Anthrax

Anthrax Anthrax is a life threatening infectious disease caused by bacteria. It affects your lungs and would cause inflammatory bowel disease. It spreads through skin contact, ingestion and inhalation of spores from animals. The bacteria that cause anthrax live in the body of animals and get contracted through spores. This deadly disease can be prevented and treated. The infection can spreads through bioterrorist attack also.

Causes :

Bacterium by name Bacillus anthracis causes anthrax infection on animals. Initially these organisms live in the soil in dormant form known as spores. The spores are capable of surviving for many years and are difficult to destroy.

Anthrax bacteria can be contracted in 3 methods :

Skin contact : The organisms can easily enter your body by direct skin contact of animals. It would cause painful sores on your skin initially and enter the body.

By ingestion : You have the possibility of getting anthrax bacterium through ingestion when you eat contaminated remains of dead animals. This can cause serious infection and can be fatal.

By inhalation : This is the most serious form of infection of anthrax which can be inhaled directly into your lungs. The spores circulate in the air and can easily be inhaled which would then migrate into the lymph nodes causing serious complications.

Incubation Period :

Incubation period is the time between the initial contact of anthrax and the onset of symptoms. It can be from 2-5 days and it varies according to the species of organisms causing it. For some people it can take weeks together for getting symptoms.

Symptoms :

Anthrax affects the animals and humans causing diseases on the skin, the lungs and the intestine. Broadly it can be categorized into three forms:

Types of Anthrax :

Cutaneous Anthrax :

The skin is the cutaneous layer of your body and anthrax symptoms may appear in the form of reddish brown spots on the skin. The area becomes slightly enlarged with blisters and pus filled ulcers. The lymph nodes in that area become swollen. Some of the symptoms of cutaneous anthrax are pain in the affected area, mild fever, headache and vomiting sensation. The symptoms can become worse in few weeks and prompt treatment of antibiotics is to be taken. In severe cases, it can prove fatal after 6 or 7 weeks, if no treatment is given.

Inhalation Anthrax :

The organisms of anthrax are inhaled by nose. Initially it would produce flu like symptoms with fever and body pain. Within few days the symptoms will get worse and cause respiratory problems. Anthrax will cause pneumonia like signs when the bacterial spores are inhaled by macrophages cells of the lungs which will cause shock, coma or even death.

Some spores will find its way to the glands of the chest where they attack the lymph nodes and start multiplying. With few days they will spread to the entire body and produce toxins. In the meanwhile they will cause tissue death called necrosis and severe hemorrhage. Inhalation anthrax is quite serious disease and most of them affected with this type of anthrax will die. Even if the patient is given antibiotics chances of survival is less since by that time the toxins would have spread to the entire body.

Gastrointestinal Anthrax :

This anthrax enters the body when a person eats contaminated meat or partially cooked food. Initially it will cause nausea, vomiting, loss of appetite and diarrhea followed by high fever and abdominal pain. The bacteria would enter the intestine through the bowel wall and gradually enters the bloodstream to spread through the entire body. It produces deadly toxins that cause death within shot time.

Diagnoses :

The doctor will collect the medical history of the affected person and order for tests like blood profile, throat swab, sputum test and chest X-ay. Further he may order for imaging tests like CT scan or MRI scanning to confirm the diagnoses. Anthrax will be tested in the laboratory and bacteria can be seen under the microscope.

For confirming the test, the lab technician would test the blood sample for the presence of Bacillus anthracis. He would also check the sputum sample or skin lesion swab for the presence of bacteria. Then total count of toxins in the blood is measured.

Risk Factors :

Any person can receive the spores that contain anthrax through inhalation. But people who are involved in certain types of jobs are placed in higher risk than others. The risk factors of getting anthrax is high for people who are working as lab technicians, veterinarians (handling infected animals daily), livestock producers, workers who deal with animal products and military personnel who are (engaged in bio-war events) handling anthrax powder.

People who frequently travel to countries like Southern/Eastern parts of Europe, central/South America, certain parts of Asia, and the Caribbean zone are more prone to develop anthrax than others. Certain areas have high risk of anthrax exposure when infected animals are slaughtered and meats were used. Finally workers who are involved in making drums (made of animal skin) and people who handle such drums are prone to develop anthrax. Such animal hides have chance of getting infected since no tests are made before such hides were imported.

Pictures of Anthrax :

Images, Pics, Pictures and Photos of Anthrax

Treatment :

Early treatment is very much necessary in the case of anthrax. Antibiotic creams that contain ciprofloxacin, tetracycline and penicillin are prescribed for treating cutaneous anthrax. For inhalation anthrax, the patient should be admitted in the hospital and given antibiotics intravenously after giving supplementary oxygen for respiration. It is essential to start with antibiotics for the affected person during a bio-terror attack even before the person becomes ill. Antitoxins are effective in treating patients whose body contains “active” anthrax. The active anthrax will multiply several folds producing toxins in huge quantity affecting the functions of vital organs.

Prevention :

Vaccine is available for treating people who have high risk of contracting anthrax bacteria. But it is not available to the general public till now. Newer forms of vaccines are under research study and being tested with animals.

Shigellosis

Shigellosis Shigellosis is a bacterial infection causing fever, diarrhea (bloody stool) and severe abdominal cramps. Most of the time, the symptoms will resolve on its own without wanting any treatment. Shigella can be contracted by other members by touching the fecal particles that contains bacteria. People working in day care centers are prone to pass on this infection by not washing hands properly while changing diapers. Children of age group 2-4 are more prone to get this bacterial infection. The infection can be fully treated by powerful antibiotics.

Causes :

Shigella is a group of bacteria that causes shigellosis infection. This family of microbe was first discovered by Japanese scientist Shiga and hence this name. Though there are many kinds of shigella bacteria like Shigella sonnei, Shigella flexneri etc. it is the “Group B” shigella bacteria that cause this infection.

There are 3 possible ways by which a child/person contracts this infectious bacterium.

• One is by touching the eyes/nose or mouth after changing the diaper for children and not washing the hands properly. The bacteria is present in the feces of the child which gets into the body by direct skin contact. Toddlers who are not toilet trained may not wash their hands properly and pass on the infection to other children who play with them.


• Second is by eating contaminated food. In restaurants and hotels, people (with this infection) can pass on the infectious bacteria to many people while handling food.


• Third method of transmitting the infection is by drinking contaminated water that contains shigella infection.

Symptoms :

The initial symptoms of Shigellosis begin in a day or two after getting infected. Some of the prominent symptoms of this disease are mild fever, headache, diarrhea (that contains bloody stool) and abdominal cramps. Many people may not have any symptoms but still may carry the infectious bacteria in their feces.

Tests :

Having diarrhea with blood discharge is the best way to identify this infection. Your doctor may order for testing of stool sample to confirm the diagnoses.

Who are at risk?

Toddlers (who are not toilet trained), people who are working in day care centers (handling diapers), workers employed in hospitals, nursing homes, and any group of people who have close contact with others (like those in jails and military barracks are likely to spread infection even if one person is infected) and gay population who are sexually active with other men with infection have increased risk of getting infected.

Complications :

Shigellosis does not create any complications and the symptoms would clear up within a week or two even without any treatment. In rare cases it may cause dehydration (due to continuous diarrhea), seizures (due to high fever), rectal prolapse (due to excess of strain caused by bowel movements), toxic megacolon and reactive arthritis.

Treatment :

For mild form of infection, no treatment is required. In moderate cases you will be given antibiotics like amphicillin trimethoprim or sulfamethoxazole or ciprofloxacin. Sometimes the bacteria become resistant to antibiotics when the infection spreads in a community.

It is true that affected child/adult will get back to normalcy within a week, but the bowel habits may take some time to become normal. For some it may take several weeks or month for getting back the right bowel habit. Some people may develop joint pains due to infection of shigella which is known as post infectious arthritis. Good news about shigellosis is any person who gets this disease become resistant to this particular type of bacteria and hence will not get infected again for several years.

Home Remedies :

If you are a healthy adult it is enough if you drink plenty of water to stay hydrated and to arrest diarrhea. In case of children Pedialyte can be given to balance the loss of water.

Prevention :

• No vaccine is available for preventing shigellosis.


• One can take precautions for not getting infected by shigella.


• Workers employed in day care centers should wash their hands thoroughly to prevent spreading infection to others.


• Children should be instructed to wash their hands with soap water after using toilet.


• People who are working in restaurants should abstain themselves from duty if they have diarrhea.


• Do not send your child to school or day care center if they have diarrhea.


• Avoid drinking contaminated water.

Avoidant Personality Disorder

Avoidant Personality Disorder Some people are overly shy in nature and keep isolated. But avoidant personality is more than this shy nature. He is marked with high rate of social inhibition and he is highly sensitive to criticism. He cannot tolerate being criticized by others. He would have serious problem in maintaining relationships with loved ones and family. About 1-2% of the general population has avoidant personality disorder.

Symptoms :

These people avoid social gathering or any activity that involves group of people in the fear of being criticized. According to them they are unwanted elements in the society though in reality that is not so. They believe that they are far inferior to others and hence have low self esteem which prevents them from interaction with the society.

Some of the prominent signs of avoidant personality disorder are:-

•  Avoiding activities that involve interpersonal contacts in the fear of being rejected or criticized


•  Generally they are unwilling to interact with strangers


•  Even with intimate relations they maintain self control due to the fear of being ridiculed


•  Most of the time they are preoccupied with thoughts of being rejected and criticized


•  Perceive themselves to be far inferior to others


•  Cannot tolerate any new relations or task involving new interpersonal action


•  They hesitate to take personal risks in involving with new activities in the fear of getting embarrassed

Many types of personality disorder become significant only when the person attains adulthood. Few of the symptoms may appear during adolescence but the person is still under development which would shape his/her personality further. By the time the person reaches 45-50 years they would experience extreme range of symptoms leading to distressed relationships.

People with avoidant personality will have social phobia or anxiety. They have overwhelming feelings of shyness, inferiority feeling and hypersensitivity. They have in-built negative emotions like fear of being rejected, detachment (withdrawal) which would cause significant distress for him/her in the society affecting their job or family life. These people will lack self confidence and a sense of belonging. They are scared to maintain intimate relationship with others. A person can be categorized with avoidant personality nature only if he/she has at least 4 of the above symptoms, according to American Psychiatric Association.

Diagnoses :

People with avoidant personality will not seek any treatment though they are fully aware of their problem. If any of your loved ones or friends have some of the above signs you can take him to psychologist for further evaluation and testing. A trained psychologist will listen to the problems and ask few questions regarding your interpersonal relations with the society before concluding about your personality type.

Causes :

There are many theories and factors that are known to cause avoidant personality disorder. It can be due to genetic factors, psychological or social factors. The personality of a person is influenced by various factors like environment, the family in which he is brought up and the way in which he perceives the world. Personality is complex is nature and keeps changing until one reaches adulthood.

Treatment :

Firstly you have to get in touch with an expert therapist who deals with various types of personality disorder. Psychotherapy is given by the therapist for long term after establishing rapport with the client. In case of severe symptoms that disrupts having intimate relationship with others, medications are given by psychiatrist. The client should be made aware of his problem so that he would willingly cooperate with the therapist for attending future sessions. It would take long term for changing particular thought or perception of thinking of an individual and you cannot expect magic results in few sittings.

Individuals with avoidant personality will have poor self image and will have inordinate fear of being ridiculed. He would see only the negative aspects in life and would take the comments passed casually in serious way. The therapist would be smart enough to observe any cues given by the client when he/she is withholding any feelings.

Initially the psychologist would make complete evaluation of his personality by repeating the questionnaire or interview sessions to find out if there is any other personality disorder with him. There is every possibility for hidden social phobia or dependent/borderline personality disorder with the client since many symptoms are commonly shared with these disorders. Once the therapist overcomes the initial inhibitions is would be easy for her to establish rapport with the client to explore his hidden problems of self image and esteem. A good therapeutic relationship is one that can inculcate formation of new relationships with others.

Sleeping Sickness

Sleeping Sickness In medical terms, sleeping sickness is called as “African Trypanosomiasis” which is caused by parasites that is distributed by tsetse fly. This disease is currently restricted to rural African regions and some areas of Saharan Africa. Each year, more than 10,000 fresh cases are being reported by World Health Organization and it is considered that more numbers go unnoticed. Sleeping sickness can be treated by medications.

How it is contracted?

A person will get infected with African trypanosomiasis when he is bitten by tsetse fly that carries the parasite by name Trypanosoma brucei. In some cases, the infection received from the fly can be transmitted to the baby by pregnant mother and by way of blood transfusion. Two types of trypanosomiasis are being recognized namely East African and West African trypanosomiasis.

Causes :

Sleeping sickness is caused by parasite Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense. Tsetse flies are considered to be the carriers of these parasites and the person gets infected by the parasite when being bitten by tsetse flies.

Who are at risk?

People living in the regions of Central Africa and those who are frequently traveling to affected countries are prone to get this infection. Tsetse fly lives in the restricted areas of Africa and infects only selected population. Tsetse fly is abundant in the woodland and savannah regions of Africa. Hence tourists and hunters who are visiting that area are prone to get infection when bitten by tsetse fly. It is advised that visitors should not spend more time in the thick bushes and river-side since they have chance of getting bitten many times.

Symptoms :

There is an incubation period for the parasite which is the interval between the bite of tsetse fly and the initial onset of symptoms. It can be anywhere from 1-4 weeks when the person is infected with East African trypanosomiasis and it can take months together for a person who is infected with West African trypanosomiasis. The symptoms of sleeping sickness include fever (mild to moderate), anxiety, dizziness, headache, loss of quality sleep, mood swings, feeling overly sleepy, excess of sweating, and fatigue. For many people the place (spot) where the fly bites will become red and swollen and may cause pain due to the formation of sores.

Once the disease progresses, it can cause serious symptoms like confusion of thoughts, changes in personality, slurred speech, epilepsy, and difficulty in walking. This occurs when the central nervous system gets affected. At this stage, the person should receive treatment immediately, failing which it can become fatal causing death.

When to see the doctor?

If you think you are infected with African trypanosomiasis or bitten by tsetse fly, having some of the symptoms above, you need to consult your doctor without any delay.

Diagnoses :

Your doctor will inspect the bitten area of the skin checking for painful sores or swollen lymph nodes. He would order for blood tests, skin biopsy and biopsy of the tissue from spinal cord. He will collect the fluid sample from the lymph nodes (known as lymph nodes aspiration) that become swollen due to infection. Once cerebrospinal fluid is collected, the lab technician would check for specific IgM level for confirming the presence of parasite.

Treatment :

The method of treatment varies with individuals depending on the intensity of the symptoms. Treatment should begin immediately if the symptoms are severe and medical reports confirm the diagnoses. Medications like Eflornithine, Pentamidine, Melarsoprol and Suramin are prescribed for treating sleeping sickness. Many patients will be hospitalized and put on IV fluids for arresting the growth of parasite inside the body. Follow up care and testing of spinal tap is necessary for at least 2 years if the diagnosis is confirmed. The infected person will not become immune to the parasite and hence he/she has every chance of getting infected again.

Prevention :

At present, no vaccination is available to prevent sleeping sickness. You can follow some of the preventive tips to avoid getting bitten by tsetse flies. You can avoid traveling to areas which are abundant with these insects. Use insect repellant creams liberally, wear long sleeved clothing that is thick. Do not use bright colored clothing since flies are attracted with dark/bright colors. In case you are sleeping in that area, use fool-proof netting. Avoid visiting bushy areas.

What happens when you are not treated?

Sleeping sickness can cause death due to cardiac arrest within 6 months, if the person is not taking treatment. The parasite will spread throughout the body releasing more of toxins causing heavy sleep and damage to the nervous system. The infected person may go into coma and eventually die.

Mental Illness

Mental Illness “Mental illness” is the general term given to various kinds of mental disorders that affect the thinking and behavior of a person. It can be anything ranging from mild anxiety to most severe forms of schizophrenia. Some types of mental illness can seriously affect the quality of your life disturbing your relationships in office and in your family. Any medical condition that affects the normal functioning of thinking and feeling interrupting the daily activities can be called as mental illness. A mental illness can make life miserable by causing problems and affecting relationships at office or family.

Some of the common mental illness is bipolar disorder, borderline personality disorder, obsessive compulsive disorder, eating disorder, major depression, panic disorder and anxiety disorder. It is possible to cure all illnesses with continued medications or psychotherapy.

Causes :

What exactly causes mental illness is still a mystery. Certain conditions or combination of factors can produce such illness according to the opinion of medical experts. Genetics play a role in causing mental illness because certain types of disorders run in families and passed on from parents to their offspring. Genes are the fundamental units that decide how you think and act in a given situation.

Biological factors like abnormal functioning of neurotransmitters can affect the normal thinking of a person causing mental illness. Neurotransmitters act as communication receptors of the brain sending and receiving signals. Any change or chemical reactions in the neurotransmitters can affect normal thinking pattern. Psychological factors like child abuse, emotional trauma or sudden loss/death can affect the brain causing mental illness.

Symptoms :

Symptoms of mental illness are not the same for all disorders. It varies considerably according to the nature and intensity of the disorder. For example depression can produce sadness, anxiety disorder can produce restlessness and excessive fears, borderline personality disorder can impair the normal thinking causing poor concentration and confused thinking, avoidant personality disorder can produce social phobia and anxiety, eating disorder can produce major changes in one’s eating habits etc.

Some of the common symptoms of mental illness include extreme mood swings, excess of fear/worries, guilt feelings, withdrawal from family/friends, confused thinking, change in behavior, detachment from reality, hypersensitivity, loss of sleep and extreme tiredness. In many cases mental illness can cause physiological changes causing headache, back pain and unexplained pain on many parts of the body.

When to see a doctor?

Any feeling or behavior affecting normal functioning of life can be mental illness. Mental illness can become worse if not treated on time. Most of the personality disorder and other illnesses can be treated by effective psychotherapy. Some people can develop suicidal thoughts due to major depression. Nonverbal communication and body language can reveal their intention of committing suicide. In such cases it is necessary to consult your doctor immediately.

Who are at risk?

Any person can develop mental illness. But there are certain factors which make you prone to mental illness. Having parents or close relatives with schizophrenia or other disorder, exposure of fetus to drug abuse or excess of alcohol in the womb, experiencing traumatic childhood, getting neglected as a child, serious injury on the brain and having chronic physical illness like cancer/AIDS etc. makes one prone to develop mental illness.

Tests :

Your doctor may get complete medical history and order for few lab tests including blood profile, hormone tests etc. He may refer you to mental health provider for evaluating the nature of disorder. Psychologists or therapists would ask you series of questions and determine about your state of mind by the way in which you are answering them.

Types :

• Mental illnesses are of many types with varying intensity.


• Mood disorders are one that affect your thinking, behavior and emotions like major depression, bipolar disorder etc.


• Anxiety disorders are one that causes frequent worries, fears and uncomfortable feeling like panic disorder, OCD and phobias.


• Disorder caused by substance/drug/alcohol abuse.


• Psychotic disorders are one that causes delusions and hallucination affecting daily activity of a person. Example: schizophrenia that makes one to lose touch with reality.


• Cognitive disorder that affects one’s reasoning ability and thinking like dementia and delirium and Alzheimer’s disease.


• Developmental disorders (autism/ADHD), personality disorders (paranoid personality, avoidant personality) and other disorders can also seriously affect one’s quality of life.

Treatment :

Psychiatrist or psychologist will examine the concerned person and check the severity of the illness. Treatment methods vary according to the nature of disease and intensity of the mental illness. Often, combination of medications and psychotherapy is effective in treating many disorders.

Medications are given depending on the symptoms of the patient. Antidepressant drugs are given for treating symptoms of hopelessness, helplessness and lack of interest. Mood stabilizing drugs are given for bipolar disorder, anxiety medications are useful for giving relief from irrational fear and anxiety and antipsychotic drugs are given for controlling more serious forms of mental illness like schizophrenia.

Psychotherapy :

Most of the mental illness responds well to psychotherapy. A therapist will make you talk freely about your inner feelings giving let-out for the pent up feelings to explore problems in inner mind. The therapist will establish rapport with the client making him/her comfortable so that he can ventilate the feelings without any inhibition. She would use total relaxation technique and psychoanalysis to explore your inner state of mind. Slowly the client will be able to overcome the stress and learn the ways to cope up with the problem. Even serious types of mental illness like phobias and anxiety can be treated by psychotherapy.

For some people doctor would use brain stimulation methods like electroconvulsive therapy and magnetic stimulation methods. For more severe cases, the patient will be hospitalized requiring residential treatment. To recover from alcohol or substance abuse, combined treatments of medications and psychotherapy is given.

Lifestyle Changes :

It is difficult to accept that you have some problem. But you can get well soon if you cooperate with your family/friends to overcome the issue. Follow the instructions of your doctor/therapist and stick on to the treatment schedule. Do exercises regularly and eat healthy foods. Go for a walk or join a gym to stay healthy and active. Don’t stop any medication without consulting your doctor. If you are not able to make important decisions get help from your family or friends. Be optimistic in approach and try to accept changes.

Prevention :

Nobody can prevent mental illness. It is not certain that mental illness develops only on weak-minded person and not on others. Some changes in chemical reaction on the brain can cause significant changes in your thinking and behavior. Don’t ignore warning signals if you suspect any symptoms. Talk to your therapist freely and get medical checkups done regularly.

Dependent Personality Disorder

Dependent Personality Disorder People with dependent personality will be feeling helpless most of the time and they are lot more submissive in nature. They always seek care and attention from others and are unable to make any decisions on their own. Even for completing everyday’s task they seek advice/assurance from others.

Symptoms :

Individuals with DPD will be emotionally dependent on others and will make every possible effort to gratify others. They exhibit clinging behavior and always need people for advice. Some of the other traits of dependant personality are:-

•  Unable to make decisions even on trivial matters without getting advice from others


•  They avoid tasks that involve independent functions and they seldom hold responsible posts


•  They will have intense fear of abandonment and helplessness in ending any relationship


•  They are highly sensitive to criticism and cannot take things easy


•  They lack self confidence and they will not disagree with others even if they know they are wrong


•  They feel uncomfortable when left alone


•  Willing to tolerate abuse and even mistreatment from others in the fear of getting abandoned


•  Will let others to take responsibility even for major decisions that concerns them

People with DPD will have high rate of separation anxiety. They grow up with intense fear, helplessness which compels them to be submissive with others. They feel insecure when left alone or separated and are always anxious about this kind of imaginative fear. Owing to this irrational fear they become overly dependent and submissive to others which would cause serious impairment in relationships at school or workplace. They do not possess certain essential social skills like independence and assertiveness.

Separation anxiety and dependent nature are acceptable behavior in childhood and even during adolescence. But the same behavior continues in adulthood it becomes unacceptable by the society. Most of the adolescents will overgrow this sort of anxiety when they become adult. However there are few people who cannot overcome this feeling and become overly dependent on others. They think that they are unable to handle any task or conflict. Basically they don’t trust their own talents.

Complications :

People with DPD may develop depression and may develop addiction for alcohol or drugs. They are also susceptible to sexual abuse or emotional abuse by others who take advantage of their personality. In some cases they go far extent of undergoing abuse to maintain a relationship.

Causes :

The real cause of dependent personality disorder is not known. It can be due to biological, developmental or psychological factors. If the parents are overly protecting the child, he may grow up to become a dependent personality.

Tests :

There is no lab test or blood test available for determining this disorder. The doctor will refer the case to psychologists who will devise specific interview techniques and assessment tools for finding out the type of personality of the person.

Treatment :

Individuals with DPD will not seek treatment on their own. Some people will go to a psychiatrist if things become worse in their life and they are preoccupied with the thoughts of fear of losing relationships. Often people with this disorder may develop anxiety/depression disorder. Sometime, the concerned person will have significant problem at his office due to his irrational fear of losing relationships with his superiors.

The therapist will use psychotherapy and cognitive therapy for bringing the desired changes in behavior and to induce self esteem in the minds of the person concerned. Cognitive therapy focuses on the belief system to bring out the hidden talents in them and in resolving the conflicts. Improvements in their behavior can be seen in the long run. Psychologists will use different strategies to boost their self confidence level and to induce assertiveness in them. To reduce the depression/anxiety problem medications are given.

Prevention :

There is no way to prevent DPD since the root cause of the problem arises from one’s thinking based on irrational fear.

Paranoid Personality Disorder

Paranoid Personality Disorder Paranoid personality disorder is characterized by odd/eccentric thinking. The affected people have paranoia with insistent mistrust on others. They would always doubt on others even though there is no reason for it. This disorder manifests in early adulthood and is found more in men than women. The personality of any person is shaped according to the way in which he/she perceives and relates the world. Some types of personality disorders show peculiar behavior that deviates clearly from the social norms. Any person is said to have personality disorder only if his behavior or thinking is different, rigid and inflexible and causes significant impairment in relationships with others.

People with paranoid personality disorder have a tendency to interpret other people action as deliberately threatening. They will always have feelings of distrust, unknown fear and unjustified suspicion on others. These people are seen often misinterpreting other’s comments/behavior that induces them to develop baseless resentment for them for long time.

Symptoms :

The intense doubts of these people would interfere with the ability to make close relationships. Some of the signs of paranoid personality disorder are:-

• Doubt the loyalty of others all the time. Having intense suspicion that each person around them are deceiving them


• Will not reveal any personal information to others due to fear that others will misuse against them


• Hold grudges on others and will not accept criticism


• Perceive casual looks as purposeful and will identify some hidden meanings in any remarks


• Have suspicion on others without any reason and will react violently and fast in responding


• Cannot maintain good relationships even with spouse or lovers


• Cannot accept their role in any problem since according to them they are always right


• Very stubborn, argumentative and socially isolate

Causes :

Like many other personality disorders the exact cause for PPD is not known. It can be due to multiple factors including hereditary, biological as well as environmental factors. Individuals with close relative having schizophrenia or other mental illness are prone to develop PPD and other types of personality problems. Negative childhood experiences and neglect or baseless parental rage can cause this problem.

Diagnoses :

The doctor will collect complete history of the affected child/person from parents and close relatives. He would also gather information about the mental health of his relatives. He would then refer the case to any psychologist or psychiatrist who will use the tools like questionnaire or other assessment methods for studying the nature of personality.

Treatment :

Individuals with paranoid personality will not accept that they have a problem. It is the duty of loved ones or close relatives to encourage them to take treatment with psychologist. Psychotherapy is often used for improving coping skills of the concerned person which in turn would increase his self esteem and communication skills. Since these people will not trust others, they will find some reason to skip the therapy sessions. It can be challenging for the therapist to convince them initially. It is really difficult to make them to stick on the treatment plan. But without treatment this disorder can become worse spoiling their relationships at office. It can lead to loss of employment or disruption of relationship with spouses.

The therapist will devise comprehensive plan for includes family support for reducing the symptoms. They would also require consistent therapy depending on the intensity of their symptoms and poor adjustments. Many times these people will terminate the therapy sessions finding some faults or excuses. Building client-therapist rapport is difficult with paranoid people. Medications are rarely given to these people only if they have depression/anxiety disorder. If the symptoms are severe anti-psychotic drugs are prescribed for relaxation.

Prognosis :

In case the disorder is chronic the person will need lifetime treatment. There are people who are able to manage relationships and jobs with paranoid personality. But many others will have tough time to maintain their relations/jobs making life complicated. The outcome may be poor if there is no continuity in the treatment plan.

Esophageal Cancer

Esophageal Cancer Esophagus is the organ that connects your throat with the stomach. It consists of thin long tube measuring about 10 inches that carries whatever food you eat to the stomach for digestion. Esophageal cancer occurs when the soft delicate lining of the esophagus gets affected and it can develop on any part of the esophagus. Esophageal cancer is of 2 types caused by squamous (affecting the upper part) cell carcinomas and adenocarcinomas (affecting the lower part of esophagus). Men are more affected than women. This type of cancer develops in 5 stages ranging from mild to most severe.

Esophagus consists of the following layers of muscular tube :-

Inner lining of mucosa is very moist so that food can easily pass to the stomach. Next comes the submucosa and the function of this is to secrete mucus to keep the inner layer moist. Next one is the muscle layer that helps in pushing the food down and the last is the outer layer that covers the esophagus superficially.

Cell is the fundamental unit of your body which produces tissues and other organs. Normally cells grow old and die following which new cells are formed. But for cancer patients the reverse happens. Old cells will not die and more and more new cells are formed leading to building up of extra cells which takes form of a tumor.

Cell growth can be malignant (cancer causing) or benign (non cancerous). Benign growth of cells is not of importance for life and they do not disturb the tissues that surround them. They will not spread to other organs also, whereas malignant growth of cells can affect and damage the neighboring tissues and spread to other parts of your body.

Symptoms :

Esophageal cancer begins initially with difficulty in swallowing food. You may have problem in chewing and swallowing some food items. It can cause chest pain or burning sensation in your chest (can be due to other reasons also). There would be loss of weight, tiredness and choking (while eating) and frequent indigestion problems. It can cause irritant cough when food particles gets stuck inside the esophagus. Some people may feel pain while swallowing and change in voice which does not go away even after taking medications. For many people, esophageal cancer does not show any early symptom.

Risk Factors :

Still doctors cannot explain why particular person develops this cancer and others do not. Some of the risk factors are being male, being aged (above 65 years), smoking and drinking regularly, being overweight and having acid reflux problem. Prolonged acid reflux problem can cause Barrett esophagus leading to adenocarcinoma. Research indicates that diet less in vegetables and fruits can make you prone to esophageal cancer.

Types :

Two types of esophageal cancer are:

Adenocarcinoma which affects the lower portion of the esophagus which is the common type of cancer and Squamous carcinoma which affects the thin lining of esophagus affecting the middle portion. In rare cases, esophageal cancer can cause bleeding and severe weight loss.

Tests :

The doctor will examine the symptoms and order for endoscopy. In this procedure, a thin tube is passed through the throat to examine the inner portion of the esophagus through the lens. Barium liquid is given to you to drink and series of X-rays are taken immediately. The resulting X-ray will underline the extra growth of the cells inside. For some cases, a biopsy is done by removing small tissue sample from the esophagus.

Stages of Esophageal Cancer :

• It is very helpful for the doctor to decide on the treatment options once he knows about the right stage of your cancer.


• First stage of cancer affects only the topmost layer of the lining of esophagus.


• Second stage of cancer invades deep into the esophagus lining spreading to the lymph nodes also.


• Third stage of esophageal cancer will spread to the deepest part of the layer affecting tissues.


• Fourth or final stage of cancer is widespread and usually affects other body parts also.

Treatment :

Treatment depends on the age, health condition and how far the cancer cells have spread. Number of methods like chemotherapy, radiation therapy and surgery is available. Normally a team of doctors like gastroenterologist, thoracic surgeon, and oncologist and radiation therapists. You may need from the dietician also if you have problems in swallowing. You can always get a second opinion from other doctor before commencing the treatment.

Surgery :

Usually a combination of treatment along with surgery is recommended for treating esophageal cancer. In case the cancer cells are very small (affecting only the superficial layer) your surgeon will remove the cancer cells alone using endoscopic procedure. If the cancer is in the second stage (spreading till the lymph nodes) your surgeon will consider removing small portion of your esophagus. He would use a small portion of the colon for replacing the missing portion of your esophagus.

In case if the cancer cells have advanced esophagogastrectomy is to be done for removing most of the upper part of the esophagus. The stomach region will be pulled up to attach with the balance portion of the esophagus. Any of the surgery mentioned above carries risk of getting infected or leakage. And depending on the intensity of the disease it can be successful or not. For minor forms of esophageal cancer the tube is widened to place a metal stent inside the esophagus. For some people a small feeding tube is inserted into the stomach directly for getting nutrition.

Chemotherapy :

Chemotherapy is given before or after surgery for treating esophageal cancer. Suitable drugs are given orally for destroying cancer causing cells. These drugs can also attack healthy cells causing infections and bleeding. It may also cause adverse effects like joint pain, rash, tingling sensation in the hands and feet.

Radiation Therapy :

Radiation is given for killing cancer cells either externally or internally. The surgeon would apply local anesthetic for numbing your throat and puts in a thin tube through which he sends radioactive rays. In many cases combination of chemotherapy and radiation gives the desired effect. Clinical trials have become the recent addition for treating esophageal cancer.

Lifestyle Changes :

You need to cope with variety of problems like difficulty in swallowing and loss of weight due to cancer. Doctors would suggest you to be on liquid diet or with tube feeding until the area are completely healed. Eat foods that are soft and easy to swallow and eat small frequent meals rather sticking on to two larger meals. Include vitamin supplements in your diet with consultation of your doctor.

Variety of alternate treatments like acupuncture, hypnosis, yoga and relaxation techniques are available for getting relief from pain.

Living with Cancer :

There would be strong feelings of sadness and shock when you are diagnosed with cancer. Learn fully about the stage of cancer from your doctor. Stay connected with your family and friends. Join a support group to share your feelings and for getting encouraged that you are not alone.

Prevention :

You can reduce the risk of developing esophageal cancer by quitting smoking and quitting drinking. Include plenty of liquids, vegetables and fruits in your diet. Do regular exercise and stay on healthy weight.

Malabsorption

Malabsorption We all depend on food and drinks for meeting the demands of our body. As long as the system has the ability to absorb the required* nutrients from the food, there is no problem. But when the body cannot absorb the necessary vitamins and minerals from the food, it causes deficiency. The inability of the body to absorb the necessary nutrients from the food is known as malabsorption. The energy derived from the source of food is sent into the blood through the intestine to carryout various functions.

Symptoms :

Some of the signs of malabsorption are foul smelling stools, bloating, fullness in the stomach, discomfort in your abdomen, loss of weight (unintentional), frequent diarrhea and flatulence and fatigue. The intestine can no longer absorb necessary nutrients like iron/Vitamin B12 which can adversely affect the general health condition of your body.

Deficiency of fat particles in your body can produce foul smelling stools which are difficult to flush out. Similarly deficiency or malabsorption of proteins in the blood can cause edema and hair loss. When there is increased deficiency of sugars in your blood it can cause bloating and frequent diarrhea. Loss of vitamins can lead to anemia, low blood pressure and loss of weight.

Causes :

Number of diseases and disorders can cause malabsorption. Any abnormality in the intestine or gastrointestinal tract will seriously affect the rate of absorption. Malabsorption can be caused due to celiac disease, any diseases in the gallbladder or liver, lactose intolerance, AIDS or other autoimmune disorders, Whipple disease, excessive growth of bacteria, excess production of gastric acid and damage to the intestine due to injury or surgery or infection.

Some other factors that cause malabsorption are overuse of antibiotics, pancreatitis, and birth defects in the gallbladder, undergoing radiation or chemotherapy and inflammation of the intestine. Diseases like short bowel syndrome and tropical sprue can also affect the function of intestine leading to malabsorption.

Who are at risk?

Long term use of antibiotics, certain diseases like cystic fibrosis or celiac disease, undergoing surgery on the intestine, excess use of laxatives, and over consumption of alcohol can cause increased risk of developing malabsorption. People who travel frequently to regions of Southeast Asia and India where tropical sprue is prevalent are at increased risk of developing malabsorption.

Tests and Diagnoses :

Your doctor will listen to your symptoms after collecting your medical history. He may order for blood tests for determining the levels of minerals and nutrients. If necessary pancreatic function test will be done for confirming the lab report. Stool test is to be done for testing the presence of excess of fat. To identify the rate of intestine absorption Xylose absorption test is done. In some cases, a biopsy is done by taking out small tissue sample from the intestine.

Treatment :

The aim of the treatment is to make good the deficiency of required nutrition. Hence giving supplemental nutrition is the best choice. The affected person should include a diet rich in minerals and vitamins that has necessary nutrients like fat, vitamins and proteins. In severe cases extra nutrients will be given through intravenous fluids by admitting the patient in hospital.

Anyone having the symptoms of malabsorption or diagnosed with this problem should get in touch with a dietician for adding the required nutrients in food. Eat small quantities of meals frequently to overcome excess of fatigue and dizziness. Absorption of nutrients from the food becomes easy for the intestine if you take small meals number of times per day. Subsequently weight loss can be overcome if you follow the diet chart of your dietician.

Prevention :

Many diseases and conditions that cause malabsorption can be managed by you by taking appropriate measures. Follow the instructions of your doctor and include plenty of supplementary nutrition in your diet.

Histrionic Personality Disorder

Histrionic Personality Disorder Individuals with histrionic personality will be craving for attention and emotionally unstable. They cannot be comfortable when they are not the center of attention in a gathering. They exhibit inappropriate behavior to draw the attention of opposite sex. In their view physical appearances counts a lot for drawing attention and hence they spend more time on showing themselves as attractive.

The other name for histrionic personality disorder is “dramatic” personality disorder since people with this problem will be highly emotional and do anything for the approval of others. They often behave inappropriate or dramatic manner for getting noticed. Their expressions are highly dramatic and theoretical. They can be easily influenced by situations and circumstances. They give more attention for relationship than for their self-worthiness.

Salient Features :

Important traits of histrionic personality are :

• Emotionally unstable and unrealistic


• Exhibit more of dramatic expression


• Attention seeking behavior all the time


• Lack of genuineness and chastity


• Not bothered about the consequences of their behavior

Their emotional instability and antagonistic behavior will put them in trouble in school or workplace, but they don’t care for the consequences. Very often histrionic type of behavior begins in childhood or early teens. These people are highly dependent on their partners and seek to control them through emotional blackmailing and seductive acts.

These people don’t give importance for old relationships since they are excited to make new relations. Their emotional instability will induce them to change their emotions rapidly. It is difficult to predict about their emotions since they are highly unstable in controlling their emotions. The symptoms are visible during adolescence and histrionic personality disorder is more prevalent in women than men.

Symptoms :

The individual with histrionic disorder will remain uncomfortable and restless if he/she is not the center of attraction. Some experts are of view that attention craving behavior will start as early as childhood in these people. Their dressing manner is provocative and often they exhibit seductive behavior. Their emotions will change rapidly and they act dramatically with heightened emotions. There will not be any sincerity or genuineness in their expressions.

These people give utmost preference for their appearance. They can be easily cheated by others since they never think before acting. They are extremely sensitive to criticism. For getting noticed they will go to any extent even making suicide attempts. They seldom maintain relationships since they keep on changing relationships.

Causes :

Exact cause of histrionic personality disorder is unknown, but experts believe that it can be inherited. The same personality disorder may run in families suggesting that genes play a vital role in shaping the personality.

Neuro-Chemical Approach :

It has been proved that people with histrionic personality have malfunction of neurotransmitters. Signals are received and transmitted by nerve cells through nor-epinephrine. Only these signals determine the way in which a person behaves. For people with HPD these impulses will not function at normal rate. This can be the reason for such behavior.

Developmental Factor :

Traumatic experience in childhood can influence his behavior and change his personality. Severe forms of histrionic personality disorder can occur if the child suffers disapproval from his parents during early childhood. Environmental factors can also influence one’s personality.

Diagnoses :

The doctor will look for the above signs and symptoms and gather information about the character of the affected person. He may order for blood tests and imaging tests to rule out any possibilities of physical illness. A psychiatrist will be assigned to diagnose the nature of mental illness. She will use different set of tools for assessing the type of personality.

Treatment :

Following any treatment plan is really a difficult task for the concerned person, because they might not like routine tasks. Also they often give excuses of various reasons for their behavior and exaggerated feelings. Psychotherapy is the effective approach for treating a person with histrionic type personality. Through repeated cognitive therapy the person will become aware of his problem which may be helpful in changing his feelings and behavior. Psychologists will motivate them and help them to learn about the ways in which one is expected to behave in a society.

Cognitive behavior therapy uses more systematic approach for focusing on the problems faced by people with histrionic type personality. This therapy is aimed in reducing the irrelevant thoughts of those affected with HPD and stresses on the importance of taking care of “self”. It would also focus on identifying the automatic thoughts to reduce their impulsive behavior. Therapists would use many novel methods for decreasing their dramatic behavior. They would also adopt modeling techniques to teach them about the ill effects of theatrical behavior on others.

Group therapy and family therapy are also effective in overcoming the dramatic behavior of these people. In case of severe depression medications are prescribed to overcome the symptoms. Except for few severe cases, others who have histrionic personality disorder can manage their lives with the help of psychologist and family support. Meditation techniques have been widely used to help the HPD patients to improve their concentration on their inner feelings. Hypnosis method is administered by psychologists to relax their inner mind to overcome their dramatic behavior.