An herbal alternative to tonsillectomy

Banish Tonsillitis Today Ebook

Natural Cure for Tonsilltis will show you that there are alternative, and cheaper ways to cure a tonsillitis. Using homeopathic or natural remedies have been proven to be very effective that it completely cured the author of this ebook, Jennifer Watt, of her tonsillitis. This is very amazing considering that the cure is so simple, and that the ingredient may even be found in your kitchen right now. In this book you will learn the revolutionary secret why you are constantly getting recurring Tonsillitis. Learn how to Stop this from occurring again! Get all the facts you need to know about tonsillitis, the causes, symptoms, treatments and learn what health problems can occur with prolonged use of antibiotics. You'll be shocked at the long term consequences of surgical removal of the tonsils. If you or anyone in the household is suffering from tonsillitis, it is time you try natural treatments you will get from Tonsillitis Natural Cure Book. This will surely save you from spending hundreds of dollars on treatments, and will eliminate the need for potentially dangerous and expensive Tonsillectomy.

Secrets To Naturally Curing and Preventing Tonsillitis Permanently Summary

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Author: Jennifer Watts
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Resection Specimens

In general, tonsillectomy specimens are only submitted in cases of unilateral enlargement or where malignancy is suspected specimens from children for repeated infective episodes or airway obstruction rarely require histological evaluation. In cases of metastatic squamous cell carcinoma to a cervical lymph node, the ipsilateral tonsil is removed when clinical and radiological evaluation fails to locate a primary lesion.

Surveys of Sick Individuals about their Use of OTC Healthcare Products

In a random-digit-dialing survey of 1505 adults, 77 of those who reported an illness in the past six months had self-treated with an OTC medication, in contrast to 43 who said they visited a physician for their illness (Labrie, 2001). Of those reporting headache symptoms, 81 self-treated of those reporting cold, cough, flu, or sore throat symptoms, 72 self-treated. This survey did not determine the time between OTC use and first contact with the healthcare system. However, it did ascertain whether OTC use was an individual's first action after the onset of symptoms. Of the individuals reporting headache symptoms, 54 said their first course of action was to take an OTC medication (34 said their first course of action was to wait and see if the symptoms would go away, and only 4 said their first course of action was to consult a physician). For individuals with cold, cough, flu, and sore throat symptoms, the first course of action was self-treatment with an OTC product in 42 , watchful...

Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is often referred to by other names or used interchangeably with similar disorders, such as chronic fatigue and immune dysfunction syndrome (CFIDS), fibromyalgia (FM), myalgic encephalomyelitis (ME), Gulf War Syndrome, and chronic Epstein-Barr disease. Recently, the Centers for Disease Control (CDC) has published epidemiologic figures estimating that approximately 800,000 Americans are affected by CFS. The associated economic loss is estimated in the billions of dollars, due to disability, medical expenses, and loss of wages. CFS is an incompletely understood, yet severely disabling disease of unknown etiology. It is characterized by profound, debilitating fatigue, of greater than 6 months duration that cannot be resolved with rest. Associated symptoms include fever, sore throat, myalgias, lymphadenopathy, sleep disturbance, headaches, neurocognitive difficulties (such as memory and concentration impairment and mental fog''), and symptoms associated with...

Clinical Presentation

Lymphadenopathy may be a presenting sign or symptom or an incidental finding. Up to two thirds of patients have non-specific causes or upper respiratory illness. Patients may present with sore throat, cough, fever, night sweats and fatigue or weight loss. There are many diseases associated with lymphadenopathy. The major categories are listed in Table 44.1.

Clinical Manifestations

Most patients with SJS have a distinct prodrome of an upper respiratory illness with fever, sore throat, rhinitis, malaise, vomiting, and diarrhea 1 to 14 days prior to the mucocutaneous eruption. Two or more mucosal sites must be involved to make the diagnosis of SJS. The oral mucosa is always involved with extensive superficial necrosis of the lips and mouth, leading to hemorrhagic crusts and followed by denudation of the mucosa and severe stomatitis (Fig. 7). Purulent conjunctivitis with photophobia can be seen. Anal and genital mucosa, and less commonly the esophagus, respiratory epithelium, and nasal mucosa can also be involved.

Reactive Lymphocytosis In Common Disease States

Reactive Lymphocytes Pics

It is normal for young children between the ages of 1 and 4 to have a relative lymphocytosis. The white cell differential in this age group will show a reversal in the number of lymphocytes to segmented neutrophils from the adult reference range. The lymphocytes, however, will have normal morphology (Fig. 10.11). By far the most common disease entity displaying variation in lymphocytes is infectious mononucleosis. This is viral illness caused by the Epstein-Barr virus (EBV), a member of the human herpes virus family, type 4. Although young children may become infected with EBV, the virus has a peak incidence at around 20 years of age. Most adults have been exposed to EBV by midlife, and this is recognized by demonstratable antibody production whether or not they have had an active case of infectious mononucleosis. The virus is found in body fluids, especially saliva, and is frequently passed through exchanges such as kissing, sharing food utensils, or drinking cups. The virus, which...

Nonneoplastic Conditions

Tonsillar enlargement tonsillitis is a common disorder of childhood characterised by frequent episodes of sore throat, dysphagia and otitis media. Although it tends to resolve with age, persistent exacerbations may be treated by tonsillectomy with or without concomitant adenoidectomy. Tonsils may be removed in adults for chronic tonsillitis or if a neoplasm is suspected, particularly if there is asymmetrical or unilateral enlargement. Lymphoid follicles with well-formed germinal centres are seen there may be fibrosis. Actinomyces colonies (sulphur granules) may be present within the crypts. Florid tonsillar follicular hyperplasia may occur bilaterally in HIV infection.

Inflammatory Autoimmune

Behcet's disease (BD) is a rare disorder of unknown etiology that affects mucocutaneous tissues, the eyes, and the genitourinary system. The classic triad of oral aphthous ulcers, uveitis, and genital ulcers is pathognomonic for BD. It may progress to involve the GI, pulmonary, renal, and central nervous systems, as well. Symptoms include malaise, fever, anorexia, and weight loss. Sore throat, dysphagia, and odynophagia are often present at acute presentation. BD is commonly misdiagnosed as pharyngitis or tonsillitis at initial presentation, resulting in a delay in appropriate treatment. Please refer to Chapter 3 for discussion of the epidemiology, pathogenesis, diagnosis, treatment, and prognosis of BD. Extraesophageal Reflux Disease. The presence of refluxed gastric contents represents a noxious stimulant to the pharyngeal mucosa and is a frequent cause of pharyngitis. Approximately 4 to 10 of patients seen by an otolaryngologist will have extraesophageal reflux...

Ebola and Marburg Fever

The incubation period for Ebola virus is between 3 and 21 days and for Marburg virus between 3 and 9 days. In contrast to Lassa fever, the onset of VHF caused by these viruses is abrupt, with onset of a prodrome lasting less than 7 days. This comprises non-specific symptoms including fever, chills, severe headache, malaise, myalgia and a maculopapular rash (onset day 2 to 7 typically on the face, neck, trunk and arms). This is followed by a rapid and progressive deterioration with severe, watery diarrhoea, abdominal pain and cramps, nausea and vomiting. Patients typically have ghost-like, drawn features with deep-set eyes and an expressionless facies. This phase is characterised by extreme lethargy. Other clinical features include chest pain, sore throat, hiccups, conjunctivitis, haematemesis, cough, photophobia and back pain.

Acute seroconversion illness

At least 50 of patients have an acute illness associated with seroconversion. The illness usually occurs within 6 weeks of infection and is characterised by fever, night sweats, malaise, severe lethargy, anorexia, nausea, myalgia, arthralgia, headache, photophobia, sore throat, diarrhoea, lymphadenopathy, generalised maculoerythematous rash and thrombocytopenia. Neurological manifestations including meningoencephalitis and peripheral neuritis are commonly observed. Acute HIV infection should be considered in the differential diagnosis of illnesses resembling glandular fever. This illness is self-limiting and usually revolves within 1 to 3 weeks. However, chronic lethargy, depression and irritability may persist after the acute illness. Non-specific viraemic sequelae such as mucosal ulceration, desquamation, exacerbation of seborrhoea and recurrences of herpes simplex may occur (see Fig. 24.1).

Abacavir hypersensitivity

The rash associated with the abacavir hypersensitivity reaction is often discrete, in contrast to the skin reactions caused by nevirapine and efavirenz in 30 of patients it may not occur at all. 80 of patients have fever. In addition to general malaise (which gets worse from day to day ), other frequent symptoms include gastrointestinal side effects such as nausea, vomiting, diarrhea and abdominal pain. Respiratory symptoms, such as dyspnea, cough and sore throat, are rare. Changes in the blood count, elevation of liver transaminases, alkaline phosphatase, creatinine and LDH may accompany the HSR. There is usually no eosinophilia. One case of Stevens-Johnson syndrome has been described (Bossi 2002). The synchronous start of therapy with abacavir and NNRTIs is unfavorable because of the difficulties of differentiating between allergic reactions to NNRTIs and HSR. If abacavir is part of the initial therapy and flu-like symptoms occur, it is difficult to distinguish between immune...

Inflammation Of Mucous Membranes

Topically, sage is used as a gargle for laryngitis, pharyngitis, stomatitis, gingivitis, glossitis, minor oral injuries and inflammation of the nasal mucosa (Blumenthal et al 2000). These uses can be based on the pharmacological activity of its chemical components. In an open-label, single-blind, RCT of 420 patients, the non-steroidal anti-inflammatory drug, benzydamine hydrochloride, was found to be more effective than sage in relieving postoperative pain when used as a mouthwash after tonsillectomy in children and adults (Lalicevic & Djordjevic 2004).

Schemata And Cognitive Processes

In one study, D'Andrade had his college student respondents categorize 30 illnesses in terms of 30 such statements for a total of 900 judgments. By examining the logical connections between these, he was able to reduce the number of meaningful clusters to three (a) those consisting of illnesses that are serious, fatal, crippling, affect the heart, and are not experienced by everyone, (b) those illnesses that are caused by germs or a lack of resistance, contracted in cold weather, accompanied by a fever, sore throat, or runny nose, and are not crippling or incurable, and (c) diseases that have

Fibrin Foam with Thrombin

Fibrin sealant has come a long way, and it is being used as a haemostatic agent for operations of heart, liver, and spleen. It is also used for prevention of sarcoma formation after soft tissue dissection, closure of fistulas, and reduced suture vascular and intestinal anastomosis.27 It was used in nephron sparing surgery by Stojkovic et al.28 in 2005 and was found to be an efficient haemostatic agent for polar resection of kidney. Histology showed less intense and smaller scarring, compared with sutures. Vaiman et al.29 compared fibrin sealant Quixil in a prospective random trial on 179 patients for rates of haem-orrhagic complications between bipolar and needle point electro-cautery with fibrin glue after tonsillectomy and adenoidectomy. The results of haemostasis were better, with good systemic and local compatibility. Pruthi et al 30 used it for hand assisted laparoscopic partial nephrectomy and found that in addition to haemostatic properties, the fibrin sealant had sealing...

Key facts and checkpoints

About 50 of patients develop an acute infective illness similar to glandular fever within weeks of acquiring the virus (the HIV seroconversion illness). 2 The main features are fever, lymphadenopathy, lethargy and possibly sore throat, and a generalised rash. If these patients have a negative infectious mononucleosis test, perform an HIV antibody, which may have to be repeated in four weeks or so if negative.

Common presenting symptoms

Common presenting symptoms in Australian practices are presented in Table 1.1 , 5 where they are compared with the United States of America. 6 The similarity is noticed but the different classification system does not permit an accurate comparison. In the third national survey of morbidity in general practice in Australia 5 the most common symptoms described by patients were cough (7.5 per 100 encounters), throat complaints (4.7 per 100), back complaints (3.8 per 100) and skin symptoms (3.6 per 100). In addition very common presentations included a check-up (13.6 per 100) and a request for prescription (8.8 per 100). McWhinney lists the ten most common presenting symptoms from representative Canadian and British practices but they are divided between males and females. 7 For males in the Canadian study these symptoms are (in order, starting from the most common) cough, sore throat, colds, abdominal pelvic pain, rash, fever chills, earache, back problems, skin inflammation and chest...

Epstein Barr mononucleosis

Epstein-Barr mononucleosis (infectious mononucleosis, glandular fever) (EBM) is a febrile illness caused by the herpes (Epstein-Barr) virus. It can mimic diseases such as HIV primary infection, streptococcal tonsillitis, viral hepatitis and acute lymphatic leukaemia. There are three forms the febrile, the anginose (with sore throat) and the glandular (with lymphadenopathy). It may occur at any age but usually between 10 and 35 years, commonest in 15-25 year old age group. The typical clinical features are presented in Table 25.2 and Figure 25.1 .

Practice makes perfect

In my case, I practised on patients with a cold. The first four months in my post were as a GP and coincided with the winter months. Thus, every GP's ''heartsink'' patient - stricken by the common cold and demanding antibiotics - became my favourite assay. I tried everything on everyone. In fact, I looked forward to my next case so I could test out my latest technique. Mother with a sick child Express concern for their child and stress the side effects of the antibiotics. 25-year-old professional Show your admiration for their soldiering on within the tough working environment. 40-year-old who is worried about that horrible sore throat they had last year Buckle under and give them the prescription but predict that the cold will get better by this Sunday. And if it does not, then they can take the antibiotics immediately on that day . . . but not before.

Complications And Prognosis

Most patients with infectious mononucleosis have the triad of fever, lymphadenopathy, and pharyngitis. The most common complication is swollen tonsils with obstructed FIGURE 1 Photograph of a patient with mononucleosis shows obstructive tonsillitis. FIGURE 1 Photograph of a patient with mononucleosis shows obstructive tonsillitis. Symptoms such as fever and sore throat usually lessen within two to three weeks. Fatigue, enlarged lymph nodes, and swollen spleen may last weeks longer. Most signs and symptoms ease within a few weeks, although two to three months may elapse before patients feel completely normal (4).

Perioperative Management

Tonsillectomies and ventilating tubes are considered low-risk procedures. High-risk procedures include intra-abdominal and neurological surgery. The incidence of perioperative events for tonsillectomy and for myringotomy tube insertion were 0 and 2.9 , respectively, compared with 16 for cesarean section (18). History of several acute pain crises within the last year and or ACS appears to be among the most significant findings of perioperative risk. Patients with end-organ damage (e.g., lung, kidney, etc.) would also be at a higher risk for complications (12). The adage an ounce of prevention is worth a pound of cure is especially true in the perioperative management of these patients. Interestingly, there is mixed evidence regarding the efficacy of various treatments for prevention of sickle cell events. Prophylactic blood transfusion to prevent sickle cell events was once popular however, evidence-based reviews of the literature did not support this practice. The current...

Head And Neck

Tonsillectomy is probably the most common surgical procedure in otorhinolaryngology. Yet, the best way to achieve haemostasis in this procedure is often debated by surgeons. Pressure with plain packs or packs soaked with a haemostatic agent are used. Ice has also been used over the tonsillar beds after resection. In addition, ties have been used to ligate specific bleeding points. Other methods using electrical means include mono-polar, bi-polar, and coblator diathermy. Instrumentation, such as, harmonic scalpel, have also been tried.7 The most important technique, and the one used by probably all surgeons, is the haemostatic, pause. The act of waiting for several minutes and relaxing the pressure applied to the tissues aids in clotting and haemosta-sis, or discovering smaller bleeding points prior to completion. Early results of a national audit into tonsillectomy showed that the most used technique in tonsillectomy haemostasis is bipolar diathermy. The technique which produced the...

Clinical Features

A sudden onset of fever, chills, and myalgias heralds the onset of this disease after an incubation period of 2 to 9 days. Sore throat, conjunctivitis, photophobia, and diarrhea may also be present. The patient may exhibit a labile mood. Three to six days into the illness, the hemorrhagic manifestations may erupt. A petechial rash and hemorrhage from most orifices and organ systems can ensue as disseminated intravascular coagulation (DIC) emerges. The liver may be enlarged and tender. Resolution of the rash may be a sign of recovery. Leukopenia, thrombocytopenia, abnormal LFTs, and abnormal clotting tests will be present. The case fatality rate is between 30 and 50 . Dengue Hemorrhagic Fever. Dengue Hemorrhagic Fever does not occur with primary infection of Dengue Fever. At least four serotypes exist, and infection with a different serotype triggers an immunologic mechanism leading to capillary leakage, bleeding diathesis, and shock. The onset of the...

Who Gets APLA

Approximately 30-50 of patients with SLE will have APLA. The antibodies can also be found in patients with other autoimmune diseases. Patients without lupus or other autoimmune disease can have symptomatic APLA (Primary APLA Syndrome). Children will often develop transient non-thrombotic APLA after viral infections. This laboratory finding often comes to attention during pre-operative evaluation for tonsillectomy. Up to 30 of patients with HIV infection will also develop APLA. The infection-associated APLA are not associated with thrombosis and are usually Anti-p2GP negative. Medication may also induce APLA. Chlorpro-mazine is the most common cause, but APLA has also been associated with use of procainamide, dilantin and quinidine. In screening studies of blood donors and normal controls, up to 10-20 of asymptomatic people have APLA. However, the APLA in these people are usually low-titer and most often occurs in young women.

Infection Viral

Adenovirus is the most common cause of viral pharyngitis. It is a double-stranded DNA virus. Serotypes 3,4, and 7 are frequently associated with viral pharyngitis. It is transmitted by either respiratory droplets or direct contact. School-aged children are most commonly affected. The classic presentation includes fever, sore throat, coryza, and red eyes. Adenovirus is cytolytic to the epithelial cells it invades and induces a localized inflammatory response in the surrounding tissues. Nasopharyngeal swabs can be obtained for viral cultures and a negative monospot test should be confirmed. It is usually self-limiting and lasts five to seven days. Treatment is supportive. Severe morbidity and mortality are rare and only seen in patients with altered immune function. Complications of adenovirus infection include keratoconjunctivitis (pink eye), acute hemorrhagic cystitis nephritis, and gastroenteritis. Ribavirin has been advocated in several case reports when systemic...

Definition

Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e. not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social or personal activities. Together with the concurrent occurrence of four or more of the following symptoms substantial impairment in short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches of a new type, pattern, or severity, unrefreshing sleep or postexertional malaise lasting more than 24 h, the symptoms must have persisted or

Clinical Summary

A 35 year old Hispanic woman was brought to the ER because of acute chest pain and shortness of breath. Her medical history included hyperthyroidism treated for 4 years with PTU (propylthiouracil), tonsillectomy at 15 years of age, and cigarette smoking for the past 20 years. The patient described non-progressive dyspnea on exertion, and occasional episodes of chest pain and abdominal pain after each meal. She had not taken any medications recently. Upon arrival, her pulse was 120 ppm with diminished carotid and lower extremity pulses and absent pulses in the upper extremities. Her BP was 97 68 mmHg. There was central cyanosis. An ECG showed RBBB and ST elevation in the anterolateral leads. An arterial blood gas showed hypoxemia. The chest x ray was unremarkable (no cardiomegaly). Blood chemistries revealed slightly low albumin (normal total protein), calcium and uric acid slightly elevated LDH, SGPT, CK, alkaline phosphatase and creatinine, and normal bilirubin and SGOT. The...

Slippery elm

Historical note The dried inner bark of the slippery elm tree was a popular remedy used by many Native American tribes, and subsequently taken up by European settlers. It was mixed with water and applied topically to treat wounds, bruises and skin irritations, and used internally for sore throat, coughs and gastrointestinal conditions. When mixed with milk, it was used as a nutritious gruel for children and convalescents. It also gained a reputation as an effective wound healer among soldiers during the American Civil War. From 1 820 until 1 960 it was listed in the US Pharmacopeia as a demulcent, emollient and antitussive (Ulbricht & Basch 2005). The name 'slippery elm' refers to the slippery consistency of the inner bark when it comes into contact with water.

Plate 32 Tonsil

The tonsils guard the opening of the pharynx, the common entry to the respiratory and digestive tracts. They can become inflamed because of repeated infection in the oropharynx and nasopharynx and can even harbor bacteria that cause repeated infections if they are overwhelmed. When this occurs, the inflamed palatine tonsils and pharyngeal tonsils (also called adenoids) are removed surgically (tonsillectomy and ade-noidectomy).

RHuSCF

The adverse event profile associated with r-metHuSCF was first defined in two small phase 1 clinical trials investigating its utility in patients with cancer receiving chemotherapy (29,30). When administered to 17 patients with nonsmall-cell lung cancer in incremental doses of 10, 25, and 50 g kg d before the administration of chemotherapy, a specific pattern of adverse events emerged. At the lowest dose level, adverse events were limited to the injection site. At dose levels > 10 g kg d, adverse events occurred as multisystem systemic reactions. Dose-related mild-to-moderate reactions occurred in all patients at all dose levels and included edema, urticaria, erythema, and pruritus. These reactions, mild to severe, as well as angioedema and der-matographia, occurred at distant cutaneous sites. Cough, throat tightness, sore throat, dyspepsia, and hypotension were transient and did not result in patient withdrawal from the study (29). In another phase 1 trial of identical design,...

Neoplasm

Cancer Tonsillar Fossa

Although neoplasms are not a cause of acute or chronic pharyngitis, tumors arising in the oropharynx often present with signs and symptoms that most commonly indicate an infectious etiology. Patients treated for infectious pharyngitis, who do not improve, warrant further investigation to identify a possible neoplasm. Common presenting symptoms of oropharyngeal cancer include unilateral sore throat, dysphagia, odynophagia, weight loss, and otalgia. On physical exam, an asymmetric pharyngeal mass is the hallmark clinical finding and warrants further investigation (Fig. 4). The mass may be ulcerative, fungating, or mucosal covered and detectable only by palpation. Cervical adenopathy is present with advanced disease that has metastasized to the locoregional lymph nodes. Risk factors for oropharyngeal cancer include tobacco and alcohol abuse. The human papilloma virus has a role in a subset of oropharyngeal tumors.

Biopsy Specimens

Incisional biopsies in the upper aerodigestive tract are usually directed at a specific lesion located either by visualisation or by CT or MR imaging. Blind biopsies may be taken, particularly from the fossa of Rosenmuller, base of the tongue, pyriform fossa and palatine tonsil, in the search for an occult primary carcinoma. Superficial biopsies of tonsil may miss a small submucosal tumour tonsillectomy is preferred. Biopsies of pharyngeal and laryngeal lesions are usually taken at endoscopy with punch or cup forceps. While usually sufficient, it is sometimes difficult to make a histological diagnosis of malignancy as the specimens tend to be superficial, and submucosal tumours or the invasive components of well-differentiated squamous carcinoma may not be represented.

Mononucleosis

Mononucleosis is caused by an infection with the Epstein-Barr virus (EBV), a DNA virus in the Herpes virus family. It typically presents with fever, sore throat, malaise, lymphadeno-pathy, and hepatosplenomegaly. It is estimated that 90 of adults have serologic evidence of prior EBV infection. Diagnosis is confirmed by the clinical picture, characteristic hematologic changes, and immunologic findings. Hematologic changes include atypical lymphocytosis of peripheral monocyte cells. Immunologic findings are an elevated heterophil antibody test, the most specific test used for mononucleosis. The heterophile antibody is an IgM antibody produced by infected B lymphocytes. It is not directed against EBV infected cells but rather is a result of the viral transformation of the B cell into a plasmacytoid state induced by the virus. It is present in 90 of cases by the third week of infection. Immunofluorescence techniques are also available to detect antibodies to EBV (50).

Clinical

Primary HIV infection is most often asymptomatic. Occasionally, an acute retro-viral syndrome has been identified involving fever, morbilliform rash, acute mononucleosis-like symptoms (sore throat, lymphadenopathy) or sometimes aseptic meningitis. This acute illness occurs 1 to 6 weeks after infection, and seroconversion to positive HIV ELISA may take another 2 to 6 weeks after the acute syndrome. After exposure to HIV infection by the sexual or parenteral route, seroconversion takes place within 3 months, and a negative test at 3 months can be accepted as evidence that HIV infection has not occurred.

Asphyxiant Gases

Ical means, as occurs with carbon monoxide. Carbon monoxide is the second most common atmospheric pollutant after carbon dioxide. It is produced by incomplete combustion from fires, faulty heating systems, volcanic eruptions, and internal combustion engines, as well as a variety of industrial processes. Carbon monoxide is an odorless, tasteless gas. Early symptoms (headache, sore throat, shortness of breath, and fatigue) can mimic the flu, especially when an entire family is affected from an exposure related to a faulty home heating system. Serious clinical effects such as tachycardia, arrhythmias, angina, and mental status changes can occur when carboxy-hemoglobin concentrations exceed 20 (especially in nonsmokers) and effects are nearly always fatal when carboxyhemoglobin concentrations exceed 60 . Clinical effects may occur at lower concentrations in subjects already suffering from cardiopul-monary diseases. Carbon monoxide toxicity is related to decreased oxygen transport due to...

Icd Codes

The International Classification of Diseases, 9th Revision, Clinical Modification (ICD) is a standard vocabulary for diagnoses, symptoms, and syndromes (see Chapter 32). ICD has a code for each class of diagnoses, syndromes, and symptoms that it covers. For example, the ICD code 034.0 Streptococcal sore throat includes tonsillitis, pharyngitis, and laryngitis caused by any species of Streptococcus bacteria. There are more than

Lassa Fever

After an incubation period of between 5 and 21 days there is the gradual onset of an illness that lasts between one and four weeks. The clinical manifestations of this and other VHFs are protean but typically cases start with non-specific symptoms of fever, headache, arthralgia and myalgia. Patients may also suffer from a sore throat with exudative pharyngitis and cough. This is followed by abdominal symptoms (vomiting, abdominal pain and tenderness, diarhorrea). Severe illness with haemorrhagic symptoms and signs, confusion, neck and facial swelling, and progression to shock with multisystem organ failure occurs in only a minority (fewer than 20 ) of patients. Other features may include encephalopathy, encephalitis,