Clinical Insights: Etiology, Symptoms, and Treatment Protocols
Women’s Health Conditions
- Polycystic Ovary Syndrome (PCOS)
- Dysmenorrhea
- Premenstrual Syndrome (PMS)
Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder characterized by hyperandrogenism, menstrual abnormalities, polycystic ovaries, chronic anovulation, and decreased fertility.
Etiopathogenesis
The central morphologic abnormality of PCOS involves numerous cystic follicles or follicle cysts that enlarge the ovaries. However, polycystic ovaries are detected in 20% to 30% of all women, so this finding is not specific. Due to an increase in free serum estrone levels, women with PCOS are also at risk for endometrial hyperplasia and carcinoma.
Clinical Manifestations
- Obesity
- Hyperinsulinemia
- Ovarian cysts
Pharmacological Management
Insulin sensitizing medications:
- Examples: Metformin, Pioglitazone
Androgen blocking medications:
- Examples: Bicalutamide, Nilutamide, Leuprolide
Birth control pills to regulate the menstrual cycle:
- Examples: Progesterone and Norethindrone, Levonorgestrel
Non-Pharmacological Management
- Consult a gynecologist if symptoms appear, and adjust lifestyle (including sleep and wake patterns) as instructed.
- Dietary patterns are essential for maintaining the Basal Metabolic Rate (BMR) and managing body weight.
Premenstrual Syndrome (PMS)
Premenstrual Syndrome (PMS) refers to symptoms of stress that appear before the onset of menstruation.
Etiopathogenesis
- PMS is caused by hormonal imbalances in the body, mainly involving progesterone and estrogen.
- It may also be triggered by stress, emotional behavior, or nutrient deficiency.
Clinical Manifestations
- Mood swings
- Irritability, anger, and anxiety
Pharmacological Management
Antidepressants:
- Examples: Escitalopram, Citalopram, Fluoxetine
Diuretics:
- Examples: Furosemide, Torsemide, Spironolactone
Oral contraceptives:
- Examples: Norethindrone, Levonorgestrel
Non-Pharmacological Management
- Consult a gynecologist if symptoms appear, and adjust lifestyle (including sleep and wake patterns) as instructed.
- Dietary patterns are essential for maintaining the BMR and managing body weight.
Ophthalmology: Eye Conditions
- Conjunctivitis (Bacterial and Viral)
- Glaucoma
Conjunctivitis (Bacterial and Viral)
The conjunctiva lining the interior of the eyelid (the palpebral conjunctiva) is tightly tethered to the tarsus and may respond to inflammation by being thrown into minute papillary folds, as occurs in allergic and bacterial conjunctivitis.
Etiopathogenesis
- Conjunctivitis can be caused by a variety of factors including bacterial or viral infections, allergic reactions, and irritants such as smoke, dust, or chemicals.
- Bacterial Conjunctivitis: This is a common eye infection, most frequent in children. It can be caused by various bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.
Clinical Manifestations
- Redness of the eye
- Itching or burning sensation
- Excessive tearing
- Discharge from the eye, which may be clear, yellow, or greenish
Pharmacological Management
Antibiotics:
- Examples: Tobramycin, Cotrimoxazole, Sulfacetamide, Bacitracin, Erythromycin, Ciprofloxacin, Moxifloxacin, Ofloxacin, Gentamycin
Anti-allergic drugs:
- Examples: Chloropyramine, Naphazoline, Bepotastine
Non-Pharmacological Management
It is important to practice good hygiene, such as washing hands frequently, avoiding touching the eyes with hands, and avoiding sharing personal items such as towels or cosmetics.
Glaucoma
Etiopathogenesis and Pathophysiology
The pathophysiology of glaucoma is understood by examining the formation and drainage of aqueous humor. Glaucoma is typically categorized into two types:
Open-Angle Glaucoma: In this type, aqueous humor has complete physical access to the trabecular meshwork, and the elevation in intraocular pressure results from an increased resistance to aqueous outflow.
Angle-Closure Glaucoma: In angle-closure, the peripheral zone of the iris adheres to the trabecular meshwork and physically impedes the egress of aqueous humor from the eye.
Clinical Manifestations
- Blurred vision
- Redness of the eye
Pharmacological Management
Beta-adrenergic blockers:
- Examples: Timolol, Betaxolol, Levobunolol
Alpha-adrenergic agonists:
- Examples: Dipivefrine, Apraclonidine, Brimonidine
Non-Pharmacological Management
- Maintain a wholesome diet.
- Avoid polluted areas, as pollutants can cause eye irritation.
Infectious Diseases and Treatment
- Tuberculosis (TB)
- Pneumonia
- Urinary Tract Infections (UTI)
- Hepatitis
- Gonorrhea and Syphilis
- Malaria
- HIV and Opportunistic Infections
- Viral Infections (SARS, CoV2)
Tuberculosis (TB)
Etiopathogenesis
The pathogenesis of tuberculosis is complex and involves several stages:
Transmission: TB is primarily transmitted through the inhalation of respiratory droplets from an infected individual. The bacteria can survive in aerosols for several hours and spread in crowded and poorly ventilated areas.
Clinical Manifestations
- Chronic cough
- Sputum production
- Appetite loss
Pharmacological Management
First line of treatment:
- Isoniazid, Rifampin, Ethambutol, Pyrazinamide, Streptomycin
Second line of treatment:
- Ofloxacin, Amikacin, Moxifloxacin, Ethionamide
Non-Pharmacological Management
- Follow all precautions (e.g., wearing a mask, sanitizing hands) prior to any activities.
- Consume a nutritious diet and follow a diet chart as instructed by the physician.
Pneumonia
Etiopathogenesis
The pathogenesis of pneumonia depends on the specific pathogen involved, but generally involves the following steps:
Entry of Pathogen: The pathogen enters the body through inhalation, aspiration, or hematogenous spread from another site of infection.
Adherence and Colonization: The pathogen adheres to the surface of the respiratory epithelium and colonizes the lung tissue. This occurs through various mechanisms, such as binding to specific receptors on host cells or using secreted enzymes to break down host tissue.
Clinical Manifestations
- Shortness of breath
- Chills and sweating
- Fever
Pharmacological Management
Antibiotics:
- Examples: Azithromycin, Moxifloxacin, Ceftriaxone, Cefepime, Tazobactam, Vancomycin, Metronidazole, Trimethoprim
Non-Pharmacological Management
- Follow all precautions (e.g., wearing a mask, sanitizing hands) prior to any activities.
Gonorrhea
Etiopathogenesis
- Gonorrhea is primarily transmitted through sexual contact, including vaginal, anal, and oral sex with an infected person.
- The bacterium can enter the body through the mucous membranes of the genitals, rectum, or throat.
Clinical Manifestations
- Painful or burning sensation during urination
- Increased vaginal or penile discharge
- Painful bowel movements or rectal itching
Pharmacological Management
- Examples: Penicillin G, Benzathine P, Doxycycline, Cefixime, Ceftriaxone, Azithromycin
Non-Pharmacological Management
Prevention of gonorrhea involves practicing safe sex, including using condoms correctly and consistently, limiting the number of sexual partners, and getting regular STI testing.
Syphilis
Etiopathogenesis
- Syphilis is primarily transmitted through sexual contact, including vaginal, anal, and oral sex with an infected person.
- The bacterium can also be transmitted from a mother to her baby during pregnancy or childbirth.
Clinical Manifestations
- Painful or burning sensation during urination
- Increased vaginal or penile discharge
- Painful bowel movements or rectal itching
Pharmacological Management
- Examples: Penicillin G, Benzathine P, Doxycycline, Cefixime, Ceftriaxone, Azithromycin
Non-Pharmacological Management
Prevention of syphilis involves practicing safe sex, including using condoms correctly and consistently, limiting the number of sexual partners, and getting regular STI testing.
Malaria
Etiopathogenesis
- Plasmodium enters the human body as sporozoites (the infectious form) through the bite of an infected female Anopheles mosquito.
- The parasites initially multiply within the liver cells and then attack the red blood cells (RBCs), resulting in their rupture.
Clinical Manifestations
- Fever and headache
- Fatigue and pain
- Chills and sweating
Pharmacological Management
- Atovaquone-Proguanil (Malarone)
- Quinine sulfate with Doxycycline
- Primaquine phosphate
Non-Pharmacological Management
- Since Anopheles vectors breed in dirty places, maintaining cleanliness is very important.
- Follow the guidelines released by the government regarding mosquito control and prevention.