VaginalProblems | HealthyLife® Student Self-Care Online

Section One

Vaginal Problems

“I just learned that yogurt could help to prevent yeast infections. Now when I take antibiotics, I eat a yogurt in the morning.”
– Kim P., University of Maryland

Vaginal problems include vaginal pain, discharge, abnormal bleeding, irritation, and/or infections. Infections may or may not be sexually transmitted. Common vaginal problems in college age females are listed below.

Signs, Symptoms & Causes

Bacterial Vaginosis

This is an infection from one or more types of bacteria. With this you may have:

• Mild vaginal irritation or burning.
• A thin, gray or milky white vaginal discharge with a fishy odor.

Pelvic Inflammatory Disease (PID)

This is an infection that goes up through the uterus to the fallopian tubes. Signs and symptoms are:

• Abdominal tenderness and/or bloating.
• Pain in the abdomen or back. The pain can be severe or it can occur midway in the menstrual cycle or during a pelvic exam.
• Pain during sex.
• Menstrual cramps can be very painful.
• The skin on your abdomen feels sensitive.
• Vaginal discharge with abnormal color or odor.
• Change in menstrual flow.
• Fever. Nausea.

Vaginal Yeast Infection

This is caused by an overgrowth of the fungus Candida. This is normally present in harmless amounts in the vagina, digestive tract, and mouth. Taking some brands of birth control pills and/or an antibiotic may trigger this overgrowth.

Symptoms of a vaginal yeast infection are:

• Thick, white vaginal discharge that looks like cottage cheese and may smell like yeast.
• Itching, irritation, and redness around the vagina.
• Burning and/or pain when passing urine or with sex.

Vaginitis From Contact Dermatitis

This is a reaction to products that irritate the vaginal area, such as harsh detergents, scented items, douches, latex condoms, and tight-fitting clothing. With this, itching and redness occur in the outer genital area without other symptoms.

Sexually Transmitted Infections

These include genital herpes, genital warts, gonorrhea, and trichomoniasis. (For signs and symptoms of these Sexually Transmitted Infections, click here.)

Treatment

Treatment for the vaginal problem depends on the cause. Bacterial infections and PID are treated with antibiotics. Fungal infections are treated with antifungal medicines.

Self-Care

For Vaginitis from Contact Dermatitis

• Avoid products that cause the problem (scented items, douches, feminine hygiene sprays, etc. ). Don’t scrub the affected area with a washcloth.
• Don’t wear tight and constricting garments (girdles, tight blue jeans, etc.).
• Use medicated wipes, such as Tucks, instead of dry toilet paper. Follow package directions.
• Add an oatmeal bath product (Aveeno) or baking soda to bath water.
• Apply an over-the-counter 1% hydrocortisone cream to the affected area. Use this infrequently, though. Hydrocortisone can lead to a thinning of the vaginal tissue.
• Put a cool compress on the affected area.
• Take a sitz bath every 4 to 6 hours or as needed. A sitz bath basin is a device that fits on the toilet seat and is used to cleanse the genital area. You can buy a sitz bath basin at a medical supply store and at some drug stores.
• Wash your underwear in a gentle detergent. Rinse it twice. Use only plain water for the second rinse. Don’t use fabric softener.

For Vaginal Yeast Infection

• For a repeat vaginal yeast infection, use an over-the-counter (OTC) vaginal medication, such as Monistat, if it treated the infection successfully in the past. Use it as directed.
• Let your health care provider know if you get yeast infections when you take an antibiotic. You may be told to use an antifungal product.
• Limit sugar and foods with sugar. Sugar promotes the growth of yeast.
• Eat yogurt and/or take an over-the-counter product that contains live cultures of lactobacillus acidophilus. Or, take an OTC product that has this.
• Take showers, not baths. Avoid bubble baths.
• Keep the vagina as clean and dry as possible.
• Wear cotton or cotton-lined underwear.
• Don’t wear garments that are tight in the crotch. Change underwear and workout clothes right away after you sweat.
• Wear knee-highs instead of panty hose, if possible. When you wear panty hose, wear one with a cotton crotch.

Cefdinir side effects and how to avoid them

Diarrhea, yeast infection, and headache are common cefdinir side effects, but this antibiotic can also cause a rash and C.Diff

Common cefdinir side effects | Diarrhea | Yeast infection | Serious side effects | Rash | C.Diff | Side effects in seniors | How long do side effects last? | Warnings | Interactions | How to avoid side effects

Cefdinir (brand name: Omnicef) is a third-generation cephalosporin antibiotic used to treat certain bacterial infections such as bronchitis, sinusitis, pharyngitis (sore throat), and urinary tract infections (UTIs). It works by killing harmful bacteria throughout the body. It comes in both capsule and oral suspension form and is usually taken for up to 10 days, depending on the type of infection being treated.

Common side effects include diarrhea, vomiting, and headache. Serious adverse reactions are less common and include severe allergic reactions, Steven-Johnson’s syndrome, and Clostridium difficile (C. difficile) infections. Drug interactions are also possible when taking cefdinir. Be sure to tell your healthcare provider if you have any medical conditions or are taking any medications before taking cefdinir.

RELATED: Learn more about cefdinir |Get cefdinir discounts

Common side effects of cefdinir

The most common side effects of cefdinir include:

• Diarrhea 
• Yeast infection (candidiasis) 
• Nausea and/or vomiting
• Headache
• Abdominal pain
• Inflammation of the vagina (vaginitis)
• Rash 
• Indigestion/Flatulence

Some clinically significant laboratory changes that might be seen include:

• Increased white blood cells in urine 
• Increased levels of protein in the urine (proteinuria)
• Microscopic amounts of blood in the urine (microhematuria) 
• Increased blood sugar (glucose)
• High levels of eosinophils (eosinophilia), which are a special type of white blood cells
• Elevated liver enzymes i. e. alanine aminotransferase (ALT) or aspartate aminotransferase (AST)

Diarrhea

In the same adult clinical trial mentioned above, 15% of adults and adolescents experienced diarrhea. 

The pediatric clinical trial showed 8% of children being treated with cefdinir experienced diarrhea and 0.8% experienced abdominal pain. The rates of diarrhea were highest in patients younger than 2 years old (17%).

If diarrhea is severe during treatment with cefdinir, consult your healthcare provider to rule out a C. difficile infection.

Yeast infection

Cefdinir destroys harmful bacteria in the body, but can also destroy the good bacteria. This may result in oral thrush and vaginal yeast infections during treatment with cefdinir. 

A clinical trial of 5,093 adults and adolescents taking 600 mg of cefdinir per day found that 4% of women experienced a vaginal yeast infection during treatment. In the same group, there was a 0.2% occurrence of yeast infections unrelated to the vagina.

Another trial of 2,289 pediatric patients showed vaginal yeast infections in 0.3% of girls being treated with cefdinir and fungal skin infections in 0.9% of all children.

RELATED: How to prevent yeast infections from antibiotics

Serious side effects of cefdinir

Serious side effects while taking cefdinir are rare but possible. These side effects include:

• Severe allergic reaction (anaphylaxis)
• Stevens-Johnson syndrome: flu-like symptoms accompanied by painful rash and blisters
• Toxic epidermal necrolysis: a rare condition causing skin peeling and blistering
• Exfoliative dermatitis: redness and peeling of large areas of skin
• C. difficile infection causing severe diarrhea and colitis
• Low neutrophils (neutropenia)
• Low platelet count (thrombocytopenia)
• Hemolytic anemia
• Aplastic anemia
• A severe immune reaction (serum sickness)
• Renal toxicity
• Liver toxicity

Cefdinir rash

Several side effects of cefdinir may be accompanied by a rash, including an allergic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, and exfoliative dermatitis.

Clinical trials reported rash at an incidence of 0.9% in adults and adolescents being treated with cefdinir. Rash occurred in 3% of children taking this medication, although the majority of these occurrences were in children younger than 2 years old.

Seek emergency medical attention right away if rash-like symptoms are accompanied by wheezing, tightness in the chest or throat, or trouble breathing. This could be a sign of a potentially dangerous allergic reaction.

Clostridium difficile-associated diarrhea

Treatment with Cefdinir can destroy some of the bacteria in the gut. This allows other organisms such as C. difficile to grow out of control. C. difficile produces toxins that may cause swelling/inflammation in the lining of the large intestine. This inflammation is called pseudomembranous colitis. This can cause diarrhea ranging in severity from mild diarrhea to fatal colitis. Symptoms include:

• Frequent watery diarrhea that is sometimes bloody
• Pain and tenderness in the stomach
• Cramping
• Nausea
• Fever
• Loss of appetite

RELATED: Antibiotics that cause C. Difficile

Cefdinir side effects in elderly

People with multiple comorbidities may have an increased risk of side effects when treated with antibiotics, and older adults have more underlying health conditions than younger patients. However, clinical trials found cefdinir to be a safe drug for older patients, with a lower adverse reaction rate compared to young adults.

How long do cefdinir side effects last?

Most cefdinir side effects will subside during or shortly after treatment, although some may require medical attention. Yeast infections, oral thrush, and C. difficile are some examples of side effects that may need to be treated with other medications.

Severe allergic reactions require immediate medical attention. Signs of a severe allergic reaction include:

• Rash or hives
• Swollen or blistered areas of skin
• Red, peeling skin
• Wheezing
• Chest tightness
• Swelling of the mouth, face, lips, throat, or tongue
• Difficulty breathing

Cefdinir contraindications and warnings

Cefdinir may not be appropriate for everyone. Discuss any medical conditions with your healthcare provider before starting treatment, especially if you have ever had:

• Kidney disease or a history of dialysis
• Allergies to other antibiotics, especially cephalosporins and penicillins
• Colitis
• Diabetes (oral suspension contains sucralose)
• Seizure disorders

Kidney disease

Use caution in patients with a creatinine clearance of <30mL/min. Dosage should be reduced in these patients with kidney problems. There is evidence that cephalosporin antibiotics may cause seizures in patients with renal impairment whose dosage was not reduced.

Colitis

Use caution in patients with a history of colitis. Clostridium difficile-associated diarrhea may be more severe in these patients if it occurs. 

Diabetes

Cefdinir can increase blood sugar on its own. The liquid form of cefdinir also contains sugar, which may alter blood glucose levels. Diabetic patients should avoid using cefdinir suspension to ensure that blood sugar levels aren’t altered during treatment. Careful glucose monitoring is required when Cefdinir must be used.

Withdrawal

Cefdinir does not cause dependency or withdrawal symptoms. However, like all antibiotics, if a patient does not finish the full course of antibiotics, an infection may persist or recur.

Overdose

Overdose on any medication is possible, including cefdinir. Signs of overdose include:

• Nausea
• Vomiting
• Stomach pain
• Diarrhea
• Seizures

If an overdose is suspected, seek emergency medical attention or call the Poison Control Center immediately. 

Children

Cefdinir is FDA-approved to treat certain bacterial infections in children as young as 2 months. It may treat bacterial ear infections (otitis media), sinusitis, pharyngitis, tonsillitis, pneumonia, and bacterial skin infections.

Pregnancy

According to the FDA, cefdinir is a pregnancy category B medication. There is no human data available to measure risk, but animal data shows no known risks or complications of taking cefdinir while pregnant. If you’re pregnant, be sure to talk to your healthcare provider about the risks before taking this medication.

Breastfeeding

Cefdinir may be taken while breastfeeding. There is no human data available to determine the risk to the infant, however, no risk is expected based on data from other cephalosporin antibiotics. It is not yet known if cefdinir affects breast milk production.

Cefdinir interactions

There are several drugs and supplements that may interact with cefdinir, according to the FDA. Be sure to tell your healthcare provider what medications, vitamins, and supplements you’re taking before beginning treatment.

• Antacids, magnesium, and iron supplements: Some antacids or supplements containing iron or magnesium may interfere with cefdinir absorption. Take 2 hours before or after Cefdinir. Patients taking iron may also experience a reddish stool discoloration (not related to bleeding). The reddish color is due to the formation of a complex between cefdinir and iron in the gut.
• Probenecid: Taking probenecid, a uric acid reducer that treats gout, may increase levels of cefdinir in the body.
• Hormonal contraceptives: Cefdinir may decrease the efficacy of hormonal birth control; use another form of birth control while taking cefdinir.
• Tetracyclines: Taking tetracyclines with cefdinir may alter the way cefdinir works inside the body.

How to avoid cefdinir side effects

Cefdinir may cause side effects, but there are ways to reduce the risk for these undesired effects. Some ways to avoid side effects while taking cefdinir include:

• Take cefdinir as directed. Follow the medical advice of your healthcare provider and instructions given by your pharmacist. Be sure to shake your liquid cefdinir before use and measure using an appropriate dosing syringe.
• Take cefdinir with or without food. You don’t have to take cefdinir with food, however, taking it with food may decrease stomach discomfort.
• Don’t skip doses. If you forget a dose of cefdinir, take the missed dose as soon as possible. If it’s almost time for your next dose, skip the missed dose. Never double up on doses, as this may cause unwanted side effects.
• Avoid antacids, magnesium, and iron supplements for at least two hours before and after taking cefdinir. Some antacids and supplements interfere with the absorption of cefdinir. Avoid taking antacids or supplements containing magnesium or iron within two hours of taking cefdinir to prevent these interactions.
• Tell your provider about all medical conditions. Cefdinir may not be the best medication for patients with certain medical conditions. Avoid taking cefdinir if you’ve had an allergic reaction to cephalosporin antibiotics in the past.
• Tell your provider what other medications you are taking. Drug interactions while taking cefdinir are possible. Tell your healthcare provider of any prescription drugs, over-the-counter medications, supplements, and herbal products before beginning treatment.
• Don’t stop taking cefdinir before you’ve finished treatment unless directed to do so by a healthcare professional. It’s important to finish your entire treatment, even if your symptoms improve. Discontinuing the medication early may cause repeat infection or antibiotic resistance.
• Store cefdinir properly. Keep this medication at room temperature away from moisture and heat and out of reach of children. Discard your unused cefdinir after treatment.

Resources

Thrush (Oral Candidiasis) in an Infant or a Baby: Condition, Treatments, and Pictures for Parents – Overview

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Images of Candidiasis, Oral (Thrush)

Overview

Oral candidiasis, more popularly referred to as thrush, is a very common disease caused by an overgrowth of yeast in the mouth and/or throat. The most common yeast causing thrush is called Candida albicans.

Who’s at risk?

Thrush is very common in newborns and infants. It is important to note that thrush is not passed from infant to infant.

Infants more likely to develop thrush are those:

• On a course of oral antibiotics.
• Undergoing chemotherapy.
• With an immune disorder.

Other factors that can lead to infants being more predisposed thrush include leaving a bottle propped in the infant’s mouth and improper wiping after feedings.

Signs and Symptoms

Thrush may appear as white or pale yellow spots on the inner surfaces of the mouth and throat, the tongue, and the lips. It may resemble cottage cheese or milk curds. However, scraping off these membranes may be difficult and may leave slightly bleeding sores.

Thrush may be accompanied by a burning sensation in the mouth or throat (oral cavity).

Self-Care Guidelines

Thrush may make eating and drinking uncomfortable, and children with thrush may lose water in their body tissues, becoming dehydrated. It is important to make sure your child maintains good nutrition and fluid intake (hydration) while infected with thrush.

See your child’s doctor for treatment of thrush with prescription medications.

When to Seek Medical Care

Thrush requires medication, which your child’s doctor will prescribe after a visit for evaluation. If your child has an immune system deficiency, you will need even quicker and more aggressive treatment to keep the yeast out of the bloodstream and prevent it from infecting other parts of the body. Seek immediate medical attention if the white or yellow membranes of thrush are accompanied by fever, chills, vomiting, or overall illness.

Treatments Your Physician May Prescribe

Your doctor will instruct you on how to keep your child’s oral cavity very clean, and treatments will center on killing the overgrown yeast with anti-fungal medications:

• Nystatin – This medicine must touch the yeast in order to kill it. Nystatin comes in a suspension or liquid, and also in a lozenge, called a troche. Have your child swish the suspension around the mouth and then swallow it. The lozenge dissolves in the mouth. Use the suspension and/or lozenges several times a day until the lesions are completely gone.
• Amphotericin B suspension – Swish the suspension around in the mouth and swallow it several times a day until the lesions heal completely.
• Clotrimazole lozenge – Let the lozenge dissolved in the mouth several times a day until the lesions have healed completely.
• Fluconazole pill or suspension – Swallow this medication once daily for 5–10 days.

Trusted Links

Clinical Information and Differential Diagnosis of Candidiasis, Oral (Thrush)

References

Bolognia, Jean L., ed. Dermatology, pp.837, 1095, 1096, 1185. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp. 2013. New York: McGraw-Hill, 2003.

Diagnosis and Treatment of Esophageal Candidiasis: Current Updates

Esophageal candidiasis (EC) is the most common type of infectious esophagitis. In the gastrointestinal tract, the esophagus is the second most susceptible to candida infection, only after the oropharynx. Immunocompromised patients are most at risk, including patients with HIV/AIDS, leukemia, diabetics, and those who are receiving corticosteroids, radiation, and chemotherapy. Another group includes those who used antibiotics frequently and those who have esophageal motility disorder (cardiac achalasia and scleroderma). Patients complained of pain on swallowing, difficulty swallowing, and pain behind the sternum. On physical examination, there is a plaque that often occurs together with oral thrush. Endoscopic examination is the best approach to diagnose this disease by directly observing the white mucosal plaque-like lesions and exudates adherent to the mucosa. These adherent lesions cannot be washed off with water from irrigation. This disease is confirmed histologically by taking the biopsy or brushings of yeast and pseudohyphae invading mucosal cells. The treatment is by systemic antifungal drugs given orally in a defined course. It is important to differentiate esophageal candidiasis from other forms of infectious esophagitis such as cytomegalovirus, herpes simplex virus, gastroesophageal reflux disease, medication-induced esophagitis, radiation-induced esophageal injury, and inflammatory conditions such as eosinophilic esophagitis. Except for a few complications such as necrotizing esophageal candidiasis, fistula, and sepsis, the prognosis of esophageal candidiasis has been good.

1. Introduction

Candida is a yeast organism that colonizes the surface epithelium of the alimentary canal and urogenital system of healthy human beings as normal flora. When there is an impaired local or systemic immune system, candida overgrowth may occur, leading to candida infection. More than 15 distinct candida species can cause diseases, and the most common pathogens are C. albicans, C. glabrata and C. tropicalis [1]. The pathogenicity of these pathogens varies from species to species, and so does the degree of damage to the immune system. Mucosal candida infections, especially those involving oropharynx, esophagus, and vagina, are most common in the general population. The most common cause of infectious esophagitis is candida infection of the esophagus, with an incidence of up to 88% [2, 3]. Normally, candida is a symbiont of the esophagus. When host defense mechanisms are impaired, it allows candida to proliferate in esophageal mucosa and form adhesive plaques [4].

Esophageal candidiasis (EC) is usually common among patients infected with human immunodeficiency virus (HIV). This is because approximately 10–15% of HIV-infected patients will develop EC [5–7] during their lifetime, while another 85–90% of HIV-infected patients will develop oropharyngeal candidiasis [8]. We have found that the incidence of EC was 0.32% in individuals with strong immunity in Korea in a single-center study [9].

2. Etiology

The occurrence of infection is the result of the interaction between pathogen and host, especially related to the immune status of the body and whether the patient has basic diseases. The diagnosis of fungal esophagitis was first presented in 1839, and candida was identified as the pathogen. Under normal circumstances, both the specific defense system and the nonspecific defense system of the body’s digestive tract can inhibit the excessive growth of fungi [4]. After the functional deficiency of host immune system or the application of antibiotics, the composition of microflora in the digestive tract changes, and the invasion ability of opportunistic pathogenic fungi is enhanced through the gene regulation mechanism, leading to opportunistic fungal infection [5]. Candida is one of the common opportunistic pathogenic fungi. The pathogenicity of candida may be related to its morphology, adhesion to tissues, and production of extracellular proteases. Furthermore, the destruction of local defense mechanism and systemic factors including low immune function, unreasonable application of antibiotics and hormones, physiological weakness, endocrine disorder, nutritional factors, chemotherapy, radiotherapy, and the presence of malignant diseases may contribute to the occurrence of this disease.

3. Risk Factors

Several studies have shown that the incidence of esophageal candidiasis is 0.32% to 5.2% in the general population. But, there are some specific populations in which the incidence of this disease is higher, while others are low. This paper attempts to assess risk factors from the following aspects.

3.1. Gender

Esophageal candidiasis affects all patients irrespective of gender. For example, a study conducted by Nassar et al. on individuals with this disease who were immunocompetent showed that there was no difference in terms of gender [10].

3.2. Age

Worldwide, the median age of patients with esophageal candidiasis is 55.5 years. In the recent study, Kliemann et al. reported that the age range of esophageal candida disease patients was 21–88 years old (average 57.4 years old; standard deviation 16.7 years) [2]. However, other factors, such as the use of medications, can also contribute to changes in the average age at which the disease occurs. Therefore, the disease may occur at early ages or late. The average age of the patients at the time of diagnosis was 39.8 years [10].

3.3. Comorbidities

Approximately 10% of HIV patients develop esophageal candidiasis in their lifetime [8]. However, the trend of this infection among HIV-positive patients is decreasing because of the effectiveness of highly active antiretroviral therapy (HARRT) [11]. In the present age, there is a rise in several cases in non-HIV patients, possibly because of comorbidities such as diabetes mellitus, peptic ulcer diseases [12], or medications such as antibiotics and corticosteroids given to patients who received transplant organs [1]. In addition, the condition called cardiac achalasia, a motor disorder of the esophagus, may cause stasis of food and secretions in the esophagus, which leads to overgrowth of Candida albicans and development of esophageal candida infections [13, 14].

3.4. Use of Proton-Pump Inhibitors

This is the most common cause of CE in individuals with strong immunity. In fact, about 72% of HIV-negative patients used proton-pump inhibitors (PPI) [15] and other acid suppression drugs. Hoversten et al. reported that PPI was the most common risk in individuals with strong immunity, contributing 63%–81% to the occurrence of candida esophagitis [15].

3.5. Smoking

Some studies suggest that smoking is also associated with the development of esophageal candidiasis. Firstly, the presence of chemicals weakens the local immune surface of esophageal squamous epithelium. Subsequently, symbiotic bacteria such as Candida albicans were allowed to invade and proliferate, leading to candida esophagitis [1, 12].

4. Pathophysiology

The mucous membrane of the esophagus is naturally lined by the protective innate immune mechanical barrier called the nonkeratinized stratified squamous epithelium. Because of this, Candida albicans may be part of the commensal that colonizes the esophagus in some individuals, accounting for about 20% [16]. However, processes that impair the immune system, as well as those that cause local lesions in the esophageal upper cortex, can lead to the proliferation and colonization of Candida albicans. Subsequently, candida adheres to the mucous membrane and forms yellow-white patches. We can see the plaques on upper endoscopy and cannot wash from the mucosa with water irrigation. These plaques can be found diffusely throughout the entire esophagus or localized in the upper, middle, or distal esophagus [11].

5. Management of Candida Esophagitis

5.1. History and Physical Examination

The clinical manifestations of the patients are often related to the extent of esophageal mucosal damage, and the most common symptoms are pain on swallowing, difficulty swallowing, and pain behind the sternum. Other symptoms include abdominal pain, heartburn, weight loss, diarrhea, nausea, vomiting, and melena [11, 17]. Esophageal endoscopic examination showed small white spots in the esophageal mucosa, and X-ray barium examination showed abnormal peristalsis at the upper and lower end of the esophagus. Only 15% of the patients show esophageal mucosal damage. Candida esophagitis can be divided into the following: (1) acute infection: extremely weak immunosuppression patients often die of acute fungal infection; (2) subacute infection: subacute infection may result in esophageal stricture or pseudodiverticulum; (3) chronic infection: usually from childhood, chronic infection is often associated with submucosal fungal infection and immunodeficiency.

5.2. Diagnosis

Because candida is a normal mycotic flora in the oral and gastrointestinal tract, isolation of candida from sputum and stool specimens cannot make a diagnosis of candida infection, which often requires histopathological evidence. The pathologic features of the endoscopic biopsy tissue are multiple abscesses with acute inflammatory reaction. Neutrophils are predominant, and fungal spores and pseudohyphae are visible.

If patients show typical clinical manifestations, candida is found in microbial cultures, and furthermore, there are high risk factors (such as broad-spectrum antibacterial drugs, corticosteroids, and immunosuppressive, and in intensive care unit, merge blood system basic diseases such as tumor, diabetes, or organ transplant, mechanical ventilation, and indwelling catheter), and suspected case of esophageal candidiasis can be diagnosed.

Suspected cases of esophageal candidiasis should be treated with short-term fluconazole antifungal therapy. Esophageal candidiasis can be diagnosed when symptoms recover after fluconazole treatment. In these cases, no further investigation is required. If the infection persists, further investigation may be required and the patient will then conduct the following investigation.

5.2.1. Endoscopy

Esophagoscopy is the diagnosis of choice for candida esophagitis. Direct visualization of the esophageal mucosa confirms the presence of white plaques or exudates that are adherent to the mucosa and cannot be washed off with water irrigation (Figure 1). Sometimes there may be mucosal breaks or ulcerations [17].

5.2.2. Histology

The next step is to identify the source of these white plaques. The gold standard for the diagnosis of candida esophagus is by histological examination. Biopsy or brushing of the esophageal mucosa is taken during endoscopy, and staining by using hematoxylin and eosin is done. Candida yeast is almost always shown as pseudohyphae, which is an important basis for the diagnosis of esophageal candidiasis. The mucous membrane involved may present as desquamated parakeratosis, characterized by a group of squamous cells that have detached or are in the process of separating from the main squamous epithelium [11].

5.2.3. Radiological Examination

According to Kodsi et al. [18], the disease was divided into 4 stages according to the extent of damage to the esophageal mucosa, and lumen stenosis would appear in the 4th stage. In stage 4, barium examination is a very useful noninvasive strategy for the diagnosis of candida esophagitis and can be used as an alternative to endoscopic examination. Barium swallow esophagogram presents the characteristic manifestations of esophageal stenosis, and some authors present esophageal stenosis as “foamy appearance” and “feather appearance” (Figure 2) [19–21]. Therefore, in these cases, double-contrast esophagography is a highly sensitive alternative to the diagnosis of candida esophagitis. Reports show that the sensitivity of double-contrast esophagoscopy to endoscopic diagnosis of candida esophagitis is up to 90% [4, 22].

6. Differential Diagnosis

Although infectious esophagitis is very common, especially Candida albicans, other forms of esophagitis are also prevalent. The trend and frequency differ based on the cause, susceptibility, and geographic area. Other causes include cytomegalovirus [23], herpes simplex virus, eosinophilic esophagitis, [24, 25] pill-induced esophagitis, gastroesophageal reflux disease, radioactive esophagitis, or any other form of esophageal mucosal inflammation [9, 23].

7. Treatment

Esophageal candidiasis usually responds well to antifungal therapy. In contrast to oropharyngeal candidiasis, the treatment of esophageal candidiasis is usually systemic rather than topical. The most commonly used medication for the treatment of esophageal candidiasis is the systemic antifungal with oral fluconazole 200 to 400 mg per day for 14 to 21 days [26]. For patients who may not be able to tolerate oral medication, the alternative is 400 mg of fluconazole intravenously daily. Itraconazole 200 mg per day orally or voriconazole 200 mg twice daily for 14 to 21 days are other treatment options. Amphotericin B deoxycholate 0.3 to 0.7 mg/kg per day may also be used in patients with nonresponsive candida esophagitis, but it has serious medication side effects, and clinicians should avoid routine use. Treatment with posaconazole 400 mg twice a day orally for patients with severe and refractory esophageal candidiasis appears to be significantly efficient [1, 27].

Other health-related conditions affect the choice of medication. For example, amphotericin B can be used for esophageal candidiasis during pregnancy in the first trimester, as teratogenic azole compounds are contraindicated [28]. Treatment with azole antifungal drugs for esophageal candidiasis rarely leads to significant side effects, but the most common symptoms include abdominal pain, nausea, vomiting, and diarrhea.

Besides active and effective antifungal therapy, dehydration, electrolyte disturbance, and acidosis should be corrected in time. It is also necessary to improve patients’ general condition, improve the immune function of the body, strengthen nutrition, actively treat basic diseases, and control blood sugar. Minimize or discontinue the use of broad-spectrum antimicrobial agents and immunosuppressants. The combined use of intestinal flora regulator and intestinal mucosal protection drugs can improve the efficacy, and the application of B vitamins can enhance the resistance of local tissues and inhibit the growth of candida.

8. Antifungal Drug Resistance

Fluconazole is still considered as a first-line agent in EC patients with no other contraindications. However, there have been noted that frequent clinical relapses and increased antifungal utilization for prophylaxis reason which are linked to increased risks of antifungal resistance, particularly fluconazole. [29]. In the randomized clinical studies conducted previously, evidences suggest that overuse of fluconazole or other antifungal agents increases the risk of drug resistance because of dosed- dependent sensitivity [30, 31]. Patients experiencing fluconazole-refractory esophageal candidiasis (B-II) should be treated with itraconazole solution (200 mg/day Po), voriconazole (200 mg B.I.D), or caspofungin (50 mg/day) (A-II). Or intravenous amphotericin B deoxycholate (0.3–0.7 mg/kg/day) [1, 32] can be considered.

9. Prognosis

Few investigators have studied the prognostic sequelae of esophageal candidiasis. Usually, EC responds successfully with antifungal agents. Resistant and refractory infections may occur and may require alternative agents for treatment or long-term antifungal prophylaxis to reduce recurrence [33].

10. Complications

Usually, esophageal candidiasis occurs in the form of superficial esophagitis. Few cases of transmural necrosis candidiasis have been reported and are associated with serious immunosuppression and neutropenia [34]or other comorbid conditions such as patients on hemodialysis [35]. The recovery of these patients is a critical concern because the mortality rate is high.

10.1. Necrotizing Esophageal Candidiasis

This is the common and entry source of the rest complications. Esophageal ulcerations predispose to esophageal perforation and upper gastrointestinal bleeding, weight loss, malnourishment, sepsis, candidemia, and fistula formation into a bronchial tree [36].

10.2. Esophageal Stricture

Stricture to the esophagus may occur especially if the candida esophageal infection is accompanied by other conditions such as connective tissue disease or glycogen storage disease [37] or those without other underlying diseases [20].

11. Conclusion

Esophageal candidiasis remains one of the most common and challenging infections of the esophagus, especially in patients with low immune function and who use spectrum antibiotics and proton-pump inhibitors. Esophageal endoscopy and histological examination can accurately diagnose the disease. For patients with difficulties in endoscopic examination, barium swallow esophagogram can also be used as an auxiliary diagnosis. In clinical practice, the pretreatment evaluation model is usually used to make diagnostic decisions. In terms of treatment, oral empirical treatment with the first line of systemic antifungal is enough. However, in severe cases, prompt investigation and aggressive treatment, such as intravenous antifungal therapy, are necessary.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

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THUMB-SUCKING AND PACIFIERS

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General Information:

Babies and young children love to suck on thumbs, fingers,

and pacifiers. A security object often becomes part of the

ritual.  The baby’s desire to suck on the breast or bottle is

important for nutrition and a full 80% or more infants suck on hands

or pacifiers when they are not hungry. Sucking seems to

help young children comfort themselves.

If your baby loves to suck, it is a good idea to give her an

orthodontic pacifier (Nuk) by about 1 month of age so that she will

not begin sucking her thumb. The pacifier does not cause the severe

overbite that can result with prolonged thumb-sucking and is easier

to wean your child from since it is not part of her body.

Do not use home-made pacifiers such as nipples taped to bottle

tops since they can come apart and choke your child.  Do not

put your child’s pacifier on a string around his neck that can

result in choking. Rather use a pacifier that clips on part of his

clothing. Do not coat the pacifier with sweets or honey since these

can cause cavities or infant botulism in babies. Do not use a

pacifier that has fluid in the middle of it since this can become

contaminated with bacteria.  Also rinse off his pacifier each

time he is finished with it or it falls on the floor.

The sucking drive decreases as children age with only about 15%

sucking their thumb or fingers by 4 years of age.

Treatment:

1. Thumb-sucking before 4 years of age does not usually

   cause any problems.  However, a sucked thumb acts as a kind of orthodontic device, creating an undesirable overbite. If your baby rejects the pacifier and is clearly going to be a thumb sucker, try to encourage the baby to hold the thumb in all the way to reduce the overbite effect.

2. Occasional thumb-sucking during the day

   when your child is tired does not cause problems; if constant during

   the day encourage your child by reminding him that big boys do not

   suck their thumb and by showing him the callous on his finger that

   may hurt at times.

3. Thumb-sucking at bedtime is usually not

   voluntary and probably unimportant if it stops after your child

   falls asleep; if it is constant during the night consult your

   dentist to see if it is affecting her teeth.

4. If by 5- or

   6-years old your child continues to suck his thumb frequently and

   your dentist is concerned that it is affecting the alignment of his

   teeth, then a bitter-tasting medicine (Stop-zit) can be applied at

   bedtime or a dental appliance may be placed in your child’s mouth to

   prevent his sucking.

5. Encourage her to stop the pacifier if

   she is 3 or 4 years by giving her stars or marks on her hand and

   lots of affection when she is able to go for a short period without

   the pacifier. Never punish or humiliate her to give up the

   pacifier.

VAGINITIS

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Vaginitis is very common in a girl before puberty because

her vagina is very sensitive to irritants at this age.  But she

is less likely to have a yeast or bacterial infection than when she

is a teenager or a young adult. She likely will complain of urinary

pain because of the inflammation of her vagina.  Usually her

urine will need to be examined to be assured that she does not have

a bladder infection.

The most common causes of vaginitis are bubble

baths, soaking in soapy water, scratching accidentally, soap residue

on her underwear, self-exploration, poor hygiene, and wiping in the

wrong direction after a bowel movement. Tight clothes and nylon

underwear may cause irritation.

Treatment:

1. Stop all bubble baths and do not give your daughter

   soap until 5 minutes before she gets out of her bath.  Do not

   wash her vagina directly since soaking in her bath for 15-20 minutes

   is sufficient for good hygiene.

2. Teach your daughter

   proper hygiene and wiping from front to back after bowel movements

   to avoid bringing stool to the vaginal opening.

3. Use mild

   soaps or double rinse all underwear.

4. Have your daughter

   wear cotton underwear and looser clothing.

5. A cream to

   apply 3 times a day may be prescribed by your doctor.  Vaseline

   may help if your daughter has accidentally scratched herself.

Call Your Doctor If:

1.  She has large amounts of discharge of any

sort.
2.  She has a vaginal discharge that contains blood or

is very foul smelling.
3.  You have any suspicion that an

older child or adult has had sexual contact with her.

VOMITING

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General Information:

Most children who are vomiting have a viral infection

causing a mild stomach upset. Antibiotics do not help vomiting and diarrhea caused by a viral infection. If your child is more than

6-months-old, vomiting and diarrhea can usually be effectively

treated at your home.  However, call your doctor if any of the

following signs appear:

• Blood in the stool

  High fever

  No urination in 8 hours

  Excessive sleepiness

  Very dry mouth

• Crying without stopping

Vomiting and diarrhea are ways your child

eliminates harmful organisms when he has a viral or bacterial

infection or tainted food (in the case of food poisoning).  The main danger of prolonged vomiting and diarrhea is the danger of dehydration, not the vomiting or diarrhea itself. This usually resolves on its own after a couple of days.

Treatment:

1. Give him no fluids for 30 minutes since the last

   episode of vomiting.

2. Give him 1-2 teaspoons of Gatorade

   or other sports drink every 30 minutes if he is older than 12 months

   (or Pedialyte for babies less than 12 months). These drinks replace

   his salt, water, and other minerals lost through vomiting.  Do

   not give him fruit juices which may cause more vomiting. An old home remedy is Coke frozen into an ice cube tray, then chopped up for the child to take a little at a time.

3. If he

   keeps fluids down, you may double the amount given him every 1-2

   hours.

4. If he vomits again, restrict his fluids for 30 minutes

   and then resume the above procedure. Call your doctor if he does not

   seem to be improving.

5. Continue giving him clear liquids for 8

   to 24 hours. Chicken broth with a little rice or noodles and plain soda crackers are usually well tolerated during recovery. If vomiting stops, restart a mild diet if older

   than 12 months (BRAT: bananas, rice, applesauce, toast) or breast

   feeding or lactose-free formula for infants.  In a day or so,

   slowly return to a regular diet in 2-3 days.

6. His symptoms will

   take a minimum of several days to go away.

7. When offering her

   fluids, avoid using red or orange liquids since they could make her

   stool look bloody.

8. Medications for vomiting or diarrhea do not

   help much in children, and at times can cause serious side effects,

   especially in young children. For this reason, most doctors are

   careful in the use of medications and stress the cautious approach

   as described above.

WARTS
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General Information:

Warts are caused by the human papilloma virus which causes

the characteristic raised, round, rough-feeling growths that are

most commonly found on the hands. These are not usually painful

unless they are located on the soles of the feet or if your child is

constantly picking at her wart.

Most warts will disappear after two or three years,

but with treatment will go away in 1 to 3 months, although with some

difficulty. Most warts are only mildy contagious to others and so

your child can attend school and other social functions. However,

you should encourage your child to not pick at his warts as they are

likely to spread on his hands or other body parts.

A related illness caused by a different virus is

called moluscum contagiosum which are smaller, wart-like growths

that usually occur in clusters of several to dozens. These are much

more likely to spread on your child than regular warts.

Treatment:

1. Try nonprescription medicines recommended by your

   pharmacist. These various brands are composed of acid which slowly

   dissolves the wart over several weeks. Use this treatment every day

   according to the instructions

2. At least once a week use a

   pumice stone to buff away the surface of the wart so as to speed up

   the dissolving process. This buffing process will work better if you

   first soak the wart for about 15-20 minutes in warm water to soften

   it.

3. Stop the buffing process if your child says that it is

   hurting or if you see any blood coming from the wart. It might be

   easier for your child to do the buffing while you supervise.

4. Freezing preparations can be used in the pediatrician’s or

   dermatologist’s office. It is normal to have to use this process

   more than once, sometimes multiple times.

5. Plantar warts on the

   bottom of your child’s foot are usually more difficult to eliminate

   because they are pressed up into the foot by your child’s body

   weight while walking.

6. Similar processes can be used on the

   mollusum contagiosum although it is a little more difficult to apply

   the acids since these are much smaller than the common wart.

7. Make an appointment to see your doctor if your child complains of

   increasing pain or he develops excessive redness around the wart

   while you are treating it at home.

WEANING
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General Information:

Weaning

from breast feeding is usually accomplished before 18 months of age

although some women will nurse their children longer. In developing

countries it is normal and safer (due to scarcity of drinkable

water) for mothers to nurse their children until 2-3 years of age.

Issues with the bottle are different. It is

recommended that an infant be off the bottle and to the cup by 12

months of age, 15 months at the latest. The infants should not be

given fluid in the middle of the night in a bottle because it can

cause choking, ear infections, and cavities from prolonged exposure

to sugar in the formula.

During the day children older than one year will

tend to carry their bottle around with them much like a security

object. They will also sip on the contents repeatedly throughout the

day. These children will often develop bottle cavities where they

have multiple teeth affected and many teeth needing to be capped,

pulled, or drilled.

Treatment:

1. With breast-feeding, eliminate the least favorite feeding

   (usually in the middle of the day) and replace it with a formula in

   a cup if older than 6 months and less than one year of age.

2. Continue to eliminate more nursing times every few days. This allows

   your breasts to reduce the amount of milk they are producing.

3. Finally, eliminate the bedtime feeding which is typically the most

   preferred by your baby.

4. If you develop engorgement of your

   breasts while trying to wean, take a

   warm shower and try to express

   the excess milk until you feel more comfortable.  If this does

   not help you may need to add one nursing time back and wean more

   slowly.

5. For bottle-feeding, you can replace the bottle with a

   cup every few days in much the same way that you wean from nursing.

   However, you can wean faster if your child tolerates it because you

   do not have to worry about breast engorgement.

6. For both

   breast- and bottle-feeding, once the weaning is complete, if your

   child asks to nurse or for a bottle, hold her for a while and

   explain that breast- and bottle-feeding are for little babies and

   she is a big girl.

7. Some infants are excessively attached to

   the bottle and will throw a tantrum if not given the bottle.

   Regardless of how upset he is, for health reasons do not give in

   when he is on the cup. His tantrums will subside in a few

   days.

YEAST INFECTIONS IN BABIES
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General Information:

Yeast infections of your baby’s diaper area and mouth are

very common. These infections usually cause only minor symptoms even

when the infection covers a large part of your baby’s bottom or

mouth.  Often the yeast is acquired when your baby passes

through the birth canal since the yeast normally lives in the

vagina. Yeast infections are more likely to occur when your baby is

on an antibiotic since antibiotics kill germs that compete with the

yeast, while not harming the yeast.

Babies have frequent yeast diaper rashes because

the yeast inhabits the rectum. With each bowel movement, his skin is

exposed to the yeast. Since it is harder for your baby to fight an

infection than an older child, medicines are usually needed to

eliminate the yeast. However, even in severe cases he is likely to

be only a little fussy.  The infection does not progress into

something more serious.

Yeast in her diaper area appears as a bright red, slightly raised

rash. At the edges there may be little isolated red spots just

beyond the main rash. Your baby may have some itching with her yeast

infections, but seldom will she have any pain.

Yeast in his mouth is also called thrush. It appears

as milky white patches on the tongue and the sides and back of his

mouth. Thrush may make your baby’s mouth a little tender if

extensive, but it seldom causes him to reduce feeding. Your infant

may have yeast in his mouth and diaper area at the same time.

Treatment:

1. Do not be overly concerned about yeast infections in your

   baby. These are mild infections that do not cause her severe

   problems unless she has a poor immune systems (such as in leukemia,

   other cancers, and AIDS).

2. For the diaper rash the main

   treatment is a cream with a yeast-killing medicine in it such as

   Lotrimin which can now be bought without a prescription. Usually it

   takes about 2-3 days before much improvement is seen in him and it

   may take 10 days before completely resolving.

3. Changing her

   more frequently may help.

4. For the thrush in the mouth some

   doctor’s offices will apply gentian violet to his mouth with a

   cotton swab. This temporarily stains his mouth purple, but is an

   effective way to eliminate mild cases.

5. Oral medicines such as

   Nystatin take longer to kill the thrush in his mouth, but also work

   best if the medicine is applied directly to the yeast by using a

   cotton swab and applying throughout the mouth including the sides

   and inside the lips.

6. Do not give her food or drink for 30

   minutes after using the medicine.

Call Your Doctor If:

1. He has recurrent yeast infections.
2. She has

difficulty eliminating yeast infections.
3. The diaper rash is

spreading outside the diaper area or seems to be quite

tender.

Bacterial Vaginosis | Causes, Symptoms and Treatment

Having a vaginal discharge can be embarrassing. However, it’s a very common symptom, and most of the time it doesn’t mean you have a sexually transmitted infection (STI).

In women who are having periods, bacterial vaginosis (BV) is the most common cause of a vaginal discharge.

What is bacterial vaginosis?

BV is a disturbance in the mix of bacteria in the vagina. Normally there is a healthy mix of millions of ‘friendly’ germs (bacteria) in our bodies, including in the vagina – we rely on them being there and they are a part of what keeps us healthy. In BV, the balance of vaginal bacteria is altered.

The type of bacteria called anaerobic bacteria (bacteria that grow in an environment without air) increase in number, whilst another type, called lactobacilli, dies off. This disturbance in the bacteria makes the inside of the vagina slightly less acidic than usual. This slight reduction in acidity then encourages the growth of more anaerobic bacteria and fewer lactobacilli.

Although the changes of BV don’t usually cause pain or itching, they do tend to cause a discharge which can smell stronger than usual. Sometimes it smells ‘fishy’, particularly after sexual intercourse. It can be watery and greyish in colour. This can be distressing and make women feel unclean. Some women then try to douche or wash themselves with soaps or perfumes – but this will only disturb the vagina more (because soaps are too alkaline for the inside of the vagina) and will make the problem worse.

How common is bacterial vaginosis?

It is not exactly known how common BV is. It is often so mild that women may not go to the doctor. It may be that as many as about 1 in 3 women have BV at some time in their lives.

How do you get bacterial vaginosis?

Bacterial vaginosis is a common condition of the vagina caused by an overgrowth of various germs. It is not one infection, caused by one type of germ.

The vagina normally has a mix of germs (bacteria), including anaerobic bacteria and lactobacilli, but in bacterial vaginosis (BV) the balance changes. As a result, the anaerobic bacteria multiply and thrive much more than usual. In other words, they are bacteria which are normally present, just not in the same balance.

BV is not caused by poor hygiene. In fact, excessive washing of the vagina (particularly if strong soaps or perfumed deodorants are used) may alter the normal balance of bacteria in the vagina even more, which may make BV more likely to develop or worsen.

We don’t really know what triggers the bacterial balance to ‘swing’ away from normal. We know that it’s more likely to happen if something disturbs the acidity of the vagina, (acidity which is CAUSED by the normal bacteria), which then allows the anaerobic bacteria to overgrow.

What is normal vaginal acidity?

Acidity is measured on the pH scale in which lower numbers are more acidic and higher numbers are more alkaline. The normal pH of the vagina is 3.8-4.5.

As soon as the pH increases above 4.5, anaerobic bacteria start to overgrow and lactobacilli (which maintain the acidity) start to die off.

What can cause bacterial vaginosis?

You are more likely to get BV:

• If you are sexually active. (Women who have never had sex can get BV too. However, it is more common in women who are having sex. You can have BV whether you have sex with women or with men.)
• If you have recently changed your sexual partner. Frequent changes of sexual partner, or having more than one regular partner, increase the likelihood of BV further.
• If you have a past history of sexually transmitted infections (STIs).
• If you smoke.
• If you have a copper coil for contraception – an intrauterine contraceptive device (IUCD).
• If your family has Afro-Caribbean origins.
• If you use bubble bath.
• If you have prolonged or heavy periods.
• Following hormonal changes. In some women BV seems to be triggered by the hormonal changes of puberty, pregnancy or the menopause. These are all conditions of changing vaginal acidity.
• Following courses of antibiotics. Courses of antibiotics tend to kill off all our good bacteria (although thrush, also called candida, is a more common complication after courses of antibiotic).

Other conditions which can upset vaginal pH or lactobacillus health, and which might be expected to increase the risk of BV include:

• Use of sex toys.
• Too much washing around the vagina – once a day is enough.
• Use of perfumed lubricants during intercourse.
• Wearing thongs or nylon tights for long periods.
• Prolonged or heavy periods.

You are less likely to get BV if:

Is bacterial vaginosis sexually transmitted?

No – BV can affect any woman, including those who do not have (or who have never had) sex. However, BV is more common amongst sexually active women than amongst non-sexually active women.

A woman can’t ‘catch’ BV from intercourse with a man, but BV is more likely to develop after a change in sexual partner, as – for reasons we don’t really understand – this can affect the balance of normal germs (bacteria) in the vagina.

Women who have sex with other women can pass each other the condition. This is probably because the anaerobic bacteria on the body of the woman with BV have become particularly good at overwhelming the lactobacilli, and are able to take the opportunity to spread further..

What is bacterial vaginosis like?

The main symptom of BV is a vaginal discharge. BV is the most common cause of vaginal discharge in women of childbearing age. Often, BV causes no symptoms. This is true in about half of the women who have the condition. This may be because the bacterial disturbance is only mild.

When BV causes symptoms, this is usually a change in vaginal discharge. Some women will also notice the characteristic smell.

• The discharge is often white-grey in colour and often has a fishy smell.
• The smell may be more noticeable during sex.
• The discharge tends to be heaviest just after a period, or after sex.
• The discharge does not usually cause itch or soreness around the vagina and vulva.

Note: BV is not the only cause of a vaginal discharge. Various conditions can cause discharge, such as thrush (infection by overgrowth of a yeast called candida, which normally lives in the bowel) and STIs.

Can bacterial vaginosis cause vaginal bleeding?

BV should not cause vaginal bleeding, although it is often more noticeable at the time of a period.

If you have unusual bleeding between periods or after intercourse, BV will not be the reason and you should consult your doctor to look for another cause.

Can bacterial vaginosis cause pain?

BV can sometimes cause pain – usually on intercourse. Some women also describe dull pains low down in their tummy. These are more suggestive of conditions affecting the womb (uterus)

itself, such as pelvic inflammatory disease or endometriosis.

What are the risks of bacterial vaginosis?

BV and surgery

If you have untreated BV, the chance of developing an infection of the womb is slightly higher following certain operations (such as termination of pregnancy or a vaginal hysterectomy). You will normally be offered treatment for the BV in these cases.

BV and other infections

Untreated BV may slightly increase the risk of you acquiring HIV infection if you have sex with someone who is infected with HIV. This is probably because the normal acidity of the vagina helps protect against STIs.

If you have HIV and BV together then you are slightly more likely to pass on the HIV.

Women with untreated BV may be at a slightly increased risk of developing pelvic inflammatory disease. See the separate leaflets called HIV and AIDS and Pelvic Pain in Women for more details.

Pregnancy

BV can affect pregnancy. If you have untreated BV during pregnancy, you have a slightly increased risk of developing some complications, including:

• Early labour.
• Miscarriage.
• Having your baby early (preterm birth).
• Having a low-birth-weight baby.
• Developing an infection of the womb after childbirth (a condition known as postpartum endometritis).

For this reason, if you develop BV in pregnancy you will usually be offered treatment. This also means that if you develop an unusual or offensive discharge in pregnancy, you should seek medical advice early.

Subfertility

BV is more common in women who are having problems getting pregnant. In women with BV who are undergoing IVF treatment, the presence of BV lowers the success rates. The studies which found these effects focused on women who were already known to have fertility problems, to see if they were more likely than other women to have BV.

This doesn’t mean that if you have BV, you will have fertility problems: BV is extremely common (possibly a third of all women of menstrual age) and fertility problems which result in a need for in vitro fertilisation (IVF) are not common. This suggests that the chances that BV will affect your fertility are very low. Even so, if you are planning to conceive in the future and you think you may have BV, you should see your doctor and discuss the best options for treatment.

Is there a test for bacterial vaginosis?

If you are in a stable, long-term relationship, your doctor or nurse may be happy to diagnose BV just by its typical symptoms.

The typical discharge and its characteristic fishy smell make BV likely. When your doctor examines you they may be able to identify BV from the appearance of the discharge.

There are some tests that can help to confirm the diagnosis. Also, if you are pregnant, it is important to make an accurate diagnosis of any unusual vaginal discharge so that any infection can be treated effectively. The tests include:

Testing the acid level of your vagina

The discharge of BV has a typical pH level (acidity level) which is higher than normal vaginal pH.

pH is measured on a scale from 0 (extreme acidity) to 14 (extremely alkaline). Pure water, which is neutral (neither acid nor alkaline) has a pH of 7.

• The normal pH of the vagina is 3.8-4.5.
• As soon as the pH increases above 4.5, anaerobic bacteria start to overgrow and lactobacilli (which maintain the acidity) start to die off.

Your doctor or nurse may suggest that they take a sample of your discharge and test it with some pH paper. You can buy a kit from a pharmacy to do this test yourself at home.

Taking a sample

To confirm the diagnosis of BV, your doctor or nurse may suggest that a sample (a swab) of your discharge be taken from your vagina and sent to the laboratory for examination and testing. The various types of germs (bacteria) that overgrow in BV are easily seen under the microscope. Your doctor or nurse may suggest that they take more than one swab from your vagina to rule out other causes of vaginal discharge.

What treatments are there for bacterial vaginosis?

There are various different treatments for BV. There are also some things which you should avoid doing, which may help the problem to resolve itself.

These include avoiding the use of douches, vaginal deodorants, bath additives and harsh soaps. Refraining from intercourse for a couple of weeks, or using a condom and a water-based lubricant, can be helpful.

Antibiotics for bacterial vaginosis

Oral antibiotics are the first-choice treatment in pregnant women with BV.

Metronidazole tablets
A full course of metronidazole tablets is the common treatment. Metronidazole is an antibiotic. This clears BV in most cases. It is important to read the leaflet that comes with these tablets for the full list of possible side-effects and cautions. The main points to note about metronidazole include:

• The usual dose is 400-500 mg twice a day for 5-7 days. A single dose of 2 grams of metronidazole is an alternative, although this may be less effective and may cause more side-effects. (Note: this single dose is not recommended if you are pregnant.) It is important to finish the course you have been prescribed, and not to miss any tablets.
• Some people feel sick or may be sick (vomit) when they take metronidazole. This is less likely to occur if you take the tablets straight after food. A metallic taste is also a common side-effect.
• Do not drink any alcohol while taking metronidazole, nor for 48 hours after stopping treatment. The interaction of metronidazole with alcohol can cause severe sickness and vomiting, and may also cause flushing and an increased pulse rate.
• Metronidazole can get into breast milk in small amounts but will not harm your baby, although it may make the milk taste different. The manufacturer recommends that if you are breastfeeding you should take the 5- to 7-day lower dose course of metronidazole rather than the single large dose.

Other possible antibiotic treatments
Tinidazole tablets may be offered if you know you are intolerant of metronidazole. Tinidazole is a similar antibiotic and you need to take 2 g once a day for two days, or 1 g once a day for five days. It has the same interaction with alcohol that is seen with metronidazole, meaning that alcohol should not be consumed whilst you are taking it, nor for 48 hours afterwards. Tinidazole is not recommended in pregnancy.

Metronidazole vaginal gel or clindamycin vaginal cream placed inside the vagina can be used if you prefer this type of treatment, or if you experience unpleasant side-effects with metronidazole tablets. These treatments are believed to be almost as effective as antibiotics by mouth.

Note: as with metronidazole tablets, you should avoid alcohol while using metronidazole gel and for at least 48 hours after stopping treatment, although the tendency of the gels to make you feel sick is not as noticeable as for the tablets.

Vaginal creams and gels can weaken latex condoms and diaphragms. Therefore, during treatment and for five days after treatment with clindamycin vaginal cream, do not rely on condoms or diaphragms to protect against pregnancy and STIs.

Other antibiotic tablets taken by mouth are also sometimes used to treat BV. These are clindamycin tablets or tinidazole tablets.

Alternatives to antibiotics for bacterial vaginosis

Yoghurt

Some women with BV say that things settle more quickly and symptoms are eased by applying a thin coat of plain, live yoghurt to the outside of the vagina daily, and by applying a small amount of plain live yoghurt on a tampon for internal use before bed.

The evidence that live yoghurt is helpful in treating or preventing BV is mixed, with some trials saying that it is helpful and some saying that it is not helpful. Overall specialists feel that there is not enough evidence in its favour to suggest it over other treatments.

Astodrimer sodium gel

Astodrimer sodium gel is a new kind of treatment for BV. It can be bought without a prescription online as Betafem® BV gel. It treats BV by creating a physical barrier that repels bacteria from coming close to and sticking to the vaginal wall. A 2019 trial showed that astodrimer gel once daily for seven days was well tolerated by women and provided rapid improvement in BV symptoms. Patients improved, or were cured at the same rate as with conventional antibiotics.

Vaginal acetic and lactic acid

Treatment with acetic and lactic acid gels aims to keep the vaginal pH at less than 4.5, to encourage lactobacilli to grow, and to discourage anaerobic bacteria from growing. Some studies have suggested that long-term use of vaginal acidifiers of this type reduces recurrences of BV. However, other studies suggest that this treatment, whilst harmless, is not effective. 

Lactobacillus tablets

Lactobacillus suppositories and oral tablets are sold in some health food shops, for use in BV.

Orally consumed probiotics are believed to reach the vagina via the bowel. There is some evidence that this can be helpful in treatment and in prevention of BV. These studies suggest treatment needs to continue for at least two months. Other studies don’t show a clear benefit. Overall, specialists feel that there is not enough evidence in its favour to suggest it over other treatments.

Intravaginal lactobacillus treatment seems as though it ought to be an obvious solution – why not put the right bacteria where they are meant to go? However, results of studies on vaginal treatments with lactobacilli are also mixed, with some studies suggesting this treatment is effective and others not.

When should I have treatment for bacterial vaginosis?

The body is often very good at getting back its own balance. The disruption in the balance of vaginal germs (bacteria) that causes BV may correct naturally, with time. So, if you have no symptoms or only mild symptoms, you may not need any treatment, particularly if you take some of the general healthy steps above.

You normally need treatment for BV if it is causing symptoms, or if the characteristic smell is noticeable to you. If you are pregnant, trying to become pregnant, or about to have a gynaecological procedure then you may be advised to get treatment for BV.

Pregnancy
If you are pregnant and you are found to have BV then you will usually be offered antibiotic treatment with oral metronidazole (see below).

If you are trying to conceive and you think you may have BV, it is a good idea to try to eradicate the BV through natural methods or treatment prior to conceiving. If you have symptoms then you should discuss having antibiotic treatment with your doctor.

Termination of pregnancy
If you are found to have BV and are undergoing a termination of pregnancy, treatment with antibiotics may be advised even if you do not have any symptoms. This is because there is otherwise a risk of BV causing infection of the womb (uterus) or pelvis after the procedure. This could lead to later fertility problems.

Gynaecological procedures
Antibiotics are not usually recommended for women with BV (and no symptoms) who are about to undergo ‘minor’ gynaecological procedures such as an endometrial biopsy – a biopsy of the lining of the womb. In fact women having these procedures are in any case not usually tested for BV, so they would not know they had it.

Women having vaginal hysterectomy are given antibiotics prior to the procedure, even if they don’t have BV, in order to lower the risk of postoperative infection. These antibiotics will also wipe out any BV-causing bacteria.

Should my partner be treated for bacterial vaginosis?

There is no evidence that treating a male sexual partner prevents his female sexual partner from developing BV. One small trial looked at whether using a sterilising alcohol gel on the penis protected their partners against BV – but the gel appeared to make BV more, rather than less, common in the women.

If you have a female partner then it does appear that treating her for BV at the same time as you – even if she doesn’t have symptoms – will prevent recurrence (in either of you).

Do I need a test to find out if my bacterial vaginosis is cured?

Women who are not pregnant

After treatment, you do not need any further tests to ensure that BV has cleared (a test of cure) provided that your symptoms have gone.

Women who are pregnant

If you are pregnant, it is suggested that you do have a test one month after treatment to ensure that BV is no longer present. A sample (a swab) of the discharge in your vagina is taken. This is tested to check you no longer have BV.

What is the treatment for persistent bacterial vaginosis?

If you have persistent BV (ie it does not settle down with the first treatment you try) then your doctor may want to take further vaginal swabs to check whether there is another cause for the discharge. They will usually suggest that you use the seven-day course of metronidazole if you have not had this before.

Another treatment which may be tried is using metronidazole gel twice a week for up to six months.

If you have a persistent BV infection which does not respond to treatment, and you have an intrauterine contraceptive device (IUCD) then your doctor may advise removing the device until things settle down, as there is some evidence that IUCDs can contribute to persistent BV.

If you have persistent BV and a same-sex partner then treating both of you at the same time is likely to be helpful in preventing persistence and recurrence – even if your partner does not have symptoms.

Can bacterial vaginosis be prevented?

The following are thought to help prevent some episodes of BV. The logic behind these tips is to try not to upset the normal balance of germs (bacteria) in the vagina:

• Do not push water into your vagina to clean it (douching). The vagina needs no specific cleaning.
• Do not add bath oils, antiseptics, scented soaps, perfumed bubble bath, shampoos, etc, to bath water.
• Do not use strong detergents to wash your underwear.
• Do not wash around your vagina and vulva too often. Once a day is usually enough, using gentle soaps and water.
• Don’t use perfumed ‘intimate hygiene’ products.
• Using a condom and/or a water-based lubricant during intercourse may help protect you.
• Avoid using sex toys inside the vagina.
• Avoid thongs and tight nylon tights.
• Have showers rather than baths.
• Lighter periods seem to make BV less likely to return, so if you have heavy periods and were considering seeking treatment, this might be another reason to do so.

Will I get bacterial vaginosis again?

BV often recurs, usually within a few months of treatment – although if any of the behaviours which can trigger it (such as using douches) apply to you then it may be less likely to recur if you avoid these things.

BV often returns after it has been treated. No good way has been found yet of preventing this from happening.

If you keep getting BV symptoms, your doctor will do some tests to be absolutely sure you have got BV and not any other infection. If it turns out to be definitely BV, a different antibiotic to the one you have taken previously may be tried. Occasionally regular preventative use of an antibiotic vaginal gel may be advised.

If you are using an IUCD for contraception, it may be advised that you consider having this removed.

Can I prevent recurrent bacterial vaginosis?

If your symptoms come back and you did not have a test using a sample (a swab) of your vaginal discharge taken initially, your doctor or nurse may suggest that they take swab tests now. This is to confirm that it is BV causing your symptoms.

BV may return if you did not complete your course of antibiotics. However, even if you have completed a full course of antibiotics, BV returns within three months in many women. If it does come back, a repeat course of antibiotics will usually be successful. A small number of women have repeated episodes of BV and need repeated courses of antibiotics.

Astodrimer sodium gel also prevents recurrent BV and associated symptoms. In a 2019 study astodrimer sodium significantly reduced BV recurrence rates. You can buy astodrimer sodium gel (brand name Betafem® BV gel) online and do not need a prescription.

If you have a copper coil for contraception – an IUCD – and have recurrent BV, your doctor or nurse may suggest that they remove your IUCD to see if this helps to improve your symptoms. You will need to consider alternative contraception measures.

If you have a same-sex partner then, even if they have no symptoms, treating both of you at the same time may reduce recurrence.

You should also take particular notice of the advice not to use douches, bath additives and vaginal deodorants. Long-term use of metronidazole gel is sometimes advised. Specialist guidelines in the USA recommend using twice-weekly for up to six months. UK specialist guidelines are less certain on the frequency and duration of preventative treatment, and your doctor may want to talk with a specialist for advice on this.

Plugged Ducts, Mastitis, and Thrush

Plugged Milk Ducts

Plugged ducts are a common concern in breastfeeding moms. A plugged milk duct feels like a tender, sore lump or knot in the breast. It happens when a milk duct does not drain properly. Pressure builds up behind the plugged duct, and the tissue around it gets irritated. This usually happens in one breast at a time.

Several things can cause plugged ducts:

• Severe engorgement,
• Regularly breastfeeding on only one breast,
• Skipping feedings or not feeding as often as usual, or
• Pressure against the milk ducts. A diaper bag strap or car seat belt pressing across your chest can cause it. So can wearing a bra that is too tight.

Here are a few tips to help you get relief:

• Take a hot shower or apply warm, moist cloths over the plugged duct and the rest of your breast.
• Massage your breast from the plugged duct down to the nipple before and during breastfeeding.
• Breastfeed frequently and use different positions.
• Empty the affected breast first.
• Wear a well-fitting, supportive bra that is not too tight. Consider trying a bra without an underwire.
• Rely on others to help you get extra sleep or relax. This will speed healing. Sometimes a plugged duct is a sign that you are doing too much.

If you have plugged ducts that keep coming back, get help from a WIC breastfeeding expert or a lactation consultant.

Breast Infection, or Mastitis

Mastitis is a breast infection. It may feel sore like a plugged duct. It may happen when you’re stressed or have changes in your usual routine. This may be when guests are visiting, during the holidays, or when you’re returning to work. It is not always easy to tell the difference between a breast infection and a plugged duct. They have similar symptoms, and both can get better within a day or two.

But the mastitis may also include other signs, like these: 

• Flu-like symptoms like fever, chills, body aches, nausea, vomiting, or fatigue.
• Yellowish discharge from the nipple that looks like colostrum.
• Breasts that feel tender, warm, or hot to the touch and appear pink or red.

If you have any signs of mastitis, or if you do not feel better within 24 hours of trying the tips for relief, contact your doctor.

The same tips for plugged ducts may help with mastitis. Apply heat, get plenty of rest, drink lots of fluids, and breastfeed often. In addition, your doctor may prescribe antibiotics.

Thrush

Thrush is a fungal infection that forms on the nipples or in the breast. This infection is also sometimes called a yeast infection. Thrush may have these signs:

• Sore nipples that last more than a few days, even after your baby has a good latch.
• Sore nipples after several weeks of pain-free breastfeeding.
• Pink, flaky, shiny, itchy, cracked, or blistered nipples.
• Achy breasts or shooting pains deep in the breast during or after feedings.
• White spots on inside of baby’s cheeks, tongue, or gums.

If you have concerns of a fungal infection, call both your doctor and your baby’s doctor. That way, you both can be correctly diagnosed and treated at the same time. This will help keep you from passing the infection back and forth.

90,000 Treatment of rotavirus in children in Krasnoyarsk. IPM Clinic for Children

02/21/2017

Rotavirus infection (“intestinal flu”) is a highly contagious disease caused by rotavirus (lat. Rotavirus), manifested by inflammation of the upper respiratory tract, stomach and intestines. Mostly children from six months to 5 years old are ill; outbreaks of this intestinal infection are often recorded in children’s collectives and in families. The disease is highly seasonal in nature, rising sharply during the winter months.In our country, the incidence occurs during the cold period (from November to April).

The main route of transmission is fecal-oral: through contaminated hands, door handles, things, toys, unwashed food. But it is also possible to get infected by airborne droplets (when coughing, talking, sneezing and kissing) through close contact with a sick person. You can easily get infected through food in the preparation of which a sick person or a virus carrier participated. Drinking unboiled water, if rotavirus has penetrated it, can provoke the development of the disease: chlorine does not affect the virus.This infection can be referred to as “dirty hands disease”.

The disease is cyclical. The incubation period (1-5 days), the acute period (3-7 days, with a severe course of the disease – more than 7 days) and the recovery period (4-5 days).

Rotavirus infection is characterized by an acute onset – vomiting, a sharp rise in temperature, diarrhea, often very characteristic stools – on the second, third day, gray-yellow and clay-like. Most patients develop a runny nose, redness in the throat, pain when swallowing…. On days 4-7, complete recovery of the child is usually observed, but there is a likelihood of a “second wave” of infection, when the main symptoms – fever, vomiting, diarrhea and acetonuria – return. Children, especially infants, can become dehydrated very quickly.

No specific treatment for rotavirus infection has been developed. Prescribe medicines and measures that treat and help recover from poisoning, sore throat and fever.

Several groups of drugs are used:

• rehydrators;
• adsorbents; 90 020 90 019 probiotics;
• enzymes

Food must be dietary.

It is forbidden to eat:

• milk cereals and whole milk
• rich broths and soups
• animal proteins with high fat content (pork, beef)
• sour berries
• fruits
• yeast bread, pastries, pastries , confectionery.

Allowed: porridge on the water, vegetable puree, yeast-free bread or crackers, baked vegetables

Prevention of infection with rotavirus infection consists in observing hygiene measures .Currently, vaccinations against rotavirus infection with the Rotatek vaccine are being carried out in our city .

When to vaccinate with Rotatek:

1. The first dose of vaccine is given to children aged 6 to 12 weeks.

2. Up to 8 months of age, the full course of these vaccinations must be completed.

3. The vaccine is given three times with an interval between vaccinations of 4-10 weeks.

Immunity is developed after three injections of the Rotatek vaccine and s protects the child throughout the critical period – up to five years . The child’s reaction to Rotatek is usually absent. The vaccine is easily tolerated by the child’s body without causing any troubles.

What are the associated digestive disorders: intoxication, allergies, bacterial and viral infections

Chef of Delicatessen and Yunost restaurants Ivan Shishkin possesses encyclopedic knowledge of the world of food, loves to talk about it and knows how to fall in love with it. Billboard Daily presents a synopsis of his detailed account of the types of digestive disorders, their differences and basic safety precautions.

Everyone knows that before boiling beans, they are supposed to be soaked. And why? You will laugh, but even beans have poison. Kidney beans contain a blood poison, a complex protein of the lactin family phytohemagglutinin, which glues blood cells together. This is expressed in a combination of unpleasant symptoms. Some raw legumes contain cyanide derivatives that are also toxic to humans.And soaking leads to the fact that all these substances are washed out or hydrolyzed, the beans become harmless, and you can try to eat them even raw.

But raw dry beans, I would still not recommend eating: it can lead to disease. For example, I read an amazing text on a raw food forum: “At one time I ate a black-eyed (this is such a bean). She went fine, no vomiting, no diarrhea, no seething in my stomach. Only takes a very long time to digest. At the exit there is a terrible chemical smell.I also tend to believe that raw beans are inedible. ” So raw beans are inedible, don’t eat them.

What is food poisoning really?

In Russian, food poisoning means all diseases associated with food. In fact, the term “poisoning” is not used quite correctly. By poisoning, we mean a disease associated with the introduction into our body of toxins, poisonous substances. While the current term “food poisoning” in the official nomenclature and medicine as a whole mixes everything into one heap: intoxication, allergies, bacterial infections, viral infections, and so on.All together for some reason this is called food poisoning, which I personally cannot accept. For me, poisoning is a consequence of taking a toxin.

What do you think is the share of poisoning in the real picture of food-related diseases? How many people exactly get poisoned when they feel bad leaving a catering establishment? The man fell ill and said: “I was poisoned yesterday in a cafe.” Remember, there was such news – about the cafe on the Patriarch’s Ponds Scramble, when thirty people were admitted to the hospital? There was salmonella, which is the number one foodborne infection in Russia.

Real poisonings are scanty. Nowadays, getting to food that contains enough toxins for poisoning is quite difficult. Firstly, modern agriculture practically does not use pesticides that are deadly for warm-blooded animals, products are not etched with mineral poisons, and nerve agents are not used. There is a system of rules that controls grain when it enters the market. Therefore, the picture with toxins is more or less favorable.At the same time, intoxication is the most difficult and unpleasant thing that can comprehend us.

The Big Three Causes of Poisoning

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Methyl alcohol

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Clostridium botulinum bacteria / Botulinum toxin

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Botulinum toxin is one of the most powerful organic poisons. Botulism is now the least common because it is associated with the action of a certain bacterium, one of the clostridia, that develops in canned foods. Modern industrial canned food is processed in such a way that there is no way for anything living to survive. In homemade canned food, it can be present, for example, in homemade herring and stew.But in our time, few people make homemade canned food. Plus, the technique of using pressure cookers and autoclaves more or less ensures that we don’t get poisoned. The last notable outbreak happened in 1986 in the Soviet Union, in Murmansk, when someone made homemade canned food, brought to the market and killed about 40 people. Since then, there have been no reported cases of massive deaths from botulism.

The number one food poisoning problem today is methyl alcohol. Recently in Irkutsk 75 people drank Hawthorn.It is clear that this is a surrogate, not quite a food product, but nevertheless people died, completely unaware of what was happening to them. They did nothing to harm themselves: they just bought something, drank and died.

More – toxins that accumulate as a result of the action of microscopic fungi. Microscopic fungi are everywhere: yeast for example. The famous penicillin is produced by the penicillum fungi. This same mold produces, along with penicillin, toxic substances, such as patulin, microtoxin.When you see blue-green blackish mold on a product, it means that you will eat an antibiotic that can kill not only bacteria, but also humans. Unpleasant liver poison, which in a certain concentration can cause serious pathology. Microscopic fungi are very common. We use one every day. Soy sauce, sake, miso are made with micro mushrooms. Others are working against us. You can get poisoned without even noticing it. It is enough to violate the rules for the safe storage of cereals, to exceed the humidity of the room and to allow the development of mold.Subsequent drying will no longer help, because some toxins do not decompose even when boiled. By the way, tea stored in damp cellars can also be a substrate for such a sad contamination.

In general, in civilized countries, the fight against microfungi, in particular against aspergillus and other microorganisms, is carried out using the HACCP system – a detailed control of critical points at each stage of product production. Nevertheless, diseases still occur, and the farther from civilization, the more often.In Southeast Asia, this is a fairly common occurrence. In Africa, the death rate from liver cancer is 50 times higher than the death rate in our country. When traveling, keep in mind that food quality control is far from being the same everywhere as in civilized countries.

What foods can be harmful?

For example, nightshade. Plants of tomatoes, eggplants, potatoes, nightshade, tobacco, belladonna, goji, one way or another, can be poisonous. It all depends on what part of the plant and how much you use.Tobacco and belladonna are toxic in their entirety. Tomato – in the form of greenery and very unripe berries. Potatoes – in the form of herbs and fruits. Eggplant and pepper greens are also very toxic. They are poisonous due to the set of alkaloids. If we talk about food poisoning, then we must mention solanine – an alkaloid that accumulates in the skin of green potatoes. That is, potatoes in which the active stage of germination has begun should not be used for food. Symptoms of solanine poisoning are fever, weakness, diarrhea, headache, disorientation, further dehydration, and death.Deaths from potatoes have not been recorded for a long time, but you can feel bad. By boiling a large vat of overripe potatoes, you can get a pronounced clinical picture. This happens more often than we might think, because a significant number of poisoning, I mean intoxication, doctors do not bother to record. Because if the poison is received in a small dose, it is excreted from the body, the symptoms subside and everything goes away. In the end, it is simply called indigestion.

Bitter almonds, apricots, cherries – all drupes contain cyanogenic glycosides.During their hydrolysis, hydrocyanic acid is released, benzaldehyde is obtained, which smells brightly of almonds, therefore, by the intensity of the smell, one can indirectly judge the toxicity of certain grains.

The most unexpected of these toxic fruits are apples. Apple seeds contain significant amounts of a cyanogenic glycoside. There will be nothing from one stub, but from a handful of seeds you can feel the symptoms of poisoning. Try to chew an apple blossom – and you will feel serious bitterness and a bright bluish aftertaste.The lethal dose of hydrocyanic acid that you can get by eating apple seeds is huge, it is very difficult to eat so much, but it is quite possible to get symptoms. Eight grains of bitter almonds give a pronounced clinical picture: difficulty breathing, weakness, and so on. You have to be careful: if you feel bitterness, spit it out.

Dangerous mushrooms

Another reliable way to get poisoned is mushrooms.One of the most ridiculous ways to kill yourself is to go to the forest, pick an unfamiliar mushroom and eat it. There are people who experiment with their health, try different mushrooms. For example, they pick fly agarics to get psychedelic effects. They receive it and finish it in the hospital, because in addition to psychotropic substances, the fly agaric contains toxic substances that block breathing, cause depression of higher nervous activity and other sad phenomena.

Mushrooms are hallucinogenic, others can poison with alkaloids, some contain hemolytics – products that destroy blood cells, such as unwashed, uncooked stitches.The dung beetle mushroom contains a substance that inhibits the secretion of the enzyme acetaldehyde dehydrogenase, which is responsible for one of the stages of alcohol metabolism. Leads to a significant exacerbation of alcohol poisoning. While not poisonous, these dung beetles are incompatible with alcohol.

Porcini mushrooms, champignons, oyster mushrooms, chanterelles are used in public catering. They are produced industrially, grown under controlled conditions, and there is no need to worry that some fungus has accumulated toxins in itself.

Unsafe Shellfish and Fish

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Molluscs are a product that, no matter how consciously we grow it, grows in the wild, and we can only control its quality indirectly.For example, mussels. All the bivalve molluscs that we eat are natural filters that pass a significant amount of water through themselves, in which microscopic organisms are present: algae, crustaceans, unicellular protozoa, some of which are poisonous. If concentrated, they can cause quite serious harm to a person. The mechanism of their accumulation in the body of the mollusk has not been fully understood. It is clear that there are microalgae, it is roughly clear what kind of algae it is, it is not very clear what initial toxin enters the mussel, whether it is digested there or simply stored, the doses are not very clear.The experiment is difficult, but we know that bivalve molluscs are a risk.

The same goes for fish. People say: I don’t eat fish, I’m allergic to it. Once I ate – then I was ill for a month. This is indeed the case. But the first poisoning arose from the fact that the fish was stale. The cause may be histamine, a substance that is produced in our body as a companion to the immune response. It is formed in spoiled fish, and we can eat a noticeable amount and cause a hypertrophied reaction, induce it from the outside.After that, our immune system remembers this case, and the subsequent introduction of fish proteins reverberates to us in the form of a powerful reaction.

Even common fish can be harmful to humans – for example, when preparing for spawning. This is a natural defense mechanism. As a result, the insides of fish and caviar, such as burbot, become toxic. Another example: in the south of Russia, Ukraine, Kazakhstan, the object of semi-commercial and amateur fishing hobby is the marinka fish from the carp family.This fish is always toxic – guts, gills, caviar. However, if you scrub them and rinse them with salt water, the marinka can be eaten. Three fish from the southern regions – marinka, barbel and osman – are poisonous.

Why do we need to know about intoxications and poisons? If I work in a restaurant and am responsible for the people who come to eat my food, I need to know where my risk field is. In the case of toxins, you need to understand how a particular problem can be systematically avoided: which products can be excluded altogether, and which products can be taken from predictable sources – without toxins.

Underdiagnosis of virus infections

There are a lot of diseases that can be obtained while eating. That is, not only through the food itself, but also by airborne droplets or by contact. These include the virus norovirus, rotavirus, enteroviruses. At the same time, the epidemiology differs from country to country: emphasis is placed on different disinfecting and preventive measures. In the United States, viruses are the dominant cause of food-borne illness. Norovirus is similar in symptoms to salmonella, but goes away on its own after two to three days.A person writes a review for the restaurant: “I got poisoned there.” But in fact, he did not poison himself, but contracted the virus. And it is not at all a fact that it is there. The virus is more difficult to recognize.

In cases of viral infections that people get in public places, including in a restaurant, there is a serious element of underdiagnosis. In Moscow, this happens quite rarely, in the provinces it is a common thing, even criminal cases are not opened. SES came, closed for three days, disinfected, imposed an administrative fine, and the work continued.Otherwise, all catering establishments would have to be closed, because the level of diagnostics and industrial culture is generally low.

Despite all the measures taken, in the entire civilized world – America, Western Europe and Russia that joined them – the incidence of food-related diseases has doubled compared to 2008. More restaurants, more people, overcrowding of animals in industrial housing. Low-temperature technology is involved, which does not always provide sterilization.Vacuum cooking technology is popular nowadays: it cooks chicken at a temperature of 64ºC, while, according to old-fashioned sanitary rules, it must be cooked until it reaches a temperature of 90ºC.

In this situation, the only barrier is our personal hygiene, industrial hygiene, common sense and basic knowledge of how microorganisms function, how they can multiply, what they are in general and in what products they can be found, how to deal with them.

Bacteria and how to prevent them from developing

Salmonella, Clostridia perfringens, Escherichia coli, Cereus bacillus, Listeria, Shigella, Yersinia are the seven monsters that we most often encounter in the kitchen.These are all diseases of dirty hands. In order to avoid carrying them over, it is sufficient to mechanically wash your hands with traditional soap. Most bacteria are quite sensitive and can be killed by simply sprinkling with lemon or heating to 60ºC. Salmonella is killed in 90 minutes at 55ºC, in 12 minutes at 60ºC and almost instantly at 75ºC. It is enough to hold the meat in boiling water and cook on the outside. In a poached egg, it will only live if you used an unwashed egg with cracks in its shell.
Salmonella lives in the gastrointestinal tract of many people without causing any pathology. At the same time, the total majority of them die from acid in the stomach, only a small proportion of the survivors begin to multiply actively. Such a person can safely bring in a small colony of bacteria simply through dirty hands. A common occurrence is when a chef takes some perishable sauce, pours it into a bottle, holds it on the table, and then pours the next portion of sauce there – and so on. Thus, feeding after feeding is carried out, and the bacterial colony blooms in lush color.A bottle of homemade mayonnaise is a classic example of a kitchen bacteriological weapon.

We want to avoid salmonella contamination – we pasteurize the eggs and store everything in the refrigerator. We want to use raw yolk – keep it at 57ºC for two hours.

It must be understood that some categories of food are often contaminated, for example, all poultry. Duck chickens are walking carriers of diseases. Therefore, they cannot be washed in shared sinks or even rooms. Campylobacter is the second most common causative agent of bacterial infections, the frequency of which is growing rapidly even in the countries of the victorious democracies.This is due to the living conditions of chickens in the poultry farm: they live crowded, the probability of transferring the disease is high. By the way, this is the difficulty in obtaining high-quality poultry meat using an organic protocol. It’s hard without drugs, the birds get sick. When you wash the chicken under the tap, the spray spreads out one and a half to two meters. But at 50ºC, Campylobacter dies almost immediately.

If I want to avoid the development of bacteria, I must keep the product out of a temperature window favorable for their growth: about 20 to 40ºC.For this, there is a rapid cooling system. The product needs to go through the temperature range as quickly as possible without giving the bacteria an opportunity. It happens that there are spores, for example, clostridium, which survive even when boiled, but they will not harm the body if they enter the body.

Thus, even if there is no way to completely avoid the presence of bacteria in food, but we do not create conditions for their reproduction, then with a high probability we will be healthy.

E. coli, yersinia, clostridia perfringens, shigella and listeria

Bacillus Cereus

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E. coli

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Clostridium perfringens

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Clostridia perfringens is present absolutely everywhere in nature (in soil, on trees).It should not be present in food, but if the product fell, lay on a dirty floor or was dug out of the ground, wait. Almost always, it can be found in products that have undergone deterioration and decay. These foods can be toxic. They must be destroyed and never, as they say in bad restaurants, not allowed to pass. There is a rule of three thumbs: the appearance, taste and smell of the product should not differ from what they should be. If the product differs in at least one of the characteristics, it must be discarded.Nevertheless, unscrupulous business owners bully chefs for writing off spoiled products, and they, fearing punishment, let them into food, thereby provoking mass diseases of people. It is not for nothing that in the West, Clostridia perfringens is called cafeteria germ – “infection from a cafe.” Getting rid of it is a matter of common sense, caution and hygiene.

E. coli is an extremely widespread and active agent that lives in the body for a long time and in large quantities, being part of the normal flora.But in comfortable circumstances, it can begin to multiply sharply. Allowing the presence of Escherichia coli, especially its pathogenic strains, in products is absolutely unacceptable in any concentration. Even the smallest amount is a sign of total pollution. The kitchen, in which Escherichia coli was found, must be closed, all routes of food movement and the state of health of the people who work there must be checked. Perhaps this kitchen contains systemic violations.

An extremely dangerous thing is the listeria bacteria, which cause acute and very difficult to cure diseases.Listeria surpasses salmonella in its activity and danger. Lives and actively reproduces in soil, centers of fermentation and processing, for example, in silos. Listeria is rarely found on food in a restaurant. The most common places are tools, knives, cutting boards and everything related to cleaning floors. This is the danger of Listeria, because everyone gets used to treating products with reverence and tries to process them, and such a simple tool as a knife, which is used every minute and with different products, sometimes is not washed at all, which creates fertile soil for the development of Listeria.So beware.

Amazing microorganism – Yersinia. Their trouble is that they feel good and even reproduce at temperatures from 1 to 4ºC, that is, in the refrigerator. This bacterium can cause trouble when we store under-processed or washed vegetables in the refrigerator. They can carry infection despite being stored in a refrigerated environment. The factor of disinfection by heat treatment remains a means of destroying them, but it is necessary to protect against their ingress by regular and thorough washing of products.

The last of our main enemies is the Shigella family. There are quite a few of them, and different ones. They cause serious illnesses such as dysentery. It is a highly active agent. Sometimes it is enough for a person to enter ten bacteria to cause a serious illness.

Dyspepsia not associated with poisons, toxins and infections

Discomfort and diarrhea can be caused not only by poisons, toxins or infections. Symptoms of dyspepsia (which was previously called indigestion) are conditions associated with poisoning, infections and the phenomena described above, but caused by other pathologies: stress, trauma, infections that did not come through food or dirty hands, a violation of the diet, including overeating , the use of foods that do not correspond to the diet for certain chronic diseases (for example, gout).In such situations, we are talking about organic or functional dyspepsia, which can be mistaken for poisoning without special examination.

The problem of diagnostics is acute, and a person who knows about such problems should be careful, because the first symptoms are too general. An interesting polyetiological condition is travelers’ diarrhea. People come somewhere and say: “I react to the water at the tap.” This is actually the case. Mineral composition of water, bacterial or viral composition of the environment, a different amount of fiber in food, fat content of food, new strains of E. coli, to which our body has not developed tolerance, taking preventive drugs can cause the same set of symptoms, and it will not be poisoning, nor a disease.These are rather adaptation problems.

Another important component of discomfort is food intolerances and food allergies. These terms must be clearly distinguished. Lactase deficiency or celiac disease (gluten intolerance) is not an allergy. Allergy is an immune response to the introduction of certain proteins into the body. Milk sugar intolerance cannot be called an allergy in any way. However, milk protein allergies do occur. Allergies to cow and goat milk are in the top five of all food allergies.It also contains soy, eggs, nuts and fish with seafood. Food allergies have very striking symptoms, but no more than two percent of the population suffers from it. And more than eighty percent of food allergy complaints are more likely to be questions of intolerance to certain foods and psychosomatic reactions, when people seriously think they have an allergy.

Tips on sanitary safety of Ivan Shishkin

To wash what needs to be washed: everything that is dirty, everything that could be dirty or touch the ground, lie on the floor or next to products that could be contaminated.Wash tools, dishes and tables.

Do not wash what does not need to be washed. For example, a chicken. No need to wash the meat. If your meat is in such a condition that it needs to be washed, it is better not to use it.

Wash hands after each manipulation, going to the bathroom, shaking hands. It should become a habit.

Do not roll on the floor. Not to eat from the floor – my mother also taught. Don’t rely on the famous 5 second rule. Despite a recently published half-joke study that says dangerous flora can’t make the transition to a fast-growing product, I wouldn’t trust that rule.

Not working in a restaurant when sick. Never come to work if there is a suspicion of infection. And not only gastrointestinal, but also colds. There is a suspicion of a virus – no need to come to work. It is the responsibility of the kitchen administrators to prevent people with symptoms or complaints from working.

Treat food sufficiently thermally. There are two key parameters – time and temperature. By combining them, you can achieve both a culinary worthy result and safety.Chill properly cooked foods quickly and store them cold.

Do not create conditions for the multiplication of bacteria, incubators. You cannot update the contents of containers with sauces and condiments. They need to be replaced and old dishes thoroughly washed.

It is clear that each of these points can go incredibly far. But our task now is to create a certain impression and encourage you to think about it continuously, in your daily life and at work.

The topic of food and its dangers is endless and multifaceted, everyone has their own experience.Unfortunately, not everyone has a sufficient set of knowledge. People who go to restaurants need to know their limits, and they also have to trust the restaurateur. At the same time, those who work in the restaurant and feed people should not trust themselves for a single moment. There must be permanent paranoia: how to make the result of the work even safer. Because it is critically important to make delicious, making beautiful also helps the business, but making it safe is the number one priority, without which public catering will not exist as such.

Ivan Shishkin’s preparatory classes are a renewed course of lectures that the chef once taught for his chefs and employees, now open to everyone. Each lecture is devoted to several topics, but is not strictly tied to them and is held in a discussion format. They are held irregularly; you can follow the schedule on the Yunost Facebook page.

90,000 Vaccination against meningococcal infection for children and adults at the MediArt clinic in ZAO Moscow

Vaccination against meningococcal infection

Meningococcal disease is a severe infectious disease transmitted by airborne droplets that affects the lining of the brain.Meningococcal infection is dangerous, as it is widespread, transient, can cause serious complications and lead to death.

Every 3-5 years, outbreaks of meningococcal infection occur in Russia, claiming several lives. Especially meningococcal infection is dangerous for children, but adults who do not start treatment in a timely manner can die from inflammation of the meninges of the brain.

Meningococcal meningitis often begins suddenly , with a sharp rise in temperature, repeated vomiting that does not bring relief (vomiting of central origin), headache as a result of increased intracranial pressure.The patient is in a characteristic posture:

• the occipital muscles are tense,

• head thrown back,

• the back is arched,

• the stomach is pulled in,

• the legs are bent and brought to the stomach.

The duration of meningococcal meningitis is on average 2-6 weeks.However, there are cases of a lightning-fast course, when the patient dies within a few hours from the onset of the disease, and cases are protracted, when the patient’s temperature rises again after a period of improvement and is established for a long time. This protracted form is either the hydrocephalic stage, or the stage when the patient develops meningococcal sepsis by the penetration of meningococcus into the blood (meningococcemia). Its characteristic feature is the appearance of a hemorrhagic rash on the skin.The temperature rises, tachycardia develops, blood pressure decreases, and shortness of breath occurs.

It is important to diagnose patients with different types of meningococcal infection on time and hospitalize them.

More than 10% of children after meningitis survive with great losses:

• loss or loss of hearing, vision;

• paresis, paralysis;

• amputation of part or all of a limb;

• persistent decline in intellectual abilities.

Most cases of diseases in both children and adults are caused by the gram-negative bacterium Neisseria meningitides of five serogroups (A, B, C, W and Y). Vaccines were developed for them. Meningococcal vaccines certified in Russia can protect against N. meningitidis of some serogroups – A + C or ACWY.

The children’s immunologist at the MediArt clinic recommends that children be vaccinated against meningitis in a timely manner.

What vaccines are certified in Russia?

Several vaccines are presented in Russia:

• “ Meningo A + C ” (Polysaccharide meningococcal vaccine A + C, against serotypes A and C)

• “ Mentsevax ” (polysaccharide tetravalent, against serotypes A, C, W and Y) with revaccination every 3 years

• “ Menaktra ” (conjugated tetravalent, against serotypes A, C, W and Y)) with revaccination every 10 years

Polysaccharide vaccines “Meningo A + C” and “Mentsevax ACWY” are administered to children from 2 years of age.For vaccination of children over 9 months of age, a conjugate vaccine against ACWY serotypes “Menaktra” can be used, in this case it is prescribed twice with an interval of at least 3 months, and after 2 years it is given once. The level of protective antibodies lasts up to 10 years.

The strains of meningococcal infection circulating in Russia change over time. In recent years, there has been a change from serotype A to serotypes B and C. Also, a variety of infection, W135, has appeared in Russia.This meningococcus is brought by businessmen, tourists and adherents of Islam who visit Mecca and other holy places for Muslims. What makes the Meningo A + C vaccine less relevant in the current situation, since it does not provide protection against new serotypes.

Persistent protection against serotypes A, C, W and Y for 10 years for children over 2 years old makes Menaktra vaccine the most economical in the long term, since there is no need to revaccinate every 3 years.

Who is the meningococcal vaccine recommended for?

• Traveling abroad to areas endemic for meningococcus.These are predominantly equatorial countries with hot climates (Africa and the Middle East).

• Children who have had their spleen removed or have lost its functionality.

• Children with congenital primary immunodeficiency.

• Students of various universities, and especially those living in hostels or in apartment-type hotels.

• Since 2003, pilgrims to the countries of Saudi Arabia are subject to compulsory vaccination against meningococcal infection at the request of the country’s Embassy.

• All “contact” during the outbreak in an organized team: children’s educational institutions, summer camps, hostels, barracks.

90,000 yeast in a child treatment

yeast in a child treatment

yeast fungus in a child treatment

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What is a child’s yeast treatment?

Remitazol has a powerful fungicidal effect.Allows, without systemic methods of therapy, to eliminate the fungus in one course of treatment, reduce the risk of relapse, prevent re-infection upon contact with pathogens by strengthening local immunity.

Effect of using yeast in a child treatment

Remitazol cream can be used at any stage of the disease – from distal to total lesion. The intensely absorbed product is able to penetrate into the deeper layers of the dermis and under the nail, stopping the spread of infection and the multiplication of spores.

Expert opinion

Remitazole – dummy? Probably the one who says this has simply never used it. For me, the cream really worked. Give odds to any drug – cured my cracked feet

How to order

In order to place an order for yeast treatment in a child, you must leave your contact information on the website. The operator will contact you within 15 minutes.Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Tata

In just 30 days of using Remitazol cream, you can eliminate wounds and ulcers, dry skin cracks between fingers, remove peeling. Intense hydration and softening will maintain the hydro balance and the upper protective layer of the epidermis to prevent re-infection.

Sofia

Remitazol against mycosis is an effective remedy that guarantees a result without harm to health. Course therapy allows you to achieve complete recovery, provides long-term remission. Deramtologists recommend that their patients who come to an appointment with a fungal infection of the skin or nails to undergo a full course of medical therapy using this particular plant-based cream

Remitazol against mycosis is an effective remedy that guarantees a result without harm to health.Course therapy allows you to achieve complete recovery, provides long-term remission. Deramtologists recommend that their patients who come to an appointment with a fungal infection of the skin or nails to undergo a full course of treatment using this particular plant-based cream Where to buy yeast from a child treatment? Is remitazole a dummy? Probably the one who says this has simply never used it. For me, the cream really worked. Give odds to any drug – healed my cracked feet

Complex treatment of fungal skin diseases in children is carried out with the use of external and systemic antifungal agents, desensitizing and corticosteroid drugs, immunostimulants, physiotherapy.Classification of fungal skin diseases in children. Yeast fungi in the feces of a child do not always indicate a pathological process. … Non-invasive species are characterized by an increase in the population of the fungus in the lumen of the colon without the formation of pseudomycelium filaments. Similar forms are diagnosed in 90% of patients with mycogenic dysbiosis. Ways of infecting a child with a fungal infection. … Symptoms of colitis caused by yeast: frequent regurgitation, vomiting. Treatment. A single accidental detection of yeast in the feces of a child in the absence of any clinical signs of the disease is not a reason for.Treatment of yeast in children requires a special, delicate approach, since too intensive therapy can cause imbalances in a fragile body and have many side effects. Fungus is a common and contagious infectious disease that affects the skin, nails, feet, mucous membranes and scalp under the scalp. In half of cases, problems with the epidermis are associated with a fungus. Methods of treatment and measures for the prevention of yeast fungus on the nails. … In children of an older age group, signs of fungus in the urine are usually.In the presence of a fungus in the urine, signs of fungal infection may appear. If the treatment of fungus on the skin of the body is a relatively easy task, then the treatment of deep and systemic mycoses is a serious problem. In this article, we will analyze the treatment and symptoms of fungal skin diseases. Pathogenesis. For the introduction of the fungus into the skin and the development of the disease are important. Mycotic diseases in children are quite common. They are infectious in nature and are caused by pathogens – pathogenic fungi that can infect the outer cover, nail plates and mucous membranes.Young children have immune defenses. Treatment of fungus in children requires an individual approach. The specialist must select the most safe for. Yeast fungus in children, which is found in an intimate place, is recommended to be treated with candles Miceleks and Monistat. It is forbidden to treat mycosis in a child on your own.

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Remitazol cream can be used at any stage of the disease – from distal to total lesion. The intensely absorbed product is able to penetrate into the deeper layers of the dermis and under the nail, stopping the spread of infection and the multiplication of spores.
yeast fungus in a child treatment

Remitazole has a powerful fungicidal effect. Allows, without systemic methods of therapy, to eliminate the fungus in one course of treatment, reduce the risk of relapse, prevent re-infection upon contact with pathogens by strengthening local immunity.

Fluconazole for nail fungus. Onychomycosis is a fungal infection of the nail plate. … I use them to treat fungal infections. The differences between Fluconazole and Pimafucin lie in the active ingredients and the form of release.Fluconazole is available in tablet and capsule form. Nail fungus (mycosis and onychomycosis) is a destructive change in the appearance and structure of the nail plate, sometimes with a transition to the skin of the legs. The reason for this phenomenon is always more than 10 types of dermatophytes, yeast-like (candida) and molds. To select one of those presented in. Fluconazole is produced in capsules of 50, 100, 150 mg. The medicine suppresses the activity of a fungal infection, it can be used for. Fluconazole is indicated in patients for the prevention of exacerbations of chronic fungal infections.Can be used to prevent illness in people passing through. The concentration of fluconazole in the nails after 4 months of use at a dose of 150 mg once a week is 4.05 μg / g c. An alternative treatment regimen is the use of the drug at a dose of 50 mg once a day for 2-4 weeks. 4. With onychomycosis, the recommended dose is 150 mg once a day. Fluconazole is highly fungal specific. Concentration of fluconazole in nails after 4 months of use at a dose of 150 mg 1.For adults, depending on the indications, treatment regimen and clinical situation, the daily dose is 50-400 mg, the frequency of application is 1. The use of Fluconazole for the treatment of toenail and toenail fungus. Application scheme and form of release. The effect of the drug on the pathogen. Indications and contraindications. Reviews of doctors and patients. Fungus of the nail is an urgent problem in the modern world. According to the statistics carried out, every 5 patient is amazed by this unpleasant. Toenail fungus tablets have fluconazole as the main active ingredient.Auxiliary components are: potato. Fluconazole for nail fungus requires the exclusion of other drugs from the treatment regimen due to the unpredictability of the consequences. … The remedy for toenail fungus Fluconazole is available in the form of a suspension, tablets, capsules. Fluconazole for nail fungus. Nail fungus is an unpleasant disease that spoils the appearance and causes. That is, Fluconazole can successfully replace many drugs for the treatment of nails, which are contraindicated in people with acute / chronic gastrointestinal diseases.

Stomatitis: treatment and symptoms in children and adults

Content of the article:

1. What is stomatitis

2. The main symptoms of stomatitis

3. Causes of stomatitis

4. Types of stomatitis:

5. Diagnosis of stomatitis

6. Treatment of stomatitis

7. Prevention of stomatitis

8. Complications of stomatitis

What is stomatitis?

Stomatitis is a disease of the oral mucosa, which is characterized by the appearance of painful rashes (aphthae, ulcers, wound surfaces).Stomatitis in adults and children is characterized by severe soreness, which is accompanied by increasing discomfort when eating, drinking, talking. Ulcers affect the gums, tonsils, the inner side of the lips and cheeks and are recurrent (appear at regular intervals)

The causes of stomatitis are very different – from mechanical damage to a viral nature, but sometimes stomatitis in the mouth can indicate other diseases in the body, be a concomitant symptom.

Stomatitis itself is not contagious, but the cause that causes it may be infectious (for example, as in herpetic stomatitis).

The main symptoms of stomatitis

Signs of stomatitis have a general similarity – the formation of painful ulcers and erosions, but there are distinctive symptoms that are directly related to the causative agent of the disease.

The main signs are expressed:

– the mucous membrane affected by stomatitis becomes swollen, reddened, painful;
– sores on the gums, cheeks, single or numerous – they look like wounds with a white film and a dot in the middle;
– bloom of white, yellow, green;
– small rashes;
– enlarged lymph nodes;
– the presence of an unpleasant taste in the mouth;
– pain is observed in the area of ​​the rash, which increases when eating or drinking, as well as when talking;
– salivation increases, gums bleed;
– the temperature rises.

Causes of stomatitis

The main risk of the onset and development of stomatitis in the palate, on the throat, on the cheek, on the lips is associated with a decrease in immunity, when the body succumbs to bacterial and infectious infection. Risk factors include gastrointestinal disease, thyroid problems, diabetes mellitus, and anemia.

The causes of stomatitis are:

– impact on the body of bacteria, fungi, mycoplasma, viral infections;
– consequences of transferred ENT diseases;
– the appearance of allergic reactions;
– injured oral cavity;
– diseases of teeth, gums, tartar and plaque;
– poor oral hygiene;
– improper nutrition;
– taking medications.

Types of stomatitis

1. Herpetic stomatitis

Photo of herpetic stomatitis:

As statistics show, viral stomatitis is 80% of cases of diseases of the oral cavity in adults.

Source of occurrence – it is provoked by the herpes virus, the method of transmission of which is airborne or contact, through household items.

Features of the course of the disease – bubbles appear in the mouth, they burst and become ulcers, within 4-5 days after the onset, they heal.The course of the disease is often severe, the temperature rises, nausea, vomiting and diarrhea occur, and disappears within a couple of weeks.

2. Aphthous stomatitis

Photo of aphthous stomatitis:

Ulcerative stomatitis manifests itself frequently, relapses may periodically occur, often in autumn and spring.

Source of occurrence – aphthous stomatitis appears under the influence of a decrease in general and local immunity, as well as with a lack of nutrients, vitamins, minerals – folic acid, vitamin B12, iron.

Features of the course – at the beginning of the disease there are aphthae – single or multiple small ulcers in the mouth, their oval and round shape prevails. When the aphthae burst, there is a thin, bright red border and a bright yellow coating around the lesions. Is a person with aphthous stomatitis contagious? He is not dangerous to others.

3. Allergic stomatitis

Allergic stomatitis is a severe type of disease that is difficult to treat.
Source of occurrence – allergy to medicines, in particular to antibacterial drugs, to materials used for prosthetics and to some food.

Features of the course of stomatitis – burning sensation, itching, unpleasant sensation in the mouth worries. With this type of stomatitis, painful sensations disturb even when air is swallowed. It can also appear in babies.

Contact allergic stomatitis – a reaction can be to dental materials, for example, fillings and dentures (which include nickel, chromium, palladium, silver, gold, acrylic plastic dentures). Also, an allergic reaction can be caused by lipstick, various creams, toothpastes.. it all depends on the constituent components to which you can have a reaction.

Photo of contact allergic stomatitis on plastic of a removable device (plate):

Photo of contact allergic stomatitis on lipstick:

4. Catarrhal stomatitis

Photo of catarrhal stomatitis:

Catarrhal stomatitis – the most common type, the course of the disease is mild.
The source of occurrence is a violation of oral hygiene, dental disease and the occurrence of plaque, as well as with an injured oral cavity, if the immunity is weakened by any factors.

Features of the course – the main symptom is a dry mucous membrane of the oral cavity, which causes painful sensations. There is redness, swelling, then erosive changes, which turn into ulcers and abscesses. If symptoms persist within 5-7 days, you need to see a gastroenterologist.

5. Fungal stomatitis

Photo of fungal stomatitis:

Fungal stomatitis occurs, often, in infants, as well as in elderly adults, people with weakened immunity.

Source of occurrence – they distinguish between such ways of occurrence of the disease – direct contact with an infected person, household items and when their own probably pathogenic fungi become such with the prevailing favorable factors for their development – when the human body is weakened, with hypothermia. Stomatitis appears in children from birth.

Features of the course – candidal stomatitis provokes a white, curdled plaque in the oral cavity, under which wounds, ulcers, and erosion appear.Stomatitis in a child is treated symptomatically.

6. Angular stomatitis

Angular stomatitis photo:

Angular stomatitis (Cheilitis) occurs in children and adults, in plain language it is a jam.
The source of stomatitis – a red, purple-red spot appears in the corners of the mouth, swelling grows, peculiar cracks appear, accompanied by pain and burning when talking, eating food and opening your mouth.

Stomatitis is often perceived as a cosmetic defect, a symptom of a cold.This disease of the skin and mucous membrane of the mouth occurs due to a microbial infection of streptococcus, a microinfection of the Candida fungus, with a lack of vitamins and iron. Another common cause is declining bite, which causes saliva to macerate the corner of the mouth.

Diagnosis of stomatitis

How effective the treatment is, how quickly you will be able to recover is directly related to how early the disease was diagnosed. To make a diagnosis, the doctor pays attention to the history, manifestation of the disease, and conducts an examination.

Laboratory determination of stomatitis consists of:

– blood test;
– taking crops;
– PCR diagnostics;
– carrying out a cytological study;
– conducting a histological examination of a biopsy;
– taking intradermal samples for yeast allergens.

It is likely that diagnostics will be required to accurately determine the type and prescription of the correct treatment.

Treatment of stomatitis

How to treat stomatitis of the cheeks and tongue is directly related to the severity of the disease and the causes of its occurrence.If the stomatitis in the tongue is simple, without complications, within a week it is treated with symptomatic measures, including folk remedies at home.

If stomatitis is a consequence of a previous illness, its complication, then treatment of stomatitis of the oral cavity takes longer, goes through the following stages:
– symptomatic treatment – at high temperatures – antipyretic, with acute symptoms – appropriate medications.
– prescribe special ointments and gels to treat stomatitis, rinses to remove local irritation and pain;
– systematic treatment of the causes of stomatitis.

How to quickly cure gum stomatitis? As prescribed by a doctor, antibacterial drugs, metronidazole drugs, as well as drugs aimed at pain relief, relief of allergic edema should be taken.

Treatment of stomatitis in children and adults takes up to 7-10 days , in case of a mild course of the disease. If serious problems and complications are identified, doctors eliminate them first. If necessary, a diet will be prescribed to eliminate irritating foods.

Stomatitis of all types is treated, including under the tongue, at home, you must follow the doctor’s recommendations and pay attention to:

– the use of toothpaste without lauryl sulfate in the composition;
– if the nature of the disease is bacterial, a local antibiotic is used, for viral stomatitis – antiviral agents are prescribed;
– prescribe drugs aimed at improving the epithelialization of the mucous membrane;
– vitamins and minerals as systemic measures.

How to treat stomatitis in the throat at home? How to cure a disease at first – you should adhere to the following recommendations:

– smoking cessation;
– refusal to use spicy, spicy, salty, sour foods, seasonings, ice cream, carbonated drinks and seasonings;
– oral hygiene – brush your teeth after each meal, rinse your mouth with anti-inflammatory herbal infusions for stomatitis.

The child can wipe the oral cavity with special compounds to remove plaque.

Prevention of stomatitis

Preventive measures for stomatitis are directly related to the causes of the disease:

– Personal oral hygiene is a special item that requires attention. Thorough hand washing after being outdoors, before eating, in contact with common items. These measures should become familiar to everyone.
– implementation of oral hygiene – it is necessary to brush your teeth twice a day, rinse after meals, and undergo a dental examination twice a year.
– provide yourself with a nutritious and balanced diet. You should also take multivitamins, minerals, eat fruits and vegetables;
– complete rejection of bad habits, especially smoking, which is a common symptom of stomatitis;
– strengthening the immune system – this is good nutrition, sports, taking vitamins, good rest, healthy sleep;
– to reduce the consumption of such products – sugar, alcohol, yeast food, namely beer and bread – they provoke the development of stomatitis;
– limiting the use of antibacterial drugs, especially if they are not prescribed by a doctor.

Complications of stomatitis

If timely treatment of stomatitis is not provided, various complications may arise , namely:

– mouth ulcer, if not treated in time, it can become infected;
– due to a violation of the chewing process, a syndrome of impaired absorption, digestion develops, this affects the work of the gastrointestinal tract;
– a manifestation of psycho-emotional instability.

In the case of a competent and professional approach, stomatitis can be eliminated quickly, for a long time, without complications.In the Lukashuk clinic, you will be provided with fast diagnostics and high-quality treatment (here is our entire price list of dental services).

Treatment of stomatitis is a complex measure, and if it has arisen from mechanical damage (chipped tooth, incorrectly placed crown, braces), this problem must be eliminated immediately.
When stomatitis on the lip arose under the influence of fungi, infections, it is necessary to pass tests and find out the cause of the occurrence. Next, a course of treatment will be prescribed to eliminate the problem and the cause of its occurrence.

Yeast and mold on smartphones, or whatever else lives on your gadget

Smartphones have become a part of everyday life. Trite, but true. And along with them, and some “surprises” from the world of microbiology. It will not be superfluous to remind that gadgets are breeding grounds for microbes. So the head of Rospotrebnadzor, Anna Popova, calls for disinfecting the devices in order to prevent an epidemic of influenza and SARS. This problem is now the most acute. “Without the need to attend major mass events, you should not go for a week until the wave leaves.And, of course, gadgets need to be wiped clean and kept clean. We often do not pay attention to them, but we touch them all the time, ”the Moscow city news agency quoted Popova as saying.

What pathogenic bacteria are teeming with the screens of our favorite gadgets, really few people seriously think. However, mobile devices as well as tablet computers carry more germs than even a toilet seat. American microbiologists say that ten times more bacteria live on gadgets than in the dirtiest places in the toilet, including the toilet seat.Perhaps the most common and well-known pathogens that freely settled on our gadgets are Staphylococcus aureus, Escherichia coli, Salmonella, Streptococcus. What other dangerous infections (but which are not “heard”) can be found on the screens of smartphones, let’s figure it out.

Clostridium difficile is a bacteria from the genus Clostridia. They are transmitted through the fecal-oral mechanism, that is, with feces (feces, urine) or vomit.Clostridium difficile causes pseudomembranous colitis, a severe infection of the rectum. Symptoms of the disease are diarrhea, frequent watery stools with mucus and blood, abdominal pain, fever, weakness, weakness, nausea, vomiting. You can get it in hospitals, including shaking hands, going to the toilet. People taking antibiotics are especially vulnerable (in these conditions, the pathogen Clostridium Difficile multiplies well).

Corynebacterium diphtheriae is the causative agent of diphtheria.Most often it affects the oropharynx, but often affects the larynx, bronchi, skin. The infection is transmitted by coughing or sneezing, through objects, as well as contaminated foods (milk, cheese, etc.). The disease is accompanied by fever, pallor, weakness, swelling of the soft tissues of the neck, difficulty in swallowing, bloom (most often gray-white), swollen lymph nodes. In severe forms of the disease, death is possible. There is a vaccine for diphtheria.

Pseudomonas aeruginosa is the causative agent of nosocomial or nosocomial infections.Pseudomonas aeruginosa manifests itself in abscesses and purulent wounds. You can pick up a stick (as the name of the infection suggests) at the hospital and bring it home. It is most commonly transmitted through water, food, equipment, and even dust. However, the infection is difficult to treat because it is resistant to antibiotics.

Yeast. Yes, yes, they are dangerous. Yeast fungus is a fungal infection caused by a pathogen of the genus Candida. It affects the nails, mucous membranes, skin of the hands and feet, and causes unpleasant itching and irritation.Too tight synthetic underwear, extra pounds, some shower gels and intimate hygiene products, a love of sweets can provoke the fungus. A neglected disease can subsequently lead to thrush.

Mold – well known. Wherever they find it – and on smartphones too. According to research, every tenth device is infected with mold. Mold not only affects the respiratory system, but also causes nail fungus.

90,000 What they are treating us with: Linex.A drug for a non-existent disease

The authors of another review, already in 2015, examined whether probiotics could prevent diarrhea in children after taking antibiotics. The answer here turned out to be positive, and for 22 out of 23 studies. However, the best reviews were awarded to strains Lactobacillus rhamnosus and Saccharomyces boulardii (one of the yeast strains), and not those strains contained in Linex.

The disease “dysbiosis” does not exist. Does Linex treat at least something?

We have more or less figured out the prevention of the consequences of taking antibiotics.But will probiotics (and yoghurts with bifidobacteria) help against diseases that have already begun?

When it comes to the same infectious diarrhea, another Cochrane review confirms that using probiotics with plenty of fluids to reduce dehydration shortens the course of the disease by an average of 25 hours, and the risk that it will not go away by the fourth day of use. also decreased. The authors note that it is necessary to develop in detail the dosage and administration of specific prebiotics for different conditions of patients.

With regard to prolonged (lasting from 14 days) diarrhea in children, the situation is much more controversial. There is little scientific evidence that probiotics will help in any way to draw conclusions from them. Better to resort to traditional treatment and eliminate the infection, then the diarrhea will go away.

When asked how the intake of probiotics influenced the course of pseudomembranous colitis caused by the same ill-fated Clostridium, the correct answer is simple: nothing.