Ciguatera refers to a rare foodborne illness affecting the muscular, digestive, or neurological system that is caused when ciguatera poisoning contaminated reef fishes are consumed. (6)

What Type of Toxin is Ciguatera

Ciguatera is a biological toxin, produced by the microalgae called Gambierdiscus that inhabit coral reefs.

Ciguatera Fish Poisoning Signs and Symptoms

Initial neurological symptoms, affecting lips, tongue, hands or feet, and beginning 30 minutes after consumption may involve:

• Itching
• Tingling
• Numbness

The only neurological symptom found in children is irritability.

Other symptoms (neurological, GI and visual), occurring between 6 to 17 hours may include:

• Abdominal cramps
• Vomiting
• Diarrhea
• Nausea
• Painful defecation
• Pain and loosening of teeth
• Muscle and joint pain
• Reversal of hot and cold sensation
• Weakness
• Blurred vision
• Abnormal sensitiveness to light
• Tremendous sweating
• Metallic taste
• Excessive salivation
• Dizziness
• Restlessness
• Wheezing

Cardiac symptoms may include:

• Blood pressure fall
• Slow or fast heart rate

The symptoms indicating severe ciguatera poisoning are:

• Chills
• Shortness of breath
• Tearing of eyes
• Skin rashes

Causes

This nonbacterial fish poisoning usually occurs as the toxin accumulated in various parts of a reef fish, on consumption, activate certain channels on the body cells, called voltage-gated sodium channels, thereby resulting in a host of symptoms. (9)

In What Kind of Food is Ciguatera Toxin Found

The toxin is found in carnivorous reef fishes such as barracuda, blackfin snapper, and moray eel as well as herbivorous and omnivorous fishes like red snapper, parrot fish or surgeonfish.

Risk Factors

Men and women of all age groups may be affected, but the primary ones are travelers to endemic regions as well as people living in tropical and subtropical countries, chiefly the Caribbean and Pacific regions. Further, pregnant women suffering from ciguatera poisoning, may transmit the toxin to the fetus trough the placenta, while infected breastfeeding mothers, may pass on the toxin to the baby through breast milk.

Complications

• Dyspnea
• Muscular paralysis
• Orthostatic hypotension
• Coma
• Bradycardia
• Respiratory arrest

Diagnosis and Tests

After an initial assessment of symptoms and dietary history, some nonspecific tests are done such to check for elevated levels of mild creatine phosphokinase (CPK) and lactate dehydrogenase (LDH).

Another nonspecific test, Visual Contrast Sensitivity (VCS) is carried out to determine the patient’s ability to detect the colors white, black and gray, which is often impaired by the neurotoxin.

Since these tests may indicate other types of neurotoxic poisoning such as botulism or shellfish poisoning, at times, a conclusive ciguatera toxin analysis may be done by subjecting the contaminated fish for diagnostic testing.

Differential Diagnosis

• Botulism
• Mushroom toxicity
• Organic phosphorous compound and carbamate toxicity
• Shellfish toxicity
• Tetrodotoxin toxicity
• Scombroid toxicity
• Guillain-barré syndrome

Treatment and Management

There is no specific treatment procedure available for the disorder. However, some modern methods may be recommended, involving:

• Gastrointestinal decontamination using activated charcoal, that may be done 3 to 4 hours after ingestion of the charcoal to absorb the toxin (3)
• Immediately pumping out all the stomach content (gastric lavage)

Since no antidote for the disorder is available, following certain procedures at home may help. According to some studies, vomiting within 3 to 4 hours of consumption of the infected fish may help. Hydration of the patient is also done to maintain the loss of his fluid balance due to vomiting.

Treatment of Associated Conditions

Medication

• Osmotic diuretics such as mannitol (Osmitrol) to effectively decrease the severity and span of neurological symptoms
• NSAID’s and acetaminophen ( eg.Tylenol) to decrease pain
• Amitriptyline (Elavil, Endep) and gabapentin (Neurontin, Gralise, Horizant) to lessen neural pain symptoms
• Diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) to provide relief in itching (3)

How to Prevent Ciguatera Poisoning

It is important to note that the ciguatera toxin neither changes the fish’s taste, smell and texture, nor does it get destroyed by cooking. Hence, the preventive measures that can be followed are:

• Restraining from eating reef fish
• Avoiding the head, liver, and intestines of small reef fish, where the toxin may concentrate

Incidence and Prevalence

The incidence of ciguatera fish poisoning is estimated to be more than 50,000 cases per year. Amidst this, 3 out of 100 travelers to high endemic areas may have this ailment. According to certain reports, global warming resulted due to climate change, seems to be one of the reasons, responsible for an increase in ciguatera fish poisoning at present.

Prognosis and Life Expectancy

Most people suffering from this disease recover slowly, with relapsable symptoms that may induce long term effects for nearly twenty years. The slow releasing nature of the toxin may be a primary reason for recurrence. Death may occur in rare cases (0.5%).

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Opioid Dependence is a type of medical condition that is characterized by the inability of an individual to refrain from opioid drugs, even when it requires him or her to do so.

An individual having such a drug dependency tends to give high priority to the consumption of opioid drugs and exhibit persistent drug-seeking behavior. The reasons that one can get addicted to these forms of drugs may be biological, social or psychological in nature. It can adversely affect one’s cognitive and behavioral skills as well as have implications on all sectors of the person’s life.

Opioid Dependence ICD-9 Code

The ICD-9 Code for this disorder is 304.0.

What are Opioids and what is Opioid Dependence?

Opioids are drugs or chemicals that attach themselves to sites within the brain known as opioid receptors. A human body is capable of manufacturing its own opioids, known as endorphins. However the opioids referred to in opioid addiction or dependence are the ones that are available from plants or made in a laboratory. For example, codeine and morphine are extracted from the opium seeds which are obtained from poppy plant, after which opium is then processed into heroin. The majority of the prescription painkillers such as hydrocodone, hydromorphone and oxycodone are synthesized in laboratories. If a person becomes addicted or dependent on these drugs, he or she needs to seek treatment for Opioid dependence.

What are the common forms of opioids?

Opioids can either be prescribed legally by doctors for relieving pain or suppression of cough symptoms or they can be taken illicitly for their mood altering properties. These drugs can cause a feeling of euphoria or sedation, which can make someone feel ‘better’ or ‘normal’. Not everybody who is taking opioid medications is at risk of developing dependence though. The most common types of opioids that are often abused are listed below:

• Tramadol – present in Ultram
• Fentanyl – present in Duragesic
• Meperidine – present in Demerol
• Oxymorphone – present in Opana
• Methadone – present in Dolophine
• Hydromorphone – present in Dilaudid
• Buprenorphine – present in Suboxone
• Morphine – present in Kadian, MS Contin and MSIR
• Hydrocodone – present in Lortab, Lorcet and Vicodin
• Oxycodone – present in Percocet, Percodan and OxyContin
• Codeine – present in Tylenol 3, Fiorinal, Fiorecet 3, as well as in certain cough syrups

Opioid Dependence Risk Factors

Although specific causes might vary from one person to the other, scientists and researchers believe that one’s heredity plays a major role in making one susceptible to develop an opioid addiction. Psychological factors such as stress, depression or anxiousness as well as social environment also have an important part to play in the developing opioid dependence. The unpleasant effects that might occur due to opioid withdrawal might cause many individuals to continue abusing illegal or prescription opioids, thereby leading to a prolonged dependence.

Effects of Opioid Dependence on the Brain

A prolonged usage of opioid medications can cause changes in the architecture as well as the chemistry of the brain. Architectural changes can occur in the brain circuitry – especially in the neuronal wiring of reward pathway. The human brain is wired to make sure that life-sustaining activities such as intake of proper food and water is carried out, which are associated with reward or pleasure. Whenever the reward circuitry gets activated, the brain keeps a record of it and propels us to repeat that experience again. Intensely emotional memories might get permanently hard wired.

In people having opioid dependence, the reward pathway is excessively stimulated by an opioid drug which makes the brain believe that the opioid medication is necessary for survival, much like regular food and water. This motivates people to repetitively consume opioids, even when they understand that it is clearly damaging to do so.

Chemical changes take place within the brain as it attempts to adapt to this excessive opioid stimulation. The brain tries to compensate for the intense highs and lows associated with repeated opioid usage and withdrawal by lowering the number of opioid-receptors in brain. This enables an opioid tolerance in individuals who are addicted to this drug. Due to this, more and more quantities of the drug are needed to produce the same effect. This eventually makes the addict feel depressed, lifeless, and unable to actively participate in regular activities that normally bring them pleasure.

To make matters further complicated, repeated opioid consumption leads to severe impairment of one’s intellectual abilities – thereby making it difficult for one to make sound judgments and appropriate decisions. As this area of one’s brain is still undergoing development in an adolescent, opioid dependence in teenagers is often far more severe and resistant to treatment. Such teens may have difficulty in admitting that they have a drug issue, and may justify their use of drugs to friends and family as well as ignore the consequences of their addictive behavior. They can even exhibit serious behavioral problems, such as lying, stealing or committing criminal acts just to get hold of the drugs that they believe to be an essential part of their survival.

Opioid Dependence Causes

It has been seen that the majority of opioid addicts have at least one severe psychiatric problem. As the opioids used in the pain therapy hardly leads to any of such conditions, they are believed to exist from a time prior to development of this dependence. Opioids have got strong antipsychotic, antidepressive and anxiolytic properties. As a result, opioid dependence frequently develops from self medication. Opioids are an excellent form of acute pain medication. However, it is their tendency to produce a euphoric effect that makes them so appealing to addicts.

Some studies also suggest that chronic exposure to these medications can lead to a permanent deregulation of endogenous opioid receptor system in the brain. Recent studies have shown that increase in the brain-derived neurotrophic factor or BDNF in ventral tegmental area (VTA) of rats can lead opiate-naive rats to display opiate-dependent behavior, such as drug-seeking tendencies and withdrawal. It is seen that when opiate-naïve individuals start taking opiates at euphoria-inducing levels, a similar increase in brain-derived neurotrophic factor takes place.

Opioid Dependence Withdrawal Symptoms

The following withdrawal symptoms may be seen in people having opioid dependence:

Physical Symptoms

The physical symptoms caused due to opioid withdrawal include:

• Itch
• Chills
• Cough
• Cramps
• Anxiety
• Tremors
• Diarrhea
• Yawning
• Priapism
• Anorexia
• Sneezing
• Vomiting
• Insomnia
• Irritability
• Weakness
• Perspiration
• Goosebumps
• Hypertension
• Dilated pupils
• Flu-like symptoms
• Abdominal cramps
• Restless legs syndrome
• Muscle and bone pains
• Increased bowel sounds
• Tachycardia or rapid heartbeats
• Rhinitis or runny, inflamed nose
• Akathisia (profound inner restlessness)

Psychological Symptoms

The psychological symptoms include:

• Malaise
• Nausea
• Cravings
• Paranoia
• Dizziness
• Insomnia
• Dysphoria
• Depression
• Anxiety or panic attacks

The duration of the withdrawal symptoms may last from 2 to 60 days, depending on the type of drug, quantity taken as well as duration and frequency of usage.

Opioid Overdose Symptoms

An individual experiencing an overdose of opioids will exhibit the following symptoms:

• Fainting
• Seizures
• Muscle spasms
• Pinpoint pupils
• Reduced heart rate
• Reduced rate of breathing
• Decreased levels of consciousness
• Blue nails and lips caused by insufficient amounts of oxygen in blood

Opioid Dependence Complications

Opioid dependence can lead to major complications in relation to the physical and mental health of an individual as well as his or her social life.

Health problems

The condition leads to the following health complications:

• Death
• Strokes
• Seizures
• Septicaemia
• Dehydration
• HIV infection
• Poor nutrition
• Dental disease
• Infective endocarditis
• Tuberculosis infection
• Hepatitis A, B, C infections
• Heart problems such as cardiac arrhythmias
• Skin infections at the injection sites, such as necrotizing fasciitis
• Arterial and venous thrombosis, caused by poor injecting techniques

Psychological problems

The addiction leads to the following psychological problems:

• Guilt
• Anxiety
• Suicidal tendencies
• Strong craving for opioids
• Loss of memory and other cognitive skills

Social problems

Opioid dependence can give rise to the following social issues:

• Criminal activities
• Relationship problems
• Homelessness and deprivation
• Issues related to child protection
• Working in improper and demeaning jobs

Opioid Dependence Diagnostic Criteria

Based on the diagnostic criteria clearly identified by the WHO and DSM-IV-TR, the clinical guidelines required for a proper diagnosis of opioid dependence makes it mandatory that three or more of these following six characteristic features be exhibited or experienced:

• A strong sense of compulsion or desire to take opioid
• Difficulties in controlling the drug-taking behavior in terms of onset, termination, or the levels of usage
• A physiological state of withdrawal experienced when use of opioid is halted or reduced, as marked by characteristic withdrawal symptoms and/or use of the same opioid drug or some similar medication to get rid of the withdrawal symptoms
• Signs of tolerance, which require an increased dosage of the opioid drug to produce the same effects that were originally produced by lower doses
• A progressive neglect of other alternative interests or pleasures due to opioid use; increased durations of time needed to take or obtain the drug or recover from the effects produced by it
• Continued use of drugs despite apparent evidence of significantly harmful effects, such as cardiac difficulties, impaired cognitive functioning or depressive mood states.

Opioid Dependence Treatment

Opioid dependence is a serious condition that frequently requires long term treatment. Treatment of this disorder is necessary due to the physical, psychological and social consequences associated with it and to bring overall general well being to the patient. The prime objectives of therapy are:

• To reduce dependent tendencies on opioid or other illicit drugs
• To reduce the risks of morbidity and mortality associated with illicit use of these drugs
• To reduce criminal or antisocial tendencies
• To facilitate reintegration of the patient into workforce and/or education system as well as improve his or her social functioning

Although the main goal is to bring a patient to a complete drug-free living state, achieving such a goal in short terms might be difficult.

As there is no single treatment that works for all patients, diverse methods of treatment are required which includes both pharmacological remedies as well as psychosocial procedures. Relapse following a detoxification procedure is quite common. Naturally, this method is hardly considered to be an adequate remedy on its own. However, this is often the first step used in many forms of long-term treatment based on abstinence. Both detoxification combined with subsequent abstinence-oriented treatment as well as substitution maintenance therapy are essential elements of effective treatment of this condition.

At present, there is a rising trend to abuse prescription opioids compared to the illicit forms such as heroin. This also has implications for prevention, therapy and treatment of Opioid dependence.

Methadone Programs

Methadone Maintenance Treatment (MMT) is a type of opioid replacement therapy that reduces or eliminates usage of illicit opiates and helps patients to increase their physical and social productivity. It also reduced the possibilities of contamination of infectious disorders like HIV and hepatitis. The main aims of this program are:

• To reduce narcotic craving
• To relieve abstinence syndrome
• To block the euphoria associated with opiates

It can also be used for pregnant women who are addicted to opiates. A methadone reduction program can be used to get rid of dependence on opioids completely.

Buprenorphine

Buprenorphine is proven to be a safer alternative to methadone due to its reduced propensity to cause overdose related mortalities during the ongoing course of treatment. Opioid dependence is often managed by Buprenorphine sublingual preparations such as Suboxone and Subutex.

Naltrexone

Naltrexone is an FDA-approved medication that is available both as an oral as well as an injectable drug.

Diamorphine

In many countries, pure injectable diamorphine is used to treat opioid dependence in patients who show resistance to treatment by methadone or other medications.

Experimental treatments

These drugs have shown varied levels of success in managing the condition:

• Ibogaine
• Ketamine
• Tramadol
• Clonidine
• Mitragynine
• Medical cannabis
• Dextromethorphan

Treatment of the condition with the aid of these medications is still at an experimental stage.

12-Step Support Groups

Once an addict overcomes the initial stages of withdrawal, attending 12-step support group programs such as Narcotics Anonymous (NA) can help one to further overcome his or her addictive tendencies.

Opioid Dependence Prognosis

The prognosis for opioid-dependent individuals is good once they have been given proper treatment. According to reports presented by the National Drug Treatment Monitoring System in UK, 49% of patients who have attended the UK drug treatment service have achieved abstinence from illegal opiate drugs when reviewed at 6 months. Another 24% showed reliable improvement and 2% had shown deterioration.

References:

http://en.wikipedia.org/wiki/Opioid_dependence

http://www.northlandaddictiontreatmentrehabcenter.com/resources/opioid-addiction

http://psychcentral.com/lib/2011/opioid-dependence-and-withdrawal/

http://www.patient.co.uk/doctor/Opioid-Abuse-and-Dependence.htm

The post Opioid Dependence appeared first on Prime Health Channel.

The condition is marked by increase in the levels of an element in the body called arsenic. Prolonged exposure to the poisonous chemical is highly detrimental to health and may produce serious repercussions.

Arsenic Poisoning History

Arsenic was used as a therapeutic agent in China to treat various diseases like syphilis. Many artists and craftsmen were severely affected due to excessive exposure to the chemical substance. In the middle ages, it was also used as a lethal weapon against the enemies. Bangladesh reported the maximum number of cases of poisoning in 1983. World Health Organization discovered well water as the source of arsenic, and called this incident as the “largest mass poisoning of a population in history” and a public health emergency.

Arsenic Poisoning Types

Based on the severity and onset of symptoms, the condition can be classified into the following types:

Chronic Arsenic Poisoning

In this type, the effects of lower levels of toxin can be long-lasting or persistent and could manifest into nearly fatal complications.

Acute Arsenic Poisoning

Short-term exposure of arsenic at or above the toxic level can cause the disease to last for a brief period of time with immediate arrival of the symptoms.

In exceptional cases, some individuals are deliberately exposed to the chemical substance, a condition better known as “intentional arsenic poisoning”.

Signs and Symptoms of Arsenic Poisoning

Presence of excessive arsenic in the body is a sign of a dreadful disorder that can give rise to a host of life-threatening conditions.

Acute Arsenic Poisoning

The symptoms normally begin within 30 minutes to 2 hours and may involve the following:

• Severe abdominal pain and cramps
• Diarrhea
• Dehydration
• Vomiting
• Smell of garlic in breath and body
• Excessive production of sweat
• Abnormal breakdown of red blood cells, resulting in anemia
• Vertigo
• Sudden severe confusion
• Seizures and shock
• Circulatory collapse
• Oral burns
• Gastrointestinal bleeding
• Cardiac changes
• Gangrene of limbs
• Breathlessness, due to acute respiratory distress syndrome
• Pulmonary swelling and irritation
• Muscle cramps
• Hair loss
• Chills
• Dark or blood-laden urine
• Death

Chronic Arsenic Poisoning

Constant build-up of the poisonous chemical in the body can lead to gradual deterioration of multiple organs. Some of the clinical presentations of the chronic condition are:

• Hyperpigmentation or discoloration of the skin
• Extreme swelling, thickening and reddening of the outer layer of the skin
• Lines of discoloration across the nails of the fingers
• Loss of sensory and motor functions
• Renal, pulmonary and hepatic failure
• Hypertension
• Metallic taste in mouth
• Muscle dystrophy
• Lack of muscle coordination

Arsenic Poisoning Causes

Arsenic is a metalloid, a mixture of metals and non-metals, which can readily combine with organic and inorganic materials and cause toxicity. Presence of the grey-appearing, heavy, chemical element in greater amounts in living tissues can cause functional erosion of the cells. Arsenic and its compounds are capable enough to react with proteins and paralyze most of the cellular functions. The metalloid can exist in either of the following forms:

Inorganic arsenic

It is available as a gaseous agent called arsine gas and forms colorless, odorless, crystalline oxides, soluble in water. In a similar fashion, the inorganic metalloid binds with chlorine and sulfur to form several compounds.

Organic arsenic

It is a chemically designed compound in which arsenic is made to combine with any carbon-containing compounds. Although not a lethal toxin at lower levels, organic arsenic can be moderately dangerous at higher concentrations.

The entry of arsenic into the body occurs when an individual unknowingly consumes or inhales it. Once the metallic agent reaches or crosses the toxic level, the condition becomes acute and results in rapid onset of the symptoms. The chief sources of the lethal element are:

• Contaminated drinking water
• Pesticides/Herbicides/Fungicides
• Paints
• Tobacco
• Burning of fossil fuels
• Few rice products
• Illegal distilled spirits
• Fruits and vegetables
• Seafood
• Poultry
• Copper and lead ore deposits

The condition is rampant among individuals working in industries like:

• Coal power plants
• Smelting
• Mining
• Pesticide plants
• Microelectronics
• Glass production and manufacturing
• Fireworks
• Wood preservation
• Nonferrous metal alloys

The various products manufactured by these industries are the potential sources of arsenic and its compounds. Occupational exposure is one of the most detrimental routes through which chronic poisoning occurs. It may equally affect people residing near such industrial places.

Arsenic Poisoning Pathophysiology

The cellular function gets largely affected when arsenic acts as an allosteric inhibitor by deactivating pyruvate dehydrogenase (PDH) complex, a trimeric enzyme that converts pyruvate into acetyl-CoA with the aid of NAD⁺. Once the enzyme gets completely inhibited, the energy system of the cell fails and causes apoptosis, the regulated process of programmed cell death. Utilization of thiamine, a water-soluble vitamin, is inhibited by the poisonous metalloid, resulting in its deficiency in the body.

Picture 1 – Arsenic Poisoning

Lactic acidosis, a condition marked by low pH in tissues and blood, occurs when arsenic aberrantly elevates the lactate levels. Potassium crucial for heart function and smooth muscle contraction gets lowered in the presence of arsenic trioxide. The most debilitating aspect of arsenic is the fact that it encourages the production hydrogen peroxide, which reacts with metals like manganese and iron to release hydroxyl radicals. The end product is the neutral form of the hydroxide ion that can damage a wide variety of macromolecules, including carbohydrates and amino acids. The trioxide form of inorganic arsenic typically present in ground water can severely impair the voltage-gated potassium channels, the transmembrane signaling proteins responsible for cellular electrolytic function. Chronic exposure of the toxic element results in high oxidative stress that disrupts the working of the cardiovascular system.

Arsenic poisoning in dogs

Consumption of rat or mouse trap bait is one of the most common causes of the metalloid poisoning in dogs. Affected animals may experience symptoms like staggering, vomiting, passing of blood-laden feces, and extreme exhaustion.

Arsenic Poisoning Diagnosis

Toxic poisoning is easily noticeable in this condition as the lethal symptoms do not take much time to appear. On the other hand, the chronic condition is marked by slow poisoning, especially in the case of contaminated water consumption, or occupational exposure. Physical examination of the skin and nails can provide the doctors with some clues that are directly related to the toxic condition. If something suspicious is observed in patients, doctors may order the following tests and exams:

Urine test

The organic compounds of arsenic are normally discharged in urine. In case of an acute exposure, the urine sample must be tested within 24-48 hours for accuracy. Examiners may find the characteristic garlic odor in the collected sample. Increased levels of inorganic arsenic can raise the toxicity of the condition.

Hematology test

The blood sample of an affected patient may reveal the following features:

• Elevated levels of arsenic within a few hours after the exposure
• Fragments of red blood cells
• Acid-base imbalance
• Increased amounts of calcium
• Decreased levels of potassium

Breath test

It is a simple diagnostic test used to detect the presence of garlic smell in the exhaled air.

X-ray

Radiography of the chest, abdomen, liver and kidneys may aid in identifying the defects caused by arsenic.

Electrocardiography (ECG)

This imaging procedure is highly reliable in detecting the abnormal rhythms of the heart, caused due to potassium imbalance.

Hair sample test

Traces of arsenic or its compounds often enter the hair from the blood. Analysis of a single hair strand not only reveals the presence of the metalloid but also helps determine the time of exposure.

Nerve conduction study

In this procedure, surface patch electrodes electrically stimulate and simultaneously record the time taken by the nerves to transmit electrical signals to the muscle. Low value of electrical conductivity indicates arsenic-induced sensory-motor peripheral neuropathy.

Arsenic Poisoning Treatment

Acute exposure of inorganic arsenic or arsine gas can be extremely fatal and result in death in the absence of spontaneous remedial actions. In such a critical situation, the patient must be immediately removed from the source of arsenic and the contaminated clothes must then be removed. In case the skin gets contaminated, it should be rinsed with adequate amount of water. Patients should immediately contact a physician, who may opt for any of the following treatment methods:

Chelation therapy

It involves the use of antidotes like dimercaprol and dimercaptosuccinic acid that removes arsenic from the blood proteins, and prevents destruction of red blood cells. However, these chelating agents may give rise to high blood pressure.

Dietary supplements

Potassium supplements must be given to patients to reduce the risk of a cardiac failure due to the formation of arsenic trioxide in the blood. Dosage is however, based on the health condition of patients and their response to therapy.

Nutritional treatment

A diet rich in garlic can combat the toxic effects of arsenic. The sulfur-containing elements in garlic and its extracts can readily bind to arsenic present in the tissues as well as blood, and discharges the metalloid in the urine.

Arsenic Poisoning Prognosis

Survivors of acute toxic exposure have a higher chance of developing peripheral nerve damage, cardiac disorders or renal problems. The prognosis for this condition usually ranges from fair to poor. However, the situation is far better in the case of chronic poisoning.

Arsenic Poisoning Complications

Consumption or inhalation of large amounts of arsenic can be extremely fatal. Long-term exposure to the metalloid has been associated with the following conditions:

• Diabetes
• Night blindness
• Jaundice
• Cancer
• Hepatic or digestive disorders

Arsenic poisoning is a highly lethal condition that needs timely treatment. Arsenic-free drinking water and a diet filled with micronutrients as well as antioxidants can prevent the aggravation of the condition.

References:

http://en.wikipedia.org/wiki/Arsenic_poisoning

http://www.bbc.co.uk/health/physical_health/conditions/arsenic_poisoning.shtml

http://www.medicalnewstoday.com/articles/241860.php

http://www.medicinenet.com/arsenic_poisoning/article.htm

The post Arsenic Poisoning appeared first on Prime Health Channel.

Lead poisoning Definition

It is a medical disorder arising from an increase in the level of lead in the bloodstream.

The condition is also referred to by the following names:

• Painter’s colic
• Plumbism
• Colica Pictonum
• Devon colic
• Saturnism

Lead poisoning Incidence

In the United States, around 310,000 kids in the age group 1-5 years are found to suffer from unsafe levels of lead in blood. It is important to seek immediate medical care in case of headaches, stomach pain and other symptoms associated to lead toxicity. Neglecting timely treatment can give rise t

Lead poisoning ICD9 Code

The ICD9 Code for this disease is 984.9.

Lead poisoning Causes

The disease originates when there is a build-up of lead in the body, over a period of several months or even years. Lead-contaminated dust in old buildings and lead-based paint are found to lead to this condition in children very frequently. Other sources include water, air and soil contaminated with lead.

The condition is not only specific to children. It may also affect adults who are exposed to lead on a regular basis. Such adult population includes those who have been renovating home for a long time, those working in auto repair shops and those working with batteries.

Lead poisoning Symptoms

Major health problems can arise due to the presence of even minor amounts of lead in the body. Like beneficial minerals such as zinc, iron and calcium, lead gets distributed throughout the body. When in the bloodstream, it causes damage to the red blood cells (RBCs) and reduces their ability to transport oxygen to and from various important tissues and organs. A lack of RBCs leads to anemia. Presence of lead in bone may also result in other problems.

The metal can also interfere with the absorption of calcium and the manufacture of blood cells. Calcium is necessary for muscular contraction, development of bones and teeth as well as various other purposes.

The disease may result in a variety of health problems, such as:

• Reproductive toxicity
• Renal disease
• Cardiovascular effects
• Neurological damage

Extremely high levels of lead in blood may prove fatal for sufferers.

The symptoms of the disorder tend to differ depending on the age of the sufferer.

Symptoms in newborns

In babies who are exposed to the metal even before birth, the condition gives rise to problems like:

• Difficulties in learning
• Retarded growth

Symptoms in children

In young children, the disorder gives rise to a number of health issues like:

• Abdominal pain
• Constipation
• Fatigue
• Irritability
• Learning difficulties
• Loss of appetite
• Sluggishness
• Vomiting
• Weight Loss

Symptoms in adults

In grown-ups, high levels of lead result in:

• Abdominal pain
• Abnormalities in sperm
• Deterioration in mental functioning
• Headaches
• High blood pressure
• Memory loss
• Miscarriage or premature birth in pregnant women
• Mood disorders
• Muscular weakness
• Numbness, pain or tingling of the extremities
• Reduced sperm count

Some other problems arising due to high lead content in blood include:

• Anemia
• Insomnia
• Low energy
• Poor appetite
• Aggressive behavior
• Lowered sensations

Abdominal cramps and pain are generally the first symptom of a high dose of lead toxicity. Extremely high level of lead may lead to staggering pace of walk, seizures, vomiting, muscular weakness or even coma.

It is important to get children tested to analyze the level of lead in their bloodstream and determine whether they stand at risk of being exposed to the metal. This is due to the fact that most individuals suffering from this type of toxicity show only mild symptoms or none at all.

Lead poisoning Diagnosis

The diagnosis of the disorder usually involves a simple examination of the blood. Blood test is highly useful in detecting lead poisoning. In this type of exam, a small sample of blood is extracted from a vein or by pricking a finger. The level of lead is measured in mcg/dL (micrograms per deciliter). A level of 10mcg/dL or above is regarded to be unsafe.

As per CDC (Centers for Disease Control and Prevention), children should be tested for lead poisoning as early as 1 or 2 years of age. It also recommends testing kids aged between 3 to 6 years in the following cases:

• If they have not been previously tested
• If they have a sibling or a friend suffering from lead poisoning
• If they receive Medicaid or any similar public medical aid
• If they live in a home built prior to 1978 that was remodeled recently

The lab tests for this condition may include:

• Bone marrow biopsy
• CBC (Complete blood count) as well as coagulation studies
• Erythrocyte protoporphyrin
• Iron level
• X-ray of the abdomen and long bones

Lead poisoning Treatment

The first and foremost treatment measure for this condition involves removing all possible sources of lead contamination. If it is impossible to obliterate the source, it is recommended that you move yourself away from the source and try to seal it in some way to avoid future risks of re-exposure. Consult your local health department to spot and lower the sources of lead poisoning in your home as well as in the surroundings.

Kids and adults with comparatively lower levels of lead in their blood should avoid possible sources of lead to lower the level of toxicity in their bloodstream.

Medical treatment

Severe cases of poisoning require immediate medical treatment, which involves:

EDTA Therapy

Level of lead in blood that is greater than 45 mcg/dL is commonly treated by a chemical known as Ethylenediaminetetraacetic acid (EDTA). The number of therapies to be used depends on the amount of lead in the bloodstream. High lead levels in blood need more than one therapy session. However, it is impossible to reverse damages that have already occurred in acute cases of the condition.

Chelation therapy

In this process, patients are administered with a drug that binds with the lead present in the body and leads to its excretion through urine.

In case of acute lead toxicity within a short time period, the following treatment measures may be beneficial:

• Gastric lavage
• Bowel irrigation with Polyethylene glycol solution

Home Treatment

Home remedial measures should follow medical measures put in practice by healthcare professionals. These include:

• Discarding old painted toys
• Running tap water for a minute or two before using it
• Not storing spirits or wine in crystal decanters made of lead
• Washing hands of self and asking the same of family members before meals

Lead poisoning Prognosis

Grown-ups with moderately high amounts of lead often recover without suffering from any problems. In kids, even moderate amount of lead toxicity may affect IQ and attention level on a permanent basis.

Those having excessive level of lead are more susceptible to long-lasting health issues. Such individuals must be monitored carefully. The muscles and nerves of such people can be severely impacted and may not function normally any more. Other physical systems, such as the blood vessels and kidneys, may be affected to varied extent.

In chronic cases, full recovery may take anywhere from several months to years.

Lead poisoning Prevention

The disease can be preventing by taking a few simple precautions. These include:

Washing hands before eating

This can help prevent intake of lead from hands that might have been exposed to the toxic metal.

Discarding old toys

Old painted toys contain lead in high amounts. Throw away your old toys if you are unsure of the paint in them. Those living in old houses in the US that have been painted before 1978 should call 800-LEAD-FYI to get the house paint examined for lead.

Cleaning dusty surfaces

Dusty surfaces often contain lead dust, which can be toxic when inhaled. Windowsills, dusty surfaces and furniture should be cleaned with a damp cloth while floors should be mopped with a wet cloth.

Using cold water

If your plumbing system is old, comprising of lead fittings or pipes, let cold water flow through them for a minute before using. Do not use hot water from tap for cooking or making baby formula foods.

Lead poisoning Risk Factors

The risk factors for this disease include:

Certain professions and hobbies

The disease more commonly affects people who are engaged in certain professions, such as stained glass manufacturing, which requires the usage of lead solder. Refinishing of old furniture may also lead to an exposure to high amounts of lead paint.

Age

Kids under 6 years of age are particularly prone to this disorder, which can seriously affect the physical and mental development of children. Young children and infants are likelier to be exposed to the metal than older children. They may eat with unwashed hands or chew on toys contaminated with lead dust. They also absorb and retain lead more easily than adults and children who are somewhat grown up.

Pica

Kids suffering from an eating disorder called Pica have an unnatural inclination towards non-food items. Naturally, they can be highly prone to lead toxicity.

Certain origins

People living in certain countries, particularly developed nations that have less strict rules for lead exposure are more likely to suffer from this disease. Families in the US who adapt a child from some other nation should test the kid to check for lead poisoning.

Lead poisoning Complications

Exposure to even moderate amounts of this metal can result in health damage over a period of time. This is particularly true in case of children. The development of the brain is affected the most, with damage to the organ being irreversible. Those surviving very high lead toxicity may suffer from some types of permanent brain damage. Kids are more vulnerable to long-term problems of an acute nature.

Higher levels of the metal in blood may cause damage to the nervous system and the kidneys in children as well as in grown-ups. Extremely elevated levels of the metal may result in seizures, fainting and even death.

If you are suffering from the symptoms of the condition yourself, or have anyone in your family suffering from them, seek medical assistance as early as possible. Timely diagnosis and treatment is extremely essential in achieving a faster recovery and preventing possible complications of this disorder.

References:

http://www.mayoclinic.com/health/lead-poisoning/FL00068

http://www.nlm.nih.gov/medlineplus/ency/article/002473.htm

http://kidshealth.org/parent/medical/brain/lead_poisoning.html

http://www.patient.co.uk/doctor/Lead-Poisoning.htm

The post Lead poisoning appeared first on Prime Health Channel.

Argyria Definition

This rare disorder results from extreme exposure to various chemical forms of silver, silver compounds and silver dust. The main characteristic of the disease is bluish-gray to slate-gray coloration of the patient’s skin as well as mucous membranes due to silver particle deposits in the skin. It is not contagious and may develop in a generalized or a localized form.

Argyria has a corresponding condition, Argyrosis, which is related to eyes.

Argyria Incidence

There is a lack of study to find out its exact incidence statistics. But, it is quite rare in countries where the dietary supplements with colloidal silver are not used. The disorder can occur in both adults and children.

Argyria Causes

It occurs due to unnatural exposure to silver and its compounds. The type of the disorder in a person is determined by its underlying causes. Mild to moderate silver exposure generally results in localized Argyria while severe exposure, like ingesting silver with medications, causes the generalized or universal form of the skin problem. There are various sources of silver exposure:

Picture 1 – Photo of Argyria patient

Occupational exposure

It can result from occupational exposure to silver to people whose work involves silver refining, silver mining, photographic processing and manufacturing silverware and metal alloys.

Medication containing silver salts

Using silver salts over a prolonged period of time for irrigation of nasal or urethral mucous membranes, for wound dressing and in eye drops can lead to this disorder. Long term use of any oral smoking remedy with silver acetate is another potential cause.

Colloidal silver supplements

These dietary supplements are marketed as an effective treatment for conditions like diabetes, arthritis, AIDS, herpetic infections and cancer. Excessive usage of the products may also increase the risk of the abnormality.

Dental and surgical procedures

It can also result from silver dental fillings and silver sutures applied in abdominal surgery.

Argyria Signs and Symptoms

It is a permanent condition with the following characteristic symptoms:

• The most important sign of the skin disorder is the bluish gray or blue coloration of certain areas of the skin of patients.
• An affected individual often have gums stained with blue-gray spots.
• The blue coloration can eventually extend to wider skin areas such as the forehead, nose, hands and other body areas that are commonly exposed to sun.

Under normal circumstances, an individual has approximately 1 mg silver in his or her body. This skin problem develops when the minimum amount of silver in the body crosses 4 gm. However, in most cases the symptoms start developing only after the levels of silver in the body reach somewhere around 20 gm to 40 gm.

Argyria Prevention

Preventing direct silver exposure can keep the skin disease from occurring. Wearing protective clothes is important for those with occupations involving regular exposure to this element. It is advisable to avoid using silver containing medications, remedies and colloidal silverhealth supplements. Sunscreens can be used for preventing the abnormal coloration from spreading to a larger area of the body.

Argyria Diagnosis

The bluish skin color is the most important feature which helps to confirm the diagnosis. Diagnosticians study the medical history of patients and examine the blue skin areas under fluorescent x-ray. Sometimes, a skin biopsy can be performed to determine whether there are any signs of silver accumulation in the affected skin areas. Various diagnostic tests are performed to determine whether the minimum amount of silver in the body of sufferers has surpassed 4 gm.

Argyria Differential Diagnosis

Diagnosticians should rule out the presence of the following diseases while diagnosing this condition:

• Methemoglobinemia
• Ochronosis
• Polycythemia
• Wilson disease
• Addison disease
• Hemochromatosis
• Carcinoid syndrome
• Ingestion of other metals like gold, bismuth, mercury as well as certain compounds including minocycline, antimalarials, chlorpromazine and amiodorone

Argyria Treatment

There are very few treatment options that can completely cure the skin disease. Severe cases caused by long term oral intake of silver may be irreversible. The treatment mainly focuses on discontinuing the silver exposure immediately to stop the advancement of the condition. It is often considered to be a cosmetic skin disorder without any serious health problems, although it may not be possible to eliminate the disfiguring blue skin coloration. Sometimes, patients are suggested to use topical hydroquinone ointment which can reduce the discoloration.

Doctors also suggest the use of sunscreens to minimize the risk of discoloration spreading to other parts of the skin. Wearing cover-up makeup can help affected individuals with very pronounced blue-skin coloration.

Research is being carried out to determine whether laser treatment can be useful for curing the skin discoloration. According to medical reports, colloidal silver ingestion induced Argyria has been treated successfully by using laser surgery.

Argyria Prognosis

The outcome of the disease is relatively poor because of the lack of effective treatment options. Due to this reason, it is better to prevent the condition by avoiding any kind of exposure to silver. Mild cases of the dermatological condition can be managed successfully.

Argyria Complications

If the exposure to silver and silver compounds continues even after the onset of the skin problem, an individual can develop dangerous complications like:

Picture 2 – Argyria Image

• Idiopathic Thrombocytopenia
• Decreased night vision
• Loss of coordination
• Persistent Bronchitis
• Fatty degeneration of major organs
• Albuminuria
• Hemorrhage
• Vestibular impairment
• Gustatory disturbance

Immediate medical attention is very important for the management of these complications. Otherwise, they can gradually lead to silver toxicity which may lead to potentially fatal conditions such as paralysis of respiratory system and brain disorders like Tonic–clonic seizures.

A number of forums and support groups have been established for providing information to spread awareness about the harmful effects of excessive silver exposure. Preventing the disease is very important as it cannot be completely cured once an individual starts having its symptoms.

References:

http://www.iamunwell.com/Diseases-Alphabet-A/argyria.html

http://www.skincareconceal.com/?p=88

http://www.argyria.net/Argyria-Prognosis.html

http://www.wisegeek.com/what-is-argyria.htm

http://dermnetnz.org/reactions/argyria.html

The post Argyria appeared first on Prime Health Channel.

Hypercapnia Definition

Hypercapnia is a condition characterized by the presence of high amounts of carbon dioxide (CO2) in the bloodstream. It is also referred to as Hypercapnea. Generally, carbon dioxide can be found in the blood of every healthy person. It is only when the concentration of Co2 becomes abnormally high that the condition is viewed as a medical emergency and referred to as Hypercapnia.

The name of this disorder comes from the merger of two Greek terms “hyper” meaning “above” and “kapnos” standing for “smoke”.

Permissive Hypercapnia

It is the name given to Hypercapnia that is seen in patients of respiratory insufficiency. Oxygenation becomes so difficult in such individuals that even the most preferred method of mechanical ventilation fails to exchange adequate amounts of carbon dioxide. Carbon dioxide, which is a gaseous product of the respiratory process, is usually released through the lungs.

Types of Hypercapnia

The condition is broadly classified into two types:

Picture 1 – Hypercapnia (Excess CO2 in blood)

Chronic Hypercapnia

It is a type of Hypercapnia that is frequently seen in people suffering from severe hypoxic lung disease. It is related with a rise in pulmonary arterial pressure that is higher than in Hypoxia. It is said to enhance the death rate during peri-operative stage. The condition may be frequently found to accompany a number of respiratory disorders that affect exchange of gases in the lungs. This makes diffusion impossible. The carbon dioxide is not able to diffuse from the venous blood present in the alveoli. The airways may also be unable to provide all alveoli with proper ventilation.

Acute Hypercapnia

In this condition, respiratory failure can occur at anytime between a few minutes to a few hours. The pH value is lower than 7.3. This is unlike chronic cases where breathing failure takes several days or more to develop. Typically, the pH value only has a slight increase in chronic cases as the body is allowed time for renal compensation and a rise in bicarbonate concentration.

Hypercapnia Symptoms

In the early stages, the signs and symptoms of this disorder include:

• Full pulse
• Flushed skin
• Dyspnoea
• Tachypnea
• Extrasystoles
• Hand flaps
• Muscular twitches
• Lowered neural activity

Affected individuals may also suffer from a possible rise in blood pressure. People with mild forms of the condition may suffer from fatigue, mental confusion and headaches. The disorder may accelerate increased arterial blood pressure and enhanced heart rate. It can also increase the tendency to have arrhythmias (unusual rate of contractions in the cardiac muscles). In individual with severe forms of the ailment, the symptoms can worsen. Patients may suffer from problems like:

• Panic
• Convulsions
• Hyperventilation
• Unconsciousness
• Disorientation

In worst cases, patients may also die. Death occurs due to total deficiency of oxygen in blood. The oxygen in blood is entirely displaced by carbon dioxide which results in complete organ failure. Even if death does not occur, this acute medical condition may lead to permanent damage of the internal organs.

In a person with Hypercapnia, the central nervous system (CNS) can become depressed. This can give rise to problems like

• Blurred vision
• Confusion
• Dizziness
• Fatigue

It may also result in increased intercranial pressure, or build-up of pressure inside the skull. Patients may also suffer from breathing difficulties. Other symptoms, associated with the underlying cause, may also be detected.

Hypercapnea and Carbon Dioxide Levels

Normally, 40 mm Hg of carbon dioxide (CO2) is present in blood. Hypercapnia begins to occur when there is over 45 mm Hg of CO2 in blood. In mild to moderate levels of exposure, the amount of carbon dioxide varies between 45 and 65-70 mm Hg. In such cases, patients show a complete recovery after a point of time. In severe cases of exposure, the level of CO2 in blood is 75 mm Hg or more. This permanently damages the central nervous system (CNS). Unless treated properly in time, it may even lead to death.

Hypercapnia Causes

Exposure to surroundings containing massive amounts of carbon dioxide is the primary cause of this condition. It may also occur due to breathing of exhaled carbon dioxide again, as happens in closed rooms due to proper lack of ventilation. It can also happen due to:

• Lung disease
• Hypoventilation
• Reduced consciousness

The condition may also arise due to administering a patient of sleep apnea with supplemental oxygen. In this case, the disease may also arise along with Respiratory Acidosis.

The disease may also occur due to rise in bicarbonate levels in blood due to use of medicines. Use of diuretics, abuse of laxatives or prolonged use of steroids may contribute to increase of bicarbonate levels in the bloodstream.

A condition known as Chronic Obstructive Pulmonary Disease (COPD) is also one of the major causes of this disorder. It lowers oxygen efficiency and enhances the level of carbon dioxide in blood. Scuba divers, who practice skip breathing, have to hold their breath to save oxygen in their air tank. They often suffer from Hypercapnia.

Hypercapnia Diagnosis

The diagnosis of the disorder depends on end tidal capnography, arterial blood gas levels, arterial pH and physiological manifestations. It involves detecting clinical symptoms like:

• Rapid, shallow respiration related with hypoventilation
• Slow rate of respiration
• Obtundation
• CNS depression
• Hypertension
• Tachycardia
• Arrhythmias

The presence of other medical symptoms of this condition may depend on the type of underlying causative agents like respiratory fatigue, drugs, toxins, neuromuscular disorders and CNS disease.

Hypercapnia Differential Diagnosis

The differential diagnosis of this disease involves distinguishing it from other conditions like Hypoventilation, increased CO2 production, increased dead space ventilation or enhanced inhalation of CO2.

Hypercapnia Treatment

The treatment of this disease is based on its severity. Cure begins with addressing the underlying problem. If this proves to be ineffective, further treatment may involve:

• Intubation and mechanical ventilation
• Non-invasive positive pressure ventilation (BiPAP, CPAP)

Picture 2 – Severe Hypercapnia

As already said, an absence of proper treatment in time may lead to permanent damage to the heart or brain dye to the presence of an excessive amount of carbon dioxide (CO2) in the blood. Based on the severity of CO2 poisoning, patients are administered oxygen through any of the following options:

• Oxygen mask
• Ventilator
• Hyperbaric chamber

Hyperbaric chamber is a big chamber where the pressure of oxygen is kept twice above normal level. This forces the oxygen of the chamber into the body and leads to a faster removal of CO2 from the bloodstream. This option is used to cure carbon monoxide poisoning or respiratory disorders.

The best way to cure this condition involves removing the patient from an environment filled with carbon dioxide and supply him/her with fresh oxygen.

If the level of CO2 in blood is anywhere from mild to moderate (45 to 65-70 mm Hg), patients can be expected to have a full recovery within a short time. If the patient has a high exposure and the CO2 level in blood is more than 75 mm Hg, the central nervous system may suffer from permanent damage.

Hypercapnia Prevention

It is best to avoid carbon dioxide poisoning to prevent Hypercapnia. Air in areas, such as shafts and underground tunnels, are known to have high levels of Carbon dioxide. Naturally, such areas should be avoided. Environments like bunched up blankets or airtight tents should also be avoided as they can lead to re-breathing.

Some effective ways to prevent increase in carbon dioxide levels in the bloodstream include:

• Ensuring adequate ventilation in enclosed areas
• Refraining from skip breathing
• Using steroids properly
• Proper use of laxatives

Patients using medicines, such as prescription steroids or diuretics, or those suffering from ailments like COPD should undergo regular blood-testing to avoid Hypercapnia.

Hypercapnia Prognosis

The outcome of this disorder is ultimately based on the severity of the underlying agent. In most cases, however, the prognosis is a guarded one. The prognosis also depends on the general medical health of the suffering individual. Animals that suffer from the condition, and need mechanical ventilation, usually show a poor prognosis. The outcome can be good when the underlying condition is reversible, as in cervical intervertebral disk disease or cases of drug overdose.

Hypercapnia Complications

Some of the main complications that patients with this condition develop involve:

Cardiac arrhythmia

It is a condition characterized by irregularity or disturbance in heartbeat. This occurs due to an abnormal rate of contractions of the muscles in the heart.

Pulmonary edema

It is a condition marked by effusion of fluid into the interstitial spaces and the alveoli of the lungs.

Respiratory acidosis

One of the main complications of this disease, it is marked by a reduction in the pH scale of the blood due to an alteration in its chemical composition.

Respiratory acidosis can result in a number of reactions which may include acceleration of the CO2 level in the blood. Doctors should closely monitor the health of Hypercapnia patients so that they can administer proper treatment if symptoms of acidosis are found to develop.

Hypercapnia and COPD

As already said, Chronic Obstructive Pulmonary Disease (COPD) is one of the main causes of this disorder. It leads to a rise in the level of carbon dioxide due to deceased oxygen efficiency. Patients suffering from COPD experience difficulties in pushing air into their lungs. They also have problems in moving air out of the lungs. This makes it hard for the lungs to expel carbon dioxide and take in oxygen, which is an important part of the respiratory process. COPD may lead to problems like Hypercapnia (high level of CO2) as well as low oxygen level in blood (Hypoxemia).

In a healthy individual, respiration consists of inhaling oxygen and exhaling carbon dioxide. The exchange of these two respiratory gases occurs in small, grape-like air sacs (alveoli) located deep inside the lungs. In people suffering from COPD, the alveoli are destroyed which destroys this process of gaseous exchange. This allows the oxygen with less surface area to get into the bloodstream from the lungs. It also leaves little surface area for carbon dioxide to get into the lungs from the blood to be exhaled. This leads to a condition known as Hypoxemia, characterized by low oxygen content in blood. It may also lead to Hypercapnia.

Hypercapnia can be a potentially life-threatening condition. It may result in respiratory failure and death. Due to this COPD patients as well as their care providers should be aware of the problems resulting from Hypercapnia. They should get in touch with the primary caregivers of the patient as soon as they notice any change in condition.

Hypoxia and Hypercapnia

Hypercapnia is often confused with Hypoxia, which is a condition marked by lack of adequate oxygen supply to the body tissues. Hypercapnia, on the other hand, is characterized by the presence of an unusually high amount of CO2 in the circulating blood. This high CO2 concentration in blood mainly occurs as a result of exposure to high amounts of carbon dioxide as well as Hypoventilation.

Hypercarbia vs Hypercapnia

Hypercapnia is often referred to as Hypercarbia. Although used as a substitute for the former, Hypercarbia is somewhat different. Firstly, it is an older medical term that was used many decades ago to denote Carbon Dioxide Poisoning. The term is still in use in various parts of the world. However, Hypercarbia actually refers to presence of carbon dioxide at a higher than normal level in blood (typically higher than 45mmHg). Hypercapnia, on the other hand, refers to an excess amount of carbon dioxide (CO2) in blood that may range from >45 to >75mmHg.

As aforesaid, Hypercapnia is an emergency condition that requires prompt medical treatment. Hence, you should seek medical attention on an immediate basis if you detect the symptoms of this disorder in any friend or a member of your family. Timely medical care will help chances of an early recovery and prevent any future complications.

References:

http://www.normalbreathing.com/hypercapnia-hypercarbia.php

http://www.medscape.com/viewarticle/410886_2

http://www.healthblurbs.com/hypercapnia-causes-high-carbon-dioxide-levels-in-blood-symptoms/

http://www.instah.com/respiratory-disorders/hypercapnic-respiratory-failure/

The post Hypercapnia appeared first on Prime Health Channel.

It is a disorder that is characterized by poisoning due to consumption of excessive amounts of Digoxin, a chemical found in plants of the genus Digitalis. Poisoning may also occur due to intake of small amounts of Digoxin over an extended period of time.

Digoxin Toxicity Signs and Symptoms

Some of the main signs and symptoms of Digoxin Toxicity (DT) involve:

Visual problems

Many DT sufferers experience changes in vision. They commonly experience the presence of non-existent green or yellow halos as well as bright or blind spots. They also suffer from changes in perceived colors.

Gastric problems

The toxic effects of Digoxin may produce acute gastrointestinal problems, including nausea, vomiting and diarrhea. Over time, a patient may begin to experience loss of appetite. Difficulties linked with blood have also been related with digoxin toxicity. These include

• Hematuria (blood in urine)
• Hematemesis (blood in vomit)
• Rise in bruising
• Tarry stools

Cardiac problems

The poisonous effects of Digoxin commonly give rise to various cardiopulmonary symptoms. These may involve:

• Irregular pulse rate
• A reduced heart rate of less than 60 beats every minute
• Fast heart rate, causing palpitations
• Fatigue
• Shortness of breath
• Generalized fatigue

While taking Digoxin, it is important for patients to inform a cardiologist about any bodily changes.

Rare Signs and Symptoms of Digoxin Toxicity

In rare cases, Digoxin toxicity gives rise to less common symptoms like:

• Skin rash
• Headaches
• Mental confused or disorientation
• Drowsiness
• Reduced consciousness

A noticeable reduction in urine output may also occur along with increasing peripheral edema. Some patients may also suffer from an unexplained weight gain.

Digoxin Toxicity Diagnosis

Patients suspected of having this condition should undergo an ECG examination. A measurement of Serum digoxin concentrations should be carried out. Measurement is, however, only truly reflective after completion of distribution (4 – 6 hours after last dosage). It usually requires two levels to make sure of the distributed levels.

Digoxin Toxicity Treatment

It can be difficult to conduct treatment of Digitalis Toxicity. This is due to the fact that the condition of the heart of a diseased individual is highly fragile due to toxic effects of Digoxin. Cure may include non-serious treatment such as,

• Monitoring cardiac condition
• Use of intravenous fluids
• Use of potassium supplements

Medications may also be used to bind Digoxin in the intestine. This will help prevent absorption of the chemical into the bloodstream. Digibind is a popular drug of this type. It is used as an antidote for Digoxin Toxicity.

It is not advisable to induce vomiting in DT sufferers as it can put further stress on hearts with reduced cardiac rate. It is also unwise to stimulate vomiting in patients suffering from other damaging conditions.

In emergency cases, afflicted individual should necessarily be assisted in breathing to keep them alive for long enough to receive treatment. Cure, in such cases, can involve removing the contents of the stomach with the aid of tubes. In cases where toxic effects have developed occurred over an extended time period, drugs may be required to reverse the harmful effects.

Digoxin Toxicity Management

Effective management of this condition depends on early recognition of its association with Dysrhythmia and/or any non-cardiac manifestation. Generally, management involves

• Assessment of the severity of the problem
• Assessment of the cause of toxicity, such as reduced renal clearance, the prescribed dosage, concurrent medications
• Assessing whether over-dosage is intentional or accidental
• Considering factors that influence treatment, such as age, chronicity of digoxin intoxication, medical history, existing renal insufficiency and/or heart disease
• Taking ECG changes into account
• Constant hemodynamic assessment, involving cardiac monitoring and 12-lead ECG
• Immediate electrolyte level measurement

Chronic Digoxin Toxicity

Digoxin Toxicity is often differentiated into acute or chronic. Chronic toxicity is generally indicated by changes in vision, but its diagnosis can be very difficult. It frequently occurs without being diagnosed. A person can suffer from this condition for a long time without being detected unless he or she is being tested for some other condition. In such cases, patients need to be assessed for Chronic Toxicity. It may take much longer to regulate the Digoxin levels in chronic sufferers.

ECG Changes in Digoxin Toxicity

In case of Digitalis use and digitalis toxicity, some characteristic Electrocardiographic (ECG) changes can be seen. At therapeutic levels, digoxin gives rise to characteristic changes in ECG readings such as scooping of the ST segments or prolongation of the PR segment. On the other hand, Digitalis toxicity may give rise to myriad changes in ECG readings.

Digoxin Toxicity in Children

In children, the toxic effects of this chemical may give rise to certain discomforts. The signs of Digoxin toxicity, in case of kids, involve

Nausea

This is typically caused by the supply of less blood to the gut.

Diarrhea

It is an early indication of DT and is most likely to coincide with other problem like nausea, vomiting and anorexia.

Loss of appetite

It is another early indicative symptom and is typically a result of stimulation of the nervous system by Digoxin.

Visual disturbances

Patients suffering from toxic effects typically suffer from a yellow haze over their visual area. In case of some other visual problems, doctors should immediately be notified.

Arrhythmias

Arrhythmias refer to irregular heart rate. It is the most important early symptom of Digoxin toxicity. Over 4 mg of Digoxin can lead to cardiac arrests in a healthy child. Cardiac arrests due to Digoxin Toxicity in elderly individuals can occur with more than 10 mg of the chemical.

Digoxin Toxicity Prognosis

The prognosis of this condition depends on how fast the treatment is conducted and whether it is proper in nature. In case of acute symptoms, family members of sufferers should immediately seek medical care. Patients taking Digoxin need to be monitored by a physician at certain intervals to help them detect any noticeable changes in the health of sufferers. A timely and effective cure can help evade future complications and make a faster recovery from toxic effects.

References:

http://www.freemd.com/digoxin-toxicity/overview.htm

http://www.hmc.org.qa/qmj/qmj_nov_2006/NOV2006/CONTINUOUS_M_E/continuous_m_e1.htm

http://www.digoxintoxicity.com/

http://emedicine.medscape.com/article/814404-overview

The post Digoxin Toxicity – Symptoms, Diagnosis, Treatment and Prognosis appeared first on Prime Health Channel.

Read on to know all about the electronic cigarette disadvantages and hidden dangers before you take a decision.

What are Electronic Cigarettes?

Electronic Cigarettes are battery operated devices that have been developed as an alternative to normal cigarettes. These are made up of a heater, a battery and a cartridge that contains a solution of propylene glycol, nicotine and some other chemicals. It gives a smoker the apparent effect of nicotine intake without delivering the toxic elements like Tobacco, Carbon Monoxide and Tar that harms the lungs. There is bad breath or yellowing of teeth either.

Man smoking Electronic Cigarette. Source: onefoot

Electronic Cigarette History

The electronic cigarette was devised in 2003 by a Chinese druggist named Hon Lik. It was introduced into the Chinese market in 2004. It began to be marketed abroad from 2005 by Golden Dragon Holdings, the company where Hon worked.

The Electronic Cigarette Association is the body that includes all private companies in trading of electronic cigarettes.

Are Electronic Cigarette Dangerous?

Electronic Cigarettes were first popularized as a safer way of nicotine intake. While Electronic Cigarette consumption is safer than having actual cigarettes filled with tobacco, they are not really a total safe option.

Read on to know about some of the main Electronic Cigarette dangers.

Diethylene Glycol

Electronic Cigarettes are found to contain an anti-freeze component known as Diethylene Glycol. It is toxic to humans and can cause health worries on inhalation. This is one of the major Electronic Cigarette side effects.

Toxicity

Other than Diethylene Glycol, e-cigarettes also contain cancer-causing compounds like nitrosamines. If the cigarette accidentally breaks, humans may be exposed to such harmful components.

Electronic Cigarette Picture. Source: shopkami

Bad Marketing

The marketing strategy of e-cigarettes has also come under criticism. Many electronic cigarette brands are being found to offer e-cigarettes in various flavours like mint, orange and chocolate. This can entice smokers as well as non-smokers. This actually promotes smoking rather than curbing it.

Some electronic cigarette juices have caramel and strawberry flavourings that may attract children into smoking.

Nicotine

Health experts argue that electronic cigarettes contain nicotine, the basic element found in cigarettes. In an electronic cigarette liquid nicotine is used. Nicotine is an alkaloid medicine that is harmful for humans. A long drag on the cigarette can make you actually suck some of the liquid nicotine into your mouth. This can be very damaging for health. You have to drag the cigarette slowly for 3-5 seconds, which is not always possible to be careful about.

Tetramethylpyrazine

E-cigarettes also consist of Tetramethylpyrazine. Prolonged exposure to Tetramethylpyrazine can result in brain damage in human beings.

Misuse

There is also a widespread concern that electronic cigarette consumption may promote drug use. There are reports of liquid nicotine being substituted with liquid THC, a popular potent marijuana resin. If electronic cigarette e liquid is replaced with addictive drugs, it can become highly damaging to health. It can cause further breakdown of the health instead of improving it. In any case, electronic cigarettes do not contribute to health.

Cost-Effective

That the electronic cigarette costs less is also a factor that can aid its popularity. Many websites offer these devices at a starting price of about 40 pounds. Cartridge refills are available for less than a pound.  This is far lesser than monthly expenditure on actual cigarettes.

Do Electronic Cigarettes cause Cancer?

People often worry whether Electronic Cigarettes give rise to cancer. In electronic cigarette nicotine, flavourings and many other harmful chemicals are used that may have cancerous effects on the body. However, carcinogenic electronic cigarette health risks have not been proved by any study.

Electronic Cigarette Risks for Heart

Electronic cigarette cartridges contain nicotine which can cause heart ailments. Cartridges containing even traces of nicotine can be risky for the health of your heart. The risk can be reduced only by using Electronic Cigarette no nicotine cartridges.

Is Electronic Cigarette Good For You?

It is a fact that no electronic cigarette company is endorsed by any health organization. This is the reason why there has been an effective Electronic Cigarette ban in a number of countries like Canada. While Electronic Cigarettes are less dangerous compared to real cigarettes, they are still a threat to smokers. For an effective removal of smoking habit, it is best to give up smoking completely. It is best not to try to stop smoking with Electronic Cigarettes.

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Smokers Cough Definition

What is a Smokers Cough? It is actually a kind of cough that smokers suffer from. People who have the habit of smoking are generally seen to have this condition. The condition may be mild or severe depending on the amount of smoking that the person does. The syndrome usually appears in people who have been smoking for a long time.

The cough is mainly of two kinds. Smokers may either suffer from a dry cough or a chesty cough. A chesty cough, unlike a dry cough, is accompanied by mucus.

How long does Smokers Cough last?

Smokers Cough, especially of the chesty variety, lasts for several weeks. Common cough, caused by cold or flu, usually disappears within 2 weeks. People suffering from chesty cough for more than this period should consult a doctor. Patients of chronic coughing are seen to break their ribs in extreme conditions.

Smokers Cough Symptoms

People affected by Smokers’ Cough display a number of symptoms. These are :

Persistent Coughing

Long time smokers are found to cough constantly because of this condition. The coughing may stop for a brief period only to resume again after some minutes.

Dry Cough

As aforesaid, smokers may experience a dry or a chesty cough. Dry cough or non-productive cough does not produce any phlegm or fluids. A chronic dry cough is one of the early symptoms of Smokers Cough syndrome.

Phlegmy Cough

Also known as productive cough, this is characterized by the presence of mucus in cough. The individual coughs up large volumes of phlegm from the lungs. In case of Smokers Cough phlegm may be clear, white, green or yellow in color. Greenish-yellow colored mucus may be a sign of lung infection caused by long-term smoking.

In extreme cases of Smokers Cough blood is also visible. This occurs in case of a bacterial disease.

Shortness of Breath (SOB)

Smokers Cough is also accompanied with breathlessness in patients.

Chest Pain

Smokers Cough causes chest pain in many sufferers. Persistent coughing gives rise to pain in the chest and rib cages.

Wheezing

In some cases, a whistling sound appears as the affected person breathes.

Crackles

A cracking or bubbling sound can also be heard in some patients affected by this syndrome.

When smokers cough is accompanied with severe diseases like Chronic Bronchitis, many other symptoms like fatigue, pallor, confusion or anxiety may occur.

Smokers Cough in the Morning

Most patients display Smokers Cough in the morning. This is because such people wake up with a substantial amount of phlegm in their throat. They need to clear their throat to clear away the irritation caused by the accumulated Smokers Cough mucus. In advanced cases, smokers have to cough for a long time after waking up to remove phlegm from their throat.

What causes Smokers Cough?

Why do Smokers Cough? As the name suggests, Smokers Cough is caused mainly by smoking or tobacco inhalation. When a person smokes for a considerable period of time, the irritants from the nicotine accumulates in the trachea, heart and lungs. It damages the cilia, tiny fibers found in the nose and trachea. The cilia guard the body from airborne germs. Damage to the cilia impairs them or even makes them non-functional. This makes the lungs more susceptible to germs like bacteria and viruses. The natural body system creates phlegm to block out these harmful germs.

When a smoker sleeps, the mucus gets accumulated in the airways. This forces him to wake up from sleep and clear away the phlegm to breathe freely. Under normal conditions, the cilia moves in a wavelike manner and moves the foreign bodies trapped in mucus upwards to the Oropharynx. This helps one swallow the phlegm.

Constant cigarette smoking impairs the function of the cilia. This is the reason why a smoker has to cough to remove the phlegm.

Over time, smokers experience a more persistent cough. This happens due to phlegm accumulation which occurs with a change in weather conditions or when the body is exposed to a cold environment.

Smokers Cough Diagnosis

If a person suffers from constant cough for more than two weeks, diagnosis should be carried out. The diagnosis of Smokers Cough condition is usually done with a chest X-Ray. Sample of the phlegm of the suffering person is also analyzed by doctors to find out if the person is suffering from smokers cough or any other respiratory disease like Pneumonia.

Smokers Cough Treatment

Picture 1 – Risk factors of Smoking
Source – consumerreports

How to get rid of Smokers Cough? Smoker Cough Remedy is generally carried out with antibiotics. Cough medicines, consisting of ingredients like sugar, honey and syrup, are commonly used to treat minor cough conditions. In patients with Smokers Cough syrup forms a coat over the interior of the throat and gives relief from irritation. It is used as a common Smokers Cough cure, though it is effective mainly for mild symptoms.

Antihistamine is usually the Smokers Cough medicine used for curing dry cough conditions. Such drugs affect the brain to suppress the nerve signal that prompts coughing. These medicines, however, give rise to side effects like drowsiness.

The best of Smokers Cough remedies include quitting smoking. Giving up smoking is very hard, but unless you stop tobacco intake or at least cut it down severely chances of permanent recovery from Smokers Cough are very low. Smoking cessation can help the cilia in the airways recover their functionality. It also helps the respiratory system recover fully. Chances of recovery from smokers cough after quitting smoking is usually very high.

Patients who find their Smokers Cough getting worse should immediately get professional medical treatment. In some cases, Smokers Cough may be an indication of respiratory tract cancers. It may also signal decreased resistance to bacterial or viral infections due to any low-immunity condition. Early medical treatment is necessary to cure such conditions.

Smokers Cough Home Remedies

You can try several Smokers Cough remedies at home to cure the condition at the earliest. These include

Drink Anise Seed Mixture

Boil a cup of water containing one tablespoon-full of anise seeds. Let the mixture sit under cover for 10-15 minutes. Strain the mixture into a glass and sweeten it with honey. Blend the mixture properly and drink it while still warm. Do this for several times throughout the day.

Drink Water

Drink lots of water throughout the day. Water lubricates the throat and makes coughing less painful for the sufferer. Cigarette smoking also dries the body. Water keeps the body hydrated.

Drink Honeyed Tea

Mix a little honey with hot tea. Drink this to soothe the throat and get a little relief from soreness due to coughing.

Inhale Vapors

Boil a pot of water containing mint leaves and Eucalyptus. Inhale the vapors arising from this. The aromatic vapors help stop the cough. It works as one of the best natural Smoker Cough treatments.

Does Smokers Cough go away?

Yes. If treatment is carried out properly and on time, the condition can be completely cured. The rate of recovery is also fast. Recovery happens rapidly if the affected person can manage to kick the butt. Stopping smoking can make treatment more effective and bring back the capability of cilia.

If you are waking up with smokers Cough at night, you should immediately consult a physician. Never neglect a smoker’s cough, for it may be an indication of complicated conditions. Early treatment will help you recover in no time and enjoy good health as long as possible.

References:

http://en.wikipedia.org/wiki/Smoker%27s_cough

http://www.wisegeek.com/what-is-a-smokers-cough.htm

http://www.wrongdiagnosis.com/s/smokers_cough/intro.htm

http://www.ehow.com/how_2161832_treat-smoker-cough.html

http://www.ehow.com/way_5642453_smoker_s-cough-home-remedies.html

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Cocaine is a stimulant that is derived from coca leaf extracts, a plant found in Peru, Colombia, and Bolivia and acts as an addictive substance that affects the Central Nervous System. It has been in use since the time of the Inca Civilization.

Picture 1 – Coca leaves
Source – c1.ecolocalizer

Cocaine Facts

Scientifically it is known as Benzoylmetylecgonine that is a crystalline tropane alkaloid that acts as a tropical anesthetic that has the ability to numb the vagina, mouth, eye and the rectum and also as an appetite suppressant. It is usually available as a fine white powder that is actually a salt scientifically known as cocaine hydrochloride snorted and absorbed by the nasal membranes. Cocaine can be smoked or injected as well as dabbed on the gum and teeth.

Picture 2 – Structure of cocaine
Source – erowid

Due to its highly addictive qualities and the strong repercussions that its intake has on the body system, its cultivation and distribution is strictly prohibited all over the world. Its possession and usage of any kind is forbidden except for purposes of medicinal research.

Cocaine Addiction & Effects

Similar to heroin and nicotine Cocaine has the ability to reach the dopamine pathways of the brain and bind with the brain proteins that help in the transport of the dopamine. This results in the buildup of dopamine in the synapse creating a euphoric sense for the addict. Cocaine has such attractive power that once smoked, injected or taken in in any other form, makes the person feel pleasant, ecstatic, and confident in an abnormal way. However such an experience lasts for a few minutes and withers away soon but its addictive power reinforces the need to take in more cocaine. It makes the user feel high and above the mundane activities of day to day experiences.

Picture 3 – Cocaine Addiction
Source – img.dailymail

However, the after effects of cocaine intake results in the diminishing of the euphoric experiences and its replacement with feelings of anxiety, irritability and depression. It may also cause the user to lose energy and feel tired and weary, thereby causing anesthesia. With the passage of time one’s feelings may turn odd and unenthusiastic and one may be compelled to take in more cocaine in order to feel good this may get the user permanently addicted to it. This may trigger the need for greater amount of cocaine addiction in order to get the same pleasurable and ecstatic feeling eventually leading to an overdose. In such extreme cases, one may suffer from Cocaine Psychosis in which conditions of restlessness, mood swings, paranoia, insomnia, craving, lack of sexual feelings, and loss of weight prevails. This is because of the rise in dopamine levels of the brain artificially through the intake of cocaine. The Cocaine side effects are also noteworthy which include asthma, chest pain, lung trauma, hemoptysis, fever, sore throat, brochospasm, hoarse voice and pruritus, etc.

Picture 4 – Effects of Cocaine
Source – upload.wikimedia.org

Once started off, one may find it quite impossible to extricate oneself from cocaine addiction.

How long does Cocaine stay in your system?

The presence of cocaine can be detected in the urine, blood and hair follicles through different drug testing methods such as urine drug test, blood drug test, saliva drug test, saliva cocaine test, sweat patch test that is conducted with the help of advanced scientific methods technological methods. The various cocaine drug testing methods are:-

Cocaine Urine Drug Test

In order to know as for how long does cocaine stay in the urine one must undergo a urine test for cocaine which detects the slightest presence of cocaine in the urine. In fact the urine drug test detection times depends on the mode of intake of the drug. In case of snorting cocaine, it can be detected within 4-10 hours. In other cases such as cocaine injection, one can detect cocaine compounds in the urine even after 20 hours of intake. The metabolites of cocaine that can be detected in urine even after 60 hours of cocaine intake or its intake for a prolonged period of time are Benzoylecgonine, coca ethylene (in case of cocaine intake with alcohol) and ecgonine methyl ester.

The procedure of a urine drug test commences from the point when a person ready to undergo the test is instructed to move to a collection site. Then the person’s urine is collected in a secure cup which is exclusively meant for the collection of urine. It is sealed with a tape that is tamper resistant and sent to a testing lab for a drug screening. Using advanced scientific methods such as GC-MS methodology, one detects the presence of cocaine in the urine sample. However it is not possible to locate the exact time of & the amount of cocaine intake through this method. Yet this test is relied on for the accuracy of the results that can be sought with the help of standard testing kits in the labs. It is also relatively cheaper than the other drug testing methods.

Cocaine Blood Test

Although this kind of a test is a bit expensive yet it is recommended by doctors on several cases so as to derive the knowledge of the effect of cocaine on the body through circulation by blood. Here the blood sample of the person is taken and is subjected to medical tests in order to detect cocaine metabolites in the blood. Cocaine can be detected in the blood within minutes of its intake to as long as 5-6 hours after its single dose. The results of this test are the most sought after and is considered to be the most accurate of all.

Cocaine Hair Follicle Test

The hair drug tests for cocaine come in with a number of benefits. First of all it is least expensive and can be afforded by all. Secondly, hair drug testing is a non-invasive method. And thirdly, the sample for the drug test can be collected in bulk for the detection of drug toxification. The detection periods for cocaine through this method extends for over a month if the hair remains uncut for long. But normally, the drug can be detected within 8 hours of the intake of cocaine which may extend for a week or more. Although washing the hairs may remove some amount of cocaine deposition yet the drug cannot absolutely wither away from the hairs.

Saliva Drug Test for Cocaine

The detection time of cocaine in case of saliva testing is the shortest. One needs to be taken for a saliva test immediately after snorting, smoking or injecting cocaine. Cocaine can be detected only within only 1-2 days of its intake.

Sweat Patch Drug Test

Cocaine can also be detected in the body through the Sweat patch test conducted within 1-4 hours after the intake of the drug. Although it is not recommended by the physicians due to the lack of unanimity among medical experts over the efficiency and reliability of such a test, yet people undergo the same owing to the low expense involved in it.

Picture 5 – Cocaine
Source – topnews.in

All the methods mentioned above have been developed in order to help detect individuals the harm that they have already caused to their body system by being addicted to cocaine. The effects of cocaine addiction (especially crack cocaine) are so very harmful that their constant use may cause heart problems, bowel gangrene, nose disorders and even immunodeficiency syndromes such as AIDS. So one who realizes the harmful implications of the intake of cocaine in any form may go through the tests at the initial stages and try and refrain oneself from such addictions with the help of anti drugs.

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