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Bacterial & Viral Diseases Of The Skin,Mucosa,Eyes


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  • Good information, but I have not found about my skin problem. I tried to look in between the lines, but my problems was not included with those discussed. I noticed that the appearance of these skin bumps after I stopped taking the hormones when I was 50 years old. It started with one then two just besides my nose and bothered I stated squeezing it and a white dead came out, and as days passed by more has grown around my nose and later in the corner of my mouth, and also in my left eyelid. I just want to know what are these skin disorder and what is the treatment. Before I forget, I went for check-up once from a gynecologist, because I felt some pimple like on my left labia and told her I squeeze it like I did to my bumps on my face and got the same white dead cell, but she said that it was just a trapped hair folicles, and advised not to scratch or try to extract it might get infected. I want to have a cure, but I wasnt prescribed any medicine to correct the problem. I want to know what are these skin bumps and how are they treated?
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Bacterial & Viral Diseases Of The Skin,Mucosa,Eyes

  1. 1. Bacterial & Viral Diseases of the Skin,Mucosa,Eyes.Wounds, Urogenital System & STD
  2. 2. Some Diseases of the Skin,Mucosa,Eyes,Wounds <ul><li>A. BACTERIAL </li></ul><ul><li>Staph infections are caused by the bacteria Staphylococcus aureus , which many healthy people carry on their skin and in their noses without getting sick. But when skin is punctured or broken, staph bacteria can enter the wound and cause infections, which can lead to other health problems. </li></ul>
  3. 3. How Staph Infections Spread <ul><li>Staph bacteria can spread through the air, on contaminated surfaces, and from person to person. Kids can carry staph bacteria from one area of their body to another — or pass it to other people — via dirty hands or fingernails. So good hand washing is vital to preventing staph infections </li></ul>
  4. 4. <ul><li>Complications of Staph Infections </li></ul><ul><li>Staph bacteria can cause toxic shock syndrome , cellulitis , and these infections: </li></ul>
  5. 5. Scalded skin syndrome (SSS) <ul><li>most often affects newborns and kids under age 5. The illness usually starts with a localized staph skin infection, but the staph bacteria manufacture 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 is dislodged and the skin surface becomes red and raw, like a burn. </li></ul>
  6. 6. <ul><li>SSS is a serious illness that needs to be treated and monitored in a hospital. It affects the body in the same way as serious burns. After treatment, most kids make a full recovery. </li></ul>
  7. 7. <ul><li>What are the signs and symptoms of staphylococcal scalded skin syndrome? </li></ul><ul><li>SSSS usually starts with fever, irritability and widespread redness of the skin. Within 24-48 hours fluid-filled blisters form. These rupture easily, leaving an area that looks like a burn </li></ul>
  8. 11. Characteristics of the rash include: <ul><li>Tissue paper-like wrinkling of the skin is followed by the appearance of large fluid-filled blisters (bullae) in the armpits, groin and body orifices such as the nose and ears. </li></ul><ul><li>Rash spreads to other parts of the body including the arms, legs and trunk. In newborns, lesions are often found in the diaper area or around the umbilical cord. </li></ul><ul><li>Top layer of skin begins peeling off in sheets, leaving exposed a moist, red and tender area. </li></ul><ul><li>Other symptoms may include tender and painful areas around the infection site, weakness, and dehydration. </li></ul>
  9. 12. <ul><li>How is staphylococcal scalded skin syndrome fever diagnosed? </li></ul><ul><li>Diagnosis of SSSS is often suspected from the characteristic history and physical examination. The diagnosis may be confirmed with a biopsy (taking a tissue sample of the infected area and examining it under a microscope) and bacterial culture (colonising the sample to identify the causative organism). </li></ul>
  10. 13. What is the treatment of staphylococcal scalded skin syndrome? <ul><li>Treatment usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used. Depending on response to treatment, oral antibiotics can be substituted within several days. The patient may be discharged from hospital to continue treatment at home. </li></ul>
  11. 14. Other supportive treatments include: <ul><li>: </li></ul><ul><li>Paracetamol when necessary for fever and pain. </li></ul><ul><li>Maintaining fluid and electrolyte intake. </li></ul><ul><li>Skin care (the skin is often very fragile) </li></ul><ul><li>Although the outward signs of SSSS look bad, children generally recover well and healing is usually complete within 5-7 days of starting treatment. </li></ul>
  12. 15. What are the complications from staphylococcal scalded skin syndrome? <ul><li>SSSS usually follows a benign course when diagnosed and treated appropriately. However, if left untreated or treatment is unsuccessful, severe infections such as sepsis, cellulitis , and pneumonia may develop. Death can follow severe infection. </li></ul>
  13. 16. How to prevent staphylococcal scalded skin syndrome <ul><li>should be treated with oral antibiotics to eradicate the causative organism. To prevent further infections these places should employ strict hand washing with antibacterial soap procedures. </li></ul>
  14. 17. Abscesses,Boils, Sty <ul><li>An abscess is a tender, easily pressed mass generally surrounded by a colored area from pink to deep red. The middle of an abscess is full of pus and debris. </li></ul><ul><li>Painful and warm to touch, abscesses can show up any place on your body. The most common sites are in your armpits (axillae), areas around your anus and vagina (Bartholin gland abscess), the base of your spine (pilonidal abscess), around a tooth ( dental abscess ), and in your groin. Inflammation around a hair follicle can also lead to the formation of an abscess, which is called a boil ( furuncle ). </li></ul>
  15. 18. <ul><li>Unlike other infections, antibiotics alone will not cure an abscess. In general an abscess must open and drain in order for it to improve. Sometimes draining occurs on its own, but generally it must be opened by a doctor in a procedure called incision and drainage. </li></ul>
  16. 19. Abscess Causes <ul><li>Abscesses are caused by obstruction of oil (sebaceous) glands or sweat glands, inflammation of hair follicles, or from minor breaks and punctures of the skin. Germs get under the skin or into these glands, which causes an inflammatory response as your body's defenses try to kill these germs </li></ul>
  17. 20. <ul><li>The middle of the abscess liquefies and contains dead cells, bacteria, and other debris. This area begins to grow, creating tension under the skin and further inflammation of the surrounding tissues. Pressure and inflammation cause the pain. </li></ul>
  18. 21. <ul><li>People with weakened immune systems get certain abscesses more often. Those with any of the following are all at risk for having more severe abscesses </li></ul>
  19. 22. Abscess Symptoms <ul><li>Most often, an abscess becomes a painful, compressible mass that is red, warm to touch, and tender. </li></ul><ul><li>As some abscesses progress, they may &quot;point&quot; and come to a head so you can see the material inside and then spontaneously open (rupture). </li></ul><ul><li>Most will continue to get worse without care. The infection can spread to the tissues under the skin and even into the bloodstream. </li></ul><ul><li>If the infection spreads into deeper tissue, you may develop a fever and begin to feel ill. </li></ul>
  20. 23. When to Seek Medical Care <ul><li>Call your doctor if any of the following occur with an abscess: </li></ul><ul><li>You have a sore larger than 1 cm or a half-inch across. </li></ul><ul><li>The sore continues to enlarge or becomes more painful. </li></ul><ul><li>You have an underlying illness such as AIDS, cancer, diabetes, leukemia, sickle cell disease, or have poor circulation. You are an IV drug abuser. </li></ul><ul><li>You are on steroid therapy or chemotherapy. </li></ul>
  21. 24. Exams and Tests <ul><li>The doctor will take a medical history and ask for information about the following: </li></ul><ul><li>How long the abscess has been present </li></ul><ul><li>If you recall any injury to that area </li></ul><ul><li>What medicines you may be taking </li></ul><ul><li>If you have any allergies </li></ul><ul><li>If you have had a fever at home </li></ul><ul><li>The doctor will examine the abscess and surrounding areas. If it is near your anus, the doctor will perform a rectal exam. If an arm or leg is involved, the doctor will feel for a lymph gland either in your groin or under your arm. </li></ul>
  22. 25. Abscess Treatment <ul><li>Self-Care at Home </li></ul><ul><li>If the abscess is small (less than 1 cm or less than a half-inch across), applying warm compresses to the area for about 30 minutes 4 times daily can help. </li></ul><ul><li>Do not attempt to drain the abscess by pressing on it. This can push the infected material into the deeper tissues. </li></ul><ul><li>Do not stick a needle or other sharp instrument into the abscess center because you may injure an underlying blood vessel or cause the infection to </li></ul>
  23. 26. Medical Treatment <ul><li>The doctor will then open and drain the abscess. </li></ul><ul><li>The area around the abscess will be numbed. </li></ul><ul><ul><li>It is often difficult to completely numb the area, but in general local anesthesia can make the procedure almost painless. </li></ul></ul><ul><ul><li>You may be given some type of sedative if the abscess is large </li></ul></ul>
  24. 27. <ul><li>The area will be covered with an antiseptic solution and sterile towels placed around it. </li></ul><ul><li>The doctor will cut open the abscess and totally drain it of pus and debris. </li></ul><ul><li>Once the sore has drained, the doctor will insert some packing into the remaining cavity to minimize any bleeding and keep it open for a day or two. </li></ul>
  25. 28. <ul><li>A bandage will then be placed over the packing, and you will be given instructions as to home care. </li></ul><ul><li>Most people feel better immediately after the abscess is drained. </li></ul><ul><li>If you are still experiencing pain, ask the doctor for some pain pills for home use over the next 1-2 days. </li></ul>
  26. 29. Follow-up <ul><li>Follow carefully any instructions your doctor gives you. </li></ul><ul><ul><li>The doctor may have you remove the packing yourself. If so, it is best to do it while you are soaking the area. </li></ul></ul><ul><ul><li>After the packing has been removed, soak or flush the area for 10-20 minutes 3-4 times daily to allow the wound to heal properly </li></ul></ul>
  27. 30. Prevention <ul><li>Maintain good personal hygiene by washing your skin with soap and water regularly. </li></ul><ul><li>Take care to avoid nicking yourself when shaving your underarms or pubic area. </li></ul><ul><li>Seek immediate medical attention for any puncture wounds. </li></ul><ul><ul><li>Especially if you think there may be some debris in the wound </li></ul></ul><ul><ul><li>If you have one of the listed medical conditions </li></ul></ul><ul><ul><li>If you are on steroids or </li></ul></ul>
  28. 31. Outlook <ul><li>Once treated, the abscess should heal. </li></ul><ul><li>Most people do not require antibiotics. </li></ul><ul><li>The pain improves immediately and subsides more each day. </li></ul><ul><li>You should soak or wash the area daily until the wound heals-about 7-10 days. </li></ul><ul><li>Usually you can remove the packing by the second day. It rarely needs to be replaced. </li></ul><ul><li>After the first 2 days, drainage from the abscess should be minimal to none. All sores should heal in 10-14 days. </li></ul>
  29. 32. Abscess Tooth
  30. 38. Boils
  31. 39. <ul><li>A boil, also referred to as a skin abscess, is a localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with infection-fighting white blood cells that the body sends from the bloodstream to eradicate the infection. This collection of white blood cells, bacteria, and proteins is known as pus. Finally, the pus &quot;forms a head,&quot; which can be surgically opened or spontaneously drain out through the surface of the skin. </li></ul>
  32. 40. There are several different types of boils. Among these are: <ul><li>Furuncle or carbuncle: This is an abscess in the skin caused by the bacterium Staphylococcus aureus . A furuncle can have one or more openings onto the skin and may be associated with a fever or chills </li></ul>
  33. 41. <ul><li>Cystic acne : This is a type of abscess that is formed when oil ducts become clogged and infected. Cystic acne affects deeper skin tissue that the more superficial inflammation from common acne. Cystic acne is most common on the face and typically occurs in the teenage years. </li></ul>
  34. 42. <ul><li>Hidradenitis suppurativa : This is a condition in which there are multiple abscesses that form under the armpits and often in the groin area. These areas are a result of local inflammation of the sweat glands. This form of skin infection is difficult to treat with antibiotics alone and typically requires a surgical procedure to remove the involved sweat glands in order to stop the skin inflammation </li></ul>
  35. 43. <ul><li>Pilonidal cyst : This is a unique kind of abscess that occurs in the crease of the buttocks. Pilonidal cysts often begin as tiny areas of infection in the base of the area of skin from which hair grows (the hair follicle). With irritation from direct pressure, over time the inflamed area enlarges to become a firm, painful, tender nodule making it difficult to sit without discomfort. These frequently form after long trips that involve prolonged sitting. </li></ul>
  36. 44. Why do boils occur? <ul><li>There are many causes of boils. Some boils can be caused by an ingrown hair. Others can form as the result of a splinter or other foreign material that has become lodged in the skin. Others boils, such as those of acne, are caused by plugged sweat glands that become infected. </li></ul>
  37. 45. <ul><li>What is the treatment for a boil? </li></ul><ul><li>Most simple boils can be treated at home. Ideally, the treatment should begin as soon as a boil is noticed since early treatment may prevent later complications. </li></ul>
  38. 46. <ul><li>The primary treatment for most boils is heat application, usually with hot soaks or hot packs. Heat application increases the circulation to the area and allows the body to better fight off the infection by bringing antibodies and white blood cells to the site of infection. </li></ul>
  39. 47. <ul><li>As long as the boil is small and firm, opening the area and draining the boil is not helpful, even if the area is painful. However, once the boil becomes soft or &quot;forms a head&quot; (that is, a small pustule is noted in the boil), it can be ready to drain. Once drained, pain relief can be dramatic. Most small boils, such as those that form around hairs, drain on their own with soaking. </li></ul>
  40. 48. <ul><li>Antibiotics are often used to eliminate the accompanying bacterial infection. Especially if there is an infection of the surrounding skin, the doctor often prescribes antibiotics </li></ul>
  41. 49. STY ( Hordeolum ) <ul><li>A sty is an acute infection or inflammation f the secretory glands of the eyelids. </li></ul><ul><li>A hordeolum , also known as a stye , is an inflammation of the eyelid margin. This condition is seen more often in children than in adults. </li></ul>
  42. 50. <ul><li>A stye occurs when bacteria infect one of the hair follicles of the eyelashes or one of the glands near the inner corner of the eye . Ninety five percent of the time, the infection is caused by Staphylococcus aureus bacteria . </li></ul>
  43. 51. <ul><li>This common infection or inflammation results from blocked glands within the eyelid . When the gland is blocked, the oil produced by the gland occasionally backs up and extrudes through the wall of the gland, forming a lump, which can be red, painful, and nodular . Frequently, bacteria can infect the blocked gland, causing increased inflammation, pain, and redness of the eye and even redness of the surrounding eyelid and cheek tissue. </li></ul>
  44. 52. <ul><li>The lump can point externally (outward) or internally (inward).  Frequently, the lump appears with a visible whitish or yellowish spot that looks much like a large pimple . Usually, one obvious area of swelling is apparent on one lid, but many styes can appear on one or both eyelids simultaneously. </li></ul><ul><li>The lump frequently goes away when the blockage of the gland opening is relieved. Furthermore, the infection goes away when the pus is drained from the s </li></ul>
  45. 53. Sty Causes <ul><li>Styes are usually caused by obstructed orifices (or openings) of the oil glands in the eyelid. Very frequently, they are infected by bacteria, most commonly staphylococcal bacteria. </li></ul>
  46. 54. <ul><li>Seborrhea (excessive oily discharge from the glands) may increase the likelihood of developing one of these infections. Certain factors can contribute to the blockage of the glands: </li></ul><ul><li>Improper or incomplete removal of eye makeup </li></ul><ul><li>Use of outdated or infected cosmetics </li></ul><ul><li>Poor eyelid hygiene </li></ul><ul><li>Inflammatory diseases of the eyelid, such as blepharitis , meibomitis , and rosacea </li></ul><ul><li>Stress </li></ul><ul><li>Hormonal changes </li></ul>
  47. 55. Sty Symptoms <ul><li>A lump on the top or bottom eyelid </li></ul><ul><li>Localized swelling of the eyelid </li></ul><ul><li>Pain </li></ul><ul><li>Redness </li></ul><ul><li>Tenderness to touch </li></ul><ul><li>Crusting of the eyelid margins </li></ul>
  48. 56. <ul><li>Mucous discharge in the eye Burning in the eye </li></ul><ul><li>Droopiness of the eyelid </li></ul><ul><li>Scratchy sensation on the eyeball </li></ul>
  49. 57. When to Seek Medical Care <ul><li>Sometimes, complications may occur from a seemingly innocent problem. Immediately contact your ophthalmologist (a medical doctor who specializes in eye care and surgery) if any of the following problems occur: </li></ul><ul><li>The eye is swollen shut. </li></ul><ul><li>Redness appears around the entire eye. </li></ul><ul><li>You have any change or disturbance in your vision. </li></ul>
  50. 58. <ul><li>Swelling lasts for more than 3 weeks. </li></ul><ul><li>The sty or styes come back or bleed. </li></ul><ul><li>Your eyelashes fall out. </li></ul><ul><li>The sty is on the bottom eyelid, near the nose. </li></ul><ul><li>The white part of the eye becomes red. </li></ul><ul><li>Pus or thick discharge continues to drain from the eye. </li></ul>
  51. 59. <ul><li>You have a fever higher than 100.5°F. </li></ul><ul><li>You have excessive persistent tearing. </li></ul><ul><li>You have persistent redness of the surface of the eye. </li></ul><ul><li>You have significant pain. </li></ul><ul><li>The sty recurs, especially if the sty does so in the same location as a previous sty. </li></ul><ul><li>You have swelling of the lymph nodes in your neck. </li></ul><ul><li>You experience double vision. </li></ul>
  52. 60. Questions to Ask the Doctor <ul><li>Is the eyelid infected? </li></ul><ul><li>Is the cornea involved? </li></ul><ul><li>Is surgery required? </li></ul><ul><li>How can I prevent a recurrence? </li></ul><ul><li>What is the chance that the sty may be a type of skin cancer? </li></ul><ul><li>Is the tear drainage system involved? </li></ul>
  53. 61. <ul><li>Exams and Tests </li></ul><ul><li>Your ophthalmologist asks questions about whether you have had any injury or previous eye problems or surgeries. Frequently, a history of similar symptoms is useful, so be sure to tell your ophthalmologist if you have previously experienced them. Your eyelid and facial hygienic habits, along with any makeup usage, are also useful information for your ophthalmologist. </li></ul>
  54. 62. <ul><li>Your eyes and eyelids are examined, including the underside of the eyelid. Your ophthalmologist may use a slit lamp (a microscope-like device with a powerful light) to examine your eye. </li></ul>
  55. 63. <ul><li>X-rays and blood work are not usually useful, except if your ophthalmologist is concerned that an infection may have spread from your eyelid to your eye socket. In this case, a CT scan of the eye socket may be required. </li></ul>
  56. 64. Sty Treatment <ul><li>Self-Care at Home </li></ul><ul><li>Most styes go away on their own in 5-7 days. </li></ul><ul><li>Apply warm compresses 4-6 times a day for about 15 minutes at a time to help the drainage. Keep your eyes closed. </li></ul><ul><li>Gently scrub the eyelid with tap water or with a mild, nonirritating soap or shampoo (such as baby shampoo). This may help with drainage. Close your eyes as you scrub so you do not injure your eyes. </li></ul>
  57. 65. <ul><li>Do not squeeze or puncture the sty. A more serious infection may occur as a result. </li></ul><ul><li>Discontinue the use of eye makeup as well as eye lotions and creams because they may be infected. </li></ul><ul><li>Discontinue wearing your contact lenses because the sty may cause an infection to spread to your cornea with the continued use of your contact lenses. </li></ul>
  58. 66. Medical Treatment <ul><li>Care is mainly provided to help relieve your symptoms and to hasten recovery. </li></ul><ul><li>Warm compresses are usually recommended. </li></ul><ul><li>Pain medicine, such as acetaminophen (Tylenol), may be given or recommen </li></ul>
  59. 67. <ul><li>Antibiotics may be necessary. </li></ul><ul><li>Topical antibiotics may be given by your ophthalmologist. </li></ul><ul><li>Occasionally, oral antibiotics are given to people either with styes that do not go away or with multiple styes as well as to those who have styes in addition to other conditions, such as blepharitis or rosacea. </li></ul>
  60. 68. Medications <ul><li>For a sty that has not resolved in 3 weeks or for multiple styes, you may be prescribed oral antibiotics by your ophthalmologist. Doxycycline is an antibiotic that is commonly used to treat persistent or complex stye </li></ul>
  61. 69. Prevention <ul><li>Good hand and facial washing may prevent styes from forming or coming back. </li></ul><ul><li>Upon awakening, application of a warm washcloth to the eyelids for 1-2 minutes may be beneficial in decreasing the occurrence of styes by liquefying the contents of the oil glands of the eyelid and thereby preventing blockage. </li></ul>
  62. 70. <ul><li>All cosmetics and cosmetic tools should be kept clean and protected from the environment. Do not share makeup or eye cosmetic tools, such as eyelash curlers. Makeup should be thrown away when it becomes old or contaminated. </li></ul>
  63. 71. <ul><li>Outlook </li></ul><ul><li>A sty may come back, even after appropriate medical or surgical care. These persistent styes need further evaluation and care because they may indicate other health concerns; rarely, they can be an indication of cancer </li></ul>
  64. 74. Impetigo <ul><li>Impetigo is a highly contagious skin infection that mainly affects children aged between two and six .Your child may have picked up the bacteria that cause it (usually staphylococcus, but sometimes streptococcus) by touching an infected child, or some object that the child had touched, such as a toy, towel, or pillowcase. </li></ul>
  65. 75. <ul><li>The infection often develops around the nose and mouth, but it can easily spread to other parts of the body. It's not usually painful, but it can be itchy. Your child may also have a temperature and swollen lymph glands in his face or neck. </li></ul>
  66. 78. How does impetigo occur? <ul><li>Normally the skin provides a very effective barrier and protects the body from infection. But when the skin is broken, as by a cut or scratch, an insect bite, a burn, or a pre-existing skin rash caused by eczema or by an allergic reaction to poison ivy, soap, or cosmetic products, bacteria can enter and cause infection. </li></ul>
  67. 79. What are the symptoms of impetigo? <ul><li>Usually a cluster of small blisters or red bumps appears first at the site of infection. These blisters will grow and rupture within about twenty-four hours. The skin exposed when the blisters burst appears red and inflamed, and will often leak either pus or a thinner fluid, which may be clear or slightly cloudy. If the infection is left untreated, the lesions may grow quite large, and will almost certainly spread to other parts of the body. </li></ul>
  68. 80. <ul><li>People living or working in crowded conditions, such as schools, daycare facilities, and military bases, are also at higher risk of being infected through contact with another person who already has the infection or, less commonly, through contact with clothing, towels, or bedding contaminated by discharge from impetigo lesions </li></ul>
  69. 81. Are there other risk factors for developing impetigo? <ul><li>Because bacteria thrive in warm, moist environments, most cases occur during the hot, humid summer months. That is also the time when children are outdoors playing in shorts and short-sleeved shirts, so they are more likely to have small skin injuries that provide an opening for the bacteria. </li></ul>
  70. 82. <ul><li>Poor nutrition, poor personal hygiene, unsanitary living conditions, or an illness that has lowered an individual’s resistance are also risk factors for developing impetigo. </li></ul>
  71. 83. How does one contract impetigo in the first place? <ul><li>Bacteria live on the surface of the skin. If a skin injury is not kept clean, it is an invitation for those bacteria to invade the body and cause infection. Good personal hygiene helps to keep the bacteria in check, both as a preventive measure, and as part of the treatment schedule if one does develop impetigo. </li></ul>
  72. 84. How can the spread of impetigo be prevented? <ul><li>To prevent the patient from spreading impetigo to other parts of his body, he should avoid scratching or touching the lesion. A child may find it hard to follow this directive, especially as impetigo itches. A child who has impetigo should have his fingernails cut short. </li></ul>
  73. 85. <ul><li>It will also probably be necessary to cover the infected areas with gauze and surgical tape. Plastic bandages should be avoided, however, because they create a warm, moist environment that would encourage the growth of bacteria and slow the healing process. </li></ul>
  74. 86. <ul><li>To prevent impetigo from spreading to other members of the household, each person in the family should have his own towels, and the towels, clothing, and bedding of the patient should be laundered daily until after the patient has been taking antibiotics for forty-eight hours, at which point he should no longer be contagious </li></ul>
  75. 87. <ul><li>The person who washes and bandages the impetigo lesions should carefully wash his or her hands after direct contact with the sores, and used bandages should also be disposed of carefully. </li></ul>
  76. 88. <ul><li>Because children are so susceptible to impetigo, it is important that they practice good personal hygiene, and that minor skin injuries be monitored for the small blisters that are characteristic of the early stage of the infection. It is easier to prevent impetigo or to treat it and prevent contagion when it is in its early stages than when lesions have begun to spread and to discharge fluid. </li></ul>
  77. 89. <ul><li>If impetigo does develop, how should it be treated? </li></ul><ul><li>Impetigo is usually treated with oral antibiotics. Parents, daycare workers, and teachers should familiarize themselves with the signs of impetigo. If a child has such signs, especially if he has been exposed to someone who has the infection, he should be seen by a doctor </li></ul>
  78. 90. <ul><li>When can a child return to school or daycare? </li></ul><ul><li>A child with impetigo should be kept home until he has been on antibiotics for forty-eight hours. At that point, he will no longer be contagious. If he is being treated only with antibiotic ointment for a very mild infection, he can return to school or daycare as soon as his skin has completely healed. </li></ul>
  79. 91. Are there any complications of impetigo? <ul><li>In most cases the condition clears up without any major problems, but occasionally other more serious conditions develop if the impetigo is left untreated (CKS 2006). These include: • a deeper, more serious skin inflammation called cellulitis • a form of psoriasis that causes sores on the chest, arms, legs and scalp • blood poisoning, also known as septicaemia </li></ul>
  80. 92. Scarlet Fever <ul><li>What is scarlet fever? Scarlet fever, sometimes called scarlatina , is a disease caused by a bacteria called group A Streptococcus or &quot;group A strep&quot;, the same bacteria that causes strep throat. Scarlet fever is a rash that sometimes occurs in people that have strep throat. People with scarlet fever typically also have a high fever and a strawberry-like appearance of the tongue. The rash of scarlet fever is usually seen in children under the age of 18. </li></ul>
  81. 95. How do you get scarlet fever? <ul><li>This illness can be caught from contact with the sick person because this germ is carried in the mouth and nasal fluids. The disease can be spread through contact with droplets shed when an infected person coughs or sneezes. If you touch your mouth, nose, or eyes after touching something that has these fluids on them, you may become ill. Also, if you drink from the same glass or eat from the same plate as the sick person, you could also become ill. The best way to keep from getting sick is to wash your hands often and avoid sharing eating utensils. It is especially important for anyone with a sore throat to wash his or her hands often and not share eating or drinking utensils. </li></ul>
  82. 96. What are the symptoms of scarlet? <ul><li>most common symptoms of scarlet fever are:  Scarlet fever begins with a rash that shows up as tiny red bumps. It most often begins on the chest and stomach but can then spread all over the body. It looks like a sunburn and feels like a rough piece of sandpaper. Most of the time it is redder in the creases of the elbows, arm pits, and groin areas. The rash lasts about 2-7 days </li></ul>
  83. 97. <ul><li>After the rash is gone, the skin on the tips of the fingers and toes begins to peel. Some other common signs of scarlet fever are:    A flush face with a pale area around the lips;   A red and sore throat that can have white or yellow patches;   A fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or higher;   Swollen glands in the neck; and    A whitish coating can appear on the surface of the tongue. The tongue itself looks like a strawberry because the normal bumps on the tongue look bigger. </li></ul>
  84. 98. <ul><li>Other less common signs of illness include:  Feeling sick to your stomach (nausea) and throwing up (vomiting);  Having a headache; and   Having body aches. </li></ul>
  85. 99. How is scarlet fever diagnosed? <ul><li>To diagnose the cause of your child’s rash or sore throat, your doctor or healthcare provider will examine your child and swab the back of the throat with a cotton swab. The swab will be then used for a throat culture or a rapid antigen test (sometimes called a “rapid strep test”) to see if there is a group A strep infection. </li></ul>
  86. 100. What is the treatment for scarlet fever? <ul><li>If your doctor or health care provider diagnoses you or your child with scarlet fever, the doctor will give you a drug that fight germs (antibiotic) for your child. Be sure to give your child the drug as the doctor tells you. Never share any of the drug with anyone else. Also, be sure to ask your doctor about drugs you can buy in the store for sore throat pain. </li></ul>
  87. 101. <ul><li>Is there anything else I can do to make my child feel better? Warm liquids like soup or cold foods like popsicles or milkshakes help to ease the pain of the sore throat. Offer these to your child often, especially when he/she has a fever since the body needs a lot of fluid when it is sick with a fever. A cool mist humidifier will help to keep the air in your child's room moist which will keep the throat from getting too dry and more sore. Your child needs plenty of rest. </li></ul>
  88. 102. <ul><li>What should I do if I think my child has scarlet fever? If you think your child has scarlet fever, take your child to his or her doctor right away. The doctor may give your child drugs that fight germs (antibiotics). Do not let your child return to daycare or school until he or she has taken the antibiotics for at least 24 hours. </li></ul>
  89. 103. ACNE <ul><li>Acne is a skin condition which has plugged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules). Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms </li></ul>
  90. 104. Types of Acne and How Acne Forms <ul><li>Acne is not caused by dirt. Testosterone, a hormone which is present in both males and females, increases during adolescence (puberty). It stimulates the sebaceous glands of the skin to enlarge, produce oil, and plug the pores. Whiteheads (closed comedones), blackheads (open comedones), and pimples (pustules) are present in teenage acne. </li></ul>
  91. 105. <ul><li>Early acne occurs before the first period and is called prepubertal acne. When acne is severe and forms deep &quot;pus-filled&quot; lumps, it is called cystic acne. This may be more common in males. Adult acne develops later in life and may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may be treated at the period and at ovulation when acne is especially severe, or throughout the entire cycle. Adult acne is not rosacea, a disease in which blackheads and whiteheads do not occur </li></ul>
  92. 106. <ul><li>Cleansing </li></ul><ul><li>Acne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make your acne worse. </li></ul>
  93. 107. <ul><li>Diet </li></ul><ul><li>Acne is not caused by foods. However, if certain foods seem to make your acne worse, try to avoid them. </li></ul>
  94. 108. <ul><li>Cosmetics </li></ul><ul><li>Wear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are &quot;non-comedogenic&quot; (should not cause whiteheads or blackheads) or &quot;non-acnegenic&quot; (should not cause acne). Remove your cosmetics every night with mild soap or gentle cleanser and wate </li></ul>
  95. 109. <ul><li>A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good for cover-up. Shield your face when applying sprays and gels on your hair. </li></ul>
  96. 110. Treatment <ul><li>Mild acne vulgaris </li></ul><ul><li>Control of acne is an ongoing process. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acn </li></ul>
  97. 111. Topicals <ul><li>Your dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist will advise you about correct usage and how to handle side effects. </li></ul><ul><li>Before starting any medication, even topical medications, inform your doctor if you are pregnant or nursing, or if you are trying to get pregnant </li></ul>
  98. 112. Special Treatments <ul><li>Acne surgery may be used by your dermatologist to remove blackheads and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result. </li></ul><ul><li>Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin. </li></ul><ul><li>Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth. </li></ul><ul><li>Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly </li></ul>
  99. 113. <ul><li>Oral </li></ul><ul><li>Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed. </li></ul>
  100. 114. <ul><li>Birth Control Pills </li></ul><ul><li>moderate acne </li></ul><ul><li>  </li></ul><ul><li>Birth control pills may significantly improve acne, and may be used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon, but possible, especially if you notice break-through bleeding. As a precautionary measure use a second form of birth control. </li></ul>
  101. 115. Proper Care is Necessary <ul><li>Severe nodular acne </li></ul><ul><li>No matter what special treatments your dermatologist may use, remember that you must continue proper skin care. Acne is not curable, but it is controllable; proper treatment helps you to feel and look better and may prevent scars </li></ul>
  102. 118. Conjunctivitis <ul><li>Conjunctivitis is an inflammation or infection of the membrane lining the eyelids ( conjunctiva ) </li></ul>
  103. 119. Symptoms <ul><li>Blurred vision </li></ul><ul><li>Crusts that form on the eyelid overnight </li></ul><ul><li>Eye pain </li></ul><ul><li>Gritty feeling in the eyes </li></ul><ul><li>Increased tearing </li></ul><ul><li>Itching of the eye </li></ul><ul><li>Redness in the eyes </li></ul><ul><li>Sensitivity to light </li></ul>
  104. 120. Signs and tests <ul><li>Examination of the eyes </li></ul><ul><li>Swab of conjunctiva for analysis </li></ul>
  105. 121. . <ul><li>Treatment </li></ul><ul><li>Treatment of conjunctivitis depends on the cause. </li></ul><ul><li>Allergic conjunctivitis may respond to treatment for the underlying allergies, or it may disappear on its own when the allergen that caused it is removed. Cool compresses may be soothing for allergic conjunctivitis. </li></ul><ul><li>Antibiotic medication, usually eye drops, is effective for bacterial conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eyedrop for pink eye to prevent bacterial conjunctivitis. </li></ul><ul><li>You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses (a clean cloth soaked in warm water ) to your closed eyes. </li></ul>
  106. 124. Trachoma <ul><li>Trachoma ( Ancient Greek : &quot;rough eye&quot;) is an infectious eye disease, and the leading [1] cause of the world's infectious blindness. </li></ul>
  107. 125. <ul><li>Trachoma is the result of infection of the eye with Chlamydia trachomatis. Infection spreads from person to person, and is frequently passed from child to child and from child to mother, especially where there are shortages of water, numerous flies, and crowded living conditions. </li></ul>
  108. 126. <ul><li>Infection often begins during infancy or childhood and can become chronic. If left untreated, the infection eventually causes the eyelid to turn inwards, which in turn causes the eyelashes to rub on the eyeball, resulting in intense pain and scarring of the front of the eye. This ultimately leads to irreversible blindness, typically between 30 and 40 years of age </li></ul>
  109. 127. Prevention <ul><li>Surgery to correct advanced stages of the disease; </li></ul><ul><li>Antibiotics to treat active infection . </li></ul><ul><li>Facial cleanliness to reduce disease transmission; </li></ul><ul><li>Environmental change to increase access to clean water and improved sanitation. </li></ul>
  110. 128. Symptoms <ul><li>The bacteria has an incubation period of 5 to 12 days, after which the affected individual experiences symptoms of conjunctivitis , or irritation similar to &quot; pink eye .&quot; Blinding endemic trachoma results from multiple episodes of reinfection that maintains the intense inflammation in the conjunctiva. Without reinfection, the inflammation will gradually subside. [2] </li></ul><ul><li>The conjunctival inflammation is called “active trachoma” and usually is seen in children, especially pre school children </li></ul>
  111. 129. <ul><li>Eye discharge </li></ul><ul><li>Swollen eyelids </li></ul><ul><li>Trichiasis (turned-in eyelashes) </li></ul><ul><li>Swelling of lymph nodes in front of the ears </li></ul><ul><li>Corneal scarring </li></ul><ul><li>Further ear, nose and throat complications. </li></ul>
  112. 132. Leprosy (Hansen's Disease) <ul><li>Not very contagious Modern medicine knows that leprosy is spread when an untreated infected person coughs or sneezes (but not by sexual contact or pregnancy). However, leprosy is not very contagious; approximately 95% of people have natural immunity to the disease </li></ul>
  113. 133. Signs and symptoms <ul><li>The earliest sign of leprosy is commonly a spot on the skin that may be slightly redder, darker, or lighter than the person's normal skin. The spot may lose feeling and hair. In some people the only sign is numbness in a finger or toe. </li></ul>
  114. 134. If left untreated, leprosy has serious effects on the body, including: <ul><li>: </li></ul><ul><li>Hands and feet - Leprosy bacteria attack the nerves in the hands and feet and cause them to become numb. A person may get cuts or burns on the numb parts and not know it, leading to infections which cause permanent damage. Fingers and toes may be lost to infection. Serious infections in the feet may require amputation. Paralysis may cause the fingers and toes to curl up permanently </li></ul>
  115. 135. <ul><li>Eyes - Leprosy bacteria attack the nerves around the eyes causing the loss of blinking reflex (which protects the eye from injury and moistens the surface). The eyes become dry and infected, and blindness may result. Because of numbness of the eye, the person cannot feel dirt or scratches in the eye. </li></ul><ul><li>Face - Damage to the internal lining of the nose causes scarring and eventual collapse of the nose. </li></ul>
  116. 139. Treatment available <ul><li>The good news is that leprosy is curable. In 1981, the World Health Organization recommended the use of a combination of three antibiotics--dapsone, rifampin, and clofazimine--for treatment, which takes six months to a year or more. </li></ul>
  117. 140. What is Plaque? <ul><li>Plaque is the soft and sticky substance that accumulates on the teeth from food debris and bacteria. Plaque can be removed by brushing and flossing thoroughly. If plaque is not removed, it can lead to gum disease and cavities. Regular dental check ups , brushing twice a day, flossing daily and eating nutritional snacks will help to prevent plaque from forming on the teeth. </li></ul>
  118. 141. Treatments <ul><li>Visiting the dentist doesn't have to be scary if you know what to expect. </li></ul>
  119. 143. Tularemia <ul><li>What is Tularemia? </li></ul><ul><li>Tularemia is a potentially serious illness that occurs naturally in the United States. It is caused by the bacterium Francisella tularensis found in animals (especially rodents, rabbits, and hares). </li></ul>
  120. 144. Symptoms of tularemia could include: <ul><li>: </li></ul><ul><li>sudden fever </li></ul><ul><li>chills </li></ul><ul><li>headaches </li></ul><ul><li>diarrhea </li></ul><ul><li>muscle aches </li></ul><ul><li>joint pain </li></ul><ul><li>dry cough </li></ul><ul><li>progressive weakn </li></ul>
  121. 145. <ul><li>People can also catch pneumonia and develop chest pain, bloody sputum and can have trouble breathing and even sometimes stop breathing. </li></ul><ul><li>Other symptoms of tularemia depend on how a person was exposed to the tularemia bacteria. These symptoms can include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and a sore throat. </li></ul>
  122. 146. How Does Tularemia Spread? <ul><li>People can get tularemia many different ways: </li></ul><ul><li>being bitten by an infected tick, deerfly or other insect </li></ul><ul><li>handling infected animal carcasses </li></ul><ul><li>eating or drinking contaminated food or water </li></ul><ul><li>breathing in the bacteria, F. tularensis </li></ul>
  123. 147. <ul><li>How Soon Do Infected People Get Sick? </li></ul><ul><li>Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as long as 14 days. </li></ul>
  124. 148. <ul><li>How Is Tularemia Treated? </li></ul><ul><li>Your doctor will most likely prescribe antibiotics, which must be taken according to the directions supplied with your prescription to ensure the best possible result. Let your doctor know if you have any allergy to antibiotics. </li></ul><ul><li>A vaccine for tularemia is under review by the Food and Drug Administration and is not currently available in the United States. </li></ul>
  125. 151. Lyme disease <ul><li>Lyme disease is an infection caused by the bacterium Borrelia burgdorferi . This bacterium is usually found in animals such as mice and deer. Ixodes ticks can pick up the bacteria when they bite an infected animal, then transmit it to a person, which can lead to Lyme disease. </li></ul>
  126. 152. Signs and Symptoms <ul><li>Lyme disease can affect the skin, joints, nervous system, and other organ systems. Symptoms, and their severity, can vary from person to person. </li></ul>
  127. 153. <ul><li>The first sign of infection usually is a circular rash, called erythema . </li></ul><ul><li>appears within 1–2 weeks of infection but may develop up to 30 days after the tick bite. This rash often has a characteristic &quot;bull's-eye&quot; appearance, with a central red spot surrounded by clear skin that is ringed by an expanding red rash. It may also appear as an expanding ring of solid redness. It may be warm to the touch and is usually not painful or itchy. The bull's-eye rash may be more difficult to see on people with darker skin tones, where it may take on a bruise-like appearance. </li></ul>appears within 1–2 weeks of infection but
  128. 154. <ul><li>Along with the rash, a person may experience flu-like symptoms such as swollen lymph nodes, fatigue, headache, and muscle aches. Left untreated, symptoms of the initial illness may go away on their own. But in some people, the infection can spread to other parts of the body. Symptoms of this stage of Lyme disease usually appear within several weeks after the tick bite, even in someone who has not developed the initial rash. The person may feel very tired and unwell, or may have more areas of rash that aren't at the site of the bite. </li></ul>
  129. 155. <ul><li>Lyme disease can affect the heart, leading to an irregular heart rhythm or chest pain. It can spread to the nervous system, causing facial paralysis (Bell's palsy) or tingling and numbness in the arms and legs. It can start to cause headaches and neck stiffness, which may be a sign of meningitis. Swelling and pain in the large joints can also occur. </li></ul>
  130. 156. <ul><li>The last stage of Lyme disease may occur if early disease was not detected or appropriately treated. Symptoms of late Lyme disease can appear any time from weeks to years after an infectious tick bite and include arthritis, particularly in the knees, and, mainly in adults, cognitive deterioration. </li></ul>
  131. 157. <ul><li>Treating Lyme Disease </li></ul><ul><li>Treatment of early localized Lyme disease typically involves a course of antibiotics administered for 3 to 4 week </li></ul>
  132. 158. PREVENTION <ul><li>To prevent Lyme disease, avoid contact with soil, leaves, and vegetation as much as possible, especially during May, June, and July, when ticks have not yet matured and are harder to detect. </li></ul><ul><li>When you do venture into the great outdoors, follow these tips: </li></ul><ul><li>Wear enclosed shoes and boots, long-sleeved shirts, and long pants. Tuck pants into boots or shoes to prevent ticks from crawling up legs. </li></ul>
  133. 159. <ul><li>Wear light-colored clothing to help you see ticks easily. </li></ul><ul><li>Keep long hair pulled back or placed in a cap for added protection. </li></ul><ul><li>When outside, don't sit on the ground. </li></ul><ul><li>While outdoors, check yourself and your child frequently for ticks. </li></ul><ul><li>Wash all clothes after leaving tick-infested areas, and bathe and shampoo your child thor </li></ul>
  134. 160. <ul><li>Ticks can bite anywhere, but they prefer certain areas of the body, such as: </li></ul><ul><li>behind the ears </li></ul><ul><li>the back of the neck </li></ul><ul><li>armpits </li></ul><ul><li>the groin </li></ul><ul><li>behind the knees </li></ul>
  135. 161. When to Call the Doctor <ul><li>If your child has a bull's-eye rash or other symptoms that can occur in Lyme disease — such as swollen lymph glands near a tick bite, general achiness, headache, or fever — call your doctor right away </li></ul>
  136. 164. Wound Infection <ul><li>What is wound infection? A wound infection happens when germs enter a break in the skin. These germs, called bacteria, attach to tissues causing wounds to stop healing, and other signs and symptoms. Wounds can be punctures (holes), lacerations (tears), incisions (cuts), or burns. Deep ulcers (open sores), large burns, or bite wounds are more likely than other wounds to get infected. Wound infection can also happen in small wounds that were not treated. </li></ul>
  137. 165. What causes wound infections? <ul><li>When a large number of bacteria get into a wound, it can get infected. There are different types of bacteria. More than one type may infect your wound at the same time. Normal bacteria that lives on your skin often enter a wound first. A break in the skin gives them a chance to enter it and cause infection. Bacteria may also come from the environment, such as soil, air, or water. If an object such as a nail caused the wound, bacteria may come from that. If you are bit by an animal or person, their saliva (spit) can also cause infection </li></ul>
  138. 166. What puts me at risk of having a wound infection? <ul><li>Diseases: Diseases such as diabetes (high blood sugar level), cancer, or liver, kidney or lung conditions slow down healin </li></ul>
  139. 167. <ul><li>Foreign objects: Dead tissue and foreign objects, such as glass or metal, stuck in the wound may delay wound healing. </li></ul><ul><li>Poor blood supply or low oxygen: Blood flow may be decreased by high blood pressure, and blocked or narrowed blood vessels. This may be a common problem in people who smoke, or have blood vessel problems or heart conditions. Low oxygen supply may be caused by certain blood, heart, and lung diseases. </li></ul>
  140. 168. <ul><li>Repeated trauma: Constant pressure on wounds may increase your risk of having wound infection, and delay healing. </li></ul><ul><li>Surgery: Infection of cuts made during surgery, also called surgical site infection (SSI), may occur. Ask your caregiver for more information on SSI. </li></ul><ul><li>Weak immune system: The immune system is the part of the body that fights infection. This may be weakened by radiation, poor nutrition, and certain medicines, such as anti-cancer medicines or steroids. </li></ul>
  141. 169. Signs and Symptoms of a wound infection? <ul><li>High or low body temperature, low blood pressure, or a fast heart beat. </li></ul><ul><li>Increased discharge (blood or other fluid) or pus coming out of the wound. The discharge or pus may have an odd color or a bad smell. </li></ul><ul><li>Increased swelling that goes past the wound area and does not go away after five days. Swollen areas usually look red, feel painful, and feel warm when you touch them. </li></ul>
  142. 170. <ul><li>Wounds that do not heal or get better with treatment. </li></ul><ul><li>An old wound that bleeds easily. </li></ul><ul><li>A wound that is painful, even though it does not look like it should be. </li></ul>
  143. 172. How is a wound infection treated? <ul><li>Wound care: </li></ul><ul><li>Cleansing: This may be done by rinsing the wound with sterile (clean) water. Germ-killing solutions may also be used to clean your wound. </li></ul><ul><li>Debridement: Debridement is done to clean and remove objects, dirt, or dead skin and tissues from the wound area. Caregivers may cut out the damaged areas in or around the wound. Wet bandages may be placed inside the wound and left to dry. Other wet or dry dressings may also be used. Caregivers may also drain the wound to clean out pus. </li></ul>
  144. 173. <ul><li>Medicines: Your caregiver may give you antibiotic medicine to fight infection. You may also be given medicine to decrease pain, swelling, or fever. </li></ul>
  145. 174. <ul><li>Other treatment: Controlling or treating the medical condition that causes poor wound healing helps treat wound infection. You will need to regularly take medicines to control diseases such as diabetes or high blood pressure. Surgery may also be done to increase blood flow if you have blood vessel problems. </li></ul>
  146. 175. <ul><li>Lifestyle changes: Vitamin C, found in oranges and other foods, helps wounds heal. Your caregiver may give you supplements (pills) or suggest a special diet to help you heal. If you smoke, quit. Smoking cigarettes, pipes and other things decreases the ability of wounds to heal </li></ul>
  147. 176. <ul><li>VIRAL </li></ul>
  148. 177. Rubella (German Measles)
  149. 178. <ul><li>What is rubella (German measles)? </li></ul><ul><li>A respiratory disease caused by a virus. </li></ul>
  150. 179. <ul><li>What are the symptoms of rubella? </li></ul><ul><li>Rash and fever for two to three days (mild disease in children and young adults) </li></ul>
  151. 180. <ul><li>What are the complications of rubella? </li></ul><ul><li>Birth defects if acquired by a pregnant woman: deafness , cataracts , heart defects, mental retardation, and liver and spleen damage (at least a 20% chance of damage to the fetus if a woman is infected early in pregnancy ). </li></ul>
  152. 181. <ul><li>How is rubella spread from person to person? </li></ul><ul><li>Spread by contact with an infected person, through coughing and sneezin </li></ul>
  153. 182. <ul><li>What is the rubella vaccine? </li></ul><ul><li>Rubella vaccine (contained in MMR vaccine) can prevent this disease. </li></ul>
  154. 183. Medications <ul><li>acetaminophen, Tylenol and Others </li></ul><ul><li>measles, mumps, rubella vaccine-injection, M-M-R II </li></ul><ul><li>rubella virus vaccine-injection, Meruvax II </li></ul><ul><li>immune globulin-intramuscular, Gamastan , Gammar </li></ul>
  155. 184. <ul><li>Rubella (Geman Measels) Incubation period : 14-21 days; Period of communicability : from 1 wk before onset of sx until rash disappears; Sx&signs : Malaise, fever, H/A, rhinits, post-auricular & suboccipital lymphadenopathy with tender nodes ; Eruption site : face & neck, spreads to trunk and limbs; Eruption characteristics : Fine pinkish macules that become confluent and often scarlintiform or pinpoint on 2nd day; Onset&duration : 1 or 2 days after onset of sx, last 1-3 days; Labs : WBC counts usually normal or slightly reduced, virus in blood and nasopharynx </li></ul>
  156. 187. Measels (Rubeola) <ul><li>Measels (Rubeola) Incubation period : 7-14 days; Period of communicability : from 2-4 days before appearence of rash until 2-5 days after onset; Sx & signs : K oplik spots, Fever, c oryza, cough, c onjuctivitis, p hotophobia, usually mild pruritis; Eruption site : starts around ears & on face and neck, spreads over trunk and limbs, limbs escape in mild cases; Eruption characteristics : Maculopapular brownish, pink and irregular confluent in severe cases, or even petechial, discrete in mild cases; Onset and duration : 3-5 days after onset of sx, lasts 4-7 days; Labs : Granulocytic leukopenia, virus in blood and nasopharynx </li></ul>
  157. 189. <ul><li>Prevention </li></ul><ul><li>Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations. </li></ul>
  158. 190. Chickenpox <ul><li>Chickenpox, also known as varicella, is a highly contagious and self-limited infection that most commonly affects children between 5-10 years of age </li></ul>
  159. 191. <ul><li>The disease shingles (also known as &quot;zoster&quot;) represents release of these viruses down the length of the skin nerve fiber and produces a characteristic painful rash . Shingles is most commonly a disease of adults. </li></ul>
  160. 192. <ul><li>The disease is highly contagious -- over 90% of nonimmune individuals will develop chickenpox following exposure. VZV is communicable by both direct skin-to-skin contact and via respiratory droplets (for example, coughing, sneezing) from the infected individual. While the average incubation period from viral exposure to onset of symptoms is 12-14 days . </li></ul>
  161. 193. <ul><li>Chickenpox Symptoms </li></ul><ul><li>Rash </li></ul><ul><li>Healthy children generally experience one to two days of fever , sore throat , and malaise approximately two weeks following exposure to VZV. Within 24 hours of these symptom </li></ul>
  162. 194. Complications <ul><li>skin infection : Secondary bacterial infections caused by either Staphylococcus or Streptococcus bacteria are well described. Rarely, an invasive form of Streptococcus can quickly spread throughout the body and may be life-threatening; </li></ul><ul><li>pneumonia : This is a relatively rare complication in healthy children, but is the primary cause of hospitalization for adults (one in 400 cases) and has a mortality (death) rate of between 10%-30%; </li></ul>
  163. 195. <ul><li>neurologic complications : Children most commonly develop an inflammation of the balance center of the brain called acute cerebellar ataxia. Symptoms of abnormal eye movements and poor balance develop in about one in 4,000 children approximately one week into the skin manifestations of chickenpox. Symptoms generally last for a few days, and a complete recovery is common. Adults more commonly develop a more generalized brain inflammation (&quot; encephalitis &quot;) whose symptoms may include delirium and seizures </li></ul>
  164. 196. <ul><li>Reye syndrome : This rare childhood complication of chickenpox (and influenza ) is most commonly associated with the administration of aspirin. A rapid progression of nausea, vomiting , headache , delirium, and combativeness that may progress to coma is a common pattern of deterioration. Supportive measures are the only therapy; and </li></ul><ul><li>rare complications : Hepatitis , kidney disease, ulcers of the intestinal tract, and inflammation of the testes (orchitis) have all been described. </li></ul>
  165. 197. When to Seek Medical Care <ul><li>Although most cases of chickenpox heal without complications, sometimes medical attention is required. Call the doctor if any of the following conditions develop: </li></ul><ul><li>Fever higher than 103°F </li></ul><ul><li>A rash involving an eye; eye pain (especially unusual sensitivity to light) </li></ul><ul><li>Dehydration , vomiting, or decreased fluid intake </li></ul><ul><li>Uncertainty of diagnosis or what </li></ul>
  166. 198. <ul><li>Uncertainty of diagnosis or what medication to give </li></ul><ul><li>Secondary skin infections </li></ul><ul><li>Signs of bacterial infection include the following: </li></ul><ul><ul><li>Blisters leaking a thick yellow or green fluid </li></ul></ul><ul><ul><li>Areas around a blister are red, increasingly painful, or swollen </li></ul></ul>
  167. 199. Chickenpox Treatment <ul><li>Self-Care at Home </li></ul><ul><li>Most cases of chickenpox can be managed at home. Chickenpox rash tends to be extremely itchy. Several treatments can be used at home to help a child feel better. </li></ul><ul><li>Cool compresses applied to blisters may give relief, as may calamine lotion. Lotions containing diphenhydramine (Benadryl) should not be used -- erratic absorption through open skin lesions may occur and be associated with toxicity due elevated blood levels. </li></ul>
  168. 200. <ul><li>You can give cool-water baths every three to four hours, adding baking soda to the water to calm itching . You may also soak in an Aveeno oatmeal bath to soothe itching blisters. </li></ul><ul><li>Trimming fingernails can help prevent infection from scratching the blisters. If you have a small infant with chickenpox, cover the child's hands with mittens to minimize scratching. </li></ul>
  169. 201. <ul><li>Diphenhydramine (Benadryl), loratadine (Claritin), or citirizine (Zyrtec) taken orally also can relieve itching. These medicines are available over the counter. </li></ul><ul><li>Treat fever with acetaminophen (for example, Tylenol ) or ibuprofen (for example, Advil, Motrin, Excedrin, Nuprin, and Pamprin are common brand names). Read the label before giving any medication. Some medicines contain many different agents. If the medicine is for a child, make sure it contains no aspirin. Never give aspirin to a child because aspirin has been associated with Reye syndrome. </li></ul>
  170. 202. <ul><li>Occasionally a child will develop blisters in the mouth, making eating or drinking painful. A person should be encouraged to drink fluids to prevent dehydration. To alleviate pain, provide cold fluids (ice pops, milk shakes, and smoothies) and soft bland foods. Avoid any foods that are spicy, hot, or acidic (for instance, orange juice). </li></ul>
  171. 203. <ul><li>Keep children at home from school and daycare until all blisters have crusted. A child with chickenpox is extremely contagious until the last crop of blisters has crusted. </li></ul><ul><li>If you take your child to a doctor's office, call ahead to let the staff know that you think your child has chickenpox. They may usher you to a special waiting or treatment room to avoid exposing other children. </li></ul>
  172. 204. <ul><li>Medical Treatment </li></ul><ul><li>If you have a fever, your doctor may recommend acetaminophen or ibuprofen. </li></ul><ul><li>If you appear dehydrated and are unable to drink fluids, your doctor may recommend IV fluids either in an emergency room or as a hospitalized patient. </li></ul><ul><li>Secondary bacterial skin infections may be treated with antibiotics. Because a virus causes chickenpox, no antibiotic can cure the disease. </li></ul>
  173. 205. <ul><li>or people who have severe infections, an antiviral agent called acyclovir ( Zovirax ) has been shown to shorten the duration and severity of symptoms if given soon after the onset of the rash. Acyclovir may be given by mouth or by IV to help people at risk for severe infection. </li></ul><ul><li>Neonatal VZV infection may be treated with VZIG (varicella zoster immune globulin) -- a form of highly concentrated anti-VZV gamma globulin. The availability of VZIG is rapidly declining since the only product manufacturer has ceased production. An alternative product, VariZIG, is available on a research protocol. </li></ul>
  174. 208. Warts <ul><li>Many of us have had a wart somewhere on our bodies at some time. Other than being a nuisance, most warts are harmless and go away on their own. </li></ul>
  175. 209. <ul><li>More common in kids than in adults, warts are skin infections caused by viruses of the human papillomavirus (HPV) family. They can affect any area of the body, but tend to invade warm, moist places, like small cuts or scratches on the fingers, hands, and feet. Warts are usually painless unless they're on the soles of the feet or another part of the body that gets bumped or touched all the time.    </li></ul>
  176. 211. <ul><li>Types of warts include: </li></ul><ul><li>common warts. Usually found on fingers, hands, knees, and elbows, a common wart is a small, hard bump that's dome-shaped and usually grayish-brown. It has a rough surface that may look like the head of a cauliflower, with black dots inside. </li></ul>
  177. 212. <ul><li>flat warts. These are about the size of a pinhead, are smoother than other kinds of warts, and have flat tops. Flat warts may be pink, light brown, or yellow. Most kids who get flat warts have them on their faces, but they can also grow on arms, knees, or hands and can appear in clusters. </li></ul>
  178. 213. <ul><li>plantar warts. Found on the bottom of the foot, plantar warts can be very uncomfortable — like walking on a small stone. </li></ul><ul><li>filiform warts. These have a finger-like shape, are usually flesh-colored, and often grow on or around the mouth, eyes, or nose. </li></ul>
  179. 214. <ul><li>Are Warts Contagious? </li></ul><ul><li>Simply touching a wart on someone doesn't guarantee that you'll get one, too. But the viruses that cause warts are passed from person to person by close physical contact or from a surface that a person with a wart touches, like a bathmat or a shower floor. (You can't, however, get a wart from holding a frog or toad, as your child might have wondered!) </li></ul>
  180. 215. <ul><li>Preventing Warts </li></ul><ul><li>Although there's no way to prevent warts, it's always a good idea to encourage kids to wash their hands and skin regularly and well. If your child has a cut or scratch, use soap and water to clean the area because open wounds are more susceptible to warts and other infections. </li></ul>
  181. 216. <ul><li>It's also wise to have kids wear waterproof sandals or flip-flops in public showers, locker rooms, and around public pools (this can help protect against plantar warts and other infections, like athlete's foot ). </li></ul>
  182. 217. <ul><li>Treating Warts </li></ul><ul><li>Warts don't generally cause any problems, so it's not always necessary to have them removed. Without treatment, it can take anywhere from 6 months to 2 years for a wart to go away. A doctor might decide to remove a wart if it's painful or interferes with activities because of the discomfort. </li></ul><ul><li>Doctors have different ways of removing warts, including: </li></ul><ul><li>using over-the-counter or prescription medications to put on the wart </li></ul><ul><li>burning the wart off using a light electrical current) </li></ul><ul><li>freezing the wart with liquid nitrogen (called cryosurgery ) </li></ul><ul><li>using laser treatment (with recalcitrant warts) </li></ul>
  183. 218. <ul><li>Also make sure that your child: </li></ul><ul><li>soaks the wart in warm water and removes dead skin on the surface of the wart with an emery board (that's never going to be used for nails) before applying the medicine. Be careful not to file into it. </li></ul><ul><li>keeps the area of the wart covered while the medicine works </li></ul><ul><li>knows not to rub, scratch, or pick at it to avoid spreading the virus to another part of the body or causing the wart to become infected </li></ul>
  184. 219. When to Call the Doctor <ul><li>Before you try to remove a wart with a store-bought remedy, call your doctor if: </li></ul><ul><li>you have a young child or infant with a wart anywhere on the body </li></ul><ul><li>your child (of any age) has a wart on the face, genitals, or rectum </li></ul><ul><li>Also call the doctor if a wart or surrounding skin is: </li></ul><ul><li>painful </li></ul><ul><li>red </li></ul><ul><li>bleeding </li></ul><ul><li>swollen </li></ul><ul><li>oozing pus </li></ul>
  185. 222. Roseola <ul><li>Roseola (also known as sixth disease, exanthem subitum, and roseola infantum) is a viral illness in young children, most commonly affecting those between the ages of 6 months and 2 years. It is typically marked by several days of high fever , followed by a distinctive rash just as the fever breaks. </li></ul>
  186. 223. <ul><li>Two common and closely related viruses can cause roseola: human herpesvirus (HHV) type 6 and possibly type 7. These two viruses belong to the same family as the better-known herpes simplex viruses (HSV) , but HHV-6 and HHV-7 do not cause the cold sores and genital herpes infections that HSV can cause </li></ul>
  187. 224. Signs and Symptoms <ul><li>A child with roseola typically develops a mild upper respiratory illness, followed by a high fever (often over 103° Fahrenheit, or 39.5° Celsius) for up to a week. During this time, the child may appear fussy or irritable and may have a decreased appetite and swollen lymph nodes (glands) in the neck. </li></ul>
  188. 225. <ul><li>The high fever often ends abruptly, and at about the same time a pinkish-red flat or raised rash appears on the child's trunk and spreads over the body. The rash's spots blanch (turn white) when you touch them, and individual spots may have a lighter &quot;halo&quot; around them. The rash usually spreads to the neck, face, arms, and legs. </li></ul><ul><li>The fast-rising fever that comes with roseola triggers febrile seizures (convulsions caused by high fevers) in about 10% to 15% of young children </li></ul>
  189. 226. <ul><li>Signs of a febrile seizure include: </li></ul><ul><li>unconsciousness </li></ul><ul><li>2 to 3 minutes of jerking or twitching in the arms, legs, or face </li></ul><ul><li>loss of control of the bladder or bowels </li></ul>
  190. 227. Contagiousness <ul><li>Roseola is contagious and spreads through tiny drops of fluid from the nose and throat of infected people. These drops are expelled when the infected person talks, laughs, sneezes, or coughs. Then if other people breathe the drops in or touch them and then touch their own noses or mouths, they can become infected as well. </li></ul><ul><li>The viruses that cause roseola do not appear to be spread by kids while they are exhibiting symptoms of the illness. Instead, someone who has not yet developed symptoms often spreads the infection. </li></ul>
  191. 228. <ul><li>Prevention </li></ul><ul><li>There is no known way to prevent the spread of roseola. </li></ul>
  192. 229. <ul><li>Duration </li></ul><ul><li>The fever of roseola lasts from 3 to 7 days, followed by a rash lasting from hours to a few days </li></ul>
  193. 230. Home Treatment <ul><li>Until the fever drops, you can help keep your child cool using a sponge or towel soaked in lukewarm water. Do not use ice, cold water, alcohol rubs, fans, or cold baths. Acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) can help to reduce your child's fever. Avoid giving aspirin to a child who has a viral illness because the use of aspirin in such cases has been associated with the development of Reye syndrome , which can lead to liver failure and death. </li></ul>
  194. 231. <ul><li>To prevent dehydration from the fever, encourage your child to drink clear fluids such as water with ice chips, children's electrolyte solutions, flat sodas like ginger ale or lemon-lime (stir room-temperature soda until the fizz disappears), or clear broth. If you are still breastfeeding, breast milk can help prevent dehydration as well. </li></ul>
  195. 232. <ul><li>When to Call the Doctor </li></ul><ul><li>Call the doctor if your child is lethargic or not drinking or if you cannot keep the fever down. If your child has a seizure, seek emergency care immediately. </li></ul>
  196. 235. Fifth disease (also called erythema <ul><li>Especially common in kids between the ages of 5 and 15, fifth disease typically produces a distinctive red rash on the face that makes the child appear to have a &quot;slapped cheek.&quot; The rash then spreads to the trunk, arms, and legs. Fifth disease is actually just a viral illness that most kids recover from quickly and without complications. </li></ul>
  197. 236. Signs and Symptoms <ul><li>Fifth disease begins with a low-grade fever , headache, and mild cold-like symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone until a rash appears a few days later. The bright red rash typically begins on the face. Several days later, the rash spreads and red blotches (usually lighter in color) extend down to the trunk, arms, and legs. The rash usually spares the palms of the hands and soles of the feet. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Kids younger than 10 years old are most likely to get the rash. </li></ul>
  198. 238. <ul><li>Older kids and adults sometimes complain that the rash itches, but most children with a rash caused by fifth disease do not look sick and no longer have fever. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to worsen until it finally fades away entirely. </li></ul>
  199. 239. <ul><li>Certain stimuli (including sunlight, heat, exercise, and stress) may reactivate the rash until it completely fades. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and rarely, rashes that look like blisters or bruises. </li></ul><ul><li>In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain, often in the hands, wrists, knees, or ankles. </li></ul>
  200. 240. <ul><li>Contagiousness </li></ul><ul><li>A person with parvovirus infection is most contagious before the rash appears — either during the incubation period (the time between infection and the onset of symptoms) or during the time when he or she has only mild respiratory symptoms. Because the rash of fifth disease is due to an immune reaction (a defense response launched by the body against foreign substances like viruses) that occurs after the infection has passed, a child is usually not contagious once the rash appea </li></ul>
  201. 241. <ul><li>Parvovirus B19 spreads easily from person to person in fluids from the nose, mouth, and throat of someone with the infection, especially through large droplets f </li></ul>
  202. 242. <ul><li>Prevention </li></ul><ul><li>There is no vaccine for fifth disease, and no real way to prevent spreading the virus. Isolating someone with a fifth disease rash won't prevent spread of the infection because the person usually isn't contagious by that time. </li></ul><ul><li>Practicing good hygiene, especially frequent hand washing , is always a good idea since it can help prevent the spread of many infections. </li></ul>
  203. 243. <ul><li>Incubation </li></ul><ul><li>The incubation period (the time between infection and the onset of symptoms) for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days. </li></ul>
  204. 244. <ul><li>Duration </li></ul><ul><li>The rash of fifth disease usually lasts 1 to 3 weeks. In a few cases in older kids and adults, joint swelling and pain because of fifth disease have lasted from a few months up to a few years. </li></ul>
  205. 245. Complications <ul><li>The majority of kids with fifth disease recover with no complications. By the time the rash appears and while it's present, they usually feel well and are back to their normal activities. </li></ul><ul><li>However, some children with weakened immune systems (such as those with AIDS or leukemia ) or with certain blood disorders (like sickle cell anemia or hemolytic anemia) may become significantly ill when infected with parvovirus B19. Parvovirus B19 can temporarily slow down or stop the body's production of the oxygen-carrying red blood cells ( RBCs ) , causing anemia. </li></ul>
  206. 248. <ul><li>Urogenital Tract Infections </li></ul>
  207. 249. How does the urinary system work?
  208. 250. <ul><li>The urinary system removes a type of waste called urea from your blood. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys. </li></ul>
  209. 251. <ul><li>The kidneys are bean-shaped organs about the size of your fists. They are near the middle of the back, just below the rib cage. The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney. </li></ul>
  210. 252. <ul><li>From the kidneys, urine travels down two thin tubes called ureters to the bladder. The ureters are about 8 to 10 inches long. Muscles in the ureter walls constantly tighten and relax to force urine downward away from the kidneys. If urine is allowed to stand still, or back up, a kidney infection can develop. Small amounts of urine are emptied into the bladder from the ureters about every 10 to 15 seconds. </li></ul>
  211. 253. <ul><li>The bladder is a hollow muscular organ shaped like a balloon. It sits in your pelvis and is held in place by ligaments attached to other organs and the pelvic bones. The bladder stores urine until you are ready to go to the bathroom to empty it. It swells into a round shape when it is full and gets smaller when empty. If the urinary system is healthy, the bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours. </li></ul>
  212. 254. <ul><li>Circular muscles called sphincters help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder into the urethra, the tube that allows urine to pass outside the body. </li></ul>
  213. 255. <ul><li>Nerves in the bladder tell you when it is time to urinate, or empty your bladder. As the bladder first fills with urine, you may notice a feeling that you need to urinate. The sensation to urinate becomes stronger as the bladder continues to fill and reaches its limit. At that point, nerves from the bladder send a message to the brain that the bladder is full, and your urge to empty your bladder intensifies </li></ul>
  214. 256. <ul><li>When you urinate, the brain signals the bladder muscles to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs </li></ul>
  215. 257. What causes problems in the urinary system? <ul><li>Problems in the urinary system can be caused by aging, illness, or injury. As you get older, changes in the kidneys’ structure cause them to lose some of their ability to remove wastes from the blood. Also, the muscles in your ureters, bladder, and urethra tend to lose some of their strength. You may have more urinary infections because the bladder muscles do not tighten enough to empty your bladder completely. A decrease in strength of muscles of the sphincters and the pelvis can also cause incontinence, the unwanted leakage of urine. Illness or injury can also prevent the kidneys from filtering the blood completely or block the passage of urine. </li></ul>
  216. 258. What are some disorders of the urinary system? <ul><li>Benign prostatic hyperplasia (BPH) is a condition in men that affects the prostate gland, which is part of the male reproductive system. The prostate is located at the bottom of the bladder and surrounds the urethra. BPH is an enlargement of the prostate gland that can interfere with urinary function in older men. It causes blockage by squeezing the urethra, which can make it difficult to urinate. Men with BPH frequently have other bladder symptoms including an increase in frequency of bladder emptying both during the day and at night. Most men over age 60 have some BPH, but not all have problems with blockage. There are many different treatment options for BPH. </li></ul>
  217. 259. <ul><li>Painful bladder syndrome/Interstitial cystitis (PBS/IC) is a chronic bladder disorder also known as frequency-urgency-dysuria syndrome. In this disorder, the bladder wall can become inflamed and irritated. The inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding, and, in rare cases, ulcers in the bladder lining. The cause of IC is unknown at this time. </li></ul>
  218. 260. <ul><li>Kidney stones is the term commonly used to refer to stones, or calculi, in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system. They vary in size. Some stones cause great pain while others cause very little. The aim of treatment is to remove the stones, prevent infection, and prevent recurrence. Both nonsurgical and surgical treatments are used. Kidney stones affect men more often than women. </li></ul>
  219. 261. <ul><li>Prostatitis is inflammation of the prostate gland that results in urinary frequency and urgency, burning or painful urination, a condition called dysuria, and pain in the lower back and genital area, among other symptoms. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics. But the more common forms of prostatitis are not associated with any known infecting organism. Antibiotics are often ineffective in treating the nonbacterial forms of prostatitis. </li></ul>
  220. 262. <ul><li>Proteinuria is the presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that your kidneys are not working properly. </li></ul>
  221. 263. <ul><li>Renal (kidney) failure results when the kidneys are not able to regulate water and chemicals in the body or remove waste products from your blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This condition can be caused by an accident that injures the kidneys, loss of a lot of blood, or some drugs or poisons. ARF may lead to permanent loss of kidney function. But if the kidneys are not seriously damaged, they may recover. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD). You may go several years without knowing you have CKD. </li></ul>
  222. 264. <ul><li>Urinary tract infections (UTIs) are caused by bacteria in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria. </li></ul>
  223. 265. <ul><li>Urinary incontinence , loss of bladder control, is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men. </li></ul>
  224. 266. <ul><li>Urinary retention , or bladder-emptying problems, is a common urological problem with many possible causes. Normally, urination can be initiated voluntarily and the bladder empties completely. Urinary retention is the abnormal holding of urine in the bladder. Acute urinary retention is the sudden inability to urinate, causing pain and discomfort. Causes can include an obstruction in the urinary system, stress, or neurologic problems. Chronic urinary retention refers to the persistent presence of urine left in the bladder after incomplete emptying. Common causes of chronic urinary retention are bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the ca </li></ul>
  225. 267. <ul><li>Who can help me with a urinary problem? </li></ul><ul><li>Your primary doctor can help you with some urinary problems. Your pediatrician may be able to treat some of your child’s urinary problems . But some problems may require the attention of a urologist, a doctor who specializes in treating problems of the urinary system and the male reproductive system. A gynecologis t is a doctor who specializes in the female reproductive system and may be able to help with some urinary problems. A urogynecologist is a gynecologist who specializes in the female urinary system. A nephrologist specializes in treating diseases of the kidney. </li></ul>
  226. 268. <ul><li>Sexually Transmitted Disease </li></ul>
  227. 269. <ul><li>Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum . It has often been called “the great imitator” because so many of the signs and symptoms are indistinguishable from those of other diseases. </li></ul>
  228. 270. <ul><li>Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils. </li></ul>
  229. 271. Signs & Symptoms <ul><li>Primary Stage The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage </li></ul>
  230. 272. <ul><li>Secondary Stage Skin rash and mucous membrane lesions characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. </li></ul>
  231. 273. <ul><li>Late and Latent Stages The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years.  The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10 – 20 years after infection was first acquired.  In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death. </li></ul>
  232. 274. How does syphilis affects pregnant woman <ul><li>The syphilis bacterium can infect the baby of a woman during her pregnancy . Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease </li></ul>
  233. 275. How is Syphilis Diagnosed? <ul><li>Some health care providers can diagnose syphilis by examining material from a chancre (infectious sore) using a special microscope called a dark-field microscope. If syphilis bacteria are present in the sore, they will show up when observed through the microscope. </li></ul><ul><li>A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe, and inexpensive blood test. A low level of antibodies will likely stay in the blood for months or years even after the disease has been successfully treated. Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis. </li></ul>
  234. 276. Treatment for Syphylis <ul><li>Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done </li></ul>
  235. 277. Prevention <ul><li>The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. </li></ul>
  236. 278. <ul><li>Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STDs so that preventive action can be taken. </li></ul>
  237. 279. <ul><li>Genital ulcer diseases, like syphilis, can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of syphilis, as well as genital herpes and chancroid, only when the infected area or site of potential exposure is protected. </li></ul>
  238. 280. <ul><li>Condoms lubricated with spermicides (especially Nonoxynol-9 or N-9) are no more effective than other lubricated condoms in protecting against the transmission of STDs. Use of condoms lubricated with N-9 is not recommended for STD/HIV prevention. Transmission of an STD, including syphilis cannot be prevented by washing the genitals, urinating, and/or douching after sex. Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately. </li></ul>
  239. 281. Gonorrhea <ul><li>Gonorrhea is a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae , a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus </li></ul>
  240. 282. How do people get gonorrhoea? <ul><li>Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery. </li></ul><ul><li>People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrh </li></ul>
  241. 283. Who is at risk for gonorrhoea? <ul><li>Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults </li></ul>
  242. 284. Signs and Symptoms <ul><li>a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms. </li></ul>
  243. 285. Complications <ul><li>in women, gonorrhea is a common cause of pelvic inflammatory disease (PID) . About one million women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube. </li></ul>
  244. 286. How does gonorrhoea affect pregnant woman and her baby? <ul><li>if a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby. Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary. </li></ul>
  245. 287. Treatment <ul><li>Several antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States, and successful treatment of gonorrhea is becoming more difficult. Because many people with gonorrhea also have chlamydia , another STD, antibiotics for both infections are usually given together. Persons with gonorrhea should be tested for other STD </li></ul>
  246. 288. How can Gonorrhoea be Prevented? <ul><li>The surest way to avoid transmission of STDs is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. </li></ul><ul><li>Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea. </li></ul>
  247. 289. <ul><li>Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to see a doctor immediately. If a person has been diagnosed and treated for gonorrhea, he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person’s risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea. </li></ul>