iPad Applications For Kids With Autism

ipad applications for kids with autism

Technology was created to facilitate human life. Although technology also has negative impact on human life, still we can't hardly live without the help of technology, in all life parts. Technology and education are close things. Apple iPad is so amazing that education experts are raving over it, but not for its ability to help children with their homework, but in the spotlight today is the iPad applications are revolutionizing the way we train kids with autism.

There are five basic skills which kids with autism learn by playing games and other iPad applications.

1. Social skills
2. Fine motor skills
3. Language and communication skills
4. Sensory skills
5. Stress reduction

Here are recommended iPad applications for kids with autism, followed by their customer reviews

Angry Octopus. ($7.99)

Children relate to the Angry Octopus in this story as the sea child shows him how to take a deep breath, calm down, and manage his anger. An effective stress and anger management technique known as progressive muscular relaxation focuses awareness on various muscle groups to create a complete resting of the mind and body. This engaging story quiets the mind and relaxes the body so your child can let go of anger and fall asleep peacefully.

First Then Visual Schedule. ($9.99)

Designed for caregivers to provide positive behavior support. For individuals with communication needs, developmental delays, Autism or those who benefit from a structured environment; visual schedules serve to increase independence and lower anxiety during transitions through different activities.

AutismXpress (Free)
The ‘Autism Xpress’ has been created to help promote greater awareness about autism spectrum disorders. It is designed to encourage people with autism to recognizes and express their emotions through its fun and easy to use interface.

Model Me Going Places 2 (Free)
It is a great visual teaching tool for helping your child learn to navigate challenging locations in the community. Each location contains a photo slideshow of children modeling appropriate behavior.


Social Skills ($3.99)
It offers parents and educators the ability to interact with six social narratives (broken into 2 levels which give a total possible of 12 social narratives) designed to help individuals improve their social ability. With Social Skills (S2L), the stories contain targeted instruction in the following core areas: Joint Attention; Non-Verbal Communication; Greetings; Structured game play; Turn Taking; Classroom rules; and Imitation.


Look2Learn ($14.99)
Look2Learn was developed by an educational team consisting of teachers, a speech therapist, and a school psychologist specializing in educating individuals with communication challenges. L2L addresses the communication needs of multiple populations including: early development communication enhancement (e.g., a two year old whose cognitive skills currently exceed his or her expressive communication); individuals with Autism Spectrum Disorder; individuals who have short or long-term communication challenges due to medical needs; as well as others who have a speech and language disorder.


Stories2Learn ($13.99)
It is an affordable and powerful way to promote social messages to individuals with autism and other developmental disabilities.


Look in My Eyes ($2.99)
Eye contact is an important social skill that some children find challenging. “Look in My Eyes” helps them practice this skill - while earning fun rewards and playing creatively. It was designed for children on the autism spectrum - especially those with Asperger’s Syndrome - but any child who has difficulties with eye contact may benefit from playing. The game rewards players for quickly focusing in on a person’s eyes. Through repeated practice we attempt to develop a habit that families can transfer to real life settings as they remind children to use the skills they have practiced in the game.


Eye Contact ($2.99)
This game helps them practice the skill while earning fun rewards. The game is similar to those in our "Look in My Eyes" series - but the reward is easier and more immediate. We developed this easy reward because of parent feedback on our previous games. Some parents who loved the eye contact practice in our "Look in My Eyes" series expressed the desire for a reward that was simpler.


Sources: 

• Apple's Application Store
• Huffington Post
• Bookroom Reviews
• B12 Patch
• Youtube

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What Is EHEC Bacteria

what is ehec bacteria

EHEC stands for enterohaemorrhagic Escherichia coli. This bacteria can casue severe food borne disease. EHEC bacteria often causes outbreaks that are mainly caused by raw milk, undercooked ground meat products, fruit and vegetables that are contaminated by feces. Actually, the EHEC bacteria infection is spontaneously cured, but in bad immune system, it may lead to a life-threatening condition such as haemolytic uremic syndrome (HUS) that mostly happen in children and elderly. The recent big outbreak of EHEC infection was in Europe, primarily in Germany, 4,000 people was infected with more of 700 cases of HUS and 46 deaths. This HUS incidence was higher than usual and it was identified that the organism involved is E coli O104. 

What is EHEC bacteria?

• Strain O157 of E coli is a member of EHEC pathotype.
• Most clinical microbiology laboratories do not routinely test for this bacteria. Sorbitol MacConkey media is commonly used to identify EHEC, which is based on EHEC's instability to ferment sorbitol.
• EHEC can also be detected from its Shiga toxins via PCR from diarrhea specimen.
• Examples of food that can promote EHEC outbreaks: undercooked hamburger, sprouts and lettuce, unpasteurized milk, and other dairy products that are contaminated by livestock excretion (bovine).

Symptoms of EHEC infection

• Diarrhea, can be bloody (haemorrhagic enteritis) in day 2-3 
• Significant abdominal pain
• Mild fever
• Vomiting
• Symptoms and signs of HUS:
• Haemolytic anemia
• Acute renal failure
• Thrombocytopenia
• Neurological complications: coma, seizure

 Treatment of EHEC infection

• Currently the treatment is supportive only
• It is important to know that the use of empiric antibiotics that are usually given to treat bacterial gastroenteritis will increase the risk of haemolytic uremic syndrome (HUS)
• Hospitalization is needed because the patients should receive proper fluid replacement 
• In HUS, the treatments are hemodialysis, blood transfusion, and possibly plasmaphoresis.

How to prevent EHEC infection?

• Cook meat and milk products thoroughly because actually EHEC is heat-sensitive.
• Follow the "Five Keys to Safer Food", a guidance by WHO. It is about how to prevent infections from food borne microorganisms such as EHEC.
• Regular hand washing, especially before food preparation and after toilet contact

Sources:

• World Health Organization
• Consultant Live

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Symptoms Of Hypertension In Pregnancy

symptoms of hypertension in pregnancy

Hypertension in pregnancy, whether it happens before or after conception, should be managed properly, since hypertension can harm the baby because of decreased blood flow to the placenta. Besides that, pregnant women with hypertension tend to deliver prematurely.

Risk factors
Pregnant women are at a high risk of hypertension during pregnancy if:

• Medical history of chronic hypertension
• Previous pregnancy with hypertension
• Age: under 20, or more than 35.
• Family history of hypertension during pregnancy
• Medical history of diabetes, cardiovascular disease
• Heavy smoker, alcoholic, drug abuser
• Medical history of kidney disease
• Medical history of auto immune disease such as SLE, rheumatoid arthritis
• Being underweight or overweight before pregnancy 

There are different kinds of hypertension in pregnancy:

• Gestational hypertension. If hypertension occurs after week 20. After delivery, the blood pressure will back to normal.
• Chronic hypertension. If hypertension occurs before pregnancy, or during pregnancy but before week 20. After delivery, it will last more than 12 weeks.
• Preeclampsia. It is a life threatening condition that is characterized by hypertension and protein in the urine after week 20 of pregnancy. 

Symptoms of hypertension in pregnancy

• Prolonged headache
• Blurred vision
• Ringing in the ears
• Upper abdominal pain (just like dyspepsia), usually on the right side
• Abnormal weight gain (more than 2.3 kg per week)
• Increased vomiting
• Swelling in the face and hands
• Numbness in extremities
• Decreased fetal movement
• Persistent vaginal bleeding

Treatment of hypertension in pregnancy

If you experience the symptoms above, please be aware of preeclampsia. Go to your obstetrician to take some blood and urine tests, and sonography to know about the fetal well being. The doctor will give you antihypertension drugs that should be taken regularly. At home, you should check the blood pressure periodically. Hospitalization is also needed in certain condition.

Sources:

• American Pregnancy Association
• Mayo Clinic

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Hyperthyroid Symptoms In Women

hyperthyroid symptoms in women 

As we have discussed before (here), hyperthyroid briefly means overactive thyroid gland. 

Hyperthyroid symptoms in women are:

• Feel weak, tired easily
• Mental instability, moody, nervous, anxiety, irritability, depression, nervousness
• Bulging eyes
• Tremor, shaky hands
• Breathing problems, breathlessness
• Fast heartbeat, sometimes irregular beat, chest pain
• Warm and itchy skin, moisy
• Hair loss
• Increased sweating, always feel hot
• Increased appetite, more eating, hungry easily
• Weight loss although you eat more than usual
• Less frequent menstruation, lighter menstrual blood flow
• Diarrhea

When you experience the symptoms above, it is very important to consult with an internist. If hyperthyroid is not properly treated, it will cause more problems for women such as: bone problems, fertility and pregnancy problems, heart problems, and thyroid storm.

Diagnostic Tests

Diagnosis of hyperthyroid is made by physical examination, signs and symptoms, and also some diagnostic tests as listed below:

• Ultrasonography (USG) of the thyroid. It is a non invasive procedure.
• Blood test:
• Free T3 and  T4 (usually high)
• TSH sensitive (usually low)

 Hyperthyroid treatment

• Anti-thyroid drugs. These drugs will reduce hyperthyroid symptoms by preventing thyroid gland from making too many hormones.  
• Propylthiouracil
• Methimazole
• Beta blockers, such as Propanolol. This drug treats heart palpitation and slower heart beat.
• Radioactive iodine. It is given orally and will absorbed by the gland. The hyperthyroid symptoms will reduce gradually in 3-6 months. 
• Surgery. If drugs and radioactive iodine do not show an improvement, in some cases, the thyroid gland should be removed. After thyroid surgery, you will need a lifetime medication to supply the thyroid hormone such as levothyroxine.

Sources:

• WebMD
• American Academy of Family Physician
• Mayo Clinic

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What Is Amyotrophic Lateral Sclerosis ALS

what is amyotrophic lateral sclerosis als

Amyotrophic lateral sclerosis, or known as ALS, motor neuron disease, or upper and lower motor neuron disease, is a severe neurological disorder in brain and spinal cord that is characterized by disorders of voluntary muscle movement such as muscle weakness, permanent disability, until death. It is also called Lou Gehrig's disease because there was a basketball player named Lou Gehrig who died of this disease. Amyotrophic lateral sclerosis is a very uncommon disease who occurs at 5 of 100,000 people in the world. The risk exact causes of amyotrophic lateral sclerosis is still unknown, but generally it is a hereditary disease. Researchers also found that amyotrophic lateral sclerosis is caused by gene mutation, bad immune response, and chemical substance imbalance such as too much glutamate.

Symptoms of amyotrophic lateral sclerosis (ALS)
Symptoms usually start after age 50. As quoted from Mayo Clinic, early symptoms of ALS are:

1. Start with weakness in the upper extremities (clumsiness) 
2. Weakness in the lower extremities (leg, feet, ankles), footdrop
3. Slurred speech, inability in swallowing
4. Twitching in tongue, shoulders, and arms
5. Generally muscle cramps

Further symptoms of amyotrophic lateral sclerosis are:

1. Paralysis
2. Difficulty of breathing
3. Difficulty of swallowing
4. Progressive muscle weakness, difficulty of walking, lifting, etc
5. Head drop (neck muscle weakness)
6. Muscle cramps
7. Speech disorder

How to diagnose amyotrophic lateral sclerosis ALS?

1. Physical examination
2. Medical history
3. Blood test, to rule out another diseases that have similar symptoms
4. Electromyography (EMG): to record muscle's electrical activity.
5. Muscular biopsy by a pathologist.
6. Head CT-scan and MRI, lumbal puncture, to rule out another brain and nervous disorders.

Treatment

The goals of treatment in ALS patients are to slow the progression of the disease, and make the patients more comfortable and independent in doing basic daily activities.

1. Pharmacologic. 
• Riluzole (Rilutek) is recommended by FDA to slow the progression of ALS. It reduces the levels of glutamate in the brain
• Symptomatic therapies to cure: pain, muscle cramps, fatigue, depression, constipation, etc
2. Physical therapy: to maintain cardiovascular and neuromuscular fitness.
3. Speech therapy: to gain alternative methods of communication, so the ALS patients can still be capable in communicating.
4. Occupational therapy: find devices to support daily activities (if needed) such as wheelchair, walker, etc.

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Kidney Transplant Donor Criteria

kidney transplant donor criteria

Nowadays, the prevalence of chronic kidney disease are rising, along with the increasing prevalence of diabetes mellitus, hypertension, metabolic syndrome, and others. In stage 5 of chronic kidney disease, or called as terminal stage (end stage), the supportive therapy that can be done is usually hemodialysis. This therapy is not satisfactory because it does not treat the cause. Kidney transplantation is definitive therapy for those kind of patients. Everybody can become a donor, not always relatives, as long as they fulfill the kidney transplant donor criteria. 

According to USTransplant.org, there are generally kidney transplant donor criteria:

• Age between 18-65 years old.
• Physical examination:  ideal BMI (body mass index), no obesity
• Medical history:
• not smoking
• no hypertension
• no history of cancer, hepatitis, cardiovascular, and kidney problems
• no history of diabetes
• no history of certain regular medications
• Blood type: in order to make a safe kidney transplant, the donor's blood type must be the same with the recipient's blood type, while Rhesus (Rh) factor is not necessary to be matched.
• Tissue match: to know the compatibility between donor's tissue and recipient's tissue, doctors will perform a blood test based on histocompatibility antigens. To pass the kidney transplant donor criteria, perfect matching is not required but some matches are better than another. 
• Psychological examination: no mental illness, ensure that the donors will be able to take care of themselves after donating their kidney.

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Sore Throat Allergies Symptoms

sore throat allergies symptoms

Allergies may be the cause of a sore throat. Some people have mistakes in using the term "sore throat" to refer many different things. But sore throat is actually the synonym of pharyngitis that means inflammation of the throat. Most cases are caused by bacterial infection such as streptococcus (strep throat) or mononucleosis.

Sore throat allergies symptoms are nearly similar with the general symptoms of sore throat such as:

• The most characteristic of sore throat allergic symptoms: post nasal drips
• Dry and irritated throat
• Nasal congestion
• Mild fever (not always)
• Painful in swallowing
• Tenderness in the throat, tonsils, and neck's lymph nodes.
• Body aches, muscular pain

Treatment of sore throat allergies

• Use humidifier to prevent a dry environment that can worsen your sore throat allergies symptoms
• Use lozenges to soothe the throat
• Use salted water to gargle (avoid using mouthwash since it will irritate your throat)
• Find the exact cause of your sore throat allergies. If it is a seasonal allergy, nasal spray containing antihistamines may help.
• Use antibiotics under doctor's advice. 

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Sexually Transmitted Diseases And Infections

sexually transmitted diseases and infections

Sexually transmitted diseases, or STD, are infections that can be transmitted via sexual contact. Sexual contact does not limit to sexual intercourse only, but refers to kissing, genital and oral sex, and the use of sex toys such as vibrator. STDs consist of many diseases, such as chlamydia, bacterial vaginosis, herpes genital, yeast infection and so on, but the most threatening now is HIV/AIDS.

Here is a list of sexually transmitted diseases and infections.

• Chancroid: a painful sore that causes by bacterial infection; treatable
• Yeast infection: fungal infection on the vagina (female) and the tip of penis (male), causes by fungi especially Candida sp.; treatable.
• Scabies (crabs): bugs that lives in the genital area; treatable.
• Chlamydia: infection on the urethra, pelvis (female), and prostate (male); treatable.
• Herpes: viral infection manifestated as blister and sores; treatable.
• Gonorrhoe: genital infection caused by bacteria: treatable.
• Trichomonas: parasite infection on the pelvis (female) and urethra (male): treatable.
• Syphilis: bacterial infection on nerves, genital, and heart:  treatable.
• Bacterial vaginosis: can cause fluor albus, bad odor, itching and vaginal discharge; treatable.
• Hepatitis: depends on its type (A and E are spontaneously cured; B and C have chance to be a cancer)
• HPV (genital wart): viral infection on the cervix, can be cancerous; cureless.
• HIV/AIDS: no cure.

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Thyroid Problem Symptoms In Women

thyroid problem symptoms in women

Thyroid is a gland located at the base of the neck. It produces the most important hormones in metabolism called T3 and T4. These hormones regulate many mechanism in the body, such as the rate of heart beat, calories metabolism, and so on. These hormones should at their right amounts to provide their proper functions.

Thyroid problems mostly affect women at about three times more than men. This fact is due to a hormonal connection. There are several types of thyroid problems in women, such as:

1. Hyperthyroidism. It is a condition where thyroid function is overactive, produce more hormones than usual. The symptoms are:
• Less frequent menstruation with lighter flow
• More eating than usual
• Fast heartbeat, sometimes irregular
• Insomnia
• Anxietas
• Irritability
• Increased sweating
• Tremor in hands and fingers
• Diarrhea; more rapid bowel movement
2. Hypothyroidism: when thyroid gland does not produce enough hormones. The symptoms are:
• More bleeding while menstruation
• Increased sensitivity to cold
• Frequent constipation
• Fatigue and muscle weakness
• Dry skin and puffy face
3. Thyroiditis. It is inflammation or infection on the thyroid gland. They are mostly auto immune disease and hereditary. Types of thyroiditis are:
• Hashimoto's thyroiditis
• Postpartum thyroiditis
4. Thyroid cancer. Most patients with thyroid cancer have also thyroid nodules but they are asymptomatic. It can be diagnosed by thyroid scan/ultrasonography. People who often exposured with radiation, older than 40 years old and have familial history of thyroid cancer are at a high risk of having thyroid cancer.
5. Thyroid nodules. It is a swelling in unilateral (one section) of the thyroid gland. Most of thyroid nodules cases are asymptomatic. Symptoms will appear when there are so many nodules that produce more thyroid hormones causes hyperthyroidism. The thyroid nodules sometimes can be palpated in the neck.
6. Goiter. It is an abnormal enlargement of the thyroid gland. The most common cause is iodine deficiency. The symptom is swelling in the neck. Very large gland will cause problems of swallowing and breathing.

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How Do You Get Walking Pneumonia

how do you get walking pneumonia

As we have discussed here, walking pneumonia is a mild form of pneumonia. People with walking pneumonia usually are not sick enough, do not need hospitalization, and still can walk around. Walking pneumonia tends to be under reported because when you see a doctor, you just look fine so the doctor does not ask you to get a chest X-ray, which is the only way to diagnose any kind of pneumonia especially walking pneumonia.

Walking pneumonia is an informal term for atypical pneumonia,or pneumonia that caused by Mycoplasma pneumonia infection. This disease most often happens to young adults and older children.

How do you get walking pneumonia?

• Mycoplasma infections are not seasonal, they occur throughout the year. In a large community, walking pneumonia outbreaks can also occur. It happens mostly in fall and late summer.
• Mycoplasma infections transmit through droplets from the nose and throat when infected people cough and sneeze. Close contact in families, schools, boarding house, and institutions happens via close contact. The incubation period is approximately less than 10 days and sometimes can be longer.
• After exposure with infected droplet, symptoms of walking pneumonia begin at 2-3 weeks. The symptoms are:
• Mild fever
• Cough
• Sore throat
• Flu like symptoms: headache, tiredness
• Bronchitis
• Occasionally ear infections (otitis media)

Diagnosis 

Walking pneumonia can be diagnosed through these ways:

1. Typical symptoms, as listed above
2. Chest X-ray
3. Blood test, to differ it from other infections

Treatment

Walking pneumonia usually does not need any treatment with antibiotic because it can spontaneously resolved. If the infections symptoms are persistent, there are some effective antibiotics such as:

• Erythromycin
• Clarithromycin
• Azithromycin

Prevention

The only way to prevent from being infected by this disease is applying hand hygiene and cough etiquette.

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What Are The Symptoms Of A Silent Heart Attack

what are the symptoms of a silent heart attack

Silent heart attack is a very serious condition that can happen to anyone, especially people who have risk factors such as diabetes, high cholesterol, heavy smoker, obesity, high blood pressure, and history of prior heart attack. People with coronary heart disease who take regular medications can also experience silent heart attack. 

Generally, when there is a part of the heart that does not receive blood, that is called silent heart attack. Lack of blood flow can cause heart tissue die and for some cases, this is an irreversible condition and very life threatening.

What are the symptoms of a silent heart attack?

• Tiring easily
• Chest discomfort and followed by the same feeling in arms or jaw that seem to go away after you take a rest
• Shortness of breath
• Nausea
• Indigestion
• Flu-like symptoms
• Test: ECG, blood test (increased cardiac marker).

As quoted from Mayo Clinic, having a silent heart attack makes us have a greater risk of another heart attack that can be fatal.. Make sure to go to the emergency room if you experience those symptoms to get the proper treatment so you will not have another heart attack that can increase the risk of complications such as heart failure.

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Breast Cancer Staging And Treatment

breast cancer staging and treatment

We have already discussed about breast cancer (here). After confirming the diagnosis of breast cancer, the next step is determining the breast cancer staging. The importance of breast cancer staging is:

• Describing the breast cancer: how severe, etc.
• Predicting the prognosis (prognosis is most likely outcome of disease)
• Determining treatment options 

Breast cancer staging is closely related with treatment options. Breast cancer staging is based on four basic informations:

1. The size of the cancer
2. Whether the breast cancer cells have spread to lymph nodes (especially under arm lymph nodes or axillary lymph nodes)
3. Whether the breast cancer cells have spread to other body parts such as liver, lungs, brain, etc.

There are many kinds of staging system. One of them is TNM system. It is based on:

• T: size of the cancer
• N: lymph node involvement
• M: whether the cancer cells have spread to other parts of the body

Here is the general breast cancer staging, as quoted from New York State Department of Health:

Stage 1

• Cancer cells are invading normal surrounding breast tissue where the tumor size is up to 2 cm
• There is no lymph nodes involvement
• There may be a microscopic invasion that can only be seen by microscope. The size of invading cancer cells can not measure more than 1 mm

Stage 2A

• The tumor size is up to 2 cm, OR 
• The tumor size is more than 2 cm but not more than 5 cm but not spread to the axillary lymph nodes, OR
• Cancer cells are found in the axillary lymph nodes (no tumor can be found in the breast tissue)

Stage 2B

• Tumor size is more than 2 cm but not larger than 5 cm AND has spread to the axillary lymph nodes, OR
• Tumor size is more than 5 cm and there is NO involvement in axillary lymph nodes.

Stage 3A

• Cancer is not found in the breast tissue but in axillary lymph nodes, which are sticking or clumped together to other structures, or cancer may have spread to lymph nodes around the breast bone, OR
• There is a cancer in any size and it has spread to axillary lymph nodes which are sticking to other structures.

Stage 3B

• There is a cancer in any size and it has spread to chest wall and/or the breast skin, AND
• Cancer may have spread to axillary lymph nodes which are sticking to other structures or it may have spread to lymph nodes near the breast bone.

Stage 4

• Cancer has spread elsewhere in the body such as liver, lung, bones, etc.
• Very life threatening.

Breast cancer staging and treatment

Stage 1

• Breast conserving surgery such as lumpectomy, partial mastectomy, or
• Mastectomy
• Axillary lymph node dissection 
• Lymph node biopsy to evaluate it
• Breast reconstruction (can be done at the same time as surgery or later)
• Radiotherapy (radiation therapy) may be given after breast-conserving surgery, but radiotherapy is contraindicated if:
• Age 70 or older
• The tumor contains hormon receptors (while hormonal therapy is given)
• Size of tumor is 2 cm or less an it has been completely removed.
• None of the lymph nodes that has been removed contains cancer
• Hormone therapy as adjuvant. The drug is Tamoxifen 

Stage 2

• Surgery
• Radiation therapy
• Chemotherapy before or after the surgery

Stage 3

• Mastectomy with or without breast reconstruction
• Adjuvant chemotherapy
• Adjuvant hormone therapy
• Inflammatory breast cancer: neoadjuvant chemotherapy with radiation, then mastectomy with axillary lymph nodes dissection.

Stage 4

• Chemotherapy
• Hormone therapy
• Surgery and radiation. They do not cure the cancer but help treat the pain and other symptoms where body parts involved.
• Symptomatic drugs to treat nausea, secondary infection, and fatigue.

Source:
Cancer Services Program, New York State Department of Health (click here)

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Down Syndrome Symptoms in Pregnancy

down syndrome symptoms in pregnancy

According to National Center for Biotechnology Information, the definition of Down syndrome is a genetic condition in which a person has  47 chromosomes, instead of the usual 46. Mostly, Down syndrome happens when there is an excess copy of chromosome number 21, that called as Trisomy 21. This disorder has many impacts on the body and brain developmental.

Down syndrome symptoms

The symptoms of Down syndrome is very variable, and can be mild or severe. Children with Down syndrome have a recognized characteristic appearance, such as: smaller had with abnormal shape, the inner cornea may be rounded not pointed. Another Down syndrome symptoms are: decreased muscle tone at birth, flat nose, small ears, small mouth, separated joints between skull bones, short hands, short fingers, and white spots on the central eye called Brushfield spots. Children with Down syndrome have a slower physical, social, and mental development. They tend to have impulsive behavior and poor judgment.

Down syndrome symptoms in pregnancy

Diagnosis of Down syndrome can be made through 2 ways: directly after birth as described above or while pregnancy. Nowadays, technology is very helpful for us to improve methods of fetal abnormalities early detection. How to diagnose Down syndrome will be described below:

• Obtaining fetal tissue samples through amniocentesis and chorionic villi sampling (CVS). They are better to be done in 10-12 weeks of pregnancy.
• USG findings: fetus with Down syndrome sometime (not always) show some characteristics signs on USG, such as: decreased femur length, increased skin behind the neck, and choroid plexus cysts.
• Maternal serum testings. These tests are better to be done in 15-18 weeks of pregnancy.
• Alpha fetoprotein. The level will decrease in mother with Down syndrome fetus.
• Estriol. It is also decreased in the Down syndrome pregnancy.
• HCG (human chorionic gonadotropin). It is increased in the Down syndrome pregnancy.
• Inhibin A. It is also increased.
• PAPP-A (pregnancy associated plasma protein A). In the first trimester, low level of PAPP-A is found in Down syndrome pregnancy.

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Typhus Fever Symptoms

typhus fever symptoms

Typhus fever is a potentially fatal infection caused by an organism named Salmonella typhosa. It is a common disease in developing countries where there are poor hygiene and sanitation, crowded areas. Typhus fever is transmitted by oral transmission via contaminated food or sewage-contaminated water, and hand-to-mouth transmission with contaminated toilet stuff.

Risk factors

According to Mayo Clinic, there are some risk factors of getting this disease such as:

• Working as a clinical microbiologist that handles Salmonella bacteria
• Having close contact with infected people
• Traveling or working in endemic areas of typhoid fever
• Drinking sewage-contaminated water
• Decreased immune system because of medications such as corticosteroids or HIV/AIDS.

Typhus fever symptoms

The signs and symptoms of typhoid fever may come gradually. They appear 1-3 weeks after exposure with Salmonella typhi. The classic symptoms includes fever, malaise, constipation, and abdominal pain.  These are typhoid fever symptoms by details.

1. Week 1: fever (especially at night, can be as high as 40 C or 103 F), headache, sore throat, diffuse stomachache, diarrhea OR constipation, rash (rose-colored spots in upper abdomen or lower chest, disappear in 4 days), weakness and fatigue.
2. Week 2: if the treatment is not adequate, you will enter the second stage of illness with symptoms such as continuing high fever, severe constipation/diarrhea, distended abdomen (may be caused by intestinal perforation)
3. Week 3: it is the initial time of life-threatening condition and the symptoms are delirious, decreased consciousness, typhoid state (being exhausted with half-closured eyes)
4. Week 4: the fever may decrease gradually in 10 days but the signs and symptoms can happen again to 2 weeks after the fever has subsided.

It is very important for you to see a doctor when you experience prolonged fever that does not recover with OTC drugs (such as paracetamol, ibuprofen, etc) with another classical symptoms as written above. There are some diagnostic tools to confirm the diagnosis of typhus fever.

• Widal test. It is a blood test to detect any presence of Salmonella antibodies against antigen. It is not recommended because it is time consuming and there are so many false positive.
• Body fluid and tissue culture, such as blood, urine, bone marrow, or stool. The most sensitive test for Salmonella typhi is culture.

Typhus fever treatment

• Antibiotics. The doctor may prescribe antibiotics such as:
• Quinolones (ciprofloxacine, ofloxacine)
• Cephalosporines (cefixime, ceftriaxone IV) for pregnant women
• Antipiretics, such as paracetamol, ibuprofen.
• Supportive therapy
• Bed rest
• Drinking fluid to prevent dehydration and help decrease the body temperature
• Low fiber diet
• Hospitalization is not always needed.

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