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Ailmemts & Remedies Pediatric

Hepatitis A

Definition:
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV).
This form of viral hepatitis also known as infectious hepatitis, due to its ability to be spread through personal contact. Hepatitis A is a milder liver disease than hepatitis B, and asymptomatic infections are very common, especially in children.

click to see the pictures

According to the World Health Organisation, there are an estimated 1.5 million new cases of illness due to hepatitis A each year worldwide, and many more people become infected without developing symptoms. It’s particularly common in less developed countries where poverty or poor sanitation are important factors.

Africa, northern and southern Asia, parts of South America, and southern and eastern Europe all have high rates of the disease. In these countries almost every adult carries antibodies to hepatitis A suggesting that it is quite usual for people to be exposed to the infection, usually in childhood, and to develop immunity.

The infection isn’t common in the UK, although it’s still the main type of infective hepatitis seen. (There are several other types of viral hepatitis, such as hepatitis B and hepatitis C.) In 2005, for example, there were 457 laboratory reports of confirmed hepatitis A virus (HAV) infection in England and Wales.

The majority of people from the UK who become infected with hepatitis A contract it when abroad in a country where it is very common.

Hepatitis A is an acute infection, rather than chronic (long-term). Rarely, it can cause life-threatening liver damage.Hepatitis A does not cause a carrier state or chronic liver disease. Once the infection ends, there is no lasting phase of illness.  However, it is not uncommon to have a second episode of symptoms about a month after the first; this is called a relapse.

Symptoms :
The incubation period of the virus before symptoms develop is between two and six weeks. How severely someone is affected varies from person to person. Some may not have any symptoms at all, while others may have just mild symptoms similar to those of a flu-like illness. This is particularly common among infants and young children.

The older someone is, the more severe the infection and symptoms are likely to be.

Possible symptoms include weakness, tiredness, headache, fever, loss of appetite, nausea and vomiting, abdominal pain and diarrhoea and dehydration. These may all occur for a week or more before jaundice appears.

Jaundice occurs in hepatitis infections because the liver becomes unable to remove a substance called bilirubin from the blood. This is a pigment that builds up in the body, causing the skin and whites of the eyes to turn yellow.

Causes:
HAV is found in the stool (feces) of persons infected with hepatitis A. HAV is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person infected with hepatitis A. This is called fecal-oral transmission. Thus, the virus spreads more easily in areas where there are poor sanitary conditions or where good personal hygiene is not observed. Most infections result from contact with a household member who has hepatitis A. Blood-borne infection has been documented but is rare in the United States. The common modes of transmission of hepatitis A are as follows:

•consuming food made by someone who touched infected feces
•drinking water that is contaminated by infected feces (a problem in communities with poor sewage treatment facilities)
•touching an infected person’s feces, which may occur with poor hand washing
•having direct contact in large daycare centers, especially where there are children in diapers
•being a resident of states in which hepatitis A is more common
•sexual contact with an infected person.

Risk Factors:
*Eating food that was prepared by someone who is infected with hepatitis A and poor hygiene.
*Consuming raw or undercooked shellfish (like oysters or clams).
*Eating raw foods (such as unpeeled fruits or vegetables) and drinking tap water or well water while traveling to countries where hepatitis A is common.
*Living in a community where hepatitis A is common and outbreaks occur (largely a risk factor for young children).
*Living in a house with someone who has hepatitis A.

Lifestyle factors that increase the risk of hepatitis A include:
* Travel to countries where hepatitis A is common.
* Be a man having sex with men.

Diagnosis
Hepatitis A symptoms often go unrecognized because they are not specific to hepatitis A, thus a blood test (IgM anti-HAV) is required to diagnose HAV infection. This test detects a specific antibody, called hepatitis A IgM, that develops when HAV is present in the body.

Treatment:
No specific treatment is available for hepatitis A. However, the following guidelines are often recommended:

•Fluids and diet. The best treatment is to make sure that the child drinks a lot of fluids and eats well.
•Rest. The child should rest while he or she has fever or jaundice. When fever and jaundice are gone, activity may be gradually increased as with the healthcare provider’s approval.
•Medications. The body’s immune system fights the HAV infection. Once the child recovers from hepatitis A, the virus leaves the body. Medications, prescription or nonprescription, should not be given without consulting the doctor.

About 15% of people will have a prolonged or relapsing illness lasting up to 9 months. Tragically, a small number of people die when the infection overwhelms the body. This is more likely to happen to people over the age of 60.

A person with hepatitis A should avoid drinking alcohol until their liver is completely back to normal, as alcohol is toxic to liver cells and will slow its recovery.

Ensuring good personal hygiene practices – washing your hands after using the toilet and maintaining good food preparation – is essential in avoiding infection with hepatitis A, especially if you visit a high risk area.

When visiting high-risk countries, it’s a good idea to avoid eating raw or inadequately cooked salads and vegetables, ice cream, unpeeled fruit and shellfish. Also avoid unpasteurised milk and drinks with ice, and check whether tap water is safe to drink before you go.

There’s an effective vaccination to protect people from hepatitis A infection. It’s available from your GP or high street travel centres, who will be able to advise you whether you need it for the country you are visiting. It’s recommended for anyone travelling to the high-risk regions of the world.

Those people who have already had hepatitis A usually have life long immunity.

Prognosis:
Viral hepatitis symptoms usually last three weeks to two months but may last up to six months. Children may return to daycare one week after symptoms first appear, with the doctor’s permission. Most children with hepatitis get better naturally without liver problems later in life. However, some children do have subsequent liver problems. For this reason, it is important to keep in close touch with the treating physician and to keep all followup appointments. Chronic, or relapsing, infection does not occur with hepatitis A. In the United States, serious complications are infrequent, and deaths are very rare.

Prevention:
According to the Centers for Disease Control and Prevention (CDC), routine vaccination of children is the most effective way to lower the incidence of hepatitis A nationwide. The CDC encourages implementation of routine hepatitis A vaccination programs for children in the 17 states which have the highest rates of hepatitis A. Hepatitis A vaccine has been licensed in the United States for use in persons two years of age and older. The vaccine is recommended (before exposure to hepatitis A virus) for persons who are more likely to get hepatitis A virus infection or are more likely to get seriously ill if they do get hepatitis A. The vaccines licensed in the United States as of 2004 were HAVRIX(r) (manufactured by Glaxo SmithKline) and VAQTA(r) (manufactured by Merck & Co., Inc).

Parents should teach their children always to wash their hands with soap and water after using the bathroom and before preparing and eating food. Travelers should avoid water and ice if unsure of their purity, or they can boil water for one minute before drinking it.

Short-term protection against hepatitis A is available from immune globulin, a preparation of antibodies that can be given before exposure for short-term protection against hepatitis A and for persons who have already been exposed to HAV. It can be given before and within two weeks after suspected contact with the virus.

Parental Concerns
The best way to prevent exposure to HAV is good habits in washing hands. Children should wash their hands every time they go to the bathroom. Good handwashing should be enforced at home and at daycare facilities. It is also very important to keep a clean environment, such as clean toilets, bathrooms, and clothing. If a child is diagnosed with HAV, other family members should be treated to prevent spread of the disease. The healthcare provider can help parents to plan treatment for the entire family.

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.answers.com/topic/hepatitis-a
http://www.bbc.co.uk/health/physical_health/conditions/hepatitisa1.shtml

http://nationalnursingreview.com/tag/hepatitis-a-sign/
http://www.utmedicalcenter.org/your-health/encyclopedia/general/image/9394/
http://medicalsin.com/risk-factors-hepatitis-a-symptoms-increase/
http://www.fehd.gov.hk/english/safefood/library/prevent_hepatitis_A/2.html

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News on Health & Science

Coffee Good for Chronic Hepatitis C Patients

Patients of chronic hepatitis C, who drink three or more cups of coffee daily, have a 53 percent lower risk of liver disease progression than non-coffee drinkers, says a new study
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The study, led by Neal Freedman of National Cancer Institute (NCI), found that patients with hepatitis C related cirrhosis who did not respond to treatment benefited from increased coffee intake. No effect on liver was observed in patients who drank black or green tea.

Hepatitis C virus (HCV) infects approximately 2.2 percent of the world’s population, including three million Americans. A centre for Disease Control and Prevention (CDC) cites HCV as the leading cause of liver transplantation in US, accounting for 8,000 to 10,000 deaths, annually.

The World Health Organisation (WHO) estimated that three to four million people contract HCV each year with 70 percent becoming chronic cases that can lead to cirrhosis of the liver and liver cancer.

This study included 766 participants enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had hepatitis C-related cirrhosis and failed to respond to standard treatment of the anti-viral drugs peginterferon and ribavirin, according to an NCI release.

Participants were seen every three months during the 3.8-year study period to assess clinical outcomes. Liver biopsies were also taken at 1.5 and 3.5 five years to determine the progression of liver disease.

“Results from our study suggest that patients with high coffee intake had a lower risk of disease progression,” said Freedman.

These findings will appear in the November issue of Hepatology

Sources: The Times Of India

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Health Quaries

Some Health Quaries & Answers

Eating out, a lot :-..
Q: I eat in restaurants very often as my nature of work requires a lot of travel. Some of the places look unhygienic. What should I do?

A: To protect yourself, drink only mineral water. Preferably carry your own water. Do not eat salads and uncooked vegetables. Immunise yourself against typhoid and hepatitis (jaundice). Protection against hepatitis A requires two injections six months apart. Protection against typhoid requires one injection every three years.

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Sleep interrupted :..
Q: I have to get up in the night several times to urinate. Even when I have finished, I feel there is more urine. That is really not the case as no matter how much I try, there is no more flow. I am 62 years old.

A: You may have an enlarged prostate. The organ is situated at the neck of the urethra, the pipe through which urine is passed. As age advances, it can increase in size obstructing free voiding of urine. The problem is usually benign prostatic hypertrophy or BPH, which is not cancer.

Your doctor can verify the diagnosis by examining you, doing an ultrasound and a blood test. As you wait for the results, you can ease your symptoms by avoiding caffeine and alcohol, passing urine regularly before you actually feel the urge, and staying away from antihistamine medicines.

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HPV vaccine
Q: My wife is 32 years old and we have one child. I read about the cervical cancer vaccine and would like to know if she will benefit from it.

A: The guidelines for the human papillovirus vaccine (HPV) advise routine administration for all girls between the ages of nine and 11 years. The decision to vaccinate an older woman should be taken after assessing her risk for previous HPV exposure. There is no test to prove or disprove exposure to the virus. It depends on the woman’s sexual history and that of her male contacts. If she is already exposed, then any benefit from immunisation is likely to be minimal.

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Hepatitis B
Q: I live with my aunt and I recently discovered she is hepatitis B positive. What should I do?

A: Check your hepatitis B status by doing a blood test in a recognised laboratory. If you are negative, immediately start on a course of vaccination. The dosage schedule is 0, 28 and 180 days. The injection has to be given in the arm and not the buttocks. But if you are already infected with hepatitis B, consult a hepatologist or gastroenterologist.

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Breast lump
Q: My 23-year-old niece has a lump in her breast. The doctor said we could wait and see. But I am worried.

A: Breast cancer is commoner in older women, but it does not mean a young woman cannot develop it. Particularly those women who may be carrying the BRAC1/2 genes, which are linked with a higher incidence of breast cancer, are at risk. If your niece has a lump in the breast, it is better to have it evaluated by another surgeon. She needs an ultrasound / mammogram / biopsy depending on the size of the lump. A “wait and watch” approach is not logical or scientific until the preliminary tests are done.

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Milky discharge
Q: My wife has milky discharge from both her nipples. It is seven years since the birth of our last child. She fed him for a year and a half and then the milk stopped by itself.

A: Discharge from both nipples is unlikely to be due to cancer. It can be a side effect of medications like perinorm or domperone. One of the pituitary hormones called prolactin triggers the production of milk. Some pituitary tumours cause excess prolactin secretion and this can lead to milky lateral nipple discharge. Thyroid disorders can also cause the same symptoms. Your wife’s condition needs evaluation.

 

Extra bones
Q: I have pain in the arms. It has been diagnosed as “cervical rib”.

A: Cervical ribs are extra bones attached to the neck vertebrae. They are present in 0.5 per cent of the population. They may cause no symptoms at all. In some individuals, these bones may compress the blood vessels and nerves to the arms. There may be tingling numbness and weakness of the muscles of the hands, particularly at the base of the thumb. In many individuals, it is possible to keep these symptoms at bay with regular exercise. Others may require surgery to remove the extra rib.

 

Scanty beard
Q: I have a scanty beard and want a thicker growth.

A: If you are genetically Oriental it is unlikely that your desire to grow a thick beard will meet with much success. Also, look around at your male relatives. Hair distribution on the face varies from family to family. Just to make sure everything is normal, check your testosterone levels. If that is normal, it means you are out of luck and destined to sport the clean-shaven look.

Source: The Telegraph (kolkata, India)

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Ailmemts & Remedies

Jaundice-A Royal Disease

Jaundice, icterus, hepatitis.” These three terms are interchanged by people to describe what they believe is a single common affliction, a disease that causes the skin and eyes to turn yellow. The word “jaundice” is actually a corrupted anglicised version of the French jaune coined in the 19th century by French physicians to describe what they thought was a single disease entity. Unaware of cause or cure, the discolouration was also called the morbus regius (the regal disease), with the belief that only the touch of a king could cure it.

Times have now changed and medicine has become evidence based. Tests can be done if a person becomes “jaundiced” to evaluate the “when, where and why”. Once the cause is removed, the disease will disappear.

The yellow colour is due to a pigment called bilirubin, normally produced in the spleen and liver when old red blood cells are broken down. The pigment is then metabolised in the liver and excreted. The level of bilirubin is usually 0.3 to 1.9mg/dl (milligrams per decilitre). The human eye can discern the yellow colour imparted by bilirubin when the level is three times or more than the normal 3mg/dl in the blood.

Infectious diseases can interfere with the ability of the liver cells to metabolise bilirubin. The most common infections are viral, commonly caused by the hepatitis group of viruses. There are several of these — some are transmitted through contaminated food or water, others through unprotected sex or unsterile injections.

Jaundice owing to viral hepatitis A is the commonest form of jaundice in young people. It is usually a mild self-limited disease that recovers spontaneously in one or two months. No specific treatment is required. Hepatitis B, C or E can be more severe, relapsing, fatal or chronic.

Out of this group, hepatitis A and B are preventable. Vaccination against hepatitis B is offered in a 3-dose schedule before the age of one year (it can be given later to anyone who missed it). Hepatitis A vaccine is given after the age of two years as a 2-dose schedule. Protection is almost 100 per cent.

Other infections caused by the herpes group of viruses, leptospirosis, cytomegalovirus, malaria or even severe bacterial sepsis can also cause jaundice. These diseases are not preventable by immunisation.

Jaundice is not always due to an infection. If for any reason the number of red blood cells destroyed is greater than normal, the liver is unable to cope with the overload of pigment and the person becomes jaundiced. This occurs in some hereditary blood disorders like thalassaemia, and sickle cell disease, or a hereditary metabolic defect like G6PD deficiency.

Sometimes, the liver cells themselves are defective and unable to cope with even the normal amount of bilirubin produced in the body. This occurs in certain inherited conditions like the Dubin-Johnson or the Gilbert syndrome. Several members of a family are affected, the jaundice is mild and fluctuating and it is not fatal.

Medications can be toxic to the liver and cause jaundice. Common examples are an overdose of paracetamol or even oestrogens. Alcohol is a direct toxin, poisonous to the liver cells. Consumption on a regular basis over many years can damage the liver and can result in jaundice.

Even when the bilirubin is adequately metabolised and produced in normal quantities, jaundice can occur, if the drainage ducts are blocked by stones, strictures and primary or secondary cancer deposits.

Sixty per cent of newborns can develop a “physiological” or normal self-limited jaundice. There is a rapid cell turnover in newborns and they produce bilirubin at a rate of 6 to 8 mg per kg per day, (more than twice the production rate in adults). The immature liver cells are initially unable to cope but the bilirubin production and level typically decline to the adult level within 10 to 14 days. Sometimes the jaundice is due to a mother-baby blood group incompatibility. The mother forms antibodies to the infant’s blood. This too is self limited and treatable.

The sudden appearance of jaundice in any age group should not be self diagnosed, ignored, treated with diet restrictions or herbs without a diagnosis. After consultations with a physician, appropriate blood and urine tests and, if necessary, scans or a laproscopy should be done to arrive at a diagnosis.

Eighty per cent of the jaundice in young adults is due to hepatitis A. As this disease is self-limited, quackery and miracle cures (like the touch of the king, amulets and bracelets) abound and appear successful.

Secondary jaundice recovers once the causative factor is removed. Abstaining from alcohol and discontinuing offending drugs may reverse jaundice. If a correctable obstruction is seen on scanning or a laparoscopy, surgical treatment provides relief.

The tragedy of jaundice is that ignorance and superstition stand in the way. Some treatable and curable forms of jaundice are not diagnosed or tackled till it is too late.

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.

Sources: The Telegraph (Kolkata, India)

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Herbs & Plants

Ji Gu Cao

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Botanical Name:Abrus fruticulosus Wall.ex Wight.et.Arn./ Abrus cantoniensis/ Abrus precatorius L.

Family:

Other Names:huang tou cao, da huang cao jia niu gan zi, hong mu ji caozhu yao caohuang se cao, xiao ye long ling cao
Tamil name: venkundri; Thai name: Maklam Phueak

Common Name: Chinese prayer bead grass

Local Name :Kacapiring ( Indonesia, Sunda), Ceplong saucer ( Java); Jempiring ( Acheh), Lutetium bruek, White king ( Acheh);

Description;
Kacapiring ( Gardenia) many looked after [by] people as ornamental plant or green fence having aroma fragrance interest. Kacapiring is including clump plant that is age annual and many having branch, close stick and also leaf. Kacapiring easy to grow any [by] place, either in cool area and also temperature. But, this plant more compatibly in mountain area or location that is height of more than 400 metre above permukaaan sea. Its(the tree trunk can reach height to shift 1-2 metre. Its(the interest is king sized, respects looking like white rose with [circle;coil] coronets and compiles forming one classy unities. Its(the leaf is in the form of oval, thick, lustrous and slippery at surface of its(the top leaf palm. Because fragrance of its(the interest, kacapiring has commercial value to be made perfume. Medium of breeding of this crop can be done by the way of cutting.

click to see the pictures

Medicinal Uses:

Properties(characteristics): sweet, slightly bitter, cool.

Actions & Indications:for acute viral hepatitis, stomach pain, breast cancer, tuberculosis of lymph glands, bruises and pain from injuries.

For acute hepatitis B

ji gu cao soup:

Ingredients: ji gu cao 38 g, bai hua she she cao 15 g, chi xiao dou 38 g, lean pork 110 g, sheng jiang   (raw ginger) 3 slices, hong zao 5 pieces, (cut open). Rinse all ingredients. Add water and make into soup.

Click to see:What is Rubia cordifolia and Rubia Root?Characters,Phytochemicals and Applications


Resources:

https://www.tcmassistant.com/herbs/ji-gu-cao.html
http://alternativehealing.org/ji_gu_cao.htm
http://traditional4fun.blogspot.com/2008_02_03_archive.html

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