Know Your Disease

HEPATITIS C

 Hepatitis C is parenterally transmitted causing a
mild acute hepatitis. 50% of patients develop chronic infection and hepatitis,
20% of whom develop cirrhosis. These patients are at risk of hepatocellular
carcinoma. The other 50% recover completely. In Britain 0.1 to 0.5% of the
population are infected with this virus. The rate of progression of the disease
is variable. In 20% of cases cirrhosis develops in 5-10 years. But in the
majority the prognosis is good. Hepatitis C virus is an RNA virus, which has
around 12 or more genotypes according to the amino acid sequence. The route of
transmission is parenteral in 40% and includes hemophiliacs,
thalassemics, drug abusers and patients on hemodialysis. Sexual transmission,
perinatal spread and intra-familial spread accounts for around 60%. The
prevalence in the general population in Western countries is 0.5-3%. Prevalence
among blood donors was found here to be 3.61%. The highest in Egyptians (27.2%)
and around 1.7% in Saudis. Other than rise in liver enzymes like SGOT and SGPT,
the bilirubin may be mildly raised. 2nd generation ELISA is quite
specific and sensitive. However the best is PCR which detects HCV as early as 2
weeks after exposure.
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Treatment: other than symptomatic treatment and improvement in the nutritional status of the patient,
specific measures undertaken include Interferon a
and use of anti-viral drug Ribavarin. Interferon a
(Intron A) treatment is indicated for patients with well documented chronic
hepatitis C in whom other causes of chronic hepatitis have been excluded and who
have at least 2-fold elevation of serum ALT (SGPT). Interferon a
is used in a dosage of 3-5 million units thrice weekly subcutaneously for a
period of 6-12 months. This normalizes transaminases in 50-85% of cases, but
relapse is common (60%). Around 20% have a sustained remission. The early side
effects are influenza-like illness. Later side effects include malaise, muscle
aches, poor appetite, weight loss, leucopenia, and thrombocytopenia. Unusual
side effects are psychosis, seizures, proteinuria, skin rashes and
cardiomyopathy. Ribavarin is a nucleoside analogue that is taken orally. The
drug may be a better choice for patients with cirrhosis, who respond poorly to
Interferon. The chief side effect is hemolysis.

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Prevention:Since the results of therapy are not satisfactory, strict attention should be paid to prevention:- Stop intravenous drug abuse, take syringe precautions in
hospitals and elsewhere, avoid un-screened blood transfusion, avoid illegal sexual activities and use barrier contraception with the spouse.  



DIABETES
Diabetes is one of the commonest diseases in the world. More and more people are suffering from this disease especially in the developed world. Even in developing world it is on the rise. This has many factors. Important ones are genetic predisposition and diet. More and more people are obese now. And sedentary too. When prosperity reached the poor people of Pima, they got lots of food. This gave them obesity and diabetes. Now Pima has 100% obese population out of which 50% is diabetic. Common symptoms are excessive thirst and excessive urine even during the night. Patient loses weight and has higher chance of developing infections. He or she may have normal or sometimes increased appetite.
Treatment is usually injections of insulin for the young and tablets for the middle aged and the elderly. This is by no means a rule, however. As it is systemic disease, meaning that it can involve any part of the body, care has to be taken to prevent complications. Hence diet restrictions and regular treatment is necessary.
Carelessness in diet and treatment may prove very harmful in the long run. The kidneys (nephropathy), the eyes (retinopathy), the nerves (neuropathy), and other systems are all involved.
Hence a regular check up with a physician and complete evaluation with blood tests for sugar, kidney, cholesterol, triglyceride, an ECG, eye check up and dietary advice is a must for all diabetics at least once in six months. An advice about hypoglycemia (lowered blood sugar) and its management should be explained to all diabetics as well as their immediate carers. Diabetics should understand the disease well so that it helps them to manage it well.
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HYPERTENSION
Hypertension in a common man's language means high blood pressure. It is a frequently encountered disease in our population. The blood pressure is higher than in normal individuals and therfore is harmful. The common symptoms are headache, giddiness, blurring of vision, palpitations etc. But one should remember that many patients have no complaints at all. That means that they are "asymptomatic". These asymptomatic patients are at maximum risk because they may not go to the doctor regularly or may not comply with the treatment once started.
Initially hypertension may be harmless but longstanding, especially untreated hypertension can damage the kidneys, the heart, the eyes, and the blood vessels of the body.
Low salt intake, fresh fruits & vegetables, good sleep, regular light exercise and relaxation helps to lower the blood pressure. Medicine prescribed by the doctor should be taken religiously.
Six monthly ECG & X-ray chest as well as blood tests for cholesterol, kidney functions, blood sugar, uric acid etc should be made part of the follow up.
So, try to be the master of hypertension rather than letting it master you!


You can find information
about a common disease on
this PATIENT PAGE. It will
be discussed in easy English
for the understanding of the
patient who is not well versed
with the technical medical terms.
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Cure lies
in the
hands of
Allah alone






In The Name of Allah, The Beneficient, The Merciful