Pertussis : Causes, Symptoms, Diagnosis, Treatment


Pertussis is also called as whooping cough. Pertussis is an  important communicable disease caused by bacteria,  results in uncontrollable, violent cough. Especially children are affected with pertussis.  As the sound comes during cough and taking air in, is called as whooping cough.  Nearly 5000 to 10000 children in united states are dieing every year because of pertussis.

Causes of pertussis

Bordetella pertussis, the bacteria causes pertussis infection. Pertussis is the disease of upper respiratory tract, if not treated causes permanent disability in children and may lead to death. Pertussis transmitted when an infected person sneezes or coughs, the bacteria spreads to air, and the person who inhales pertussis infected air droplets becomes infected with pertussis. Hence pertussis is an infectious disease easily spreads from person to person. Cough, sneezing, runny nose are the early symptoms of pertussis. After the pertussis bacteria multiplies in body, severe cough starts. Children experience weakness, fatigue and discomfort as the cough becomes severe. The continuous cough leads to impaired breathing and the children make whoop sound after coughing, is called whooping cough. Whooping sound is absent in infants less than 8 months. Some children vomits along with small amount of sputum. Coughing and vomiting simultaneously may lead to chocking in infants. Pertussis infection usually lasts for a period of 6 weeks. Whooping cough affects not only children but elder people can also get infected with pertussis. Now the incidence of pertussis is reduced as children are immunized during infancy, and higher rate pertussis is seen in  adolescents and elders.

Symptoms of pertussis

  • Runny nose, sneezing
  • mild fever up to 102 °F.
  • Severe, continuous cough
  • difficulty in  breathing
  • both night and day cough,
  • vomiting with sputum and cough,
  • dry cough develops after some days,
  • presence of whooping sound after cough while taking breath,
  • generalized weakness and fatigue,
  • Some children will have diarrhoea,
  • Choking may occur in infants.

Diagnosis of pertussis

The initial diagnosis is the physical examination and history collection. The symptoms of pertussis are similar to pneumonia and the careful examination is needed to diagnose pertussis.

  • Sputum test for bacterial culture,
  • Nasal secretions test in laboratory,
  • Chest x ray is also taken to differentiate from pertussis.
  • Blood test is done to check elevated white blood cells.

Treatment of Pertussis

Antibiotics such as erythromycin and amoxicillin are the choice of drugs for pertussis treatment. Analgesics and antipyretics  are given to reduce fever and body ache. Incentive care should be taken to treat the infants infected with pertussis, and careful monitoring of progress of diseases and prognosis of treatment is needed. Hospitalization is needed in severe pertussis infected children. An oxygen tent with high humidity is used for infants have breathing difficulty. Intravenous fluids administration is also done to maintain water and electrolyte balance. Sedatives  may be given by the pediatrician for young children to avoid crying and induce sleep. Expectorants, and cough suppressants are  not helpful in treating pertussis.

Prevention of pertussis

The DPT vaccine ( diphtheria, pertussis,tetanus) or only pertussis vaccine Helps lot in preventing pertussis. Immunization schedule n most of countries  recommended for DPT-vaccine in infancy itself. The booster shot of pertussis is given after some months in infants. In adults also booster dose of pertussis is given to prevent pertussis in adolescents and adults. Pertussis affected children should follow the measures to prevent spread of pertussis infection by wearing face mask, or avoiding school for some days. The vaccination also given to elders aged above 65 years to prevent pertussis.

Diabetes symptoms : Type 1 and Type 2 Diabetes symptoms

Diabetes symptoms

Diabetes has affected the millions of people world wide. The main types of diabetes are type 1 and type 2 diabetes mellitus. Both types of diabetes have the same diabetes symptoms. The main symptom of diabetes is imbalanced blood sugar level. Hyperglycemia is the main diabetes symptoms and others are as follows. The diabetes symptoms  are because of poor insulin production or insulin resistance by the peripheral tissues.

Type 1 Diabetes symptoms

In type 1 diabetes,  pancreas is unable to produce sufficient insulin due to autoimmune disorder or viral damage of pancreas. The insulin has the function of converting excess glucose in the blood into glycogen. The decreased insulin level in the body fails to convert glucose into glycogen, and leads to hyperglycemia, is the main diabetes symptoms. when glucose level is less in the body, the fat is broken down excess to produce energy. This  leads to formation of ketone bodies. Excess ketone bodies causes ketoacidosis is another symptoms of diabetes. Dehydration is seen due to electrolyte disturbance. Severe hyperglycemia may lead to coma and death.

Type 2 Diabetes symptoms


Increase in urine production and eliminating excess urine is an important diabetes symptoms. Polyuria leads to  dehydration because both sugar and  a large amount of water from body is also excreted out.


The person feels frequently drinking water. The increased glucose in blood stimulates central nervous system to provoke thirst.


The hormone insulin has a role of stimulating hunger. when blood  sugar level is high  in blood, body produces insulin to maintain homeostasis, this leads to increased hunger by a diabetes patient. Polyphagia is the common one among diabetes symptoms.


When there is no adequate glucose supply to the cells, stored fat of body is metabolized to gain energy. When fat is broken down in the body, excess calorie is burned and it leads to fatigue.

Weight loss

The diabetes symptoms such as glycosuria, polyphagia, polyuria, and excess fat metabolism in body  leads to weight loss. Some individuals will gain weight because of increased appetite.

Blurred vision

Hyperosmolar hyperglycemia nonketotic syndrome occurs when body fluid is pulled out of tissues. Due to hyperglycemia the  fluid inside eye lenses is also pulled out,  and weak ability of lens to focus, results in  blurred vision.


The inadequate blood supply to peripheral parts of the body causes peripheral neuritis, characterized by itching and burning pain in sole, etc..

Poor wound healing

 Increased  blood sugar resists the well development of WBC, (white blood cell) which provides immunity to our body. When WBC cells do not function effectively, wound healing is failed or becomes poor. Another cause of poor wound healing is thickened blood vessels  because of prolonged untreated diabetes. This diabetes symptoms may lead to gangrene formation of infected wound.

These are the main diabetes symptoms. The diabetes symptoms should be treated before the disease becomes complicated.

Diabetes : Type 2 diabetes Treatment, Diabetes diet

Diabetes Mellitus

Diabetes Mellitus is a multi system disease related to abnormal insulin production, impaired insulin utilization, or both. It is a serious health problem throughout the world. Factors that cause diabetes mellitus are as follows: age, hereditary, nutrition, pancreatic disorders etc. Diabetes insipidus and diabetes mellitus are the two types of diabetes and diabetes treatment has lesson the symptoms and relieved from developing complications.

Diabetes Treatment

1) Nutritional Therapy

 Nutritional therapy is the most important step to treat Diabetes Mellitus. The measure steps involved in nutritional therapy is to avoiding high sugar containing foods.

Nutritional therapy For Type-1 Diabetes Treatment

  • Calories- to decrease the body weight and restoring the body tissues help in achieving sugar level in control in diabetes patients.
  • Diet and insulin therapy both helps in the control of blood sugar in diabetes patients.
  • Avoid over intake of glucose by diabetes individual.
  • Flexibility should be avoided in the insulin treatment for diabetes treatment.
  • Moderate physical activities along with the 20 g/hr of Carbohydrates should be maintained for diabetes treatment.
  • Should include more intake of green leafy vegetables in their daily meals and fruits that have low sugar content should be taken.

Nutritional therapy for type 2 diabetes

  • Caloric intake should be reduced in over weight or obese patients, as an effective diabetes treatment.
  • Diet alone can sufficiently control blood glucose level.
  • Weight should be reduced to prevent development of Diabetes for success of diabetes treatment.
  • Avoid bed time snacks.
  • If the patient is in insulin or sulfonylureas diabetes treatment, it is necessary to be in nutritional supplement for exercise programs.
  • Alcohol should be avoided because it is high in calories, has no nutritive value, and alcohol also promotes hypertriglyceridemia.
  • High fat contained foods are strictly avoided.
  • More carbohydrate foods should be included in diet along with the protein and very less fat in food.
  • Carbohydrates decreases the absorption of other foods, hence prevent the hyperglycemic state in the patient.
  • High fiber diet decreases the fat absorption in the gastrointestinal track.
  • Artificial sweeteners should be avoided and all above are the nutritional diabetes treatment methods.

2) EXERCISE -Diabetes treatment 

Exercise decreases the blood glucose level by, increasing the glucose uptake by the body muscles and improving the utilization of the insulin by the body tissues. And also decreases the cardiovascular risk factors, by maintaining the balance in the blood i.e, exercise increases the high-density lipoproteins and decreases the amount of low-density lipoprotein in the blood, and hence it alter the blood lipid level. So exercise is an effective method of diabetes treatment. Exercise also improves the feeling of well being and reduces the emotional stress in diabetic patient.

Exercise should be done preferably at the same time daily and in the same amount each day. Walking is safe and beneficial form of exercise in most of the patient as diabetes treatment and it does not require any special precautions to be taken. It is important to increase the exercise gradually is recommended. Vigorous exercises in diabetes treatment is avoided because it is not safe, vigorous exercise increases the blood glucose rapidly, that may lead to diabetes complication. It is better to the exercises after having meals, when the blood glucose rises. It is also important to monitor the blood glucose level during and as well after and before the exercise you begin. Exercises  are best diabetes treatment method.

  • A precaution that to be taken in exercise therapy for diabetes treatment includes
  • Appropriate use of foot wears and other protective equipments.
  • Exercise should be avoided in an extreme heat or cold.
  • Daily inspection of feet is done by diabetic patient during diabetes treatment.
  • Exercise should be avoided during the periods of metabolic rate, for diabetes treatment.

3) Pharmacological therapy – Diabetes treatment

Insulin therapy: insulin is a hormone secreted by the pancreas, which maintain the normal blood glucose level by increasing glucose transport and glucose absorption by the body tissues. Insulin is available in various forms for example Humulin R. lispro, linte, glargine, NPH etc. Insulin therapy is the effective diabetes treatment.

Types of Insulin for diabetes treatment

Short acting insulin. Eg- regular (Humulin R, Novoli N)
Long acting insulin. Eg- Ultralintel (Humilin U).
Combination therapy. Eg- NPH/regular 50/50 (Humulin 50/50).
Rapidly acting insulin. Eg- Lispro (Humalog), Aspart (Novolog).

Drug Therapy for Diabetes treatment

Sulfonylureas : Since 1950 these are widely used anti diabetic drugs. Sulfonylureas are of 2 types’ first generation and second generation are commonly used drugs for diabetes treatment. Eg-Orinase, Dymelor.

Maglitinides : These drugs increase insulin production from the pancreas. And before administration of maglitinides the patient should be advised to take it 30 min before each meal for successful diabetes treatment.

Biguanides : These primarily action of these drugs include, these drugs reduce glucose production by the liver, and it also enhance the insulin sensitivity at the tissue level. Eg- Metformin, Glucovance.

Alfa Glucosidase inhibitors: Also known as “stomach blocker”. These work by slowing down the absorption of carbohydrate in the small intestine. These taken with the first bite of each meal, they are more effective in lowering post-prandial blood glucose in diabetes treatment.  Eg- Glyset, Precose.

Thiazolidinediones: “insulin sensitizers”. Eg- Pioglitazone (Actos). Rosiglitol (Glyset). Other drugs used for diabetes treatment which affects Blood Glucose Levels are : these drugs involve both Glucose-Lowering effect ( acetaminophen, allopurinol, Biguanides) and Glucose-Raising Effect (acetazolamide, Alcohol, Arginine etc)

4) Monitoring of Blood Glucose for diabetes treatment  

It is the self monitoring of the glucose in the urine. This procedure was used  in the past. The draw back of this diabetes treatment is, it does not provide current blood glucose level.In the hospital portable glucose meters are used to check the blood glucose level. This gives more quick results, hence it is most preferably used in the hospitals for diabetes treatment.

5) Pancreas Transplantation for diabetes treatment

: This procedure for diabetes treatment is used as the treatment of the option for patients with types I diabetes mellitus. Who have end-stage renal disease.

Indication for the patients who do not have renal failure : a history of frequent, acute, and severe metabolic complications. Eg- Hypoglycemia, Hyperglycemia, Ketoacidosis.
Clinical and emotional problem with exogenous insulin therapy those are as severe as to be incapacitating.
Consistent failure of insulin-based management to prevent acute complications.

Pregnancy symptoms : early signs and symptoms of pregnancy

Early pregnancy symptoms

Pregnancy symptoms are the experiences felt by the mother during gestational period. The pregnancy symptoms varies from one woman to another. Pregnancy symptoms varies in their frequency, intensity and duration. The pregnancy symptoms can appear same as that of pre-menstrual discomforts.The woman experiences variety of physical mental changes in the period of pregnancy. These all pregnancy symptoms are listed below. These are considered as typical early pregnancy symptoms, these may in there duration of appearance. Some of the pregnancy symptoms are subtle, they are not obvious.

The pregnancy symptoms may confused with other pathological causes. Pregnancy symptoms may occur within a week of conception but these may occur after few weeks in other woman. For confirmation of Pregnancy symptoms the woman must undergo pregnancy test. Following are the important Pregnancy symptoms.

Pregnancy symptoms no – 1

Amenorrhea : There is missing in monthly regular menstrual cycle is called amenorrhea. This is most important symptom of pregnancy, if there is absence of two continues cycle indicate conception and is the early and vital sign of pregnancy. But sometimes it may confuse with other causes, so the woman must undergo pregnancy test immediately.

Some woman might not have missing of cycle but experience lighter period when compared with the previous cycles is also a pregnancy symptoms. Sometimes there are chances of delay in the duration of the menstruation. And the next period should miss if the woman is under pregnancy. Differential diagnosis of pregnancy symptoms : These amenorrhea symptoms often confused with hormonal problems, fatigue, Excessive weight gain/loss, breast-feeding, ceasing to take the birth control pill, tension, stress. So the woman must undergo pregnancy test as soon as possible.

Pregnancy symptoms – 2

Increase in the breast size :There will be chances of Breast Tenderness, that means swollen, and enlarge in size of the breast and breast sore will be present. These changes might happen because of breast undergo some hormonal changes for the purpose of producing milk. This is one of the pregnancy symptoms.

When women becomes pregnant, mother’s body begins preparing  breasts for producing milk and breastfeeding. Hormones start increasing. In addition to breast tenderness and swelling,   nipples may feel sore or extra sensitive. Some women notice their nipples darken in color.

There will be development of primary and secondary areola leads to darkening of the nipples, and the breast will becomes more sensitive. This is the most important early symptom of pregnancy. Differential diagnosis of pregnancy symptoms : Enlargement of the breast is often confused side effects of birth control pills, hormonal imbalance, impending menstruation also will cause the breast tenderness.

Pregnancy symptoms – 3

Fatigue : Because of the growth of the fetus there is increase in the fatigue and exhaustion. The mother will start to go to bed as sooner and she will be tired of doing a small works, she will feel harder to get from bed in the morning.

Mother has to put more efforts for exercises, simple activities may feel wiped and the mother feels light headed.

Differential diagnosis of pregnancy symptoms: Fatigue also associated with exhaustion, stress, common cold or flu, depression and other illness also causes feeling of tiredness or fatigued.

Pregnancy symptoms – 4

Nausea/Morning sickness : There is a presence of sensation of vomiting, this is a signs of queasiness, the mother will have nausea in the morning when she is going to have coffee or if she is going to take breakfast on an empty stomach. During this period mother will suffer from this problem very adversely. Morning sickness is also important among Pregnancy symptoms.
This can be reduced by eating smaller, and by taking more frequent snack size meals. And also it can be helped with saltine crackers and milk. This will appear after a period of month and it will persist till the body get adjust to the changes.

Differential diagnosis  of Pregnancy symptoms: This is also associated with food poisoning, other stomach disorders and stress can also cause mother to feel queasy.

Pregnancy symptoms – 5

Frequent Urination : It is one of the early pregnancy symptom mother will frequently void the urine. This pregnancy symptom is due to increase in the size of the uterus puts more pressure on the bladder causing frequent urination.

This also due increase in volume of body fluids and there is increase in process of kidneys and bladder. This pregnancy symptom will persist till nine months.

Other causes: Diabetes, urinary tract infection, increasing liquid intake and taking excessive diuretics.

Pregnancy symptom – 6

Heartburn and/or Constipation : Due to presence of the oestrogen hormone there is relaxation of the cardiac sphincter so it leads to gastroesophageal reflux. The gastric content will reflux in to the oesophagus and causing burning sensation. And also it caused due to increase in the size of the uterus will pushing the other organs towards the stomach. Heartburn is the minor Pregnancy symptoms.

Increased level of hormones may slow down the digestion, leading to heartburn. The bowel function will allow the body to absorb the minerals and vitamins, nutrients as much as possible from the foods.
Treatment includes drinking plenty of water and eats fruits, small frequent foods and vegetables, soda crackers and sparkling water will help to reduce the burning. And it also can be reduced by taking some quality vitamin formulas contain digestive enzymes will help with digestion. In severe cases mother should have to take some antacids prescribed by the doctor.

Pregnancy symptoms  – 7

Higher body temperature : There will be increase in the temperature of the body higher than the normal and it will persist for two weeks. But if the fever is persists for prolonged period mother may have to seek the doctor. Higher body temperature is the minor Pregnancy symptoms.

Pregnancy symptom – 8

Lack of concentration : Because of the fatigue, morning sickness the mother will feel mentally fuzzy, and even when the mother took the rest she may experience an inability to concentrate and she will have forgetfulness. Lack of concentration is also a minor pregnancy sign.

Pregnancy symptom – 9

Mood Swings : When there is fluctuation in the hormonal level leads to variation in the mood during pregnancy. The mother will feel mixed emotions, excitement and depression, and as well as the joy and sorrow, tears and laughter. She will be confused and need support and understanding. This early pregnancy symptoms may decrease in the second trimester. It can also be reduced by get plenty of sleep, by taking prenatal vitamins, eat at right time and by some moderate exercises. Mood swings may not appear in all mothers with pregnancy symptoms.

Pregnancy symptoms – 10

Bloating and Weight Gain : In pregnancy there will be gradual increase in the weight of the mother, its due to increase in the size of the fetus. And also it is due to increase in the extracellular fluid volume, growth of the uterus. Weight Gain is the later pregnancy symptoms.

Pregnancy symptoms no – 11

Low Back Pain :Due to alteration in the posture and increase in the weight gain as well as difference in the body alignment leads to prolonged back pain. The pain is in the torso which pulls on mothers back.

These are the main symptoms of pregnancy.

Hair vitamins : Sources of Hair vitamins, Faster hair growth

Healthy Hair

Healthy hairs provide pleasure to the person and also pleasing to the person and set him mentally as well as physically comfortable. For the growth of the hairs stronger and longer, hair vitamins are the important aspects. There should be a well balanced hair vitamins, if there increase in the amount of hair vitamins or decrease in the amount may also leads to hair loss.

Healthy hair is depending upon the good nutrition, how the good nutrition is essential to growth of our body. Some vitamins play vital role the good hairs. It is important that certain metabolic requirements of the cells should be met for adequate growth of the hair. That means certain vitamins and minerals should be present in the adequate amount otherwise it may leads to faulty or nonexistent hair growth.

Because of the hurry life now a day we are not giving that much importance for our food. Extreme work schedule will pushing the peoples to develop poor eating habits. Along with this stress, exposure to sun, toxic environment, smoking and alcohol consumption in excess amount as well as lack of sleep leads to poor absorption of the hair vitamins and cause loss of the hair.

Taking proper amount of vitamins and minerals plays a major role in keeping our hair healthy and beautiful. So our goal is take the hair vitamins adequately. Heavy intake of certain vitamin supplements in some cases will resulted in stimulating hair growth. Deficiency of vitamin B6 will lead to often lose the hair because of hair vitamin deficiency.

Condition of our hair reflects the condition of our body. If our body is healthy and well nourished, hair will be looking good and shining glory. Nutritional deficiencies cause to hair becomes brittle and thin.

Hair Vitamins

Vitamin A 

 It plays a major role in the growth of the hair and good healthy hair. Dose of hair vitamins A is 5,000 IU. Foods rich in vitamin A: cheese, eggs, carrots, apricots, meat, milk, broccoli, peaches and fish liver oil. These foods provides hair vitamins.

Large doses that is more than 25,000 IU of hair vitamins may also leads to loss of hair when the taking vitamin A is stopped the problem will be reversed.

Essential fatty acids also should be taken to improve the texture of the hair and also they prevent dry, brittle hair. Dosage of this hair vitamin is : 500 mg daily. Contraindication of this hair vitamins is, shouldn’t  be given to child

Vitamin B

 Vitamin B is important for the health and for the growth of the hair. Foods rich in B vitamin are beans, peas, cauliflower, nuts and eggs, yeast, soy beans. This vitamin B complex with the some following B-vitamins will results in best results. So vitamin b are best hair vitamins.

Vitamin B3 also known as niacin, and Dose of vitamin b3 is : 50 mg 3 times daily. Food rich in vitamin B3: Brewer’s yeast, chicken, fish, wheat germ, turkey and meat.

Vitamin B5 also known as pantothenic acid is one of the hair vitamin. Dose: 100 mg 3 times daily. Food sources of vitamin b5 are  Brewer’s yeast, organ meats and egg yolks, whole grain cereals.

Vitamin B6 also known as pyridoxine is also a hair vitamin.
Dose: 50 mg 3 times daily. Food sources are Liver, whole grain cereals, vegetables, organ meats and egg yolk, brewer’s yeast. Vitamin b6 is a good hair vitamins.

Vitamin B12, Dose: 2 mg daily and Food sources are : Chicken, fish, eggs and milk.

Vitamin C

 Vitamin C will improve scalp circulation. It maintain capillaries which carry blood to the follicles. Foods rich in vitamin c are antioxidants like citrus fruits, kiwi, cantaloupe, tomatoes, potatoes, green leafy vegetables, pineapple and strawberries. Dosage is  3,000-10,000 mg daily.

Vitamin E

This hair vitamins also enhances the scalp circulation. Foods rich in vitamin E are vegetable oils, soybeans, raw seeds and nuts, Cold-pressed vegetable oils, and leafy green vegetables, wheat germ oil, dried beans. Daily dosage is  Up to 400 IU.

Precautions: the patients taking antihypertensive or anticoagulants should have to consult the doctors before taking the Vitamin E supplements.


 It is very important for the growth of the hair and healthy hair. It prevents hair loss. biotin is commonly prescribed hair vitamins for hair loss treatment. Food sources of biotin are whole grains, green peas, oats, soybeans, rice and milk, egg yolks, Brewer’s yeast, bulgur, lentils, sunflower seeds, brown rice, and walnuts. Daily dose is  50 mg 3 times daily.


 It is very essential hair vitamins for the growth of the hair. Daily dosage of this hair vitamins is 100 mg twice daily. Above mentioned are the main hair vitamins, essential for healthy hair growth and to prevent hair fall.

Elderly depression: Symptoms, causes, treatment

Elderly depression

Elderly depression is the depression seen in the old age people. Most of the old age people are at the risk of Elderly depression with number of risk factors. Nearly 10 to 15 % of aged people about 65 years, suffers from elderly depression. Elderly depression is one of the major public health problem. A research study says that older adults with both diabetes and elderly depression are 36 percent to 38 percent risk of dying from any cause.

Most of the elderly depression are not identified easily in nursing homes and general hospitals. A mental health center is the right place to diagnose elderly depression and to provide appropriate mental health care. Hospitalization and different psychotherapies helps in reducing depression and restoration of mental health.

Somatic complaints and cognitive impairments are main symptoms usually associated with elderly depression. Antidepressant medications  are given to treat depression in elders and the dosage fixing and checking for drug tolerance is very important.

Causes of elderly depression

  • Normal aging process,
  • Loss of spouse or loved one,
  • Loneliness,
  • Loss of independence,
  • Feeling of being neglected form young ones,
  • Fear of death or dying,
  • Feelings of purposelessness
  • Chronic medical illnesses,
  • Nutritional deficiency,
  • Prolonged drug therapy,
  • Psychosocial factors, and
  • Mental health problem
  • Loss of mobility due to joint deformity,

Symptoms of Elderly depression

  • Likes to be alone always,
  • Refuses to take food,
  • Loss of appetite and weight loss,
  • Loss of self-worth,
  • Deficit sleep,
  • Sadness,
  • Anxiety and worries
  • Neglects personal care,
  • Loss of memory,
  • Not interested in mingling with family members,
  • Social withdrawal and isolation,
  • Likes to stay in a dark room,
  • Fixation on death and likes to die,
  • Becomes alcoholics and drug abused,

Treatment of  Elderly depression

Antidepressant therapy : Antidepressant medications  lessens the symptoms of elderly depression. Care should be taken to lessen the side effects of drugs which occurs in elders. Treating underlying cause is also needed. Neuroleptic medications are also beneficial in some individuals.

Psychological counseling : is very beneficial in relieving symptoms of depression. Counseling should facilitate to make off loneliness, and should be according to the need and life situation of elder ones.

Music therapy : Listening to musical songs, devotional songs also helps in treating elderly depression. ECT electroconvulsive therapy can be given to some individuals.

Emotional support : The family members should mingle with elders to remove loneliness. Make the elders to play with small kids. Take a regular walk and advice to love the environment. Make them feel some one is caring and love the elders.

First pregnancy : symptoms of first pregnancy

First pregnancy symptoms

Every women on this world likes to be mother. Most of the women becomes very happy as soon as they come to know, they are pregnant. As the lady going to create the new life in her own womb.

Even though the happiness is very high during first pregnancy, some fear also arises in the mother. Labour process or the child birth process may create some fear in women. The responsibility of women as a mother also may cause stress to the mother.

Helpful facts about pregnancy

  • women should be happy as you are becoming mother.
  • Don’t get fear about childbirth or Labour after First pregnancy.
  • Millions of mothers have given birth to their child and your mother also.
  • Even though some pain is present in first labour, when you see the baby you will forget all worries of first pregnancy and child birth process.
  • Know about symptoms of pregnancy and don’t think even a small health deviation as disease.
  • Read good books during first pregnancy to get healthy baby.
  • Don’t be bored with your First pregnancy and be active.
  • Eat fruits and vegetables, enough to maintain good health of both First pregnant mother and growing fetus.
  • Avoid smoking and stop alcohol during pregnancy.

The symptoms of first pregnancy

  • Missed period,
  • Morning sickness or nausea,
  • Abdominal bloating,
  • Dark areolas,
  • Tender and swollen mammary gland,
  • Headache,
  • Fatigue, and tiredness,
  • frequent urination etc.  .

Fever: causes, symptoms, measurement, classification & treatment


Fever can be defined as elevation of the body temperature more than usually by about 1-2 ° above the normal 98.6 degrees Fahrenheit (F) or 37 degrees Celsius (C). Fever is not a disease and is a symptom and it differs from hyperthermia.

Causes of fever

  • Viral or bacterial Infections : influenza, common cold, Human immunodeficiency virus, malaria, infectious mononucleosis, or gastroenteritis, strep throat, pneumonia, flu and chickenpox, Endocarditis, Encephalitis and Meningitis Gastroenteritis (Stomach Flu), Melioidosis, Staph Infection (Staphylococcus Aureus) , Respiratory Syncytial Virus, and other infections causes fever.
  • Various skin inflammations : boils, pimples, acne, or abscess cause fever.
  • Immunological diseases : lupus erythematosus, sarcoidosis, inflammatory bowel diseases also cause fever.
  • Tissue destruction : which can occur in hemolysis, surgery, infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc cause fever.
  • Drug fever : is directly caused by the drug, e.g. lamictal, progesterone, or chemotherapeutics causing tumor necrosis.
  • as an adverse reaction to drugs, e.g. antibiotics or sulfa drugs.
  • After drug discontinuation, e.g. heroin or fentanyl withdrawal
  • Cancers : most commonly renal cancer and leukemia and lymphomas leads to fever as a first  symptom.
  • Metabolic disorders : gout or porphyria also causes fever.
  • Thromboembolic processes : pulmonary embolism or deep venous thrombosis

Symptoms & Signs of fever

  • Increase in body temperature more than 100.4 degrees F (38 degrees C) is main sign of fever.
  • presence of chills due to increase in temperature of the body than the external environment is associated with fever.
  • Increase in heart rate and muscle tone is the main symptom of fever.
  • Shivering will be there.
  • In severe cases of fever sometimes there will be presence of delirium and convulsions. Delirium and convulsions  are usually seen in children.
  • When there is rise in body temperature patient feels warm. If fever reduces the person may start to sweat.
  • Severe cases of fever will be associated with some other symptoms at that time the patient has to meet the doctor immediately to treat fever.

Measurement of fever

The fever is measured using an instrument called thermometer. It contains mercury in it. The instrument is placed in different parts of the body and the temperature can be measured. There are varies types of thermometer are there. They are

  • oral thermometer,
  • axillary thermometer and
  • anal thermometer.

If the temperature is taken in the anal region we have to subtract 1 degree from the total temperature because there is always high temperature in there.
If the temperature is measured in the oral region it is the normal there is no need of adding or subtraction.
When we are taking temperature in the axillary route we have to add 1 degree

Classification of fever

fever is classified according to the grade of temperature, they are

  • Low grade fever : approximately varies from 100.4-102.2 degrees of F
  • Moderate fever : approximately varies from 102.2-104.0 degrees of F
  • High grade fever : approximately varies from104.0-107.6 degrees of F
  • Hyperpyrexia : is the maximum level that is more than the 107.6 degrees of F

Advantages of fever

  • According to some studies the fever is essential for the immune bodies to fight against the antigen of bacteria. it speeds up certain immunological reactions.
  • Fever may be sometimes very essential in some extents because it cause unbearable environment for the pathogens.
  • Fever is useful for the immunological bodies, it provides favorable environment for the white blood cells, so they will proliferate easily and can fight against the pathogens. There will be increased activity during fever.

Treatment for fever

  • Fever is not treated essentially because it is a essential reaction of our body. So the fever needs only the symptomatic management. There will be so much of dehydration so the patient should be hydrated properly with intravenous fluids.
  • During fever period the patient may be disoriented, so the patient needs psychological support to recover from fever, nurse should give psychological assurance that fever will be get reduced as soon as possible.
  • The fever patient needs complete bed rest, and room should be well ventilated and provide an environment to sleep well.
  • Feed the fever patient only with small, frequent diet, because there will be alteration in the bowel pattern and indigestion may occur.
  • The immediate cause of the fever should be found and proper steps to be taken to reduce fever.
  • There will be chances of hyponatremia, the patient is given sports’ drinks or intravenous administration of the electrolytes.
  • If the fever is so high, cold bath or tepid sponge bath should be given.
  • If the fever remains same the patient must take antipyretics like paracetamol or ibuprofen, Aspirin etc.
  • The actual reason for fever should be find out and the cause should be treated immediately.

Rabies vaccine: vaccination grades, dosage and side effects

Rabies can be defined as  ‘ A fatal viral infection, is usually acquired through the bite of an infected animal to the human beings’. Nearly all morbidity in human beings worldwide is due to the bite of a rabid dog, and rabies infection. The rabies occurs from the rabdo virus. Rabies vaccine has reduced the incidence of rabies morbidity.

Rabies vaccination is the active immunizing agent  used to prevent the infection caused by the rabies virus that carried by the animals. It is a killed rabies virus vaccine.

There are two types of rabies vaccinations

  1. Pre-exposure prophylaxis : this type of rabies vaccination is done for the persons who are at high risk of getting infected. Animal handlers, veterinarians, travelers, the persons who are in contact with the wild animals are likely to get infected.
  2. Post-exposure prophylaxis : this type of rabies vaccination prophylaxis is done to the patients who are exposed to the animal bites, indicated by bite, scratch, or lick.

Facts related to rabies vaccine

  • The rabies  spreads through the pet animals as well as wild animals; dogs, bats, raccoons, skunks, cats, horses, swine, foxes and cattle are the usual ones. So it is better to immunize the domestic animals with rabies vaccine.
  • A person who is bitten by the infected animal  should receive the rabies vaccine after the animal bite. If patient is known to be hypersensitive to the rabies vaccine, then the rabies vaccine should be administered under supervision with all the immediate measures for managing anaphylactic shock.
  • Prophylactic use of the rabies vaccination should be avoided in children, adolescents, antenatal mother & adults on treatment for any acute illness.
  • Pre exposure rabies vaccine is to be avoided if person is known to be allergic to rabies vaccine.
  • The further rabies vaccination or  immunization is avoided in persons who had complications on rabies vaccine administration.

The immunization schedule is classified under some grades as

  • Grade I : when the person is in contact with the animal but not in contact with the saliva or blood. For this kind scheduled rabies vaccination is not needed.
  • Grade II : If the animal has licked or if any other kind of expose to the saliva and superficial, non- bleeding scratches made by the animal, immediate rabies vaccine immunization should be given according to the schedule B.
  • Grade III :  includes all bites, bleeding scratches, all wounds on the head, neck, scapular region, extremities. Direct contact of animal saliva with mucous membrane of patient, immediate concomitant prophylaxis with rabies vaccine is needed according to schedule C.

The classification according to severity of expose to animal

Schedule A: In this type one injection of rabies vaccine of Prophylactic immunization prior to exposure is given. One injection is given IM on days 0,7,28 and 365.

Schedule B: Immunization vaccine  should be given after exposure but it is of somewhat long  coarse. One injection of  rabies vaccine IM is given on days 0,3,7,14,30 & if necessary it is given on day 90.

Special precautions for rabies vaccine administration

The person who has received rabies vaccine of doubtful potency and who has discontinued the course of injections has to receive the entire course of rabies vaccine according to exposure.  In case the person is re-exposed after 5 yrs., entire course should be completed according to grade of exposure.

Dosage and administration of rabies vaccine

There is no difference in the dose for children & adults. 1ml of rabies vaccine is given by intramuscular injection in the deltoid muscle (arm) or in the thigh in small children. The prescribed schedule should be followed strictly  even if some time has passed since the exposure.

Rabies vaccine side effects

  • This rabies vaccine doesn’t cause that much vital side effects, but it will cause generally mild and non serious side effects.
  • There will be a mild pain, redness and swelling may occur at injection spot as a side effect.
  • Rarely arthritis, gastrointestinal disorders or lymph node swelling may occur as  rabies vaccine side effects.
  • Sometimes anaphylactic shock may occur.

Contraindications for rabies vaccine

If there are hypersensitivity reactions to the vaccine or acute febrile illness the rabies vaccine is contraindicated for pre-exposure prophylaxis. In case of pregnancy vaccine should be given if the level of risk is high for pre-exposure prophylaxis.

Throat cancer: symptoms and diagnosis

Throat cancer is the malignancy of the throat, it may be the presence of tumor in pharynx or in the larynx. Some of the common symptoms include the lump or the sore that does not heal for the long time, there will be chronic cough, dysphagia will be present for long time, and there will be hoarseness in the voice which not resolves in 1 or 2 week.

The throat cancer symptoms sometimes may be due to some other reasons will be often confused with the throat cancer symptoms so there should be proper diagnosis and treatment should be given. And the doctor must collect the history of all the symptoms.

General throat cancer symptoms

  • Epistaxis
  • Chronic earaches
  • Pain in the upper teeth
  • Headaches
  • Swelling in the eyes
  • Chronic sinus infections that do not go away when treated with antibiotics
  • Blocked sinuses that will not clear
  • Sore throat that not decrease for weeks even antibiotics are administered is main throat cancer symptoms.
  • There will be sudden unexplained weight loss
  • Coughing of blood
  • Breath sounds will be high pitched
  • Blood-flecked phlegm.
  • The sensation of something permanently stuck in the throat as a throat cancer symptoms.
  • ( Gastrointestinal disorders )
  • Excessive reflux, diarrhoea or constipation
  • Enlarged lymph nodes
  • Disfigurement of face
  • Deformities in skin and other
  • Throat Cancer Symptoms that are very prominent.
  • There is a presence of Numbness or paralysis of facial muscles
  • There will be chronic Facial pain associated with throat cancer symptoms.
  • Long duration neck pain is also a throat cancer symptoms.

Diagnosis of throat cancer

  • If there is presence of all the above throat cancer symptoms the patient should undergo immediately some diagnostic measures to confirm the throat cancer. The diagnostic test includes the following. Laryngoscopy :there is lighted camera in a tube is introduced in to the throat and the throat is examined for the presence of the tumor or malignancy is used to diagnose throat cancer symptoms.
  • CT scan of the cranium should be done or the cranial MRI can be done to confirm the cancer that spread to the lymph nodes, is used to diagnose throat cancer symptoms.
  • Biopsy is the collection of the tissue from throat to confirm with the tumor cells. Under microscopic examination of this cell will reveal the cancer cells, is used to diagnose throat cancer symptoms.