FOOD POISONING
Severe vomiting and diarrhea following consumption of food is called food poisoning. It may be due to infective or chemical causes. Infective cause is of two types, namely, those that are caused by live micro-organisms and those caused by pre-formed toxins produced by organisms present in the food. Some of the causative micro-organisms are salmonella, clostridium botulinum, bacillus cereus, etc. Chemicals causing food poisoning include arsenic, lead and mercury particles. The infectious organisms and toxins on entering the intestine prevent the absorption of food but releases water from the cells into the intestine leading to diarrhea and vomiting. Loss of water produces signs of dehydration which is treated with adequate supplementation of water and electrolytes like sodium, chloride, potassium and glucose (in the form of salt and sugar). Anti-diarrheal drugs should never be used without finding out the underlying cause. Infection is treated with appropriate antibiotics if the presence of specific organism is found out. Contamination with infected food handlers, flies, chemicals, unhygienic food materials, infected tinned foods should be avoided. Food poisoning cases usually occur in groups with all patients sharing a history of a common meal or traveling. Good hygiene is the only effective measure to prevent it.
Pneumonia is still the leading cause of death among infants and children in developing countries. It is caused by micro organisms like bacteria, viruses and fungi. Overcrowding, low socioeconomic status, polluted unhygienic surroundings, predispose to the development of pneumonia. It is more prevalent and more serious in infants than adults. The organisms reach the lungs through the nasal route and on reaching the lower respiratory passages start multiplying. It thus establishes an infectious focus which may even spread to the whole lungs in immune deficient, malnourished and the infants. It presents as difficulty in breathing, fever, productive cough and wheeze and chest pain. Infants express it by inability to feed, abnormally sleepy and presents with chest indrawing and convulsions. Treatment is by vigorous therapy antibiotics like cotrimoxazole, amoxicillin and others. Sensitivity tests should be performed to find the antibiotic to which the organism is susceptible before deciding the appropriate antibiotic since drug resistant strains are more rampant now. Breathing should be carefully monitored and wheezing treated by inhalational, oral or intravenous adrenergic. Vaccines for pneumonia like Hib, measles and Pneumocccal conjugate vaccines are now available which can be given to infants, young children and immuno compromised. These help preventing the disease.
Skin cancer is rapid growing, highly invasive, destructive tumor that invades the deeper tissues so much even before it becomes grossly obvious to the exterior. More common among whites and fair skinned people whose skin is more sensitive to sun’s rays. There are three types of skin cancer namely squamous cell carcinoma, basal cell carcinoma and malignant melanoma. Melanoma is a malignant change of a birth mark or a newly acquired nevus. It should be suspected following the ABCD rule A-asymmetry B-borders irregular C-color variations D-diameter increase. Causes of skin cancer are sun’s harmful UV rays, some chemicals and benzene dyes. This causes knockout or alteration of certain genes in DNA which control cell cycle leading to unchecked proliferation of cells resulting in cancer. The cancer cells reach distant organs via blood setting up malignant change in several foci. It may present as a obvious mass, a chronic ulcer, a pigmented nevus or with non specific symptoms like fatigue, loss of weight and appetite. A well defined lesion is treated with excision and topical application of anti cancer drugs. Oral drugs are prescribed in invasive cases. Whole body is scanned by CT or MRI to detect hidden cancerous foci. Elimination of occupational hazards and sun blocking methods are few preventive measures.
Typhoid is a common infectious disease caused by salmonella typhi. This bacterium survives well in sewage, ditches, contaminated water and food items. Food gets contaminated with this bacterium through water or through infected food handlers who may be suffering from disease or by carriers. The bacterium is shed in excreta of infected patients. Therefore unhygienic measures are the primary cause of spread of this disease. The bacillus reaches the intestine by oral route and sets up an infection. Spillover of bacilli to blood results in fever with a typical step ladder pattern. The other symptoms of this disease are vomiting, diarrhea alternating with constipation, rose spots (visible in fair skinned people), weakness of muscles etc. the duration of illness is about 2 weeks after which it starts resolving. But intestinal ulcers are formed as a result of improper healing of infectious foci leading to the risk of perforation of bowel. Other complications include pneumonia, nephritis, urinary retention etc. Chronic carrier state results in prolonged shedding of bacilli for even 40 years a typical example of which is Typhoid Mary, a food handler who infected thousands of people in England. Treatment is by antibiotics like ciprofloxacin, amoxicillin and cotrimoxazole. Hygienic measures keep the disease at bay.