Symptoms of an ill traveller. Diagnosing the tropical traveller

In every ill traveller is necessary to consider the symptoms thatt may reveal a tropical disease:

Malaria
It presents with fever,rigors,headache,dizzines,flulike symtopms,diarrhea.
Mosquitos may stowaway in luggage causing malaria in non -tropical areas.
Typhoid
It presents with fever,relative bradicardia (low heart rate),abdominal pain,dry cough,constipation,lymphodenophaty (lymph nodes abnormal in size),headache and rarely rose spots.
Dengue fever
Its presents with fever,headache,myalgia,skin rush,pallor.
Amoebic liver abscess
Presents with fever,jaudince,upper abdomen pain.

Travelling to a tropical area does not mean that having fever or headche symptoms are signs of a tropical disease,that's why is necessary to have a doctor visit a the necessary investigations in establishing the exact diagnosis in time,prevent catching a tropical disease by vaccination before travveling and avoid as much as possible contact with contaminated food and water.

Disorders of urinary system.Who is most at risk of developing urinary disorders?

The urinary system rids your body of waste,so it is crucial that functions well.

The urinary system,also known as the urinary tract,consist of a pair of kidneys,the bladder,the ureters,which connect each kidney to the bladder and the urethra,through which urine leaves the body.
Most kidney diseases affects the filtration capacity of the kidneys,causing them to lose function.
Kidney disorders are broadly classified as acute (the sudden failure of the kidney,which may be fatal) or there may ba a gradual reduction in fucntion over months or years,in which case it is chronic.
Although the urinary system is structured in a way that help ward off infection,infections can occur.
They are caused by germs that get into the urethra,which can spread to the kidneys.

Urinary tract infections

Infections can occur if bacteria get into the body via the bloodstream or the urethra.Urinary tract infections (UTI's) are more common in women.
Despite containing fluids,salts and waste products,urine is sterile (free from germs such as bacteria).An infection occurs only when bacteria begin to grow.A woman's urethral opening lies near sources of bacteria from the anus and vagina.
Infections often start in the urethra.From there,the bacteria can move up into the bladder,causing an infection (cystitis).If the infection si not treated,it can spread to the kidneys,causing pyelonephritis,which is serious and can demage the kidneys.

Who is most at risk of developing urinary disorders?

Diet and lifestyle:
People who live n hot climates and who are susceptible to kindney stones are at increased risk if they do not drink enough fluids to replace that lost through perspiration.
Gender and age:
About 20% of women will contract a urinary tract infection (UTI) at some point in their life.The reason for this are not fully understood,although it may because a woman's urethra is short,allowing bacteria quick access to the bladder.Kidney stones are more common in Caucasians,in men and in those between the age of 20 and 40.
Family history:
You are more likly to develop a stone if someone in your family has had a kidney stone.Similarly,anyone who has a kidney stone is at increased risk of having an other .
Other factors:
Any abnormality of the urinary tract that obstruct the flow of urine (a kidney stone,for exemple) sets the stage for a urinary tract infection.
An enlarged prostate gland can also slow urine flow,thus increasing the risk of infection.Sexually,active woman or those who use a diaphragm for birth control may be more likly to have a UTI.
People with diabetes have a higher risk of a UTI because of changes in their immune system.
People with ulcerative colitis or Crohn's diseases,or who have had intestinal bypass surgery for weight loss,are at risk of developing oxalate kidney stones and those poeple may be prescribed preventive treatment.
People with diabetes or high blood pressure,or who have suffered repeated kidney infections are at greatest risk of developing kidney failure.

Brain Injuries in case of Head Trauma-Signs

Signs of Brain Injury in case of head trauma:
-the patient suddently falls unconscious
-the eyes are closed
-pupils dilated
-the muscles are relaxed
-lost of reflexes
-sphincters are incontinent
-rapid and weak pulse
-subnormal temperature
-low blood pressure
-slow and shallow respiration
Uncomplicated cases usually recovers completely within minutes and rarely hours.
After recovery the patient still suffers from headache and amnesia.

In this case hospitalization and medical observation for at least 24 hours is needed.

Trauma Of The Eye- Ordinary Black Eye or a Subconjunctival Hemorrhage in case of fracture base of the skull

In case of head or face trauma,the injury signs can relieve a passible subconjunctival hemorrhage as result of a fracture base of the skull.

Subconjunctival hemorrhage happens if the orbital roof is fractured.
A subconjunctivated hemorrhage can be differentiated an ordinary black eye due just to a direct trauma to the eye.

Signs of an ordinary black eye:
-the bruise appears immediatly after trauma to the eye
-develops in the upper lid first
-has a tringular shape with its posterior borders seen and its base towards the cornea
-the occular mobility is not impaired
-proptasis does not occur.

Signs of a subconjunctival hemorrhage (so a skull fracture occured):
-develops hours after trauma
-no skin bruises
-develops in the lowest lid first
-has a triangular shape without posterior limits and its apex is toward the cornea
-occular mobility may be impaired
-proptosis occurs.

In case of base fracture of the skull appears a continuous salty taste and the blood extravation under the galea and in the lids (panda bear effect).

First aid management in case of severe trauma or multiple injuries SAVE LIVES! Learn how to give first aid

First aid management of the patient as emergency before hospital management:

1.Prevent asphyxia by the fallowing:
-keep patient airway
pull tangue
-if necessary insert air through mouth
-tilt the head to one side
-support the mandible forward
-clean any secretion.

2.Control of bleeding:
-pack the wound with textile and due local pressure to the bandage
-elevate the hurted part

3.Antishock measures: warm the trunk,elevation of lower part of the body,fluids.

4.Avoid any movement of the spine and splintage for any fracture: in case of cervical spine injury.

5.Immediatly transfer to the hospital !

Hospital management of the patient:

-section of blood,saliva and vomiting from the pharynx and oral cavity
-endotrocheal tube is inserted with mechanical ventilator in hypoventilation,hypoxia or comatosed patient
-oxygen by mask
-seal the wounds
-relieve pain by sedative.
-examination of all system of the body
-urgent investigations.

Immunization: Influenza Vaccines

For immunization are used two influenza vaccines:inactivated and attenuated.

INACTIVATED INFLUENZA VACCINE:
Application of Vaccination:

Vaccination is recommended yearly for protection of high-risk individuals and groups.
The elderly of more than 65 years old,specially when having chronic disease,or in geniatric or nursing homes or hospitalized.
Individuals exposed to increased risk of influenza complications when infected:
-chronic heart and lung disease
-kidney and metabolic disorders.
Dangerous groups who may transmit infection,though their work to high-risk group:
-helth and medical care providers
-personnel serving chronic cases in different institutes and centers.
Children having chronic disease like heart and respiratory including asthmatics.
The vaccine is not given below two years of age ,who can be immunized by a special vaccine.

Contraindication of Vaccination:
 Vaccination is contraindicated when history of allergy to egg protein is given since the virus are grown in embryonated eggs and some eggs protein is found in the vaccine,otherwise they develop manifestation of hypersensitivity after vaccination.

LIVE ATTENUATED INFLUENZA VACCINE:
Is a recombinant vaccine,made to replace the inactivated vaccine that provides moderate immunity of t most 70% only and lacks stimulating local immunity that is needed to resist respiratory infection.

Types of Sleep and Characteristics

The sleep is a state of unconsciousness from which a person can be aroused by proper stimuli.
Exist 2 types of sleep that alternate with each other:

1.NON REM sleep:Slow wave sleep which is the first to occur when the person falls asleep.
2.REM sleep.

1.Non REM Sleep:
-occurs at the start of sleep
-takes 80% from the sleep time
-has a duration cycle around of 90 min
-non-rapid eye movement,eyes deviate up
-hypotonic (decreased) muscle tone
-the dreams are present nut not remembered
-talking and wlking can be present
-easy awaked

2.REM Sleep:
-occurs after 4th stage of non REM sleep
-takes 20% of the sleep time
-has a duration around of 20 min
-rapid eye movement
-marked hypotonia
-dreams are present and remembered
-the talking and walking are absent
-difficult to awaken.

Non REM sleep have 4 stages:
According to the brain waves registration during sleep:
-low amplitude-high frequency
-light sleep
-high amplitude-low frequency (moderate sleep)
-few frequency (deep sleep).

For REM Sleep:
-small rapid irregular waves like an alert person.

Types of Headache and Causes

Headache is a reffered pain of two origins:
-INTRACRANIAL
-EXTRACRANIAL

The brain is insensitive to pain.

Causes of INTRACRANIAL Headache:

-Meningeal Irritation:due to meningitis,brain tumors or opertive trauma.
-Migraine Headache: it is abnormal vascular phenomenon.
tension or emotion causes vasospasmof cerebral vessels.The vessels becomes flaccid and pulsates with blood pressure,this giving severe headache.
-Hypertension: Headache due to marked expansion of cerebral brain vessels.
-Alcohol Headache: alcohol produces toxic meningeal irritation.
-Constipation: causes headache due to absorption of toxic substances to the blood resulting irritation.

Causes of EXTRACRANIAL Headache:
-Head and neck: muscular spasm of scalp and neck muscles due to emotional tension.
-Nose: irritation of the nasal sinuses.
-Eye: error of refraction.
-Ear: otitis media.
-Teeth: tootache.
-Systemic disorders: as anaemia or carbon dioxid poisoning.