Gestational diabetes is a kind of diabetes that just happens in pregnant ladies. That implies you can’t get gestational diabetes except if you’re pregnant.

Definition

Gestational diabetes is a kind of diabetes that just happens in pregnant ladies. That implies you can’t get gestational diabetes except if you’re pregnant. You may create gestational diabetes out of the blue during pregnancy or you may have a gentle undiscovered instance of diabetes that deteriorates when you’re pregnant. Normally during your pregnancy, the manner in which your body utilizes insulin changes. The insulin in your body separates the nourishment and nutrients that you get with glucose or sugar. You at that point utilize that glucose for vitality.

You’ll normally turn out to be progressively impervious to insulin when you’re pregnant to help furnish your infant with more glucose. In certain ladies, the procedure turns out badly and your body either quits reacting to insulin or doesn’t make enough insulin to give you the glucose you need. At the point when that occurs, you’ll have an excess of sugar in your blood.

Pathophysiology of Gestational diabetes

Gestational diabetes occurs when the body is unable to produce enough insulin to meet the needs of the pregnancy. Insulin is a hormone that promotes the uptake of glucose from the blood and its subsequent storage as glycogen.

In pregnancy, there is progressive insulin resistance. This means that a higher volume of insulin is needed in response to a normal level of blood glucose. On average, insulin requirements rise by 30% during pregnancy.

A woman with a borderline pancreatic reserve is unable to respond to the increased insulin requirements, resulting in transient hyperglycaemia. After the pregnancy, insulin resistance falls – and the hyperglycaemia usually resolves.

Types of Gestational diabetes

Two types of diabetes can happen in pregnancy. These are:

Gestational diabetes: In this condition, you don’t have diabetes before pregnancy. You develop it during pregnancy. This type of diabetes goes away after your baby is born.

Pregestational diabetes: In this condition, you have diabetes before getting pregnant. You may have type 1 or type 2 diabetes.

  • People with type 1 diabetes don’t make insulin. Your body needs insulin to use blood sugar. You’ll need to take insulin shots.
  • People with type 2 diabetes can’t use the insulin they make. Or their bodies don’t make enough insulin. You’ll need blood sugar-lowering medicine and possibly insulin.

It’s important to manage your blood sugar during pregnancy. This can lower your baby’s risk for problems.

Gestational diabetes risk factors

Gestational diabetes can develop in any woman who is pregnant. But women over the age of 25 who are of African, Asian, Hispanic, Native American or Pacific Island descent are at a higher risk.

Other factors that may increase your chances of GD include:

  • Heart disease.
  • High blood pressure.
  • Inactivity.
  • Obesity.
  • Personal or family history of GD.
  • Polycystic ovary syndrome (PCOS).
  • Previous birth of a baby weighing nine pounds or more.

Causes

Healthcare providers don’t know what causes gestational diabetes. But they do know what happens.

The placenta gives your growing baby nutrients and water. The placenta also makes several hormones to keep the pregnancy healthy. These hormones include:

  • Estrogen
  • Progesterone
  • Cortisol
  • Human placental lactogen

These hormones can affect how your body uses insulin (contra-insulin effect). This often begins about 20 to 24 weeks into your pregnancy and could lead to gestational diabetes.

During pregnancy, more fat is stored in your body, you take in more calories, and you may get less exercise. All of these things can make your blood sugar (glucose) levels higher than normal and possibly lead to gestational diabetes.

As the placenta grows, it makes more of the hormones. The risk for insulin resistance becomes greater. Normally your pancreas is able to make more insulin to overcome insulin resistance. But if it can’t make enough to overcome the effects of the placenta’s hormones, you can develop gestational diabetes.

Symptoms of Gestational diabetes

Signs and symptoms associated with gestational diabetes include:

  • Increased, frequent urination
  • Increased thirst
  • Fatigue
  • Nausea and vomiting
  • Weight loss even with increased appetite
  • Blurred vision
  • Yeast infections

Yet, for many pregnant women, gestational diabetes does not cause any recognizable symptoms. That is why screening tests for the condition are recommended for all pregnant women, notes.

Complications

When a woman has GD, her body passes more sugar to her fetus than it needs. With too much sugar, her fetus can gain a lot of weight. A large fetus (weighing 9 pounds or more) can lead to complications for the woman, including:

  • Labor difficulties
  • Caesarean birth
  • Heavy bleeding after delivery
  • Severe tears in the vagina or the area between the vagina and the anus with a vaginal birth

Diagnosis and test

Doctors also advises that you be tested for type 2 diabetes if you have risk factors for this condition. This testing should be done at your first prenatal visit.

Screening is done by these tests:

One-hour glucose tolerance test: You drink a special beverage high in sugar. One hour later, the healthcare provider measures your blood sugar (glucose) levels. If your levels are higher than a certain level, this is considered an abnormal result.

Three-hour glucose tolerance test: If the 1-hour test is abnormal, you will have a second glucose tolerance test done to confirm the diagnosis. You will drink another special beverage, but with more sugar. Your healthcare provider will measure your blood sugar levels 1 hour, 2 hours, and 3 hours later. You have gestational diabetes if at least two of the glucose measurements are higher than normal.

If you are diagnosed with gestational diabetes, you should get tested for diabetes 4 to 12 weeks after your baby is born. You should also get this screening at least every 3 years for the rest of your life

Treatment and medications

Treatment for gestational diabetes will be started immediately upon diagnosis. The goal is to keep your blood sugar low and steady to give you and your baby the best shot at a healthy pregnancy and birth. Your treatment will usually include some of the following:3

Diet: Limiting highly refined carbohydrates (sugars) in favor of nutrient-rich fruits, vegetables, whole grains, and lean proteins is key. A nutritionist or your doctor can help you learn how to make healthy dietary choices that keep your blood sugar at acceptable levels. This advice will include how to plan meals and snack well.

Exercise: While intense physical activity is not recommended in late pregnancy, light to moderate exercise is encouraged. An active lifestyle can help keep GD in check.

Blood sugar monitoring: Your doctor will advise you on how often you need to test your blood sugar through finger pricks, but it is typically several times a day. You will be taught how to do this on your own.

Medication, including insulin injections: Not everyone will need to use insulin. Many people are able to control blood sugar with diet and exercise alone. Your practitioner will monitor your blood sugar to determine if you need additional help from insulin injections.

Prevention of Gestational diabetes

For most women, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes. If you have type 2 diabetes, your pancreas makes too little insulin or your body becomes resistant to it (can’t use it normally).

Here’s what you can do to help reduce your risk of developing type 2 diabetes after pregnancy:

  • Breastfeeding can help you lose weight after pregnancy. Being overweight makes you more likely to develop type 2 diabetes.
  • Get tested for diabetes 4 to 12 weeks after your baby is born. If the test is normal, get tested again every 1 to 3 years.
  • Get to and stay at a healthy weight.
  • Talk to your provider about medicine that may help prevent type 2 diabetes.

Vulvodynia is the term used to describe the condition experienced by women who have the sensation of vulval burning and soreness in the absence of any obvious skin condition or infection.

Definition

Vulvodynia is the term used to describe the condition experienced by women who have the sensation of vulval burning and soreness in the absence of any obvious skin condition or infection. The sensation of burning and soreness of the vulva can be continuous (unprovoked vulvodynia), or on light touch, e.g. from sexual intercourse or tampon use (provoked vulvodynia). Women who have unprovoked vulvodynia were formerly known as having dysaesthetic (or dysesthetic) vulvodynia where pain was felt without touch.

Vestibulodynia is the term replacing vestibulitis where the pain is felt on light touch. A recent change in the terminology used to describe these conditions means that the description of women with vulvodynia can be more uniform amongst health professionals and patients.

Many women have symptoms which overlap between both conditions. Dysaesthetic vulvodynia and vestibulitis are now obsolete terms that you’ll hear less and less frequently as they are phased out.

Types of Vulvodynia

The two major subsets of the condition: generalized vulvodynia and localized vulvodynia. Vestibulodynia is a specific kind of localized vulvodynia.

Generalized vulvodynia is characterized by pain that is spread out throughout the vulvar region. It can be present in the labia majora and/or labia minora. Sometimes it affects the clitoris, perineum, mons pubis and/or inner thighs. The pain may be constant or intermittent, and it is not necessarily initiated by touch or pressure to the vulva. The vulvar tissue may appear inflamed, but in most cases, there are no visible findings.

Localized vulvodynia is more common and the pain is at only one site, such as the vestibule. Women with vestibulodynia have pain when touch or pressure is applied to the vestibule ( the area surrounding the opening of the vagina). Women may experience pain with intercourse, tampon insertion, gynecologic exam, bicycle riding, horseback or motorcycle riding, and wearing tight clothing, such as jeans. Most often, the vestibule of women with VVS is inflamed and red.

Regardless of the type of vulvodynia a woman has, the disorder imposes serious limitations on a woman’s ability to function and engage in normal daily activities. The pain can be so severe and unremitting that it forces women to resign from career positions, abstain from sexual relations, and limit physical activities. Not surprisingly, these limitations negatively affect a woman’s self-image; many women become depressed because of the physical pain itself and the associated psychological and social implications.

Vulvodynia risk factors

Associations with other chronic pain conditions are common, with one study finding 45% of women with vulvodynia also having one of the following:

  • Fibromyalgia
  • Irritable bowel syndrome
  • Chronic fatigue syndrome
  • Interstitial cystitis
  • Endometriosis

A history of recurrent vulvovaginal candidiasis is commonly associated.

Women with a past history of anxiety and/or depression are more likely to get vulvodynia

Causes of Vulvodynia

Vulvodynia often doesn’t have a specific cause. It likely has lots of different causes working together, including things like:

  • Nerve irritation or nerve damage in your vulva
  • Inflammation (swelling) in your vulva
  • Some genetic disorders, like chronic pain or problems fighting infections
  • Problems with your pelvic floor muscles
  • Reactions to certain infections
  • Food sensitivities
  • Conditions that impact the muscles or bones near your vulva
  • Sexual abuse or trauma in your past

Symptoms of Vulvodynia

Pain is the main symptom of vulvodynia. Depending on the person, the pain may:

  • Be felt only in one spot, such as near the opening of the vagina, and only when something touches that area. This is called localized vulvodynia. Or you may feel the pain on or around most of the vulva, even when nothing touches those areas. This is called generalized vulvodynia
  • Be constant or come and go for months or even years
  • Flare-up when you sit on a bicycle, put in a tampon, or wipe your vulva
  • Be mild or very bad
  • Be felt during and after sex

Other symptoms may include:

  • Burning or stinging
  • Itching
  • Swelling
  • Throbbing
  • Rawness

Complications

Having this condition can take a physical and emotional toll. It can cause:

  • Depression and anxiety
  • Problems in personal relations
  • Sleep problems
  • Problems with sex

Working with a therapist can help you better deal with having a chronic condition.

Diagnosis and test

Before diagnosing vulvodynia, your doctor will ask you questions about your medical, sexual and surgical history and to understand the location, nature, and extent of your symptoms.

Your doctor might also perform a:

Pelvic exam: Your doctor visually examines your external genitals and vagina for signs of infection or other causes of your symptoms. Even if there’s no visual evidence of infection, your doctor might take a sample of cells from your vagina to test for an infection, such as a yeast infection or bacterial vaginosis.

Cotton swab test: Your doctor uses a moistened cotton swab to gently check for specific, localized areas of pain in your vulvar region.

Treatment and medications

Vulvodynia treatment takes time. Finding the treatment or combination of treatments that will bring you relief from pain is a process of trial and error, and treatments that work might not work immediately.

Treatments you and your doctor might try include:

A nerve block: This is an injection of medication that interrupts the signals that send pain from nerves to the brain.

Physical therapy: Physical therapy is used for the treatment of vulvodynia, but not for muscle strengthening. This treatment is used for myofascial release. Muscles in the pelvic floor are often in spasm in women with vulvodynia. Working with a physical therapist trained in pelvic floor disorders can help to relax these muscles.

Vestibulectomy: This is a surgical procedure to remove tissue in the area where the patient feels pain. This can be helpful for women who have localized vulvodynia and haven’t been significantly helped by other treatments.

Counseling: This might be recommended, since vulvodynia can affect sexual relationships, self-esteem and overall quality of life.

Medications used to treat vulvodynia

Several medications can be used to treat vulvodynia. Medications can be taken in pill form (oral), injected into the affected area, or applied to the skin (topical). The following medications have been found to be helpful in treating vulvodynia:

Topical medications: Creams and ointments containing anesthetics or nerve-stabilizing medications and are applied to the vulvar area. Sometimes these are used before sexual intercourse.

Oral medication: These medications can include antidepressants and anticonvulsants, to address nerve pain.

Local anesthetics- These medications are applied to the skin. They may be used before sexual intercourse to provide short-term pain relief, or they can be used for extended periods.

Antidepressants and antiseizure drugs- Drugs used to treat depression and to prevent seizures also may help with the symptoms of vulvodynia. It may take a few weeks for these medications to work. Some types of antidepressants can be provided in the form of a cream that is applied to the skin.

Hormone creams- Estrogen cream applied to the vulva may help relieve vulvodynia in some cases.

Lifestyle and home remedies

The following tips might help you manage vulvodynia symptoms:

Try cold compresses or gel packs: Place them directly on your external genital area to ease pain and itching.

Soak in a sitz bath: Two to three times a day, sit in comfortable, lukewarm (not hot) or cool water with Epsom salts or colloidal oatmeal for five to 10 minutes.

Avoid tightfitting pantyhose and nylon underwear: Tight clothing restricts airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. Wear white, cotton underwear to increase ventilation and dryness. Try sleeping without underwear at night.

Avoid hot tubs and soaking in hot baths: Spending time in hot water can cause discomfort and itching.

Don’t use deodorant tampons or pads: The deodorant can be irritating. If pads are irritating, switch to 100 percent cotton pads.

Avoid activities that put pressure on your vulva, such as biking or horseback riding.

Wash gently: Scrubbing the affected area harshly or washing too often can increase irritation. Instead, use plain water to gently clean your vulva with your hand and pat the area dry. After bathing, apply a preservative-free emollient, such as plain petroleum jelly, to create a protective barrier.

Use lubricants: If you’re sexually active, apply a lubricant before having sex. Don’t use products that contain alcohol, flavor, or warming or cooling agents.

Genital warts are contagious, fleshy growths in the genital or anal area. They are one of the most common types of sexually transmitted infections.

Genital Warts – Overview

Genital warts are contagious, fleshy growths in the genital or anal area. They are one of the most common types of sexually transmitted infections. They are also known as venereal warts or condylomata acuminate. They are caused by the human papillomavirus (HPV), and they are a symptom of HPV.

Genital warts consist of fibrous overgrowths covered by a thickened, outer layer. They can appear around a man’s scrotum, anus, and penis, or a woman’s vulva, cervix, vagina, or anus. They are usually benign, or non-cancerous, but some types can become cancerous in time.

In appearance, genital warts are often flesh-colored or gray swellings. If several clusters together, they may resemble a cauliflower. Some may be too small to be seen by the naked eye. About 1 in 100 sexually active people in the United States have genital warts. Between 2011 and 2014, the prevalence of HPV was 7.3 percent amongst adults aged 18 to 69 years.

It is possible to have HPV without showing symptoms. Genital warts often appear about 3 months after infection. However, in some cases, there may be no symptoms for many years.

Pathophysiology

Human papillomavirus (HPV) invades cells of the basal layer of the epidermis, penetrating skin and mucosal microabrasions in the genital area.

A latency period of 3 weeks to 9 months may ensue. Following that period, viral DNA, capsids, and particles are produced. Host cells become infected and develop the morphologic atypical koilocytosis of genital warts.

Most frequently affected are the penis, vulva, vagina, cervix, perineum, and perianal area. These mucosal lesions occasionally can be found in the oropharynx, larynx, and trachea. HPV-6 even has been reported in other uncommon areas (eg, extremities).

Multiple simultaneous lesions are common and may involve subclinical states as well as different anatomic sites. Subclinical infections have an infectious and oncogenic potential. However, most infections are transient and clear up within 2 years without intervention.

Consider the possibility of sexual abuse in pediatric cases; however, remember that infection by direct manual contact or, rarely, by indirect transmission from fomites may occur. Additionally, passage through an infected vaginal canal at birth may cause respiratory lesions in infants.

What Causes Genital Warts (HPV)?

Genital warts are caused by human papillomavirus (HPV). Over 100 types of HPVs have been identified; about 40 of these types have the potential to infect the genital area.

  • Most genital warts are caused by two specific types of the virus (HPV-6 and -11), and these HPV types are considered “low risk,” meaning they have a low cancer-causing potential. Other HPV types are known causes of premalignant changes and cervical cancers in women. HPV-16, one of the “high-risk” types, is responsible for about 50% of cervical cancers. HPV types 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68 are other known “high risk” virus types. High-risk HPV types are also referred to as oncogenic HPV types. HPV is believed to cause 100% of cases of cervical cancer.
  • Common warts are not the same as genital warts and are caused by different HPV types that infect the skin.

The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once cells are invaded by HPV, a latency (quiet) period of months to years may occur, during which there is no evidence of infection.

  • Generally, about two-thirds of people who have sexual contact with a partner who has genital warts develop them within three months.
  • Genital warts are indirectly associated with the use of birth control pills due to increased sexual contact without the use of barrier protection, multiple sex partners, and having sex at an early age.

Who’s at Risk?

Anyone who’s sexually active can get or spread HPV.

Some things can make you more likely to get genital warts. They include

  • Having more than one sex partner (or a partner who does)
  • Being pregnant
  • Having a weakened or damaged immune system
  • Smoking

There’s a vaccine for people 9 to 26 years old. You get it as three injections over a 6-month period. Or you can get the same amount of protection from just two shots as long as you get both doses before age 15.

You must get the shots before you’re exposed to HPV in order for it to work. The vaccine won’t protect you if you’ve already been infected with certain HPV strains, but it can protect you from many others, but not all types of HPV you have not been exposed to.

Symptoms of genital warts

Most people who have an HPV infection will not develop any visible warts. If genital warts do appear, it can be several weeks, months or even years after you first came into contact with the virus.

Warts may appear as small, fleshy growths, bumps or skin changes anywhere on the genitals or around the anus. In some cases, the warts are so small they are difficult to notice.

A person can have a single wart or clusters of multiple warts that grow together to form a kind of “cauliflower” appearance.

Warts in women

The most common places for genital warts to develop in women are:

  • Around the vulva (the opening of the vagina)
  • On the cervix (the neck of the womb)
  • Inside the vagina
  • Around or inside the anus
  • On the upper thighs

Warts in men

The most common places for genital warts to develop in men are:

  • Anywhere on the penis
  • On the scrotum
  • Inside the urethra (tube where urine comes out)
  • Around or inside the anus
  • On the upper thighs

Other symptoms

Warts are usually painless, although on some people they can become itchy and inflamed. If a wart becomes inflamed, it may lead to bleeding from the urethra, vagina or anus.

The urethra is the tube connected to the bladder, which urine passes through. Warts that develop near or inside the urethra can also disrupt the normal flow of urine.

See treatment of genital warts for more information

Complications of Genital Warts

Pregnancy complications

Enlarged warts may obstruct the path of urine, causing urinary problems in pregnant women. Warts affect the skin of your vaginal walls and vulva. They may bleed or make it difficult for your tissues to stretch during delivery.

Mother-child transmission

Genital warts can also pass from mother to child when the baby passes through the vaginal canal. Infants who develop warts on their mouth or throat may need to have them surgically removed, especially if there is a danger to the baby’s airway.

Cancer

Genital warts and HPV are associated with cervical cancer, and other cancers of the vulva, anus, throat, and mouth.

Genital Wart diagnosis and testing

Your doctor may perform the following tests to check for genital warts and/or related STDs:

  • An examination of visible growths to see if they look like genital warts
  • Application of a mild acetic acid (vinegar) solution to highlight less visible growths
  • A complete pelvic exam and Pap smear (for women)
  • A specialized test for high-risk HPV (low risk should not be screened for), collected in a way similar to a Pap smear
  • Biopsy of cervical tissue (if abnormal Pap smear or visible abnormality) to make sure there are no abnormal cells that could develop into HPV-related cervical cancer; a cervical biopsy involves taking a small sample of tissue from the cervix and examining it under a microscope.
  • Examination of the rectum

Female patients may be referred to a gynecologist (a doctor who specializes in female reproductive health) for further testing and biopsy.

How are genital warts treated?

While visible genital warts often go away with time, HPV itself can linger in your skin cells. This means you may have several outbreaks over the course of your life. So managing symptoms is important because you want to avoid transmitting the virus to others. That said, genital warts can be passed on to others even when there are no visible warts or other symptoms.

You may wish to treat genital warts to relieve painful symptoms or to minimize their appearance. However, you can’t treat genital warts with over-the-counter (OTC) wart removers or treatments.

Your doctor may prescribe topical wart treatments that might include:

  • Podofilox
  • Imiquimod
  • Podophyllin
  • Trichloroacetic Acid

If visible warts don’t go away with time, you may need minor surgery to remove them. Your doctor can also remove warts through these procedures:

  • This involves freezing off the warts with liquid nitrogen. Cryotherapy may cause a burning sensation, as well as pain and blistering.
  • Surgical excision. This involves a doctor cutting away warts. Before the procedure, they will give the person a local anesthetic to numb the area.
  • This involves a doctor burning warts off the skin with an electrical device. A person may require a local or general anesthetic.
  • Laser therapy. In this procedure, a surgeon uses a powerful beam of light to destroy warts. It can cause pain and irritation afterward.
  • Injections of the drug interferon

Home remedies for genital warts

Don’t use OTC treatments meant for hand warts on genital warts. Hand and genital warts are caused by different strains of HPV, and treatments designed for other areas of the body are often much stronger than treatments used on the genitals. Using the wrong treatments may do more harm than good.

Some home remedies are touted as helpful in treating genital warts, but there is little evidence to support them. Always check with your doctor before trying a home remedy.

Can Genital Warts Be Prevented?

Genital warts and other types of HPV can be prevented by a vaccine. The HPV vaccine series is recommended for all kids when they’re 11–12 years old. Older teens and adults also can get the vaccine (up to age 45). Even if someone already has had one type of HPV infection, the HPV vaccine can protect against other types of HPV.

HPV almost always spreads through sex. So the best way to prevent it is to not have sex (vaginal, oral, or anal). If someone does decide to have sex, using a condom every time for sex (vaginal, oral, and anal) helps prevent HPV and other STDs. But condoms can’t always prevent HPV because they don’t cover all areas where HPV can live.

Should Sexual Partners Be Told About Genital Warts?

Someone diagnosed with genital warts should have an honest conversation with sexual partners. Partners need to be seen by a health care provider who can check for genital warts and do screenings for other STDs.

If the couple plan to continue having sex, both people need to understand that a condom will help lower the risk of spreading genital warts/HPV but can’t completely prevent it.

Looking Ahead

If you or someone you know has been diagnosed with genital warts, it is important to:

  • Know that HPV can spread to partners during sex, even if there are no warts.
  • Tell any sexual partners about warts before having sex.
  • Use a condom every time they have sex (vaginal, oral, or anal).
  • Get tested for other STDs as recommended by your health care provider.
  • Gets all doses of the HPV vaccine.

Rotavirus Infection is caused by Rotavirus, a contagious virus that causes diarrhea.

Overview – Rotavirus Infection

Rotavirus Infection is caused by Rotavirus, a contagious virus that causes diarrhea. It’s the most common cause of diarrhea in infants and children worldwide, resulting in over 215,000 deaths annually. Before the development of a vaccine, most children in the United States had been infected with the virus at least once by age 5.

Although rotavirus infections are unpleasant, you can usually treat this infection at home with extra fluids to prevent dehydration. Occasionally, severe dehydration requires intravenous fluids in the hospital. Dehydration is a serious complication of rotavirus and a major cause of childhood deaths in developing countries.

Good hygiene, such as washing your hands regularly, is important. But vaccination is the best way to prevent rotavirus infection.

Rotavirus transmission

Rotavirus is transmitted between hand and mouth contact. If you touch a person or object carrying the virus and then touch your mouth, you could develop the infection. This is most common from not washing your hands after using the toilet or changing diapers.

Infants and children under 3 are at the highest risk for rotavirus infection. Being in daycare also raises their risk. You might consider taking extra precautions during winter and spring months, as more infections occur this time of year.

The virus can also remain on surfaces for a few weeks after an infected person touches them. This is why it’s crucial to disinfect all common surfaces in your home frequently, especially if a member of your household has rotavirus.

Pathophysiology of Rotavirus Infection

Rotavirus, like other viruses that cause enteritis, primarily infects the cells of the small intestinal villi, especially those cells near the tips of the villi. Because these particular cells have a role in the digestion of carbohydrates and in the intestinal absorption of fluid and electrolytes, rotavirus infections lead to malabsorption by the impaired hydrolysis of carbohydrates and excessive fluid loss from the intestine. A secretory component of diarrhea with increased motility can further exacerbate the illness. This increased motility appears to be secondary to virus-induced functional changes at the villus epithelium.

The pathologic changes to the intestinal lining may not correlate well with the clinical manifestations of the illness. In normal hosts, infections rarely occur in another organ system, although extraintestinal infections have been seen in immunocompromised hosts.

The virus is shed in high titers in the stool starting before the onset of symptoms and persists for up to 10 days after symptom appearance.

What causes rotavirus in a child?

Rotavirus is most often spread through a fecal-oral route. This is often because a child does not wash his or her hands properly or often enough. It can also be caused by eating or drinking contaminated food or water.

The virus may live on surfaces such as doorknobs, toys, and other hard objects for a long time. For this reason, outbreaks can occur in households and child-care centers. To prevent the spread of the virus, children who aren’t sick should not be in contact with a sick child.

Risk factors of Rotavirus Infection

More common risk factors

Children are most at high risk of getting rotavirus disease. Risk factors associated with rotavirus infection include:

  • Those in child care centers or other settings with many young children are most at risk for infection.
  • Unvaccinated children, aged 3 to 35 months old, can be severely infected by rotavirus.

Less common risk factors

  • Older adults have, to some extent, the risk of getting infected.
  • Adults who are caring for infected children by rotavirus.
  • Immunocompromised patients like HIV patients.

What are rotavirus infection symptoms and signs?

Symptoms of the disease include fever, vomiting, and watery diarrhea. Abdominal pain may also occur, and infected children may have profuse watery diarrhea up to several times per day. Symptoms generally persist for three to nine days. Immunity from repeated infection is incomplete after a rotavirus infection, but repeated infections tend to be less severe than the original infection.

Rotavirus infection can be associated with severe dehydration in infants and children. Severe dehydration can lead to death in rare cases, so it is important to recognize and treat this complication of rotavirus infection. In addition to the symptoms of rotavirus infection discussed above, parents should be aware of the symptoms of dehydration that can occur with rotavirus infection or with other serious conditions.

Symptoms of dehydration include

  • Lethargy
  • Dry, cool skin
  • Absence of tears when crying
  • Dry or sticky mouth
  • Sunken eyes or sunken fontanel (the soft spot on the head of infants), and
  • Extreme thirst

Complications of Rotavirus Infection

Rotavirus infection in infants and young children can lead to severe diarrhea, dehydration, electrolyte imbalance, and metabolic acidosis.

Children who are immunocompromised because of congenital immunodeficiency or because of bone marrow or solid organ transplantation may experience severe or prolonged rotavirus gastroenteritis and may have evidence of abnormalities in multiple organ systems, particularly the kidney and liver.

Diagnosis and Test of Rotavirus Infection

A stool test can detect rotavirus.

In a laboratory, enzyme immunoassay can detect the virus.

Licensed test kits are available that are sensitive, specific and detect all serotypes of rotavirus.

Symptoms normally disappear without treatment.

A doctor should be consulted if:

  • Symptoms do not improve after a week
  • The individual has recently traveled abroad
  • There is blood or mucus in the stool

The person should also visit a doctor if they already have a weakened immune system, due to a health condition, such as acute leukemia, or as a side effect of medical treatment, such as chemotherapy.

How is rotavirus infection treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Antibiotics are not used to treat this illness. Medicines for diarrhea are also not recommended. Some healthcare providers may recommend probiotics. But their effectiveness is unclear.

The goal of treatment is to help reduce symptoms. Treatment may include:

  • Giving your child plenty of water, formula, breastmilk, or fluids with electrolytes (sugars and salts). Don’t give young children soda, juice, or sports drinks.
  • Feeding your child solid foods if he or she can eat. Don’t restrict food if your child is able to eat. Not having food may cause diarrhea to last longer.

If your child loses too much water, he or she may need to be in the hospital. Treatment there may include:

  • Intravenous (IV) fluids. A thin, flexible tube is put into your child’s vein. Fluids are given through this tube.
  • Blood tests. These are done to measure the levels of sugar, salt, and other chemicals (electrolytes) in your child’s blood.
  • Nasogastric (NG) tube feedings – a small tube may be placed into your child’s stomach through their nose

Rotavirus vaccines

The rotavirus vaccine was first introduced in the market in 2006. Before this time, it was commonplace for young children to have at least one bout of rotavirus infection.

You can help prevent rotavirus and its complications by making sure your child gets vaccinated. The vaccine comes in two forms:

  • Rotarix for infants 6 to 24 weeks old
  • RotaTeq for infants 6 to 32 weeks old

Both of these vaccines are oral, which means they are administered by mouth, not with an injection.

There is no vaccine available for older children and adults. This is why health professionals recommend getting the rotavirus vaccine for your child at a young age while you can.

Although the rotavirus vaccine can help, no vaccine is 100 percent effective in preventing future infections. You can talk to your pediatrician about the risks versus benefits of this type of vaccine, and whether it’s the best preventive measure for your child. Babies with severe combined immunodeficiency or intussusception, or who are already severely ill shouldn’t get the vaccine.

Rare side effects of the vaccine include:

  • Diarrhea
  • Fever
  • Fussiness
  • Irritability
  • Intussusception (very rare)

Lifestyle and home remedies

If your baby is sick, offer small amounts of liquid. If you’re breast-feeding, let your baby nurse.

If your baby drinks formula, offer a small amount of an oral rehydration fluid or regular formula. Don’t dilute your baby’s formula.

If your older child isn’t feeling well, encourage him or her to rest. Offer bland foods that don’t contain added sugar, such as whole-grain bread or crackers, lean meat, yogurt, fruits, and vegetables.

Plenty of liquids are important, too, including an oral rehydration fluid. Avoid soda, apple juice, dairy products other than yogurt, and sugary foods, which can make diarrhea worse.

Avoid anything that may irritate your stomach, including highly seasoned foods, caffeine, alcohol, and nicotine.

Prevention of Rotavirus Infection

Exclude people with rotavirus from childcare, preschool, school, and work until there has been no vomiting or diarrhea for at least 24 hours. If working as a food handler in a food business, the exclusion period should be until there has been no diarrhea or vomiting for 48 hours.

Infants, children, and adults with rotavirus infection should not swim until there has been no diarrhea for 24 hours.

The rotavirus vaccine provides good protection against the most common types of rotavirus. A rotavirus vaccine is recommended for all infants. The first dose of the rotavirus vaccine, in combination with other vaccines, is now recommended to be given at 6 weeks of age. It is important for immunization providers and parents to remember that there are upper age limits for the doses of vaccine. For more information see the rotavirus vaccine page.

Follow good hand washing and keeping areas clean procedures including objects (including toys) that may be shared.

Babies and small children without diarrhea who are not toilet trained should wear tight-fitting waterproof pants or swimming nappies in swimming pools and changed regularly in the change room. When fecal accidents occur, swimming pools should be properly disinfected.

Rapid Response Squad (RRS) have arrested six young men for stealing personal effects of couples whose vehicle had an accident.

Officers of the Rapid Response Squad (RRS) have arrested six young men for stealing personal effects of couples whose vehicle had an accident on Monday night, 3 January, 2022 at Otedola Bridge inward Ojodu-Berger, Lagos.

The suspects are: Stephen God’s love, 21; Christopher Edema, 25; David Tobore Sodiq, 22; Joseph Hassan, 23; Adebayo Rashid, 23; and Sulaiman Akinwunmi, 30.

The six suspects, were arrested at the scene of the accident when Rapid Response Squad (RRS) officials got to the place after them. The suspects were met fighting over the personal effects of the accident victims rather than assisting them as at the time the policemen got there.

The arrival of the RRS Team led to the recovery of a handbag containing the couples’ personal belongings and an Android phone. 

However, two Android phones belonging to the driver of the vehicle were missing. And, all efforts made to recover the two Android phones from the suspects proved abortive.

Preliminary investigations by the officers revealed that four of the suspects: Adebayo Rashid, David Tobore Sodiq, Stephen Godslove and Christopher Edema are ex – convict.

The six suspects were descending the slope of Otedola Bridge towards Olowopopo Road in groups when they witnessed the accident.

The suspects, according to the couples, “surrounded us and were robbing us while we were struggling to make it out of our vehicle. They were helping themselves with our phones and hand bag. Thank God RRS arrived the scene just in the nick of time.”

Luckily, while the victims’ vehicle was badly damaged, the couples did not sustain serious injuries.

Meanwhile, the Commander, Rapid Response Squad (RRS), CSP Olayinka Egbeyemi,k who condemned the actions of the six suspects after carefully listening to them directed that they be transferred to the Command’s Special Squad for further investigations and  prosecution.

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Breaking: Nigeria SSS invites Bishop Mathew Kukah for questioning after Christmas sermon.

The State Security Service has invited Bishop Matthew Kukah for questioning, days after the prominent Catholic priest ramped up his criticism of President Muhammadu Buhari for failing to curb nationwide insecurity, Peoples Gazette can report.

Mr Kukah had slammed Mr. President in his christmas sermon, saying the Nigerian leader has failed to show competence as terrorists, bandits and other violent criminals embark on a coordinated and relentless rampage across the country.

We also have lost count of hundreds of individuals and families who have been kidnapped and live below the radar of publicity,” Mr Kukah of Catholic Diocese of Sokoto said.

Does the President of Nigeria not owe us an explanation and answers as to when the abductions, kidnappings, brutality, senseless, and endless massacres of our citizens will end? We need urgent answers to these questions.

Mr Kukah’s comment, which was only the latest amongst several scathing criticisms he had directed at the president in recent years, drew criticism from Mr Buhari’s supporters.

The SSS, a federal secret police with a reputation for intimidating, arresting and assassinating government critics from military days, quickly ordered Mr Kukah to appear at its headquarters for questioning, according to a top source familiar with the invitation. 

Mr Kukah had yet to honour the invitation as of Saturday afternoon, The Gazette understands.

A spokesman for The Kukah Centre did not immediately return a request seeking comments on Saturday afternoon. 

A spokesman for the SSS sidestepped all queries from The Gazette about the development. 

Mr Kukah is revered amongst Nigeria’s political, business and religious elite for his relentless fight for justice and national unity.

His advocacy inspired other prominent Nigerians to speak up against wanton killings across the country since Mr Buhari assumed office and shunned a reconciliatory tone towards aggrieved elements.

Obadiah Mailafia, a former central banker who became a strong voice against the killing of Christians in central Nigeria, was invited repeatedly and periodically detained by the SSS.

In an interview he granted before his mysterious death in September 2021, Mr Mailafia alleged an attempt on his sponsored by the Buhari regime.

The government strongly denied the allegations but did not offer condolences to Mr Mailafia’s family.

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Human right activist Adeyanju Deji react over the killing of 200 people by bandit in Zamfara.

Lately, there have been series of insecurity issues in different parts of the country, most especially in the northern parts. Just recently, it was reported that over 200 people were killed and buried by bandits in Zamfara State.

The killing of these innocent Nigerians caused several Nigerians to react differently, including a well known human rights activist, Adeyanju Deji.

While reacting, he lamented, stating it clearly that over 200 people were killed and buried by bandits/terrorists in Zamfara State, yet nobody in the north talk about the killing.

Indeed this is so sad and unfortunate. For how long must these innocent Nigerians be killed? With the way things are going presently in Nigeria, it is clear that those in government have failed those who voted for them, by failing to protect them.

If nothing is done now to stop these terrorists from killing innocent Nigerians, any of us might eventually become a victim. Something must be done now before it becomes too late.

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South Africa should step up COVID-19 vaccinations, President Cyril Ramaphosa said on Saturday (Jan 8).

South African President Cyril Ramaphosa addresses a press conference after the G20 Compact with Africa conference at the Chancellery in Berlin, Germany, Aug 27, 2021. (File photo: Reuters/Pool/Tobias Schwarz)08 Jan 2022 10:45PM (Updated: 08 Jan 2022 10:45PM)

South Africa should step up COVID-19 vaccinations, President Cyril Ramaphosa said on Saturday (Jan 8), urging members of his governing African National Congress (ANC) party to fight vaccine hesitancy in communities.

Nearly 40 per cent of South Africa’s adult population has been fully vaccinated, higher than in many other African countries but less than the government had hoped for by this stage. Late last year, the government deferred some vaccine deliveries as the pace of inoculations slowed.

We can do better as South Africans, so I therefore urge all of us who have not yet been vaccinated, let us go out in our great numbers (and get the vaccine),” Ramaphosa told an ANC anniversary event.

The recovery of our economy is very much dependent on many of us being vaccinated.

The ANC wants a policy on vaccine mandates to be finalised, Ramaphosa added.

He had raised the possibility of vaccine mandates for certain places and activities in late November after local scientists alerted the world to the Omicron coronavirus variant, but that is yet to be implemented despite months of talks between the government, businesses and trade unions.

“We now need to give our people an incentive to go and be vaccinated, because that is the only defence and shield that we have,” he said.

The president, who contracted COVID-19 in December, said he had gone through “quite a lot of health difficulties” after testing positive but being vaccinated helped him stay out of hospital.

The ANC’s priorities for 2022 include addressing unemployment and poverty, restoring the party’s credibility and intensifying the fight against corruption, Ramaphosa continued.

A series of sleaze and corruption scandals under his predecessor, former president Jacob Zuma, tarnished the reputation of Africa’s oldest liberation movement.

Ramaphosa has made tackling graft a priority since taking over from Zuma as head of state in February 2018, although some opposition politicians have criticised him for doing too little to stop the rot when he was Zuma’s deputy.

The ANC is due to hold a leadership contest at the end of this year at which Ramaphosa is expected to seek re-election.

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Sports: Napoli sign Axel Tuanzebe on a loan.

Napoli have completed the signing of Manchester United centre back Axel Tuanzebe on loan until the end of the season, the Italian club announced on Saturday (Jan 8).

The 24-year-old has signed a temporary deal until June 30, 2022 with the Serie A side.

Tuanzebe, who spent last season on loan at English Premier League side Aston Villa, has struggled for game time in Manchester this term.

The England Under-21 international started six league games in 2021-22.

He will now bolster Luciano Spalletti’s side, who are third in Serie A, six points off top, and host Sampdoria on Sunday.

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