NEUROSURGERY REPORT:Stenting Alters Flow Impingement Zone

Background: Self-expanding intracranial stent-assisted coiling of bifurcation aneurysms has recently been shown to straighten target cerebral vessels, a phenomenon with unknown hemodynamic effect.

Objective: To investigate the impact of angular remodeling in aneurysms treated with single stent-assisted coiling using computational fluid dynamic (CFD) techniques.

Methods: Fourteen patients (7 women, mean age 55) who underwent stent-coiling of 14 wide-necked bifurcation aneurysms were included based on availability of high-resolution three-dimensional rotational angiography. Pre-treatment datasets underwent virtual aneurysm removal to isolate the effect of stenting. Wall shear stress (WSS) and pressure profiles obtained from constant flow input CFD analysis were analyzed for apical hemodynamic changes.

Results: Stenting increased bifurcation angle with significant straightening immediately after treatment and at follow-up (107.3[degrees] vs. 144.9[degrees], P<.0001). The increased stented angle at follow-up led to decreased pressure drop at the bifurcation apex (12.2 vs. 9.9 Pa, P<.003) and migration of the flow impingement zone (FIZ) towards the contralateral non-stented daughter branch by a mean of 1.48+/-0.2 mm. Stent-induced angular remodeling decreased FIZ width (WFIZ) separating peak apical WSS (3.4 vs. 2.5 mm, P<.004). Analysis of FIZ distance (DFIZ) measured from parent vessel centerline showed it to be linearly (r=.58, P<.002) and WFIZ inversely correlated (r=.46, P<.02) to vessel bifurcation angle.

Conclusion: Stent-induced angular remodeling significantly altered bifurcation apex hemodynamics in a favorable direction by blunting apical pressure, and inducing narrowing and migration of the flow impingement zone, a novel response to intracranial stenting which should be added to intimal hyperplasia and flow diversion.

From: Angular Remodeling In Single Stent-Assisted Coiling Displaces and Attenuates The Flow Impingement Zone At The Neck Of Intracranial Bifurcation Aneurysms by Gao et al.

HYDROPS OF LABYRINTH

                                                    MENIERE' DISEASE

ETIOLOGY:The exact cause of the disease is still being investigated and likewise the pathogenesis but known triggers include Viral illness, Autoimmune reactions, Endocrinopathies, Allergies, Stress, Sodium and Water retention, Trauma of Head, Alcohol intoxication, Side effect of drugs e.g ototoxic antibiotic; Aminoglycosides

CLINICS:
 Main Signs: Hearing loss/Deafness,Dizziness/Vertigo,Tinnitus, Nystagmus, Aural Fullness
 Minors: Headache,change in heart activity during attacks, pale skin, cold sweat.

There is always a period of remission and exacerbation. The patient due to aural fullness can feel when the wave of attack is about to start. Attack period ranges from hour to several weeks. Based on this, patient has stages of disease;
First stage---- 1-2hours twice or thrice a year
Second stage--- 2-4hrs once a month
Third stage-----9-12hrs daily

Note that during remission, symptoms are not seen in patient except for Deafness that remains always.
Diagnostics:
Neurological examination
ENT examination;
Tuning fork test
Audiometry(subjective and objective form and this includes impedometry),
Vestibulometry
Electrocochleography (ECOG)
Electronystagmography (ENG) or videonystagmography (VNG)
Head MRI scan
Glycerol Test must be positive

Treatment
There is no known cure for this disease but it can be managed,Treatment is basically symptomatic,
Treat other diseases present in patient
Manage patient with Diuretics, Diet, Lifestyle changes and Physiotherapy.
Note that Labyrinthectomy is indicated in uncontrollable vertigo thou it doesn't cure illness but takes care of vertigo.
Prognosis in every patient can be determined by how well a doctor can manage the symptoms in patient and the course of illness in individual patient.

MOUTH SORES

Different types of sores can appear anywhere in the mouth. Some of the places mouth sores can occur are:
Bottom of the mouth
Inner cheeks
Gums
Lips
Tongue
Causes

Mouth sores may be caused by irritation from:
A sharp or broken tooth or poorly fitting dentures
Biting your cheek, tongue, or lip
Burning your mouth from hot food or drinks
Braces
Chewing tobacco

Cold sores are caused by the herpes simplex virus . They are very contagious. Usually, you will have tenderness, tingling, or burning before the actual sore appears. Cold sores usually begin as blisters and then crust over. The herpes virus can live in your body for years. It only appears as a mouth sore when something triggers it, such as:
Another illness, especially if there is a fever
Hormone changes (such as menstruation)
Stress
Sun exposure

Canker sores are not contagious. They may look like a pale or yellow ulcer with a red outer ring. You may have one, or a group of them. Women seem to get them more than men. The cause of canker sores is not clear. It may be due to:
A weakness in your immune system (for example, from the cold or flu)
Hormone changes
Stress
Lack of certain vitamins and minerals in the diet, including vitamin B12 or folate

Less commonly, mouth sores can be a sign of an illness, tumor, or reaction to a medication. This can include:
Autoimmune disorders (including systemic lupus erythematosus)
Bleeding disorders
Cancer of the mouth
Infections such as hand-foot-mouth disease
Weakened immune system -- for example, if you have AIDS or are taking medication after a transplant

Drugs that may cause mouth sores include aspirin, beta-blockers, chemotherapy medicines, penicillamine, sulfa drugs, and phenytoin.

Home Care

Mouth sores often go away in 10 to 14 days, even if you don't do anything. They sometimes last up to 6 weeks. The following steps can make you feel better:
Avoid hot beverages and foods, spicy and salty foods, and citrus.
Gargle with salt water or cool water.
Eat popsicles. This is helpful if you have a mouth burn.
Take pain relievers like acetaminophen.

For canker sores:

Mix 1 part hydrogen peroxide with 1 part water and apply this mixture to the sores using a cotton swab.
For more severe cases, treatments include fluocinonide gel (Lidex), anti-inflammatory amlexanox paste (Aphthasol), or chlorhexidine gluconate (Peridex) mouthwash.

Over-the-counter medications, such as Orabase, can protect a sore inside the lip and on the gums. Blistex or Campho-Phenique may provide some relief of canker sores and fever blisters, especially if applied when the sore first appears.
To help cold sores or fever blisters, you can also apply ice to the sore.

When to Contact a Medical Professional

Call your doctor if:
The sore begins soon after you start a new medication
You have large white patches on the roof of your mouth or your tongue (this may be thrush or another type of infection)
Your mouth sore lasts longer than 2 weeks
You have a weakened immune system (for example, from HIV or cancer)
You have other symptoms like fever, skin rash, drooling, or difficulty swallowing
What to Expect at Your Office Visit

The doctor or nurse will examine you, and closely check your mouth and tongue. You will be asked questions about your medical history and symptoms.

Treatment may include:
A medicine that numbs the area such as lidocaine to ease pain. (Do not use in children.)
An antiviral medication to treat herpes sores. (However, some experts do not think medicine makes the sores go away sooner.)
Steroid gel that you put on the sore.
A paste that reduces swelling or inflammation (such as Aphthasol).
A special type of mouthwash such as chlorhexidine gluconate (such as Peridex).

Prevention
You may reduce your chance of getting common mouth sores by:
Avoiding very hot foods or beverages
Reducing stress and practicing relaxation techniques like yoga or meditation
Chewing slowly
Using a soft-bristle toothbrush
Visiting your dentist right away if you have a sharp or broken tooth or misfitting dentures

If you seem to get canker sores often, talk to your doctor about taking folate and vitamin B12 to prevent outbreaks.

To prevent cancer of the mouth:
Do not smoke or use tobacco.
Limit alcohol to two drinks per day.
Wear a wide-brimmed hat to shade your lips. Wear a lip balm with SPF 15 at all times.

Free CME Article: Long-term Outcomes of PLIF

Background: Although posterior lumbar interbody fusion (PLIF) is regarded as an effective treatment for spondylolisthesis, few studies have reported comprehensive, long-term outcome data, and none has investigated the incidence of deterioration of outcomes.

Objective: To determine and compare the success rates and long-term stability of outcomes of open PLIF and minimal-access PLIF in the treatment of radicular pain and back pain in patients with spondylolisthesis.

Methods: Forty-three patients were followed for a minimum of 3 years. They completed a Short-Form Health Survey and visual analog scores for back pain and leg pain and underwent lumbar spine radiography. Outcomes were compared with baseline data and 12-month data.

Results: Surgery succeeded in reducing listhesis and increasing disc height, but had little effect on lumbar lordosis or the angulation of the segment treated. At 12 months after surgery, listhesis was reduced, disc height was increased, leg pain was reduced or eliminated, and physical functioning restored. Back pain was less often relieved. These outcomes were largely maintained over the ensuing 2 years. Only 5% to 10% of patients reported deterioration in their relief of pain. Depending on the definition adopted for success, the long-term success rate of PLIF may be as high as 70%.

Conclusion: For the relief of leg pain, the success rates of open PLIF (70%) and minimal-access PLIF (67%) for spondylolisthesis are high and durable in the long-term. PLIF is less often successful in relieving back pain, but the outcomes are maintained. The outcomes of open PLIF and minimal-access PLIF were statistically indistinguishable.

DBS in Lateral Habenular Complex

Background: Deep brain stimulation (DBS) has recently been discussed as a promising treatment option for severe cases of major depression. Experimental data have suggested that the lateral habenular complex (LHb-c) is a central region of depression-related neuronal circuits. Due to its location close to the midline, stereotactic targeting of the LHb-c confronts surgeons with distinct challenges.

Objective: To define the obstacles of DBS surgery for stimulation of the LHb-c and thus establish safe trajectories.

Methods: Stereotactic MRI datasets of 54 hemispheres originating from 27 DBS patients were taken for analysis on a stereotactic planning workstation. After alignment of images according to the ACPC-definition, analyses focused on vessels and enlarged ventricles interfering with trajectories.

Results: As major trajectory obstacles, (1) enlarged ventricles and (2) an interfering superior thalamic vein were found. A standard frontal trajectory (angle >40[degrees] relative to the ACPC in sagittal images) for bilateral stimulation was safely applicable in 48% of patients, whereas a steeper frontal-trajectory (angle <40[degrees] relative to ACPC in sagittal images) for bilateral stimulation was possible in 96%. Taken together, safe bilateral targeting of the LHb-c was possible in 98% of all patients.

Conclusion: Targeting LHb-c is a feasible and safe technique in the majority of patients undergoing surgery for DBS. However, meticulous individual planning to avoid interference with ventricles and thalamus-related veins is mandatory, as an alternative steep frontal entry point has to be considered in about half of the patients.

On Diabetes.

November is Diabetes awareness month and with just few days to its end I decided to write on it. Moreover, it seems to be one of the leading reason for hospital visits.

Diabetes itself means plenty urination(polyuria) and increased thirst(polydipsia). Diabetes could be Mellitus i.e related to insulin or Insipidus related to vasopressin.
The most common one is Diabetes Mellitus. Insulin is a hormone secreted in the pancreas by the beta cells of langerhans. Its secretion is stimulated by glucose in blood when we eat and hence it functions at driving glucose into cells and ensuring its usage in energy production and building up energy stores. As discussed by most recent studies by WHO, it can be classified into 4 based on its causes(Etiological)
1. Insulin Dependent Diabetes mellitus, popularly known as type 1, its know to be of juvenile onset appearing in childhood though few related cases of adult after immune stimulation has been recorded LADA. This form of DM has been related to genetics, chromosome 6 and is known to be aggravated by childhood diseases not well treated like measles, chicken pox, parotitis etc The body generate immune body T cells and B cells against this disease causing microbes but in the process generate autoimmune bodies against the insulin secreting cells in pancreas causing their death hence reduced insulin secretion.
2.NON INSULIN DEPENDENT DM: this is of adult onset thou children are been recorded to having it now. its the types most of our parents have. Its genetically related to changes in chromosome 11 and its aggravated by Obesity(most especially abdominal form of obesity). Life style has a lot to do with this, the food we eat, the drinks we take, lack of physical activities etc. What happens here is that due to excessive fat in our body, we develop resistance to insulin and then Tolerance to Glucose.
3. DM RELATED TO OTHER DISORDERS: This includes; DM associated with endocrinopathies like cushing disease, Addisons etc;genetic defects of Beta cells of pancreas, pathology of exocrine gland of pancreas, drug induced Diabetics e.g unregulated use of Beta-adrenoblockers
4.DM ASSOCIATED WITH PREGNANCY: Due to changes that occurs in woman during pregnancy, she develops resistance to insulin thou its slight in healthy pregnancy and in women who visits antenatal clinics. Hence not all pregnant women have DM thou they are a risk group during pregnancy and post delivery if not well taken care of. 

Prediabetes is an elevated blood glucose level that is not quite high enough to be diagnosed as diabetes, but is higher than normal. Most do not even know they have it. Many people with prediabetes who do not lose weight or do moderate physical activity will develop type 2 diabetes within 3 years.Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and amputations of the foot, toe or leg. Diabetes is the seventh leading cause of death

Symptoms:
frequent urinations
Increased thirst
Increased Appetite
loss of weight over time
Dizziness
sleeping in day and restless at night,visual problem, itching of skin.

Treatment:
its best to Visit a doctor and not do self medication so i will not mention specific drugs.
In DM1: mild form we only regulate patient diet
In severe, we regulate diet and do insulin therapy.
In DM2:mild form-diet
Moderate:Diet+oral hypoglycemic drugs
Severe:Diet+oral hypoglycemic drugs+Insulin
Note that in Severe case of DM2, patient is regressing into type 1 clinical features.

Complications:
Acutes: Ketoacidotic coma, Hyperglycemic coma, Hypoglycemic coma and Lactacidemic coma.

Chronics: Angiopathies, Retinopathy,Cardiomyopaties, Ischemic Heart Disease, Diabetic Foot, Encephalopathy,Respiratory Diseases, Nephropathy etc.

Prevention:

Healthy Diet

• Eat a variety of foods from all the food groups


• Choose foods high in fiber and low in cholesterol and fat (especially saturated fat)


• Eat plenty of fruits and vegetables (at least half your plate should be made up of these foods)


• Choose lean meats


• Choose whole grains over processed foods


• Consume foods in as close to their natural state as possible


• Eat in moderation and exercise portion control

Stay Active

• Lowers blood sugar: 1 minute of exercise can lower your blood glucose level by 1 to 1.5 points


• Lowers blood pressure and cholesterol


• Helps improve weight management


• Lowers your risk for heart disease and stroke


• Helps insulin work more efficiently


• Strengthens your heart, muscles and bones


• Decreases body fat and increases muscle mass


• Improves blood circulation


• Reduces stress and improves self esteem


• May help curb appetite


• Keeps body and joints flexible

Let us note that the reason this is being discussed is not to bring fears into our heart but to enlighten us about the disease and see reasons why we should have healthy lifestyles(reduce that pot belly of yours) and when diagnosed of it, follow your treatments.
                                                                                                                               Adenuga O.A

Questions

Question: 5% Dextrose in Normal Saline is: 

A.Hypotonic 
B.Isotonic
C.Hypertonic
D.A blood Substitute

TDR TB: ARE WE PREPARED

“The health is not all, but all without the health are no one.” Socrates. 

Totally drug resistant; Are we prepared for this?

Tuberculosis is one of the most serious infectious diseases of the developing world and it remains the leading cause of death from infectious disease globally. Tuberculosis (TB) is a contagious and potentially fatal disease that can affect almost any part of the body but manifests mainly as an infection of the lungs. It is caused by a bacterial microorganism, the tubercle bacillus or Mycobacterium.

 Totally drug-resistant tuberculosis (TDR-TB) is a generic term for tuberculosis strains that are resistant to a wider range of drugs than strains classified as extensively drug-resistant tuberculosis. TDR-TB has been identified in three countries; India, Iran, and Italy. The emergence of TDR-TB has been documented in four major publications. TDR-TB has resulted from further mutations within the bacterial genome to confer resistance, beyond those seen in XDR- and MDR-TB. Development of resistance is associated with poor management of cases. Drug resistance testing occurs in only 5% of TB cases worldwide. Without testing to determine drug resistance profiles, MDR- or XDR-TB patients may develop resistance to additional drugs. TDR-TB is relatively poorly documented, as many countries do not test patient samples against a broad enough range of drugs to diagnose such a comprehensive array of resistance. The United Nations' Special Programme for Research and Training in Tropical Diseases has set up a TDR Tuberculosis Specimen Bank to archive specimens of TDR-TB. Multi-drug-resistant tuberculosis (MDR-TB) is defined as tuberculosis that is resistant at least to isoniazid (INH) and rifampicin (RMP), the two most powerful first-line anti-TB drugs. Isolates that have multiple resistant to any other combination of anti-TB drugs but not to INH and RMP are not classed as MDR-TB. Extensively drug-resistant tuberculosis (XDR-TB) is a form of tuberculosis caused by bacteria that are resistant to some of the most effective anti-TB drugs. XDR-TB strains have arisen after the mismanagement of individuals with multidrug-resistant TB (MDR-TB).

Though terms likes such as “totally drug resistant” have not been clearly defined for tuberculosis by WHO. While the concept of “total drug resistance” is easily understood in general terms, in practice, in vitro drug susceptibility testing (DST) is technically challenging and limitations on the use of results remain: conventional DST for the drugs that define MDR and XDR-TB has been thoroughly studied and consensus reached on appropriate methods, critical drug concentrations that define resistance, and reliability and reproducibility of testing. Data on the reproducibility and reliability of DST for the remaining SLDs are either much more limited or have not been established, or the methodology for testing does not exist. 

To be remembered is the fact that the race by all medical practitioners to find a cure started since the existence of TB down to all its variants. Yet this mycobacterium seems to elude us as it keeps resisting each of our solution? Hence, it begs the question will these devastating disease take its leave? Will it be eradicated completely? Will our generation survive it? And if yes, will another strain of this mycobacterium exist?

Finally, I ask you all if our medical society of practitioners will survive these.

Fecal Incontinence

Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control in someone who is older than 4 years old.

Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. Fecal incontinence may be due to a weakened anal sphincter associated with aging or to damage to the nerves and muscles of the rectum and anus from giving birth.

Whatever the cause, fecal incontinence can be embarrassing. But don't shy away from talking to your doctor. Treatments are available that can improve, if not correct, fecal incontinence.

Treatments and drugs

A variety of treatments are available for fecal incontinence, depending on the severity of your symptoms. Treatment may include dietary changes, medications, special exercises that help you better control your bowels, or surgery.

Medications
Sometimes, doctors recommend medications to treat fecal incontinence, such as:

Anti-diarrheal drugs. Your doctor may recommend medications to reduce diarrhea and help you avoid fecal incontinence. A drug called loperamide (Imodium) may be used because it helps treat diarrhea.
Laxatives. If chronic constipation is to blame for your incontinence, your doctor may recommend the temporary use of mild laxatives, such as milk of magnesia, to help restore normal bowel movements.
Stool softeners. To prevent stool impaction, your doctor may recommend a stool-softening medication.
Other medications. If diarrhea is the cause of your fecal incontinence, your doctor may recommend drugs that decrease the spontaneous motion of your bowel (bowel motility) or medications that decrease the water content of your stool.
Therapies
A variety of therapies may improve fecal incontinence:

Dietary changes. What you eat and drink affects stool consistency. Your doctor may recommend changes to your diet to help improve your bowel movements.

For example, if chronic constipation is to blame for fecal incontinence, your doctor may recommend that you drink plenty of fluids and eat fiber-rich foods. A fiber supplement may also be recommended. If diarrhea is contributing to the problem, your doctor may recommend that you increase your intake of high-fiber foods to add bulk to your stools, making them less watery. In general, your doctor will recommend a diet that helps you gain good stool consistency for increased control of your bowels.

Bowel training. If fecal incontinence is due to a lack of anal sphincter control or decreased awareness of the urge to defecate, you may benefit from a bowel-training program and exercise therapies aimed at helping you restore muscle strength.

In some cases, bowel training means learning to go to the toilet at a specific time of day. For example, your doctor may recommend that you make a conscious effort to have a bowel movement after eating. This helps you gain greater control by establishing with some predictability when you need to use the toilet.

Biofeedback is another bowel-training treatment for fecal incontinence. It involves inserting a pressure-sensitive probe into your anus. This probe registers muscle strength and activity of your anal sphincter as it contracts around the probe. You can practice sphincter contractions and learn to strengthen your muscles by viewing the scale's display. These exercises can strengthen your rectal muscles.

Treatment for stool impaction. Your doctor may have to remove an impacted stool if taking laxatives or using enemas doesn't help you pass the hardened mass. To remove an impacted stool, your doctor inserts one or two gloved fingers into your rectum to break apart the impacted stool. These smaller pieces are easier to expel.
Sacral nerve stimulation. Another treatment for fecal incontinence is sacral nerve stimulation. The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Sacral nerve stimulation is carried out in stages. First, small needles are positioned in the muscles of your lower bowel, and these muscles are stimulated by an external pulse generator to identify which muscle stimulates anal contractions the most. The muscle response to the stimulation generally isn't uncomfortable. After a successful response, you may have a permanent pulse generator implanted. This treatment is usually done only if other treatments haven't worked.
Surgery
For some people, treatment of fecal incontinence requires surgery to correct an underlying problem. Surgical procedures to treat fecal incontinence aren't necessarily easy or free of complications. But, certain causes of fecal incontinence — anal sphincter damage caused by childbirth or rectal prolapse, for example — can often be effectively treated with surgery. Surgical options include:

Sphincteroplasty. This is surgery to repair a damaged or weakened anal sphincter. In this procedure, an injured area of muscle is identified and its edges are freed from the surrounding tissue. The muscle edges are then brought back and sewn together in an overlapping fashion. This strengthens the muscle, tightening the sphincter.
Treating rectal prolapse, a rectocele or hemorrhoids. If you have other problems, such as a condition in which a portion of your rectum protrudes through your anus (rectal prolapse), a protrusion of the rectum into the vaginal wall (rectocele) or hemorrhoids that are causing fecal incontinence, surgical correction of these problems will likely reduce or eliminate your fecal incontinence.
Sphincter replacement. An artificial anal sphincter can be used to replace a damaged anal sphincter. The device is essentially an inflatable cuff, which is implanted around your anal canal. When inflated, the device keeps your anal sphincter shut tight until you're ready to defecate. To go to the toilet, you use a small external pump to deflate the device and allow stool to be released. It then reinflates itself.
Sphincter repair. During a surgical procedure called a gracilis muscle transplant, a muscle is taken from your inner thigh and wrapped around your sphincter. This restores muscle tone to your sphincter.
Injection of biomaterials. Injection of a silicone-based material into the anal sphincter may improve incontinence by increasing the size of the anal sphincter. Other types of biomaterials are under study.
Colostomy. As a last resort, a colostomy may be the most definitive way to correct fecal incontinence. Colostomy is generally considered only after other treatments have failed. A colostomy is an operation that diverts stool through an opening in the abdomen. A special bag is attached to this opening to collect the stool.

Endocrinology Posting

Hey people, guess you have all been wondering how distant i have been from this blog. Yeah i was MIA.

It was endocrinology posting  and i will say it took much of my time. Well it was interesting as well as boring.

During my first few days in this rotation, i sat still trying to remember types of inflammation and which one occurs in different autoimmune scenarios, i was taken back to my knowledge of biochemistry  the many metabolic pathways: PPP(Pentose phosphate pathway), glycolytic, gluconeogenesis, glyconeogenesis, glycogenolysis, beta oxidation and Krebs cycle. Anatomical knowledge wasn't left out cos you have to know location of the endocrine organs and how they function from there location.Every Physiological detail about these organs, their reception, transport and function were also all needed to make studying pathology of the endocrine system a success.

I learnt there was no fast-forward button in med-school because for every skipped learning, you will have to press the rewind  to move on in medical career successfully.

During cu ration, i had opportunity to examine a diffuse  toxic nodular goiter patient and it was fun getting to learn from the illness and how to maintain it. i mean the anti-thyroid drugs, beta adrenoblockers and sedatives majorly calms it off.

So if you are looking forward to the cycle be sure you  enjoy it as Diabetes mellitus ad mist  others will catch your attention.

And now i am of to ENT........... 

MNEMONIC OF THE DAY

 

"Screw The Lawyer Save A Patient": branches of axillary artery

Superior thoracic
Thoracoacromiol
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral

Alternatively: "Some Times Life Seems A Pain".

THE CRIMSON TONGUE

There are five main medical reasons for the appearance of strawberry tongue. Some of these reasons can even be life threatening, especially for toddlers or pre teen children. Their immune systems are not yet able to fully handle the diseases related to this condition.

Scarlet fever is an illness that is related to strawberry tongue. This disease happens when the bacteria streptococcus invades the body. But every child that comes in contact with the bacteria may not be affected. For example, if two children from the same families are infected with streptococcus, one may come down with Scarlett fever but the other may just get a normal strep throat. The strep throat can be easily treated with an antibiotic. For some children the strep bacteria turns into toxic poison within the body. Along with the red tongue, these children also get a rash that appears to look like sunburn and can be itchy. Small blisters can also form. The rash starts on the neck and face and quickly spreads to other areas of the body. A fever and swollen lymph nodes can also be seen. If properly treated with antibiotics, Scarlett fever can be cured in around a week.

Deficiencies of certain vitamins can be a contributing factor to strawberry tongue. Folic acid and B-12 deficiencies can make a person anemic. This affects red blood cell production by reducing the cells efficiency. This opens the body up to more than a few health problems, like difficulty breathing and intestinal issues. Incorporating more vitamins into your diet can help clear up this condition. Along with pills that have to be taken for a full four months.

Kawasaki syndrome is a condition that mostly affects children under the age of five. It isn't clear what causes this disease but some of the symptoms include a high fever, swollen lymph nodes, a rash on the abdominal area and a swollen red tongue. This disease can be cleared up with the proper medication but only if it is identified immediately. If it goes unnoticed, it can cause serious heart valve damage.

Geographic tongue is a condition that can be irritating. White or bald patches appear on the tongue and although it is not a serious problem, if it persists for two weeks or longer you must see a physician. It is not known what exactly causes geographic tongue but it mostly affects women and people with compromised immune systems. It also has a genetic background because most people who acquire it have siblings with the same problem.

Bacterial toxic shock syndrome has been associated with strawberry tongue. This condition may be fatal if not immediately diagnosed. It is caused by toxins produced by staphylococcus bacteria and has many symptoms. A high fever, extreme headache, sore throat and rashes are seen with this disease. Most cases of toxic shock syndrome are related to women and tampon use but anyone can get the disease. The treatments for the disease include an intravenous drip with anti resistant antibiotics and maybe even dialysis, to remove the bacteria from the blood.