Hepatitis B

What is hepatitis B?

Hepatitis B is a viral infection of the liver, which follows a very variable course. The hepatitis B virus (HBV) can cause an acute illness that resolves itself quickly without causing long-term liver damage. However, in about 20% of cases it causes a chronic illness that lasts more than six months, sometimes for life, with symptoms that come and go. In 15-40% of those with chronic infection cirrhosis, liver cancer or liver failure develop, and so the infection may eventually be fatal.
Hepatitis B is not very common in the UK, with new infections occurring in about 7 out of every 100,000 of the population every year, usually in adults. Worldwide, however, it is a major health problem. In Asia and most of Africa, most people pick up the infection around the time of birth or during childhood. As a result, two billion people worldwide are infected with hepatitis B, with 350 million suffering from chronic HBV infection. It is the 10th leading cause of death worldwide.
The virus is usually transmitted through contact with infected blood or body fluids. Only a tiny amount of blood is needed to transmit the virus because it's so infectious. The hepatitis B virus may also be present in saliva, vaginal secretions, breast milk and other bodily fluids.
In the UK, infection commonly occurs through unprotected sexual intercourse, the sharing of contaminated needles by drugs users, accidental injury with a contaminated needle (if needles used for tattooing, body piercing or acupuncture are contaminated) and sharing razors.
In countries where screening of blood products isn't routine, or where medical equipment isn't adequately sterilised, hepatitis B may be transmitted during medical treatment.
Many people contract hepatitis B while on holiday, especially in countries where it is very prevalent, when unprotected sex, experimenting with drugs and accidents needing medical treatment are far more likely.

Hepatitis B symptoms

The incubation period of the hepatitis B virus before symptoms develop is between six weeks and six months.
In the acute phase symptoms vary. Roughly one-third of cases have no symptoms - this is called a silent or subclinical infection, or sometimes anicteric infection, meaning there is no jaundice or yellow appearance of the skin and membranes. In another third of cases, the infection causes mild symptoms similar to those of a flu-like illness, with weakness, aches, headache, fever, loss of appetite, diarrhoea, jaundice, nausea and vomiting.
In the final third of cases, the acute phase of infection can cause severe illness that last many months. In addition to the flu-like symptoms, there's abdominal pain, diarrhoea and jaundice.
Jaundice occurs in hepatitis infections because the liver becomes unable to remove a substance called bilirubin from the blood. This is a pigment that builds up in the body, causing the skin and whites of the eyes to turn yellow.
Rarely, rapid liver failure develops, which may need a life-saving liver transplant.
In as many as one in five cases, the infection then goes into a chronic phase, where people may be apparently healthy with no symptoms but carrying and shedding the virus (known as healthy carriers). Alternatively, they may develop a chronic active hepatitis, with similar symptoms to the acute phase of the infection and also fatigue, poor appetite, nausea and abdominal discomfort.

Hepatitis B causes

In the UK, the people most at risk of contracting hepatitis B are injecting drug users, people who have unprotected sex with different partners, close family members of someone with the infection, babies born to infected mothers and travellers to high-risk countries who come into contact with infected blood and other bodily fluids.
Hepatitis B is considered an occupational hazard for healthcare workers, the police and the emergency services.

Preventing hepatitis B

Practising safe sex by using condoms and not sharing needles when using drugs can reduce the risk of infection. The same advice applies when travelling.
When having any body piercing, tattoo or acupuncture, make sure the business is registered with the local authority, that the needles used are disposable and that an autoclave is used for any equipment that's sterilised. If the proprietor cannot confirm these, go elsewhere.
Normal social contact carries no risk of infection. You can't catch hepatitis B from toilet seats or by touching an infected person. Clothing with the virus is thought to be killed by a normal hot wash in a washing machine, and by washing-up liquid and hot water for plates and cutlery.

Hepatitis B vaccine

There's an effective vaccination to protect people from hepatitis B infection. It's available from your GP or high street travel centres, who will advise you whether you need it.
Family and other household members of an infected person should be vaccinated against hepatitis B. Healthcare workers, the police, the emergency services and anyone who is likely to come in contact with infected blood through their job should also be vaccinated.

Hepatitis B treatments

The majority of people with hepatitis B don't need specific treatment other than rest, and they eventually make a full recovery. However, it is important that the infection is monitored to check whether chronic disease develops, and the person is given advice about the risk of passing the infection on.
If the infection lasts more than six months (chronic hepatitis infection, where the virus continues to actively reproduce in the body) you may need more specific drug treatment to reduce the risk of permanent liver damage (cirrhosis) and liver cancer. Your GP should refer you to a specialist in either liver disease (a hepatologist) or general digestive diseases (a gastroenterologist). They may recommend treatment either with treatment called interferon, or with antiviral drugs.
Interferon (either alpha interferon or longer lasting pegylated interferon) is given as regular injections and helps boost the immune system to fight the infection. The response to interferon is variable, and some people who initially get better get worse again when the treatment is stopped. Others find that the side effects of interferon mean that they cannot continue with treatment.
Several different antiviral drugs, known as nucleoside analogues, are also now used to treat chronic hepatitis. They aren't a cure, but they do suppress the virus. These drugs may also have side effects - although not usually so severe as with interferon - and the virus may become resistant to them.
Occasionally, when there is severe damage to the liver, a liver transplant is recommended.
READMORE:http://www.bbc.co.uk/health/physical_health

Hepatitis A

What is hepatitis A?

Hepatitis A is an infection of the liver caused by the hepatitis A virus.
According to the World Health Organisation, there are an estimated 1.5 million new cases of illness due to hepatitis A each year worldwide, and many more people become infected without developing symptoms. It's particularly common in less developed countries where poverty or poor sanitation are important factors.
Africa, northern and southern Asia, parts of South America, and southern and eastern Europe all have high rates of the disease. In these countries almost every adult carries antibodies to hepatitis A suggesting that it is quite usual for people to be exposed to the infection, usually in childhood, and to develop immunity.
The infection isn't common in the UK, although it's still the main type of infective hepatitis seen. (There are several other types of viral hepatitis, such as hepatitis B and hepatitis C.) In 2005, for example, there were 457 laboratory reports of confirmed hepatitis A virus (HAV) infection in England and Wales.
The majority of people from the UK who become infected with hepatitis A contract it when abroad in a country where it is very common.
Hepatitis A is an acute infection, rather than chronic (long-term). Rarely, it can cause life-threatening liver damage.

Hepatitis A symptoms

The incubation period of the virus before symptoms develop is between two and six weeks. How severely someone is affected varies from person to person. Some may not have any symptoms at all, while others may have just mild symptoms similar to those of a flu-like illness. This is particularly common among infants and young children.
The older someone is, the more severe the infection and symptoms are likely to be.
Possible symptoms include weakness, tiredness, headache, fever, loss of appetite, nausea and vomiting, abdominal pain and diarrhoea and dehydration. These may all occur for a week or more before jaundice appears.
Jaundice occurs in hepatitis infections because the liver becomes unable to remove a substance called bilirubin from the blood. This is a pigment that builds up in the body, causing the skin and whites of the eyes to turn yellow.

Hepatitis A causes

The hepatitis A virus is found in the faeces of infected people. It's spread because of poor personal hygiene, such as when people don't wash their hands after using the toilet.
The most common causes of infection are contaminated food or water and person-to-person contact. In countries where sanitation and sewage disposal are poor, drinking water may become contaminated, causing major outbreaks of hepatitis A.
Food prepared or washed with contaminated water can also easily transmit the infection. Fruits, salads, raw vegetables and any uncooked foods are considered to be high risk, as are ice, iced drinks and ice cream. Food that comes into contact with contaminated seawater, for example, shellfish, can also transmit the infection.
There have also been outbreaks of hepatitis A among intravenous drug users although other types of hepatitis (B and C) are usually of more concern in this group.

Preventing hepatitis A

How to avoid infection:

• Ensure high level of personal hygiene
• Avoid eating raw or inadequately cooked salads, vegetables and shellfish
• Check whether tap water is safe to drink before you go
• Get vaccinated against hepatitis A if visiting high-risk countries

Hepatitis A treatments

There's no specific treatment for hepatitis A, but fortunately the majority of people recover within a few weeks. On average, around one in five people between the ages of 15 and 39 with hepatitis A is admitted to hospital for supportive treatment such as intravenous fluids, medication for pain and itching, and general nutritional support.
About 15% of people will have a prolonged or relapsing illness lasting up to 9 months. Tragically, a small number of people die when the infection overwhelms the body. This is more likely to happen to people over the age of 60.
A person with hepatitis A should avoid drinking alcohol until their liver is completely back to normal, as alcohol is toxic to liver cells and will slow its recovery.
Ensuring good personal hygiene practices - washing your hands after using the toilet and maintaining good food preparation - is essential in avoiding infection with hepatitis A, especially if you visit a high risk area.
When visiting high-risk countries, it's a good idea to avoid eating raw or inadequately cooked salads and vegetables, ice cream, unpeeled fruit and shellfish. Also avoid unpasteurised milk and drinks with ice, and check whether tap water is safe to drink before you go.
There's an effective vaccination to protect people from hepatitis A infection. It's available from your GP or high street travel centres, who will be able to advise you whether you need it for the country you are visiting. It's recommended for anyone travelling to the high-risk regions of the world.
Those people who have already had hepatitis A usually have life long immunity.
READMORE:http://www.bbc.co.uk/health/physical_health

Cystitis

Causes of cystitis

Cystitis usually occurs as the result of an infection.
Although anyone can get cystitis, adult women are most commonly affected. Most women get at least one attack in their lifetime.
For some women cystitis is a rare event, for others it happens four or five times a year. Cystitis is more common in sexually active women, during pregnancy and after the menopause.

Symptoms of cystitis

Common symptoms are a sharp pain when passing urine, and an urgent and frequent need to pass urine, often with little or no urine being passed.
Other possible symptoms include blood in the urine, backache, loin pain, lower abdominal aches and generally feeling unwell.

Preventing cystitis

Drink at least eight glasses of water a day. Drinking one glass of cranberry juice a day is also believed to help prevent cystitis.
After visiting the toilet, women should always wipe themselves from front to back. Loose clothing and cotton underwear help, too.
Avoid potential irritants such as perfumed bath oils and vaginal deodorants. Don't douche. Always wash before and after sex, and pass water as soon after sex as possible.

Cystitis treatments

Treatment options include:

• Drinking plenty of water throughout the day, including cranberry juice
• Making urine less acidic by mixing a teaspoon of bicarbonate of soda with half a pint of water (over-the-counter remedies containing sodium citrate or potassium citrate are available in solutions or sachets)
• Your GP may prescribe antibiotics if a bacterial infection is present
• Over-the-counter painkillers such as paracetamol and ibuprofen

Ask the doctor for advice if this is the first time cystitis has occurred, if the symptoms don't improve after 24 hours or get worse, if blood is present in the urine or if symptoms are accompanied by fever, loin pain or lower backache.
READMORE:www.bbc.co.uk/health/physical_health

Hernia

What is a hernia?

A hernia simply means a protrusion of body tissues through a weakness or hole in other body tissues. It most often refers to a part of the intestines protruding through the muscular wall of the abdomen (although other types of hernia are sometimes seen elsewhere in the body). The most common are inguinal hernias and, especially in small children, umbilical hernias.

Hernia symptoms

When a hernia first occurs you may have a feeling that something has given way and may experience a little pain. This soon wears off. Later, a lump appears. This doesn't hurt and may get bigger when you cough. It may intermittently disappear and reappear as the herniating tissue slips back into place and then protrudes again.
Although in most cases hernias just cause discomfort and are a bit of a nuisance, the real worry is that they'll strangulate. This means the tissue gets stuck through the weakness or hole, and its blood supply is cut off. Without an emergency operation to release it and restore its blood supply, some of the tissue will die leading to serious illness.
If you suspect you may have a hernia, you should get a doctor to confirm the diagnosis.

Hernia causes

The abdominal wall is a sheet of muscle that acts like a corset to stop the organs of the abdomen - principally, the intestines - from falling out. When a weakness or tear occurs in this muscle, part of the intestine bulges through and appears as a lump under the skin.
In the past, hernias were often called ruptures. They are most common in the groin (inguinal hernias). Men are particularly predisposed to inguinal hernias because of their anatomy - there is what amounts to a tunnel through the tissues of the groin which allowed the testes to descend from the abdomen into the scrotum during development. Intestinal tissue can also pass into this tunnel, forming a hernia.
Anything that raises the pressure within the abdomen, such as heavy lifting (for example, weights or building materials), coughing, even straining on the toilet, can cause a weakness or tear in the abdominal wall, or force intestinal contents out through a weakness. Vigorous exercise often results in hernias.
Sometimes the weakness is already present - for example, from birth around the umbilicus (umbilical hernia) in children or under the scar of an operation (incisional hernia).

Hernia treatments

In the past, trusses or supports were used to keep the hernia in place, but these days it's better to have a simple operation to repair the weakness before further problems arise.
Hernia operations are the most common operations performed on men in the UK. The NHS performs more than 100,000 hernia repairs every year. Most operations are done in under an hour and you can go home the same day.
A special mesh material is used for the repair and, depending on the local hospital arrangements and your own fitness, it may be done under local or general anaesthetic and sometimes by keyhole surgery.
With some advanced techniques you can be back to work in under a week, although this depends on your job and what the surgeon advises.
To prevent a hernia occuring, try to maintain your ideal weight and lift correctly, bending at the knees and keeping your back straight. Stopping smoking will help to prevent excessive coughing. Eating a good, high-fibre diet (with plenty of water) will help to avoid constipation and the need to strain on the toilet, which increases pressure inside the abdomen.
READMORE:http://www.bbc.co.uk/health