Covid: Vaccine volunteers sought for children’s second dose study

A trial to test how well second doses of different coronavirus vaccines work in children is looking for volunteers.

Scientists want to see if giving two doses of different vaccines gives as good an immune response as two doses of the same vaccine.

The study, running at University Hospital Southampton, is looking for 360 volunteers aged 12-16 to take part.

From Monday, children aged 12 to 15 in the UK are to be offered one dose of the Pfizer vaccine.

The year-long trial is taking place in four locations in the UK – University Hospital Southampton, University of Oxford, St George’s University Hospital in London and Bristol Royal Hospital for Children.

It will see the volunteers given a full standard dose of Pfizer vaccine.

About eight weeks later they will then be given a second dose of one of the following:

  • A full standard dose of Pfizer vaccine
  • A half standard dose of Pfizer vaccine
  • A full dose of Novavax vaccine
  • A half dose of Moderna vaccine

However, they will not know which second dose vaccine they have received.

The vaccine has already been offered to those aged 16 and above. However 16-year-olds who have already received one dose are eligible for the trial.

Dr Katrina Cathie, from University Hospital Southampton, said initial results of the trial were expected at about Christmas and would “directly inform decisions about the roll-out of a second dose of a Covid-19 vaccine in this age group in the spring”.

Volunteers need to attend up to six study visits over the next year.

University Hospital Southampton said the visits would be “primarily after school and at weekends to avoid disruption to schooling”.

The study is being led by the University of Oxford and funded by the UK Vaccine Task Force and the National Institute of Health Research. BBC

Galleri cancer test: What is it and who can get it?

It’s hoped the Galleri test can detect more than 50 types of the disease before symptoms appear.

What is the Galleri cancer test?

It’s a simple blood test that looks for the earliest signs of cancer, particularly those that are typically difficult to identify early or for which there are no NHS screening programmes – such as lung, pancreas or stomach cancers.

Developed by Californian firm Grail – and already used in the US – the test can detect subtle changes caused by cancers, when patients may have no other obvious symptoms.

It works by finding chemical changes in fragments of genetic code – cell-free DNA (cfDNA) – that leak from tumours into the bloodstream.

The signal does not mean that a person definitely has cancer. It just means that they might have cancer, and that they will need to have some follow-up tests to check.

“This quick and simple blood test could mark the beginning of a revolution in cancer detection and treatment here and around the world,” says NHS England’s Chief Executive Amanda Pritchard.

Who can volunteer for the NHS-Galleri trial?

The trial aims to recruit 140,000 volunteers across England.

But only people living in these areas can take part and they must be invited:

  • Cheshire and Merseyside
  • Cumbria
  • Greater Manchester
  • the North East
  • West Midlands
  • East Midlands
  • East of England
  • Kent and Medway
  • South East London

Letters have already been sent to tens of thousands of people asking them to take part.

Those being asked are aged between 50 and 77, from a range of backgrounds and ethnicities, and must not have had a cancer diagnosis in the past three years.

How will the trial work?

Participants will be asked to give a blood sample at a locally based mobile clinic.

They will then be invited back twice – after 12 months and two years – to give further samples.

Half those taking part will have their blood screened with the Galleri test immediately.

However, others will simply have their samples stored away to be tested in the future – should they go on to be diagnosed with cancer.

This is because the trial is what’s known as a Randomised Control Trial (RCT).

It will allow scientists to see whether cancer is detected significantly earlier among people who have their blood tested straight away.

Will participants know if their blood has been tested?

People will only know they’re in the first test group if they are among the small minority whose blood test detects potential signs of cancer.

Those people will be contacted by the trial nurses by phone and referred to an NHS hospital for further tests.

Everyone taking part will be advised to continue with their standard NHS screening appointments and to still contact their GP if they notice any new or unusual symptoms.

What is the aim of the trial?

The NHS hopes the blood tests will help increase five-year survival rates for cancer, which are below the levels seen in many other high-income countries.

Developing a blood test for cancer has been keeping scientists busy for many years without much success.

Making one that’s accurate and reliable has proved incredibly complex. The danger is that a test doesn’t detect a person’s cancer when they do have it, or it indicates someone has cancer when they don’t.

“The test could be a game-changer for early cancer detection,” says Prof Peter Sasieni, one of the trial’s lead investigators. But he adds a note of caution:

“Cancer screening can find cancers earlier when they are more likely to be treated successfully, but not all types of screening work.”

What difference could it make to cancer patients?

Patients whose cancers are found early – known as stage one or two – typically have a broader range of treatment options available to them, which can often be less aggressive.

NHS England says a patient diagnosed at the earliest stage typically has between five and 10 times the chance of surviving compared with those found at the more advanced stage four.

Initial results from the Galleri study are expected by 2023. If successful, the NHS in England plans to extend the rollout to a further one million people in 2024 and 2025. BBC

Some home remedies for earache.

1. Heat

Heat from an electric heating pad or hot pack can reduce inflammation and pain in the ear.

Apply a hot pad to the ear for 20 minutes. For best results, people should touch the neck and throat with the hot pad.

The heating pad should not be unbearably hot. People should never fall asleep with a heating pad, or allow a child to use a hot pack without adult supervision.

2. Cold

A cold pack can help with the pain of an earache.

Try wrapping ice in paper towels or freezing a cold pack and then covering it with a light cloth. Hold this to the ear and the area immediately under the ear for 20 minutes.

The cold should not hurt, and parents should never apply ice directly to their children’s skin.

Some people find that heat offers greater relief than cold. For others, alternating hot and cold packs (20 minutes hot, followed by 20 minutes cold) provides the best pain relief.

3. Ear drops

Ear drops can reduce pressure in the ear caused by fluid and earwax.

People should read the directions carefully, and talk to a doctor before using ear drops on a child.

Ear drops are no substitute for prescription ear drops or antibiotics, so people should only use them for a few days. If symptoms return, people should see a doctor.

It is important to remember that people should not use ear drops in a child with tubes in their ears or whose eardrum has ruptured.

4. Massage

Gentle massage can help with ear pain that radiates from the jaw or teeth, or that causes a tension headache.

People can massage the tender area, as well as any surrounding muscles. For example, if the area behind the ear hurts, try massaging the muscles of the jaw and neck.

Massage may also help with the pain of an ear infection.

  • Using a downward motion, apply pressure beginning just behind the ears and down the neck.
  • Continuing to apply pressure downward, work forward to the front of the ears.

This type of massage may help drain excess fluid from the ears, and prevent the pain from getting worse.

5. Garlic

Garlic has long been used in folk medicine to relieve pain. Some research suggests it has antimicrobial properties that can fight infection.

People should not use it as a substitute for antibiotics a doctor has recommended. Instead, consider adding garlic to an antibiotic regimen to speed up relief.

To prevent ear infections, try eating a clove of garlic each day.

Garlic ear drops may also reduce pain and prevent an infection from getting worse. Cook two or three cloves in two tablespoons of mustard or sesame seed oil until brown, then strain the mix. Then, apply a drop or two to each ear.

6. Onions

Like garlic, onions can help fight infection and reduce pain. Also like garlic, onions are not a substitute for medical attention.

Heat an onion in the microwave for a minute or two. Then, strain the liquid and apply several drops to the ear. A person may want to lie down for 10 minutes, and then allow the liquid to flow out of the ear. Repeat this as needed.

7. Sucking

Sucking can help reduce pressure in the Eustachian tubes, offering some relief.

Babies who are nursing may feel better when allowed and encouraged to nurse as frequently as possible. Adults and children can suck on hard candy or cough drops.

8. Breast milk

Breast milk has antimicrobial properties. Some research suggests that a mother’s breast milk changes based on the microbes to which a baby is exposed.

This means that breast milk is most effective in babies. However, some sources suggest that breast milk may even help adults. Infants and children should continue nursing to get the most benefits from breast milk.

In nursing babies, as well as in children and adults, topical application of breast milk may also help. Even if it doesn’t, breast milk is unlikely to cause any serious side effects.

People can try dropping a few drops of breast milk in each ear, and repeat the application every few hours as needed

Causes of ear pain

Ear infections are the most common cause of ear pain. When the ear becomes infected, inflammation and buildup of pressure cause pain that can be intense.

People with ear infections often have other symptoms, such as sinus pressure or a sore throat because infections from nearby areas may affect the ear. An ear infection can also be a standalone condition. Most ear infections are bacterial, not viral.

Only a doctor can diagnose an ear infection. People should not take antibiotics without a prescription, or assume that symptoms are due to an ear infection.

However, earaches are not always caused by an ear infection. Other conditions can also cause pain in the ear.

Those include:

  • Referred pain: This may be from infections or inflammation elsewhere in the body. For example, a toothache may cause aching pain in the ear.
  • Chronic conditions: These include temporomandibular joint (TMJ) dysfunction.
  • Skin infections: If they are in or around the ear.
  • Allergic reactions: These could be from a range of things, such as soap, shampoo, or earrings.
  • Water: This may cause pain if trapped in the ear.
  • Pressure: Changes in altitude can affect pressure in the ears. This usually resolves on its own, often with a popping sensation.

If left untreated, ear infections can spread to the jaw and other regions of the body. They may also damage the ear itself and can cause dangerously high fevers.

When symptoms of an ear problem are present and do not resolve on their own within a day or two, people should speak to a doctor. If the pain is intense, is accompanied by a high fever, or includes hearing loss, people should seek medical attention immediately.

What is rabies?

Rabies is a serious disease that is caused by a virus. It is mainly a disease of animals, but humans can get rabies when animals infected with the disease bite them. The virus is transmitted to humans through the infected animal’s saliva. Very rare cases occur when infected saliva gets into someone’s eyes or mouth or into an open wound.

Infected wild animals – especially bats, but also skunks, raccoons, foxes, and coyotes – typically transmit the disease to humans. In the United States, dogs rarely transmit rabies to humans; however, outside the United States, infected dogs are the most common source of transmission to humans. Any mammal (i.e., warm-blooded animal with fur) can get rabies. Animals that are not mammals (e.g., birds, fish, snakes) cannot get rabies.

What are the symptoms of rabies?

Symptoms can appear as soon as a few days after being bitten by an infected animal. However, in most cases, symptoms may not appear until weeks or months later.

One of the most unique symptoms of rabies infection is a tingling or twitching sensation in the area around the animal bite. After the virus leaves the local bite area, it travels up a nearby nerve to the brain and can cause such symptoms as:

  • Pain.
  • Fatigue.
  • Headaches.
  • Fever.
  • Muscle spasms.
  • Irritability.
  • Excessive movements.
  • Agitation, aggressiveness.
  • Confusion.
  • Seizures.
  • Bizarre or abnormal thoughts.
  • Hallucinations.
  • Weakness, paralysis.
  • Increased production of saliva or tears.
  • Extreme sensitivity to bright lights, sounds, or touch.
  • Difficulty speaking.

At advance stages of the infection (when the infection spreads to other parts of the nervous system), the following symptoms can develop:

  • Double vision.
  • Problems moving facial muscles.
  • Abnormal movements of the diaphragm and muscles that control breathing.
  • Difficulty swallowing and increased production of saliva, causing the “foaming at the mouth” usually associated with a rabies infection.

MANAGEMENT AND TREATMENT

How is rabies treated?

Rabies is both prevented and treated with a rabies vaccine. The rabies vaccine is made from killed rabies virus. The vaccine cannot cause rabies. Current vaccines are relatively painless and given in the arm similar to other common vaccines.

A special immune globulin can also be helpful in some cases. When it is useful; starting early is important. A medical professional can help you determine if rabies immune globulin is appropriate for your case.

To treat rabies:

If you have been bitten by an animal or exposed to rabies, call your doctor and go to a nearby emergency room immediately. Once there, the doctor will clean the wound thoroughly and give a tetanus shot if you are not up-to-date with your tetanus immunization.

The decision to treat rabies right away by beginning a series of rabies vaccine shots will be based on a number of factors. These include:

  • The circumstances of the bite (whether the bite provoked or unprovoked).
  • The type of animal (wild or domestic; species of animal).
  • The animal’s vaccination history (whether or not it is vaccinated).
  • Any recommendations from local health authorities regarding the circumstance surrounding the bite.

How dangerous is rabies if it is not treated?

Rabies is almost always fatal if it is left untreated. In fact, once someone with rabies starts experiencing symptoms, they usually do not survive. This is why it is very important to seek medical attention right away following an animal bite, especially if the bite is from a wild animal.

Is the rabies vaccine safe?

The risk of the vaccine causing serious harm is very small. Current vaccines used in the United States cause fewer bad reactions than previous rabies vaccines. Typical mild problems include soreness, redness, swelling, or itching at the sit of the shot. Other mild problems can include headache, nauseaabdominal pain, muscle aches, and dizziness.

More moderate to severe vaccine side effects include hives, joint pain, and fever. Signs of a severe allergic reaction include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, rapid heartbeat, or dizziness. Waiting in the doctor’s office or emergency area for 30 minutes after a vaccine will usually provide time to see if a severe allergic reaction will occur. If you experience any moderate to severe side effects, call your doctor right away.

How can I prevent rabies?

People at high risk of exposure to rabies should get the rabies vaccine before they come in contact with animals that might have rabies. Such people include veterinarians, animal handlers, and all rabies healthcare and scientific workers. Other people should consider pre-exposure vaccination. This group includes people whose activities bring them in frequent contact with animals that could be rabid. Also, international travelers who may visit parts of the world where rabies is common should get a pre-exposure vaccine.

The pre-exposure vaccination schedule consists of 3 doses, given as follows:

  • First dose given.
  • Second dose given 7 days after first dose.
  • Third dose given 21 days or 28 days after first dose.

If the decision is made to begin the rabies vaccine shots and you have never been vaccinated against rabies:

  • You should get 5 doses of the rabies vaccine – first dose immediately, then additional doses 3, 7, 14, and 28 days after the first dose.
  • You should also get a shot of Rabies Immune Globulin at the same time as the first dose of rabies vaccine.

If you have been previously vaccinated against rabies:

  • You should get 2 doses of the rabies vaccine – the first dose immediately, and the second dose 3 days later.
  • You do not need to get a shot of Rabies Immune Globulin.

What are the immediate steps I need to take in case of an animal bite?

  • Wash the bite area with soap and water for 5 to 10 minutes.
  • Cover the bite area with a clean bandage.
  • Call your doctor and go to a nearby emergency room.
  • If you know the animal’s owner, get all the information about the animal, including vaccination status and owner’s name and address. Call your local health department, especially if the animal hasn’t been vaccinated.
  • If you don’t know the animal’s owner or if a wild animal bites you, immediately call your local animal control authorities to get help finding the animal that caused the bite. The animal will need to be confined and observed for signs of rabies.

Gastrochisis

What Is Gastroschisis?

Gastroschisis is a birth defect that develops in a baby while a woman is pregnant. This condition occurs when an opening forms in the baby’s abdominal wall. The baby’s bowel pushes through this hole. The bowel then develops outside of the baby’s body in the amniotic fluid.

The opening is most often on the right side of the baby’s belly button. It can be large or small, but is typically one to two inches in size. In more severe cases, the stomach and/or liver can sometimes make their way through the opening as well.

Because the bowel is outside of the baby’s body, it is unprotected. That means there is a chance it can become irritated, swollen and damaged.

This condition is relatively rare but has seen an increase in recent years. It occurs in about one in every 2,000 babies. It develops early in pregnancy, during the fourth through eighth weeks. Gastroschisis occurs due to a weakness in the baby’s abdominal wall muscles near the umbilical cord. If your baby develops this condition during your pregnancy, you will not experience any symptoms related to it.

Gastroschisis can be repaired with surgery after your baby is born. It is usually not associated with other malformations.

What Causes Gastroschisis?

The exact cause of gastroschisis is not known. It does not appear to be inherited. Having one baby with gastroschisis does not make it more likely that you would have another baby with the condition.

Severity of Gastroschisis

Gastroschisis is labeled as simple or complicated. This is based on how inflamed the bowel and/or organs are that have moved through the opening.

With simple gastroschisis

With complicated gastroschisis, one or more of the following occurs:

  • The bowel outside of the baby’s body is extremely damaged, e.g., a portion of the tissue has died (called necrosis), or the bowel has become twisted or tangled.
  • Intestinal atresia, which occurs when part of the baby’s bowel doesn’t form completely, or the intestine is blocked.
  • Other organs, such as the stomach or liver, protrude out of the opening as well.

Simple cases are more common than complicated ones.

Gastroschisis Evaluation and Diagnosis

It is possible for gastroschisis to be detected in the third month of pregnancy. However, we most often perform evaluations for it at 20-24 weeks, after it has shown up on an ultrasound. It is most commonly diagnosed by ultrasound around weeks 18-20 of pregnancy.

Some women are referred to us for gastroschisis late in pregnancy. We see them within two weeks of their referral. It is important to make a diagnosis and delivery plan as early as possible.

In babies with gastroschisis, the ultrasound will show loops of bowel floating freely. This often shows up when a woman goes in for a routine ultrasound with her obstetrician (OB). It is at this point that most of our patients affected by gastroschisis are referred to hospitals. Here, we’ll work with you to assess how severe your case is and create a plan for the remainder of your pregnancy. We will also talk to you about what to expect after delivery.

An evaluation for gastroschisis consists:

  • An ultrasound (we can use an ultrasound performed within two weeks of your appointment with us, or one will be done on the day of your evaluation)
  • Possibly an MRI and/or a fetal echocardiogram to test your baby’s heart function
  • A meeting with a nurse, social worker and genetic counselor
  • A team meeting with a maternal-fetal medicine specialist (MFM), pediatric surgeon and neonatologist

An important part of the evaluation is determining whether the condition is gastroschisis or omphalocele. These conditions can sometimes look similar on an ultrasound. In omphalocele, a sac from the umbilical cord covers and protects the intestines that are outside of the baby’s body.

After your tests are complete, our team of experts meets with you to discuss the extent of the baby’s condition and its impact on the rest of the pregnancy. We’ll also cover medical treatments that might be needed right after the birth of your child, and long-term prognosis of babies with gastroschisis.

For patients who are local or plan to deliver locally, we also discuss:

  • Delivery at one of our level III hospitals
  • Transferring your baby to Cincinnati Children’s
  • Postnatal surgical care for your baby
  • Length of stay in the neonatal intensive care unit (NICU)
  • Possible complications that could arise

We recommend frequent ultrasounds throughout the remainder of your pregnancy. These will help to monitor your baby’s health, the severity of the gastroschisis, and how it evolves.

Gastroschisis Treatment Options

There are no fetal interventions recommended for babies with gastroschisis. The condition cannot be corrected while you are pregnant. Rather, it must be treated right after your baby is born.

Any baby with gastroschisis must have surgery after birth. An infant cannot survive with his or her bowel outside of the body.

After your baby is born, doctors will assess how severe the gastroschisis is. The type of repair needed depends on how much bowel and/or organs are outside of your baby’s belly and any inflammation or damage to those tissues.

Primary Repair

With a simple gastroschisis, treatment often is what’s called a “primary repair.” This is a surgery where the bowel is placed back inside of the baby’s belly and the abdominal opening is closed. When possible, this surgery is done the day your baby is born.

This type of repair is performed when there’s relatively small amount of bowel outside of the belly, and the bowel is not overly swollen or damaged.

What is polio?

Poliomyelitis (polio) is a disease caused by poliovirus. It happens mostly in children younger than 5 and in parts of the world that have not yet seen wide-scale vaccination.

What causes polio?

A virus called poliovirus causes polio. The virus enters the body through the mouth or nose, getting into the digestive and respiratory (breathing) systems. It multiplies in the throat and intestines. From there, it can enter the bloodstream. It can also attack the nervous system, the nerve network that helps the brain communicate with the rest of the body.

There are three strains of poliovirus: types 1, 2 and 3. Types 2 and 3 have been eradicated (eliminated), but type 1 still affects people in a few countries.

In some parts of the world, a live poliovirus vaccine is still used. This oral live virus vaccine can very rarely cause polio. In the United States and many areas of the world, this live virus vaccine is no longer used and an inactivated vaccine that cannot cause polio is used instead.

Is poliovirus contagious?

Poliovirus is very contagious, and a person can transmit (spread) it even if they aren’t sick. The virus goes from person to person in two ways.

People with poliovirus in their bodies shed the virus through their feces (poop). The virus can then spread to other people when they swallow contaminated water or food. This exposure is more likely in areas that have poor hygiene or weak systems to clean water.

A person can also pick up the virus after someone sneezes or coughs. If you get droplets of an infected person’s phlegm or mucus in your mouth or nose, you can become infected.

What are the symptoms of polio?

About 90% of people infected with poliovirus have no signs of the disease or just mild symptoms. If symptoms do occur, they usually appear about seven to 10 days after exposure to the virus. But symptoms can take as long as 35 days to show up.

Early symptoms of polio are like those of influenza and last about two to 10 days:

  • Fatigue .
  • Fever .
  • Headache.
  • Neck stiffness.
  • Pain in the arms and legs.
  • Vomiting.

While most people fully recover from polio, the disease can cause very serious problems. These problems can sometimes develop quickly (hours after infection) and include:

  • Numbness , a feeling ofpins and needles or tingling in the legs or arms.
  • Paralysis,in the legs, arms or torso.
  • Trouble breathing because of muscle paralysis in the lungs.
  • Death when the muscles you use to breathe become paralyzed.

How is polio diagnosed?

If you have symptoms of polio, contact a healthcare provider. The healthcare provider will ask you about your symptoms and whether you have traveled recently.

Because polio symptoms look a lot like flu symptoms, the healthcare provider may order tests to rule out more common viral conditions.

To confirm polio, a healthcare provider will take a small sample of:

  • Cerebrospinal fluid (liquid around the brain and spinal cord).
  • Saliva from your throat.
  • Stool (poop).

The healthcare team will look at the sample under a microscope to identify poliovirus.

How is polio treated?

While there’s no cure for polio, and no way to prevent paralysis, some things may keep you more comfortable:

. Fluids (such as water, juice and broth).

. Heat to soothe the muscles

. Medications that relax the muscles, also called antispasmodic drugs.

. Pain relievers, such as NSAIDS (non steroidal anti inflammatory drugs) .

. Physical therapy and exercises to help protect the muscles.

. Rest.

. Mechanical ventilation , or a machine that helps you breathe.

How do I prevent polio?

The best prevention against polio is a series of four vaccine shots in the arm or leg.

The inactivated polio vaccine used in the United States is very effective and safe, and cannot cause polio.

The recommended vaccination schedule for children is based on age:

  • First shot when 2 months old.
  • Second shot when 4 months old.
  • Third shot between 6 and 18 months old.
  • A “booster” shot when 4 to 6 years old, for an extra dose to secure protection.

If you didn’t get polio vaccines as a child, you should get three shots in adulthood:

  • First dose at any time.
  • Second dose a month or two later.
  • Final dose six to 12 months after the second.

If you didn’t get all your vaccine doses during childhood, you should get the remaining shots as an adult.

Who should get the vaccine?

Everyone should get vaccinated for polio, preferably during childhood. But even if you’ve had all the normal polio doses, you may need a booster shot if:

  • You work in a lab where you might come into contact with poliovirus.
  • You work with patients who may have gotten exposed to poliovirus.
  • You’re planning to travel to certain areas of the world. (Check the list of countries where polio remains a risk, and talk to your healthcare provider.)

Are polio vaccines safe?

The Centers for Disease Control and Prevention (CDC) considers polio vaccines to be very safe. The CDC tracks vaccine safety and problems.

Any vaccine may cause:

  • Allergic reaction.
  • Pain that lasts awhile (in rare cases).
  • Redness where the needle entered the skin.
  • Soreness in the area where you got the shot.

If you’re not feeling well after a shot or have an allergic reaction, tell your healthcare provider. Also touch base with your provider before future doses.

What does post-polio syndrome feel like?

Symptoms of post-polio syndrome may start slowly and then get worse. They’re like the symptoms of polio:

  • Fatigue.
  • Muscle atrophy (slow decrease in muscle size).
  • New weakness in the same muscles that polio affected.
  • Pain in the joints.
  • Scoliosis (curved spine).

Symptoms of post-polio syndrome are rarely life-threatening, but they can cause difficulties with:

  • Breathing.
  • Participating in normal activities.
  • Sleeping.
  • Swallowing.

Is post-polio syndrome contagious, too?

Post-polio syndrome is not contagious. Only someone who once had polio can have the syndrome.

What are nasal polyps?

What are nasal polyps?

Nasal polyps are painless and benign (not cancerous) growths. They’re found in nasal passages and sinuses, hollow spaces in the bones around your nose. They form from mucous membranes — thin, soft tissue that lines these body parts.

Nasal polyps can get irritated and swollen, partially blocking the nasal passages and sinuses.

Who gets nasal polyps?

Nasal polyps don’t tend to develop until well into adulthood, when people are in their 30s or 40s. They’re usually linked with some cause of inflammation in the nose, such as:

  • Asthma
  • Allergic Rhinitis or other allergies, such as to aspirin or fungus/fungi
  • Chronic rhinosinusitis (CRS).
  • Cystic fibrosis
  • Repeat sinus infections or other infections.

Do nasal polyps happen on one side or both sides of the nose?

Nasal polyps usually appear on both sides. A growth on only one side may actually be something else, such as a cancerous tumor.

What causes nasal polyps?

Polyps develop because the mucous membranes lining the nose or sinuses change. The membranes become inflamed for a long time or become inflamed over and over again. The inflammation features swelling, redness and fluid buildup.

Researchers believe that allergies and infections cause the inflammation. They think that because they’ve studied tissue taken from nasal polyps. Those samples contained extra eosinophils, white blood cells linked to infections and allergic reactions. The evidence points to inflammation causing small growths filled with fluid. Those growths then turn into polyps.

What are the symptoms of nasal polyps?

Small polyps may not cause any symptoms. But as they grow, they may lead to:

  • Headaches.
  • Loss of smell or taste.
  • Nasal congestion (stuffy nose).
  • Nasal drainage (runny nose).
  • Nosebleeds.
  • Postnasal drip (constantly feeling like you have to clear your throat).
  • Pressure or pain in the sinuses, face or top teeth.
  • Snoring

When polyps get big enough, they can block the nasal passages and sinuses, leading to:

  • Frequent asthma attacks in people with asthma.
  • Repeated sinus infections.
  • Sleep apnea  or other trouble sleeping.
  • Trouble breathing, even in people who don’t have asthma.

How are nasal polyps diagnosed?

If you have symptoms of nasal polyps, talk to a healthcare provider.

  • Ask about your health history, especially allergies, infections and asthma.
  • Ask you about your symptoms and how long you’ve had them.
  • Look inside your nose with a nasal endoscope (thin, flexible tube with a tiny camera and light).
  • Order a CT scan to take detailed pictures inside your sinuses.

How are nasal obstructions treated?

Not all patients can be cured of nasal polyps, but several treatments can help:

  • Steroid sprays to shrink polyps and improve symptoms.
  • Oral steroids (pills you swallow).
  • Injections (shots) under the skin to deliver a medicine called dupilumab.
  • Outpatient (no overnight stay) surgery to place a tiny stent. It props open the nasal passages and delivers steroids or other medications.
  • Outpatient surgery using endoscopy to remove polyps when other treatments don’t work.

What is Cholelithiasis?

Cholelithiasis is a medical condition where hard, pebble-like deposits develop within the gallbladder of an individual. They are also known as gallstones. These stones can be as small as a grain of sand or as large as a golf ball. The gallbladder is a small organ present in the abdominal cavity of human beings whose function is to store the bile. When stones develop within this organ, it may give rise to excruciating pain along with jaundice. Treatment is essential immediately after detection as gallstones may lead to severe complications.

There are two types of gallstones

Cholesterol Stones

The most prevalent kind, approximately 80 per cent of all gallstones fall into this category. They are made of cholesterol and are yellow-green.

Pigment Stones

Also called bilirubin stones, these stones are made of bilirubin, and they mostly develop at the time of haemolysis ( the destruction of red blood cells in the body ). They are dark brown or black in color

How does Cholelithiasis occur?

The exact cause for the occurrence of cholelithiasis has not been determined. Recent studies hint that the presence of excess cholesterol in the blood may be responsible for the formation of cholesterol stones. When bile in the liver cannot dissolve excess cholesterol, it develops into gallstone.

Similarly, the pigment stones develop as a result of abundant bilirubin in the body. Specific conditions like liver damage or blood disorders lead to the formation of excess bilirubin which the gallbladder is unable to break down. It may result in the development of hard, dark coloured pigment stones within the gallbladder.

Who is Prone to Cholelithiasis?

The risk of developing cholelithiasis.

  • Age above 40 years.
  • Family history of cholelithiasis.
  • Organ transplant or bone marrow transplant.
  • Diabetes
  • Cirrhosis of the liver.
  • Medical conditions like haemolytic anaemia and sickle cell anaemia.

What are the Symptoms of Cholelithiasis? How is Cholelithiasis Diagnosed?

The symptoms of cholelithiasis include:

  • Pain on the right side of the upper abdomen.
  • Nausea and vomiting.
  • Fever.
  • Jaundice.
  • Dark coloured stools.
  • Dark coloured urine discharge.
  • Diarrhoea.

In some cases, when cholelithiasis does not produce any symptoms, its known as “silent gallstones” or “asymptomatic cholelithiasis.” The pain occurs when these gallstones block the pathway of the cystic duct or common bile duct. This condition is also known as biliary colic. In 80 per cent of the cases, gallstones remain asymptomatic. The patient remains unaware of this condition until it gets detected through X-Ray at the time of routine health analysis.

Diagnosis

In most of the cases, cholelithiasis gets diagnosed at the time of routine health check-up through X-Rays and lower abdomen ultrasound examination. However, if the patient experiences sharp pain in the middle to the upper abdomen, the doctor performs a physical exam to detect abnormalities in the physical characteristic of the body. If he notices a yellow tint on the skin and in the eyes, he diagnostic tests like ultrasound examination, abdominal CT scan, gallbladder radionuclide scan and Endoscopic retrograde cholangiopancreatography (ERCP). All these tests help in the confirmation or ruling out of cholelithiasis in patients. The gallbladder radionuclide scan helps to find out whether there is an infection or blockage associated with the cholelithiasis.

What are the Complications of Cholelithiasis?

If left untreated for a prolonged period, gallstones may lead to severe complications like:

Acute Cholecystitis

Here the gallstones block the cystic duct which supplies the bile juice from the gallbladder. It results in inflammation, infection, along with excruciating pain in the abdominal region. Approximately 1-3 per cent of patients having gallstones may develop cholecystitis in the future.

Other complications of cholelithiasis include sepsis (infection in the blood), gallbladder cancer, cholangitis (a disorder in the gallbladder), fever, chills, jaundice, pain in the abdomen, and appetite loss.

What is the Treatment for Cholelithiasis?

If Cholelithiasis becomes symptomatic, surgery is the best treatment. This process is known as a cholecystectomy. Earlier, surgeons usually performed open cholecystectomy or removal of the entire gallbladder to eliminate the stones. Nowadays, laparoscopic cholecystectomy is a more common course of treatment. Some doctors also use chemicals like chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) to dissolve the gallstones and flush it out through urine. However, a higher probability of recurrence of cholelithiasis exists, and this treatment takes a longer time to show effective results.

Sydney COVID-19 cases may hit peak next week as Australia steps up vaccine rollout

SYDNEY, Sept 6 (Reuters) – Authorities in Australia’s New South Wales, the epicentre of the country’s biggest coronavirus outbreak, said on Monday daily infections were expected to peak next week, as they look to speed up immunisations ahead of easing restrictions.

Australia is trying to contain a third wave of infections that has locked down its two largest cities, Sydney and Melbourne, and its capital Canberra, putting more than half its 25 million population under strict stay-at-home restrictions.

New South Wales Premier Gladys Berejiklian said the government’s modelling revealed the state would require its highest number of intensive care beds in early October, with “additional pressure on the system” in the next few weeks.

Daily cases in Sydney’s worst-affected suburbs are expected to rise to as high as 2,000 until the middle of this month, the modelling showed.

“I do want to qualify that to say that modelling depends on a number of things, a number of variables … if too many of us do the wrong thing, there are too many super-spreading events, we could see those numbers higher,” Berejiklian said during a media briefing in Sydney, the state capital.

A total of 1,071 COVID-19 cases are currently in hospitals, with 177 people in intensive care (ICU), 67 of whom require ventilation. Officials have said they had quadrupled ICU beds to about 2,000 in the state early last year to handle the pandemic.

The state detected 1,281 new cases on Monday, most of them in Sydney, down from 1,485 a day earlier. Five new deaths were recorded.

Victoria state, which includes Melbourne, reported 246 new cases on Monday, its biggest daily rise of the year.

Despite the recent outbreaks, Australia’s coronavirus numbers have remained relatively low at around 63,000 cases and 1,044 deaths.

VACCINE RUSH

Officials are trying to accelerate the vaccine rollout to help minimise deaths and hospitalisations with the government pledging more freedom of movement once 70-80% of the population aged over 16 is vaccinated.

Just over 38% of Australia’s adult population has been fully vaccinated, with the country expected to reach 70% by early November based on current rates.

Last week, Australia entered into vaccine swap deals with Britain and Singapore for a total of around 4.5 million doses of the Pfizer-BioNTech vaccine, double this month’s supply. read more

Nearly half a million doses, the first batch of shipments, arrived overnight.

“There will be another set of flights in a couple of days, but we’ll pretty much be getting a million of the four million every week over the next four weeks,” Lieutenant General John Frewen, head of the vaccination taskforce, told broadcaster ABC.

Under the vaccine swap deals, Australia will return equivalent numbers of Pfizer-BioNTech vaccines to Britain and Singapore later this year. Reuters

What is Myasthenia Gravis.

Myasthenia gravis is a chronic neuromuscular disease that leads to fluctuating muscle weakness and fatigue. The disease is characterized by variable degrees of weakness of the skeletal muscles. The name myasthenia gravis is derived from a Latin word, meaning “grave muscle weakness.”

The muscle weakness happens mainly due to the circulation of antibodies which block nicotinic acetylcholine receptors at the postsynaptic neuromuscular junction. By blocking the ability of the neurotransmitter acetylcholine to bind to these receptors in the muscle, these antibodies deter motor neurons from signalling the muscle to contract.

Alternatively, in a much rarer form, muscle weakness is the result of a genetic defect in some portion of the neuromuscular junction that is inherited at birth as compared to the development through passive transmission from the mother’s immune system at birth or through autoimmunity later in life.

Symptoms of myasthenia gravis include:

  • Hoarse voice.
  • Double vision.
  • Drooping of eyelids.
  • Difficulty in talking.
  • Difficulty in swallowing or chewing.
  • Problems in lifting objects and walking upstairs.
  • Difficulty in breathing due to muscular weakness.

Although myasthenia gravis could affect any of the muscles that you control voluntarily, certain muscle groups are more commonly affected than others, some of them are:

  1. Eye Muscles
  • Double vision.
  • Drooping of one or both eyelids.
  1. Face and Throat Muscles
  • Altered speaking.
  • Difficulty swallowing.
  • Problems in chewing.
  • Limited facial expressions.

Myasthenia Gravis Causes

Myasthenia gravis is resulted by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction—the place where nerve cells connect with the muscles they control.

This neuromuscular disease is caused by transmission defects in nerve impulses to muscles. The neuromuscular junction is apparently affected: acetylcholine, which produces muscle contraction under normal conditions no longer produces the contractions necessary to muscle movement.

Myasthenia Gravis Causes

Myasthenia gravis is resulted by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction—the place where nerve cells connect with the muscles they control.

This neuromuscular disease is caused by transmission defects in nerve impulses to muscles. The neuromuscular junction is apparently affected: acetylcholine, which produces muscle contraction under normal conditions no longer produces the contractions necessary to muscle movement.

Myasthenia Gravis Treatment

Myasthenia gravis is believed to be caused by variations in certain genes. The disorder occurs when the immune system malfunctions and attacks the body’s tissues. There is no cure for myasthenia gravis. The goal of treatment is to manage symptoms and control the activity of your immune system through the below-mentioned ways:

  • Medication.
  • Plasma Exchange.
  • Lifestyle Changes.
  • Thymus Gland Removal.
  • Intravenous Immune Globulin.
  • Avoid stress and heat exposure.
  • Rest to help minimize muscle weakness.