All About Shingles

Cells infected with varizella zoster virus (left) causes the childhood skin disease chickenpox (right).

   

Herpes Zoster which is known as Shingles (herpes zoster virus) is an extremely painful viral infection of the nerve roots resulting in a skin rash caused by the same virus that causes the childhood illness chickenpox. The reactivated virus responsible for these conditions is called the Varicella zoster virus (VZV).t has a characteristic rash that evolves over time. Sometimes shingles is confused with other rashes, but it's the only one that can potentially cause the complication, Postherpetic Neuralgia.

Varicella zoster virus (VZV).                       

 The following are some quick facts about shingles:
*The lifetime risk of shingles is 10% to 20%.
*In the United States, approximately 300,000 to 600,000 cases are reported yearly.
*Less than 5% of the cases occur in children under 14 years of age.
*The most important risk factor for the developing shingles is increasing age. 
*A well-defined risk factor is a compromised immune system.






Shingles and Chickenpox?
 
The rash of shingles is caused by a reactivation of the varicella-zoster virus. This is the virus that causes chickenpox. After a person has been infected with the varicella virus, the virus travels back into the body and waits. For various reasons, the virus can reactivate, travel down the nerve to the skin, and cause the shingles rash.  
VZV is still referred to by separate terms:
*Varicella: The primary infection that causes chickenpox  
* Herpes zoster: The reactivation of the virus that causes shingles Varicella (Chickenpox). 

How is shingles caused? 
   

Dormant Varicella zoster virus (chickenpox) can cause shingles.

After an individual has chickenpox, the virus lives in the nervous system where it "sleeps" (is dormant) in the nerve roots. In some people, it remains dormant forever. In others, a weakened immune system can cause the virus to "wake up," reproduce, and travel along the path of the nerve fiber to the skin's surface, resulting in shingles. If the virus becomes active again, it can only cause shingles, not chickenpox. 



"Conditions that can reactivate the varicella virus and cause shingles'' include:

*Illness.

*Trauma. 

*Bereavement.

*A suppressed immune system.

*HIV infection.

*Cancer - especially leukemia or lymphoma .

*Drugs that suppress the immune system including steroids 8Chemotherapy. 

*Organ transplant.

Appearance of Shingles:
 

The first symptoms of shingles are usually itching, tingling, or significant pain with just a light touch. This pain occurs on one side of the body in a band-like area called a dermatome. During this time, people often experience headache, sensitivity to light, and fatigue, but rarely fever. One to five days later, the rash starts as an area of redness that progresses quickly to clusters of fluid-filled blister. These blisters can continue to form for three to five days. The blisters fill with pus, pop, and then crust over. It usually takes two to four weeks for the blisters to heal. Scarring and skin discoloration often occur. 

  
Who is at risk for shingles?

Shingles most commonly occurs in people over the age of 60.

   Anyone who has ever had chickenpox is at risk for the development of shingles, although it occurs most commonly in people over the age of 60. Weakened immune systems, emotional stress, immune deficiency (from AIDS or chemotherapy), or cancer can cause the virus to reactivate. It has been estimated that up to 500,000 cases of shingles occur each year in the U.S.

 Diagnosis of Shingles:
Shingles is often diagnosed based on the appearance of the rash when it is typical. If it is difficult to diagnose, specialized tests might be performed.

 What does the shingles rash look like?
Pain, itching, tingling, or burning of the skin are symptoms of shingles that often precede an outbreak. Shingles starts as small blisters on a red base with new blisters continuing to form for three to five days. The painful rash resembles the lesions of chickenpox and is usually localized to a concentrated area. If you think you have shingles, you should see a doctor as soon as possible.

    Small blisters form during the initial stage of shingles (left) followed by a full skin rash resembling chickenpox lesions (right).   

 

How long does shingles last?

Shingles blisters eventually burst and begin to crust over

  
The cluster of blisters that forms with shingles fill with fluid, pop, then start to ooze. Eventually the affected areas crust over and heal like the rash shown here.The whole process may take three to four weeks from start to finish. Once all of the blisters are crusted over, the person is no longer contagious.

Shingles can be spread to people who have not had chickenpox.

Is shingles contagious?

Yes, shingles is contagious. It can be spread from an infected person to anyone who hasn't had chickenpox as long as there are new blisters forming and old blisters healing. But instead of developing shingles, these people develop chickenpox. Once they've had chickenpox, people cannot catch shingles from someone else. They do, however, have the potential to develop shingles later in life. 



What are complications from shingles? 

 Generally, shingles heals well, resulting in few problems. However, on occasion, blisters can become infected and are usually treated with antibiotics. The most common complication of shingles is postherpetic neuralgia, where damaged nerves cause pain to persist even after the rash is gone. A more worrisome complication is when shingles affects the face (forehead and nose), which may spread to the eye and lead to loss of vision.




Treatment of Shingles :

  There is no cure for shingles, but treatment may help you get well sooner and prevent other problems. Bathing is permitted, and the affected area can be cleansed with soap and water. Cool compresses and anti-itching lotions (calamine lotion) may also provide relief. Steroids, antiviral medicines, and pain medicines can also help ease recovery. Most people with intact immune systems recover completely from shingles although recurrences are possible.here is no cure for shingles, but treatment may help you get well  

Shingles Treatment: Antivirals, Corticosteroids

if you have a normal and healthy immune system, shingles treatment is most effective if you get medication within 72 hours (3 days) of developing a rash.
Your doctor may prescribe drugs known as corticosteroids and antivirals for shingles, such as Acyclovir.
If you have a compromised (weakened) immune system, you will probably receive similar treatment, but you need to be followed closely by your healthcare provider. You also probably will not receive corticosteroids, since they are riskier to take if your immune system is impaired. Always see your doctor for specific treatment options.

Treating Shingles Symptoms and Pain:

Placing a soft, sterile non-sticky dressing or bandage over your lesions will protect your skin from clothing, and it will protect others from direct contact with open wounds. For pain related to an acute case of shingles, usually opoids are necessary. To prevent or treat post-herpetic neuralgia, the American Academy of Neurology states that any of the following may be necessary (but see your doctor for specific treatment):
Antidepressant drugs, specifically tricyclic antidepressants such as amitriptyline, nortriptyline, and desipramine
Anticonvulsants, such as gabapentin (Neurontin) or pregabalin (Lyrica)
Pain medications, either anti-inflammatory drugs like ibuprofen, or opioids, such as morphine sustained-release or fentanyl patches
Topical anesthetics, such as lidocaine gels or patches, which should be applied to healed, intact skin only.
Capsaicin is also growing in popularity as a pain treatment

Shingles Treatment for Herpes Zoster Ophthalmicus:

 Herpes zoster ophthalmicus is a serious complication that can occur if the shingles virus affects a certain nerve around the eye. People who are suspected to have this complication are treated with oral antiviral medications as above AND should have close follow-up with an ophthalmologist.

Is there a shingles vaccine?

In 2006, the FDA approved the first vaccine for adult shingles. The vaccine, Zostavax, is approved for adults over 60 who have had chickenpox. It contains a booster dose of the chickenpox vaccine usually given to children. The single-dose vaccine is more than 60% effective in reducing shingles symptoms, and it reduces the incidence of postherpetic neuralgia by at least two-thirds. Studies are ongoing to evaluate the long-term effectiveness of the vaccine.

Recognising Child Stroke

Did you know that children can have strokes? Did you realize that they can strike infants, and even fetuses still in the womb?
If that’s news to you, you’re not alone! A lot of medical personnel are in the dark about childhood strokes as well, and the lack of awareness is a major obstacle to improving kids’ treatment and recovery. Recognizing strokes right away – and knowing what to do about them – is crucial in limiting the damage they can do to the rest of a child’s life.
Would you recognize the signs of a stroke in your child? And if you did, would you know where to take her to receive the best possible treatment in those first critical minutes?

 Kids Who Have the Following Conditions Have a Higher Risk of Stroke:

 *Sickle Cell Anemia

 *Heart Defects

 *Blood Disorders

 *Meningitis
 
 *High Blood Pressure

 *Dehydration

*Chicken Pox – risk of stroke is higher in the time period after having chicken box

But 25% of children who have strokes fall into no known risk group.

   
 

What To Watch Out For In Children:
*Some Possible Signs of Stroke in Children
Onset of a stroke in a child may be marked by:
 *Headache

*Difficulty with vision / blurred vision

*Weakness on one side (arm or leg)

*One side of body feels asleep

*Slurred speech/difficulty speaking

*Child’s face may (but may not) droop to one side



What To Watch Out For In Infants :The signs of stroke in an infant are harder to detect because the baby can’t tell you what’s wrong.
-Some Possible Signs of Stroke IN PROGRESS In Infants 
*Crankier Than Usual
*Sleepier Than Usual
*Not Feeding Well

These symptoms are simply an indication that something may be physically wrong, and the answer may not be stroke; however, if the symptoms do appear, a parent can help a doctor with a diagnosis by simply RAISING THE POSSIBILITY of stroke, as a diagnosis the doctor might not have thought of, and should consider.

**Some Possible Signs of PAST STROKE In Infants (for example: strokes “in utero” – that is, before the baby was born):
*Less Use Of One Side of the Body (Arm or Leg)
*Hand Constantly Clenched In Fist
*Dragging One Leg Behind

Stroke in an infant (or in utero) may not be recognizable for months – until someone notices the child favoring one side, or child is late in starting to crawl or walk

 Recognising the symptoms of a stroke in children early is key to avoiding further brain injury, it has been claimed.
   Many strokes in children go unrecognised when they first occur, but are capable of repeating within a month, according to researchers from the Children's Hospital of Philadelphia.
As a result, children do not often receive the necessary treatment to prevent further brain injury caused by this reoccurrence.


*What To Do If A Child Is Having A Stroke In Front of You ?

 
Get to the hospital immediately – IF POSSIBLE, A PEDIATRIC EMERGENCY ROOM! (Or, if the child is a teenager and there is no nearby pediatric emergency room, a stroke center can also be a good choice)
SPEAK UP TO THE DOCTORS ABOUT THE SIGNS & ABOUT YOUR SUSPICION OF STROKE!
Consider pressing for an MRI, or, in the case of a teen, a transfer to a stroke center

Doctors can:
Get an MRI, which may help find out what’s causing the stroke
Provide treatment appropriate to the cause, which can differ in different cases.

To Help Diagnose a Stroke: 

REMEMBER THE ACRONYM “FAST”
F - FACE – face sagging to one side?
A - ARMS – can person raise both?
S - SPEECH – can person repeat a simple sentence
T - TIME – time is of the essence!

GET THEM TO AN EMERGENCY ROOM! TELL THEM YOU SUSPECT STROKE!



Remember: SPEED COUNTS in dealing with ALL strokes, pediatric or adult! 

 

Stroke Incidence Increasing Among Children And Young Adults in USA

A large study has revealed that the rate of stroke among children, adolescents and young adults in the USA has been increasing at an alarming rate. The rate at which ischemic stroke patients are being hospitalized has also increased considerably, the authors reported in Annals of Neurology.

    A Stroke occur when  a ruptured blood vessel or blood clot interrupts blood flow to a part of the brain. If brain cells do not receive their supply of blood oxygen and glucose they die, leading to brain damage. The patient may subsequently have problems with memory, movement, speech, and could even die.

Blood is carried to the brain via a complex network of arteries and vessels. A stroke occurs when one of these arteries becomes blocked or an artery ruptures

 

There are two main types of stroke:

*First Type Is Ischemic stroke:

An ischemic stroke occurs when an artery in the brain becomes blocked.

What is it? Ischemic stroke occurs when an artery to the brain is blocked. The brain depends on its arteries to bring fresh blood from the heart and lungs. The blood carries oxygen and nutrients to the brain, and takes away carbon dioxide and cellular waste. If an artery is blocked, the brain cells (neurons) cannot make enough energy and will eventaully stop working. If the artery remains blocked for more than a few minutes, the brain cells may die. This is why immediate medical treatment is absolutely critical. 

   What causes it? Ischemic stroke can be caused by several different kinds of diseases. The most common problem is narrowing of the arteries in the neck or head. This is most often caused atherosclerosis, or gradual cholesterol deposition. If the arteries become too narrow, blood cells may collect and form blood clots. These blood clots can block the artery where they are formed (thrombosis), or can dislodge and become trapped in arteries closer to the brain (embolism). Another cause of stroke is blood clots in the heart, which can occur as a result of irregular heartbeat (for example, atrial fibrillation), heart attack, or abnormalities of the heart valves. While these are the most common causes of ischemic stroke, there are many other possible causes. Examples include use of street drugs, traumatic injury to the 
blood vessels of the neck, or disorders of blood clotting.

*Second Type Is Hemorrhagic stroke:
     It results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral hemorrhage or subarachnoid hemorrhage.
Hemorrhagic stroke occurs when a weakened blood vessel ruptures. Two types of weakened blood vessels usually cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs) 

 A ruptured blood vessel will leak blood into the brain, eventually causing the brain to compress due to the added amount of fluid.

In this study, researchers found that over the period 1995-1996 to 2007-2008:
*Ischemic stroke incidence rose 50% among males aged 35 to 44 years
*Ischemic stroke incidence rose 46% among males aged 15 to 34.
*Ischemic stroke incidence rose 51% among boys aged 5 to 14.

In 1996, 3.1 per 10,000 hospitalizations for boys were for ischemic stroke, compared to 4.7 in 2008.
*Among females aged 35 to 44, ischemic stroke incidence rose 29%
*Among females aged 15 to 34, ischemic stroke incidence rose 23%
8For girls aged 5 to 14, ischemic stroke incidence increase by just under 3%

 
Mary G. George, MD, MSPH, and team from the CDC said:
"The increase in the stroke hospitalization rate from 1995 to 2008 was 30% to 37% higher" among those aged 15-44. In the young adults and adolescents, we were surprised to see that large of an increase. Seeing this in a young population really underscores the need for adopting and maintaining healthy lifestyles from the time they are very young."
 In this study, the investigators also looked at the traditional stroke risk factors.

Lee Schwamm, MD., vice chair of neurology at Massachusetts General Hospital and professor of neurology at Harvard Medical School said:

"The increasing incidence of risk factors in
young patients is very concerning."


Schwamm was not involved in the research but reviewed the findings.

The increase could be partly due it more advanced medical technology, George said. More accurate current imaging technology can probably identify a greater number of strokes among younger patients.

However, such risk factors as drug and alcohol abuse can be associated with strokes in a much briefer time frame

child suffers from stroke

George said:

"We found significant increases in high blood pressure, lipid [cholesterol] disorders, diabetes, tobacco use, and obesity . . . . things we consider traditional risk factors." One in every three ischemic stroke patients aged 15-34 had three stroke factors, while half of 35-44 year olds with ischemic stroke had hypertension (high blood pressure). Approximately one in every for 35 to 44 year olds with ischemic stroke had diabetes.

The researchers also found that tobacco use, raised cholesterol and obesity were common problems among patients with ischemic stroke.


The following risk factors are said to be linked to stroke risk:
*A family history
*Having had a previous stroke
*Having had a TIA (transient ischemic attack)
*African Americans and those of Hispanic or Asian/Pacific Island descent have a higher risk of stroke
*Birth control pills
*Some other hormone therapies
*Cardiovascular disease
*Cocaine usage
*Diabetes
*Heavy alcohol consumption
*Hypertension
*High cholesterol
*High amino acid levels in the blood (hormocysteine) 
*Obesity/overweight
*Smoking
*Being over 55 years of age

                  

Benefits of Chili Pepper

*Research Shows Heat in Chili Peppers Can Ease Sinus Problems

    Hot chili peppers are known to make people "tear up," but a new study led by University of Cincinnati allergy researcher Jonathan Bernstein, MD, found that a nasal spray containing an ingredient derived from hot chili peppers (Capsicum annum) may help people "clear up" certain types of sinus inflammation.

 The study, which appears in the August 2011 edition of Annals of Allergy, Asthma & Immunology, compares the use of the Capsicum annum nasal spray to a placebo nasal spray in 44 subjects with a significant component of nonallergic rhinitis (i.e., nasal congestion, sinus pain, sinus pressure) for a period of two weeks

Capsicum annum contains capsaicin, which is the main component of chili peppers and produces a hot sensation. Capsaicin is also the active ingredient in several topical medications used for temporary pain relief. It is approved for use by the U.S. Food and Drug Administration and is available over the counter. 

"Basically, we concluded that the spray was safe and effective on non-allergic rhinitis," Bernstein says of the study which showed that participants who used a nasal spray with Capsicum reported a faster onset of action or relief, on average within a minute of using the spray, than the control group. 

 

 Non-allergic rhinitis is an upper respiratory condition not caused by allergies but instead caused by environmental factors such as weather, household chemicals or perfumes; however, there are some people who have no triggers or don't know what triggers are causing the inflammation, Bernstein says.

 This is the first controlled trial where capsaicin was able to be used on a continuous basis to control symptoms. It is considered a significant advance, "because we don't really have good therapies for non-allergic rhinitis," says Bernstein, adding that in previous trials the ingredient was too hot to administer without anesthesia. 

 So Chili is A Natural Products to Relieve Sinus Infections and problems effectively..

As the pepper heat helps to stimulate secretions that aid in clearing mucus from your nose, combatting nasal congestion. It also contains antibacterial properties that help fight chronic sinus infections.

  













Another Benefit for Chili Pepper .. Chili Peppers Help Lower High Blood Pressure 

Eating chili peppers are naturally high in vitamins A and C, and also bioflavinoids. They help strengthen our blood vessels, which makes them more elastic and better able to adjust to blood pressure fluctuations. Chili peppers also can make us sweat, which causes fluid loss, temporarily reducing overall blood volume.
  
 Study leader Zhiming Zhu said that a clue to the possible beneficial effect of long-term chili consumption came from his own home region of Chongqing in south-west China. 

In his study, rats suffering from high blood pressure were given a long term diet containing capsaicin. The study found that capsaicin helped increase the production of nitric oxide in the blood. The gas is known to protect blood vessels against inflammation and dysfunction 

This study isn't the first to look for a molecular link between capsaicin and lower blood pressure. But earlier studies were based on acute or short-term exposure to the chemical, with some conflicting results.
 
So far, there is no indication of how chili peppers could help humans, or how much chili you would need to eat to lower blood pressure.

And if you are one of those people who can't tolerate the effects of spicy foods such as chili, there may be some hope - a milder Japanese pepper contains a compound called capsinoid that is closely related to capsaicin.
"Limited studies show that these capsinoids produce effects similar to capsaicin," Dr Zhu said. "I believe that some people can adopt this sweet pepper." 




Third Benefit is ...Chili Pepper Can Help You Burn Fat and Lose Weight

Did you know that capsaicin is a thermogenic? Thermogenics stimulate the body's burning of fat byincrease the metabolism of the body's adipose tissue, generating heat. So many of us can stand to shed a few pounds and lose some unwanted extra weight, so a smart and healthy move is to drop the fatty foods and replace them with some chili pepper spice, along with the inclusion of regular exercise, of course. 

chili and peppers increase your metabolic rate by almost 50 percent for three hours after eating. The spice increases your heart rate and gets your metabolism moving faster 

''We found that consuming red pepper can help manage appetite and burn more calories after a meal, especially for individuals who do not consume the spice regularly," said Richard Mattes, distinguished professor of foods and nutrition who collaborated with doctoral student Mary-Jon Ludy. "This finding should be considered a piece of the puzzle because the idea that one small change will reverse the obesity epidemic is simply not true. However, if a number of small changes are added together, they may be meaningful in terms of weight management. Dietary changes that don't require great effort to implement, like sprinkling red pepper on your meal, may be sustainable and beneficial in the long run, especially when paired with exercise and healthy eating." 

 Other studies have found that capsaicin, the component that gives chili peppers their heat, can reduce hunger and increase energy expenditure -- burning calories. The amounts tested, however, were not realistic for most people in the U. S. population, Mattes said.

This study found that those who did not consume red pepper regularly experienced a decrease of hunger, especially for fatty, salty and sweet foods.

"The appetite responses were different between those who liked red pepper and those who did not, suggesting that when the stimulus is unfamiliar it has a greater effect. Once it becomes familiar to people, it loses its efficacy. The finding that there is a difference between users and non-users is novel and requires further study to determine how long it will be effective and how to adjust the diet to improve continuous effectiveness." 

* Forth Benefit ... Chili Peppers Help Protect Your Heart 

Capsaicin may help to protect the heart by reducing cholesterol, triglycerides and platelet aggregation. It may also help the body dissolve fibrin, which is necessary for blood clots to form. Further, cultures around the world that use hot peppers liberally in their meals have significantly lower rates of heart attack and stroke than cultures that do not. 

Study Suggests ..Eating Dried Plums Helps Prevent Fractures and Osteoporosis

   Florida State University researcher has found a simple, proactive solution to help prevent fractures and osteoporosis: eating dried plums.

  
  "Over my career, I have tested numerous fruits, including figs, dates, strawberries and raisins, and none of them come anywhere close to having the effect on bone density that dried plums, or prunes, have," said Bahram H. Arjmandi, Florida State's Margaret A. Sitton Professor and chairman of the Department of Nutrition, Food and Exercise Sciences in the College of Human Sciences. "All fruits and vegetables have a positive effect on nutrition, but in terms of bone health, this particular food is exceptional."

  

Arjmandi and a group of researchers from Florida State and Oklahoma State University tested two groups of postmenopausal women. Over a 12-month period, the first group, consisting of 55 women, was instructed to consume 100 grams of dried plums (about 10 prunes) each day, while the second -- a comparative control group of 45 women -- was told to consume 100 grams of dried apples. All of the study's participants also received daily doses of calcium (500 milligrams) and vitamin D (400 international units).

 
The group that consumed dried plums had significantly higher bone mineral density in the ulna (one of two long bones in the forearm) and spine, in comparison with the group that ate dried apples. This, according to Arjmandi, was due in part to the ability of dried plums to suppress the rate of bone resorption, or the breakdown of bone, which tends to exceed the rate of new bone growth as people age. 

In the United States, about 8 million women have osteoporosis because of the sudden cessation of ovarian hormone production at the onset of menopause. What's more, about 2 million men also have osteoporosis. 

"In the first five to seven postmenopausal years, women are at risk of losing bone at a rate of 3 to 5 percent per year," Arjmandi said. "However, osteoporosis is not exclusive to women and, indeed, around the age of 65, men start losing bone with the same rapidity as women." 

  Arjmandi encourages people who are interested in maintaining or improving their bone health to take note of the extraordinarily positive effect that dried plums have on bone density.

"Don't wait until you get a fracture or you are diagnosed with osteoporosis and have to have prescribed medicine," Arjmandi said. "Do something meaningful and practical beforehand. People could start eating two to three dried plums per day and increase gradually to perhaps six to 10 per day. Prunes can be eaten in all forms and can be included in a variety of recipes."