Leprosy:-

Leprosy is the infectious disease caused by Mycobacterium leprae. Peripheral nerves, upper respiratory tract and muscles are affected by leprosy. Skin lesions are main symptoms of leprosy.

Causes of Leprosy:-

Leprosy is caused by the bacteria, Mycobacterium leprae.

The incubation period of leprosy is long. So the method of disease transmission is difficult to identify. Leprosy is not a easily communicable disease. Children are more prone to get leprosy than adults.

Types of Leprosy:- there are two types of Leprosy

1. Tuberculoid and
2. Lepromatous .

Both forms have similar symptoms but, lepromatous is severe form, forms lumps on the skin and sores are worsened.

Symptoms of Leprosy:-

* NERVES, MUSCLES AND SKIN are mainly affected by leprosy.

* Peripheral nerve damage is the main symptom of leprosy. The limbs are affected first.

* Skin lesions : Skin lesions are different from other lesions. The lesions are less sensitive to touch, heat or pain. lesions Won’t heal, even after several months.

* Numbness at peripheral region : hands, feet, arms, and legs loses sensation or numbness is present.

* Muscle weakness, leads to generalized weakness.

* Mucus membrane is also affected.

Diagnosis and treatment:-

*  To distinguish tuberculoid, and lepromatous leprosy, Lepromin skin test
is done.

*  To find acid fast bacteria, skin scraping is done.

*  Antibiotics are used to combat the infection.

* Drugs such as steroids, and analgesics are given to reduce inflammation.

* Prognosis of leprosy is good, if early recognition and treatment are provided.

* People should be educated to take medical help as soon as the skin lesions appears.

Prevention of Leprosy:-

*  Close physical contact with leprosy infected person should be avoided.

*  Proper physical examination, to find lesions is important to control leprosy disease in early stage.

Blood in stool:-

Blood in stool is a complaint by the person who passes bloody stool . In medicine blood in stool is called as:-

Malena : the stool is dark blackish in color, is due to bleed in upper part of digestive tract.

Hematochezia :  The stool containing bright blood, is due to bleed in lower part of digestive tract.

The term fecal occult blood is used when presence of blood is confirmed in blood after laboratory studies.

Blood in stool is an indication of injury or bleed in the digestive tract.

when patient complaints blood in stools, no need to get anxious. The blood in the stool may be due to presence of red pigment, which is escaped from digestive tract. The small amount of fresh blood in stool is not a problem. The black, dark stool indicates that blood is from upper digestive tract , i.e. esophagus, stomach, and upper part of intestine. After passing through digestive tract blood becomes tar color. The fresh blood indicates bleeding from lower part of digestive tract. Most of the times fresh blood in stool is associated with hemorrhoids.

Causes of stool in blood:-

* bleeding in upper digestive tract.
* bleeding stomach or gastric ulcer,
* esophagus varices,
* vascular malformation,
* bowel ischemia, ( lack of blood supply to intestines )
* presence of foreign body in upper digestive tract.

Lower digestive tract causes:-

* hemorrhoids,
* fissures,
* intestinal infections,
* trauma or foreign body,
* vascular malformation,
* presence of foreign body,
* diverticular bleeding,
* tumor in lower digestive tract, etc.

Other causes:-

* bloody diarrhoea,
* colitis,
* regional enteritis,
* acute food poisoning,
* ischemic colitis, etc

The questions to be asked:-

* if blood present only on toilet paper ?
* blood is bright or dark color in stool ?
* from how many days you have noticed blood in stool ?
* are you taking anticoagulants or NSAIDS ?
* do you got any abdominal injury or ingested foreign body to digestive tract ?
* have you lost any weight recently ?
* do you have any other problems associated with blood in blood ?

Diagnostic tests:-

* colonoscopy,
* gastroscopy or EGD,
* complete and differential blood count,
* barium test,
* angiography,
* bleeding scan,
* abdominal x ray.
* test to confirm helicobacter pylori in stomach.

Prevention of blood in stool:-

* Consume green leaf vegetables and fibre rich food to reduce the risk of hemorrhoids, colon cancer, diverticulitis, and constipation.
* Drink adequate fluids to avoid constipation,
* GIVE UP SMOKING as it causes gastric ulcer and bleeding.
* Avoid alcohol consumption to avoid irritation of esophagus and stomach.
* DON’T take NSAIDS for prolonged period, as they cause intestinal bleeding.
* Get antibiotic treatment for helicobacter pylori infection.
* Get appropriate medical treatment as soon as you notice blood in stool for more than three times defecation.

Tuberous Sclerosis is a genetic disease, forms benign tumor in the brain and other vital organs of the body such as heart, kidney, lungs, eyes, skin etc. Tuberous Sclerosis mainly affects the central nervous system.

Tuberous Sclerosis is manifested by seizures, convulsions, behavioural problems, mental retardation, skin disorders, pulmonary and renal disorders, etc. Tuberous Sclerosis may be present at birth but the symptoms are seen during growing period of the child. The gyri, foldings of brain becomes thick and firm in the TSC affected  individual.

Causes of Tuberous Sclerosis:-

Genetic cause is the main cause of tuberous Sclerosis. Inheritance of autosomal dominant genes, causes Tuberous Sclerosis.

SIGNS AND SYMPTOMS:-

* Learning difficulties are the main symptoms of tuberous sclerosis, found in 50 % totally affected.
* Less intelligent quotient, ( IQ ), when large part of brain is involved.
* Autism is seen in nearly 25 % of Tuberous Sclerosis affected.
* Behavioural problems,
* Difficulty in adjustment to environment,
* Aggression,  OCD, etc.

The Tuberous Sclerosis individual Will have the symptoms of renal, pulmonary or integumentary system on the basis of tumors presence on those organs.

Diagnosis of Tuberous sclerosis:-

* Family history helps in diagnosing tuberous Sclerosis, as it helps in knowing any history of Genetic cause.
* Woods Lamp is used to visualise the skin, mouth, etc..
* CT scan, MRI scans provides clear image of the affected part.
* Ultrasound Scan is used to find tumors in the kidneys,
* Echo cardiogram, Fundoscopy, are the diagnostic tests performed for Tuberous Sclerosis.

Mumps:-

Mumps is a communicable disease causes inflammation of salivary glands, results in swelling of salivary gland and Pain. Mumps is caused by the
Virus.

Salivary glands are the glands produces the juice called saliva, which
has several enzymes and acts as lubricant for chewing food.

Causes of Mumps:-

* Mumps is caused by the virus. Mumps is transmitted through inhalation of infected droplet. The droplets are infected the person who have an infection of Mumps.

* Incubation period of mumps is 12 to 24 days.

* Children aged between 2 and 12 are prone to have Mumps, if not vaccinated to mumps.

* Adults who didn’t had vaccination of mumps also can be infected with mumps.

* The largest salivary gland parotid gland is also infected by mumps virus.

* Central nervous system, pancreas are also infected by mumps.

Symptoms of mumps:-

* Pain in the jaw and face,
* Swelling of parotid glands,
* Fever,
* Headache,
* Sore throat,
* Earache during chewing,
* Loss of appetite,
* Abdominal pain,
* Nausea, vomiting,
* swelling in temporomandibular area,

Meningitis and pancreatitis are the complications of Mumps.

Diagnosis of mumps:-

Mumps is diagnosed through, physical examination.
Physical examination confirms the swelling of salivary gland.
Serological antibody test also confirms the infection.

Treatment of Mumps:-

No specific treatment for mumps.

Apply ice packs on swelled region to relieve discomfort.

Acetaminophen can be given to relieve pain.

Antipyretics are given to relieve pain.

Don’t give aspirin to children with mumps, as it may cause Rey’s syndrome.

If once an individual comes out of mumps infection, There is no chance or recurrence for life time, as immunity to mumps is developed.

Prevention of Mumps:-

All the children should get MMR immunization, (measles, mumps, and rubella) between the age of 12 to 15 months old.
The booster dose to be given at the age of 6 years, and 12 years.

Seek medical help when the child has fever, headache, and other symptoms such as convulsions.

Jaundice:-

Yellow colouration of the body skin, conjunctiva of eye, and passing yellow coloured urine is called as Jaundice. Jaundice is also called as xxxxxIcturs.  Yellow colouration is due to excess bilirubin, a byproduct of red blood cells breakdown. Jaundice which occurs in newborns  is called as jaundice in newborns.

Increased bilirubin level in the blood called  hyperbilirubinemia,  turns mucus membrane colour into Yellow. Hyperbilirubinemia  leads to excess bilirubin in the extracellular fluid. Jaundice is the derived from french which means Yellow.

Excess Red blood cell death leads to increased bilirubin in the blood.  Normally liver processes the breakdown, old RBCs. when RBC number increases liver becomes unable to purify and bilirubin is delivered into blood stream through biliary duct.

Causes of Jaundice in newborns:-

* physiologic jaundice in new born,
* Viral hepatitis,
* autoimmune hepatitis,
* Hemolytic anaemia,
* Biliary atresia,
* Malaria,
* Gilbert’s syndrome,
* birth disorders,
* Feeding problems,

During the first week of life more than 1 % of babies undergo newborn jaundice because of physiological problems. Dehydration and/ or  low caloric intake is believed as the cause of Physiological jaundice. After a baby is one week old physiological jaundice appears and no treatment is needed for physiological jaundice. Substances present in mothers milk, and decrease infant liver capacity to deal with RBC and bilirubin may cause newborn jaundice.

Causes of Jaundice in Adults:-

* Defect in bilirubin metabolism,
* Hemolytic uremic syndrome,
* Metastatic carcinoma,
* Gallstones in the bile duct,
* Viral infection of liver, or Viral hepatitis
* Medication induced cholestasis,
* Drug induced hepatitis,
* Excess alcohol consumption and liver disease,
* Alcoholic cirrhosis,
* pancreatic cancer,
* Primary biliary cirrhosis,
* Ischemic hepatocellular jaundice,
* Intrahepatic cholestasis of pregnancy,
* Hemolytic anemia,
* Syndromes disturbs bilirubin processing,
* Chronic active hepatitis,
* Autoimmune hepatitis,
* Malaria, and other diseases causes Jaundice.

Diagnosis of Jaundice in newborns:-

Physical examination shows cornea and conjunctiva are yellow, yellowish urine,

Blood test : blood serum is tested for excess bilirubin,

Blood culture to identify hepatitis,

Urine test : confirms excess bilirubin production,

Liver biopsy,

Ultrasound scan,

Treatment of Jaundice in newborns:-

Treatment of jaundice in newborns is given on the basis of cause.

If jaundice is  due to hepatitis, it need to be cured.

Measure are taken to reduce extracellular bilirubin level in the blood serum.

A ureter is tube like structure and pain in ureter is common. Human beings have two ureters. Ureters are the muscular ducts convey urine secreted in the kidneys to urinary bladder.

There are two ureters and both are linked to the pelvis of the kidneys ( renal pelvis) in the upper side and to urinary bladder in the lower end. The place where the ureters join to bladder is called Trigon.  Joining of two ureters, and a urethra forms a triangular structure called as Trigon.

Anatomical features of uterus:-

The normal length of ureters in adults is  25-30cm long. Ureter has the diameter of 3 millimeter and has a star shaped lumen. The lumen of uterus is lined with transitional epithelium.

The ureters run  down posteroinferiorly on the lateral walls of pelvis.

The urine conveyed from the ureters is stored in the bladder and in normal cases urine will not go reverse in the ureter when the bladder is filled. The back flow of urine is not possible due to presence of ureterovesical valves, which prevents back flow of urine from bladder to ureter.

Applied anatomy or Ureter abnormalities:-

* Obstruction of the ureter,
* Ureter reflux,
* Ureter stones,
* Cancer of Ureter,
* Ureter pelvic junction,
* Urethritis, inflammation of ureter,
* Ureter cancer,
* vesicoureteric reflex,
* ureterocele,
* Megaureter,
* anatomical abnormalities of Ureter, etc.

Symptoms of ureter abnormalities:-

* Pain is common when any foreign body obstruction.
* Ureter calculi also leads to ureter pain,
* Prolapse of the ureter,
* Obstruction in urine flow,
* Discomfort in the pelvic region, etc.

Nurses:-

Nurse is a health care provider, works with other health care workers for the diagnosis, and treatment of disease and tries to restore the health and The main objective of the nurse is provide health care.

Nurse provides care for the sick, ill persons and injured or diseased persons. Along with treating the health problem nurses provide incentive  care  and emotional support to the patients.

Nurses who are qualified are also called Registered nurse. In most of countries, Graduation in nursing is compulsory to become a Registered nurse or RN.

Nurses plays an important role in history collection, collection of sample for diagnosis, medication administration, etc..

Nurses are specialised such as geriatric nurse, pediatric nurse, psychiatric nurse, etc.

Functions of nurses:-

*  Nurses provides health education about how to care of families and themselves. Health education by the nurse also includes diet, exercise,  how to follow medications and check up etc..

*  Some highly educated Nurses runs immunization centers and  clinics.

*  Nurses work in different hospital setup such as operation theater, paediatric ward, out patient department, Minor operation theater, geriatric care, psychiatric setup, obstetrics and gynaecology, and other health care setup. Nurse also provides emergency care and intensive care.

*  Most of the nurses assists doctors in diagnosing a disease,  medication administration, dressing of  wounds, etc.

*  Home health nurses provides health care going to the patients home. The nurses provides health care in helicopters or aeroplanes are called flight nurse.

*  Some nurses works in the medical laboratories, nursing homes etc..

*  Community health nurses provides health care to community people.

*  Nurses work to promote health, diagnosis, treating or cure of disease, to provide care to sick.

*  Nurses provides care to sick, mental patients, and works in rehabilitation centers.

Cerebral hemorrhage:

Cerebral hemorrhage, symptoms of cerebral hemorrhage – The article describes the causes, symptoms, diagnosis, and treatment of Cerebral hemorrhage. Bleeding inside the brain because of ruptured blood vessels is called as Cerebral hemorrhage.

Cerebrum is the main part of the brain comprises the largest part of human brain. Cerebral hemorrhage is the subtype of intracranial hemorrhage, occur within Brain tissue, or inside cranium. An external injury or mechanical injuries are the common cause of Cerebral hemorrhage. Types of intracranial hemorrhage are axial hemorrhage, epidural, subdural and subarachnoid hematomas. All these occurs inside the cranium and outside of the brain tissue. The Internal bleeding inside the brain leads to blood clots inside the brain and leads to further complications. Bleeding in the brain may occur at one part or at different regions of the brain on the basis of cause of bleeding or  hemorrhage.

Causes of Cerebral hemorrhage:

Trauma or injury to Brain : Leads to intracranial hemorrhage or ruptures the blood vessels of the cerebrum.

High blood pressure : An untreated high blood pressure also leads to rupture of small blood vessels or arterioles and leads to internal hemorrhage.

Idiopathic : Cause is unknown,

Leakage of blood from vessels leads to internal clots or causes Hematoma. Swelling, cerebral edema and hematoma creates the pressure on brain and leads to further brain damage.

Other causes are:

• Bleeding disorders such as
• Disseminated intravascular coagulation,
• Hemophilia,
• Sickle cell anaemia,
• Leukemia
• Decreased platelet levels in blood,
• anticoagulant medications such as aspirin,
• Vitamin K disorder, and
• Brain tumor

Symptoms of Cerebral hemorrhage:

Symptoms of internal hemorrhage vary on bleeding part of brain, and extent of brain tissue damage. The symptoms  develops  soon after the rupture of blood vessels in brain even during activity.  Symptoms of Cerebral hemorrhage may gradually develop slowly in case of chronic diseases.

Headache : Occur with change in body position, lying flat, bending the body, coughing, sneezing etc.

• Nausea and  vomiting
• Altered level of consciousness
• Apathy, lethargy,

Unconscious and coma with severe cerebral hemorrhage,

Change in Vision : such as Decreased vision, drooping of eyelid, vision changes, etc.

changes in Sensation  : such as decreased  sensation, numbness, facial paralysis, weak sensation, difficulty in speaking, difficulty in swallowing, unable to write, etc.

• Weakness,
• loss of coordination,
• loss of balance,
• Seizure,
• Altered sense of taste etc
• are the main symptoms of Cerebral hemorrhage

Diagnosis of Cerebral hemorrhage:

History collection of any injury, history of hypertension, etc.

Physical examination may reveal  pain on compressing the injured part,

X- ray to identify the injured part,

CT – scan for identification of bleeding site,

MRI : magnetic resonance image for perfect identification of nature and site of Cerebral hemorrhage

Treatment of Cerebral hemorrhage:

Treatment is given on the basis of cause, severity of cerebral damage, symptoms of Cerebral hemorrhage, etc.

Surgery is indicated in most of the Cerebral hemorrhage disorder,  when is not corrected with medical efforts.

AIDS and HIV:-

acquired immune deficiency syndrome, (AIDS)  is the disease caused by HIV, human immune virus resulting in destruction of human immune system. AIDS is manifested by the group of symptoms with different infections. As the immune system becomes weak an individual is prone to get any infection easily, and the worsening of disease symptoms leads to death of an individual affected with AIDS.

AIDS leads to chronic or gradual deterioration of human immune system and destroys CD4 Positive T cells there by reduces the body resistance to infections diseases. HIV infected person or AIDS person gets an endless infection and chronically becomes ill.

It is highly difficult to understand the replication and division of Human Immune Virus, so no effective Vaccine against AIDS have been established.

The main channel of transmission of AIDS or HIV is through direct contact to:-

* Mucus membrane,
* Body fluids such as blood etc..

An estimation in 2007 shows that nearly 33.2 million people lived with AIDS worldwide and 2 millions were killed by AIDS , including thousands of children.

Even though the treatment are available for AIDS / HIV infection, no permanent cure, no effective vaccines established.

HIV is a retrovirus, replicated inside the body using DNA genes.

Causes of AIDS / HIV infection:-

AIDS is a immune deficiency disorder caused by HIV. The human body has white blood cells, and lymphatic system which provides immunity to body and provides resistance by fighting against disease causing agents.  The HIV virus after entering body, establishes infection and starts destroying the  T lymphocytes in the human body, ESPECIALLY THE cd4 POSITIVE LYMPHOCYTES.  This weakens the immune power and reduces resistance of body to diseases.

Transmission of AIDS / HIV:-

Sexual transmission :  Is the main channel of AIDS / HIV  transmission. During oral sex, or active sex, the HIV is transmitted through body fluids and contact with mucus membrane and mucus produced during sex. Sharing uncleaned sexual devices which are not covered by condom also may transmit the HIV infection.

KEEP in the mind that SEX WITH HIV INFECTED PERSONS ONLY TRANSMITS THE AIDS / HIV INFECTION, NOT AN UNPROTECTED SEX WITH normal individual.  Except condom use, any other protective sex using  chemicals also may cause AIDS/ HIV infection.

Transmission through infected Blood : Contact of body membranes or body fluid with HIV infected blood causes AIDS/ HIV infection.  Infected syringes, untested  infected blood transmission, using infected razors and blades for shave, medical persons who come in contact with infected blood or infected materials such as instruments accidentally are at risk of getting AIDS/ HIV infection.

Transmission through needles : Infected needles transmits the HIV virus and causes AIDS.  Special care by medical persons not using infected needles and instruments helps in preventing AIDS.

Transmission through mother to fetus or baby : Thousands of infants or babies are infected with AIDS or HIV from the infected mother. The HIV virus is transmitted through placenta in the womb itself, and the baby in the womb get affected with AIDS /HIV.  Now a days is possible to prevent  transmission of AIDS from mother to baby in the womb.  The transmission of AIDS through mother to baby is high in poor countries.

ARE  the main causes and transmission channels of AIDS / HIV.

tips to skin care:-

* there are number of skin care formulas available to take care of skin.
* the skin bath lotions are available for different skin conditions such as dry skin, oily skin and normal skin.
* milk bath lotion is also available for skin care.
* according to skin condition, skin lotion should be selected to protect glowing skin.
* one can match the skin lotion as per skin condition.
* skin care bath lotions should be used soon after bath.
* these skin lotions nourishes skin.
* skin care lotion is also applied to wrinkled fingers and toes after bath.
* skin care bath lotions retsore the oil loses during bath.
* skin care lotions also moisturises the skin, and helps to skin glow.
* skin bath lotion is beneficial for dry skin.
* skin bath lotions can be changed with seasons.

types of skin care:-

cleansing of face :- cleansing of skin is the best method of skin care. It is ideal to clean the skin 2 to 3 times a day. If the skin is oily you need to clean the face more times a day.  For dry skin, no need of frequent cleansing and oil based cosmetic cleansers are used.

To clean the skin, water and soap is not only a method but, lotions, gels, milk, and creams are available. These creams and lotions are the mixtures of oil, wax and water, and suitable for different skin types.

* A cotton pad dipped in milk is also a effective skin cleanser.
* skin lotions and creams to be applied upward and outward movement on face.  Don,t over stretch the skin or pull it.
* Leave the skin cleanser on the face for 2 to 3 minutes. then wipe the cleanser with cotton pad or tissue paper in upward and outward movement.
* At last clean the face with water.

face mask:- Usually all face masks have face cleaning action. Clay is the ideal mask used for skin mask. Face mask helps to remove all oil content, sebum, dirt, dead skin etc.
Fuller earth is an another type of special clay used for face pack or mask. It contains aluminium silicate and helps to absorb dead skin skin and also absorbs excess oil on face; so is good for oily skin.
Kaolin is the best mask for oily skin and not for dry skin.

Oatmeal and bran, which are rich in vitamin E , and b complex are used as peelers and best for skin care.
cucumber, curds, and lemon juice are also used as skin care ingredients, which maintains acids and alkali content of face.

freshening of skin:- skin care cosmetics also include skin fresheners which contain alcohol and water.
These fresheners are applied to skin after cleaning. Skin Fresheners tones  skin and also maintains acid and alkali balances of skin.
Non alcoholic fresheners are available for dry skin care.

moisturizing:- skin moisturisers help to keep the skin moisture. Skin moisturizers not only prevent water loss of skin, but also protect from external environmental temperature.
Moisturising creams are highly beneficial for dry skin, as they keep the skin moisturised.

moisturisers are of two types:-

* oil in water emulsions and

* water in oil emulsions.

for dry skin oil based emulsions are better,  for normal skin water based emulsions are beneficial.

protection of skin:- Sun light is the most harmful factor causing skin changes. So protection of skin from ultraviolet rays is essential for healthy skin. Prolonged Exposure of skin to ultraviolet rays may cause, skin rashes, loses skin elasticity, and forms skin wrinkles. Sun burn is common with exposure to sun rays.

* Sunscreen lotions are best method to protect skin from ultraviolet rays and also from dirt and pollutants. Sunscreen lotions also keep the moisture of skin.
* sunscreen lotions and creams are available along with sun protection factors. These sunscreen creams block the ultraviolet rays of sun and protect skin.