Ebola Virus Disease

Due to the recent outbreak of the Ebola virus, we thought it necessary to post some pertinent information regarding the disease.

What is Ebola?

Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases.The infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. Severely ill patients require intensive supportive care. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients.

How is it transmitted?

Ebola is transmitted via direct contact with any bodily fluid and tissue of an infected person. Infection could be through direct or indirect contact with blood, saliva, corpses of persons infected with the disease to mention a few. There are also some animal reservoirs of the virus. Examples include gorillas, chimpanzees, rodents, fruit bats.

Symptoms

During the incubation period, which can last about 1 week (rarely up to 2 weeks) after infection, symptoms include: 

• Arthritis 
• Backache (low-back pain) 
• Chills 
• Diarrhea 
• Fatigue 
• Fever 
• Headache 
• Malaise 
• Nausea 
• Sore throat 
• Vomiting 

Late symptoms include: 

• Bleeding from eyes, ears, and nose 
• Bleeding from the mouth and rectum (gastrointestinal bleeding) 
• Eye swelling (conjunctivitis) 
• Genital swelling (labia and scrotum) 
• Increased feeling of pain in the skin 
• Rash over the entire body that often contains blood (hemorrhagic) 
• Roof of mouth looks red 

Treatment
Treatment is largely supportive since there is no actual drug therapy for the disease. Fluid and electrolyte management are the mainstay. Antibiotics are not effective against the disease because it is not a bacterial infection. However, antibiotics may be used to prevent bacterial superimposition on the disease.

Prevention

Prevention is very crucial to breaking the disease transmission and overcoming the epidemic. Avoiding direct and indirect contact with bodily fluids and tissue of infected persons is the way to go. The practice of barrier nursing for patients in hospitals is effective, so also is frequent hand washing. The use of gloves and appropriate personal protective equipment must be used in taking care of ill patients.There are currently no vaccines for the prevention of Ebola fever though research is ongoing

Further Information

For more information on the Ebola virus, please visit the links below.

http://www.cdc.gov/vhf/ebola/index.html

http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/viral-hemorrhagic-fevers

http://www.who.int/csr/don/2014_08_04_ebola/en/

http://www.who.int/csr/disease/ebola/faq-ebola/en/

Use of Asthma Inhalers (With and without spacer device)

The importance of properly using your asthma inhaler cannot be overstated. There are many persons however, that are unaware or unsure of the proper technique when using these inhalers. A lack of understanding of these techniques may lead to sub-therapeutic dosing, giving rise to exacerbation of symptoms. Please see the videos below for the correct method of their use.

The following video shows how to use your spacer device effectively.

We will be happy to answer any further questions you may have.

Gastroesophageal Reflux Disease (GERD)

What is GERD?

Gastro Esophageal Reflux, GERD is that burning sensation that occurs after a meal as a result of acidic stomach contents that moves upwards into the esophagus. GERD is a condition in which the stomach contents leak backwards from the stomach into the esophagus. This can irritate the esophagus and cause heartburn and other symptoms.

SIGNS AND SYMPTOMS

 Heartburn
 Bringing back up food
 Burning on swallowing
 Tasting acid/burning in throat
 Belching
 Nausea

HOW DOES IT OCCUR?

Acid reflux occurs when the normal defense mechanisms such as the Lower Esophageal Sphincter (LES) and Esophageal Motility are defective or become overwhelmed so that the esophagus is bathed in acid or bile and acid containing fluid for prolonged periods.

Delayed gastric emptying can also increase stomach volume and pressure until the LES fails and the valve mechanism is defeated, leading to acid reflux.

COMMON CAUSES

1. Drugs - Certain drugs you may be taking, can cause acid reflux. These include:

• Aspirin 
• Ibuprofen
• Diclofenac
• Naproxen
• Iron Supplements
• Narcotics
• Anti-Depressants
• Nitrates

2. Diet- foods high in fat, spicy foods, caffeine, citrus juices, soft drinks, alcohol

3.Lifestyle-cigarette smoking, obesity, tight-fitting clothes, heavy exercise, laying too flat while sleeping, stress

4. Medical or surgical– Your doctor may advise you accordingly, in the event you may have some underlying condition

LIFESTYLE CHANGES

• Avoid stressful situations 
• Maintain an adequate weight and quit smoking 
• Eat meals more frequently but in small quantities 
• Raise the head of the bed at a 20 degree angle 
• Have dinner at least 2 hours before bedtime 

DIETARY RECOMMENDATION FOR PATIENTS WITH GERD
Dairy Products

• Skim milk
• Milk (1% fat)
• Low fat soy milk

Vegetables

Celery, Eggplant, Broccoli, Cauliflower, Spinach, Cucumber, Sweet peppers, Lettuce, Carrots


 

Drinks

• Mix of drinks (without sugar)
• Fruit teas (except mint tea) 

PHARMACOLOGIC TREATMENT

There are many treatments for GERD which include:
Antacids: these are in the form of chewable tablets, dissolvable powders, or liquids which neutralize the stomach acid and help to reduce the burning and discomfort associated with GERD. Eg: Calcium carbonate, magnesium hydroxide.

Histamine Receptor Antagonists: they are Cimetidine, Nizatidine, Famotidine and the most commonly used one Ranitidine, it comes in tablet form as well as dissolvable tablets, they help in GERD by reducing the formation of acid in the stomach and provide relief by reducing the associated discomfort.

Proton Pump Inhibitors: these are Pantoprazole, Rabeprazole, Esomeprazole and the most common is Omeprazole, they work by reducing the production of acid in the stomach, they are the most effective at reducing the amount of acid present in the stomach, they take a short while to work but are very effective in reducing the discomfort associated with GERD.