Child’s Brain Development

Be it reciting a jingle heard on the television, running after everything that catches their fancy or bewildering adults with their endless questions, toddlers give us a glimpse of their infectious energy every day. Their energy and curiosity often leave parents astounded. This fascination about the world around them stems from the fact that the brains of young children are more active than adult brains.
Knowing more about brain development can help us make sense of their behavior and provide the best conditions for their growth. Up to 6 years of age, the brain is constantly learning, developing and forming memories. In fact, the brain develops up to 90% of its capacity by age 6¹. With the number of active brain connections, a toddler processes more information than an adult brain.
Brain development in young children:
Overall, a toddler’s brain grows up to 25% of an adult brain size by age 3. We know that different areas of the brain serve different functions. Essential brain functions are active right from birth. After birth, sensory functions such as sight and smell are the first to develop followed by higher cognitive functions such as problem-solving. Language development occurs between the ages of two and four.

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There are several parts of the brain that see phenomenal growth during the first few years of life. Synapses are connections between two different nerve cells in the brain. The development of synapses is the fastest among young children. This allows them to learn more than adults in the same amount of time.
The visual cortex, located at the hind side of the brain, aids in visual perception and the growth of this part improves the brain capacity to sense depth and color. The growth of the cerebellum is linked to motor skills that allow a child to crawl and later start walking.
There are quite a few factors that create ideal conditions for brain development. Mentally stimulating activities help exercise the developing brain while adequate nutrition provides the nutrients for its development.

Resources: The Telegraph, Kolkata(India)

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Bad effects of sugar

SUGAR -The bigger killer than infectious diseases; every year it claims 35 million lives worldwide:
it was believed that sugar is bad for health because it adds a whole lot of calories to the diet but no nutrition. Now, new research reveals that too much sugar in the blood – even if you are not a diabetic – can actually ravage your heart and liver, upset the hormonal system, raise the level of cholesterol, triglycerides, blood pressure, and increase the chance of cancer.
The study, published in a recent issue of the journal, Nature, states that the annual worldwide death toll due to sugar overload is approximately 35 million – as much as the population of Morocco. In other words, sugar is a bigger killer than even infectious diseases. And here is a list of some of the food types in which it lurks.

Fat-free food
To keep increasing weight in check, some people get obsessed with removing all fat from the diet. They insist on having only food and drinks labelled low-fat.
But what exactly is low-fat food? Let’s begin with fat-free food or drinks such as double toned milk, low-fat ice cream or zero-calorie colas. These items are so bland that manufacturers add something, usually variants of sugar and preservatives, to make them palatable. As a result, you get rid of the fat but not the calories.
The thing to keep in mind is that not all fats are bad. Fats such as monounsaturated fatty acid (Mufa) – found in almonds, cashews, peanut butter and olive oil – or polyunsaturated fatty acid (Pufa) – walnuts, animal fats, safflower oil – are beneficial. They play a key role in nutritional balance and disease prevention. It is trans-fats – found in deep fried foods as well as commercial baked goods like biscuits – that are harmful.

Processed food:
Most processed food has a lot of added sugar. That includes breakfast cereals, bread, canned or packed fruit juice, beer, sauce, ketchup, cookies, candy, mayonnaise, salad dressings, soft drinks and so on. A 300ml bottle of soft drinks usually has eight teaspoonfuls of sugar while a single scoop of ice cream has five.
To put it in perspective, according to WHO, men must not have more than nine teaspoons of sugar a day, while six teaspoonfuls are enough for women. A US government guideline on nutrition says about 10-15 per cent of calories can be derived from sugary food but studies reveal that most of us get 25 per cent of calories from sugar.
Refined sugars
Sugar is added to food in many avatars – white, brown, high fructose corn syrup (present in most processed food) and agave nectar. Milk and fruits have the natural sugars lactose and fructose, respectively. These are less harmful.

“The protein in dairy products and the fibre in fruits help our body absorb the natural sugar slowly. Slowing down the digestion of sugar prevents an insulin spike and is less harmful to the liver,” says Dr Satinath Mukhopadhyay, head of Endocrinology at IPGMER, Calcutta.
Avoid processed food and limit the intake of sugar-rich food.

Sugar addiction:
According to a study at the University of Florida, sugary food can be as addictive as nicotine and cocaine. Whenever we see sugar, the brain gets a rush of dopamine, a neurotransmitter associated with pleasure. When we consume sugar, our natural opiods and beta-endorphins rush to the brain, a reaction similar to someone on nicotine, cocaine or heroin.
Experts contend that sugar addiction has become the biggest public health crisis in history. “Since sugar induces the same addictive pathways as narcotics, why should this not be taken seriously,” asks Dr Mukhopadhyay.

Sweeteners: good and bad
• Replace sugar with molasses, palm sugar or date palm juice, which provide Vitamin B, iron, calcium and potassium
• Fresh cane juice has vitamins B and C, iron and manganese; coconut sugar (dehydrated sap of the coconut palm) has antioxidants, calcium, zinc, iron and potassium. It doesn’t raise blood sugar and is good for diabetics
• If dessert is a must, have dates – rich in potassium, calcium and Vitamin B6 – raisins and other dry or fresh fruits
• While baking, use palm sugar. Add fresh or dry fruits to sweeten puddings
• Add honey to green tea and maple syrup to tea and coffee. While these sweeteners have calories, they also have antioxidants.
• Avoid sugar substitutes such as aspartame. If you are addicted to sweet tea, add a bit of sugar but never an artificial sweetener, which can give you migraine, eye problems, nausea and vomiting, insomnia, stomach problems, joint ache, depression and even brain cancer.

Resources: The Telegraph Calcutta (India)

Nipah virus (NiV)

Description:
Nipah virus (NiV) infection is a newly emerging zoonosis that causes severe disease in both animals and humans. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus.

NiV was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998. On this occasion, pigs were the intermediate hosts. However, in subsequent NiV outbreaks, there were no intermediate hosts. In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented, including in a hospital setting in India.

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NiV infection in humans has a range of clinical presentations, from asymptomatic infection to acute respiratory syndrome and fatal encephalitis. NiV is also capable of causing disease in pigs and other domestic animals. There is no vaccine for either humans or animals. The primary treatment for human cases is intensive supportive care.

Symptoms:
Human infections range from asymptomatic infection, acute respiratory infection (mild, severe), and fatal encephalitis. Infected people initially develop influenza-like symptoms of fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The incubation period (interval from infection to the onset of symptoms) is believed to range between from 4-14 days. However an incubation period as long as 45 days has been reported.

Most people who survive acute encephalitis make a full recovery, but long term neurologic conditions have been reported in survivors. Approximately 20% of patients are left with residual neurological consequences such as seizure disorder and personality changes. A small number of people who recover subsequently relapse or develop delayed onset encephalitis.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.

Causes:
Nipah virus is an RNA virus that is part of the Paramyxovidae family that was first identified as a zoonotic pathogen after an outbreak involving severe respiratory illness in pigs and encephalitic disease in humans in Malaysia and Singapore in 1998 and 1999.

Nipah virus can cause a range of mild to severe disease in domestic animals such as pigs.

Nipah virus infection in humans causes a range of clinical presentations, from asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis.

Nipah virus can be transmitted to humans from animals (bats, pigs), and can also be transmitted directly from human-to-human.

Fruit bats of the Pteropodidae family are the natural host of Nipah virus:-

Nipah virus (NiV) is an emerging zoonotic virus (a virus transmitted to humans from animals). In infected people, Nipah virus causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. NiV can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.

Nipah virus is closely related to Hendra virus. Both are members of the genus Henipavirus, a new class of virus in the Paramyxoviridae family.

Although Nipah virus has caused only a few outbreaks, it infects a wide range of animals and causes severe disease and death in people, making it a public health concern.

Transmission:

NiV is a zoonotic virus (a virus transmitted to humans from animals). During the initial outbreaks in Malaysia and Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via respiratory droplets, contact with throat or nasal secretions from the pigs, or contact with the tissue of a sick animal.

In the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.

Limited human to human transmission of NiV has also been reported among family and care givers of infected NiV patients. During the later outbreaks in Bangladesh and India, Nipah virus spread directly from human-to-human through close contact with people’s secretions and excretions. In Siliguri, India, transmission of the virus was also reported within a health-care setting (nosocomial), where 75% of cases occurred among hospital staff or visitors. From 2001 to 2008, around half of reported cases in Bangladesh were due to human-to-human transmission through providing care to infected patients.

Natural host: Fruit bats
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Fruit bats of the family Pteropodidae – particularly species belonging to the Pteropus genus – are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

It is assumed that the geographic distribution of Henipaviruses overlaps with that of Pteropus category. This hypothesis was reinforced with the evidence of Henipavirus infection in Pteropus bats from Australia, Bangladesh, Cambodia, China, India, Indonesia, Madagascar, Malaysia, Papua New Guinea, Thailand and Timor-Leste.

African fruit bats of the genus Eidolon, family Pteropodidae, were found positive for antibodies against Nipah and Hendra viruses, indicating that these viruses might be present within the geographic distribution of Pteropodidae bats in Africa.

Nipah virus in domestic animals:
________________________________

Nipah outbreaks in pigs and other domestic animals (horses, goats, sheep, cats and dogs) were first reported during the initial Malaysian outbreak in 1999.

Nipah virus is highly contagious in pigs. Pigs are infectious during the incubation period, which lasts from 4 to 14 days.

An infected pig can exhibit no symptoms, but some develop acute feverish illness, labored breathing, and neurological symptoms such as trembling, twitching and muscle spasms. Generally, mortality was low except in young piglets. These symptoms are not dramatically different from other respiratory and neurological illnesses of pigs. Nipah should be suspected if pigs also have an unusual barking cough or if human cases of encephalitis are present.

Diagnosis:
Initial signs and symptoms of NiV infection are non-specific and the diagnosis is often not suspected at the time of presentation. This can hinder accurate diagnosis and creates challenges in outbreak detection and institution of effective and timely infection control measures and outbreak response activities.

In addition, clinical sample quality, quantity, type, timing of collection and the time necessary to transfer samples from patients to the laboratory can affect the accuracy of laboratory results.

NiV infection can be diagnosed together with clinical history during the acute and convalescent phase of the disease. Main tests including real time polymerase chain reaction (RT-PCR) from bodily fluids as well as antibody detection via ELISA. Different tests include:

*Enzyme-linked immunosorbent assay (ELISA)
*Polymerase chain reaction (PCR) assay
*Virus isolation by cell culture.

Treatment:
There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.

Prevention:
Nipah virus in domestic animals

Nipah outbreaks in pigs and other domestic animals (horses, goats, sheep, cats and dogs) were first reported during the initial Malaysian outbreak in 1999.

Nipah virus is highly contagious in pigs. Pigs are infectious during the incubation period, which lasts from 4 to 14 days.

An infected pig can exhibit no symptoms, but some develop acute feverish illness, labored breathing, and neurological symptoms such as trembling, twitching and muscle spasms. Generally, mortality was low except in young piglets. These symptoms are not dramatically different from other respiratory and neurological illnesses of pigs. Nipah should be suspected if pigs also have an unusual barking cough or if human cases of encephalitis are present.

Reducing the risk of bat-to-human transmission: Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and to other fresh food products. Keeping bats away from sap collection sites with protective coverings (e.g., bamboo sap skirts) may be helpful.Freshly collected date palm juice should be boiled and fruits should be thoroughly washed and peeled before consumption.

Reducing the risk of animal-to-human transmission: Gloves and other protective clothing should be worn while handling sick animals or their tissues, and during slaughtering and culling procedures. As much as possible, people should avoid being in contact with infected pigs.

Reducing the risk of human-to-human transmission: Close unprotected physical contact with Nipah virus-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people.

Controlling infection in health-care settings:
___________________________________________________________

Health-care workers caring for patients with suspected or confirmed NiV infection, or handling specimens from them, should implement standard infection control precautions for all patients at all times.

As human-to-human transmission in particular nosocomial transmission have been reported, contact and droplet precautions should be used in addition to standard precautions.

Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories.

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.who.int/csr/disease/nipah/en/
https://en.wikipedia.org/wiki/Henipavirus
http://www.who.int/news-room/fact-sheets/detail/nipah-virus

Dysthymia

Other Name: Persistent Depressive Disorder (PDD)

Description:
Dysthymia is a serious state of chronic depression, which persists for at least two years (one year for children and adolescents). Dysthymia is less acute and severe than major depressive disorder. As dysthymia is a chronic disorder, sufferers may experience symptoms for many years before it is diagnosed, if diagnosis occurs at all. As a result, they may believe that depression is a part of their character, so they may not even discuss their symptoms with doctors, family members or friends.

Dysthymia often co-occurs with other mental disorders. A “double depression” is the occurrence of episodes of major depression in addition to dysthymia. Switching between periods of dysthymic moods and periods of hypomanic moods is indicative of cyclothymia, which is a mild variant of bipolar disorder.

In the DSM-5, dysthymia is replaced by persistent depressive disorder. This new condition includes both chronic major depressive disorder and the previous dysthymic disorder. The reason for this change is that there was no evidence for meaningful differences between these two conditions.

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Symptoms:
Dysthymia characteristics include an extended period of depressed mood combined with at least two other symptoms which may include insomnia or hypersomnia, fatigue or low energy, eating changes (more or less), low self-esteem, or feelings of hopelessness. Poor concentration or difficulty making decisions are treated as another possible symptom. Mild degrees of dysthymia may result in people withdrawing from stress and avoiding opportunities for failure. In more severe cases of dysthymia, people may even withdraw from daily activities. They will usually find little pleasure in usual activities and pastimes.

The main symptoms of PDD are similar to those of depression. However, the key difference is that PDD is chronic, with symptoms occurring on most days for at least two years.

These symptoms include:

*Persistent feelings of sadness and hopelessness
*Sleep problems
*Low energy
*A change in appetite
*Difficulty concentrating
*Indecisiveness
*A lack of interest in daily activities
*Decreased productivity
*Poor self-esteem
*A negative attitude
*Avoidance of social activities

The symptoms of PDD often begin to appear during childhood or adolescence. Children and teens with PDD may appear to be irritable, moody, or pessimistic over an extended period. They may also display behavior problems, poor performance at school, and difficulty interacting with other children in social situations. Their symptoms may come and go over several years, and the severity of them may vary over time.

Causes:
There are no known biological causes that apply consistently to all cases of dysthymia, which suggests diverse origin of the disorder. However, there are some indications that there is a genetic predisposition to dysthymia: “The rate of depression in the families of people with dysthymia is as high as fifty percent for the early-onset form of the disorder”. Other factors linked with dysthymia include stress, social isolation, and lack of social support.

The main causes may include:

*A chemical imbalance in the brain
*A family history of the condition
*A history of other mental health conditions, such as anxiety or bipolar disorder
*Stressful or traumatic life events, such as the loss of a loved one or financial problems
*Chronic physical illness, such as heart disease or diabetes
*Physical brain trauma, such as a concussion

In a study using identical and fraternal twins, results indicated that there is a stronger likelihood of identical twins both having depression than fraternal twins. This provides support for the idea that dysthymia is in part caused by heredity.
Diagnosis:
The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), published by the American Psychiatric Association, characterizes dysthymic disorder. The essential symptom involves the individual feeling depressed for the majority of days, and parts of the day, for at least two years. Low energy, disturbances in sleep or in appetite, and low self-esteem typically contribute to the clinical picture as well. Sufferers have often experienced dysthymia for many years before it is diagnosed. People around them often describe the sufferer in words similar to “just a moody person”. Note the following diagnostic criteria:

During a majority of days for two years or more, the adult patient reports depressed mood, or appears depressed to others for most of the day.

When depressed, the patient has two or more of:

*Decreased or increased appetite
*Decreased or increased sleep (insomnia or hypersomnia)
*Fatigue or low energy
*Reduced self-esteem
*Decreased concentration or problems making decisions
*Feelings of hopelessness or pessimism
*During this two-year period, the above symptoms are never absent longer than two consecutive months.
*During the duration of the two-year period, the patient may have had a perpetual major depressive episode.
*The patient has not had any manic, hypomanic, or mixed episodes.
*The patient has never fulfilled criteria for cyclothymic disorder.
*The depression does not exist only as part of a chronic psychosis (such as schizophrenia or delusional disorder).
*The symptoms are often not directly caused by a medical illness or by substances, including drug abuse or other medications.
*The symptoms may cause significant problems or distress in social, work, academic, or other major areas of life functioning.

In children and adolescents, mood can be irritable, and duration must be at least one year, in contrast to two years needed for diagnosis in adults.

Early onset (diagnosis before age 21) is associated with more frequent relapses, psychiatric hospitalizations, and more co-occurring conditions. For younger adults with dysthymia, there is a higher co-occurrence in personality abnormalities and the symptoms are likely chronic.[citation needed] However, in older adults suffering from dysthymia, the psychological symptoms are associated with medical conditions and/or stressful life events and losses.

Dysthymia can be contrasted with major depressive disorder by assessing the acute nature of the symptoms. Dysthymia is far more chronic (long lasting) than major depressive disorder, in which symptoms may be present for as little as 2 weeks. Also Dysthymia often presents itself at an earlier age than Major Depressive Disorder.

Treatments:
Often, people with dysthymia will seek out treatment not necessarily because of depressed mood, but rather due to increasing levels of stress or because of personal difficulties that may be situation-related. This is hypothesized to be because of the chronic nature of the disorder, and how depressed mood is often thought to be a characterological pattern for the individual with the condition. Thus, it is only when the person experiences increasing stress that he or she thinks to go to some sort of trained professional for symptom relief. It is usually through the administration of the Structured Clinical Interview for DSM-IV that dysthymia is first diagnosed. At this point, with the help of a trained professional, a certain line of treatment is often discussed and then selected. It is important to consider all factors in the person’s life that may be affected when deciding on a particular course of treatment. Additionally, if one method of treatment does not particularly work for a certain individual, it may be helpful to try something else.

Therapy:
Psychotherapy is often effective in treating dysthymia. Different modalities have been shown to be beneficial. Empirically-based treatments, such as cognitive-behavioral therapy, have been researched to show that through the proper course of treatment, symptoms can dissipate over time. Other forms of talk-therapy (e.g. psychodynamic psychotherapy, interpersonal psychotherapy) have also been said to be effective in treating the disorder. It may be helpful for people diagnosed with dysthymia to develop better coping skills, search for the root cause of symptoms, and work on changing faulty beliefs (such as when patients believe themselves to be worthless).

In addition to individual psychotherapy, both group psychotherapy and self-help, or support groups, can be an effective line of treatment for dysthymia as well. Through these treatment modalities, issues such as self-esteem, self-confidence, relationship issues/patterns, assertiveness skills, cognitive restructuring, etc., can be worked through and strengthened.

Medications:
The first line of pharmacotherapy is usually SSRIs due to their more tolerable nature and reduced side effects compared to the irreversible monoamine oxidase inhibitors or tricyclic antidepressants. Studies have found that the mean response to antidepressant medications for people with dysthymia is 55%, compared with a 31% response rate to a placebo. The most commonly prescribed antidepressants/SSRIs for dysthymia are escitalopram, citalopram, sertraline, fluoxetine, paroxetine, and fluvoxamine. It often takes an average of 6–8 weeks before the patient begins to feel these medications’ therapeutic effects. Additionally, multi-clinic governmental study, found that people with overall depression will generally need to try different brands of medication before finding one that works specifically for them. Research shows that 1 in 4 of those who switch medications get better results regardless of whether the second medication is an SSRI or some other type of antidepressant.

In a meta-analytic study from 2005, it was found that SSRIs and TCAs are equally effective in treating dysthymia. They also found that MAOIs have a slight advantage over the use of other medication in treating this disorder. However, the author of this study cautions that MAOIs should not necessarily be the first line of defense in the treatment of dysthymia, as they are often less tolerable than their counterparts, such as SSRIs.

Tentative evidence supports the use of amisulpride to treat dysthymia but with increased side effects.

Combination treatment:
A combination of antidepressant medication and psychotherapy has consistently been shown to be the most effective line of treatment for people diagnosed with dysthymia. Working with a psychotherapist to address the causes and effects of the disorder, in addition to taking antidepressants to help eliminate the symptoms, can be extremely beneficial. This combination is often the preferred method of treatment for those who have dysthymia. Looking at various studies involving treatment for dysthymia, 75% of people responded positively to a combination of cognitive behavioral therapy (CBT) and pharmacotherapy, whereas only 48% of people responded positively to just CBT or medication alone.

In a meta-analytic study from 2008, researchers found an effect size of ?.07 (Cohen’s d) between pharmacologic treatments and psychological treatments for depressive disorders, suggesting pharmacologic treatments to be slightly more effective, though the results were not found to be statistically significant. This small effect is true only for SSRIs, with TCAs and other pharmacologic treatments showing no differences from psychological treatments. Additionally, there have been several studies yielding results that indicate that severe depression responds more favorably to psychotherapy than pharmacotherapy.

Resistance:
Because of dysthymia’s chronic nature, treatment resistance is somewhat common. In such a case, augmentation is often recommended. Such treatment augmentations can include lithium pharmacology, thyroid hormone augmentation, amisulpride, buspirone, bupropion, stimulants, and mirtazapine. Additionally, if the person also suffers from seasonal affective disorder, light therapy can be useful in helping augment therapeutic effects.

Regular Yoga exercise with meditation under a trained & experienced teacher helps a lot to recover substantially  & sometimes permanently.

Prevention:
Though there is no clear-cut way to prevent dysthymia from occurring, some suggestions may have been made. Since dysthymia will often first occur in childhood, it is important to identify children who may be at risk. It may be beneficial to work with children in helping to control their stress, increase resilience, boost self-esteem, and provide strong networks of social support. These tactics may be helpful in warding off or delaying dysthymic symptoms.

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:
https://en.wikipedia.org/wiki/Dysthymia
https://www.healthline.com/health/dysthymia

Clostridium difficile (C-Diff)

Description:
Clostridium difficile infection (CDI or C-dif) is a symptomatic infection due to the spore-forming bacterium, Clostridium difficile. Symptoms include watery diarrhea, fever, nausea, and abdominal pain. It makes up about 20% of cases of antibiotic-associated diarrhea. Complications may include pseudomembranous colitis, toxic megacolon, perforation of the colon, and sepsis.

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Clostridium difficile infection is spread by bacterial spores found within feces. Surfaces may become contaminated with the spores with further spread occurring via the hands of healthcare workers. Risk factors for infection include antibiotic or proton pump inhibitors use, hospitalization, other health problems, and older age. Diagnosis is by stool culture or testing for the bacteria’s DNA or toxins. If a person tests positive but has no symptoms, the condition is known as C. difficile colonization rather than an infection.

C. difficile infections occur in all areas of the world. About 453,000 cases occurred in the United States in 2011, resulting in 29,000 deaths. Rates of disease globally have increased between 2001 and 2016. Women are more often affected than men. The bacterium was discovered in 1935 and found to be disease-causing in 1978. In the United States, health–care associated infections increase the cost of care by US$1.5 billion each year.

Symptoms:
Many people have C diff living in their intestines and the bacteria doesn’t cause any problems for them. When kept in check by other good bacteria, C diff can cause no symptoms. However, when something (most often antibiotic usage) throws off the balance of bacteria in the body then this is when a problem can occur and C diff can start growing rapidly.

C. difficile bacteria can release toxins that attack the lining of the colon by not only destroying cells, but also creating patches of inflammatory cells that cause watery diarrhea.

Symptoms of overgrowth C diff can include:
*Watery diarrhea (at least three bowel movements per day for two days or longer)
*Appetite loss
*Nausea
*Fever
*Abdominal pain and/or tenderness

Symptoms of severe C diff infection can include:

*Watery diarrhea 10 to 15 times a day
*Abdominal cramping and pain, which may be severe
*Swollen abdomen
*Nausea
*Loss of appetite
*Pus or blood in the stool
*Fever
*Rapid heart rate
*Dehydration
*Weight loss
*Increased white blood cell count
*Kidney failure

Couses:
A C diff infection is caused by C diff bacteria. C. difficile bacteria can be found in several common places including human and animal feces as well as soil, air and water. The bacteria can also be found in some foods such as processed meat. The human intestines have somewhere around 100 trillion bacterial cells and up to 2,000 different kinds of bacteria. Much of this bacteria is good because it keeps possibly problematic bacteria in check and guards the body against infection. According to Mayo Clinic, “A small number of healthy people naturally carry the bacteria in their large intestine and don’t have ill effects from the infection.”

Risk Factors:
Antibiotics:
C. difficile colitis is associated most strongly with the use of these antibiotics: fluoroquinolones, cephalosporins, and clindamycin.

Some research suggests the routine use of antibiotics in the raising of livestock is contributing to outbreaks of bacterial infections such as C. difficile.[20]

Healthcare environment:
People are most often infected in hospitals, nursing homes, or other medical institutions, although infection outside medical settings is increasing. Individuals can develop the infection if they touch objects or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Healthcare workers could possibly spread the bacteria to patients or contaminate surfaces through hand contact. The rate of C. difficile acquisition is estimated to be 13% in patients with hospital stays of up to two weeks, and 50% with stays longer than four weeks.

Long-term hospitalization or residence in a nursing home within the previous year are independent risk factors for increased colonization.

Acid suppression medication:
Increasing rates of community-acquired CDI are associated with the use of medication to suppress gastric acid production: H2-receptor antagonists increased the risk 1.5-fold, and proton pump inhibitors by 1.7 with once-daily use and 2.4 with more than once-daily use.

Elemental diet:
As a result of suppression of healthy bacteria, via a loss of bacterial food source, prolonged use of an elemental diet elevates the risk of developing C. difficile infection.

Diagnosis:
Prior to the advent of tests to detect C. difficile toxins, the diagnosis most often was made by colonoscopy or sigmoidoscopy. The appearance of “pseudomembranes” on the mucosa of the colon or rectum is highly suggestive, but not diagnostic of the condition. The pseudomembranes are composed of an exudate made of inflammatory debris, white blood cells. Although colonoscopy and sigmoidoscopy are still employed, now stool testing for the presence of C. difficile toxins is frequently the first-line diagnostic approach. Usually, only two toxins are tested for—toxin A and toxin B—but the organism produces several others. This test is not 100% accurate, with a considerable false-negative rate even with repeat testing.

Toxin ELISA:
Assessment of the A and B toxins by enzyme-linked immunosorbent assay (ELISA) for toxin A or B (or both) has a sensitivity of 63–99% and a specificity of 93–100%.

Previously, experts recommended sending as many as three stool samples to rule out disease if initial tests are negative, but evidence suggests repeated testing during the same episode of diarrhea is of limited value and should be discouraged. C. difficile toxin should clear from the stool of previously infected patients if treatment is effective. Many hospitals only test for the prevalent toxin A. Strains that express only the B toxin are now present in many hospitals, however, so testing for both toxins should occur. Not testing for both may contribute to a delay in obtaining laboratory results, which is often the cause of prolonged illness and poor outcomes.

Other stool tests:
Stool leukocyte measurements and stool lactoferrin levels also have been proposed as diagnostic tests, but may have limited diagnostic accuracy.

PCR:
Testing of stool samples by real-time polymerase chain reaction is able to pick up the disease about 90% of the time and when positive is incorrectly positive about 4% of the time. Multistep PCR testing algorithms can improve overall performance. Repeat testing may be misleading, and testing specimens more than once every seven days in patients without new symptoms is highly unlikely to yield useful information.

Treatments:
Carrying C. difficile without symptoms is common. Treatment in those without symptoms is controversial. In general, mild cases do not require specific treatment. Oral rehydration therapy is useful in treating dehydration associated with the diarrhea.

According to the CDC: “Whenever possible, other antibiotics should be discontinued; in a small number of patients, diarrhea may go away when other antibiotics are stopped. Treatment of primary infection caused by C. difficile is an antibiotic such as metronidazole, vancomycin, or fidaxomicin. While metronidazole is not approved for treating C. difficile infections by the FDA, it has been commonly recommended and used for mild C. difficile infections; however, it should not be used for severe C. difficile infections. Whenever possible, treatment should be given by mouth and continued for a minimum of 10 days.”

Another important fact that the CDC points out is that when antibiotics are used to treat a primary C diff infection, the infection ends up coming back in around 20 percent or a fifth of patients. Even worse, for some C diff patients, the infection doesn’t just come back once, but again and again. You can imagine how difficult that must be on a person’s body. When the infection comes back the first time, the same antibiotic is typically used, but if the infection comes back more than once then stronger antibiotics are employed.

Natural Treatments:
*Stop Antibiotics Whenever Possible

*Load Up On Good Bacteria
Also get lots of probiotic-rich foods from your diet that will help to balance the intestinal flora and fight C diff. Some top probiotic foods to consume regularly: cultured dairy products (such as kefir, goat milk yogurt or cultured probiotic yogurt made from raw cow’s milk), raw apple cider vinegar, fermented vegetables (sauerkraut, kimchi, kvass) and probiotic beverages (kombucha and coconut kefir). To get the most out of apple cider vinegar, make sure to buy a raw variety with the “mother” intact, which means it still contains all its beneficial compounds including probiotics.

*Avoid or Reduce Certain Foods
According to the C Diff Foundation, there are some of the foods most people find helpful to avoid during a C Diff infection. For example dairy products,greasy, fatty foods and processed foods,some foods that are definitely healthy but may cause extra bloating, gas and discomfort,raw fruits and veggies,Processed fat-free foods like Olestra,spicy foods and large quantities of caffeine.

*Thorough Hand Washing

*Consume Natural Antibiotics like manuka honey,raw garlic, and oil of Oregano.

Prevention:

Prevention is by limiting antibiotic use, hand washing, and terminal room cleaning in hospital. Discontinuation of antibiotics may result in resolution of symptoms within three days in about 20% of those infected. Often the antibiotics metronidazole, vancomycin or fidaxomicin will cure the infection. Retesting after treatment, as long as the symptoms have resolved, is not recommended, as the person may remain colonized. Recurrences have been reported in up to 25% of people. Some tentative evidence indicates fecal microbiota transplantation and probiotics may decrease the risk of recurrence.

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:
https://en.wikipedia.org/wiki/Clostridium_difficile_infection#Role_in_disease
https://draxe.com/c-diff/