Ebola in African Countries

 Ebola in Africa

Ebola is the name of a particularly aggressive virus capable of producing potentially fatal hemorrhagic fever in humans and other primates (monkeys, gorillas, and chimps); the virus was discovered in 1976 in Congo (Africa).

It is a dangerous and frequently fatal disease that can be passed from person to person through direct contact with an infected patient's blood or secretions.

Origination of Ebola

The exact origins of the infection are unknown, but Guinean health officials connected the epidemic to the funeral of a nurse in early February in Goueké, near the southeastern town of Zerecoré.

The funeral was attended by all seven afflicted individuals. They later complained of diarrhea, vomiting, and bleeding. At least three of these people were killed. The others remain hospitalized.

In West Africa, traditional funerals are often the scene of community ceremonies where those present help wash the dead’s body. This can be especially dangerous if the corpse is infected with Ebola. The incubation period for the disease can last from two days to three weeks.

The outbreak in Guinea comes a week after the Democratic Republic of Congo (DRC) confirmed two Ebola deaths - three months after the Central African nation declared the end of an epidemic that spanned about half a year in 2020. , and which claimed 55 lives among 130 cases of infection. So far, the cases in Guinea and Congo do not appear to be related.

Symptoms of Ebola 

The virus  can appear after 2 to 21 days after exposure to the virus and include:

• fever,

• headache,

• joint and muscle pain,

• weakness,

• diarrhea,

• A stomach ache,

• lack of appetite.

Other symptoms may also occur including

• rash cutaneo,

• Red eyes

• and internal and external bleeding (hemorrhages).

The first symptoms with which the infection occurs are similar to other more common diseases and this makes a timely diagnosis difficult, which is usually confirmed through specific laboratory tests.

There is no specific cure, the treatment, therefore, includes supportive therapies such as

• fluids,

• oxygen

• and treatment of complications.

Considering overall the high mortality, the rapidity with which symptoms appear, and the localization of infections (usually isolated regions), the risk of a global epidemic is considered low; however, the virus could potentially be used as a biological weapon.

Ebola Virus

The virus has some animal species as its main reservoir, the bat seems to be the main one, and human beings can contract the virus from infected animals (which is confirmed to be absent in Italy ).

After initial transmission, viruses can spread from person to person through contact with contaminated body fluids or needles.

How Ebola Spread?

Since the main reservoir has not yet been proven with certainty, how the first human subject is affected has not yet been clarified, but it is speculated that it is through contact with an infected animal.

From animals to man

The virus could be transmitted to humans by exposure to the body fluids of an infected animal:

Blood: The slaughter or consumption of infected animals can spread the virus. Scientists who operated on infected animals contracted the virus as part of their research.

Waste products. Tourists of some African caves and some workers in mines have been infected with the Marburg virus, a similar virus, probably by contact with the feces or urine of infected bats.

From person to person

Infected people typically don't become contagious until they develop symptoms.

There is no evidence that the Ebola virus can be spread via insect bites.

When Ebola infection occurs in humans there are several ways the virus can be passed on to other men and women:

direct contact with fluids and secretions of an infected person (saliva, blood, sweat, feces, urine, vomit, semen, ...),

exposure to objects (such as needles) that have been contaminated with infected secretions.

The viruses that cause the disease find it easy to spread in families and groups of friends as they are subjects who come into close contact with the infecting secretions when caring for the sick. During outbreaks (i.e. small epidemics) the disease can spread rapidly even within health facilities (such as clinics and hospitals) if the staff does not wear adequate protective equipment such as masks, gowns, and gloves. Medical centers in Africa are often so poor that they have to reuse needles and syringes, and some of the worst Ebola outbreaks have occurred due to contaminated injections.

The contagiousness lasts as long as blood, secretions, organs, or semen contain the virus: Ebola virus has been isolated from sperm up to months after the onset of the disease, and transmission through sperm has been ascertained 7 weeks after clinical recovery (source: Safe Travel ).

Food and more

The Ebola virus does not spread through the air, water, or even food, although in reality there may have been cases of contagion in Africa due to the careless handling of the meat of wild animals that have come into contact with infected bats.

There is no evidence that mosquitoes or other insects can transmit the Ebola virus, and only a few mammal species (e.g. humans, bats, and monkeys) have demonstrated the ability to be infected with the Ebola virus.

Symptoms

The US CDC has reported the following criteria for identifying patients at risk:

Clinical criteria, including

• fever above 38.6 ° C,

• headache,

• muscle aches,

• diarrhea,

• abdominal pain,

• unexplained bleeding.

Epidemiological risk factors in the last 21 days before symptoms appear, such as

contact with the blood or other bodily fluids or human remains of a patient known to have or suspected of having the infection;

residence or origin from an affected area,

direct handling of bats or non-human primates from disease-endemic areas.

In the absence of both these conditions there is no reason to fear contagion, but let's see specifically the main symptoms of the disease.

The average incubation time is about 8-12 days, but it can vary from 2 to 21, while the average interval between the onset of the first symptoms and death varies from 3 to 21 days, with an average of about 10 days.

The first symptoms that appear in the case of Ebola are:

• fever (87% of patients),

• sore throat,

• skin rash (more visible in fair-skinned patients),

• red eyes and conjunctivitis,

• chills,

• joint and muscle pain,

• malaise,

• weakness (76% of patients).

Gastrointestinal symptoms may appear after about 5 days:

• watery diarrhea (66% of patients),

• nausea and vomiting (68% of patients),

• stomach pain,

• abdominal pain,

• loss of appetite (65% of patients).

and other symptoms such as

• chest pain,

• shortness of breath

• headache,

• confusion.

Some patients may also experience:

• hiccups,

• cough,

• convulsions,

• weight loss,

• difficulty swallowing,

• bleeding ( bleeding inside and outside the body).

Hemorrhage is not always present but can manifest itself in a second phase in the form of petechiae, bruising / hematoma, unjustified bleeding following injections.

In patients who will die, more severe clinical signs usually develop from the first days; on the contrary, in cases of recovery, patients may have a fever for several days and improve, usually around day 6, although they still need a prolonged convalescence.

Mortality among patients in West Africa in the epidemic that began in 2014 is about 71% (range from 46% in Nigeria to 69-72% in Guinea, Sierra Leone, and Liberia); risk factors significantly associated with a fatal outcome in affected African countries are:

• age over 45,

• unexplained bleeding,

• several other signs and symptoms that are not all common:

• diarrhea,

• chest pain,

• cough,

• respiratory difficulties,

• difficulty swallowing,

• conjunctivitis,

• sore throat,

• confusion,

• hiccup,

• coma or unconsciousness.

Unfortunately, pregnant women are usually subject to spontaneous abortion.

For people who survive, recovery is slow, it can take months to regain weight and strength, and the virus remains in the body for many months.

Dangers

According to the viral strain, the mortality rate is extremely high, ranging from 50 to 89%.

As the disease progresses it can cause:

• failure of several organs,

• severe bleeding,

• jaundice,

• delirium,

• convulsions,

• shock.

Finally, researchers have identified the so-called post-ebola viral syndrome, a condition capable of affecting a patient who has survived the infection and which manifests itself with the appearance of symptoms such as:

• joint pain,

• muscular pain,

• eye problems (in some cases blindness),

• neurological disorders,

• severe fatigue,

• hearing loss

• hair loss,

• changes in the menstrual cycle,

• long-term worsening of general health.

• Diagnosis

Early diagnosis of the disease is difficult because early symptoms such as red eyes and skin rash are non-specific and are often seen in patients with more common diseases.

Laboratory tests used in diagnosis include:

Within a few days after the symptoms begin

• ELISA test (Enzyme-Linked ImmunoSorbent Assay)

• IgM

• PCR

• Virus isolation

Later in the course of the illness or after hospitalization

• IgM and IgG antibodies

• In deceased patients

• Immunohistochemistry test

• PCR

• Virus isolation

Cure to Ebola || Treatment and therapy

The standard treatment for Ebola is unfortunately limited only to patient support and symptom management, as there are currently no specific drugs, through

administration of fluids and electrolytes via drip,

constant maintenance of the state of oxygenation and blood pressure, possibly also with transfusions,

treating any over-infections.

Early treatment is important, but unfortunately not easy as early diagnosis is not always possible.

Prevention of Ebola

Disease prevention presents many challenges; since the exact path of contagion is still unknown, some guidelines have been developed for health personnel to be adopted when the first cases appear, but in fact, isolation of the patient is essential to safeguard family and friends.

Also worth remembering for travelers:

• Avoid traveling to areas of known outbreaks.

• Wash your hands frequently, using soap and water or products containing at least 60 percent alcohol.

• Avoid bushmeat in developing countries.

• Avoid contact with infected people.

• Do not handle the remains of patients who have died of Ebola.

Vaccine for Ebola

On 11 November 2019, the first vaccine against Ebola was authorized for marketing, with the trade name Ervebo (produced by Merck Sharp & Dohme BV) and understudy since 2014 (the year of the most serious epidemic. never recorded in recent age).

This is a conditional authorization, which made it possible to adopt a more streamlined procedure than normal, by the pressing need to find an effective preventive solution to the emergency linked to the epidemic; this possibility is reserved for specific cases, where the advantage of immediate availability outweighs the risk associated with the availability of still incomplete data (generally speaking, therefore, of medicines aimed at treating, preventing or diagnosing seriously debilitating or life-threatening diseases).

In other words, the vaccine is still considered to be tested (in Congo, where the current mortality rate linked to the infection is about 67%), but according to the WHO it is considered sufficiently effective and safe to be able to enjoy a wider use; the current data speaking of efficacy in immunization equal to 97.5% of vaccinated patients.

Current information identifies classic reactions to injectable vaccines, such, as the most common side effects

• pain, swelling, and erythema at the injection site,

• headache,

• fever,

• muscle and joint pain,

• fatigue.

A second vaccine, made by Johnson & Johnson, was approved in July 2020 and several others are under study.

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Genital Herpes In Pregnant Women

 

Genital Herpes In Pregnancy

Genital herpes is a virus that can also be commonly contracted by pregnant women, who are at risk of transmitting it to the fetus by contact at the time of delivery. The incidence of this infection is 5-80 cases per 100,000 live births.

 In many cases, however, these are old herpes infections already before pregnancy itself, for this reason, the patient's personal history should be studied already at the beginning of the first trimester of gestation. In addition, women who have experienced recurrent herpes in their lives should be well informed about the risk of herpes transmission at the time of delivery.

Neonatal herpes is a severe systemic viral infection contracted in almost all cases through direct contact with maternal secretions at the time of delivery (rare cases of postnatal transmission are also reported).

Factors affecting the likelihood of transmission are the type of infection (primary or recurrent), the presence of protective maternal antibodies capable of crossing the placenta, the length of time between rupture of membranes and delivery, the use of monitoring on the fetal scalp and mode of delivery. Exceptionally, the congenital infection can be transmitted via the placenta.

 

The personal history of genital herpes should be investigated in every pregnant woman and their partners.

The risk of transmission to the newborn from an infected mother is high (30% -50%) in case of a primary infection contracted near the term of pregnancy. The risk of transmission to the newborn is low (<1%) in case of a primary infection contracted in the first half of pregnancy or case of recurrent episodes near the term of pregnancy.

The frequency of recurrent episodes in pregnancy, much higher than that of the first episode of infection, means that the proportion of newborns infected by a mother with recurrent infection remains consistent.

Given the possibility of asymptomatic infections, the first clinical episode may not coincide with the first infection so the distinction between primary or recurrent infection can be difficult. In case of a first clinical episode of genital herpes in the third trimester of pregnancy, it is advisable to perform an immunoassay (anti-HSV IgG assay 1 and 2), since the type of infection influences the probability of transmission and the mode of delivery.

How To Prevent Neonatal Herpes

The prevention of neonatal infection is based on two fundamental aspects:

 

1) preventing primary infection in women during the last trimester of pregnancy.

To this end, pregnant women should refrain from having sexual intercourse with infected or suspected partners during the last trimester of pregnancy.

Performing specific serological tests may be considered in pregnant women with HSV-infected partners. The efficacy of antiviral drug therapy in reducing the risk of transmission to pregnant women has not been studied.

 

2) Avoid exposure of the newborn to herpetic lesions during birth.

Viral cultures performed during pregnancy in women with or without visible genital lesions do not predict the possibility of virus shedding during childbirth and should not be performed routinely.

 

Cesarean section is recommended if genital herpetic lesions are present at the time of delivery, but not always.

In the case of primary infection, a cesarean section is recommended for lesions present at the time of delivery or appearing within 6 weeks of the term of pregnancy.

In the presence of active lesions from recurrent infection, not everyone agrees in recommending a cesarean section. According to the Royal College of Obstetricians and Gynaecologists, the low risk of neonatal transmission should be assessed in conjunction with the maternal risks associated with the surgery. The recommendation is not to perform the cesarean section routinely, but to agree on the mode of delivery based on the clinical circumstances and preferences of the woman. During vaginal delivery, invasive maneuvers (e.g. electrode on the fetal scalp) should be avoided.

Cesarean section is not recommended in case of a primary infection contracted in the first-second trimester of pregnancy, or a case of recurrent infection during pregnancy, due to the very low risk of transmission to the newborn.

The cesarean section does not eliminate the risk of transmission.

 
How Is Genital Herpes Diagnosed?

If you have blisters in your genital area, your doctor may order tests to diagnose genital herpes. Your doctor may take a sample of cells from the fluid inside the protrusion or order a blood test.

 

Therapy Of Genital Herpes

Oral acyclovir can be started during pregnancy in the event of an infectious episode to reduce the extent and duration of symptoms and shorten the virus shedding period. Treatment is well tolerated in late pregnancy, requires no dosage adjustment, and there is no evidence of maternal-fetal toxicity. In the case of therapy in the first trimester, some data report overlapping risks between women exposed to the drug and the general population, but given the limited number of pregnancies studied, it is not possible to draw definitive conclusions.

Acyclovir should therefore be used with caution before the 20th week of gestation, should be proposed in case of severe symptoms, or administered intravenously in disseminated forms. It is rarely needed in case of a recurring episode.

Studies on valacyclovir and famciclovir are still too scarce.

 

Suppressive therapy with acyclovir during the last 4 weeks of pregnancy reduces the presence of genital lesions at the time of delivery in women with recurrent herpes, thereby lowering the frequency of cesarean sections.

 

There are no studies to support the use of antiviral therapy in women serologically positive for HSV but without a history of genital herpes.

Infants exposed to the virus during birth should be closely monitored. Some specialists recommend carrying out cultures to identify the virus before the onset of the clinical picture, others recommend carrying out therapy with acyclovir on the newborn in case of primary maternal infection in the third trimester, given the high risk of transmission.

 

It is important to avoid herpes infection during pregnancy. The first episode during pregnancy can increase the risk of transmission to the newborn baby. However, it is rare for women with genital herpes to infect their babies. If you have active disease at the time of delivery, a cesarean section may be recommended.

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Genital Herpes In Women

Genital herpes

Genital herpes is a sexually transmitted disease (STD). The infection is caused by herpes simplex which differs into type 1 and type 2, the latter being the one that affects the genital area. It manifests itself as small blisters that can open, leaving open wounds in the vaginal and anal area, but also the thighs and buttocks. How is it transmitted and what is the cure?

What Are The Symptoms Of Genital Herpes

Symptoms of genital herpes are pretty specific, but they are common to other conditions as well. They can also be traced back to bacterial infections or vaginal mycosis. The only way to diagnose genital herpes is to do a physical exam, swab, or blood test. The main symptoms of herpes are:

 

Chapped, rough, or red skin around the genitals with or without pain, itching, or tingling;

Itching or tingling around the genitals or anal region;

Small blisters that rupture and cause painful sores and scabs;

Pain when urinating, especially in women;

Flu-like symptoms, such as fever, swollen lymph nodes, and fatigue;

The incubation period of herpes

Symptoms may go unnoticed at first and usually occur after five to six days or at most within two weeks of infection. But it is also possible not to have an initial outbreak after the infection and remain asymptomatic for months or even years.

 

After diagnosis, the partner must also undergo a tampon.

 

How Genital herpes is transmitted

Genital herpes is very easy to transmit and is very contagious. It can be transmitted through skin-to-skin contact with the infected area (including vaginal, anal, and oral sex). It can be prevented by using a condom during sexual intercourse, although it is also easy for the skin of the thighs to become infected and therefore this makes the protection of the condom completely ineffective.

 

How long does herpes last

Herpes may start with a first outbreak, which in many cases resolves spontaneously within a few days or may require an antiviral and pain treatment. But the virus remains dormant in the body and can cause new manifestations of the infection throughout life. Some people will never have symptoms again, while others may have several outbreaks throughout the year and this may require antiviral therapy for a longer time.

 
Genital Herpes, How to Treat

Genital herpes is a recurrent infection caused by two viral serotypes: HSV1 and HSV2. The serotype influences the prognosis: type 1 causes up to 30% of cases of primary infection, type 2 is the most involved in relapses. Clinical diagnosis is often insensitive and nonspecific because typical vesicular-ulcerative lesions are frequently absent in people infected with the virus.

 

Viral isolation in culture is the best diagnostic test in the case of active lesions, but loses sensitivity in the case of recurrent or healing lesions, with possible false negatives.

Viral DNA testing (PCR) is more sensitive, but not always feasible on genital samples. The negativity of culture tests does not indicate with certainty an absence of infection, since the viral antigen test does not allow the serotype to be distinguished, but it is possible with the serological antibody test, which is useful both for confirming the diagnosis and for identifying asymptomatic infected people.

Positive serology for HSV2 is in almost all cases due to anogenital infection, while in the case of isolated positive serology for HSV1 in an asymptomatic subject, it is not possible to distinguish between orolabial and anogenital infection.

 

Systemic therapy with antiviral drugs (acyclovir, famciclovir, valacyclovir) should be undertaken both in the case of the first infectious episode and in relapses, resulting in a marked improvement in the extent and duration of symptoms and a shortening of the elimination time of the virus. Therapy does not eradicate the infection, nor does it decrease, once interrupted, the risk, frequency, severity of relapses. Topical antiviral therapy offers little benefit and is not recommended.

 

In the case of a first clinical episode, the recommended treatment regimen is:

 

Acyclovir * 400mg orally three times a day for seven to ten days

or

Acyclovir * 200mg orally five times a day for seven to ten days

 

Famciclovir (250mg orally 3 times a day for 7-10 days) and Valacyclovir (1g orally 2 times a day for 7-10 days), judged to be equally effective, are much more expensive.

 

In case of relapses, you can choose:

 

episodic treatment, to be started within 1 day of the appearance of the lesions or the first symptoms:

Acyclovir 400mg orally three times a day for five days

or

Acyclovir 800mg orally 3 times a day for 2 days

or

Acyclovir 800mg orally 2 times a day for 5 days

or

Famciclovir 125mg orally 2 times a day for 5 days

or

Famciclovir 1000mg orally 2 times a day for 1 day

or

Valacyclovir 500mg orally 2 times a day for 3 days

or

Valacyclovir 1g orally 1 time a day for 5 days

 

 

the long-lasting suppressive treatment reduces the frequency of relapses by 70-80% in particularly prone patients (i.e. presenting more than 6 episodes in a year) and appears to reduce the risk of transmission to the partner

Acyclovir * 400mg orally 2 times a day

or

Famciclovir 250mg orally 2 times a day

or

Valacyclovir 1g orally 1 time a day

 

 

Suppressive therapy can be discontinued after one year and the patient reevaluated clinically. If frequent recurrences reappear, therapy can be restarted.

The efficacy and safety of the suppressive regimen have been demonstrated with both acyclovir * treatment for 6 years and famciclovir for 1 year. The result is a noticeable improvement in the quality of life of those affected.

 

Counseling infected people and their partners are very important. It is necessary to provide some fundamental information, in particular, it must be certain that the patient or the patient:

 

know the natural history of the disease, know the possibility of relapse and the risk of transmission, possible even in asymptomatic periods

be informed about possible treatments available to prevent or shorten the duration of relapses

are encouraged to inform current or future partners and to refrain from sexual intercourse with uninfected partners if prodromal symptoms or injury are present

be aware that the condom, when used correctly and if it covers infected areas, reduces the risk of sexual transmission

know that neonatal transmission is possible and that pregnant women should refrain from having sex with infected partners during the last trimester

Natural Remedies for Herpes

Here are some useful tips to naturally treat blisters at home and avoid acute symptoms:

 

·         Keep the area clean to prevent the blisters from becoming infected;

·         apply an ice pack wrapped in flannel fabric for pain relief;

·         rinse with warm water and 3% salt or boric acid;

·         applying petroleum jelly or a pain reliever cream to reduce pain when urinating;

·         use a topical gel-based on zinc sulfate and/or iodine;

·         pee in the bidet while keeping the water jet open, this should reduce the burning;

·         do not wear tight clothing that could irritate blisters or sores;

·         do not put ice directly on the skin do not touch the blisters or sores unless you are applying the cream;

·         avoid sexual intercourse until the sores have disappeared.

·         Supplementing with propolis, echinacea, and other natural immune system stimulants may also be helpful.

 

In any case, the woman is subjected to antiviral therapy starting from the 36th week of gestation, therefore in the vicinity of birth, which can be vaginal (although in particular circumstances a cesarean section may be recommended).

 

Frequently asked Questions

What if I don't have a lesion? || Herpes of The Mouth

Most patients with genital herpes do not have lesions. Many people do not realize they are infected with the genital herpes virus until a blood test shows they have antibodies to the virus.

 

Do condoms help prevent the spread of genital herpes?

Yeah. We always recommend using condoms to prevent herpes transmission. Many patients are contagious even when they have no symptoms. Many new herpes infections are caused by partners who are asymptomatically shedding the virus, so the use of condoms is highly recommended.

 

If you already have genital herpes, can it spread to other parts of the body, such as the arms or legs?

No. Genital herpes cannot spread to another part of your body, such as an arm, leg, or hand after the initial infection has occurred. If you have genital HSV II, you cannot transmit HSV II to another part of your body. The immune system produces antibodies that protect other parts of your body from infection.

 
Can genital herpes be transmitted through oral sex?

Yes: Genital herpes (type I or II) can be transmitted through oral sex.

 

Can I get genital herpes when I have cold sores in my mouth?

Yeah. Herpes is usually caused by HSV I. People who have HSV I are more likely to become infected with HSV II, the common cause of genital herpes.

 
Is genital herpes infection associated with HIV?

Herpes and HIV are caused by different viruses. However, patients infected with these viruses are more likely to transmit both diseases to their sexual partners. Herpes patients are more vulnerable to HIV infection. People newly diagnosed with herpes should be tested for HIV infection and other sexually transmitted infections.

 

Patients infected with both herpes and HIV may have a higher concentration of HIV in their bodies due to the interaction between the herpes virus and HIV. When HIV damages a person's immune system, the person is more likely to spread the herpes simplex virus.

 

Does Genital Herpes Affect Fertility?

Genital herpes, like other sexually transmitted diseases, can affect fertility because, if caught during pregnancy, it can be responsible for early miscarriage and preterm birth. Also, as we have seen, it can be passed on to the baby and neonatal herpes is a very serious condition.

 

Genital herpes in pregnancy

Women who have had herpes before pregnancy can expect to have no particular complications vaginal delivery goes well and there is no risk to the baby. This is because the antibodies already present should also protect the baby.

If, on the other hand, genital herpes occurs for the first time during pregnancy, there is a risk that the baby will develop a serious disease called neonatal herpes which requires immediate antiviral treatment.

 

 

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Cure of hepatitis b

 What is hepatitis b?

Hepatitis B is an inflammatory disease of viral origin, which involves the liver by altering its functionality.

Hepatitis B can occur in both acute and chronic forms. Usually, the acute form is self-limiting and resolves itself, while for the chronic form it is necessary to resort to the use of drugs.

How hepatitis b is transmitted || How hepatitis b spread

Hepatitis B is caused by a DNA virus belonging to the Hepadnaviridae family: the hepatitis B virus or HBV.

HBV is transmitted through the blood or body fluids (such as vaginal secretions and semen ) of infected individuals.

Those exposed to a greater risk of contagion are certainly drug addicts who often use used syringes (perhaps from infected people) to inject drugs, people who have unprotected sex, and health and emergency personnel who can easily enter contact with patients blood and body fluids. In addition, infants whose mothers have hepatitis B can become infected during childbirth.

Symptoms of Hepatitis B

Most individuals with hepatitis B show no symptoms of any kind. In the case of symptomatic hepatitis B, however, nausea and vomiting, weakness, fever, loss of appetite, muscle pain, abdominal pain, dark urine, light stools, and jaundice may occur.

In adult patients, hepatitis B usually occurs in an acute and asymptomatic form and tends to self-resolve. In children, on the other hand, the hepatitis B virus can cause chronic infections more easily than in adults. Chronic hepatitis B can lead to dangerous complications, such as cirrhosis, fibrosis, liver failure, and liver cancer.

The information on Hepatitis B - Medicines to Treat Hepatitis B is not intended to replace the direct relationship between health professionals and patients. Always consult your doctor and/or specialist before taking Hepatitis B - Medicines to Treat Hepatitis B.

What can cure hepatitis b? || Treatment of hepatitis b guidelines

The use or not of drugs for the treatment of hepatitis B depends on the form in which the disease presents itself.

The acute form of hepatitis B usually does not require any type of therapy, since the immune system can eradicate the virus independently. Despite this, patients with acute hepatitis B must still keep the course of the disease under control using appropriate analyzes and must introduce small changes in their lifestyle.

More specifically, this category of patients must adopt a balanced diet rich in light foods, avoid hyperlipidemic foods and alcohol, drink plenty of fluids, and rest. For further information: Diet and Hepatitis

The question is different, however, for patients suffering from chronic hepatitis B. In this case, it is necessary to resort to the use of drugs, such as antivirals and immunostimulants, even if it is not always possible to completely eradicate the infection.

The following are the classes of drugs most used in the therapy against chronic hepatitis B and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.

Interferons

Interferons are proteins that are normally produced by our immune system when the presence of dangerous agents such as viruses, bacteria, parasites, and even cancer cells is detected.

Medicines based on interferons contain, in fact, these proteins and are defined as immunostimulating drugs since they can "collaborate" with the patient's immune system, helping him to eradicate, in this case, the viral infection.

Among the interferons used for the treatment of chronic hepatitis B, we find:

Natural interferon-alpha (Alfaferone ®): even if the optimal dosage of the drug for the treatment of chronic hepatitis B has not yet been exactly established, the dose of natural interferon-alpha usually used is 2.5-5 million IU / m 2 of body surface area, to be administered three times a week intramuscularly or subcutaneously. The duration of treatment is generally 4-6 months.

Interferon alfa-2a (Roferon-A ®): the drug dose usually administered for the treatment of chronic hepatitis B is 2.5-5 million IU / m 2 of body surface area, to be administered subcutaneously three times a week, for 4-6 months.

Interferon alfa-2b ( IntronA ®): for the treatment of chronic hepatitis B, the dose of drug usually used is 5-10 million IU, to be administered subcutaneously three times a week on alternate days.

Peginterferon alfa-2a ( Pegasys ®): the dose of drug usually used for the treatment of chronic hepatitis B in adults is 180 micrograms once a week, to be administered subcutaneously. For children, the amount of drugs to be given varies according to their height and body weight.

Antivirals for the treatment of chronic hepatitis B

As can be deduced from their very name, the antiviral drugs used for the treatment of chronic hepatitis B have the task of fighting and eradicating the HBV virus.

Among the antivirals used in the treatment of chronic hepatitis B, we find:

Lamivudine ( Zeffix ®, Lamivudine Teva ®): the dose of the drug usually administered is 100 mg per day, to be taken orally. In patients with kidney problems, the doctor may decide to prescribe a lower dose of lamivudine than is normally used.

Adefovir ( Hepsera ®): the dose of antiviral usually used is 10 mg per day, to be taken orally. Lower doses of adefovir may be prescribed in patients with kidney disorders.

The drugs just described can be taken individually or in combination. The following combined therapies can also be used for the treatment of hepatitis B :

Interferon alfa + lamivudine;

Peginterferon alfa + lamivudine or adefovir;

Adefovir + lamivudine.

Furthermore, it is good to remember that all patients with hepatitis B (acute or chronic) must avoid the use of paracetamol, ibuprofen, acetylsalicylic acid, and other drugs that can overload the liver already tried by the disease.

Vaccines for Hepatitis B

In any case - despite the presence of different therapeutic strategies for the treatment of hepatitis B - the best weapon against this pathology remains prevention. 

in this regard, a vaccine and immunoglobulin treatments are available that are used in the immunoprophylaxis of hepatitis B:

Hepatitis B vaccine ( Hbvaxpro ®): the vaccine is administered in three different doses of 5 micrograms each in patients aged 0 to 15 years. It is administered intramuscularly (generally in the thigh of newborns and infants and in the deltoid muscle of children and adolescents). The first two injections must be given one month apart, while the third dose is injected six months after the first administration.

The vaccine can guarantee immunization from the hepatitis B virus for 20 years.

Anti-hepatitis B immunoglobulins (Igantibe ®, Niuliva ®): immunoglobulins allow to obtain passive immunization against the hepatitis B virus.

Immunoglobulins can be administered intramuscularly in non-immunized subjects who have come into contact with the HBV at a dose of 500 IU, but the injection should preferably be done within 24-72 hours of contact with the virus.

Immunoglobulins are also used to prevent the onset of the disease in newborns whose mothers are affected by hepatitis B at a dose of 30-100 IU / kg of body weight.

Also, if needed, immunoglobulins can be given to people who have already received the hepatitis B vaccine., even on the same day, provided that the administration takes place at different points.

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Remove kidney stones

Kidney stones is a complication that can arise from subjective predisposition or for factors such as obesity, unbalanced diet, poor hydration, infections, or simply because a subject eliminates excess substances such as calcium or uric acid or has to a lesser extent, in the body, chemicals such as citrates or magnesium that prevent their formation.

Removing Kidney stones by surgery

Usually, this procedure is practiced only in case of large and complex kidney stones, such as mold stones. A stencil stone is a stone that extends into large sections of the renal pelvis or one or more renal calyxes.

 Percutaneous nephrolithotripsy (PCNL) involves the removal of kidney stones by creating an artificial opening in the back. To do this, the kidney is pricked from the hip directly through the skin. 

This allows an endoscope to be inserted into the collecting apparatus of the kidneys, where the stone is located. This is usually done under general anesthesia. 

The urinary tract is prepared for the operation with the patient in the lithotomy position. After that, the patient is turned over on his stomach so that he is face down. This allows you to perform the surgery on your back.

The puncture occurs under visual control using radiographic and ultrasound imaging. Once the endoscope, which can be the thickness of a pencil, has been inserted into the kidney, it is possible to crush the stone with a laser or ultrasound probe and then remove the pieces.

 To finish the operation, a catheter is inserted into the kidney (external urinary derivation via the flank) or a ureteral stent (internal derivation) to avoid obstruction of the urinary flow.

Usually, the patient has to stay in the hospital for three to five days. If the procedure is performed by an experienced surgeon, the complication rate is usually low.

Kidney stones: what are the surgical options?

Stones that fail to proceed into the ureter must undergo surgical treatment. It is possible to resort to different techniques, the choice of which naturally depends on the characteristics, size, location, and several stones. Surgical procedures include;

EXTRACORPOREAL LITHOTRYSIS

PERCUTANEOUS RENAL LITHOTRISSY

URETRORENOSCOPY  (endoscopic urethral lithotripsy)

OPEN SURGICAL TREATMENT

Remove kidney stone procedure

EXTRACORPOREAL LITHOTRYSIS: consists of the fragmentation of small stones from outside the body, which are subsequently eliminated in the urine. This therapeutic method is minimally invasive and is mainly used for some calcium oxalate stones, struvite stones, and uric acid stones. On the contrary, the calculations of cystine and those of oxalate calcium monohydrate do not respond well to extracorporeal technique, therefore, are generally removed by percutaneous or transurethral lithotripsy;

PERCUTANEOUS RENAL LITHOTRISSY: it is performed through a hole at the lumbar level from which one enters with an instrument that allows the destruction of the stone and the aspiration of the fragments;

URETRORENOSCOPY  (endoscopic urethral lithotripsy): another solution is endoscopic removal. In practice, thin probes are introduced through the urethra, along the urinary tract, to reach the point where a small stone has stopped, to mobilize it, and make it go down into the bladder. An endoscopic method, which can always be performed by penetrating through the urethra and moving up from the bladder to the ureter, is ultrasound ureteroscopy. This procedure allows you to get to the stone and break it into fragments, which can then be eliminated together with the urine or removed with small pliers or "baskets".

OPEN SURGICAL TREATMENT: in cases so complex that the endoscopic approach is not recommended, it may be necessary to resort to open surgery, which involves opening the abdomen.

To know more on the various ways to Remove Kidney Stones CLICK HERE

            Remove kidney stones by laser

What is laser lithrotrissia?

Laser lithrotrissia is a surgical technique used to remove kidney stones using wave types: ultrasonic, electrohydraulic, or shock. 

The holmium laser, in particular, is among the most advanced techniques and allows the treatment of urethroscopy or endoscopy, using a laser beam of thermal energy that eliminates the obstructive tissue.

 This is a minimally invasive procedure that is usually done under local anesthesia or mild sedation to eliminate the pain of the surgery.

Why is it performed?

Laser lithrotrissia is used to fragment all types of kidney stones, whether they are cystine, calcium oxalate monohydrate, or brushite (calcium phosphate). It offers:

Great effectiveness in fragmenting any calculation

Maximum surgeon control during treatment as the laser introduces minimal propulsion or movement into the stone

Optimal use of fibers of different calibers and of great flexibility, which can be used with any endoscope

What does it consist of?

Laser lithrotrissia (remove kidney stones with laser) is a minimally invasive technique. Access to kidney stones is through a puncture in the skin at the lumbar level or the urethra to the bladder or ureter, depending on where the stone is located. 

Introduced is an optical fiber tube with a rigid and flexible tip, connected to a camera. Once the stones are located, they are fragmented with laser pulsation. The energy contained in the laser allows you to act quickly on the calculation.

Preparation for laser litrotrissia (remove kidney stones with laser)

Before carrying out laser lithotripsy(remove kidney stones with laser), the patient must communicate to the doctor:

If you are or might be pregnant

The medications you are taking

In addition, the doctor may request, in the days before the surgery to stop taking acetylsalicylic acid, anti-inflammatories, or drugs that make it difficult for blood to clot. On the day of the procedure, the patient must:

Do not drink or eat for several hours before surgery

Take the medications indicated by your doctor accompanied only by a small sip of water

Care after surgery

Inserting an endoscopic instrument into the urinary tract can cause it to swell, which can, in turn, obstruct the passage of urine from the kidney to the bladder. Consequently, a catheter should be temporarily placed within the urinary tract. Although it is slightly annoying, it is useful for carrying out normal urination.

 In addition to the discomfort of the urethral catheter in some cases, there may be slight bleeding in the urine, which does not last for more than 5 days.

It is always recommended that the patient be accompanied, even though it is an outpatient procedure, and that he be accompanied home. Once at home, rest and taking antibiotics and anti-inflammatories are indicated. 

The following day the patient can already return to daily activities. However, It is necessary to drink plenty of fluids in the following weeks: 8-10 glasses per day, to help remove debris. One month after the procedure, the patient will have to undergo a metabolic examination, with an evaluation of urine and blood for 24 hours, to study the factors that can intervene in the formation of stones. To this is added a 

                      remove kidney stones without surgery

Extracorporeal shock wave lithotripsy is the non-invasive procedure par excellence and is indicated when the stone is placed in the kidney and has a small size (less than 1.5 - 2 centimeters). 

The patient is made to lie down on the machine (lithotripter) by placing his side on a pillow filled with water. The calculation is shattered thanks to the shock waves generated by the machine and all conveyed to the calculation. The treatment does not include anesthesia, does not require hospitalization, and has a duration of 45-60 minutes.

 The stone fragments are then excreted in the urine over the next few days.

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Snakes in toilets|| How do snakes get in toilets

As of late, there has been worry over reports of a said woman to have passed on from a snake bite when she was involving the Toilet in her condo prompting many asking how that could be within the realm of possibilities.

To be sure, snakes can get into toilets through the interfacing lines and pits outside the house or get into the house, and afterward slither up and, or fall into the Toilet subsequent to being in the house

To see how section through pipes and interfacing pits occurs, one can initially check out the construction of the Toilet and how it associates with outside elements of the strong waste arrangement of a structure

A Toilet typically has three openings.

The first and greatest opening is the edge or top of the toilet; it is the part through which squanders from people (pee and crap) are delivered in the  toilet. Snakes can get into the toilet in the event that they move over the edge from the  toilet floor underneath, or from an open or broken window above. They may likewise fall into it from a stature over the edge for example open or broken roof, or the highest point of storage spaces and stacks around

The subsequent one is a little opening found simply behind and exceptionally near the highest point of the  toilet. This opening conveys the little line that acquires the flushing shower into the  toilet from the tank over the  toilet that holds the flush water. Snakes can get into this opening through the tank yet this possibly occurs assuming the front of the tank is broken, not sitting as expected or has been intentionally taken out and the flush siphon isn't set up. The flush siphon ordinarily covers the highest point of this line from inside the tank.

The third and last opening is a 100mm (four inches) wide round opening on the rear of the  toilet, it opens straightforwardly into the huge lines that interface the structure to the underground pits and tanks outside the structure

Most hid reptiles found in the  toilet typically get into the  toilet utilizing this last opening

How?

The line interfaces the  toilet to a review chamber, a crate like design right external the house, generally exceptionally near the mass of the  toilet, which thusly has pipes that connect to the septic tank (or, and, drench away pit,) and a vent pipe, that permits foul air to escape from the chamber and the septic tank/splash away pit.

A snake can get into an opening on the associating pipes, the investigation chamber, septic tank, splash away pit (like a major break on the cover chunk) and advantageously advance into the line that connects the  toilet seat to these designs, then, at that point, up, into the house.

The vent pipe is normally the most fragile moment that it isn't as expected covered or its cover tumble off and is left unattended

Hence, snakes get into  toilet

Try not to visit the  toilet without a light

Continuously review the  toilet toilet and its environmental factors before use

Try not to utilize the toilet floor as pressing space. Keep it clean to such an extent that it is not difficult to see on the double whether it is spotless and clear, or involved by unfamiliar bodies.

Review vent pipes, splash away pits and assessment chambers, roofs, rooftops, dividers, windows intermittently for openings, breaks and loosed covers. Fix this when they are taken note.

Recruit the perfect individuals to assemble, keep up with or clean your home or haven.

Permit great and clear space between your structure and encompassing designs, for example, fences and trees from which snakes can get into structures

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