Tensions have mounted between the West and Russia over accusations Moscow is preparing to invade Ukraine.
If Moscow escalates the Ukrainian security crisis, the United States may refer the matter to the UN Security Council, US officials said Friday (Jan 14), stressing Washington still favors a diplomatic solution.
“If Russia takes action, we’re not going to hesitate to pursue an appropriate response in the Council and defend the principles of the UN Charter,” a US official told reporters, on condition of anonymity.
“All options for Security Council response are on the table and we’re discussing all of those with other Security Council members and with partners here in New York,” the official added. “We are looking at the appropriate time to raise the issue in the Council.”
Russia has amassed tanks, artillery and tens of thousands of troops near the border of Ukraine as it demands guarantees that its neighbor will never join NATO.
US officials said earlier Friday they had obtained intelligence showing Russia is planning a “false-flag” operation to create a pretext for an invasion.
“If Russia further escalates tension to really go to the heart of the principles and commitments that all nations states have made in the UN Charter … there will be obviously an opportunity for discussion at the UN Security Council,” another US official said, also on condition of anonymity.
The second official said the Security Council will in part be a forum “where you can see publicly a debate between the US and Russia in the event of they choose (an) escalatory path.”
But he reiterated the US stance that Washington and its allies “vastly prefer … a path of diplomacy.”
So far, the UN has stayed silent on the recent mounting tensions between Moscow and Washington, two permanent members of the Security Council with veto power over its decisions.
UN chief Antonio Guterres has himself made few comments on the Ukraine issue, and none of the other 13 members of the Security Council has so far requested a meeting on the crisis.
According to oneworld news channel it was gathered that the US Secretary of State Antony Blinken said on Thursday (Jan 13) that North Korea may be seeking attention with its missile launches, which he said were destabilising.
The top US diplomat renewed calls for North Korea to sit down for talks with the United States, which he said harboured no hostile intent toward Kim Jong Un’s regime.
I think some of this is North Korea trying to get attention. It’s done that in the past; it’ll probably continue to do that, Blinken said in a televised interview with MSNBC.
North Korea’s tests are profoundly destabilising, it’s dangerous, and it contravenes a whole host of UN Security Council resolutions, Blinken said.
North Korean state media reported on Wednesday that Kim personally oversaw a successful launch of a hypersonic missile, the second such launch by the nuclear-armed nation in less than a week.
Washington soon afterward announced sanctions on five north koreans linked to the ballistic missile programme, prompting accusations from a foreign ministry spokesman in Pyongyang that it was intentionally escalating” the situation.
If the US adopts such a confrontational stance, the DPRK will be forced to take stronger and certain reaction to it”, the spokesman said in comments carried by state news agency KCNA early Friday in North Korea.
Diplomacy has been at a standstill since Kim held three meetings with former US president Donald Trump, who took an unusually personal approach to the diplomacy.
Trump’s talks did not produce a lasting agreement and North Korea has not shown interest in offers of lower-level engagement by President Joe Biden’s administration.
North Korea tested a railway-borne missile in its firing drills on Friday (Jan 15), state media KCNA said on Saturday, marking its third weapons test this month.
South Korea’s Joint Chiefs of Staff said it had detected what it presumed were two short-range ballistic missiles launched eastward from North Pyongan Province on the northwest coast of North Korea.
The official KCNA news agency said a firing drill was held to “check and judge the proficiency in the action procedures of the railway-borne regiment,” which the country tested for the first time last September, designed as a potential counter-strike to any threatening forces.
The spokesperson said the new sanctions underscore hostile US intent aimed at “isolating and stifling” the North despite Washington’s repeated calls for Pyongyang to resume diplomacy that has stalled over disagreements about sanctions relief and nuclear disarmament steps.
The Biden administration on Wednesday imposed sanctions on five North Koreans over their roles in obtaining equipment and technology for the North’s missile programs in its response to the North’s latest missile test this week and also said it would seek new United Nations sanctions.
The announcement by the Treasury Department came just hours after North Korea said leader Kim Jong Un oversaw a successful test of a hypersonic missile on Tuesday that he claimed would greatly increase the country’s nuclear “war deterrent”.
Brugada syndrome is a genetic disorder that can causes a dangerous irregular heartbeat. In many cases, a defect in the SCN5A gene causes the genetic form of this condition. When this defect occurs, it may cause a ventricular arrhythmia. This is a type of irregular heartbeat. When this happens, the lower chambers of your heart (ventricles) beat irregularly and prevent blood from circulating properly in your body. This can be dangerous and may result in fainting or even death, especially during sleep or rest. The disease has been known as sudden, unexplained nocturnal death syndrome because people with it can often die in their sleep.
Brugada syndrome is rare. It affects about 5 of every 10,000 people worldwide. Symptoms usually show up during adulthood, although the disorder can develop at any age, including infancy. The average age of death related to the disease is 40 years old.
Types of ECG in Brugada Syndrome
There are three types of ECG findings in Brugada syndrome patients:
Type I: Lead V1 has a “coved” ST segment elevation of at least 2 millimeters, followed by a negative T wave.
Type II: There is a “saddleback” appearance of the ST segment in lead V1 with ST segment elevation of at least 2 millimeters; this can be present in normal individuals as well.
Type III: Features of type I (coved) or type II (saddleback) with less than 2 millimeters of ST segment elevation.
It can run in families. About 30% of people who have it have a problem with a gene that helps their heart stay in normal rhythm. If you have a family member who has it, you may want to see your doctor to find out if you’re at risk for it too.
In other cases, doctors don’t know what causes it. Some possibilities include:
High levels of calcium in your blood
Medicines that treat high blood pressure, depression, or chest pain
Very high or very low levels of potassium
There are a few risk factors for developing Brugada syndrome. These include:
Family history. Since the mutations that cause Brugada syndrome can be inherited, if someone in your immediate family has it, you may have it as well.
Although the condition can affect both males and females, it’s 8 to 10 timesTrusted Source more common in men than in women.
Brugada syndrome appears to occur more frequently in people of Asian ancestry.
Brugada syndrome is an example of a channelopathy, a disease caused by an alteration in the transmembrane ion currents that together constitute the cardiac action potential. Specifically, in 10-30% of cases, mutations in the SCN5A gene, which encodes the cardiac voltage-gated sodium channel Nav 1.5, have been found. These loss-of-function mutations reduce the sodium current (INa) available during the phases 0 (upstroke) and 1 (early repolarization) of the cardiac action potential.
This decrease in INa is thought to affect the right ventricular endocardium differently from the epicardium. Thus, it underlies both the Brugada ECG pattern and the clinical manifestations of the Brugada syndrome.
The exact mechanisms underlying the ECG alterations and arrhythmogenesis in Brugada syndrome are disputed. The repolarization-defect theory is based on the fact that right ventricular epicardial cells display a more prominent notch in the action potential than endocardial cells. This is thought to be due to an increased contribution of the transient outward current (Ito) to the action potential waveform in that tissue.
A decrease in INa accentuates this difference, causing a voltage gradient during repolarization and the characteristic ST elevations on ECG. Research has provided human evidence for a repolarization gradient in patients with Brugada syndrome using simultaneous endocardial and epicardial unipolar recordings. See the image below.
When the usual relative durations of repolarization are not altered, the T wave remains upright, causing a saddleback ECG pattern (type 2 or 3). When the alteration in repolarization is sufficient to cause a reversal of the normal gradient of repolarization, the T wave inverts, and the coved (type 1) ECG pattern is seen. In a similar way, a heterogeneous alteration in cardiac repolarization may predispose to the development of reentrant arrhythmias, termed phase 2 reentry, which can clinically cause ventricular tachycardia and ventricular fibrillation.
An alternative hypothesis, the depolarization/conduction disorder model, proposes that the typical Brugada ECG findings can be explained by slow conduction and activation delays in the right ventricle (in particular in the right ventricular outflow tract).
One study used ajmaline provocation to elicit a type 1 Brugada ECG pattern in 91 patients, and found that the repolarization abnormalities were concordant with the depolarization abnormalities and appeared to be secondary to the depolarization changes. Using vectorcardiograms and body surface potential maps, investigators were able to show that depolarization abnormalities and conduction delay mapped to the right ventricle.
Many people don’t know that they have Brugada syndrome. This is because the condition either doesn’t cause noticeable symptoms or causes symptoms that are similar to other arrhythmias.
Some signs that you may have Brugada syndrome include:
Experiencing heart palpitations
Having an irregular heartbeat
Gasping for breath or having difficulty breathing, particularly at night
Sudden cardiac arrest
Symptoms can also be brought on by a variety of factors, including:
Having a fever
What are complications of Brugada Syndrome?
If Brugada syndrome is untreated, the irregular heartbeats can cause fainting (syncope), seizures, and difficulty breathing, often when an affected person is resting or asleep. Sudden death is the most serious complication of Brugada syndrome. It usually happens unexpectedly, while a person is sleeping.
Complications of the use of an implantable cardiac defibrillator (ICD) may include:
Diagnosis of Brugada Syndrome
If your doctor thinks you might have Brugada syndrome, they’ll recommend a physical exam along with some other tests:
Electrocardiogram (EKG or ECG)
This test records the electrical activity of your heart to find out if there’s a problem with its rhythm. A technician will put electrodes (small patches with wires) on your chest that pick up and record electrical signals from your heart. You also might take medication — usually given through an IV — that will help identify a certain pattern caused by Brugada syndrome.
Electrophysiology studies (EPS)
If an EKG shows you have Brugada syndrome, this test can help your doctor see where the arrhythmia is coming from and understand how to treat it. You’ll be given some medication to make you sleepy. Then they’ll put a flexible tube (called a catheter) through a vein in your groin and up to your heart. Electric signals are sent through the catheter, and they record what’s happening in the different areas.
Genetic testing can help to confirm the diagnosis of Brugada syndrome, but is usually not helpful in estimating a patient’s risk of sudden death. Furthermore, genetic testing in Brugada syndrome is quite complex, and often does not yield clear-cut answers. Still, it can be useful to help identify affected family members.
Treatments for Brugada Syndrome
There’s currently no cure for Brugada syndrome, but there are things you can do to reduce your risk of experiencing serious problems.
If your doctor thinks your risk of developing a dangerously fast heartbeat is low, you might not need any treatment at first.
You can reduce your risk of developing a fast heartbeat by avoiding things that can trigger it, including:
A high temperature – if you develop a high temperature, take painkillers such as paracetamol to bring it down; get medical advice as soon as possible if this does not help
Drinking too much alcohol – avoid drinking lots of alcohol in a short space of time
Dehydration – get medical advice if you have diarrhoea or you keep being sick, as you may lose a lot of fluid and may need to take special rehydration drinks
Certain medicines – make sure any healthcare professional you see knows you have Brugada syndrome, and avoid medicines that can trigger the condition unless they’re recommended by a doctor – the BrugadaDrugs.org website has more information about medicines that could act as possible triggers
If there’s a high risk you could develop a dangerously fast heartbeat, your specialist may recommend having an implantable cardiac defibrillator (ICD) fitted.
An ICD is a small device placed in the chest, similar to a pacemaker. If it senses your heart is beating at a dangerous speed, it sends out an electric shock to help it return to normal.
An ICD does not prevent a fast heartbeat, but can help stop it becoming life threatening.
Antiarrhythmic drugs such as Isoproterenol which are used during ventricular arrhythmias and electrical storms.
How do you prevent Brugada Syndrome?
Many cases of Brugada syndrome are related to a genetic defect. It’s not possible for you to prevent inheriting this condition. However, identifying the condition is key to preventing its potential complications. If you have Brugada syndrome and plan to have children, you may want to consult with a genetic counselor first.
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine (hematuria) and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi.
The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters.
Pathophysiology of stone formation
Calcium stone formation begins with the formation of calcium phosphate deposits (Randall plaques) on the external urothelial surface of the papilla. Hence, calcium oxalate stones typically have a small component of calcium phosphate (apatite or brushite).
If small particles were not anchored to these plaques, they would simply wash into the urine. Stone formation requires that crystalloids be present in supersaturating concentrations; but even when this condition is met, the stone formation may not occur in the presence of adequate concentrations of inhibitors, including citrate, magnesium, and macromolecules.
On the other hand, some substances, such as uric acid and alkaline urine pH, act as promoters to facilitate stone formation at a given level of supersaturation.
Urinary saturation approximates the ratio of the concentration product (eg, of calcium oxalate) to its solubility in urine. At values greater than 1 (supersaturation), crystal formation is favored; values below 1 do not support the stone formation and some crystals (uric acid, cystine) may even dissolve.
Stone formation correlates with supersaturation values, and measuring supersaturation may be helpful, for example, in monitoring calcium-phosphorus supersaturation in patients with stones who are receiving alkali therapy.
Commercial laboratories offer urinary metabolic profiles that also include urinary saturation of calcium oxalate, calcium phosphate, and uric acid
Types of Kidney stone
Knowing the type of kidney stone helps determine the cause and may give clues on how to reduce your risk of getting more kidney stones. Types of kidney stones include:
Calcium stones: Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate levels. Your liver also produces oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones may also occur in the form of calcium phosphate.
Struvite stones: Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.
Uric acid stones: Uric acid stones can form in people who don’t drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.
Cystine stones: These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
Other stones: Other, rarer types of kidney stones can occur.
Kidney stone risk factors
Risk factors include:
Dehydration: Not drinking enough fluids can make pee become extra-concentrated. This increases the chance of crystals forming.
An unhealthy diet and lifestyle: Drinking lots of sugary, caffeinated, or sports drinks and eating a diet high in sodium (salt) can increase the risk of calcium stones. Obesity also can make kids more likely to get them.
Urinary tract defects: A structural defect in the urinary tract can block the flow of pee and create an area where it collects in a tiny pool. When pee stops flowing, crystal-forming substances may settle together and form stones.
Some medicines: Some prescription and over-the-counter medicines can increase the risk of kidney stones if taken in large doses.
Metabolic disorders: Having a metabolic disorder (a problem in the way the body breaks down and uses food) can lead to concentrated levels of oxalate (a substance made in the body and found in some foods) or cystine in the urine.
Cystinuria: This genetic condition causes too much cystine to pass from the kidneys into the pee, causing cystine stones.
Other medical conditions: A number of diseases and conditions can increase the risk of kidney stones, including gout (a type of arthritis), other kidney diseases, conditions that affect the thyroid or parathyroid gland, and some urinary tract infections (UTIs).
Causes of Kidney stone
Kidney stones are common. Some types run in families. They often occur in premature infants.
There are different types of kidney stones. The cause of the problem depends on the type of stone.
Stones can form when urine contains too much of certain substances that form crystals. These crystals can develop into stones over weeks or months.
Calcium stones are the most common. They are most likely to occur in men between ages 20 to 30. Calcium can combine with other substances to form the stone.
Oxalate is the most common of these. Oxalate is present in certain foods such as spinach. It is also found in vitamin C supplements. Diseases of the small intestine increase your risk of these stones.
Calcium stones can also form from combining with phosphate or carbonate.
Other types of stones include:
Cystine stones can form in people who have cystinuria. This disorder runs in families. It affects both men and women.
Struvite stones are mostly found in women who have a urinary tract infection. These stones can grow very large and can block the kidney, ureter, or bladder.
Uric acid stones are more common in men than in women. They can occur with gout or chemotherapy.
Other substances such as certain medicines also can form stones.
The biggest risk factor for kidney stones is not drinking enough fluids. Kidney stones are more likely to occur if you make less than 1 liter (32 ounces) of urine a day.
Stones in the kidney often do not cause any signs and can go undiagnosed. When a stone leaves the kidney, it travels to the bladder through the ureter. Often the stone can become lodged in the ureter. When the stone blocks the flow of urine out of the kidney, it can cause the kidney to swell (hydronephrosis), often causing a lot of pain.
Common symptoms of kidney stones are:
Sharp, cramping pain in the back and side, often moving to the lower abdomen or groin. Some women say the pain is worse than childbirth labor pains. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone.
A feeling of intense need to urinate.
Urinating more often or a burning feeling during urination.
Urine that is dark or red due to blood. Sometimes urine has only small amounts of red blood cells that can’t be seen with the naked eye.
Nausea and vomiting.
For men, you may feel pain at the tip of the penis.
Kidney stone complications
Complications can occur after the treatment of large kidney stones.
Your surgeon should explain these to you before you have the procedure.
Possible complications will depend on the type of treatment you have and the size and position of your stones.
Complications could include:
Sepsis, an infection that spreads through the blood, causing symptoms throughout the whole body
A blocked ureter caused by stone fragments (the ureter is the tube that attaches the kidney to the bladder)
An injury to the ureter
A urinary tract infection (UTI)
Bleeding during surgery
Diagnosis and test
Diagnosis starts with a physical exam and review of your medical history. Other tests include:
Blood test: to measure how well your kidneys are functioning, to look for signs of infection, and to look for biochemical problems that lead to forming kidney stones.
Urine sample test: to look for signs of an infection and to examine the levels of the stone-forming substances- calcium, oxalate, urate, cysteine, xanthine, and phosphate.
Imaging tests: to see the size, shape, and location of the stones; determine the most suitable treatment, and sometimes to review the result of treatment. Types of imaging tests used are X-rays, CT scan, and ultrasound. Both X-ray tests and CT scans use a small amount of radiation to create their images.
Two types of X-rays are used: a standard X-ray of the urinary tract or a special type of X-ray called an intravenous pyelogram (IVP). If an IVP is ordered, you receive an injection of a dye in your vein before the X-ray is taken. The dye is used to get a sharper image of problems in the kidneys, ureters, and bladder resulting from urine being blocked.
A CT scan of the abdomen is an imaging test that creates a 3-dimensional view of the organs within the abdominal cavity. It is used with or without the injection of a dye in your vein. This test shows the stone size and location and conditions that may have caused the stone to form. In addition, the other organs within this area of the body can be evaluated.
An ultrasound of the urinary tract uses sound waves to detect kidney stones and indirect signs of kidney stones, such as changes in the kidney’s size and shape.
Kidney stones usually pass on their own without causing any long-term problems. If they don’t, or if you’re in a lot of pain, your doctor can break up or remove the crystals.
Your treatment depends on where and how big your stone is and what symptoms you have.
First, You Wait
If your stone doesn’t bother you, your doctor may suggest you wait 2-4 weeks for it to pass on its own. She may tell you to drink extra water to help flush it out of your body.
She may ask you to catch the stone in a strainer when you pee. A lab can test it for minerals to see if medication might prevent more stones.
If you’re in discomfort, you can manage your symptoms while you wait for the stone to exit.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can help. You might also need a drug to ease nausea.
Prescription drugs can help hurry the stone along:
Calciumchannel blockers and alpha-blockers: These relax your ureter, the tube through which pee passes from your kidney to your bladder. A wider ureter will help the stone move more quickly.
Potassiumcitrate orsodium citrate: If your stone is made from uric acid, the doctor might give you one of these solutions to dissolve it.
Sometimes, a stone is too big to come out by itself. Your doctor may have to break it up or remove it. She also may do that if you are:
In a lot of pain
Have an infection
Unable to pee because the stone is blocking the flow
Your doctor can choose from several procedures.
Shock wave lithotripsy (SWL) is the most common treatment in US. It works best for small or medium stones. Your doctor aims high-energy sound waves to break up the kidney stone into little pieces. The shock waves come from outside the body, which is why the procedure sometimes is called extracorporeal SWL.
Ureteroscopy, which involves passing a very thin tube (ureteroscope) into the urinary tract to the stone’s location, where instruments can then be used to remove the stone or break it up for easier removal. Occasionally, you may need a small hollow tube (ureteral stent) placed in the ureter for a short time to keep it open and drain urine and any stone pieces. Ureteroscopy is often used for stones that have moved from the kidney to the ureter.
Percutaneous nephrolithotomy, which is the most effective way to remove large stones. This surgery generally requires a small (1 cm) incision in the side or back and the use of a scope to remove the kidney stone. This procedure is performed on an inpatient basis.
Prevention of Kidney stone
Some general precautions for a patient diagnosed with kidney stone disease are:
Increase your daily fluid intake (water intake should exceed two liters per day)-if you already have a renal failure you need to check with your doctor about how much water you can have.
Lower the content of animal protein in your diet (reduce meat intake)
Limit coffee, tea, and cola intake
Do not take the excess of Vitamin D supplements. Take them only as prescribed.
Lower daily salt intake (2000 mg sodium restriction per day)
Lemon and cranberry juice are considered safe
Lower intake of high oxalate content foods (example: spinach, beets, and chocolate)
Staph infection is caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections. But staph infections can turn deadly if the bacteria invade deeper into your body, entering your bloodstream, joints, bones, lungs or heart. A growing number of otherwise healthy people are developing life-threatening staph infections. Treatment usually involves antibiotics and drainage of the infected area. However, some staph infections no longer respond to common antibiotics.
What are some types of staph infections?
Types of staph infections include:
Blisters – These look similar to a whitehead or a pimple. Once it breaks open and the pus drains out, the infection’s threat goes away.
Boils – Deeper than blisters, with the skin surrounding a boil, appear red, swollen and sore. It’s often very painful.
Impetigo – This contagious skin infection looks like a rash with a yellow crust. Impetigo sometimes secretes fluid and also is painful. You often see impetigo among children. It’s typically not serious and can be treated with a topical antibiotic.
Cellulitis – This skin inflammation occurs when your infection gets under the layers of your skin and spreads. It causes redness and painful swelling. You may even develop sores. Cellulitis can become more serious if it’s not treated immediately.
Sepsis – If your skin infection is severe it can progress to a more advanced stage known as sepsis. This inflammation, which enters your bloodstream, is more dangerous to older adults.
Endocarditis – Endocarditis occurs when staph enters your bloodstream and attacks your heart. Doctors typically treat it with strong antibiotics. Surgery is sometimes necessary if the infection damages your heart valves.
Pathophysiology of staph infection
For the majority of diseases caused by S. aureus, pathogenesis is multifactorial, so it is difficult to determine precisely the role of any given factor. However, there are correlations between strains isolated from particular diseases and expression of particular virulence determinants, which suggests their role in a particular disease. The application of molecular biology has led to advances in unraveling the pathogenesis of staphylococcal diseases. Genes encoding potential virulence factors have been cloned and sequenced, and many protein toxins have been purified. With some staphylococcal toxins, symptoms of human disease can be reproduced in animals with the purified protein toxins, lending an understanding of their mechanism of action.
Human staphylococcal infections are frequent but usually remain localized at the portal of entry by the normal host defenses. The portal may be a hair follicle, but usually it is a break in the skin which may be a minute needle-stick or a surgical wound. Foreign bodies, including sutures, are readily colonized by staphylococci, which may make infections difficult to control. Another portal of entry is the respiratory tract. Staphylococcal pneumonia is a frequent complication of influenza.
The localized host response to staphylococcal infection is inflammation, characterized by an elevated temperature at the site, swelling, the accumulation of pus, and necrosis of tissue. Around the inflamed area, a fibrin clot may form, walling off the bacteria and leukocytes as a characteristic pus-filled boil or abscess.
More serious infections of the skin may occur, such as furuncles or impetigo. Localized infection of the bone is called osteomyelitis. Serious consequences of staphylococcal infections occur when the bacteria invade the bloodstream. Resulting septicemia may be rapidly fatal; bacteremia may result in seeding other internal abscesses, other skin lesions, or infections in the lung, kidney, heart, skeletal muscle or meninges.
What causes staphylococcal infection?
Despite being harmless in most individuals, S aureus is capable of causing various infections of the skin and other organs. S aureus infection is common in people with frequent skin injuries, particularly if the skin is dry. Staph skin infections are seen most commonly in prepubertal children and certain occupational groups such as healthcare workers. But they may occur for no obvious reason in otherwise healthy individuals.
Most staphylococcal infections occur in normal individuals, but underlying illness and certain skin diseases increase the risk of infection. These include:
Medication with systemic steroids, retinoids, cytotoxics or immunosuppressives
Immunoglobulin M deficiency
Chronic granulomatous disease
Job and Wiskott Aldrich syndromes (associations of severe staphylococcal infection with eczema, raised immunoglobulin E and abnormal white cell function)
Who Is at Risk for Staph Infections?
While anyone can get a Staph infection, some conditions put people at higher risk including:
Women who are breastfeeding
Vascular or lung disease
Weakened immune system
Those who inject drugs or medications
Skin injuries or disorders
Use of intravenous catheters
What Are the Signs & Symptoms of a Staph Skin Infection?
Staph skin infections show up in lots of different ways. Conditions often caused by S. aureus include:
Folliculitis: This is an infection of the hair follicles, the tiny pockets under the skin where hair shafts (strands) grow. In folliculitis, tiny white-headed pimples appear at the base of hair shafts, sometimes with a small red area around each pimple. This happens often where people shave or have irritated skin from rubbing against clothing.
A furuncle, commonly known as a boil: These swollen, red, painful lumps in the skin usually are due to an infected hair follicle. The lump fills with pus, growing larger and more painful until it ruptures and drains. Furuncles often begin as folliculitis and then worsen. They most often appear on the face, neck, buttocks, armpits, and inner thighs, where small hairs can get irritated. A cluster of several furuncles is called a carbuncle. Someone with a carbuncle may feel ill and have a fever.
Impetigo: This superficial skin infection is most common in young children, usually on the face, hands, or feet. It begins as a small blister or pimple and then develops a honey-colored crust.
Cellulitis: This begins as a small area of redness, pain, swelling, and warmth on the skin, usually on the legs. As this area spreads, a child may feel feverish and ill.
A stye: Kids with one of these have a red, warm, uncomfortable bump near the edge of the eyelid.
MRSA: This type of staph bacteria is resistant to the antibiotics used to treat staph infections. MRSA infections can be harder to treat, but most heal with proper care. Most MRSA infections involve the skin.
Scalded skin syndrome: This most often affects newborns and kids under age 5. It starts with a small staph skin infection, but the staph bacteria make a toxin that affects skin all over the body. The child has a fever, rash, and sometimes blisters. As blisters burst and the rash passes, the top layer of skin sheds and the skin surface becomes red and raw, like a burn. This serious illness affects the body in the same way as serious burns. It needs to be treated in a hospital. After treatment, most kids make a full recovery.
Wound infections: These cause symptoms (redness, pain, swelling, and warmth) similar to those from cellulitis. A person might have a fever and feel sick in general. Pus or a cloudy fluid can drain from the wound and a yellow crust can develop.
What are the complications of staph infections?
Scalded skin syndrome is a potentially serious side effect of infection with staph bacteria that produce a specific protein that loosens the “cement” holding the various layers of the skin together.
This allows blister formation and sloughing of the top layer of skin. If it occurs over large body regions, it can be deadly, similar to a large surface area of the body having been burned.
It is necessary to treat scalded skin syndrome with intravenous antibiotics and to protect the skin from allowing dehydration to occur if large areas peel off.
The disease occurs predominantly in children but can occur in anyone. It is known formally as staphylococcal scalded skin syndrome
Treatment for staph infection
Treatment of a staph infection may include:
Antibiotics. Your doctor may perform tests to identify the staph bacteria behind your infection and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin. Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines. But vancomycin and some other antibiotics have to be given intravenously. If you’re given an oral antibiotic, be sure to take it as directed, and to finish all of the medication prescribed by your doctor. Ask your doctor what signs and symptoms you should watch for that might indicate your infection is worsening.
Wound drainage. If you have a skin infection, your doctor will likely make an incision into the sore to drain fluid that has collected there.
Device removal. If your infection involves a device or prosthetic, prompt removal of the device is needed. For some devices, removal might require surgery.
Diagnosis of staph infection
For skin infections, a doctor’s evaluation
For other infections, a culture of blood or infected body fluids
Staphylococcal skin infections are usually diagnosed based on their appearance.
Other infections require samples of blood or infected fluids, which are sent to a laboratory to grow (culture), identify, and test the bacteria. Laboratory results confirm the diagnosis and determine which antibiotics can kill the staphylococci (called susceptibility testing).
If a doctor suspects osteomyelitis, X-rays, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Radionuclide Bone Scanning, or a combination is also done. These tests can show where the damage is and help determine how severe it is. A bone biopsy is done to obtain a sample for testing. The sample may be removed with a needle or during surgery.
How can you prevent a staph infection?
Practice good hygiene.
Wash your hands often with soap and clean, running water. You can also use an alcohol-based hand sanitizer. Hand-washing is the best way to avoid spreading bacteria.
Keep cuts and scrapes clean. Cover them with a bandage. Avoid contact with other people’s wounds or bandages.
Don’t share personal items such as towels, face cloths, razors, or clothing.
Keep your environment clean by using a disinfectant to wipe surfaces you touch a lot. These include countertops, doorknobs, and light switches.
If you’re in the hospital, remind doctors and nurses to wash their hands before and after they touch you.
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). The virus is primarily spread when an uninfected (and unvaccinated) person ingests food or water that is contaminated with the feces of an infected person. The disease is closely associated with unsafe water or food, inadequate sanitation, poor personal hygiene, and oral-anal sex.
Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms and fulminant hepatitis (acute liver failure), which is often fatal. Overall, WHO estimated that in 2016, 134 persons died worldwide (accounting for 0.5% of the mortality due to viral hepatitis).
It occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. The HAV is one of the most frequent causes of foodborne infection. Epidemics related to contaminated food or water can erupt explosively, such as the epidemic in Shanghai in 1988 that affected about 300 000 people. They can be also prolonged, affecting communities for months through person-to-person transmission. Hepatitis viruses persist in the environment and can withstand food-production processes routinely used to inactivate and/or control bacterial pathogens.
The incubation period of hepatitis A virus (HAV) is 15-45 days (average, 4 weeks). The virus is excreted in stool during the first few weeks of infection, before the onset of symptoms. Young children who are infected with HAV usually remain asymptomatic. Acute hepatitis A is more severe and has higher mortality in adults than in children. The explanation for this is unknown.
HAV is not directly cytopathic to the hepatocyte. Injury to the liver is secondary to the host’s immune response. Replication of HAV occurs exclusively within the cytoplasm of the hepatocyte. Human leukocyte antigen (HLA)-restricted, HAV-specific CD8+ T lymphocytes, and natural killer cells mediate hepatocellular damage and destruction of infected hepatocytes. Interferon-gamma appears to have a central role in promoting the clearance of infected hepatocytes.
What causes hepatitis A and how is it contracted?
People develop hepatitis A infection after contracting HAV. This virus is typically transmitted by ingesting food or liquid contaminated with fecal matter that contains the virus. Once transmitted, the virus spreads through the bloodstream to the liver, where it causes inflammation and swelling.
In addition to transmission from eating food or drinking water containing HAV, the virus can also be spread by close personal contact with an infected person. HAV is contagious, and a person who has this can easily pass the disease to others living in the same household.
You can contact by:
Having food prepared by someone with the HAV
Consuming food handled by preparers who don’t follow strict hand-washing routines before touching food that you eat
Eating sewage-contaminated raw shellfish
Not using condoms when having sex with someone who has the hepatitis A virus
Drinking polluted water
Coming in contact with HAV infected fecal matter
If you contract the virus, you will be contagious two weeks before symptoms even appear. The contagious period will end about one week after symptoms appear.
Who is at Risk for Hepatitis A Infection?
Anyone who is not immune can get hepatitis A infection. Food-borne outbreaks occur sporadically throughout the USA. Certain groups of people do have a higher risk of developing HAV infection and should be vaccinated:
Persons experiencing homelessness
Persons living in the same household with an infected person
Sex partner(s) of an infected person
Persons traveling to countries where hepatitis A is common
Men who have sex with men
People who use injection drugs
Children in daycare
People who eat raw or under-cooked shellfish
What Are the Symptoms of Hepatitis A?
You can get the first symptoms anytime between 15 and 50 days after you came in contact with the virus. But they usually show up between about 2 and 4 weeks later.
Most people usually have sudden:
Loss of appetite
Muscle aches and pains
Nausea and vomiting
Several days later, some symptoms of liver problems can show up. You may have:
Light-colored bowel movements
Yellow skin (jaundice). It’s less common in children under age 6.
Yellowing of the white part of your eyes
Pain in the upper right part of your belly
If your child has hep A, he may also have:
If you’re over age 50 or have long-term liver disease, you may have a more severe case of the disease called fulminant hep A infection. You could have symptoms like:
Spontaneous bleeding or easy bruising
Confusion and changes in alertness
The liver function that gets worse
Yellowing of the skin and eyes that gets worse
What are the complications of hepatitis A?
People typically recover without complications. In rare cases, it may lead to liver failure. Liver failure due to this infection is more common in adults older than age 50 and in people who have another liver disease.
Older people and people with other medical conditions, such as diabetes, anemia or congestive heart failure, may take longer to recover from the infection.
How Is Hepatitis A Diagnosed?
The health care professional will ask questions about the illness and symptoms, and about any possible exposures to other people diagnosed with hepatitis, especially the type of hepatitis (type A, B, C, or others).
If the health care professional determines that the patient may be at risk for contracting hepatitis, then it is likely the patient will undergo blood tests.
The blood will be tested to determine how well the liver is functioning.
A test will be ordered to detect antibodies to hepatitis A. The results of this test will also determine if the patient has been recently exposed to HAV.
Blood probably will be tested for the hepatitis B and hepatitis C viruses, and others. For example, if a patient has had a large amount of vomiting or has not been able to take in liquids, the blood electrolytes may be out of balance. Blood chemistry may be tested to check electrolytes.
Treatment and Medications
There is no specific treatment, but supportive therapy can improve comfort levels and prevent complications such as dehydration and exhaustion.
Replenishing nutrition and fluids
Rest, with time off work
Taking over-the-counter (OTC) pain relievers if needed
Patients with significant nausea and vomiting may be admitted to the hospital for intravenous (IV) fluids.
Complications are rare, and most people recover fully. Around 85 percent of people with HAV-infected recover fully within 3 months, and most people have complete recovery by 6 months.
Precautionary treatment after exposure
If a person has not been vaccinated, and they know they have been exposed to HAV, they can still receive either the vaccine or immune globulin within 2 weeks of the exposure.
This may include:
Colleagues of a food handler who has tested positive for HAV
Employees and children in a daycare center where someone has received a diagnosis of HAV
Anyone in close personal contact with a person who has HAV, including nurses or carers
Which treatment they should receive will depend on the age and health status of the person.
Are There Home Remedies for Hepatitis A?
The following measures can help you feel better while you are having symptoms.
Take it easy; curtail normal activities and spend time resting at home.
Drink plenty of clear fluids to prevent dehydration.
Avoid medicines and substances that can cause harm to the liver such as acetaminophen (Tylenol) and preparations that contain acetaminophen.
Should alcoholic beverages, as these can worsen the effects of HAV on the liver.
Reduce prolonged, vigorous exercise until symptoms start to improve.
Prevention / Vaccination
Can hepatitis A be prevented?
Yes. The best way to prevent it is through vaccination with the hepatitis A vaccine. To get the full benefit of the hepatitis A vaccine, more than one shot is needed. The number and timing of these shots depend on the type of vaccine you are given. Practicing good hand hygiene – including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food – plays an important role in preventing the spread of hepatitis A.
Who should get vaccinated?
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for the following people:
All children at age 1 year
Travelers to countries where hepatitis A is common
Family and caregivers of adoptees from countries where hepatitis A is common
Men who have sexual encounters with other men
Users of recreational drugs, whether injected or not
People with unstable housing or experiencing homelessness
Having chronic or long-term liver disease, including hepatitis B or hepatitis C
People having clotting factor disorders
People with direct contact with others who have hepatitis A
Any person wishing to obtain immunity (protection)
How is the hepatitis A vaccine given?
The hepatitis A vaccine is safe and effective and given as 2 shots, 6 months apart. Both shots are needed for long-term protection. The hepatitis A vaccine also comes in a combination form, containing both hepatitis A and B vaccine, that can be given to anyone 18 years of age and older. This combination vaccine is given as 3 shots, over 6 months. All three shots are needed for long-term protection for both hepatitis A and B.
Is the hepatitis A vaccine effective?
Yes, the hepatitis A vaccine is highly effective in preventing HAV infection. A second hepatitis A shot results in long-term protection.
Is the hepatitis A vaccine safe?
Yes, the hepatitis A vaccine is safe. No serious side effects have been reported. Soreness at the injection site is the most common side effect reported. As with any medicine, there is always a small risk that a serious problem could occur after someone gets the vaccine.
Molar Pregnancy often referred to as Hydatidiform Mole is a rare pregnancy complication. Molar pregnancy is basically a type of gestational trophoblastic disease that occurs when tissues that instead of normally developing into a fetus, turns into an abnormal growth. The condition is characterized by unusual growth of trophoblasts, the cells which normally develop and form a major part of the placenta in pregnancy.
A molar pregnancy can be a scary thing as the growth inside is not an embryo but a chromosomal abnormality. The abnormal tissue needs to be treated right away as it can cause serious complications in some women.
Types of Molar Pregnancy
There are two main types include:
Complete molar pregnancy
The fertilized egg of a healthy pregnancy is made up of 23 chromosomes from the mother and 23 chromosomes from the father.
In a complete molar pregnancy, genetic material from the mother is lost at the time of fertilization. The egg contains only 23 chromosomes from the father and no chromosomes from the mother at all. This means that there is no baby.
The placenta develops rapidly with abnormal cells that grow as cysts. These cysts grow in clusters and can be seen on ultrasound. They are referred to as a mole.
Partial molar pregnancy
In a partial molar pregnancy, the egg has the usual 23 chromosomes from the mother but is fertilized by two sperm, each with 23 chromosomes which makes 69 chromosomes in total rather than the normal 46.
Some normal placental tissue forms among the abnormal cells and a baby may begin to develop, but it will be genetically abnormal and unable to live beyond 3 months.
Things that may increase your risk include:
Age: The risk of complete molar pregnancy steadily increases after age 35.
A history of molar pregnancy, especially if you’ve had two or more.
A history of miscarriage
A diet low in folic acid or carotene: Carotene is a form of vitamin A. Women who don’t get enough of these vitamins have a higher rate of complete molar pregnancy.
Causes of Molar Pregnancy
It is not fully understood why molar pregnancies happen. However, molar pregnancies are more common:
In teenagers and women in their 40s
In women from Asia
If you have had a molar pregnancy in the past
At first, your pregnancy might seem normal. But over time, you may start to notice the following:
Bleeding from your vagina in the first 3 months of pregnancy
Watery brown discharge
Sacs (they look like clusters of grapes) that pass out of your vagina
Nausea and vomiting that are more frequent or severe than what’s normal during pregnancy
Lots of pressure or pain in your pelvis
Call your doctor if you have these or any other unusual symptoms during pregnancy.
Molar pregnancy is usually diagnosed early with minimal symptoms, but if a diagnosis is delayed the following complications can arise:
Breathlessness (when it spreads to the lungs)
Pre-eclampsia (toxaemia of pregnancy), involving high levels of certain substances in the blood that raise blood pressure and affect the kidneys and (sometimes) liver function
Excess thyroid hormone production, which causes heart palpitations and other thyroid hormone effects.
If a molar pregnancy is not treated or does not miscarry completely it can progress and cause a range of serious conditions (known as gestational trophoblastic neoplasia), including:
Persistent GTD- Persistent growth of the abnormal placental tissue
Invasive mole- The tumour spreads into the wall of the uterus
Metastatic mole- Molar cells migrate to other organs of the body and cause secondary tumours. The lungs are common sites for metastatic moles
Gestational choriocarcinoma- A rapidly spreading type of cancer that can travel to any part of the body via the blood vessels or lymphatic system.
Diagnosis and test
Molar pregnancy is diagnosed using:
Medical history, which could include current pregnancy or recent childbirth, miscarriage or abortion
Blood test to check for high levels of the pregnancy hormone hCG
ultrasound (the most common imaging tool used)
Other scans including x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) if it is thought cancer may have spread to other areas of the body.
Molar pregnancy can be hard to diagnose because:
A woman who experiences a miscarriage will not know whether or not she passed a hydatidiform mole unless the aborted tissue is examined in a laboratory.
If recent pregnancy, labour, and birth were normal, there is often no reason to suspect molar pregnancy until symptoms become apparent.
Treatment and medications
A molar pregnancy can’t continue as a normal viable pregnancy. To prevent complications, the abnormal placental tissue must be removed. Treatment usually consists of one or more of the following steps:
Dilation and curettage (D&C): To treat a molar pregnancy, your doctor will remove the molar tissue from your uterus with a procedure called dilation and curettage (D&C). A D&C is usually done as an outpatient procedure in a hospital.
During the procedure, you’ll receive a local or general anesthetic and be positioned on the operating room table on your back with your legs in stirrups. Your doctor will insert a speculum into your vagina, as in a pelvic exam, to see your cervix. He or she will then dilate your cervix and remove uterine tissue with a vacuum device.
Hysterectomy: Rarely, if there is an increased risk of gestational trophoblastic neoplasia (GTN) and there’s no desire for future pregnancies, the uterus may be removed (hysterectomy).
HCG monitoring: After the molar tissue is removed, your doctor will repeat measurements of your HCG level until it returns to normal. If you continue to have HCG in your blood, you may need additional treatment.
Once treatment for the molar pregnancy is complete, your doctor may continue to monitor your HCG levels for six months to one year to make sure there’s no remaining molar tissue. Because pregnancy HCG levels also increase during a normal pregnancy, your doctor may recommend you wait six to 12 months before trying to become pregnant again. Your provider will recommend a reliable form of birth control during this time.
It is not much you can do to prevent a molar pregnancy. Should one occur, there are some serious but uncommon risks, including:
Dangerous levels of bleeding if your body passes the tissue on its own.
Possible development of cancerous tissue if some of the mole remains inside your uterus.
Although it is distressing to find out that you have a molar pregnancy, the good news is that it is manageable and that most women who have a molar pregnancy will go on to have healthy pregnancies in the future.
The Nigeria President, Muhammadu Buhari has ordered an immediate termination of the contract awarded to Integrated Logistics Services (Intels) which belong to the Former Vice President Atiku ABUBAKAR.
The contract was awarded to carry out the restoration of the boat pilotage for the Nigerian Ports Authority (NPA).
Recent Reports reveals that President Buhari cancelled the contract on legal advice from the Attorney-General of the Federation and Minister of Justice, Abubakar Malami (SAN) as well as the Director-General, Bureau of Public Procurement (BPP), and Acting Director-General, Infrastructure Concession and Regulatory Commission (ICRC).
Intels, is partly owned by Abubakar and an Italian national, Gabriele Volpi, won the pilotage contract in January 2021.
In a letter dated January 7, 2022, and signed by the Chief of Staff to the President, Ibrahim Gambari, President Buhari directed the termination of Intels contract with the NPA.
Buhari’s letter was also addressed to Malami and the Minister of Transportation, Rotimi Amaechi, directing that the procurement process initiated by NPA be forwarded immediately to the BPP for action within 60 days to avoid further loss of revenue.
The President added that the Ministry of Transportation should present a memorandum on the procurement process to the Federal Executive Council (FEC) for consideration.
He, however, directed the NPA to ensure that the sanctity of the agreements with respect to Onne 4 (Berths 9, 10 & 11) be maintained, as there is no subsisting contract with Intels for their utilization.