Stevens Johnson Syndrome

This syndrome has been named after the pediatricians AM Stevens and SC Johnson who were the first to diagnose a reaction of eye and mouth due to a drug in the year 1922. It is a rare disorder or condition but does serious damage to the mucus membranes besides the skin. Abbreviated as SJS, it is a medical emergency known as toxic epidermal necrolysis which requires immediate attention and medical care as it is known to be one of the most adverse drug reactions recognized in USA. The affected groups include Elderly and the children.

This condition causes swelling of face and lips with red and purple rash that blisters on the face accompanied by crusty lip sores. In case the eyes catch it then it can cause vision issues and corneal ulcers.

Genetic Issues – If a close family member has suffered from SJS, there is high possibility of SJS risk. There is a strong connection particularly with the Asian population between HLA-A 33:03 and HLA-C 03:03 alleles as well as allopurinol induced SJS or TEN.

Causes because of medication reactions
Usually the reaction to a certain drug appears within a week of starting the course but with some medications like anti-convulsants, the reaction might take as long as a month to surface. The antibiotics that are particularly on the list to cause SJS are Penicillins like bacampicillin and amoxicillin, cephalosporins like cephalexin and cefaclor, macrolides like azithromyvin, erythromycin and clarithromycin. Some anticonvulsantsare used for treating peilepsy, allopurinol used for gout treatment, Nevirapine for treating HIV infections, Acetaminphen, an all age group medication.

Immunity Issues – If you have an immune system that is weak like HIV infection, due to organ transplant or chemotherapy and more could increase the risk of SJS

Infections that Predispose to SJS
The viral infections that are known to precede SJS include influenza, Hepatitis A, mums, HIV and more while the bacterial include conditions like typhoid, brucellosis, mycoplasma pneumonia to name a few. Malaria and trichomoniasis are the protozoal infections.

Previous infections – There is a high risk of SJS recurring if the same medication of the same group has been used earlier and has been responsible for causing SJS infection.

Symptoms
It primarily looks like an upper respiratory tract infection, cold or cough, headache, body pain and sore throat
It is followed by blisters on the skin, mouth, nose, ears and genitals as well. The rashes are red or purple in color and with the progress of the conditons may tend to merge as well as rupture thus exposing sores that are painful. Further, the top skin layer forms a crust and sheds.

The face and lips swell and mouth catches ulcers. The lips form a crusty sore and due to the ulcer buildup in the mouth, its becomes difficult to swallow. If there are ulcers in the digestive tract, they may cause diarrhea and even dehydration.

Diagnosis
There are two ways by which the Stevens Johnson syndrome can be diagnosed.
1. Clinical Examination – The target rash characteristic plays an important role in diagnosis of SJS but to study the predisposing factor a complete clinical history is checked.
2. Skin biopsy – Sometimes even a skin biopsy could be needed to confirm the diagnosis.

Treatment -

The patient needs immediate hospitalization because it is considered to be a medical emergency. The first step is to stop the medications responsible for SJS. For treating the infection that is already developing, local antiseptics and antibiotics are used.

To stop the condition from getting worse and spreading, intravenous immunoglobulins are given.
The eye treatment involves artificial tears and lubricants so that the surface drying stops. Even antibiotics, antiseptics and topical fluids are used in order to prevent inflammation as well as infection.
For women suffering from the condition intravaginal steriod oinments are used for preventing scar tissue formation
Painkillers/ Analgesics for relief
Psychological consultancy for emotional stability and anxiety if the need be.

Prevention
If some close relative has developed SJS its important to know the drug that caused it and try and avoid that drug so as to prevent it
These days medicalert bracelets are available so that the health professional who treats come to know about any emergency situation.

Genetic testing is rarely carried out and might be suggested only in cases of South East Asian and Indian descent.
It is known that of the one third cases diagnosed with Stevens Johnson syndrome, the recurrence does occur and hence it is important to stay informed about the medications that might just not be suitable for intake for this condition.

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*Source from the internet

All You Need To Know About White Tongue

Known to cause a greyish- white coating on the tongue, this condition called White tongue is a common and generally harmless symptom that could indicate a serious condition. Rarely serious conditions like cancer causes white tongue.

White Tongue

Causes
Lack of Brushing of flossing or doing it in an improper way.
Lack of regular Tongue cleaning or doing it improperly.
Addictions like alcohol, smoking and chewing tobacco
Dry mouth that is a result of sleeping with open mouth or mouth breathing

Dehydration
Irritation due to sharp edges resulting form dentures or braces inside the mouth
Though there are certain conditions that are caused inspite of maintaining oral hygiene. These include conditions like oral thrush, Oral lichen planus and Leukoplakia.

Oral Thrush – This is a type of fungal infection caused by candida yeast. Patches develop on the tongue and mouth. White or off white in color, they can be painful and also have unpleasant taste. Oral thrush usually occurs in people with low immunity or those who have undergone a recent chemotherapy treatment or taken antibiotics. Some other causes include inhalation of asthma related medications like corticosteroids and diabetes.
Treatment – Anti-fungal medicines like oral drops are used for its treatment for a couple of weeks.

Syphillis – Also known as sexually transmitted condition (STI), if left untreated it can lead to white tongue as well as mouth sores.
Treatment – Pencillin is used for its treatment for reducing the disease causing bacteria

Oral Lichen Planus – An inflammatory condtion, Oral Lichen planus causes white patches thick in the mouth and on the tongue accompanied with painful cheek, gums as well as ulcers.
Treatment – Generally monitored but in serious cases croticosteriods are used.

Leukoplakia – This condition is a result of addictions caused by irritants like alcohol and tobacco or even due to dentures. They are harmless mostly but still a diagnosis is important to check out the rare possibility of complications.
Treatment – Continuous monitoring to avoid it from spreading further

Home Remedies
There are a few home based remedies that can help you fight the condition. These include use of probiotic foods like kimchi, konbucha and more, using baking soda while brushing teath and tongue cleaning. Consumption of raw garlic and scraping tongue properly for removal of bacteria.

Prevention
The best possible solution is maintaining proper oral hygiene backed with regular oral checkups other than that it is not always possible to get away from it.

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The Technique of Knocking Out Genes – A Sneak Peek

Knocking out genes is a technique which researchers and scientists use when the want to find out
which gene is responsible for production of which protein. In a human body there are around 20,500 different genes that each gene is responsible for making a protein because they are known to be the building blocks for different components of the body be it muscles or bones or brain and more. Apparently, our body is made up proteins. Every gene is responsible for producing a different type of protein and the knocking out technique only helps scientists figure out who is responsible for what.

The Technique of Knocking Out Genes - A Sneak Peek

Knocking out a Gene
The scientists first find out genes with some serious mutation or mistake or create one if needed. These genes are dud genes and do not contribute a bit in production of protein. Now, this gene is injected into the DNA of a healthy cell. The scientists attach a tag called reporter gene to it for identification purpose of whether they have been accepted by the cell. Another identification of reporter genes is that the proteins they produce often glow in blue or green. The scientists apparently fool the DNA in a way. A DNA a we know is made up of long strand of genes and these genes can get damaged but the DNA has an inbuilt mechanism to fix the issue. With the help of a cellular tool box the scientist insert the knocked out gene into the DNA. They do this very smartly by making it look like a perfect copy of the surrounding gene that is to be replaced in that DNA. This disguise of sorts fold the DNA repair system and its swaps the dud gene for the old healthy gene, thus knocking out the original gene.

Some times scientists do not have to swap the gene fully. They can simply insert the reporter gene into the DNA they wish to get rid of, randomly. Now, the reporter gene is wedged in the middle of the old gene. Now, there is an all new piece of DNA inside and if a cell goes to read the gene, the instructions would not make sense to the cell due to its presence there. It would not use the gene to make a protein.

The scientist keep a watch on the process. They observe the working in case it is yeast or bacterium but if it is an embryo, scientists observe on how the animal or plant growth differs from other normal ones.
Today, scientists use different techniques to knock out the genes of any organism they want to. It could be mice or bacteria or for that matter even plants that have knocked out genes. Well, scientists today can knock out even human cells growing in the labs.

Rajarajeswari Medical College and Hospital – MOTTO: Availability of medical facilities is of utmost importance. We aim to serve the healthcare requirements needs to the medically unreached population. Through this, we provide quality medical, paramedical, nursing and allied healthcare education, excellent and compassionate hospital services with state of the art facilities as well as to carry out health research for the betterment of the humankind in tune with the holistic values of the institution.

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Hopes on for Vaccines Offering Lifelong Protection against Flu

Vaccines Offering Lifelong Protection against Flu-

Flu as we all know is a common condition that all of us encounter many a times during our stay on the earth or say our life span. You would rarely find a human who has not been a victim of this health condition. But, there is some good news around this condition. A recent study of a new vaccine containing ancestral flue virus genes is a ray of hope for researchers in the direction of life long protection against flu.

The vaccine was tested on mice and gave 100 percent results. The vaccine was so effective that even after being given nine different flu virus dozes of lethal nature they survived. The best part was they didn’t even fall sick.
Comparatively those mice that were given the traditional shots of flu did fall sick after these lethal doses were given to them and even died. Though, the study is primarily conducted on mice and it would be too early to say how it worked on humans, there is definitely a ray of hope. The hope that one day a universal flu vaccine is developed that would provide long term rather life long protection against flu viruses.

Though even after trying out the researchers still haven’t really succeeded in creating a vaccine that could offer life long protection because of the reason that flu viruses mutate fast. A recent study though used a different approach. The vaccine they created had ancestral and consensus flu genes from four main strain types namely H1 to H5. The delivery of these genes was done using adenovirus, the one responsible for causing common cold but an altered version of it that was harmless and had the ability to carry ancestral genes.

The results as mentioned were affirmative as these mice survived heavy doses of H1N1, H3N1, H3N2 and H5N1 which can easily kill the mice. Apparently 100% of the vaccinated mice survived.

Well, its too early to confirm the success but further study on different animals will certainly help the researchers determine the efficacy of the vaccine in terms of long term protection.

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Medicine As a Career in India

Indian parents have been long obsessed with this career stream and yes no marks for guess that right… its medical offcourse. Though, times are changing, but the attraction for medicine hasn’t faded as yet with parents only because of the surefire career that it is. But, over the years there are a lot of choices that are available around the medicine field apart from MBBS. So, students who aren’t able to crack the NEET can try to opt for some related courses that include BDS, Physiotherapy, Phsychiatry, Pharmacy and more. So, as per your area of interest you may choose a course. One major advantage of NEET being brought into effect is that intelligent students coming from lower income groups can try to get entry into medical without paying hefty donations to colleges.

Medicine As a Career in India

In case you opt for MBBS, a masters is always a good idea considering future growth. You could either opt for a MD or MS. Though being a surgeon isnt a cake walk and invovles daily encounters with patients fighting for their lives. Its a great responshibility to shoulder and a time costing too.

As a surgeon or a masters degree holder you need to be available to your patients anytime. It could be in the wee hours of the night as well. So, its quite a stressful and hectic work schedule that you’ll have to manage. But, the perks include immense work satisfaction with successful medical procedures and blessing from families. If surgery is not your cup of tea then you might as well opt for MD in areas like radiology, anaesthesiology, paediatrics, forensic medicine and more.

Well, if not MBBS than the option of Physiotherapy, BDS, Ayurvedic medicine, Homeopathy, Veterinary and Pharmacy are definitely some of the good choices around medicine. A masters degree with these streams can offer rewarding career prospects.

Coming down to the bottom line, medical education does blow a hole into your pocket and for students coming from middle income and lower income groups, its not an easy way ahead. But, with the help of student loans, you may as well manage to realize your medical education dreams. Though, it is important to have indepth information on the student loan interest, payback procedure and time for repayment in detail, needs to be known particularly when you are planning to pursue higher education abroad.

Medical is undoubtedly a lucrative career but having said that it does come with its own cons which need to be considered before taking a plunge into it.

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