Have other people told you that your voice is very soft or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson's disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.
What is normal?
A chest cold or other virus can cause your voice to sound different, but you should go back to sounding the same when you get over your cough or cold.
Have you been told that you have a serious, depressed or mad look on your face, even when you are not in a bad mood? This is often called facial masking. If so, you should ask your doctor about Parkinson's disease.
What is normal?
Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.
Dizziness or Fainting
Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson's disease (PD).
What is normal?
Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.
Stooping or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson's disease (PD).
What is normal?
If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
In some cases, myositis is a short-term problem that goes away after a few days or weeks. In other cases, it is part of a chronic (long-term) condition. Chronic forms of myositis can lead to muscle atrophy (wasting and shrinking) and severe disability.
There are many different types of myositis, including:
Idiopathic inflammatory myopathies. In this rare group of muscle diseases, the cause of the muscle inflammation is unknown (idiopathic). There are three major types: dermatomyositis, polymyositis and inclusion body myositis.
Infectious myositis. Myositis sometimes occurs as part of a systemic (whole body) infection, especially a viral infection. It is especially common among people who have the flu (influenza). Myositis also can be caused by trichinosis, an infection in which tiny parasites invade the muscles. People can develop this infection by eating meat that has not been cooked enough. One type of infectious myositis is called pyomyositis, a bacterial infection that causes one or more pockets of pus (abscesses) inside a muscle. It usually is caused by Staphylococcus ("staph") bacteria. Pyomyositis is a relatively common infection in developing countries in tropical climates, especially where sanitation and health care are poor. However, it sometimes occurs in the United States, primarily in people who inject illegal drugs and in people infected with HIV.
Benign acute myositis. In benign acute myositis, a young child suddenly develops severe leg pain and cannot walk normally. These symptoms are dramatic and frightening, but they usually disappear within a few days. Benign acute myositis usually occurs in children who are recovering from the flu or some other respiratory infection caused by a virus. Doctors are not sure whether the child's muscle symptoms are caused by the virus itself or by the body's immune reaction to the virus.
Myositis ossificans. In myositis ossificans, a lump of bony material forms inside a muscle. This usually happens after a muscle injury, especially a deep bruise.
Drug-induced myositis. In drug-induced myositis, muscle inflammation occurs as a side effect of a medication or a combination of medicines. Although this is rare, the most common medications that can cause myositis are the cholesterol-lowering drugs called statins, including atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) and zidovudine (Retrovir), also called AZT, a drug used to treat HIV/AIDS.
Symptoms of myositis can include muscle weakness, muscle pain and muscle tenderness. Other symptoms vary, depending on the specific cause of myositis:
Idiopathic inflammatory myopathies. These conditions typically cause painless muscle weakness that develops slowly over weeks, months or years. Although up to 40% of people with 1 of these conditions have muscle pain, the weakness is usually worse than the pain.
Infectious myositis. When infectious myositis is caused by the flu, symptoms include not only muscle aches and muscle weakness, but also high fever, chills, sore throat, cough, fatigue and runny nose. When caused by trichinosis, symptoms in the early stages include diarrhea and vomiting. Later, as the parasites invade the muscles, symptoms can include fever, eye redness with swelling in the lids and muscle pain. Patients with pyomyositis usually have a fever, and the abscessed muscle is painful, tender and slightly swollen. Skin over the muscle may be red and hot.
Benign acute myositis. A child suddenly has trouble walking and complains of severe leg pain. This pain is often worst in the calf muscles. In most cases, the child also has a history of recent fever, runny nose, sore throat and other upper respiratory symptoms.
Myositis ossificans. A lump appears in the affected muscle, and this lump may hurt when you press it. These symptoms usually begin several weeks after a muscle injury, especially a bruise.
Drug-induced myositis. Symptoms include muscle soreness, pain and weakness. These symptoms usually begin soon after a person starts taking a new drug or a combination of drugs. Myositis is more common when a person is taking a combination of lipid-lowering medications, such as gemfibrozil (Lopid) and lovastatin (Mevacor), than when a single medication is used.
Your doctor will ask you to describe your symptoms. It is especially important to describe the exact location of any weakness or muscle pain and how long you have had it. The doctor also will review your medical history and current medications.
Next, your doctor will examine you, paying special attention to your muscles and nerves. Depending on what your doctor finds, he or she may order diagnostic tests. Common tests used to diagnose muscle problems include:
Blood tests to measure levels of muscle enzymes, auto-antibodies (antibodies directed against one's own cells or organs) and antibodies to infectious agents
An electromyogram, a test that measures the electrical activity of muscles
Magnetic resonance imaging (MRI), a painless scan that can identify abnormal muscle and can be used to locate the best site for a biopsy to establish the diagnosis or to monitor the progress of a known type of myositis
A standard X-ray or a bone scan if your doctor suspects you have myositis ossificans
An ultrasound, computed tomography (CT) scan or MRI if pyomyositis is suspected
Avian influenza (bird flu) is a notifiable disease in the UK and is listed in section 88 of the Animal Health Act 1981. Section 15 (1) of the Act says:
“Any person having in their possession or under their charge an animal affected or suspected of having one of these diseases must, with all practicable speed, notify that fact to a police constable.”
Loosely translated this means that if you suspect or are aware of the presence of a notifiable disease there is a legal obligation to notify a DEFRA Divisional Veterinary Manager immediately. DEFRA is the Department of the Environment, Food and Rural Affairs and is responsible for overseeing animal health in the UK.
Avian influenza in birds is spread via secretions from the eyes, respiratory tract and from faecal matter, with droplets of liquid sneezed by infected birds spreading the disease extremely rapidly in environments where large numbers of birds are housed. In wild birds the situation is different with many migratory birds (including waterfowl, sea birds and shore birds) carrying the virus for long distances and being implicated in the international spread of the disease. Migratory waterfowl - most notably wild ducks - are the natural reservoir of bird flu viruses and these birds are also the most resistant to infection. They can carry the virus over great distances and excrete it in their droppings, yet develop only mild and short-lived illness themselves. There is a great deal of speculation about the importance of this very large reservoir of influenza viruses in wild birds as it is a source of viruses for other species, including humans, lower mammals, and birds. The high rate of infection allows for the maintenance and emergence of new and potentially highly dangerous strains by means of mutation and/or genetic reassortment.
Some strains of avian influenza can be transmitted to humans and other animals but this is normally only the case following high levels of exposure to infected birds and/or their faecal matter. People most at risk would be those involved in intensive farming, in particular the poultry industry. These strains will normally only cause mild symptoms in humans but a current south-east Asian strain has caused a number of deaths. Although humans can be infected from birds the current highly pathogenic H5N1 strain does not readily infect people and there is very little chance, if any, for human-to-human spread of the disease.
The main significance for human health is that birds could be the source of new strains of influenza virus. Existing bird strains could mutate to form a new strain, which could, in turn, readily infect humans. Likewise, if mammals are infected with both human and avian strains of the disease at the same time the mixing of genetic material from the two viruses might produce new strains. These strains would have the potential to spread readily between humans. If a new strain of avian flu was to mutate, humans would have little or no immunity to it and a serious worldwide epidemic could occur.
Although avian influenza has hit the headlines on numerous occasions over the last few years the disease is yet to have a major impact in the UK, with only minor outbreaks which have been confined to poultry production units. The most recent outbreaks of avian influenza have been the low pathogenic strain with an outbreak of H7N2 in Conwy, North Wales in May 2007 and more recently an outbreak of the H7 strain in St Helens, Merseyside in June 2007. In both cases restrictions that were imposed on the sites concerned were removed promptly, in the case of Conwy within 5/6 weeks of investigation and in the case of St Helens within a day of investigation. The most recent outbreak of highly pathogenic avian flu was the strain H5N1 identified on a poultry unit in Holton, Suffolk in February 2007. Amongst restrictions imposed on the facility were a 3 km Protection Zone and a 10 km Surveillance Zone along with a much wider Restriction Zone. All restrictions were removed from the farm just over one month later.
Although avian influenza has been restricted, in the main, to the mass production of poultry, the feral pigeon has inevitably been identified as one species that has the potential to carry and pass the disease onto humans based on the birds’ close association with man. The main focus of attention has been the racing pigeon industry due to the fact that it involves the transportation of pigeons across international borders. Clearly, if pigeons are released in EU countries where avian influenza is active, when they return to lofts in the UK there is clear potential for those birds to carry and transmit the disease to other domesticated birds, wild birds and animals and indeed humans. As it is migratory birds that are considered to be the main carriers of avian influenza, racing pigeons must also fall into this category as they are frequently required to cross international borders.
Much research has been carried out to better understand the threat posed by the pigeon (feral and domesticated) and research is ongoing in many parts of the world, particularly in those countries worst affected. A thorough scientific research programme was undertaken following the outbreak of the highly pathogenic strain H5N2 in the north-eastern United States (in 1983/4) to assess the potential for wild birds to spread disease amongst local farms. The following species were included in this survey:
- Wild and free-flying domestic ducks and geese
- Wild or free-flying domestic birds (including pigeons)
- Dead or sick birds within the quarantine area
Attempts to isolate the virus were conducted on a sample of 4,132 birds, of which 473 were pigeons, and of this number 92.6% were collected from infected farms. A further 81 feet, taken from dead pigeons, were also assessed for the purposes of the research - this is because pigeons commonly feed on agricultural sites and by walking in infected faecal matter the birds could potentially pass on the disease. In order to assess the sample, tracheal (throat) and vent (anus) swabs were taken from each bird. None of the 4,132 birds collected tested positive for the H5N2 strain. Blood samples taken from 383 pigeons were also negative for antibodies (antibodies are protective substances that are produced by the defensive network of the body in response to an infection) to avian influenza, an indication that infection by this virus had not occurred in these birds. An additional 50 pigeons, collected from within the quarantine zone, were also negative for the influenza virus. Experimental attempts made to infect pigeons with the highly pathogenic H5N2 strain of avian influenza did not result in either multiplication of the virus or any evidence of antibodies in the blood. The results of all of these studies indicated that pigeons were not infected with avian influenza and did not spread it.
In another outbreak of avian influenza in the USA in 1993 (in the period February to May) blood samples were collected from 17 flocks of pigeons located within the quarantine area for evidence of antibodies to avian influenza. Flock sizes varied from 2000 - 3000 birds and represented a total of between 34,000 and 51,000 birds. Approximately 10 birds per flock were sampled (a total of 160 birds) and in every instance all pigeons tested were negative for antibodies to this avian influenza.
Another study published in 1996 on the susceptibility of pigeons to avian influenza found that groups of pigeons inoculated with two strains of highly pathogenic influenza virus, or two strains of non-pathogenic virus, remained healthy during the 21-day trial period. The sample did not shed virus and did not develop antibodies to this disease - further evidence that pigeons are not a factor in the spread of avian influenza. More recent scientific evidence, from experimental work in 2001/2002, has shown that pigeons infected with the highly pathogenic form of the virus (designated H5N1 of Hong Kong origin) did not develop signs of this disease and did not have detectable changes to the disease in their tissues. Neither was the virus found in their tissues and nor was it re-isolated from swabs of tissues. These findings indicated once again that pigeons (along with starlings, rats and rabbits used in these studies) are largely resistant to infection with this highly pathogenic strain of the virus.
It is quite clear from all the information available that avian influenza continues to be a threat to both humans and birds, but the likelihood of its transmission to humans as a result of contact with the feral pigeon or its faeces is virtually nil. The feral pigeon is reputed to be the ultimate disease-carrier, harbouring the capability to spread a huge variety of diseases to both humans and other birds and animals, but in reality this is a myth. As can be seen from the findings of several research programmes, the feral pigeon is at the bottom of the list of those species that have the potential to spread avian influenza and it is likely that this is the case with most of the other diseases that are commonly associated with the pigeon.
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Influenza is transmitted to a healthy person from an infected person through tiny droplets expelled from a runny nose or during sneezing, breathing or coughing.
People with weak immune systems are more prone to getting infected. Once the virus attaches itself to cell receptors, it replicates in large quantities and invades the entire body.
Influenza: phases of viral replication
The first signs of influenza are felt after round 48 hours (incubation period) of the viral infection. The influenza virus originates and infects the human body in 4 phases. They are:
a) Attachment: The virus binds to a respiratory epithelial cell membrane.
b) Endocytosis: The virus wraps in an endocytic vesicle and releases mucleocapsides into the cytoplasm of the cell.
c) Replication: Genome of influenza virus serves as a template using which each infected cell produces virus in large number
d) Protein synthesis: The virus starts using the energy released from cellular metabolism to synthesize its own proteins.
Vaccination for Influenza
Vaccination is perhaps the best guard against influenza infection. Prophylaxis is the most commonly administered vaccination for influenza. However the kind of vaccination administered depends on the epidemiological context.
The effectiveness of Influenza vaccination lasts for around a year, after which fresh vaccination is required. The body develops immunity after round two weeks of vaccination. In addition, the vaccination is effective only against certain strains of influenza and may fail as new strains originate.
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The re-appearance of iodine deficiency and hypothyroidism in developed countries is caused by a trend towards low salt consumption. In a bid to reduce the risk factor for hypertension and edema, most people in affluent nations are taking the widely publicized health advice to drop salt from their diet.
Unfortunately, iodized salt has been the most used and the most effective public health initiative to reduce iodine deficiency and prevent goiter, cretinism, and hypothyroidism.
Adding iodine to salt is a very cheap means of eradicating iodine deficiency. Experts estimate that it costs only a few cents for every ton of salt produced.
However, care should be taking with treating iodine deficiency with iodized salt.
Where the deficiency is severe and met with high intake of iodized salt, hyperthyroidism may result. In addition, people who are older than 40 years have a greater risk of developing hyperthyroidism from taking iron-fortified food products.
Where salt consumption is heavily restricted, iodine can still be obtained from the diet by eating more saltwater fish and sea vegetables such as kelp.
With swine flu claiming so many lives across the nation it is little tricky to give a straight answer to such a simple question. However, there is a fair amount of chance to recover from the flu if tr
With swine flu claiming so many lives across the nation it is little tricky to give a straight answer to such a simple question. However, there is a fair amount of chance to recover from the flu if treatment and care can be provided on time and during the initial phase soon after contracting the viral infection.
‘One must realise that unlike other viral diseases like leptospirosis, malaria, dengue where the entire immune system and all major organs have to face the wrath of the virus, in case of swine flu, the immunity of a person is suppressed and only the lung function is affected, although to a great extent. So, recovery of a patient from swine flu largely depends on the extent of lung damage one has faced due to the virus,’ says Dr Prakash Jiandani, director of critical care unit, Wockhardt Hospital, South Mumbai. In some rare cases of swine flu, it can also lead to cardiac arrest and brain damage. But most of the time, a life is lost battling a respiratory infection because of swine flu and it doesn’t reach to that extreme. Here is all that you need to know about the treatment and medication of swine flu.
Lines of treatment
In case of swine flu, the first line of treatment is antiviral therapy given either by oral suspension or in capsule form. If a patient fails to recover with oral medications the second line of treatment would be to start on ventilation. ‘The idea of starting a patient suffering with moderate to severe symptoms of swine flu on ventilation, is done to restore oxygen supply in the blood and revive lung function. However, one must realise that even best ventilation mechanisms can help patients only to a certain extent. If the damage done to the lungs is beyond any repair, then even the best of supportive care provided would fail to help one survive any longer,’ informs Dr Jiandani. Here are the symptoms of swine flu you should know about.
Prevention is better than cure
This is the reason why preventing a bout of swine flu is more important than treating it. ‘It is necessary to take steps early and visit the doctor if you develop any symptoms of the seasonal flu. However, not all the healthy individual with cold and cough needs to be treated for swine flu. One should be diagnosed carefully for the symptoms, especially those who fall under the risk group, like people suffering from High BP, diabetes or the elderly,’ says Dr Jiandani. Here are 15 tips for everyone to prevent a bout of swine flu.
Oral antiviral medication, when given within 48 hours after experiencing the symptoms can help one recover fast. However, if it delays recovery then oxygen therapy with proper ventilation goes in long way to resurrect lung function. ‘High frequency ventilation or extracorporeal membrane oxygenation (ECMO) can help patients recover from the symptoms of flu,’ says Dr Jiandani. (Read: IMA guidelines to tackle swine flu (H1N1 influenza) in India)