About Dr. Harshal Narkhede

Dr. Harshal Narkhede (MBBS, MD, PGDHHM, MS-CIT) is the Assistant Professor of Biochemistry at Government Medical College, Nagpur. A specialist in Clinical Chemistry, Biochemistry, and Diagnostics, he has close to five years of medical experience.

Typhoid Fever Treatment – Effective Measures For Recovery

Typhoid fever is an infection caused by the Salmonella typhi or Salmonella paratyphi bacteria. Being a bacterial infection, typhoid fever treatment mainly involves the use of antibiotics to kill the typhoid bacteria.

 typhoid fever treatment

Doctors usually recommend antibiotics for typhoid fever treatment.

Typhoid Fever Treatment – A Look At What’s Involved

The use of antibiotics is recommended for typhoid fever treatment to:

  • Alter The Course Of The Disease

    Antibiotics are used to resist the progress of typhoid and the growth of the typhoid bacteria in the body. They reduce the duration of the typhoid fever symptoms (from 14-25 days to 3-5 days) if the treatment is started at the earliest.

  • Treat The Basic Cause

    Antibiotics kill the infectious agent, preventing the progress of the infection.

  • Reduce Mortality Rates In Typhoid Cases

    With the use of appropriate antibiotics, the mortality rate in cases of typhoid has been reduced from 15% in the past to less than 1%.

  • Prevent Dangerous Complications

    If left undiagnosed and untreated, typhoid may result in complications like intestinal perforation and the spread of the infection to other organs, especially to the peritoneum i.e. the membranous sac in abdomen

Components Of Typhoid Fever Treatment

  1. Treating The Basic Cause

    Typhoid patients are primarily treated with antibiotic medicines, in order to counter the causes of typhoid. As this disease is caused by bacterial infection, killing the bacteria automatically stops the symptoms and the progress of the disease. Some of the drugs used are:

      • Fluoroquinolones – This group of drugs includes ciprofloxacin, which is a commonly used antibiotic to kill the typhoid bacteria and reduce their number in body
      • Cephalosporins – Antibiotics belonging to this group, such as Cefotaxime, Cefixime, and Ceftriaxone have been observed to be very effective
    • Old Antibiotics Versus New Antibiotics

      Previously, antibiotics like Chloramphenicol, Ampicillin, and Trimethoprim-sulphamethoxazole were used to treat typhoid, but due to various undesirable effects and reasons, they have become obsolete.

      Modern day antibiotics include Ceftriaxone, Cefixime, Cefotaxime, Ciprofloxacin, and Azithromycin. These drugs are more effective than the older ones and also have fewer side effects.

    • Choice Of An Antibiotic

      Drug selection is based upon the sensitivity of the typhoid bacteria to the drug in question. The response of the bacteria has to be tested with culture and sensitivity studies in  the laboratory. Other factors for selecting the appropriate drug include the patient’s tolerance toward the drug, the presence of any kidney or liver disease, and the data generated from the studies conducted in that particular geographical region.

    • The Resistance Of Bacteria To Drugs

      Over a period of time, the typhoid bacteria become resistant to the effects of some drugs, despite having been sensitive to them earlier. This phenomenon is called bacterial resistance.

    • The Duration And Dosage Of Medication

      The frequency and duration of drug administration varies with the severity of the disease, the drug chosen, and the standard dosage schedules advocated for these drugs. The drug may be administered either orally or through injections directly into the veins. The dosage schedules must be followed strictly as per the doctor’s advice.

  2. Treating The Symptoms Of Typhoid

    • Reducing fever- As patients may have high grade fever as a typhoid symptom, antipyretics (drugs that control fever) like Paracetamol can be used to normalize the body temperature.
    • Fighting body aches and headaches – Headaches, muscle pains, and generalized body pain can be treated with analgesics (drugs that alleviate pain) like Paracetamol, Ibuprofen, and Diclofenac.
  3. Surgical Treatment

    Surgery may be required only in patients with complications of typhoid, such as intestinal perforation and peritonitis (spread of the infection to the peritoneum in abdomen).

    In the case of people who are long-term carriers of the Salmonella bacteria, if antibiotics fail to destroy the bacteria, the gall bladder may be removed to eliminate the site of the Salmonella typhi colonization.

  4. Recovery Measures

    • If you have a typhoid infection, rigidly follow the drug schedules prescribed by your doctor. This helps reduce the chances of complications, hastens the recovery process, and decreases the duration of the illness.
    • Maintain high levels of sanitation. Ensure that you wash your hands properly after using the toilet and before eating food.
    • Drink safe water and reduce the risk of water contamination by adopting measures like boiling and chlorination of water.
    • Complete the prescribed course of medication to avoid becoming a long term carrier of typhoid even after the symptoms have disappeared.
    • Keep an eye out for the occurrence of similar symptoms again in future, as this could indicate a relapse.
typhoid treatment

Typhoid treatment measures include increased levels of hygiene.

Typhoid fever treatment is mainly dependent on the use of antibiotics to kill the typhoid bacteria. Early diagnosis through the Typhoid test and subsequent treatment of the infection can help avoid complications like intestinal perforation. If you have been infected with typhoid, ensure that you strictly follow your doctor’s advice to recover quickly and avoid becoming a long-term carrier of the typhoid bacteria.

Typhoid Fever Symptoms – Signs To Look Out For

Typhoid fever is an infection caused by the Salmonella typhi or Salmonella paratyphi bacteria. Observing the typical pattern of typhoid fever symptoms helps doctors diagnose and treat typhoid better.

typhoid fever symptoms

High grade fever is the most common of typhoid fever symptoms.

Typhoid Fever Symptoms

Typhoid symptoms vary widely and are very much similar to the symptoms of other microbial infections. Here are some of the common typhoid fever symptoms.

  • Variable degrees of high grade fever in about 75% of cases
  • Muscle pains and body aches
  • Chills
  • Decreased appetite
  • Headaches
  • Nose bleeds
  • Pain in the abdomen in 20 to 40 % of cases
  • Dizziness
  • Rose spots (rashes) over the skin
  • Weakness and fatigue
  • Neurological symptoms resulting in altered behaviour
  • Constipation or diarrhoea
  • A sore throat and a cough

Typical Patterns Of Typhoid Fever Symptoms

It may take anywhere between 3 and 21 days for typhoid symptoms to appear after the entry of the Salmonella bacteria into a person’s body. This duration is called the incubation period.

In patients who are not undergoing any form of typhoid fever treatment, there is a specific pattern of symptoms, which can be classified into 4 phases. Each phase lasts for about a week.

Here are the four phases mentioned above. It is important to note that symptoms refer to the effects experienced by the patient, while signs refer to the doctor’s findings noted after his clinical observation of the patient.

The First Phase

Symptoms During The First Phase

  • Fluctuating fever, with a gradual rise in body temperature
  • Body aches
  • Headaches
  • Weakness

Signs During The First Phase

  • Leukopenia – A decrease in the count of white blood cells
  • Relative lymphocytosis – A relative rise in the number of lymphocytes in the blood (lymphocytes are a type of white blood cells)

During the first phase, a blood sample taken from the subject is put over a culture medium that favors the growth of bacteria. This sample is then subjected to microscopic examination to detect and confirm the presence of the Salmonella typhi bacteria.

The Second Phase

Symptoms During The Second Phase

  • Spikes of fever – The fever levels may go as high as 103°F to 104° F, usually in the afternoons
  • Diarrhea – Patients of typhoid may report up to around 6 to 8 rounds of stool discharge within a day. Stools are marked by a typical peanut-soup-like smell
  • Constipation, in some cases
  • Nervous fever – A state of confusion and nervousness

Signs During The Second Phase

  • Bradycardia (A decrease in the pulse rate) – It is called relative bradycardia when it relates to typhoid. Unlike the fevers brought on by other infections, the fever brought on by typhoid shows a mismatch between the rise in the pulse rate and the rise in the body temperature. For this reason, it is referred to as relative bradycardia
  • Rose spots over the skin – In about one-third of typhoid cases, rose-colored spots may appear on the abdomen and the lower part of the chest
  • Rhonchi – Rhonchi are coarse, rattling sounds that arise from secretions in the respiratory airways and they can be heard through a stethoscope
  • Borborygmi – These are sounds are produced in the body due to the movements of air and fluids in the intestines
  • Hepatosplenomegaly – Enlargement of the liver and the spleen

The Third Phase

It is during this phase that the patient is prone to various dangerous complications like:

  • Intestinal bleeding
  • The perforation of the intestine  – The last segment of the small intestine is the usual site of perforation. It results in the spillage of the intestinal contents into the abdomen. This may cause the spread of various toxins in the bloodstream, resulting in a fatal condition known as septicemia
  • Spread of the infection – The discharge of infective foci to other organs like the gall bladder, heart, and the bones may cause infection in them as well (these infections are known as cholecystitis, endocarditis, and osteitis respectively)
symptoms of typhoid fever

Rose spots are common symptoms of typhoid fever.

The Fourth Phase

This phase occurs during the fourth or fifth week of the infection. During this phase, the fever may subside. If it still continues in the form of high spikes, dehydration may occur.

If typhoid fever symptoms are observed early, the diagnosis and treatment of the infection can be done in a timely manner, with the right antibiotics. A simple typhoid test can help in identifying the disease. If left untreated, the infection can cause various complications, some of which may even require surgical intervention. So, the next best thing to preventing typhoid is to seek immediate clinical treatment for the infection.

The Causes Of Epilepsy – How The Seizures Are Triggered

The causes of epilepsy can be attributed to various factors. Seizures occur when there are fluctuations in the normal balance between neuronal excitation and inhibition in the brain. Depending upon the extent of the area of the brain that is affected, the patterns and severity levels of the seizures vary to a large extent.

causes of epilepsy

Head injuries are common causes of epilepsy in people of all age groups.

How The Causes of Epilepsy Vary With The Age Of The Individual

The causes of epilepsy differ from one individual to another based on his age. Here is an age-based classification of epilepsy causes.

1. In Babies Who Are Less Than A Month Old

  • Bleeding in the brain due to injury caused during the birth of the baby
  • Low oxygen supply to the brain during birth
  • Bacterial or viral infections in the brain
  • Defects in the development of the brain while the fetus is growing
  • Genetic reasons
  • Abnormal biochemical changes
  • Low blood sugar levels
  • Low levels of calcium or magnesium in the blood
  • The deficiency of vitamin B6

2. In Children Between 1 Month And 12 Years Of Age

  • Infection in the brain tissue
  • Traumatic injury to the brain
  • Genetic diseases such as congenital metabolic diseases
  • High grade fever between 3 months and 5 years of age (This triggers seizures called febrile seizures.)

3. In Adolescents Between 12 And 18 Years Of Age

  • A lump in the brain
  • A brain infection
  • The use of illicit drugs
  • Genetic defects in the brain

4. In Adults Between 18 And 35 Years Of Age

  • Head injuries
  • Injuries to the brain
  • Sudden abstinence from alcohol following long-term alcohol consumption
  • A lump in the brain

5. In Elderly People

  • Sudden alcohol withdrawal
  • Metabolic abnormalities
  • A high level of urea in the blood
  • Low blood sugar levels
  • Severe liver diseases
  • Abnormal levels of certain constituents of the blood

Causes Of Epilepsy – Why Seizures Occur

  • The brain is susceptible to seizures under specific conditions.

    Even normal human neuronal cells are susceptible to the factors that provoke seizures under specific conditions. But the susceptibility varies based on the severity of these factors (e.g. high grade fever in children).

    The threshold for the occurrence of seizures is determined by various parameters like genetic factors, the family’s history as far as epilepsy is concerned, or the birth of a defect during the development of brain structures.

  • A variety of conditions are responsible for long-term seizure disorders.

    Serious head injuries like penetrating trauma pose up to a 50% risk of causing long- term damage to the neural tissue. In such cases, the neurological network becomes abnormally hyper-excitable. This phenomenon is called epileptogenesis.

    Other processes like strokes, infections, neural defects, or genetic abnormalities in the brain can also trigger epileptogenesis.

  • There are certain factors that provoke seizures.

    Seizures usually occur intermittently. Individuals with epilepsy often exhibit completely normal behavior between episodes of seizures, and any routine activity may trigger a seizure episode.

    The factors that provoke seizures include:

    • Inadequate sleep
    • Exposure to flashes of light
    • Heavy alcohol consumption
    • Drug overdose (Even certain drugs of common medicinal use)
    • High stress levels
    • Hormonal changes (e.g. during menstruation)
    • Hyperventilation i.e. excessive rapid breathing
    • High grade fevers
    • Neurological infections

How Are The Seizures Triggered?

Here’s the mechanism that triggers epilepsy symptoms.

  1. Neurons (brain cells) have their own electrical potentials, set in order to maintain their optimum function. These potentials are derived from graded concentrations of various ions (sodium, calcium, potassium, etc.) both inside and outside of these cells.
  2. Under normal circumstances, these electrical potentials across the membranes of the neuronal cells are well-balanced and well-regulated. When this balance is disturbed, episodes of convulsions (seizures) are triggered by different mechanisms, depending upon the cause.
  3. Neurons of different parts of the brain control the tone and activity of the muscles of different parts of the body.
  4. Under normal conditions, excessive contractions are inhibited by opposing neurons. GABA (Gamma Amino Butyric Acid) is a neuro-chemical that inhibits further contractions of muscles via neuronal control and constantly regulates the frequency and extent of the contraction-relaxation cycles. When precipitating factors step in, this balance is disturbed and the electrical potentials across the neuronal membranes fluctuate. This causes uncontrolled, irresistible, and frequent contractions of muscles. When high-frequency bursts of electrical potential occur in localized parts of the brain, focal seizures occur.
  5. When these bursts of electrical potential are transmitted to other parts of brain, generalized tonic-clonic seizures appear.
cause of epilepsy

A lack of sleep is also a common cause of epilepsy.

Certain Other Causes Of Epilepsy

  • In the case of seizure episodes caused by infections, high grade fever, metabolic changes, poison, or trauma, the neurons become hyper-excitable and the subsequent high-frequency electrical potential bursts provoke seizures.
  • When seizures are triggered by genetic factors, the underlying reason is often the defective development of certain parts of the brain or the defective production of neuronal ion-channels. Both these factors affect neuronal excitability.

Knowing the causes of epilepsy can help you avoid or control many of the factors that trigger seizure episodes. Knowing about the types of epilepsy, its symptoms, and epilepsy treatment can help you counter this condition effectively. In fact, the best thing to do would be to take proper measures for epilepsy prevention.

The Causes Of Typhoid Explained – How The Disease Spreads

One of the main causes of typhoid fever is the feco-oral transmission of typhoid bacteria. Unsafe sanitary practices lead to the contamination of water and food by the typhoid bacteria, in turn encouraging the spread of the disease.

causes of typhoid

Insects like the housefly are indirect causes of typhoid as they help in transmitting the disease through food and water.

The Causes Of Typhoid – How The Disease Spreads

The Infective Agent

The bacteria Salmonella typhi and Salmonella paratyphi are the main causes of typhoid fever. They are know to infect only humans.

The Spread Of Typhoid

The typhoid infection usually spreads through food and water that has been contaminated with the salmonella bacteria. This bacteria is transmitted to insects (e.g. the house fly) that feed on stools. When a person consumes water or food that has been contaminated by these insects, the Salmonella typhi bacteria enter the person’s body, causing the typhoid infection.

The Infectious Dose

The infectious dose is a term that refers to the number of bacteria that need to enter the body to cause the infection and the characteristic typhoid fever symptoms. This number can vary from 1 thousand to 1 million bacteria. The possible reason for such a large variation in number could be that the Salmonella bacteria have varying abilities to resist the highly acidic environment of the stomach.

Causes Of Typhoid – The Journey Of The Typhoid Bacteria

  • The body has a protective mechanism in the form of a highly acidic environment in the stomach to counter various bacteria. As a result, the ability of bacteria to escape unaffected from this environment decides their fate in the body.
  • Once the Salmonella typhi escapes from the strong acid barrier in the stomach, it travels to the small intestine, where it has to fight against other defense mechanisms of the body, such as Lysozymes (chemicals that destroy infective organisms) and small intestinal secretions that contain some cationic antimicrobial substances.
  • After passing through all the hurdles the body presents, the bacteria invade the intestinal membranes and stay inside Payer’s patches. Payer’s patches are collections of lymphoid cells (that protect against infections) in the intestinal walls.
  • After crossing the intestinal membranes, the bacteria enter the circulatory system and spread to various parts of the body like the liver, bone marrow, and the lymph nodes.
  • The bacteria then start forming colonies at these sites. During this phase, the patient may remain asymptomatic. The symptoms begin to manifest when an adequate number of bacteria have been produced after replication.

Individuals Susceptible To Typhoid

People who have a weak acidic barrier in the stomach are prone to the typhoid infection. Some of the factors that weaken the acidic barrier include:

  • Repeated Use Of Antacids: Drugs that decrease acidity, when consumed frequently, create an environment suitable for the typhoid bacteria.
  • Age: Children less than 1 year of age are susceptible to the typhoid infection
  • Diseases of the stomach associated with reduced acid production also weaken the acidic barrier of the stomach.
  • Intestinal diseases: These damage the intestines and favour the presence of the typhoid bacteria
  • Surgery: A history of surgery on the stomach or the intestines is also an important factor.
  • Excessive use of antibiotics: Antibiotics are used to cure various infections. But when used inappropriately, they may damage some helpful bacteria that live in the intestines and prevent the growth harmful organisms.

Are You A Carrier Of The Typhoid Bacteria?

The Carrier State

Though typhoid symptoms completely disappear after the treatment of the infection, there is a chance that the patient will keep shedding the bacteria through his stools or urine for more than a year. This bacteria often gets transmitted to food and water, contaminating both in the process.

About 1 to 5% of people with typhoid fever may end up becoming carriers of the Salmonella bacteria. The following people run the risk of turning into typhoid carriers:

  • People with stones in the gall bladder
  • Patients with cholecystitis i.e. inflammation of the gall bladder
  • People with cancers of the intestine, gall bladder, or the stomach
  • Those with structural defects in the gall bladder, which favor the prolonged stay of the bacteria inside the gall bladder

Who Is At Risk Of Being A Carrier?

Some people have a higher possibility of carrying the Salmonella bacteria and transmitting them, as they are given to interacting with a large number of people on a daily basis. Some of these people are:

  • Hotel cooks
  • Healthcare or hospital workers

People with previous episodes of typhoid are also prone to be carriers.

Measures To Prevent The Spread Of Typhoid

The following measures can go a long way in countering the spread of typhoid.

  • Washing hands properly after using the toilet, so as to avoid contaminating the food with unclean hands
  • Maintaining high standards of sanitation and hygiene, especially in public places
  • Staying away from food and water that could possibly be contaminated, such as street food

As the main causes of typhoid are usually unsanitary conditions and the consumption of contaminated food and water, it is best to take immediate precautions to counter these factors. The infection can be easily diagnosed by taking a typhoid test during the initial stages of the disease, when the symptoms start showing.

Epilepsy Treatment Measures – How To Control The Condition

Epilepsy treatment mainly aims at epilepsy prevention by negating the chances of further episodes of seizures and at the treatment of the root causes that provoke epilepsy symptoms. Here are some measures implemented to control epilepsy:

  • Treating the basic cause of seizures
  • Reducing exposure to the factors that provoke seizure episodes
  • Treatment in the form of medicines or surgery, depending upon the causes of epilepsy
  • Specific treatment plans for individual cases (Treatment is based on the cause of seizures and the patient’s response to particular drugs)
  • Multimodal therapy i.e. treatment that involves multiple measures

 

epilepsy treatment

Seek immediate medical help for persons who are experiencing seizures, so that they can get timely epilepsy treatment.

Epilepsy Treatment – What Needs To Be Done During A Seizure Episode

The abrupt onset of seizures may confuse the patient as well as the people present around him. A few important measures must be taken when one comes across a person experiencing seizures:

  • Protect the person from falling down (To prevent head injuries and bone fractures)
  • Stabilize the person in order to avoid trauma to his limbs
  • Place some cylindrical object (e.g. pen, stick, spoon, etc.) in between the jaws of the person to ensure that he doesn’t bite his tongue
  • Seek immediate help for mobilizing the person to the hospital

Epilepsy Treatment Measures

  1. Treatment Of The Underlying Cause Of Seizures

    Depending upon the underlying cause that triggers seizures, variable measures are taken to cure or avoid the cause.

    • In the case of a seizure due to metabolic disturbance, the disturbance is corrected to alleviate the trigger and avoid further seizure episodes
    • When the seizures are due to substances like cocaine and alcohol, it is adviseable to stop the consumption of such substances
    • If the seizures are triggered by a defect in the neural (brain) tissue (e.g. Pus / Tumour/ Defective vessels), the lesion is removed to eliminate the trigger

    Most of the cases falling under this category may not require medicines to cure seizures. Mere removal of the root cause prevents further episodes of epilepsy.

  2. Avoidance Of The Seizure-Provoking Factors

    Factors that provoke epileptic seizures are:

    • High grade fevers
    • Lack of sleep
    • Neurological infections
    • Overconsumption of alcohol
    • Drug overdose
    • Intense light
    • Mental or physical stress
    • Hormone imbalance, such as during menstruation

    Epileptic patients are asked to avoid these factors, as avoiding them will automatically prevent epileptic spells.

  3. Medical Prescriptions

    The use of anti-epileptic medicines has been the principle mode of treatment for most of the cases of epilepsy.

    Choice Of Medicine

    The choice of drug for epilepsy treatment is mainly based upon the type of epilepsy (i.e. Generalized / Partial / Myoclonic / Absence).

    The Effect Of Drugs On Epilepsy

    Different drugs act in different ways to cure epilepsy. They regulate the electrical potentials over neuronal cells by stabilizing the channels that transport ions like sodium, potassium, and calcium across the membranes of these cells. This prevents the neurons from turning hyper-excitable. Some drugs act by increasing secretions of the neuro-chemical GABA (Gamma Amino Butyric Acid), which inhibits excess contractions in muscles.

    Indications To Start Drug Therapy

    Patients with recurrent seizures are prescribed medication when the cause of epilepsy is not known or when it is known but not reversible. Patients with known brain defects (tumour/ infection) and who are prone to repeated seizures are also candidates for medical treatment.

    Medication Protocols

    The frequency of medication may vary from once a day to 3-4 times a day, depending upon the type of seizure, the patient’s tolerance to the drugs, and the side effect of the drugs. Commonly used anti-epileptic drugs are Phenytoin, Carbamazepine, Lamotrigine, and Valproic acid.

    Some common side effects of anti-epileptic drugs are:

    • Rashes
    • Suppression of the bone marrow
    • Liver damage
    • Enlarged gums & excess hair growth over the face (seen in the case of Phenytoin)

    Monitoring Of Patients

    When the patient is put on anti-epileptic drug therapy, he is regularly monitored for varying blood cell counts and the level of drugs in the blood. He is also subjected to various tests to assess liver function. The medication is modified based on these observations.

    Time To Stop Medication

    epilepsy treatment guidelines

    A normalized EEG pattern may prompt the doctor to stop drug therapy, as the EEG indicates that the epilepsy treatment guidelines have worked.

    The doctor’s decision to stop drug therapy depends upon different criteria such as:

    • The pattern of seizures, which is different for various types of epilepsy
    • The neurological status of patient
    • Absolute absence of seizure episodes for 1 to 5 years (the duration varies with the type of epilepsy)
    • Normalized EEG (Electroencephalogram)
  4. Surgery For Epilepsy

    Around 20 % of epileptic patients may not respond to medicines, even after taking the most effective drug combinations. Such patients are usually required to undergo surgery.

    Surgery involves the removal of the part of the brain that is suspected to be the focus of epilepsy (e.g. parts of structures like the amygdala, the hippocampus, etc. in the brain). The removal of this focal trigger point reduces or completely stops the occurrence of epilepsy.

  5. Vagus Nerve Stimulation

    The vagus nerve is one of the most important nerves in the body. An electrode that generates electrical stimuli is placed near the vagus nerve. The intermittent spikes it generates are intended to stimulate the vagus nerve and raise the threshold of the neurons to control the seizures.

Epilepsy treatment can bring visible results if the patient follows his doctor’s advice and adheres to the medication schedules, dosages, and tests as prescribed. If you’re undergoing epilepsy treatment, ensure that you keep a detailed record of all the epileptic episodes you’ve had and take the prescribed medication without fail. In any case, don’t discontinue the medication without consulting a doctor first.

Epilepsy Symptoms That Spell Trouble – The Symptoms Explained

Epilepsy is a clinical condition characterized by uncontrolled, involuntary contractions of the muscles of a part or whole of the body. Discrete neurological (brain) regions trigger fluctuations in the electrical potentials in the brain, causing repeated muscular contractions in the area controlled by that part of brain. Epilepsy symptoms are varied for different types of epilepsy.

epilepsy symptoms

Headaches are common epilepsy symptoms seen in the phase after a seizure episode.

Epilepsy Symptoms That Spell Trouble

Each type of epilepsy is characterized by a different set of symptoms. Epilepsy symptoms vary in terms of factors like the extent of the seizures (a part or the whole of the body), the duration of seizure episodes, the patient’s levels of consciousness during/after the episode, and his awareness of his surroundings during the seizures.

Epilepsy Symptoms For Certain Types Of Epilepsy

  1. Generalized Tonic-Clonic Epilepsy (Grand Mal Epilepsy)

    In this type of epilepsy, seizures begin suddenly and without warning. In some cases, individuals may report prior vague perceptions throughout the body. The phase of active seizure is known as the ictal phase, while the phase following the seizure is called the postictal phase. Here are the symptoms for each phase.

    • Tonic Phase

      Active muscle contractions (generalized) lasting for a few seconds

    • Clonic Phase

      Muscle relaxation that lasts for less than a minute

    • Postictal Phase

      • Excessive salivation
      • The involuntary passage of urine or stools
      • Strenuous breathing
      • Unresponsiveness and varying levels of consciousness for a few minutes to a few hours
      • Confusion about one’s surroundings
      • Headaches
      • Muscle pains

    The patient’s Electroencephalogram (EEG) shows progressively rising, fast and high amplitude voltage discharges in the neuronal tissue. As the patient recovers from the seizure episode, the EEG almost comes back to normal. Ictal Cry Contractions of the respiratory muscles push the air out of the lungs forcibly. At the same time, the contracting muscles of the larynx (respiratory airway opening) prevent this blast of air from coming out of the respiratory path. This process may produce a loud moan, better known as an ictal cry.

    Cyanosis

    Cyanosis is characterized by a bluish appearance of the fingertips, the tip of the nose, and the ear lobes, due to insufficient oxygen in the blood. Impaired respiratory muscle movements pull in the respiratory secretions causing impaired lung function, which ultimately leads to cyanosis.

    Tongue Bite

    When a person forcefully contracts his jaw muscles during a convulsive episode, he runs the risk of severely injuring his tongue if it gets caught in between both the jaws. If this happens, it can be very painful for him. Additional epilepsy symptoms in the case of generalized tonic-clonic seizures include a rapid heart rate, high blood pressure, and dilated pupils.

  2. Absence Seizures (Petit-Mal Epilepsy)

    Absence seizures usually occur among children between 4 and 8 years of age, and they are often characterized by:

    • Abrupt onset
    • A short episode of unconsciousness that lasts for a few seconds
    • Complete postural control
    • No postictal confusion
    • Frequent seizures, often even up to 100 times a day

    Sometimes, certain additional symptoms are noted, such as:

    • Repeated and rapid chewing movements
    • Rapid eye blinking
    • Rapid hand movements
  3. Atonic Epilepsy

    Here are some symptoms of atonic epilepsy:

    • A brief seizure, characterized by a nodding movement of the head or a sudden transient head drop
    • Abrupt loss of muscle tone (for about 1 to 2 seconds)
    • Impaired consciousness for some time
    • No feeling of confusion post seizures
    • In some cases, a collapse of the patient to the ground
  4. Myoclonic Epilepsy

    Myoclonus is characterized by symptoms like:

    • Abrupt contraction of the muscles of either a part or the whole of the body
    • In the case of Juvenile Myoclonic Epilepsy, the onset of generalized seizures in early adolescence, with single or repeating jerky movements on both sides of the body. They usually occur in the morning after the patient wakes up. Lack of adequate sleep is a precipitating factor in such cases
  5. Simple Partial Seizures

    Characteristic features of simple partial seizures are:

    • No obvious loss of consciousness
    • Sensory, motor, autonomic, or psychic symptoms
    • Repetitive flexion-extension movements of arms
    • Synchronous hand and facial movements
    • Onset of seizures in a localized part of the body (such as the fingers), which gradually progress to the whole of the part (such as the hand or the arm)

    Additional symptoms

    • Altered sensations or Paraesthesias
    • Vertigo or dizziness
    • Sweating
    • “Aura” of epilepsy – A feeling that warns about the onset of seizures
    symptoms of epilepsy

    Vertigo or dizziness is one of the symptoms of epilepsy, often seen in simple partial seizures.

    Epileptics people may experience unusual perceptions like:

    • Intense smells (e.g. the odor of burning)
    • Flashes of light
    • Different crude sounds

    These symptoms make the patient look confused and frightened.

  6. Complex Partial Seizures

    The main difference between simple and complex partial seizures is the lack of awareness of one’s surroundings that occurs during complex partial seizures. In this condition, the seizures begin in a certain part of the body, causing the person to lose contact with his surroundings. The patients does not respond to verbal communication. Typical complex partial seizures exhibit:

    • An abrupt motionless state at the onset
    • Repeated smacking lip movements and rolling movements of the hands
    • A temporary loss of memory wherein the individual cannot recollect the seizure episode after it has occurred
    • A state of confusion after the seizure episode, sometimes lasting for hours

As epilepsy can be highly disturbing for the person who has this condition as well as the people around him, it best to take the necessary measures to counter it. The best remedy is to avoid its triggers that act as causes of epilepsy in the first place by taking the necessary steps for epilepsy prevention. If you experience any of the epilepsy symptoms mentioned above, rush to the doctor immediately for epilepsy treatment.

Taking The Typhoid Test – How The Disease Is Diagnosed

Typhoid fever, a bacterial infection caused by Salmonella typhi and paratyphi, may prove dangerous if not diagnosed and treated on time. Untreated typhoid may result in serious complications like intestinal perforation, peritoneal infection, and intestinal bleeding or ulcers. These harmful possibilities make the early diagnosis and typhoid fever treatment very important. A laboratory typhoid test can confirm the diagnosis of typhoid fever.

typhoid test

A typhoid test can help detect the presence of Salmonella and confirm a typhoid infection.

Take A Typhoid Test

Here are some of the common typhoid tests conducted as part of typhoid diagnosis.

  1. Widal Test

    An Introduction To The Widal Test

    • The Widal test detects the presence of the antibodies that act against the antigens of typhoid bacteria. The substance that triggers the formation of an antibody is called an antigen and a particle produced by the body on exposure to an antigen is called an antibody.
    • During typhoid infections, two types of antigens namely ‘H’ and ‘O’ are present in the blood of the patient. The antigen ‘H’ is derived from the flagella (a tail-like structure) of bacteria, while the antigen ‘O’ comes from the body of these organisms.
    • When a person acquires a typhoid infection, these antigens are sensed as foreign particles by the body and in response to them, the body produces antibodies. These antibodies can be detected with the Widal test.

    How Is The Widal Test Done?

    • In a test tube (or over a glass slide) the blood sample taken from the patient is allowed to react with a solution that contains antigens (H and O) of typhoid bacteria. Now, if the blood contains antibodies against these antigens, clumping appears in the mixture. This clumping can be seen with naked eyes.
    • Serial dilutions of Salmonella antigens are done in different test tubes (or on slides) and the patient’s blood, taken as a sample, is mixed with them. The level of specific titre (concentration) is noted and the result is interpreted accordingly. A titre that exceeds 200 for antigen H and a titre above 100 for antigen O antigen are considered as significant.

    Facts Related To The Widal Test

    • The Widal test is not very accurate. Also, the results of multiple tests are more reliable as a single test might not prove conclusive. Though it is easier, faster, and cheaper to perform than other tests, the Widal test has a few limitations.
      • It cannot distinguish between the antibodies present due to the current infection and the ones left over from previous infections.
      • There is a chance that other infections may yield a positive result on this test.
      • Patients who have been vaccinated against typhoid may also show positive results on the test.
    • The Widal test may be negative in the first week and the titres begin to rise at the end of the first week or at the beginning of second week. Between the second and fourth week, the titres rise gradually and then decline slowly.
    • Patients treated with antibiotics may not show any rise in titres.
  2. Culture

    Culture is probably the only specific method to diagnose typhoid. It is considered as the ‘Gold standard’ method for diagnosing typhoid fever. Cultures can be generated using samples like blood, urine, stool, bone marrow, and intestinal secretions. One of these samples is spread over specific culture media that is designed to favor the growth of Salmonella. The culture shows typical characteristics that help identify these bacteria.

    • Stool Culture

      Stool culture may remain negative during the first week. It becomes positive by the third week of typhoid, if it has not been treated until then. Stool culture is a good way of detecting a long-term carrier state, as the carrier person can shed Salmonella for more than a year.

    • Blood Culture

      Results of a blood culture may vary as per the duration of the illness. High yield may be observed during the first week of infection and this decreases gradually by the third week. The yield of the culture is determined by the number of Salmonella bacteria present. There are chances that with antibiotic therapy, the yield will decrease.

    • Bone Marrow Culture

      It is a more sensitive method than blood culture to detect the presence of the Salmonella bacteria.

    • Intestinal Secretion Culture

      Culture generated from intestinal secretions may show a positive result even when the bone marrow culture gives a negative result. This helps eliminate any false negatives.

  3. Typhidot-M

    Typhidot-M, a new typhoid test, detects IgM and IgG (Immunoglobulins M and G) type of antibodies in the blood of the patient. Typhidot is capable of detecting typhoid within 2-3 days of infection and its results can be generated within few hours.

    IgM antibodies are indicative of recent infection while IgG antibodies indicate past infection. As Typhidot can distinguish between IgM and IgG, it becomes easier to diagnose recent infections.

The Widal test, though not very specific for the diagnosis of typhoid, is usually the typhoid test of choice due to its simpler, faster, and cost-effective method. Typhoid can turn fatal if it is not diagnosed and treated in a timely manner. If you suspect a typhoid infection or see any typhoid fever symptoms, consult a doctor immediately.

Photosensitive Epilepsy Symptoms – Signs That Indicate An Issue

Photosensitive epilepsy is a type of epilepsy in which seizures occur as a result of exposure to flickering lights or flashes of light of varied wavelengths, colors, and patterns. Photosensitive epilepsy symptoms are similar to those seen in other types of epilepsy.

photosensitive epilepsy symptoms

Photosensitive epilepsy symptoms may be triggered by prolonged exposure to the flickering lights from television screens or video game screens.

Photosensitive Epilepsy Symptoms

Here are some characteristics of photosensitive epilepsy.

Some Basic Information About Photosensitive Epilepsy Symptoms

  • A typical case of photosensitive epilepsy can occur during something as routine as watching television or playing video games for longs hours. In such cases, the seizure episode is triggered by the light flickers in the television or gaming screen.
  • Usually, children and adolescents are affected by photosensitive epilepsy
  • Individuals with a history of exposure to bright, high contrast flickering lights before an epileptic attack are more susceptible to photosensitive epilepsy.
  • In some cases of the condition, the individual may experience seizures with eyes closed and in some cases, he may experience them with open eyes. Even when the eyes are closed, external lights cannot be completely occluded. Flashes of light passing through closed eyelids can also precipitate seizures.

Some Common Photosensitive Epilepsy Symptoms

  • Muscles become stiff due to contractions
  • Epileptic cry – A loud moan, caused by a forceful burst of air from the lungs as a result of the vigorous contractions of respiratory  muscles, is known as an epileptic cry. It signifies the onset of an epileptic attack.
  • The individual may collapse of the ground (and in some cases acquire a head injury)
  • Impaired consciousness
  • Temporary loss of control over the bladder or the stools
  • A tongue injury in case the tongue is caught in between the jaws during the seizure

An Important Warning Sign That Marks The Onset Of A Seizure Episode

A subjective feeling of abnormal aural, visual, olfactory (of the nose), or tactile sensations just before an epileptic seizure is called as an aura. Experiencing such an aura during exposure to bright flickering lights should warn you that an attack of epilepsy is about to start within next few minutes.

Patterns of Seizures in Photosensitive Epilepsy

The pattern and nature of the seizures may vary from person to person. They may be  generalized tonic-clonic seizures or absence seizures. The seizure episodes may vary from simple to intense, as well.

Generalized Tonic-Clonic Seizures

In generalized tonic-clonic seizures, alternating, often forceful, contractions and relaxations of the muscles occur throughout the body. This phase can last for up to 5 minutes.

Partial/Focal Seizures

In partial seizure episodes, the muscles of a certain part of the body are involved. If the electrical activity spreads to other areas of brain, the seizures may become generalized.

Ictal Phase

The actual phase when the seizure is occurring is called the ictal phase. The type of seizure may vary depending upon the level of neuronal excitation and its spread in the brain. Localized focus of neuronal activity in the brain causes focal seizures (involving only a part of the body), while widespread electrical activation to various parts of the brain results in generalized tonic-clonic seizures.

Postictal Phase

The phase following a seizure episode, the postictal phase, lasts for a few minutes. Some symptoms commonly seen during this phase are:

  • Short-term memory loss
  • Heavy pain in the head and the muscles of body
  • Confused behavior
  • Signs of exhaustion

EEG (Electroencephalogram)

EEG indicates the electrical changes that take place continuously inside the brain. An EEG involves placing multiple electrodes all over the head of the patient and recording the electrical potentials coming from different parts of brain.

Photosensitive epilepsy symptoms are observed to identify the condition, which can then be confirmed by observing the changes in the EEG wave patterns while the person is being exposed to flickering light.

The Symptoms Of Diabetes In Dogs – Is Your Canine Affected?

Diabetes mellitus is a disease that results due to insulin deficiency, and like humans, even dogs may be affected by this condition. Reports say that there is a three-fold increase in number of dogs diagnosed to be diabetic in last thirty years. By keeping an eye out on the clinical symptoms of diabetes in dogs, you can ensure that your four-legged friend is always healthy.

It should be noted that the symptoms of diabetes in dogs are almost the same as those in humans.

The Breeds That Are Affected

Diabetes generally affects all breeds of dogs, but certain breeds like German Shepherds, Poodles, Miniature Schnauzers, and Golden Retrievers are affected at a comparatively higher rate. In most cases, the main cause behind the condition is the immunological destruction of insulin producing cells of the pancreas. Genetic predisposition is also an important factor when it comes to the symptoms of diabetes in dogs.

symptoms of diabetes in dogs

The symptoms of diabetes in dogs are more commonly noticed in specific breeds like German Shepherds

How To Know If Your Dog Is Diabetic

Diabetes commonly affects middle-aged and elderly dogs. Over 70 percent of the affected dogs are above seven years of age, at the time of diagnosis. Diabetes seldom occurs in younger ones.

A typical diabetic dog would be middle-aged, overweight, and of the female gender. The female to male diabetes ratio in dogs is around 3:1.

The Main Symptoms Of Diabetes In Dogs

Symptoms appear gradually (over weeks) by 6-9 years of age in affected dogs.

Diabetes causes hyperglycemia, which is marked by high blood glucose levels – a characteristic feature of diabetes. Hyperglycemia further leads to the appearance of following symptoms.

  • Polydypsia – Increased thirst and water consumption
  • Polyphagia – Increased hunger, marked by a frequent urge to eat
  • Polyuria – Increased frequency of passing urine

Other symptoms of diabetes in dogs include:

  • Unexplained weight loss
  • Weakness and fatigue
  • Cataract, amrked by cloudy eyes that cause diminution of vision

The Advanced Symptoms Of Diabetes In Dogs

As the condition progresses, the symptoms of diabetes in dogs also turn complex and serious in nature. Multiple organs in the body are affected during the advanced stages of diabetes, and here are some of the commonly observed complications:

  • Diabetic Ketoacidosis

This is a serious complication of diabetes, so if you have any reason to suspect that your dog has ketoacidosis, find a veterinarian immediately.

Inadequate sugar utilization necessitates the formation of ketone bodies, which act as alternative sources of energy. These ketone bodies are the by-product of metabolic reactions in the body, and excess levels of such ketones in the blood can be detected in the laboratory to ketoacidosis.

It manifests clinically as an odor in the breath, and typically smells like a nail polish removing solution.

  • Infections

Diabetic dogs are especially prone to urinary tract infections, and mouth and gum infections. High levels of blood sugar facilitate the growth of infectious germs, and obvious symptoms like lethargy and vomiting generally point to infection.

  • Kidney Damage

This condition is known as diabetic nephropathy. Long term blood sugar fluctuations can cause damage to the kidneys, bringing about renal failure with time.

  • Cataract

The lens of eye is a transparent structure, but diabetes makes it susceptible to cataract (and the lens becomes opaque). This makes the eyes look cloudy and leads to the gradual loss of vision. This is one of the most easily identifiable symptoms of diabetes in dogs.

Once you note such symptoms, doctors will be able to confirm the presence of diabetes through various tests and laboratory findings. They will mainly look for:

  • Elevated blood cholesterol lipids
  • Protein in the urine, indicating kidney damage
  • Increased liver enzymes and/or enlarged liver
  • Elevated white blood cell count due to bacterial infections

Keeping an eye out for the symptoms of diabetes in dogs can help you save your dog and seek immediate consultation from veterinarians when there is a problem. Statistics reveal that only 50% of diabetic dogs survive for at least 2 months after diagnosis, with continued successful treatment at home. Dogs that are being treated for diabetes have the same life expectancy as non-diabetic dogs, so help your canine friend counter the condition.

The Different Types Of Epilepsy – Understanding The Condition

Epilepsy is a state of frequent involuntary muscular contractions (seizures) that occur due to underlying focal or general neurological defects. The electrical fluctuations in discrete areas of the brain trigger contractions in the muscles that are controlled by that particular part of the brain. For this reason, there are different types of epilepsy as well as the causes of epilepsy span a great range.

types of epilepsy

Grand Mal epilepsy is one of the types of epilepsy and it is characterized by severe headaches and muscle pain.

Epilepsy is a common neurological condition and it is characterized by recurrent, unexpected seizures. It may affect people from all age groups, ranging from children to the elderly. About 5-10 among 1000 humans are estimated to suffer from the problem worldwide.

Understanding The Different Types Of Epilepsy

Depending on the pattern of seizures and brain activity, epilepsy is broadly grouped/sub-grouped into different categories. The two main types of epilepsy are:

  • Generalized Epilepsy
  • Partial Epilepsy

Types Of Epilepsy: Generalized Epilepsy

Generalized seizures are attributed to widespread cellular, structural, or biochemical disturbances in the brain. Diffused and hyper-synchronized electrical fluctuations in the brain may cause these seizures to appear.

  • Generalized Tonic-Clonic Epilepsy

    The generalized tonic-clonic seizure (also called Grand Mal epilepsy) is the most common among the types of epilepsy, and this accounts for about 10% of all seizures.

    It is characterized by sudden muscle stiffness in the body (known as the “Tonic phase” of the seizure) which lasts for about 10 to 20 seconds. This is followed by a “Clonic phase” which is superimposed with the relaxation of these muscles, lasting for less than a minute.

    After the seizures disappear, the affected individual becomes unresponsive, confused, and disoriented for a while.

    Excessive salivation, breathing difficulty, and tongue biting (as the tongue gets caught between the jaws during seizures) can be observed in such cases. Patients may even pass stool or urine during the episode. After a tonic clonic seizure, the patient may gain consciousness in just a few minutes or after hours. Severe headache and muscle pain are other characteristic symptoms.

    An Electroencephalogram (EEG, which is a graphical record of the brain’s electrical activity) will reveal significantly abnormal electrical changes in brain.

  • Tonic Epilepsy

    This is characterized by muscular contractions, making them stiff for a while.

  • Clonic Epilepsy

    Clonic contractions of the muscles are typically repetitive, rhythmic, and occur in muscles of both sides of body simultaneously.

  • Absence Seizures

    Absence seizures (also called Petit-Mal seizures) are featured by an abrupt loss of consciousness, without any loss of control over the posture of body. They last for a few seconds and patients do not experience confusion after the seizures alleviate.

    Children between 4 to 8 years of age or adolescents are affected by this condition.

    One of the common types of epilepsy, an absence seizure may precipitate in the form of rapid eye blinking or chewing movements. It is characterized by generalised tonic-clonic convulsions. In about 60-70% of the cases, the epileptic individuals experience remission. This type of epilepsy can be treated through medication.

  • Atonic Epilepsy

    People with Atonic Epilepsy mostly face an abrupt loss of muscle tone for 1 to 2 seconds along with a brief spell of unconsciousness, without further disorientation.

    This is one of the dangerous types of epilepsy as head injuries might occur if the individual falls during his unconscious state.

  • Myoclonic Epilepsy

    This type of epilepsy is characterized by brief and abrupt muscular contractions, either in specific parts or the whole body. Jerky muscular movements during sleep, which many people commonly experience, underline this type, and mostly, the cause is an underlying neurological dysfunction.

Types Of Epilepsy: Partial Epilepsy

Partial seizures (also known as local or focal seizures) occur due to any physical damage or structural anomalies in certain areas of the brain. The types of epilepsy here are:

  • Simple Partial Seizures
  • Complex Partial Seizures
  • Simple Partial Seizures

    Simple partial seizures are characterised by the gradual onset muscular contractions in specific body parts, based on where the damage has occurred in the brain.

    Typically, clonic and repetitive contractions-relaxations are observed during the epileptic attack. One of the five special senses (hearing, taste, vision, touch, or smell) may present with abnormal sensations before or during the episode. This feature is called the ‘Aura’ of epilepsy.

    There are some variants among simple partial seizures:

    • Jacksonian March: Abnormal finger contractions gradually progress to the arm within a few minutes
    • Todd’s Paralysis: Localized loss of power and sensations (from a few minutes to hours) in the affected region after the episode
  • Complex Partial Seizures

    A typical ‘loss of contact with surroundings’ is the distinguishing feature of complex partial seizures. Patients often lose touch with the environment during such episodes, and may find it hard to recollect the events later.

    Complex partial seizures occur in the form of ‘automatisms’. These epilepsy symptoms are involuntary movements like lip-smacking, chewing, or swallowing.

different types of epilepsy

Photosensitive epilepsy is one of the different types of epilepsy, which can be triggered by intense flashes of light.

Photosensitive Epilepsy

This type of epilepsy is precipitated by stimuli like intense lights, flashes, fluorescent glows, and regular or bold moving light patterns. Individuals afflicted with this condition should avoid any form of flashing lights, in computers and even in nightclubs.

The different types of epilepsy, as shown, have different triggers. By isolating the cause of the epileptic attack, the ideal epilepsy treatment can be finalized. It is no doubt very important to take epilepsy prevention measures in the first place.