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FOOD POISONING
Food poisoning is an acute gastroenteritis caused by the consumption of a food material or a drink which contains the pathogenic micro organism or their toxins or poisonous chemicals.Food poisoning is common in hostels,hotels,communal feedings, and festivel seasons.
A group of persons will be affected with same type of symptoms ,and they give a history of consumption of a common food before few hours.
Types of food poisoning
1) Bacterial food poisoning:
Here the micro organisms called bacteria are responsible.The food material may contain the pathogenic bacteriae or their toxin and will be ingested along with the food.
2) Non bacterial food poisoning:
Due to the presence of toxic chemicals like fertilizers,insectisides,heavy metals and ect.
Since bacterial food poisoning is common it is discussed here.
Bacterial food poisoning:
All bacteria are not harmful.There are some pathogenic bacteria which secrete toxins and cause clinical manifestations.These organisms enter the human body through food articles or drinks.
How food poisoning occures:
1) Presence of bacteria in the water.
2) The raw materials for the food may contain toxins.
3) Premises where the food is prepared may contain micro organisms or toxins.
4) Food handlers may have some infectious diseases.
5) Some animals like dogs,rats may contaminate the food.
6) If prepared food is kept in the room temperature for a long time and heated again can make a chance for food poisoning.
7) Purposely some body mixing toxins in the food.
Some common bacterial food poisonings.
1) Salmonella food poisoning:
There are three different varieties of salmonella bacteria.(salmonella typhimurium,salmonella cholera suis,salmonella enteritidis) These bacteria are present in milk, milk products and eggs. Symptoms of this food poisoning include nausea, vomiting and diarrhoea. Fever is also common.
2) Botulism:
This is the dangerous type of food poisoning caused by clostridium botulinum. The spores of these organisms are seen in the soil and enters the human body through pickles and canned fish ect.Compared to other food poisonings here vomiting and diarrhoea are rare Mainly the nervous system is affected.The symptoms starts with double vision,numbness with weakness.Later there will be paralysis with cardiac and respiratory failure ending in death.
3) Staphylococcal food poisoning:
It is caused by staphylo coccus aureus. These organisms usually cause skin troubles like boils and eruptions.It causes mastitis in cow.Through the milk and milk products it enders and causes gastroenteritis.There will be vomiting,abdominal cramps with diarrhoea.
4) Closteridium food poisoning:
This is caused by closteridium perfringens.They are present in stool,soil and water. They enter the body through,meat,meat dishes and egg ect.If food articles are cooked and kept in room temperature for a long time and heated again before eating can result this food poisoning.Symptoms include vomiting ,diarrhoea and abdominal cramps.
5) Bacillus cereus:
The spores of these organisms can survive cooking and causes enteritis. Diarrhoea and vomiting is common in this infection.
How to investigate food poisoning?
1) Examine each and every person affected.
2) Water sample should be tested.
3) Kitchen, store room and food samples should be examined.
4) The cook and food handlers should be questioned and examined.
5) Samples of vomitus and stool of all victims should be tested to identify the bacteria.
How to prevent food poisoning:-
1) Only purified water should be used.
2) Hygiene should be maintained by all persons keeping contact with food.
3) Workers should use masks, cap and gloves during cooking and serving.
4) Sick individuals should not come in contact with food materials.
5) Kitchen and premises should be neat and clean.
5) Vessels should be washed with soap and hot water.
6) Should not keep the prepared food for a long time in room temperature.
7) All food materials should be kept in closed containers.
8) Animals like dog, cat, rat ect should not come in contact with food materials.
9) Vegetables should be washed before cooking.
10) Meat should be fresh and should be purchased from recognised slaughter house.
HERNIA
Introduction
Hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity.A combination of increased pressure inside the body with weakness in the wall is responsible for this condition.In this condition internal organs or parts of organs are protruded out forming a swelling which will increase the size with coughing and lifting weight,and while passing stool and urine.In lying down position the swelling goes inside except in strangulated and irreducible hernia.
Causes:-
1, Weakness in the body wall:–
a) Congenital weakness.
b) Acquired weakness due to injuries,wasting of muscles,suppurative lesions in the wall and presence of weak natural openings,obesity,lack of exercise,repeated pregnancy.
c) Surgical operation with improper suturing or sepsis of operated site.
2) Increased pressure inside the body.
a) Chronic constipation.
b) Recurrent cough.
c) Weight lifting.
d) Stricture of urethra.
Common sites for hernia:–
Hernia can occure anywhere in the body.However there are some common sites for hernia.Due to the presence of hard bony covering chest wall is normally not affected.Hernia in the lower back is also rare due to spine and back muscles and tough ligaments and sheeths.The common site for hernia is abdominal wall.Compared to other parts the abdominal wall is weak due to the presence of some natural orifices.There are some areas wherein the abdominal muscles are weaker and thin and all these factors make a chance for herniation.The common sites for hernia are following.
a) Inguinal hernia:
Here the abdominal contents protrude through the inguinal canal (passage in the lower abdominal wall just above the inguinal ligament.It is seen on either side).This type is common in males.Initially the swelling comes only while straining and goes back while lying down. Later the large portion of intestine may come out which may not go back easily.
b) Femoral hernia:
This type of hernia is more in females.Here the abdominal contents pass through the femoral canal which is seen just below the junction between the thigh and lower abdominal wall(Inside the femoral triangle).The contents pass downwards and comes out through saphenous opening in the thigh and forms a swelling under the skin.
c) Umbilical hernia:
This is common in children.The umbilicus is the weaker part of the abdomen.The contents of the abdomen may protrude as a bulb like swelling while crying and defecating.
d) Incisional hernia:
These hernias are seen in operated sites. Due to improper suturing or sepsis the operated site becomes weak resulting in hernia.
e) Epigastric hernia:
Here the hearniation occures in the epigastrium. It is a rare type.
f) Lumbar hernia:
Here the hernia appear in the lumbar area on either side of the lumbar spine(in the lumbar triangle).This is also a rare type.
g) Obturator hernia:
This is a rare type of hernia. Here the contents pass through obturator foramen in the pelvic bone.
Complications of hernia:–
1) Strangulation:
If the hernial orifice is narrow the abdominal contents may not go back easily, and later the blood flow to the herniated tissues may be blocked due to constricition.This can cause death of protruded intestine.
2) Intestinal obstruction:
This occures when the whole portion of the intestine is protruded in to the hernial sac. The narrow hernial orifice will block the passage of bowels.
3) Infection and peritonitis:
If there is strangulation with death of a portion of intestine there will be spread of infection to the abdomen resulting in peritonitis.
Treatment of hernia:–
Initial treatment: In the initial stages of hernia the following steps may be useful
1) Use of hernia belt:
Special types of hernia belts are available for each type of heania.This will prevent the protrusion and will reduce pain.
2) Constipation,recurrent cough,urinary obstruction ect should be treated.
3) Fat reduction will increase the strength of abdominal wall.
4) Abdominal exercises to increase the muscle tone.
5) Take plenty of leafy vegetables, fruits and fibrous diet for easy bowel movements.
6) Try other systems like Homoeopathy,Herbal medicine and ect
If no relief by the above steps consult a general surgeon for surgical management.
Surgical treatment.
The following operations are done depending up on the type and nature of hernia.
1) Hertniotomy : In this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and the sac is cut off.
2) Herniorrhaphy: Here along with herniotomy the posterior wall is repaired.
3) Hernioplasty: This operation is done if herniotomy is not possible due to wide neck of the sac.Here the repair is done with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or stainless steel mesh.
HOMOEOPATHY
Introduction
Homoeopathy is a system of medicine introduced by a german physician Dr Samuel Hahnemann.He was basically an allopathic doctor who has left the practise because of side effects and temporary relief of symptoms of allopathy.For his bread and butter he started translating the medical books to different languages.While he was translating cullen’s materia medica he came across a herbal medicine called cinchona.It was written that cinchona can cure malaria and it can also produce symptoms similar to malaria on healthy individuals.This point clicked hahnemann’s brain and he prepared an extract of cinchona bark and taken himself.To his surprise he developed some symptoms of malaria like chills and achings.He started doing the same experiment on different individuals and the result was the same.
By this experiment hahnemann came to know that any drug which can produce a set of symptoms on a healthy humanbeing can be used to cure the similar symptoms in a diseased person.He gave cinchona to various malaria patients and the result was wonderful and a system called homoeopathy originated.The word homoeo means similar,pathy means suffering.The basic principle of homoeopathy is ‘similia similibus curantur’ means like cures cure.Hahnemann prepared some other drugs using alcohol as a vehicle and started experimenting on different age groups and noted down the symptoms produced in them.He proved nearly 30 drugs and the symptoms produced were noted down systematically.The symptoms collected by drug proving were categorised in the order in a book form named materia medica pura.
Hahnemann noticed that by diluting the crude drug substences in spirit a dynamic power is developed and is responsible for producing the symptoms on healthy people.Hahnemann started giving treatement to somany diseased persons with the medicines prepared by him on applying the principle similia similibus curantur and got wonderful cures and homoeopathy started spreading all over the world.
He gave medicines to some patients and noticed that symptoms are coming back again.So he understood that the cause for the disease should be treated .After doing experiments and observations he came to know that diseases are actually caused by some dynamic forces and he named them as miasms.[psora ,syphilis,sycosis] He noticed that to cure a person completely these miasms should be eradicated using a similar dynamic force.This idea lead to antimiasmatic drugs which are drugs having disease producing power similar to miasms.He developed anti miasmatic drugs and experimented on diseased persons and got wonderful cures.
Developement of homoeopathy
The principles of homoeopathy was written in book form and he named it organon of medicine.Lateron he started publishing these works and six editions of organon were published.Right from the beginning of homoeopathy somany doctors of other system started working against homoeopathy.But those who were against homoeopathy lateron came to know the truth behind homoeopathy and started practising the same.Physicians like Dr J T Kent,Dr Hering,Dr Boenonghausen ect followed Dr hahnemann’s mission and developed the system.They all started preparing somany other drugs on the basis of guidlines given by Hahnemann.Physicians came to know that by diluting the drug substance in spirit in a systematic way the medicinal power is increasing eventhough the quantity of drug decreases.Since diseases are due to dynamic causes the medicine also should be dynamic.By a process called potentisation same drug in different levels of potencies were made.They found that by increasing the potency the penetrating power of medicine is increased so that it act on a higher level than the usual material form of drugs used in other systems.This unique nature of homoeopathic medicine is the reason for the wonderful cures of even the mental diseases.
General principles
Homoeopathy treats the diseased individual as a whole rather than treating diseased parts or organs.The physical,mental,emotional,social spheres of a person is considered for a permanent cure.This system believes that the diseases are caused due to the derangement of vital force which is an invisible power in every individual.In a healthy state the vital force maintains the equilibrium of mind body and soul .During this man will have normal sensations and functions.When the vital force gets affected there will be external manifestations in the form of signs and symptoms.The imbalance in the body functions makes a shelter for forign organisms(bacteria,viruses,fungi,protozoa ect) and allow them to proliferate &produce so called diseases.Homoeopathy believes thet the real desease comes before the bacteria & viruses,hence the root cause of the disease has to be treated for a permenent cure.The antibacterial and antiviral agents only remove the secondary causes mentioned above.
Diseases are produced by noxious morbific agents called Miasms which are dynamic influences which affect the vital force.There are mainly three miasms PSORA ,SYPHILIS&SYCOSIS. These three causes are accepted by other schools of medicine but called by different names. Psora causes functional disturbances, syphilis causes structural changes in the form of destructions and sycosis causes changes in the form of overgrowth.These three miasms can act individually or in combined form to produce different disease conditions.
Preperation of medicine in homoeopathy
In homoeopathy medicines are prepared from different sources like minerals, plants, animals, toxins, diseased parts ect. Medicines are prepared from these substances by a special process called potentisation.Here the soluble substances are potentised by diluting(mixing with spirit with a downward stroke) with spirit and insoluble substances by grinding(trituration) with sugar of milk.The crude drug substance is first mixed with a calculated quantity of spirit and water and kept for few days .From this mixture extract is taken and is called mother tincture(denoted as Q).From this mother tincture dilutions are prepared by potentisation.Potentisation is a mathematical process by which the quantity of original drug substance reduces but medicinal power increases. Depending upon the ratio of quantity of drug substance and vehicle(spirit or sugar of milk)there are different scales for this process.Each scale has got different potencies which indicate power of medicine.Example in decimal scale the drug substance vehicle ratio is1/10 and the availables potencies are 3x,6x.12x ect.In centismal scale the ratio is 1/100 and the available potencies are 30c,200c ect,in LM potency the ratio is 1/50000 and the available potencies are 0/1,0/2,0/3 ect.Potency is written after the name of every medicine
Same medicine is available in different potencies. Suitable potency is selected according to so many facters like severity,depth of disease,condition of the patient ,nature of disease ,type of symptoms,age of patient and ect.
Subjects studied in homoeopathy:-
History of medicine
History & developement of homoeopathy
Pioneers of homoeopathy
Organon of medicine
Homoeopathic philosophy
Materia medica
Homoeopathic pharmacy & pharmacognosy
Homoeopathic repertory
Homoeopathic case taking
Homoeopathic therapeutics
General medical subjects:
( Anatomy,physiology,pathology,microbiology,parasitology,toxicology,forensic medicine,social & preventive medicine,surgery ,ENT ,gynaecology & obstetrics, opthalmology, dentistry, orthopedics, surgery,general medicine,pediatrics,dermatology ,psychiatry and ect)
Homoeopathic case taking and prescription.
Cure by a homoeopathic medicine is rapid ,gentle and permenent if correct remedy in suitable dose is given. . Just giving one drug for one disease (specific drugs)may not give good result.To come to a correct remedial diagnosis we should have the symptomatology of the person .It is the total symptoms of a person which includes mental generals,physical generals,particular symptoms ect.
All signs and symptoms (mental&physical)of the person is taken in detail.Knowledge about past illness,family history of diseases,food & bowel habits,notable causes,relation to climatic changes and constitution ect are noted down in a systematic order.
Mental symptoms:
Example: fear,anxiety,depression,anger,jealousy and ect….
Physical symptoms:
Example: Body makeup, appetite, thirst, desires, aversions, bowels, urination, sleep, taste, nature of smell, discharges any abnormal sensations like pain, burning, climatic changes, thermal relations, and etc…
Peculiar uncommon symptoms:
This is the speciality of homoeopathic system of medicine.For the selection of a suitable remedy these symptoms are very important.common symptoms which are seen almost in all patients are least important. This is the reason for giving different medicines to different individuals suffering from same disease.Example: Five people suffering from typhoid may get five different remedies because of changes of individual symptoms.
Particular/local signs&symptoms:
This include signs &symptoms related to body parts &organs.
Example: Part affected,any swelling,discolouration ect.
Systemic examination:-
Different systems are examined in a systematic order.(Respiratory system ,digestive system,nervous system,cardio vascular system and ect….) Vital signs
Pulse,blood pressure,temperature,respiratory rate ect are checked here.
General physical examination:
Here body parts are examined from head to foot to findout any changes.
provisional disease diagnosis; Here probable diseases are diagnosed. In homoeopathy disease diagnosis is not that much important for the selection of a remedy,but needed for general management and to know the prognosis.
Investigations : This includes lab investigations and other methods to find out any other major illnesses.
Final disease diagnosis:
After doing all investigations the disease is diagnosed.
Remedial diagnosis:
This is the most importnant part as far as homoeopathy is concerned. For this the selected symptoms are arranged in a systematic order on the basis of importance. Symptoms are analysed to find out the importance of each symptom for the selection of a remedy.Remedies are selected on the basis of similarity.
Suitable remedies are diagnosed by a process called repertorisation. Here books called repertories are used. Repertory is the index of symptoms of materia medica(books which contain the symptoms of drugs).Nowadays computer softwares are used for repertorisalion.By this process we will get the remedies covering maximum important symptom of the patient.
Amoung this group of remedies the most suitable remedy is selected by referring various books and considering the life space investigation of the patient..The selected medicine is given in suitable potency & dose.
ANTI MIASMATIC TREATMENT:
The root cause of disease is miasms which should be eradicated using suitable anti miasmatic drugs.Every drug can eradicate the miasm if there is symptom similarity.There are anti psoric drugs,anti syphilitic drugs and anti sycotic drugs.After diagnosing the miasm suitable anti miasmatic drug has to be given to complete the cure.