Bulutong Tubig , Chicken Pox or Varicella Zoster

A 30 year old female consulted for low grade fever 2 days prior to consultation with associated muscle pain, sore throat and lack of appetite. A day before she developed pruritic rashes, starting from the face and scalp down to the chest and abdomen.
On examination patient had fever ,38.2 Centigrade, with red papular rashes,"tear drop",vesicles on face, trunk and in the upper extremities.Patient also had generalized lympadenopathies " kulani" and admitted that a household member exhibited similar symptoms about two weeks ago.She was diagnosed with Chicken pox or Varicella Zoster, or Bulutong Tubig
Patient was given Diphenhydramine 50mg cap, an Anti-histamine 3x day to relieve itchiness. Ascorbic acid 500mg , for faster wound healing,was also given as well as Paracetamol 500mg Tab every 4 hours for fever, in some cases Ibuprofen 400mg or Mefenamic acid 500mg may be given for pain relief. In cases where the rashes develop within 24 hours prior to consultation, anti virals, like Acyclovir 800 mg tab 5x a day for 7 days,maybe given to shorten the time of viral shedding,lessens appearance of new lesions,reduce duration of fever and for faster healing. Acyclovir cream may also be applied to lesions 5x a day , especially in the facial area, to lessen discomfort and scarring. Oral rehydrating salts (Hydrite, Glucolyte etc.) may also be given to prevent dehydration.
Varicella, commonly known as "bulutong" or chickenpox, is caused by the varicella-zoster virus. The disease is generally regarded as a mild, self-limiting viral illness with occasional complications. Usual complications are acute respitatory infections, infected skin lesions while the most serious complications are varicella pneumonia and encephalitis which are associated with a high mortality rate.
Varicella spreads primarily by airborne droplets. The infectious particles are cell-free virus particles derived from skin lesions or the respiratory tract. The disease is infectious a day before the rash appears. The incubation period is typically 10-14 days, although it may extend to 21 days.
The best option to prevent Varicella or Chikenpox is thru vaccination which is available but a bit expensive(Varilrix, Okavax, V-Z Vax).The first dose should be given when the child is 12 - 15 months old.Children should receive the second dose when they are 4 – 6 years old. However, the second dose can be given before age 4, as long as as 3 months have passed since the first dose.
People 13 and older who have not received the vaccine and have not had chickenpox should get 2 doses 4 to 8 weeks apart while people 13 and older who have had a previous dose and have not had chickenpox should receive a second dose.

Reminder: Article was written as a physician's personal experience and should be viewed for information and guide only, and was not intended to replace actual consultation with a medical practitioner.

Bird Flu or Avian Influenza

Bird flu or Avian Influenza is a contagious disease of birds ranging from mild to severe form of illness.

The outbreaks affecting some Asian countries caused by influenza A/H5N1 virus may also cause severe infection in humans.

Bird Flu is transmitted to humans through inhalation or contamination with infected discharges or feces of sick chicken.

Signs and Symptoms
Fever
Body weakness or muscle pain
Cough
Sore throat
Sore eyes and/or diarrhea
In severe cases, difficulty of breathing in a week’s time from onset


Treatment
Treatment of Bird Flu in humans is the same as the treatment for other influenza viruses. Antiviral drugs like Oseltamivir halt the progress of the illness if given within the first two days from the onset of fever.

Prevention
Wash hands thoroughly with soap and water before and after handling live and dressed chicken.
Cook chicken thoroughly.
Do not put live chicken, ducks, and pigs together in one cage or pen area.
Do not catch, get near or keep in captivity wild birds.
Do not handle sick or dead birds with bare hands. Use facial masks, goggles, and gloves or plastic material for the hands.
Report to the nearest agricultural or veterinary office any unusual death or illness of chicken and other birds.
Report to the nearest local health centers any case of respiratory illness with history of exposure to sick chickens and other birds.

CM, GMANews.TV

Source: Department of Health

Canker Sores or "Singaw" (Aphthous Stomatitis)

 Canker sores, "Singaw"or Aphthous stomatitis is a benign autoimmune condition that is usually due to nutritional deficiencies arising from lack of Iron, Vitamin B12 or Folic Acid.
Aphthous stomatitis are among the most common oral mucosal lesions physicians and dentists observe. Recurrent aphthous ulcer is a disorder of unknown etiology that can cause clinically significant morbidity. One or several discrete, shallow, painful ulcers are visible on the unattached mucous membranes. Individual ulcers typically last 7-10 days. Larger ulcers may last several weeks to months and can scar when healing.

Management usually begins with good oral hygiene and by avoiding toothpaste containing Sodium Lauryl SO4.Chlorhexidine Gluconate[Orahex] mouhwash preferably alcohol free can also help lessen the severity and course of the discomfort.
Multivitamins with iron are recommended but do not have any clear benefit unless the patient has laboratory-confirmed hematinic deficiency.Vitamin B12 and Folic Acid may also be prescribed if patient shows signs of deficiency or malnutrition.

The easiest home remedy is to apply hydrogen peroxide with a cotton swab on the canker sore (1 part hydrogen peroxide to 1 part water). Then dab a small amount of milk of magnesia on the canker sore 3-4 times a day. This is not only soothing, but it appears to help healing

What is Runner's Knee (Patellofemoral Pain Syndrome)?

Runners Knee is a condition characterized by pain behind or around the kneecap. Poor kneecap tracking is believed to be the main cause this condition. The kneecap (patella) slides over a groove on the thighbone (femur) as your knee bends and straightens. If, for example, the front thigh muscles (quadriceps) are weak or imbalanced, the resulting muscle imbalance can pull the kneecap to the left or right of the groove, causing pressure, friction, and irritation to the cartilage on the undersurface of the kneecap when the knee is in motion.
Runner's knee isn't really a condition itself. It's a loose term for several specific disorders with different causes. Runner's knee can result from:

Overuse. Repeated bending of the knee can irritate the nerves of the kneecap. Overstretched tendons (tendons are the tissues that connect muscles to bones) may also cause the pain of runner's knee.
Direct trauma to the knee, like a fall or blow.

Management: Medical
A.Relative rest
-Avoid squats and lunges
-Reduce Running mileage to painless distance
-Cross-train with biking, swimming, eliptical trainer
B.Pain relief
-NSAIDs (variable efficacy)eg. Mefenamic Acid, Ibuprofen, Naproxen etc.
-Ice Therapy
C. Patellofemoral Knee Exercises
D. Quadriceps strengthening
E.Lower extremity Stretching Exercises
1.Quadriceps Stretching
2.Quadriceps strengthening
a.Do not load knee at more than 45 degrees flexion
3.Hamstring stretches
4.Iliotibial Band stretches
5.Ankle stretches
F.Shoe modifications
-Replace excessively worn Running Shoes
G.Avoid provocative factors
1.Limit weight on a flexed knee
2.Consider cross-training activity
3.Reduce mileage and pace
4.Avoid uphill and downhill Running
H.Patellar Taping (inconsistent evidence of benefit)

Please watch the video from Shine at Yahoo.com by Susan Rinkunas that would help prevent runners knee

http://www.youtube.com/watch?v=zYt4AC9cn7c&feature=player_embedded
Susan Rinkunas is an associate editor at Runner’s World, a magazine (and website) that informs, advises, and motivates runners of all ages and abilities—and we mean it. Her blog on Yahoo! Shine offers tips on running technique, nutrition and weight loss, shoes and apparel, and balancing fitness and life.

Hand ,Foot and Mouth Disease

Hand-foot-and-mouth disease (HFMD) is a viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. Most commonly, the etiologic agents are coxsackieviruses, members of the Picornaviridae family.
HFMD is a common viral illness of infants and children. The disease causes fever and blister-like eruptions in the mouth and/or a skin rash. HFMD is often confused with foot-and-mouth (also called hoof-and-mouth) disease, a disease of cattle, sheep, and swine; however, the two diseases are not related—they are caused by different viruses. Humans do not get the animal disease, and animals do not get the human disease.
Hand-foot-and-mouth disease (HFMD) is more severe in infants and children than adults, but generally, the disease has a mild course. Symptoms such as malaise, low-grade fever, and anorexia are often present. Occasionally, patients have high fever, marked malaise, diarrhea, and arthralgias.

Infection is spread from person to person by direct contact with infectious virus. Infectious virus is found in the nose and throat secretions, saliva, blister fluid, and stool of infected persons. The virus is most often spread by persons with unwashed, virus-contaminated hands and by contact with virus-contaminated surfaces. The viruses that cause HFMD can remain in the body for weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though he/she appears well. Also, some persons who are infected and excreting the virus, including most adults, may have no symptoms.

Usually, no medical care is necessary for hand-foot-and-mouth disease (HFMD).The topical application of anesthetics is beneficial. Viscous lidocaine, dyclonine solution, or diphenhydramine (Benadryl) may be used to treat painful oral ulcers. Antipyretics may be used to manage fever, and analgesics may be used to treat arthralgias.

What is the normal platelet count?

In an adult, a normal count is about 150,000 to 450,000 platelets per microliter (x 10 6 /Liter) of blood.

If platelet levels fall below 20,000 per microliter, spontaneous bleeding may occur and is considered a life-threatening risk .Patients suffering from dengue hemorrhagic fever,have a high possibility of spontaneous bleeding and must be manage promptly and accordingly. It is the usual practice to monitor the platelet count every 24 hours if a patient is being suspected to have the dengue virus once the platelet falls lower than 200,000 /mcl, and a reading below 150,000 is usually advised admission to a hospital for further evaluation and management.
In patients who have a bone marrow disease, such as leukemia or another cancer in the bone marrow, often experience excessive bleeding due to a significantly decreased number of platelets (thrombocytopenia). As the number of cancer cells increases in the bone marrow, normal bone marrow cells are crowded out, resulting in fewer platelet-producing cells.

Low number of platelets may be seen in some patients with long-term bleeding problems (e.g., chronic bleeding stomach ulcers), thus reducing the supply of platelets. Decreased platelet counts may also be seen in patients with Gram-negative sepsis

Dengue Hemorrhagic Fever

What is Dengue Hemorrhagic Fever?

Dengue hemorrhagic fever is a more severe form of the viral illness. Manifestations include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

What are the signs and symptoms of Dengue Fever?

A.Abrupt symptom onset 3-15 days after Mosquito Bite
B.Undulant Fever
1.Fever falls on Day 3
2.Fever rises again later
C.Chills
D.Sever frontal Headache
E.Arthralgias
F.Bone pain
G.Rash
1.Red Morbilliform or punctate rash
2.Rash starts on hands and feet
3.Rash spreads to trunk

What is New in Treatment of Dengue?

Given that dengue is an infection, treatment can be performed using the simple concept of 'getting rid of the pathogen and limiting the complications'. In general, the use of supportive and symptomatic treatment is widely used for dengue treatment, aiming to limit the complications of the infection. The application of fluid therapy has become key in dengue management and this is applied based on the severity of disease. In simple dengue, oral fluid replacement is sufficient and there is no need for hospitalization. In severe cases of dengue infection, fluid replacement should be carefully used and must be performed under close observation in a hospital. Parenteral, intravenous fluid replacement by either colloids or crystalloids should be considered in order to prevent shock.[51] The basic recommendation for intravenous fluid-replacement therapy is administration of 0.9% normal saline solution at a rate of 20 ml/kg/h in the first 2 h, followed by 10 ml/kg/h for 6 h, then the rate can be adjusted according to the status of the patient in the following 16 h.

image from A.D.A.M., DOH Website