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    • Nam Nguyen
      Nam Nguyen posted to the wire
      Herpes Zoster<=> Herpes zoster, or shingles, is a skin eruption of acute nature, closely related to CHICKENPOX and consisting in the appearance of small yellow vesicles, which spread over an area, dry up, and heal by scabbing. It receives its name from the Greek word for a ‘circingle’ or girdle, because it spreads in a zone-like manner along the intercostal nerves around half the chest. Herpes of the face also occurs, particularly on the brow and around the eye. Causes Shingles is due to the same virus that causes chickenpox. This invades the ganglia of the nerves, particularly the spinal nerves of the chest and the ?fth cranial nerve which supplies the face. Despite being due to the same virus as chickenpox, it is rare for herpes zoster to occur as a result of contact with a case of chickenpox. On the other hand, it is not unusual for a patient with herpes zoster to infect a child with chickenpox. It is a disease of adults rather than children, and the older the person, the more likely he or she is to develop the disease. Thus in adults under 50, the incidence is around 2·5 per 1,000 people a year; between 50 and 60 it is around 5 per 1,000; whilst in octogenarians it is 10 per 1,000. Occasionally it may be associated with some serious underlying disease such as LEUKAEMIA, LYMPHADENOMA, or multiple myeloma (see MYELOMATOSIS).
      • Nam Nguyen
        Nam Nguyen posted to the wire
        Herpes Viruses<=> One member of a group of viruses containing DNA which cause latent infections in animals and humans. Viruses from this group cause HERPES SIMPLEX, HERPES ZOSTER (shingles) and CHICKENPOX, and include CYTOMEGALOVIRUS (CCMV) and EPSTEIN-BARR VIRUS.
        • Nam Nguyen
          Nam Nguyen posted to the wire
          Herpes Simplex<=> Except in the case of herpes of the cornea, the eruption clears completely unless it becomes contaminated with some other organism. In the case of the cornea, there may be residual scarring, which may impair vision. Treatment Aciclovir is e?ective both topically as cream or eye drops or orally. In severe systemic infections it can be given intravenously.
          • Nam Nguyen
            Nam Nguyen posted to the wire
            Herpes Simplex<=> Symptoms Symptoms vary with the age of infection. In young infants, herpes simplex may cause a generalised infection which is sometimes fatal. In young children the infection is usually in the mouth, and this may be associated with enlargement of the glands in the neck, general irritability and fever. The condition usually settles in 7–10 days. In adults the vesicles may occur anywhere in the skin or mucous membranes: the more common sites are the lips, mouth and face, where they are known as cold sores. The vesicles may also appear on the genitalia (herpes genitalis) or in the conjunctiva or cornea of the EYE, and the brain may be infected, causing ENCEPHALITIS or MENINGITIS. The ?rst sign is the appearance of small painful swellings; these quickly develop into vesicles which contain clear ?uid and are surrounded by a reddened area of skin. Some people are particularly liable to recurrent attacks, and these often tend to be associated with some debilitating condition or infection, such as pneumonia.
            • Nam Nguyen
              Nam Nguyen posted to the wire
              Herpes Simplex<=> An acute infectious disease, characterised by the development of groups of super?cial vesicles, or blebs, in the skin and mucous membrane. It is due to either simplex type 1 or 2 virus, and infection can occur at any time from birth onwards; however the usual time for primary infection with type 1 is between the second and 15th year. Once an individual is infected, the virus persists in the body for the rest of their life. It is one of the causes of scrum-pox. Type 2 causes HERPES GENITALIS.
              • Nam Nguyen
                Nam Nguyen posted to the wire
                Herpes Genitalis<=> An infection of the genitals (see GENITALIA) of either sex, caused by HERPES SIMPLEX virus type 2. It is mostly acquired as a result of sexual activity; some cases are caused by simplex type 1. After initial infection the virus lies latent in the dorsal nerve root ganglion (of the spinal cord) which enervates the a?ected area of the skin. Latent virus is never cured and reactivation results in either a recurrence of symptoms or in asymptomatic shedding of the virus which then infects a sexual partner. Around 30,000 cases of genital herpes are reported annually from clinics dealing with SEXUALLY TRANSMITTED DISEASES (STDS) in England, but there are also many unrecognised (by either patient or doctor) infections. Patients may have a history of painful attacks of ulceration of the genitals for many years before seeking medical advice. All patients with a ?rst episode of the infection should be given oral antiviral treatment, and those who su?er more than six attacks a year should be considered for suppressive antiviral treatment. ACICLOVIR, valaciclovir and famciclovir are all e?ective antiviral drugs. If a woman in the ?nal three months of her pregnancy contracts herpes genitalis, this can have serious consequences for the baby as he or she will be at risk of herpes encephalitis after delivery.
                • Nam Nguyen
                  Nam Nguyen posted to the wire
                  Herpangina<=> Herpangina is a short febrile illness in which minute vesicles or punched-out ulcers develop in the posterior parts of the mouth. It is due to infection with the group A COXSACKIE VIRUSES.
                  • Nam Nguyen
                    Nam Nguyen posted to the wire
                    Heroin<=> Also known as diacetyl morphine or diamorphine, this Class A controlled drug is an opiate – a group which includes morphine, codeine, pethidine and methadone. It is a powerful analgesic and cough suppressant, but its capacity to produce euphoria rapidly induces DEPENDENCE. Popular with addicts, its mostly pleasant e?ects soon produce TOLERANCE; the need to inject the drug, with associated risks of HIV infection, has a?ected its use by addicts. Withdrawal symptoms include restlessness, insomnia, muscle cramps, vomiting and diarrhoea; signs include dilated pupils, raised pulse rate, and disturbed temperature control. Although rarely life-threatening, the e?ects of withdrawal may cause great distress, and for this reason methadone, which has a slower and less severe withdrawal syndrome, is commonly used when weaning addicts o? heroin. Legally still available to doctors in the UK, heroin is normally only used in patients with severe pain, or to comfort the dying.
                    • Nam Nguyen
                      Nam Nguyen posted to the wire
                      Herniotomy<=> The surgical removal of the sac of connective tissue surrounding a HERNIA. In children or healthy young adults with an inguinal hernia, a herniotomy is usually su?cient to cure the condition.
                      • Nam Nguyen
                        Nam Nguyen posted to the wire
                        Herniorraphy<=> Surgical repair of a HERNIA. This may be done as an open operation or as MINIMALLY INVASIVE SURGERY (MIS) using a LAPAROSCOPE.
                        • Nam Nguyen
                          Nam Nguyen posted to the wire
                          Hernioplasty <=> A surgical technique for repair of a HERNIA. The abnormal opening is sewn up or the weakness strengthened with sutures or the insertion of a polypropylene mesh.
                          • Nam Nguyen
                            Nam Nguyen posted to the wire
                            Hernia<=> Treatment Conservative treatment with a compression belt, or truss, is now used only for those un?t for surgery or while awaiting surgery. Surgical repair can be at an open operation or by laparoscope, and consists of returning the herniated organs to their proper place and then repairing the defect through which the hernia occurred. This may be done safely under local or general anaesthetic, often as a day-case procedure, and most operative repairs result in a permanent cure.
                            • Nam Nguyen
                              Nam Nguyen posted to the wire
                              Hernia<=> Complications Small hernias may cause no problems at all. However, some may be large and cumbersome, or may give rise to a dragging sensation or even pain. Although most reduce spontaneously under the e?ects of gravity or gentle pressure, any organs that may have been displaced inside some hernias may become stuck, when they are said to be irreducible. If the contents become so trapped that their blood supply is cut o?, then strangulation occurs. This is a surgical emergency because the strangulated organs will soon die or rupture. When strangulation – usually of a loop of intestine – does occur, the hernia becomes irreducible, red, and very painful. If the hernia contains bowel, then the bowel may also become obstructed.
                              • Nam Nguyen
                                Nam Nguyen posted to the wire
                                Hernia<=> Anatomy of indirect inguinal hernia: area 11 is where the displaced loop of intestine intrudes into scrotum. Diaphragmatic or hiatus hernia showing the stomach pushing through the diaphragm into the chest cavity. Site of inguinal hernia (shaded). Causes Hernias may be due to a defect present at birth (congenital), or may develop later in life (acquired). Acquired hernias arise due to the development of a defect or injury of the abdominal wall or due to increased pressure within the abdominal cavity, which forces the organ through a potential weakness. Such causes include chronic coughing or excessive straining due to constipation.
                                • Nam Nguyen
                                  Nam Nguyen posted to the wire
                                  Hernia<=> The protrusion of an organ, or part of an organ, through the wall of the cavity that normally contains it. The most common types of hernia involve the organs of the abdomen which can herniate externally through the abdominal wall, or internally usually through a defect in the diaphragm. External hernias appear as a swelling, covered with skin, which bulges out on coughing or straining but which can normally be made to disappear with gentle pressure. Types Inguinal hernia appears in the groin; less common is femoral hernia, which appears just below the groin. Incisional hernia may occur through a defect in any abdominal surgical scar, a paraumbilical hernia arising just to the side of the umbilicus and an epigastric hernia in the mid line above the umbilicus. In children, herniation may occur through the umbilicus itself, which is a natural weak spot. The commonest internal hernia is a hiatus hernia, when part of the stomach slips upwards into the chest through the DIAPHRAGM (see diagram).
                                  • Nam Nguyen
                                    Nam Nguyen posted to the wire
                                    Hermaphrodite<=> An individual in whom both ovarian (see OVARIES) and testicular (see TESTICLE) tissue is present. Hermaphrodites may have a testis on one side and an ovary on the other; or an ovotestis on one side and an ovary or testis on the other; or there may be an ovotestis on both sides. Both gonads are usually intra-abdominal. The true hermaphrodite usually has a UTERUS and at least one Fallopian tube (see FALLOPIAN TUBES) on the side of the ovary, and on the side of the testis there is usually a VAS DEFERENS. Most true hermaphrodites are raised as males, but external virilisation is not usually complete. Even when signi?cant phallic development is present, HYPOSPADIAS and CRYPTORCHIDISM are common. At puberty, GYNAECOMASTIA develops and MENSTRUATION is common, as ovarian function is usually more nearly normal than testicular function. The condition is rare. A more common condition is pseudohermaphroditism: these are individuals who possess the gonads of only one sex but whose external genitalia may be ambiguous. The cause is a hormonal imbalance and can usually be corrected by hormone treatment.
                                    • Nam Nguyen
                                      Nam Nguyen posted to the wire
                                      Heredity<=> The principle on which various peculiarities of bodily form or structure, or of physical or mental activity, are transmitted from parents to o?spring. (See also GENES.)
                                      • Nam Nguyen
                                        Nam Nguyen posted to the wire
                                        Herbal Medicine<=> The use of herbs as medicines is probably as old as mankind; every culture has its own traditions. Herbalism was formally established in England by an Act of Parliament during Henry VIII’s reign. Di?erent parts of a variety of plants are used to treat symptoms and to restore functions.
                                        • Nam Nguyen
                                          Nam Nguyen posted to the wire
                                          Hepolenticular Degeneration<=> See WILSON’S DISEASE.
                                          • Nam Nguyen
                                            Nam Nguyen posted to the wire
                                            Hepatomegaly<=> Enlargement of the LIVER. This may be caused by congestion (e.g. in heart failure), infection (e.g. HEPATITIS), malignancy, in?ammation, or early CIRRHOSIS.

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