Predisposing factors may include:

• poor nutrition and hygiene and lack of proper prenatal care

• incompetent cervix (perhaps as a result of abortions)

• increased intrauterine tension due to excessive amniotic fluid or multiple pregnancies

• defects in the amniochorial membranes’ tensile strength

• uterine infection.

What are its Symptoms?

Typically, premature rupture of the membranes causes blood-tinged amniotic fluid to leak or gush from the vagina. Maternal fever, fetal rapid heart rate, and a foul-smelling vaginal discharge indicate infection.

How is it Diagnosed?

Characteristic passage of amniotic fluid confirms this condition. A physical exam shows amniotic fluid in the vagina. Examination of this fluid helps determine appropriate management. The physical exam also determines the presence of multiple pregnancies, and helps determine fetal presentation and size.

How is it Treated?

Treatment of this condition depends on fetal age and the risk of infection. In a term pregnancy, if spontaneous labor and vaginal delivery don’t occur within a relatively short time (usually within 24 hours after the membranes rupture), the doctor usually tries to induce labor; if induction fails, cesarean delivery is usually necessary. Cesarean. hysterectomy is recommended for women with a severe uterine infection.

Management of a preterm pregnancy of less than 34 weeks is controversial. However, with advances in technology, a conservative approach has now proved effective. In a preterm pregnancy of 28 to 34 weeks, treatment includes hospitalization and observation of the mother and fetus for signs of infection while awaiting fetal maturation. If tests confirm infection, labor must be induced, followed be, intravenous administration of antibiotics. The newborn may also require antibiotics.

What can a Woman with Premature Rupture of the Membranes do?

If you think your membranes have ruptured, call your doctor right away. Don’t use a douche or have sexual intercourse.

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What is this Condition?

Unlike the nausea and vomiting a woman may normally have between the 6th and 12th weeks of pregnancy, this condition involves severe, constant nausea and vomiting that persist after the first trimester. If untreated, it produces substantial weight loss, starvation, dehydration, and other problems.

This condition occurs in about 1 in 200 pregnancies. The prognosis is good with appropriate treatment.

What Causes it?

Although its cause is unknown, abnormal vomiting during pregnancy often affects women with conditions that produce high levels of a hormone called human chorionic gonadotropin. These conditions include cysts in the uterus or multiple pregnancy. Other possible causes include pancreatitis, bile duct disease, drug toxicity, inflammatory bowel disease, and vitamin deficiencies (especially of vitamin B G )·

What are its Symptoms?

The cardinal symptoms of this disorder are constant nausea and vomiting. The vomit initially contains undigested food, mucus, and small amounts of bile; later, only bile and mucus; and finally, blood and material that resembles coffee grounds. Persistent vomiting causes substantial weight loss and eventual emaciation.

How is it Diagnosed?

Diagnosis depends on a history of uncontrolled nausea and vomiting that persists beyond the first trimester, evidence of substantial weight loss, and other characteristic symptoms. Lab tests may also provide important evidence. Diagnosis must rule out other conditions with similar clinical effects.

How is it Treated?

The woman with this condition may require hospitalization to correct electrolyte imbalances and prevent starvation. Intravenous feedings maintain nutrition until her condition improves. She progresses slowly to a clear liquid diet, then a full liquid diet and, finally, small, frequent meals of high-protein solid foods. Snacks help stabilize blood sugar levels, and vitamin B supplements help correct vitamin deficiency.

When vomiting stops and electrolyte balance has been restored, the pregnancy usually continues uneventfully, and most women feel better as they begin to regain normal weight. However, some continue to vomit throughout the pregnancy, requiring further treatment. If appropriate, some women may benefit from consultations with a clinical nurse specialist, a psychologist, or a psychiatrist.

What can a Pregnant Woman with Abnormal Vomiting do?

Eat dry foods if you have a poor appetite, and decrease your liquid intake during meals. To boost your appetite, try to have company and conversation at mealtimes. Stay upright for 45 minutes after eating to decrease the risk of vomiting.

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