Epilepsy and seizures

 What is Epilepsy?

Epilepsy, seizure... You always see these words being thrown around, from TV shows to books to jokes. A lot of people know what the simplified meaning of what an epilepsy is, but not a lot knows it in depth or even the true meaning of it. The meaning of having an epilepsy is to have two or more unprovoked seizures. Well, what does unprovoked mean then? An unprovoked seizure is a seizure which its cause is unknown. Seizures caused by allergic reactions, low blood sugar, infections... are provoked seizures, because there is a direct cause for it. Moving onto stats, did you also know that epilepsy is the fourth most common neurological disorder? Unfortunately, it is. As of 2019, a staggering 1.2% of people have active epilepsy, which is about 3.4 million people in the US alone! Other than that, over 1 in 26 will experience an epilepsy in their lifetime. That is scary to think of! That's about 4% of people! And the worse thing is that it doesn't only happen to adults, it happens to children too. Out of the 3.4 million cases in the US, 470000 of them are children. 

What are seizures?

Seizures are sudden surges of electrical activities in a person's brain. This can be an imbalance of activity caused by lack of or too much activity. It can affect the patient in many way, such as the common violent shaking. Over 10% of people will experience a seizure in their lifetime!

Types of Seizures:

- Generalized Seizures: affects the whole brain

    -Petit Mal Seizures:

        - Absence seizure -- Blank out for a few seconds and recover

    -Grand Mal Seizures:

        - Tonic seizure -- Muscle stiffens

        - Clonic seizure -- Recurrent shaking, jerking and twitching for parts of body

        - Myoclonic seizure -- Irregular singular short jerking of parts of body (short clonic seizure)

        - Atonic seizure (Drop attacks) -- Sudden loss of muscle strength

- Focal Seizures: affects a specific part of the brain

    - Simple Focal seizure -- sudden twitch or change in sensation

    - Complex Focal seizure -- causes confusion

    - Secondary Generalized seizure -- causes focal seizure first, then causes generalized seizure

Causes of seizures:

- Alcohol Withdrawal (when you suddenly stop consuming alcohol after a long time of drinking it)4

- Alcohol Overdose

- Brain Infection

- Brain/Head Injury

- Brain Defect

- Brain Tumor/Cancer

- Choking

- COVID-19 (severe cases)

- Drug Withdrawal

- Drug Overdose

- Electric Shock

- High Blood Pressure (Too high)

- High Fever

- Kidney Failure

- Liver Failure

- Low Glucose Levels (Too low)

- Sleep Deprived

- Strobe lights/sounds (Photosensitive seizure)

- Stroke

Treatment:

- Anti-Seizure medication

- Surgery

- Vagus Nerve Stimulation

- Neurostimulation 

- Deep Brain Stimulation

Prevention:

- Get enough sleep

- Take less alcohol

- Don't take drugs without prescription

- Don't play video games for too long

- Try to relieve stress

Gangrene

 What is Gangrene?

Gangrene is an extremely dangerous medical condition. Gangrene is the term used to describe body tissue death, which usually only happens with severe blood loss or bacterial infection. Even though it usually only affects limbs, fingers, toes... it can also affect muscle tissues, organ tissues and even genitals in cases of Fournier's Gangrene.

Types of Gangrene: 

- Dry Gangrene

- Wet Gangrene

- Gas Gangrene (wet)

- Internal Gangrene (wet)

- Fournier's Gangrene (wet)

- Meleney's Gangrene (wet)

What is Dry gangrene?

Dry gangrene is a type of gangrene that is not caused by infection. Dry gangrene is only caused by loss of blood, which causes the tissue to turn black, dry up and fall off. However, a dry gangrene can become an infection, causing a wet gangrene.

What is Wet gangrene?

Wet gangrene is usually always because of a bacterial infection. As the name suggests, wet gangrene causes blisters to build up, causing it to be wet from the pus. The blisters swells and can quickly cut off blood circulation and also easily spread to other parts of the body.

What is Internal gangrene?

Internal gangrene is a type of wet gangrene. It refers to gangrene of internal organ tissues, and it can affect organs like the colon, intestines and more. This can be extremely fatal if left untreated. 

What is Fournier's gangrene?

Fournier's gangrene is a rare type of gangrene, usually caused by Necrotizing Fasciitis, and it specifically attacks the male genitals. 1 in 62500 men have Fournier's Gangrene every year, making them 10 times more affected than women, but this doesn't mean women won't be affected. Older males between the ages of 50 and 60 are also more vulnerable to it. On the opposite end of the spectrum, children almost never get Fournier's Gangrene.

What is Meleney's gangrene?

Meleney's gangrene, or Progressive Bacterial Synergistic Gangrene is another rare type of gangrene. It is very dangerous because it can spread at a phenomenal speed. It usually only happens after surgeries with an unclean wound, however, the mortality rate can be up to 40%, and for diabetic people, the mortality rate can shoot up to 90%. It is also hard to diagnose it because symptoms aren't obvious.

Causes:

- Trauma

- Burns

- Deep wounds

- Blocked off blood supply

- Bacterial infection

Symptoms:

- Blisters/Swelling with pus and blood coming out

- Foul-smelling wound

- Discoloured skin

- Pale and cold skin

- Severe pain

- Numbness

- Septic Shock

Treatment: 

- Antibiotics (kill bacteria)

- Skin Debridement (Surgery)

- Maggot Debridement

- Hyperbaric Oxygen Chamber (for Gas Gangrene)

- Vascular Surgery

Prevention:

- Wash your wounds 

- Lose weight

- Eat less cholesterol so it wouldn't block your arteries

- Care for Diabetes

- Prevent severe frostbites

Necrotizing Fasciitis (NF)

 What is Necrotizing Fasciitis?

Necrotizing Fasciitis (NF) is an extremely rare but lethal flesh-eating disease. Most NF cases are caused by bacteria, even though there is a slim chance where it could be fungal-caused. There are 4 types of NF, Type I, II, III and IV/Other. This will be elaborated below. Only 0.0004% or 4 out of 1,000,000 people in the US and 0.001% or 1 per 100,000 in Europe fall victim to this, however, according to the CDC, the death rate can be 20-40%, especially with STSS (Streptococcal Toxic Shock Syndrome). STSS was introduced in the last article, so go check it out after reading this. CDC Data shows that 9000-11500 cases of NF are diagnosed every year, with 1000-1800 deaths every year.

Types of NF:

- Type I: Type I NF describes NF that is caused polymicrobially. Poly means many, and microbial means microorganism, so polymicrobial-caused NF means that there are more than one bacteria involved in the infection. An example of a Type I infection would be Staphylococcus Aureus and Haemophilus.

- Type II: Type II NF describes monomicrobial NF. Mono means one/single, and microbial as said above means microorganism, so monomicrobial-caused NF means single bacteria caused NF. This is mostly caused by a Group A Strep infection or MRSA infection, and is the most common among the four.

- Type III: Type III NF is caused by Clostridia. This is usually caused by Clostridia Perfringens, but it could also be caused by Clostridia Septicum. Clostridia is a disease that causes gas gangrene to develop. 

- Type IV / Other: Type IV NF is caused by other organisms and fungi. The most common Type IV NF is caused by marine organisms, mostly with them getting into cuts and open wounds.

How is NF transmitted?

NF isn't contagious, nor is it communicable. It is only transmitted when there is a wound, and usually it has to be a deep one. It is also very rare, so there is a low chance of transmission from human to human. However, this doesn't mean it isn't possible. If you have a small wound that is not cared for properly or someone that has NF touches your open wound, there is a chance the disease could develop there.

Symptoms:

- Extreme pain at the wound

- Redness, warmness and swelling at wound

- Fever

- (Pus)

- (Blisters/ulcers)

- (Fatigue and dizzy)

- (Diarrhea)

Consequences:

If left untreated, the situation and infection would get worse, and eventually cause shock, sepsis, organ failure and death. 

Treatment:

The treatment of necrotizing fasciitis is surgery and antibiotics. Usually in a serious case of NF, removal of the infected tissue or amputations have to happen to remove the bacteria from the body. In some cases, people have their whole limbs chopped off just to stop the spread.

Prevention:

The best prevention for NF is to clean your wounds thoroughly so bacteria don't get into your wound. Avoid going out to the sea if you have a wound, especially a deep one. Avoid touching your wound before washing your hands, or else bacteria can sneak in. 

Strep A

 What is Strep?

Streptococcus, also known as strep is a bacteria that is most commonly found in the mouth and throat. There are 4 main types of strep - A, B, C and G, which Strep A is the most common of all. Streptococcus Group A is rarely life-threatening. In most cases, it is healed in a one or two days with the help of antibiotics, but on rare occasions, they can get very dangerous. It can cause high fevers and muscle aches. In more severe cases, it even causes pneumonia, multi organ failures, heart problems, amputations, Necrotizing Fasciitis, STSS and death in a few hours. Approximately 12000 people get Strep A every year, and it kills up to 1600 patients per year.

What is Necrotizing Fasciitis?

Necrotizing Fasciitis (NF), commonly known as the flesh-eating disease is a severe infection that causes a rapid death of soft tissue. Usual symptoms are purple coloured dead skin and severe pain with fever. There are 4 types of NF. Type I is polymicrobial, Type II is monomicrobial, Type III is Marine Vibrio and Type IV is fungal. Type II is where Strep caused and MRSA caused NF lies.

What is STSS?

Streptococcal Toxic Shock Syndrome, or STSS is a rare complication of Strep with serious effects. STSS has to be treated with antibiotics in a hospital by a doctor, or else a patient can get shock and organ failure from STSS and die shortly after. Some may even need surgery and 30% to 70% of patients die after contracting STSS. However, even though anyone can get STSS, elders 65 and above or people with wounds are more likely to contract STSS with serious complications.

How do you catch strep?

Strep is very contagious. It is spread by airborne droplets, such as someone sneezing or coughing at another person, or someone touching an infected surface and then touching their face. 

Symptoms:

- Sore and Painful Throat

- Fever

- Swelling in Tonsils with redness, white patches and pus

- Swollen Lymph Nodes

- Red spots on roof of mouth

Consequences if left untreated:

If Strep is left untreated, it can cause lots of other problems, such as kidney inflammation, joint inflammations, rashes or even heart valve problems even though it can go away on its own in about a week.

Treatment:

Antibiotics are very useful during strep. Most doctors will prescribe it to decrease the time of healing.

Prevention:

- Sneeze or cough into a tissue or elbow

- Stay home if you're sick

- Wash or disinfect your hands

Sepsis

 What is Sepsis?

Sepsis is a rare but extremely fatal condition. It is your bodies' most extreme reaction to a bacterial infection. Sepsis usually starts mildly when an infection isn't treated properly or a few infections happen at once. As it is ignores, the case worsens, blood flow weakens and blood clots form, it can cause multiple organ failure and tissue death. Without treatment in time, it can worsen in no time and kill quickly. Even though most people recover from mild sepsis after being treated, if sepsis isn't treated, it will kill within 36 hours. The average mortality rate for sepsis is 40% and causes 270000 deaths per year, which is an even bigger killer than opiods, breast cancer and prostate cancer combined. Even if you survive a severe sepsis episode, you may be more vulnerable to future infections.

How do you catch Sepsis?

Sepsis happens when you don't treat your bacterial infection properly and it enters your bloodstream. After it enters your bloodstream, white blood cells and bacteria fight all around the body because the blood carries it to different organs, causing clots and leaky blood vessels. This causes inflammation all around the body and organs, which can cause tissue death and organ failure. The most common causes are from lung infections and urine tract infections.

Stages:

- Mild Sepsis: still recoverable, but has to be treat in time

- Severe Sepsis: organ damage, tissue dysfunction

- Septic Shock: organ damage and failure, tissue death (gangrene), hypotension

Symptoms:

Shivering, chills (above 38 degrees celcius or below 36 degrees celcius)

Extreme pain/discomfort (abnormal organ functions)

Pale

Sleepy, confused, disoriented

I feel like death

Short of breath

- No urination

- Rapid Pulse

- Low blood pressure and oxygen

Prevention:

Remember to treat your infections properly, and if you feel more than 2 warning signs of sepsis, go to a doctor immediately or call EMS. The earlier you get help, the faster and better you'll recover.

MRSA

 What is MRSA?

MRSA, or Methicillin-Resistant Staphylococcus Aureus Superbug is a disease you've probably heard before, but never really knew what it is. MRSA is a staph(staphylococcaceae) bacterium superbug. Superbugs is an informal name for antibiotic resistant bacteria, and some examples of superbugs are MRSA or Drug-Resistant TB from the last blog post. Resistance is usually formed during evolution by the overuse of antibiotics. Because of its drug-resistance, MRSA is much harder to treat than other staph. A study shows that of 273 patients admitted for USA300 strain MRSA, 66 patients (24%) passed away. Out of the patients, 17.7% of the deaths occured within 30 days. In 2017 alone, it ended over 20000 lives and caused over 120000 bloodstream infections. 

What is Staph?

Staph, or staphylococcaceae is not to be confused with strep (streptococcus), which is a mouth or throat infection while staph is a skin infection. There are more than 30 types of staph, with MRSA being one of them.  

How do you catch MRSA?

MRSA usually spreads by skin-to-skin contact. This can be direct or indirect. If someone infected touches someone else, they can infect the other person with it, which is quite obvious, but another way it can transmit is by touching contaminated items. For instance, if someone infected uses gym equipment, and you use it, you have a chance to be infected.

Symptoms:

• Red swollen pusful bump/lumps (usually painful and warm to the touch)
• Fever
• Chills
• Cough
• Chest Pain
• Aches
• Organ Problems (Lungs, Joints, Heart, Bones...)

Consequences and if left untreated:

• Sepsis
• Impaired Lymphatic Functions
• Death

Risks:

• Hospitals (HA-MRSA Healthcare associated-MRSA)
• Hospitals-infections take up a great amount of MRSA cases
• Invasive devices put into you making wounds
• Community (CA-MRSA Community associated-MRSA)
• Exposed wounds
• Intravenous drugs 
• Unsanitary

Prevention:

• Hand washing
• Cover and clean wounds
• Don't use other people's personal items especially for skin
• Shower and clean
• Don't inject intravenous drugs unless medically necessary

Tuberculosis

What is Tuberculosis?

Tuberculosis (TB) is a Mycobacterium Tuberculosis bacterial infection that affects the lungs. It can be dangerous in various different ways, and some types of tuberculosis are expensive and risky to treat. Tuberculosis is the most deadly bacteria in the world, claiming over 4000 lives a day, and just in 2017 alone, 1.6 million people died from it. The Tuberculosis bacteria destroys lung tissues, causing lung damage and making them cough and spread the bacteria. TB is an opportunistic infection as well. It often targets people with HIV more because their immune systems are weakened by it.

What are opportunistic infections (OI)?

Opportunistic infections are infections that take the opportunity to attack people who have HIV. OIs can be very dangerous for people who have HIV because their immune systems are weakened and isn't able to fight another disease. Hepatitis B and C are examples of OIs.

How do you catch it?

TB bacteria is caught when you breathe it in. So if someone with TB coughs, sneezes or speaks into your face or close to you , you may contract it.

Types:

- Active TB

    - Non-drug resistant TB: Can be treated with antibiotics

    - Mono resistant TB: Only resistant to one front line drug

    - Poly resistant TB: Resistant to 2 or more front line drug but not to isoniazid or rifampicin

    - Rifampicin resistant TB: Resistant to rifampicin and/or other drugs

    - Multi resistant TB (MDR TB): Resistant to both isoniazid and rifampicin

    - Extensive resistant TB (XDR TB): Resistant to more than only the first-line drugs (including            isoniazid and rifampicin)

- Miliary TB: Affects all organs because the bacteria flowed into the bloodstreams, causing a fatal situation

- Latent TB: No symptoms, only diagnosed by tuberculin test, but can turn into active

What is Rifampicin and Isoniazid?

They're a strong pair of drugs against TB, usually used together, however more strains of TB bacterias have grown immunity to either one or both of them. (MDR/RR TB)

Symptoms:

    - cough that lasted longer than 3 weeks

    - chest pain

    - coughing up blood/sputum

    - weakness

    - fatigue

    - weight loss

    - loss of appetite

    - chills

    - fever

    - night sweating

Risks:

    - HIV patients

    - TB patients before

    - Babies

    - Young children

    - Drug addicts

    - Sick people

    - Elderly

Diagnosis needed:

    - Tuberculin skin test (TST)

    - TB Blood Test

    - Lab Test to detect for resistance patterns

Treatment:

    - Non-drug resistant TB: common antibiotics/rifampicin and isoniazid

    - Mono: use the non-resistant drug

    - Poly: use the non-resistant drug

    - MDR: Pyrazinamide/ Fluoroquinolone/ Ethionamide/ Prothionamide/Cycloserine/ PAS(para-aminosalicylic acid)

    - XDR: Depends, read this website to understand more: XDR

Preventions:

TB is most common in developing countries which are crowded, where TB can be easily transmitted. If you want to stay safe from TB, wash your hands often, cover your mouth and nose while you cough and sneeze and take your medications if you need to.