Tuesday, June 21, 2011

Foods With High Uric Acid Levels

Food guide for persons with high uric acid

I. High Purine Foods- Avoid These!!!
1.Alcoholic beverages
Beans on Toast!

2.Organ Meats
- Liver
- Kidney

3.Fish and Seafood
- Anchovies
- Sardines
- Herring
- Mussels (Tahong)
- Codfish
- Scallops
- Trout
- Haddock
- Fish Paste (Patis)

- Bacon
- Veal
- Venison
- Turkey

II. Moderate Purine Foods- Eat in Moderation
- Asparagus
- Kidney beans
- Lentils
- Lima beans
- Mushrooms
- Spinach

2. Meats
- Beef
- Chicken
- Duck
- Pork or Ham

3. Miscellaneous
- Bouillon

4.Fish and Seafood

Friday, April 30, 2010

Cotard's Syndrome


Imagine hearing a person gripe about his life being "dead". It must be difficult dealing with the fumes of a putrefying body or the tragedy of disappearing vital organs. In episode 14 of the 4th season of the hit TV series " Scrubs", a character named Jerry depicted the role of a patient with the "Walking Corpse Syndrome".

The "Walking Corpse Syndrome" is a form of psychosis that deludes the patient into thinking that he is dead and decaying. Sorry necrophiliacs, because in reality, he's very much alive and not about to decompose anytime. He believes he's losing parts of his body, organs or blood, his soul included. It is also called "Cotard's Syndrome," after Jules Cotard, the Parisian neurologist who first described its symptoms.

This syndrome is typically related to depression and in psychoses such as schizophrenia and bipolar disorder. Road daredevils beware, as cases arising from brain injuries have also been reported. In 1996, a Cotard's case was documented in a patient who suffered brain injury after a motorcycle accident. After being discharged from the hospital in Scotland, his mother brought him to South Africa. However, according to the patient, it was a trip to hell, as evidenced by the heat and that he died from various causes, from septicemia to AIDS, to an overdose of a yellow fever injection. He believed his mother's spirit was borrowed to show him around hell. "Going through hell" gets a new perspective, with parental guidance this time.

Cotard's is thought to be related to Capgras's Syndrome (the belief that your relatives have been replaced by impostors). A disconnection between the brain areas that recognize faces and the area that associates them with the emotions that are connected with that particular face has been implicated as the culprit. It has higher incidence among middle-aged and older patients.
Cases known are too few for a reprise of Michael Jackson's video, "Thriller". Electroconvulsive therapies have shown help especially with associated severe depressive disorders. With the rarity of this syndrome, doctors are still at a loss for adequate treatments. This calls for a challenge among medical researchers to save these patients from their untimely "deaths".

Wednesday, March 24, 2010

Acute Bronchitis

What is Acute Bronchitis?

Acute bronchitis is a clinical syndrome caused by the inflammation of the linings of your airway passages (the tracheobronchial tree). The irritated membrane swells and increases its production of mucus which leads to coughing.

woman holding a tissue for her son (10-12) to sneeze
It can affect all age groups but among children, they are more frequently found in those younger than 5 years old.

Acute bronchitis is differentiated from chronic bronchitis by its onset, duration of illness and causative agents. Acute bronchitis is a sudden onset, self-limiting process lasting for about 10-14 days and commonly caused by an infection. Chronic bronchitis, on the other hand, is a long term, recurring, more serious condition with production of sputum for 3 months of the year, for at least 2 years in a row, which is usually a part of an underlying chronic pulmonary disease. It is another lung pathology that requires a separate discussion.

What Causes Acute Bronchitis?

Acute bronchitis is commonly infectious in origin, with 90% of cases caused by viruses and 10% by bacteria. Very rarely, it can be due to fungal agents. The viruses responsible for a common cold may be the same viruses that can bring about an acute bronchitis, except that the damage is further down in the respiratory tree. Acute bronchitis may in fact, accompany or follow a bout of cold or flu.

Although viruses are the usual culprit in acute bronchitis, the damage done in the bronchial linings make it more prone to a secondary attack by bacteria.

Viruses commonly implicated:
  • Influenza
  • Parainfluenza
  • Adenovirus
  • Rhinovirus
      ·    Respiratory syncytial virus
      ·    Coxsackievirus
Bacterial causes:
  • Mycoplasma pneumoniae
  • Chlamydia  pneumoniae
  • Bordatella pertussis- may occur in children that are incompletely vaccinated
Acute bronchitis can be transmitted when you breathe in these germs or touch hands and objects coated with these microorganisms. It can also result from inhaling air pollutants such as smoke and other noxious fumes, and from food or vomit that accidentally enters into your lungs. The body fights back by creating an inflammatory response, which leads to swelling of the walls of the bronchial tree, increasing mucus production with subsequent narrowing or air passages and stimulating the cough reflex.

What are the Symptoms?

  • Dry cough that subsequently loosens and becomes productive of yellowish or greenish phlegm. In children that do not know how to expectorate, the phlegm is swallowed and will only be noted upon vomiting.
  • Nasal discharge that becomes thicker
  • Shortness of breath
  • Low Grade Fever
  • Sore Throat
  • Wheezing
  • “Rattle” sensation in the chest
  • Chest Pain
  • Muscle and joint pains
  • A general feeling of tiredness

How is Acute Bronchitis Diagnosed?
  • Medical history and Physical Examination. No routine laboratory examination can reliably confirm the diagnosis. Rather, it will be heavily dependent on the symptoms that you have observed and on physical examination done by your doctor.
  • Physical findings. The presence of irritation of the eyes and enlargement of the lymph nodes may suggest adenovirus as the causative agent, although this is not specific.  In most cases, the physical findings are unremarkable.
  • Chest X-ray may be requested to exclude the possibility of pneumonia. In uncomplicated cases of acute bronchitis, the lung fields will appear normal on x-ray.
  • Complete blood count may show elevated levels of white blood cells, indicating an ongoing inflammatory process.
  • Gram stain and culture sensitivity of the sputum will aid in the diagnosis if bacteria is entertained as the possible cause. It will likewise determine which antibiotic will be effective.

How is Acute Bronchitis Treated?

1. Drug Therapy
  • Antibiotics have no role in the treatment of acute bronchitis due to viruses. However, it may be prescribed when acute bronchitis is caused by bacteria or is complicated by a secondary bacterial infection. Macrolides are usually chosen because of their activity against Mycoplasma pneumoniae, Chlamydia pneumoniae and Bordatella pertussis, which are the common bacterial offenders.
  • Analgesics/ Antipyretics are used to control fever and body pains
  • Cough preparations including expectorants, mucolytics and antitussives may temporarily alleviate coughing, although their efficacy remains uncertain.
  • Decongestants to relieve nasal congestion
  • Bronchodilators or drugs prescribed for asthma may be especially useful if you experience wheezing. These will help open tight air passages in the lungs.
  • Antiviral agents and influenza vaccinations offer protection for acute bronchitis caused by Influenza A and B.

2. Non-Pharmacologic Therapy
  • Get adequate rest in a well-ventilated room to allow your body regain the energy needed to fight the infection.
  • Warm-compress over the chest to relieve discomfort
  • Increase fluid intake to help thin out the mucus in your lungs
  • Steam inhalation using mentholated vapor can help clear out your nasal discharges and bronchial secretions
  • Smoking cessation. If you smoke, you have to stop, to avoid further damage to your bronchial linings and enable faster healing.

When Do I Consult A Doctor?

You can contact your health care provider if you notice any symptoms of acute bronchitis.  Being a self-limited disease, it can be treated at home. However, these are the signs to look out for that warrant immediate consultation with an expert:
  • Breathlessness, increased difficulty of breathing or wheezing even while at rest
  • Chest pain that is crushing or squeezing in quality
  • High-grade fever or chills
  • Blood in the sputum
  • Symptoms worsening or lasting for more than 2 weeks
  • Presence of chronic lung disorders or other debilitating diseases, especially in older patients
 What Are the Complications of Acute Bronchitis?

In most cases, patients recover totally after 10-14 days. In less than 5% of cases, it can develop into Pneumonia. Persons with asthma or chronic pulmonary disease can have a longer recovery period or may find their symptoms getting worse.

How Do I Avoid Acquiring Acute Bronchitis?

  • Wash your hands often to prevent transmission of germs.
  • Avoid noxious chemicals and other air pollutants.
  • Do not smoke. Smoking damages the protective linings of your bronchial airways.
  • Getting a flu shot may lessen your chances of acquiring acute bronchitis since influenza viruses are commonly implicated in the disease.

Friday, March 19, 2010

Ophthalmology: The Wills Eye Manual

The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease (Rhee, The Wills Eye Manual) (Paperback)

Now in full color and completely updated, the Fifth Edition of this best-selling manual is a reliable quick-reference guide for all clinicians who treat eye disorders. Every disorder encountered in the office, emergency room, or hospital is covered in concise outline format: symptoms, signs, work-up, treatment, and follow-up. Also included are chapters on differential diagnosis of ocular symptoms and signs, a section on current imaging modalities in ophthalmology, and a Pharmacopoeia. This edition features over 200 full-color photographs and includes the newest drugs, procedures, and treatment protocols. New topics covered include iridodialysis/cyclodialysis, shaken baby syndrome, crystalline keratopathy, refractive surgery complications, aberrant regeneration of the third nerve, venous stasis retinopathy, choroidal effusion/detachment, and common laser procedures. New appendices cover intravitreal injections and antibiotics, anterior chamber paracentesis, laser peripheral iridotomy, and YAG capsulotomy. "Doody's Core Titles™ 2009."

Sunday, January 31, 2010

My Medical Blog

A young adult Caucasian female doctor looking at an x-ray

I'm on a roll! Obviously, I'm not contented with keeping just 3 blogs so I'm adding a 4th one which will be my medical journal. This will keep you updated on the latest medical trends and discuss some cases that I encounter  in my practice.

As they say, use it or lose it. Being away from training isn't an excuse for blunting my clinical knowledge so here I am, keeping abreast with the  medical developments and bringing them to you.

Hang on for my future posts!