Tag Archives: Mental disorder

Jet Lag

Definition:     Jet lag is nothing but circadian rhythm disorder of our body system.It is also known as time zone change syndrome or desynchronosis.It can occur when people travel rapidly from east to west, or west to east on a jet plane. Jet lag symptoms tend to be more severe when the person travels from westward compared to eastward. It is a physiological condition which upsets our body’s circadian rhythms –

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Circadian rhythm is the 24-hour cycle in the biochemical, physiological and behavioral process of our bodies. In layman’s terms, it means biological clock of our body. The word circadian comes from the Latin word circa meaning “about”, and the Latin word diem or dies meaning “day”. Our circadian rhythms are driven by an internal time-keeping system. This biological clock is entrained by external environmental occurrences, such as the light-dark cycle of night and day. Put simply, our circadian rhythm regulates our daily activities, such as sleep, waking, eating and body temperature regulation. Problems readjusting our internal biological clock causes jet lag, as do problems with shift work, and some sleeping disorders.

People with jet lag have their sleep-wake patterns disturbed. They may feel drowsy, tired, irritable, lethargic and slightly disoriented. The more time zones that are crossed rapidly, the more severe jet lag symptoms are likely to occur.

Researchers from the University of Washington revealed that the disruption occurs in two separate but linked groups of neurons in a structure called the suprachiasmatic nucleus, below the hypothalamus at the base of the brain. One group is synchronized with deep sleep that results from physical fatigue and the other controls the dream state of rapid eye movement, or REM, sleep

The condition of jet lag may last several days until one is fully adjusted to the new time zone, and a recovery rate of one day per time zone crossed is a suggested guideline. The issue of jet lag is especially pronounced for airline pilots, crew, and frequent travelers. Airlines have regulations aimed at combating pilot fatigue caused by jet lag.

The common term jet lag is used, because before the arrival of passenger jet aircraft, it was generally uncommon to travel far and fast enough to cause jet lag. Trips in propeller-driven aircraft and trains were slower and of more limited distance than jet flights, and thus did not contribute as widely to the problem.

Symptoms:
Symptoms of jet lag vary and depend on several factors, including how many time zones were travelled, the individual’s age, state of health, whether or not alcohol was consumed during the flight, how much was eaten during the flight, and how much sleep there was during the flight. Jet lag usually requires a change of three time zones or more to occur, though some individuals can be affected by as little as a single time zone or the single-hour shift of daylight saving time. Symptoms and consequences of jet lag can be a significant area of concern for athletes traveling east or west to competitions as performance is often dependent on a combination of physical and mental characteristics that are impacted by jet lag.

Light is the strongest stimulus for re-aligning a person’s sleep-wake schedule and careful control of exposure to and avoidance of bright lights can speed adjustment to a new time zone.
Traveling east causes more problems than traveling west, because the body clock has to be advanced, which is harder than delaying it, and the necessary exposure to light to realign the body clock does not tie in with the day/night cycle at the destination.Traveling east by six to nine time zones causes the biggest problems, as it is desirable to avoid light in the mornings.

General symptoms of jet lag are as follows:
*Headaches
*Head feels heavy
*Lethargy, fatigue
*Insomnia
*Irritability
*Mild depression
*Attention deficit – hard to concentrate on one thing for long
*Loss of appetite
*Slight confusion
*Dizzy unsettled feeling – this may be due to moving from the plane, which wobbles all the time, to firm land.
*Some gastrointestinal disturbances, such as diarrhea or constipation.

*Travel fatigue:
Travel fatigue is general fatigue, disorientation and headache caused by a disruption in routine, time spent in a cramped space with little chance to move around, a low-oxygen environment, and dehydration caused by limited food and dry air. It does not necessarily have the shift in circadian rhythms that cause jet lag. Travel fatigue can occur without crossing time zones, and it often disappears after a single day accompanied by a night of high-quality sleep
Causes:
Jet lag is a chronobiological problem, similar to issues often induced by shift work and the circadian rhythm sleep disorders. When travelling across a number of time zones, the body clock (circadian rhythm) will be out of synchronization with the destination time, as it experiences daylight and darkness contrary to the rhythms to which it has grown accustomed. The body’s natural pattern is upset, as the rhythms that dictate times for eating, sleeping, hormone regulation and body temperature variations no longer correspond to the environment nor to each other in some cases. To the degree that the body cannot immediately realign these rhythms, it is jet lagged.

The speed at which the body adjusts to the new schedule depends on the individual; some people may require several days to adjust to a new time zone, while others experience little disruption. Crossing one or two time zones does not typically cause jet lag.

The condition is not linked to the length of flight, but to the trans-meridian (west–east) distance traveled. A ten-hour flight from Europe to southern Africa does not cause jet lag, as travel is primarily north–south. A five-hour flight from the east to the west coast of the United States may well result in jet lag.

Crossing the International Date Line does not contribute to jet lag, as the guide for calculating jet lag is the number of time zones crossed, and the maximum possible disruption is plus or minus 12 hours. If the time difference between two locations is greater than 12 hours, subtract that number from 24. Note, for example, that the time zone GMT+14 will be at the same time of day as GMT-10, though the former is one day ahead of the latter.

Management & prevention:

Tip 1: Stay in shape

If you are in good physical condition, stay that way. In other words, long before you embark, continue to exercise, eat right, and get plenty of rest. Your physical stamina and conditioning will enable you to cope better after you land. If you are not physically fit, or have a poor diet, begin shaping up and eating right several weeks before your trip.

Tip 2: Get medical advice

If you have a medical condition that requires monitoring (such as diabetes or heart disease), consult your physician well in advance of your departure to plan a coping strategy that includes medication schedules and doctor’s appointments, if necessary, in the destination time zone.

Tip 3: Change your schedule

If your stay in the destination time zone will last more than a few days, begin adjusting your body to the new time zone before you leave. For example, if you are traveling from the U.S. to Europe for a one-month vacation, set your daily routine back an hour or more three to four weeks before departure. Then, set it back another hour the following week and the week after that. Easing into the new schedule gradually in familiar surroundings will save your body the shock of adjusting all at once.

If you are traveling east, try going to sleep earlier and getting up and out into the early morning sun. If traveling west, try to get at least an hour’s worth of sunlight as soon as possible after reaching your destination.

Tip 4: Avoid alcohol

Do not drink alcoholic beverages the day before your flight, during your flight, or the day after your flight. These beverages can cause dehydration, disrupt sleeping schedules, and trigger nausea and general discomfort.

Tip 5: Avoid caffeine

Likewise, do not drink caffeinated beverages before, during, or just after the flight. Caffeine can also cause dehydration and disrupt sleeping schedules. What’s more, caffeine can jangle your nerves and intensify any travel anxiety you may already be feeling.

Tip 6: Drink water

Drink plenty of water, especially during the flight, to counteract the effects of the dry atmosphere inside the plane. Take your own water aboard the airplane if allowed.

Tip 7: Move around on the plane

While seated during your flight, exercise your legs from time to time.Move them up and down and back and forth. Bend your knees. Stand upand sit down. Every hour or two, get up and walk around. Do not take sleeping pills, and do not nap for more than an hour at a time.

These measures have a twofold purpose. First, they reduce your risk of developing a blood clot in the legs. Research shows that long periods of sitting can slow blood movement in and to the legs, thereby increasing the risk of a clot. The seat is partly to blame. It presses against the veins in the leg, restricting blood flow. Inactivity also plays a role. It decelerates the movement of blood through veins. If a clot forms, it sometimes breaks loose and travels to the lungs (known as pulmonary embolism), lodges in an artery, and inhibits blood flow. The victim may experience pain and breathing problems and cough up blood. If the clot is large, the victim could die. Second, remaining active, even in a small way, revitalizes and refreshes your body, wards off stiffness, and promotes mental and physical acuity which can ease the symptoms of jet lag.
Tip 8: Break up your trip

On long flights traveling across eight, 10, or even 12 time zones, break up your trip, if feasible, with a stay in a city about halfway to your destination. For example, if you are traveling from New York to Bombay, India, schedule a stopover of a few days in Dublin or Paris. (At noon in New York, it is 5 p.m. in Dublin, 6 p.m. in Paris, and 10:30 p.m. in Bombay.)

Tip 9: Wear comfortable shoes and clothes

On a long trip, how you feel is more important than how you look. Wear comfortable clothes and shoes. Avoid items that pinch, restrict, or chafe. When selecting your trip outfit, keep in mind the climate in your destination time zone. Dress for your destination.

Tip 10: Check your accommodations

Upon arrival, if you are staying at a hotel, check to see that beds and bathroom facilities are satisfactory and that cooling and heating systems are in good working order. If the room is unsuitable, ask for another.

Tip 11: Adapt to the local schedule

The sooner you adapt to the local schedule, the quicker your body will adjust. Therefore, if you arrive at noon local time (but 6 a.m. your time), eat lunch, not breakfast. During the day, expose your body to sunlight by taking walks or sitting in outdoor cafés. The sunlight will cue your hypothalamus to reduce the production of sleep-inducing melatonin during the day, thereby initiating the process of resetting your internal clock.

When traveling with children, try to get them on the local schedule as well. When traveling east and you will lose time, try to keep the child awake until the local bedtime. If traveling west when you will gain time, wake your child up at the local time.

Tip 12: Use sleeping medications wisely — or not at all

Try to establish sleeping patterns without resorting to pills. However, if you have difficulty sleeping on the first two or three nights, it’s OK to take a mild sedative if your physician has prescribed one. But wean yourself off the sedative as soon as possible. Otherwise, it could become habit-forming.

There are also some homeopathic remedies that may be used. A product called No Jet Lag contains homeopathic remedies leopard’s bane (Arnica montana), daisy (Bellis perennis), wild chamomile (Matricaria chamomilla), ipecac (Cephalelis ipecacuanha), and club moss (Lycopodium).

Valerian root is an herb that can be used as treatment for insomnia. Do not take valerian with alcohol. It is important to consult your physician before taking these or any other homeopathic or herbal remedy.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://en.wikipedia.org/wiki/Jet_lag
http://www.medicinenet.com/jet_lag/page4.htm#how_long_does_jet_lag_last

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Hope Therapy

Hope is an emotion characterized by positive feelings about the immediate or long-term future and often coupled with high motivation, optimism, and a generally elevated mood.Hope is a partially subjective term, and both psychologists and philosophers have struggled to define it. Some argue that hopefulness is a relatively stable personality trait, others believe that hope depends on external circumstances and previous experience, and some people view hope as a choice. Hope is commonly associated with warm feelings about the future, an increased willingness to work toward a goal, and an upbeat mood.

Hope therapy is a fairly recent idea with a fairly basic point. The main way this therapy is practiced is by teaching people in a group class setting to become more oriented toward positive thinking . Positive thinking with positive goals and behavior will help people toachieve their goals. It is separate from the idea of optimism, which is generally having a pervasive belief that good things are likely to happen. Instead, researchers believe that people can be taught to improve their outlook and minor depression in class settings, instead of through traditional talk therapy, which may tend to focus on negative experiences.

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It is observed that Hope therapy helps a lot to the people with severe macular degeneration, and people with mild depression, who were not classed as having a mental illness. Most people learn how to create goals, how to determine ways to reach goals and also how to use positive self-talk. Instead of focusing on negative incidents. Hope therapy relied on positive goal-based training. Many people in the groups noted significant elevation of mood, were able to absorb the training and became more goal oriented and were successfully able to use positive self-talk to diminish negative thinking patterns.

Hope therapy is  not just about the “power of positive thinking.” Instead it is based somewhat on the cognitive behavioral model of therapy which works to replace old or negative “hot thoughts” or core beliefs with new ones that are more truthful and positive. However, cognitive behavioral therapy (CBT) does spend at least some time analyzing how negative thoughts or experiences have influenced thoughts and behavior patterns in the here and now. Hope therapy appears to differ from this by focusing more on simply learning to change mindset, without much examination of what caused negative mindset in the past.

People who are facing personal and emotional conflicts, it is not that everything is lost for them. There is HOPE for them, they can also leave beautiful and happy life if some goal is set for them and with proper mental training they start exerting to reach the goal. The Hope Therapy Center (HTC) is a place where disheartened people may find healing and an opportunity to talk with a trained pastoral psychotherapist.

Hopelessness can also affect physical health. People who are not optimistic about their health or about their medical treatment are more likely to remain sick, more likely to report high levels of pain, and less likely to see an improvement in their overall health. Some mental health practitioners, aware of the role hope plays, encourage clients to work on thinking positively about life developments and finding things to be hopeful about. Many mental health professionals believe that hope is an indispensable key to happiness and that people cannot be happy without hope.

Hope therapy will be very much active and successful if this therapy is done along with Yoga exercise with Pranayama & Meditation under the guide line of some expert.

Help taken from:
http://www.wisegeek.com/what-is-hope-therapy.htm
http://www.hopetherapycenter.com/index.html
http://www.goodtherapy.org/blog/psychpedia/what-is-hope

Let’s Talk About Schizophrenia

People sometimes change inexplicably in their late teens – they behave bizarrely, argue unnecessarily with everyone, imagine events, become suspicious or withdraw into a shell. This is actually a disease called schizophrenia and these forms are classic, delusional, paranoid and catanonic. The word itself means “split mind ” in Greek as it was confused with a multiple personality disorder by earlier physicians. Today, these two illnesses are classified separately.
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Schizophrenia is a serious mental illness that is likely to affect one in 100 men and women (0.5-0.7 per cent respectively). It strikes people usually in their late teens and twenties. It is rare for schizophrenia to set in after the age of 40 and children are rarely diagnosed with it. They can, however, go on to develop it as adults if they have some other mental illness such as autism.

The onset of schizophrenia is so gradual that it mostly goes unrecognised and untreated, especially in developing countries with inadequate healthcare. In addition, people baulk at the idea of admitting they or a loved one is suffering from schizophrenia though no one has a problem saying they have an incurable chronic illness like diabetes or hypertension.

Schizophrenic patients may be delusional or hallucinate — that is see and hear things that are not real. Their speech may be disconnected, dressing and behaviour may be socially inappropriate and they may cry and laugh for no reason at all. Sometimes the person may be “catatonic” or unresponsive to any external stimulus.

Unreasonable behaviour and a quarrelsome nature may affect relations with friends, family and colleagues. The person may be unable to keep a job. Insomnia and morning drowsiness affect efficiency. The appetite may be poor.

The diagnosis of schizophrenia is difficult as the symptoms evolve gradually over a period of months or years. It is often difficult to pinpoint the exact date at which the changes were noticeable. The symptoms should be present for a month for schizophrenia to be suspected and remain for six months for the diagnosis to be established. The patient or a caretaker can report the symptoms. They should be substantiated by evaluation by a qualified medical professional.

PET scans also do not strictly conform to normal parameters. The brains in schizophrenics have smaller temporal and frontal lobes. The levels and ratios of certain brain chemicals like serotonin, dopamine and glutamine are altered.

The exact reason for these behaviour altering brain changes is not known. However, seven per cent of persons with schizophrenia have a family member who suffers from a similar disease. Many have been born to mothers who suffered several viral illnesses during pregnancy. Environmental factors also play a role — the incidence of the disease increases in persons who are financially insecure or from dysfunctional families with a history of childhood abuse.

Schizophrenics tend to gain weight because their lifestyle is sedentary. Patients also have a predilection for addiction — to tobacco products, alcohol and drugs like cannabis. They are often unwilling to check the addictions to control lifestyle diseases like diabetes or hypertension. Also, they do not adhere to diet modifications or medications needed to keep their disease in check; so this shortens lifespan. They eventually die 10-15 years earlier than their peers. They are also 15 per cent more likely to commit suicide.

Gone are the days when schizophrenics were locked up, immersed in cold baths or given electrical shock therapy. Today there are a plethora of drugs that can be used singly or in combination to control the symptoms of schizophrenia and help the person function fairly normally. These drugs act by correcting the enzyme and chemical imbalances in the brain. Response to medication may be slow and this may be frustrating for the patient as well as caregivers but medication can be increased only gradually to optimal levels. Drugs, combinations and dosages have to be individualised and vary from person to person.

The side effects of medication are weight gain, menstrual irregularities and drowsiness. Some people become very stiff and have abnormal smacking movements or grimaces but doctors are able to tackle this with other medications.

Rehabilitation is important. Once the symptoms are controlled, patients can function in society and even hold down jobs. They need to be trained to handle money and in personal care and hygiene. Medication needs to be continued even when the symptoms have disappeared. The involvement of the whole family helps as the person is then more likely to follow medical treatment and less likely to relapse.

People often ask for a “miracle drug” — a single tablet to treat all diseases. The only universal ingredient to improve health in all diseases (even mental problems) is physical exercise. So go take a walk.

Source : The Telegraph ( Kolkata, India)

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Glandular fever

Definition:
Glandular fever is a viral infection associated with a high fever.It’s also known as infectious mononucleosis or kissing disease (long ago it was realised that the infection was passed on through saliva – for example, by kissing).

It is a viral infection caused by the Epstein-Barr virus. Glandular Fever is often spread through oral acts such as kissing, which is why it is sometimes called “The Kissing Disease“. However, Glandular Fever can also be spread by airborne saliva droplets.

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Infectious Mononucleosis (IM) is an infectious, widespread viral disease caused by the Epstein-Barr virus (EBV), one type of herpes virus, to which more than 90% of adults have been exposed. Occasionally, the symptoms can reoccur at a later period. Most people are exposed to the virus as children, when the disease produces no noticeable symptoms or only flu-like symptoms. In developing countries, people are exposed to the virus in early childhood more often than in developed countries. As a result, the disease in its observable form is more common in developed countries. It is most common among adolescents and young adults.

Especially in adolescents and young adults, the disease is characterized by fever, sore throat and fatigue, along with several other possible signs and symptoms. It is primarily diagnosed by observation of symptoms, but suspicion can be confirmed by several diagnostic tests.

The syndrome was described as an infectious process by Nil Filatov in 1887 and independently by Emil Pfeiffer in 1889.
Symptoms:-
The following are mainly the symptoms of Glandular Fever:
*Headache
*Fever
*Sore throat/hard to swallow
*Tiredness, fatigue and malaise
*Enlarged lymph nodes
*Loss of appetite
*Muscle aches
*Tender enlargement of the glands (lymph glands or lymph nodes)
*Skin rash
*Sweating
*Stomach pain and enlarged spleen
*Enlarged liver
*Jaundice
*Depression
*Joint pain
*Swelling around eyes
*Orange urine (or discolored
*High blood pressure

Causes:
Glandular fever is caused by the Epstein-Barr virus. This can attack only two types of cell in the body: those in the salivary glands and white blood cells known as B lymphocytes (B-cells).

The most common way of spreading the virus is through the transmission of saliva from one person to another. Coughing, sneezing, and sharing drink bottles, eating utensils and other personal items can also spread the virus. In addition, the virus can also be spread through blood transfusion and organ transplantation.

Infection begins in the salivary glands, which release large amounts of the virus into the saliva. The infection spreads to the B lymphocytes, causing them to multiply, and causing the lymph glands to swell and become painful.

Once infected, the virus remains dormant in the body’s cells for the rest of a person’s life.

Diagnosis:
The diagnosis of glandular fever or infectious mononucleosis is based on your physical symptoms, and will include a blood test and a throat swab. Your doctor will perform a blood test to determine abnormalities in the white blood cells. A throat swab will help determine if you have glandular fever.

The most commonly used diagnostic criterion is the presence of 50% lymphocytes with at least 10% atypical lymphocytes (large, irregular nuclei), while the person also has fever, pharyngitis and adenopathy. Furthermore, it should be confirmed by a serological test.  The atypical lymphocytes resembled monocytes when they were first discovered, thus the moniker “mononucleosis” was coined. Diagnostic tests are used to confirm infectious mononucleosis but the disease should be suspected from symptoms prior to the results from hematology. These criteria are specific; however, they are not particularly sensitive and are more useful for research than for clinical use. Only half the patients presenting with the symptoms held by mononucleosis and a positive heterophile antibody test (monospot test) meet the entire criteria. One key procedure is to differentiate between infectious mononucleosis and mononucleosis-like symptoms.

There have been few studies on infectious mononucleosis in a primary care environment, the best of which studied 700 patients, of which 15 were found to have mononucleosis upon a heterophile antibody test. More useful in a diagnostic sense are the signs and symptoms themselves. The presence of splenomegaly, posterior cervical adenopathy, axillary adenopathy, and inguinal adenopathy are the most useful to suspect a diagnosis of infectious mononucleosis. On the other hand, the absence of cervical adenopathy and fatigue are the most useful to dismiss the idea of infectious mononucleosis as the correct diagnosis. The insensitivity of the physical examination in detecting splenomegaly means that it should not be used as evidence against infectious mononucleosis.

In the past the most common test for diagnosing infectious mononucleosis was the heterophile antibody test which involves testing heterophile antibodies by agglutination of guinea pig, sheep and horse red blood cells. As with the aforementioned criteria, this test is specific but not particularly sensitive (with a false-negative rate of as high as 25% in the first week, 5–10% in the second and 5% in the third). 90% of patients have heterophile antibodies by week 3, disappearing in under a year. The antibodies involved in the test do not interact with the Epstein-Barr virus or any of its antigens. More recently, tests that are more sensitive have been developed such as the Immunoglobulin G (IgG) and Immunoglobulin M (IgM) tests. IgG, when positive, reflects a past infection, whereas IgM reflects a current infection. When negative, these tests are more accurate in ruling out infectious mononucleosis. However, when positive, they feature similar sensitivities to the heterophile antibody test. Therefore, these tests are useful for diagnosing infectious mononucleosis in people with highly suggestive symptoms and a negative heterophile antibody test. Another test searches for the Epstein-Barr nuclear antigen, while it is not normally recognizable until several weeks into the disease, and is useful for distinguishing between a recent-onset of infectious mononucleosis and symptoms caused by a previous infection. Elevated hepatic transaminase levels is highly suggestive of infectious mononucleosis, occurring in up to 50% of patients.

A fibrin ring granuloma may be present.

Diagnosis of acute infectious mononucleosis should also take into consideration acute cytomegalovirus infection and Toxoplasma gondii infections. These diseases are clinically very similar by their signs and symptoms. Because their management is much the same it is not always helpful, or possible, to distinguish between EBV mononucleosis and cytomegalovirus infection. However, in pregnant women, differentiation of mononucleosis from toxoplasmosis is associated with significant consequences for the fetus.

Acute HIV infection can mimic signs similar to those of infectious mononucleosis and tests should be performed for pregnant women for the same reason as toxoplasmosis.

Other conditions from which to distinguish infectious mononucleosis include leukemia, tonsillitis, diphtheria, common cold and influenza

Treatment:
Self care:
Infectious mononucleosis is generally self-limiting and only symptomatic and/or supportive treatments are used.  Rest is recommended during the acute phase of the infection, but activity should be resumed once acute symptoms have resolved. Nevertheless heavy physical activity and contact sports should be avoided to mitigate the risk of splenic rupture, for at least one month following initial infection or splenomegaly has resolved, as determined by a treating physician.

MedicationsIn terms of pharmacotherapies, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be used to reduce fever and pain. Prednisone, a corticosteroid, is commonly used as an anti-inflammatory to reduce symptoms of pharyngeal pain, odynophagia, or enlarged tonsils, although its use remains controversial due to the rather limited benefit and the potential of side effects. Intravenous corticosteroids, usually hydrocortisone or dexamethasone, are not recommended for routine use but may be useful if there is a risk of airway obstruction, severe thrombocytopenia, or hemolytic anemia. There is little evidence to support the use of aciclovir, although it may reduce initial viral shedding. However, the antiviral drug valacyclovir has recently been shown to lower or eliminate the presence of the Epstein-Barr virus in subjects afflicted with acute mononucleosis, leading to a significant decrease in the severity of symptoms. Although antivirals are not recommended for patients presenting with simple infectious mononuscleosis, they may be useful (in conjunction with steroids) in the management of patients with severe EBV manifestations, such as EBV meningitis, peripheral neuritis, hepatitis, or hematologic complications. Antibiotics are not used as they are ineffective against viral infections. The antibiotics ampicillin and later the related amoxicillin   are relatively contraindicated in the case of any coinciding bacterial infections during mononucleosis because their use precipitates a non-allergic rash close to 99% of the time.

In a small percentage of cases, mononucleosis infection is complicated by co-infection with streptococcal infection in the throat and tonsils (strep throat). Penicillin or other antibiotics (with the exception of the two mentioned above) should be administered to treat the strep throat. Opioid analgesics are also relatively contraindicated due to risk of respiratory depression.
Prognosis:
Serious complications are uncommon, occurring in less than 5% of cases:

*CNS: Meningitis, encephalitis, hemiplegia, Guillain-Barré syndrome, and transverse myelitis. EBV infection has also been proposed as a risk factor for the development of multiple sclerosis (MS), but this has not been confirmed.

*Hematologic: Hemolytic anemia (direct Coombs test is positive) and various cytopenias; Bleeding (caused by thrombocytopenia).[

*Mild jaundice

*Hepatitis (rare)

*Upper airway obstruction (tonsillar hypertrophy) (rare)

*Fulminant disease course (immunocompromised patients) (rare)

*Splenic rupture (rare)

*Myocarditis and pericarditis (rare)

Once the acute symptoms of an initial infection disappear, they often do not return. But once infected, the patient carries the virus for the rest of his or her life. The virus typically lives dormantly in B lymphocytes. Independent infections of mononucleosis may be contracted multiple times, regardless of whether the patient is already carrying the virus dormantly. Periodically, the virus can reactivate, during which time the patient is again infectious, but usually without any symptoms of illness.  Usually, a patient has few if any further symptoms or problems from the latent B lymphocyte infection. However, in susceptible hosts under the appropriate environmental stressors the virus can reactivate and cause vague physical complaints (or may be subclinical), and during this phase the virus can spread to others. Similar reactivation or chronic subclinical viral activity in susceptible hosts may trigger multiple host autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, Sjogren’s syndrome, antiphospholipid antibody syndrome, and multiple sclerosis. Such chronic immunologic stimulation may also trigger multiple type of cancers, particularly lymphoma—strongest cancer associations with EBV are nasopharyngeal carcinomas, Burkitt’s lymphoma, and Hodgkin’s lymphoma. EBV’s potential to trigger such a wide range of autoimmune diseases and cancers probably relates to its primary infection of B lymphocytes (the primary antibody-producing cell of the immune system) and ability to alter both lymphocyte proliferation and lymphocyte antibody production.

Prevention:
A vaccine against the Epstein-Barr virus is under development. The infection is most contagious during the feverish stage, when contact with others should be avoided.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nativeremedies.com/ailment/glandular-fever-symptoms-info.html
http://simple.wikipedia.org/wiki/Glandular_fever
http://simple.wikipedia.org/wiki/Glandular_fever
http://www.bbc.co.uk/health/physical_health/conditions/glandularfever2.shtml

http://www.treatfast.com/mononucleosis-xidc18255.html

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Feeding Problems

Definition:
Feeding problem of infancy or early childhood is characterized by the failure of an infant or child under six years of age to eat enough food to gain weight and grow normally over a period of one month or more. The disorder can also be characterized by the loss of a significant amount of weight over one month. Feeding disorder is similar to failure to thrive, except that no medical or physiological condition can explain the low food intake or lack of growth.
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Infants and children with a feeding disorder fail to grow adequately, or even lose weight with no underlying medical explanation. They do not eat enough energy or nutrients to support growth and may be irritable or apathetic. Factors that contribute to development of a feeding disorder include lack of nurturing, failure to read the child’s hunger and satiety cues accurately, poverty, or parental mental illness. Successful treatment involves dietary, behavioral, social, and psychological intervention by a multidisciplinary

Feeding problems are common throughout childhood and affect both boys and girls.

Causes:
The kind of feeding problem may depend on the age of the child.

Some new mothers take a while to get the hang of breastfeeding and may worry they’re not producing sufficient milk or their baby isn’t satisfied. But as long as the baby is gaining weight at the normal rate, there’s no need for concern.

 

Occasionally, early feeding problems are due to anatomical difficulties (for example, a severe cleft palate or oesophageal atresia) or more general illness, but these are usually quickly identified.

Minor infections, such as a cold, can interrupt established feeding patterns, but rarely for long.

Gastro-oesophageal reflux disease (GORD) can also make feeding difficult, affect weight gain and cause great stress for parents.

More serious conditions can interfere with the absorption of food and weight gain, including coeliac disease, cystic fibrosis, inflammatory bowel disease and food intolerance.

In toddlers and older children, emotional and social factors can cause feeding problems. Older children, especially girls, are more likely to develop eating disorders such as anorexia nervosa and bulimia.

Symptoms:
The symptoms of feeding disorders can vary, but common symptoms include:

•Refusing food
•Lack of appetite
•Colic
•Crying before or after food
•Failing to gain weight normally
•Regurgitating or vomiting
•Diarrhoea
•Abdominal pain
•Constipation
•Behavioural problems

Diagnosis :
Between 25% and 35% of normal children experience minor feeding problems. In infants born prematurely, 40% to 70% experience some type of feeding problem. For a child to be diagnosed with feeding disorder of infancy or early childhood, the disorder must be severe enough to affect growth for a significant period of time. Generally, growth failure is considered to be below the fifth percentile of weight and height.

Feeding disorder of infancy or early childhood is diagnosed if all four of the following criteria are present:

•Failure to eat adequately over one month or more, with resultant weight loss or failure to gain weight.
•Inadequate eating and lack of growth not explained by any general medical or physiological condition, such as gastrointestinal problems, nervous system abnormalities, or anatomical deformations.
•The feeding disorder cannot be better explained by lack of food or by another mental disorder, such as rumination disorder.
•The inadequate eating and weight loss or failure to gain weight occurs before the age of six years. If feeding behavior or weight gain improves when another person feeds and cares for the child, the existence of a true feeding disorder, rather than some underlying medical condition, is more likely.

Treatments :-
Successful treatment of feeding disorders requires a multidisciplinary team approach to assess the child’s needs and to provide recommendations and education to improve feeding skills, behavior, and nutrient intake. The multidisciplinary team for treatment of feeding disorders in childhood usually includes physicians specializing in problems of the gastrointestinal tract or of the ear, nose, and throat; a dietitian, a psychologist , a speech pathologist, and an occupational therapist. Support from social workers and physicians in related areas of medicine is also helpful.

An initial evaluation should focus on feeding history, including detailed information on type and timing of food intake, feeding position, meal duration, energy and nutrient intake, and behavioral and parental factors that influence the feeding experience. Actual observation of a feeding session can give valuable insight into the cause of the feeding disorder and appropriate treatments. A medical examination should also be conducted to rule out any potential medical problems or physical causes of the feeding disorder.

After a thorough history is taken and assessment completed, dietary and behavioral therapy is started. The goal of diet therapy is to gradually increase energy and nutrient intake as tolerated by the child to allow for catch up growth. Depending on the diet history, energy and nutrient content of the diet may be kept lower initially to avoid vomiting and diarrhea. As the infant or child is able to tolerate more food, energy and nutrient intake is gradually increased over a period of one to two weeks, or more. Eventually, the diet should provide about 50% more than normal nutritional needs of infants or children of similar age and size.

Behavioral therapy can help the parent and child overcome conditioned feeding problems and food aversions. Parents must be educated to recognize their child’s hunger and satiety cues accurately and to promote a pleasant, positive feeding environment. Changing the texture of foods, the pace and timing of feedings, the position of the body, and even feeding utensils can help the child overcome aversions to eating. If poverty, abuse, or parental mental illness contribute to the feeding disorder, these issues must also be addressed.

Prognosis :-
If left untreated, infants and children with feeding disorders can have permanent physical, mental, and behavioral damage. However, most children with feeding disorders show significant improvements after treatment, particularly if the child and parent receive intensive nutritional, psychological, and social intervention.

Prevention :-
Providing balanced, age-appropriate foods at regular intervals—for example, three meals and two or three snacks daily for toddlers—can help to establish healthy eating patterns. If a child is allowed to fill up on soft drinks, juice, chips, or other snacks prior to meals, appetite for other, more nutritious foods will decrease.

Positive infant and childhood feeding experiences require the child to communicate hunger and satiety effectively and the parent or caregiver to interpret these signals accurately. This set of events requires a nurturing environment and an attentive, caring adult. Efforts should be made to establish feeding as a positive, pleasant experience. Further, forcing a child to eat or punishing a child for not eating should be avoided.

You may click to see :

*Feeding Problems in Infants and Children
*Problems feeding your baby?

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/feedingproblems2.shtml
http://www.minddisorders.com/Del-Fi/Feeding-disorder-of-infancy-or-early-childhood.html

http://www.brighttomorrowstoday.com/behavior-feeding-therapy.html