HEPATITIS A
Hepatitis A is caused by the viral hepatitis A or (HAV). It is an acute illness (acute viral hepatitis) that never becomes chronic. It was once referred to as "infectious hepatitis" because it could be spread from person to person like other viral infections. Infection with hepatitis A virus can be spread through the ingestion of food or water, especially where unsanitary conditions allow water or food to become contaminated by human waste containing hepatitis A (the fecal-oral mode of transmission). Hepatitis A typically is spread among household members and close contacts through the passage of oral secretions (intimate kissing) or stool (poor hand hygiene). It also is common to have infection spread to customers in restaurants and among children and large groupings if hand washing and sanitary precautions are not observed.
DESCRIPTION-SIGNS AND SYMPTOMS:
Hepatitis A is a liver disease caused by the hepatitis A virus. Good personal hygiene and proper sanitation can help prevent hepatitis A. Vaccines are also available for long-term prevention of hepatitis A virus infection in persons 12 months of age and older. Immune globulin(IG) is available for short-term prevention of hepatitis A virus infection in individuals of all ages.
Adults will have signs and symptoms more often than children.
• jaundice
• fatigue
• abdominal pain
• loss of appetite
• nausea
• diarrhea
• fever
LONG-TERM EFFECTS:
There is no chronic (long-term) infection. Once you have had hepatitis A, you cannot get it again.
About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.
TRANSMISSION:
HAV is found in the stool (feces) of persons with hepatitis A. HAV is usually spread from person to person by the fecal-oral route. Food borne transmission occurs when an HAV-infected food handler contaminates food during preparation or when food is contaminated during harvesting or processing before reaching the food service establishment or home( putting something in the mouth-even though it might look clean) that has been contaminated with the stool of a person with hepatitis A.
PERSONS AT RISK OF INFECTION:
Household contacts of infected persons, Sex contacts of infected individuals, persons especially children- living in areas with increased rates of hepatitis A, Men who have sex with men and Users of injection and non-injection drug.
PREVENTION:
Hepatitis A vaccine is the best protection. Short-term protection against hepatitis A is available from immune globulin(IG). It can be given before and within 2 weeks of coming in contact with HAV. Always wash your hands with soap and water after using the bathroom, changing undergarments, and before preparing and eating food.
VACCINATION:
Among the vaccines available are Havrix and Vaqta. Both contain inactive (killed) hepatitis A virus. For adults, two doses of the vaccine are recommended. After the first dose, protective antibodies develop in 70% of vaccine recipients in 2 weeks and more than 95% of recipients in 4 weeks. After two doses of the hepatitis A vaccine, immunity against hepatitis A infection is believed to last for many years.
Individuals at increased risk for acquiring hepatitis A and individuals with chronic liver disease (e.g., cirrhosis or chronic hepatitis C) should be vaccinated. Although individuals with chronic liver disease are not at increased risk for acquiring hepatitis A, they can develop serious (sometimes fatal) liver failure if infected with hepatitis A and, thus, they should be vaccinated.
Individuals at increased risk of acquiring hepatitis A are:
• Travelers to areas where hepatitis A is common
• Men who have sex with men who are infected
• Illegal drug users (either injection or non-injection drug use)
• Researchers working with hepatitis A or primates that are susceptible to infection with hepatitis A
• Patients with clotting factor disorders who are receiving clotting factor concentrates that can transmit hepatitis A
Some local health authorities or private companies may require hepatitis A vaccination for food handlers.
Because protective antibodies take weeks to develop, travelers to endemic areas should be vaccinated at least 4 weeks before departure. Immune globulin is recommended to be given in addition to vaccination if departure is prior to 4 weeks. Immune globulin provides quicker protection than the vaccines, but the protection is short-lived.
Sunday, July 20, 2008
Friday, July 4, 2008
KENYA IS NOT FOR SALE
It is mind boggling to read this kind of garbage from the media that a full deputy- prime- minister of a coalition government is actually trying to justify corruption/and or a mismanagement-and in a not so covert way...... Deputy Prime Minister Uhuru Kenyatta also defended the Finance Minister saying that he was being subjected to a “lynching mob".
And also that there were actually some skin heads demonstrating. So I am not sure what the demonstrators were trying to prove- That embezzling/fleecing public assets are birth rights for some people/group? me think not. But will be interesting to see how this one spins out.
Actually two groups were demonstrating in support of Mr. Kimunya drawing mixed reactions from police as one was dispersed with teargas while the other marched to the hotel at the centre of the onslaught against the minister.
The first group, led by Lang’ata politician Stanley Livondo and comprising about 500 protesters, marched from the Arboretum grounds to the city centre before anti-riot police intercepted them. Waving placards, the group ignored an order from a senior police officer not to proceed to Parliament, forcing him to call for reinforcements. "You need a permit to have a procession and since you have not requested one, you should disperse,” said the officer.
Mr Livondo defied the order and urged the protesters to continue with their march.“You cannot stop us from conveying our message. These MPs who are accusing the minister are known to be corrupt and cannot throw stones at him,” he said. Mr Livondo accused Prime Minister Raila Odinga of pretending that he was not aware of the deal.
Mr Odinga has said he was briefed by Central Bank of Kenya governor Prof Njuguna Ndung’u as claimed by Mr Kimunya on Wednesday but added that at the time, there were conflicting statements from gorvernment officials about the sale of the hotel.
Meanwhile, the other group of demonstrators marched from Jevanjee Gardens to Mr Kimunya’s Treasury Building office. They chanted “Kimunya kaa Ngumu (Kimunya stay put!)” as they marched through the streets carrying placards. Some of their placards read “No Kimunya, No cabinet, MPs must be taxed, MPs are pretending.”
A spokesman, Mr Hosea Mwangi said the group comprised “concerned Nairobians” agitated by the fact that some of the MPs calling for Mr Kimunya’s resignation had been involved in mega scandals.“They are crucifying Kimunya because of his proposal to tax them. If he has done anything wrong, he should be allowed to tell his side of the story,” he said.
He accused the MPs of trying to divert Kenyans’ attention from more important issues by hounding Mr Kimunya. The demonstrators briefly gathered outside the Grand Regency where they chanted and danced before marching to the Freedom Corner at Uhuru Park.
Another blogger's perspective captured it best:
"THE ARROGANCE OF KIMUNYA- WITH THE SUPPORT OF THE KIKUYU MAFIA THE LIKES OF WAKINA UHURU KENYATTA IS DESPICABLE!!"
God complex is the self-delusion that one has a special mission to save the world. This delusion is engendered by extreme arrogance and absence of humility. It is a disease that afflicts the rich, the powerful and the privileged.
This complex is manifested in Finance minister Amos Kimunya.
When confronted by Parliament on Wednesday with a list of misdeeds, he responded by saying how he had rid the country of land-grabbers and tax dodgers, and how he had laid the institutional and legal structures to fight corruption. Mr Kimunya missed an opportunity to defend himself.
The minister is young, compared to most Kenyan political leaders, and well read, but completely naive in political leadership. Public service demands that the leaders live by the code they preach. It does not matter how many good laws one passes; it doesn’t matter how many anti-corruption institutions are set up — what matters is whether a leader abides by them.
Mr Kimunya’s public life betrays a man with contempt for systems he has set up. In the sale of Grand Regency Hotel to Libyans, if indeed they are, he broke every law applicable. He treated the hotel as casually as one would a ball-point pen.
But let us first have a look at what happened to world leaders with arrogance milder than Mr Kimunya’s so that we may realize how we have treated him with velvet gloves. David Blunkett was born blind, yet he rose to be a close and powerful confidante of British Prime Minister Tony Blair and held various Cabinet positions, including home affairs.
Socialite mistress
Mr Blunkett had a pretty and socialite mistress called Kimberley Quin, the editor of The Spectator magazine.
Ms Quin imported a Filipino nanny called Leoncia Casalme and, as required by law, she applied for a long-term work permit which takes about a year to complete. Ms Casalme qualified for the permit, but had to wait like everyone else for the process to complete its course.
Ms Quin, being the Home Affairs minister’s mistress, did not have such patience and on April 23, 2003, asked Mr Blunkett to fast-track the process.
Indeed, five days later, the permit was issued. When this fast-tracking was leaked to the media, the United Kingdom Parliamentary Committee on Standards censured him, and he quit.
In the US, Eliot Spitzer, a celebrity attorney-general for the New York state, went about his work with such gusto and chutzpah that he rid the city of economic crimes perpetrated by the large companies.
Wall Street was shaken to the ground and many were fined billions of dollars in plea bargains. In America, the law allows companies to in certain cases pay millions of dollars to avoid criminal investigations and prosecution, but on condition that one fixes up the problem.
New York was grateful and elected Mr Spitzer governor. In the same way he rid the city of economic crimes, he changed course to now deal with crimes personal: rid the city of prostitution.
It later transpired that while fighting the vice, the governor was member No 9 of an elite prostitution group, arrogantly called VIP Emperors Club. In shame, the governor resigned when he was hounded by the media.
Mr Blunkett and Mr Spitzer did not wait to be sacked or impeached respectively; they quit when their private peccadilloes were made public. Both men demanded from the public a high moral rectitude, yet they never lived by it.
They wanted to decouple their private lives from the public perceptions they had created. The false firewall was bound to fall and it did. And both men who had just begun national leadership and on the way to higher callings, have now disappeared into obscurity.
What did, or did not, Mr Kimunya do? At the outset, we must accept the fact that the entire truth and all the details surrounding the Grand Regency sale may never be told to the public.
Building the case:
But the information available to all is enough to build a case of impropriety on the part of the minister, Central Bank, National Security Intelligence Service and errant officers at Lands ministry.
The land Grand Regency is built on falls under the Registration of Titles Act, Cap 281, which is the clearest and most elaborate of the land laws. I have argued before in these columns that all land laws should be simplified and brought together within this Act.
This Act sets out the process of registering and deregistering land titles. The registrar of titles is the chief executive for properties falling under this Act and acts without any external interference.
Sections 59 and 60 of the Act allow him to recall and cancel a title deed obtained by deception, fraud, error, misrepresentations or by mistake, as has happened here.
Mr Kimunya says the land was sold for Sh2.9 billion to the Libyan government. We now know that the land was sold for Sh1.8 billion and that the buyer is a Kenyan company with Kenyan directors who have since disowned their signatures. And the minister insists that the sale is a government-to-government deal, yet this is not true.
The minister insists also that the land was sold for Sh2.9 billion even when the evidence is to the contrary. The sale agreement conveniently splits the transaction into two parts — the actual land and the hotel’s “movable assets”.
This dichotomy is false, fraudulent and misleading. Grand Regency was being sold as a going concern, yet the sale is a cannibalized one.
As a going concern, the hotel ought to have been sold at an all-inclusive price for the land, the building, the movable assets, the business goodwill, the reputation and all other intellectual property rights it has acquired.
If Grand Regency was being bought to be used as an office block, the dichotomy may make sense. No prestigious hotel has been sold the way Grand Regency has; the valuations are ridiculous, if not deceptive.
In law, land includes the physical land, the building on it and anything annexed to it. There is a legal doctrine — quicquid plantatur solo, solo cedit — that captures the entire meaning of land law.
This doctrine is that anything attached to land is part of the land. If, therefore, the wall paintings, beds, machines and kitchens at Grand Regency are firmly fixed on the floors and walls, then they are part of the land, and not separate, as the sale agreement implies. In making these false separations, the Government may have lost stamp duty worth more than Sh44 million. Who pocketed this money?
Once Grand Regency was surrendered to Central Bank, it became a public asset and its disposal was subject to the Public Procurement and Disposal Act, 2005, and the Privatization Act, 2005. Disposal of land is specifically identified as being a transaction that falls under these two Acts.
The law demands that the process of disposal include open tendering — invitation of tenders through advertisements and competitive bidding. Above all, the entire process is subject to the Cabinet’s control and vetting. Again, other than Mr Kimunya himself, every minister who has spoken has denied knowledge of the process.
And what was the National Security Intelligence Service doing at the lands offices overseeing the registration?
Normal land transactions take at times as long as three months, yet NSIS saw to it that the Grand Regency transfer was done in a day. Section 5 of the National Security Intelligence Service Act, 1998, clearly states that the security agency’s core and only duty is to protect Kenya from threats or potential threats.
When did the Grand Regency sale become part of the national security matrix? For the umpteenth time, I wish to say that NSIS is of no value to the country. We pay it Sh8 billion a year for its officers to idle till they misinterpret their mandate to think it includes running errands for politicians or dealing in properties sales. NSIS ought to be disbanded.
Throughout the entire process of the sale, Mr Kimunya was economical with the truth. The Public Officer Ethics Act, 2003, demands of him honesty, integrity, courtesy and respect to the public and the Government. But he violated every provision in the Act.
The sale shows that mandatory provisions of the Registration of Titles Act, Cap 281; the National Security Intelligence Service Act, 1998; the Central Bank of Kenya Act, Cap 491; the Anti-Corruption and Economic Crimes Act, 2003, and the Public Officer Ethics Act, 2003, were broken with impunity by Mr Kimunya, and with the tacit support of CBK governor Njuguna Ndung’u and NSIS director-general Michael Gichangi.
Mr Kimunya, Mr Ndung’u and Maj-Gen Gichangi must be indicted if the rule of law exists in this country.
In its absence, we will know that the law is two-tracked — for the powerful and the weak. We can only respect our systems if its top officers themselves respect them. Impunity that arises from political arrogance must end.
And also that there were actually some skin heads demonstrating. So I am not sure what the demonstrators were trying to prove- That embezzling/fleecing public assets are birth rights for some people/group? me think not. But will be interesting to see how this one spins out.
Actually two groups were demonstrating in support of Mr. Kimunya drawing mixed reactions from police as one was dispersed with teargas while the other marched to the hotel at the centre of the onslaught against the minister.
The first group, led by Lang’ata politician Stanley Livondo and comprising about 500 protesters, marched from the Arboretum grounds to the city centre before anti-riot police intercepted them. Waving placards, the group ignored an order from a senior police officer not to proceed to Parliament, forcing him to call for reinforcements. "You need a permit to have a procession and since you have not requested one, you should disperse,” said the officer.
Mr Livondo defied the order and urged the protesters to continue with their march.“You cannot stop us from conveying our message. These MPs who are accusing the minister are known to be corrupt and cannot throw stones at him,” he said. Mr Livondo accused Prime Minister Raila Odinga of pretending that he was not aware of the deal.
Mr Odinga has said he was briefed by Central Bank of Kenya governor Prof Njuguna Ndung’u as claimed by Mr Kimunya on Wednesday but added that at the time, there were conflicting statements from gorvernment officials about the sale of the hotel.
Meanwhile, the other group of demonstrators marched from Jevanjee Gardens to Mr Kimunya’s Treasury Building office. They chanted “Kimunya kaa Ngumu (Kimunya stay put!)” as they marched through the streets carrying placards. Some of their placards read “No Kimunya, No cabinet, MPs must be taxed, MPs are pretending.”
A spokesman, Mr Hosea Mwangi said the group comprised “concerned Nairobians” agitated by the fact that some of the MPs calling for Mr Kimunya’s resignation had been involved in mega scandals.“They are crucifying Kimunya because of his proposal to tax them. If he has done anything wrong, he should be allowed to tell his side of the story,” he said.
He accused the MPs of trying to divert Kenyans’ attention from more important issues by hounding Mr Kimunya. The demonstrators briefly gathered outside the Grand Regency where they chanted and danced before marching to the Freedom Corner at Uhuru Park.
Another blogger's perspective captured it best:
"THE ARROGANCE OF KIMUNYA- WITH THE SUPPORT OF THE KIKUYU MAFIA THE LIKES OF WAKINA UHURU KENYATTA IS DESPICABLE!!"
God complex is the self-delusion that one has a special mission to save the world. This delusion is engendered by extreme arrogance and absence of humility. It is a disease that afflicts the rich, the powerful and the privileged.
This complex is manifested in Finance minister Amos Kimunya.
When confronted by Parliament on Wednesday with a list of misdeeds, he responded by saying how he had rid the country of land-grabbers and tax dodgers, and how he had laid the institutional and legal structures to fight corruption. Mr Kimunya missed an opportunity to defend himself.
The minister is young, compared to most Kenyan political leaders, and well read, but completely naive in political leadership. Public service demands that the leaders live by the code they preach. It does not matter how many good laws one passes; it doesn’t matter how many anti-corruption institutions are set up — what matters is whether a leader abides by them.
Mr Kimunya’s public life betrays a man with contempt for systems he has set up. In the sale of Grand Regency Hotel to Libyans, if indeed they are, he broke every law applicable. He treated the hotel as casually as one would a ball-point pen.
But let us first have a look at what happened to world leaders with arrogance milder than Mr Kimunya’s so that we may realize how we have treated him with velvet gloves. David Blunkett was born blind, yet he rose to be a close and powerful confidante of British Prime Minister Tony Blair and held various Cabinet positions, including home affairs.
Socialite mistress
Mr Blunkett had a pretty and socialite mistress called Kimberley Quin, the editor of The Spectator magazine.
Ms Quin imported a Filipino nanny called Leoncia Casalme and, as required by law, she applied for a long-term work permit which takes about a year to complete. Ms Casalme qualified for the permit, but had to wait like everyone else for the process to complete its course.
Ms Quin, being the Home Affairs minister’s mistress, did not have such patience and on April 23, 2003, asked Mr Blunkett to fast-track the process.
Indeed, five days later, the permit was issued. When this fast-tracking was leaked to the media, the United Kingdom Parliamentary Committee on Standards censured him, and he quit.
In the US, Eliot Spitzer, a celebrity attorney-general for the New York state, went about his work with such gusto and chutzpah that he rid the city of economic crimes perpetrated by the large companies.
Wall Street was shaken to the ground and many were fined billions of dollars in plea bargains. In America, the law allows companies to in certain cases pay millions of dollars to avoid criminal investigations and prosecution, but on condition that one fixes up the problem.
New York was grateful and elected Mr Spitzer governor. In the same way he rid the city of economic crimes, he changed course to now deal with crimes personal: rid the city of prostitution.
It later transpired that while fighting the vice, the governor was member No 9 of an elite prostitution group, arrogantly called VIP Emperors Club. In shame, the governor resigned when he was hounded by the media.
Mr Blunkett and Mr Spitzer did not wait to be sacked or impeached respectively; they quit when their private peccadilloes were made public. Both men demanded from the public a high moral rectitude, yet they never lived by it.
They wanted to decouple their private lives from the public perceptions they had created. The false firewall was bound to fall and it did. And both men who had just begun national leadership and on the way to higher callings, have now disappeared into obscurity.
What did, or did not, Mr Kimunya do? At the outset, we must accept the fact that the entire truth and all the details surrounding the Grand Regency sale may never be told to the public.
Building the case:
But the information available to all is enough to build a case of impropriety on the part of the minister, Central Bank, National Security Intelligence Service and errant officers at Lands ministry.
The land Grand Regency is built on falls under the Registration of Titles Act, Cap 281, which is the clearest and most elaborate of the land laws. I have argued before in these columns that all land laws should be simplified and brought together within this Act.
This Act sets out the process of registering and deregistering land titles. The registrar of titles is the chief executive for properties falling under this Act and acts without any external interference.
Sections 59 and 60 of the Act allow him to recall and cancel a title deed obtained by deception, fraud, error, misrepresentations or by mistake, as has happened here.
Mr Kimunya says the land was sold for Sh2.9 billion to the Libyan government. We now know that the land was sold for Sh1.8 billion and that the buyer is a Kenyan company with Kenyan directors who have since disowned their signatures. And the minister insists that the sale is a government-to-government deal, yet this is not true.
The minister insists also that the land was sold for Sh2.9 billion even when the evidence is to the contrary. The sale agreement conveniently splits the transaction into two parts — the actual land and the hotel’s “movable assets”.
This dichotomy is false, fraudulent and misleading. Grand Regency was being sold as a going concern, yet the sale is a cannibalized one.
As a going concern, the hotel ought to have been sold at an all-inclusive price for the land, the building, the movable assets, the business goodwill, the reputation and all other intellectual property rights it has acquired.
If Grand Regency was being bought to be used as an office block, the dichotomy may make sense. No prestigious hotel has been sold the way Grand Regency has; the valuations are ridiculous, if not deceptive.
In law, land includes the physical land, the building on it and anything annexed to it. There is a legal doctrine — quicquid plantatur solo, solo cedit — that captures the entire meaning of land law.
This doctrine is that anything attached to land is part of the land. If, therefore, the wall paintings, beds, machines and kitchens at Grand Regency are firmly fixed on the floors and walls, then they are part of the land, and not separate, as the sale agreement implies. In making these false separations, the Government may have lost stamp duty worth more than Sh44 million. Who pocketed this money?
Once Grand Regency was surrendered to Central Bank, it became a public asset and its disposal was subject to the Public Procurement and Disposal Act, 2005, and the Privatization Act, 2005. Disposal of land is specifically identified as being a transaction that falls under these two Acts.
The law demands that the process of disposal include open tendering — invitation of tenders through advertisements and competitive bidding. Above all, the entire process is subject to the Cabinet’s control and vetting. Again, other than Mr Kimunya himself, every minister who has spoken has denied knowledge of the process.
And what was the National Security Intelligence Service doing at the lands offices overseeing the registration?
Normal land transactions take at times as long as three months, yet NSIS saw to it that the Grand Regency transfer was done in a day. Section 5 of the National Security Intelligence Service Act, 1998, clearly states that the security agency’s core and only duty is to protect Kenya from threats or potential threats.
When did the Grand Regency sale become part of the national security matrix? For the umpteenth time, I wish to say that NSIS is of no value to the country. We pay it Sh8 billion a year for its officers to idle till they misinterpret their mandate to think it includes running errands for politicians or dealing in properties sales. NSIS ought to be disbanded.
Throughout the entire process of the sale, Mr Kimunya was economical with the truth. The Public Officer Ethics Act, 2003, demands of him honesty, integrity, courtesy and respect to the public and the Government. But he violated every provision in the Act.
The sale shows that mandatory provisions of the Registration of Titles Act, Cap 281; the National Security Intelligence Service Act, 1998; the Central Bank of Kenya Act, Cap 491; the Anti-Corruption and Economic Crimes Act, 2003, and the Public Officer Ethics Act, 2003, were broken with impunity by Mr Kimunya, and with the tacit support of CBK governor Njuguna Ndung’u and NSIS director-general Michael Gichangi.
Mr Kimunya, Mr Ndung’u and Maj-Gen Gichangi must be indicted if the rule of law exists in this country.
In its absence, we will know that the law is two-tracked — for the powerful and the weak. We can only respect our systems if its top officers themselves respect them. Impunity that arises from political arrogance must end.
Friday, June 27, 2008
THE TWISTS AND TURNS OF THE GRAND REGENCY HOTEL OWNERSHIP
cut and paste:
ANGLO-(F)LEASING PART II?
Saturday, June 28, 2008-DN.
ANGLO-(F)LEASING PART II?
Saturday, June 28, 2008-DN.
Sunday, June 22, 2008
COMMON LIVER DISEASES -PART TWO
LIVER DISEASES PART TWO:
HEPATITIS:
Hepatitis in itself- is the inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs/medications, alcohol, chemicals, and autoimmune diseases. Also many organisms most specifically viruses,i.e virus of mononucleosis and the cytomegalovirus can inflame the liver. Most viruses, however, do not primarily attack the liver; the liver is just one of several organs that the viruses affect. When doctors/health professions speak of viral hepatitis, they usually are referring to hepatitis caused by a few specific viruses that primarily attack the liver. There are several hepatitis viruses; they have been named types A, B, C, D, E, F (not confirmed), and G. As the knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C.
The liver, located in the upper right hand side of the abdomen and mostly behind the rib cage normally weighs close to 1.5kgs. It does the following vital functions:
1. The liver helps purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications or alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that then are eliminated from the body in the urine or stool.
2. The liver produces many important substances, especially proteins that are necessary for good health. For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.
3. The liver stores many sugars, fats and vitamins until they are needed elsewhere in the body.
4. The liver builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body. An example of this type of function is the manufacture of cholesterol.
When the liver is inflamed, it does not perform these functions well, which brings about many of the symptoms, signs, and problems associated with hepatitis.
****TO BE CONTINUED****
HEPATITIS:
Hepatitis in itself- is the inflammation of the liver. Many illnesses and conditions can cause inflammation of the liver, for example, drugs/medications, alcohol, chemicals, and autoimmune diseases. Also many organisms most specifically viruses,i.e virus of mononucleosis and the cytomegalovirus can inflame the liver. Most viruses, however, do not primarily attack the liver; the liver is just one of several organs that the viruses affect. When doctors/health professions speak of viral hepatitis, they usually are referring to hepatitis caused by a few specific viruses that primarily attack the liver. There are several hepatitis viruses; they have been named types A, B, C, D, E, F (not confirmed), and G. As the knowledge of hepatitis viruses grows, it is likely that this alphabetical list will become longer. The most common hepatitis viruses are types A, B, and C.
The liver, located in the upper right hand side of the abdomen and mostly behind the rib cage normally weighs close to 1.5kgs. It does the following vital functions:
1. The liver helps purify the blood by changing harmful chemicals into harmless ones. The source of these chemicals can be external, such as medications or alcohol, or internal, such as ammonia or bilirubin. Typically, these harmful chemicals are broken down into smaller chemicals or attached to other chemicals that then are eliminated from the body in the urine or stool.
2. The liver produces many important substances, especially proteins that are necessary for good health. For example, it produces albumin, the protein building block of the body, as well as the proteins that cause blood to clot properly.
3. The liver stores many sugars, fats and vitamins until they are needed elsewhere in the body.
4. The liver builds smaller chemicals into larger, more complicated chemicals that are needed elsewhere in the body. An example of this type of function is the manufacture of cholesterol.
When the liver is inflamed, it does not perform these functions well, which brings about many of the symptoms, signs, and problems associated with hepatitis.
****TO BE CONTINUED****
COMMON LIVER DISEASES -PART ONE
LIVER DISEASES PART ONE
LIVER ABSCESS:
Liver abscess occurs when bacteria or protozoa destroy liver tissue, producing a cavity that fills with infectious organisms, liquefied liver cells and white blood cells. The dead tissues may then seal off the cavity from the rest of the liver making it less effective. Although uncommon, sometimes the puss-filled abscesses may rapture into another body cavity resulting into multiple abscesses, posing serious complications for the patient and can sometimes be fatal.
Causes:
The puss-filled liver abscesses commonly result from infection by such bacteria as Escherichia coli (E.coli), Klebsiella, Entrobacter, Salmonella, Staphylococcus and Enterococcus. These bacteria may invade the liver through liver wound, or spread from the lungs, skin, or other organs through the liver’s artery, veins or bile duct. And usually more than one abscess is present often allowing peritonitis, cholecystitis, pneumonia and bacterial endocarditis.
An amoebic abscess is usually caused by the infection of protozoa- Entamoeba histolytica..the same organism that is mostly associated with dysentery. And usually there is one amoebic abscess occurring in the right lobe of the liver.
Symptoms:
The symptoms vary from one individual to another. In some people, they are acutely ill while in others, the abscess is recognized only during autopsy after death from another illness. The bacterial symptoms are sudden and those of protozoan origin are more subtle. And the common signs may include; right abdominal and shoulder pains, weight loss, fever, chills, perspiration, nausea, vomiting and anemia. If the abscess extends to the diaphragm, there will be signs in the lungs. Abscess related liver damage may also cause jaundice.
Diagnosis:
Usually the doctor reviews the patients’ medical history and among other tests evaluates a liver scan to check for filling defects at the area of abscess. A liver ultrasound may also indicate the presence of an abscess but is less definitive than a liver scan. Computed tomography scan (CAT scan) can be used to confirm the diagnosis. Also laboratory tests such as blood/stool cultures are used to provide additional details as the protozoa or bacteria responsible can be easily identified.
Treatment:
The physician can start antibiotic therapy immediately if the causal organism has not been isolated. And if cultures show that the infection is caused by E.coli, the treatment includes drugs like ampicillin-(good for gram negative rods such as E.coli)
If the tests show the presence of Entamoeba histolytica, then the treatment will include Aralen or Flagyl. The therapy usually continues for 2 to 4 months. And an abscess that fails to respond can be surgically removed.
LIVER ABSCESS:
Liver abscess occurs when bacteria or protozoa destroy liver tissue, producing a cavity that fills with infectious organisms, liquefied liver cells and white blood cells. The dead tissues may then seal off the cavity from the rest of the liver making it less effective. Although uncommon, sometimes the puss-filled abscesses may rapture into another body cavity resulting into multiple abscesses, posing serious complications for the patient and can sometimes be fatal.
Causes:
The puss-filled liver abscesses commonly result from infection by such bacteria as Escherichia coli (E.coli), Klebsiella, Entrobacter, Salmonella, Staphylococcus and Enterococcus. These bacteria may invade the liver through liver wound, or spread from the lungs, skin, or other organs through the liver’s artery, veins or bile duct. And usually more than one abscess is present often allowing peritonitis, cholecystitis, pneumonia and bacterial endocarditis.
An amoebic abscess is usually caused by the infection of protozoa- Entamoeba histolytica..the same organism that is mostly associated with dysentery. And usually there is one amoebic abscess occurring in the right lobe of the liver.
Symptoms:
The symptoms vary from one individual to another. In some people, they are acutely ill while in others, the abscess is recognized only during autopsy after death from another illness. The bacterial symptoms are sudden and those of protozoan origin are more subtle. And the common signs may include; right abdominal and shoulder pains, weight loss, fever, chills, perspiration, nausea, vomiting and anemia. If the abscess extends to the diaphragm, there will be signs in the lungs. Abscess related liver damage may also cause jaundice.
Diagnosis:
Usually the doctor reviews the patients’ medical history and among other tests evaluates a liver scan to check for filling defects at the area of abscess. A liver ultrasound may also indicate the presence of an abscess but is less definitive than a liver scan. Computed tomography scan (CAT scan) can be used to confirm the diagnosis. Also laboratory tests such as blood/stool cultures are used to provide additional details as the protozoa or bacteria responsible can be easily identified.
Treatment:
The physician can start antibiotic therapy immediately if the causal organism has not been isolated. And if cultures show that the infection is caused by E.coli, the treatment includes drugs like ampicillin-(good for gram negative rods such as E.coli)
If the tests show the presence of Entamoeba histolytica, then the treatment will include Aralen or Flagyl. The therapy usually continues for 2 to 4 months. And an abscess that fails to respond can be surgically removed.
Friday, June 20, 2008
TYPHOID FEVER
Typhoid fever is an enteric form of (fever) caused by Salmonella typhi, the typhoid bacillus. It is characterized by prolonged fever and multi-system involvement, including lymph nodes, liver, and spleen. The sudden onset of sustained fever, severe headache, and nausea, loss of appetite, constipation or sometimes diarrhea can be life threatening. Severe forms have been described with mental dullness and meningitis. The paratyphoid fever can be caused by any of three serotypes of Salmonella paratyphi A, B and C. It is similar in its symptoms to typhoid fever, but tends to be milder, with a lower fatality rate. In endemic areas, the incidence of typhoid fever is highest in children and young adults from 5-19 years old.
Transmission:
Upon ingestion, typhoid bacilli rapidly penetrate the small intestinal mucosa by transcytosis through M cells and enterocytes, and are taken up by macrophages or diffuse into mesenteric lymph nodes. A primary bacteraemia follows and the pathogen rapidly attains intracellular haven throughout the reticuloendothelial system. This is followed by a sustained secondary bacteraemia associated with clinical illness. S. typhi also shows remarkable predilection for the gall-bladder, where infection tends to become chronic especially in individuals with a pathologic gall-bladder condition.
The disease is almost exclusively transmitted by food and water contaminated by the faeces and urine of infected people and those that are carriers. Polluted water is the most common source of typhoid transmission. In addition, shellfish taken from sewage-contaminated beds, vegetables fertilized with night-soil and eaten raw, contaminated milk and milk products also have been shown to be a source of infection. People can transmit the disease as long as the bacteria remain in their body; most people are infectious prior to and during the first week of convalescence, but 10% of untreated patients will discharge bacteria for up to 3 months. In addition, 2–5% of untreated patients will become permanent, lifelong carriers of the bacteria in their gall-bladder. Usually 10% of the cases can be reduced to less than 1% with appropriate antibiotic therapy. However, strains resistant to chloramphenicol and other recommended antibiotics (ampicillin, cotrimoxazole and even ciprofloxacin) have become prevalent in recent years.
Vaccine:
The two most commonly used are: - oral typhoid vaccine and a single-dose injectable vaccine. These two produces fewer side effects than the older two-dose injectable vaccines. Both vaccines are equally effective and offer 65% to 75% protection against the disease. It is also important to note that, at present no vaccine offers 100% immunity.
The oral vaccine (Vivotif) contains a live but weakened strain of the Salmonella bacteria that causes typhoid fever. The vaccine consists of four capsules that are taken every other day over a one-week period. The capsule protects the vaccine against stomach acid so it remains active when it reaches the intestine where the immunity develops. The oral vaccine can be given either as a first-time dose or as a booster dose. The protection should last about 5 years, at which time another booster dose may be needed. The oral vaccine is not recommended for children under 6 years old.
The single-dose injectable vaccine, (Typhim VI) contains capsular polysaccharide antigen given as a single 0.5 cc/ml intramuscular injection. Immunity is conferred seven days after vaccination and should last for 2 years. Subsequent booster doses are recommended at 2-year intervals. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. Side effects, while greater than those of the oral vaccine, are much less than those experienced with the old 2-dose injectable vaccine.
The safety of typhoid vaccine during pregnancy is unknown. If typhoid immunization is necessary during pregnancy, the injectable polysaccharide vaccine (Typhim Vi) is probably preferable, because it does not contain live bacteria. Oral typhoid vaccine is safe in HIV-infected individuals as long as their CD4 lymphocyte counts remain above 200.
Breastfeeding is probably protective against typhoid fever in infants.
Due to limited efficacy of the typhoid vaccine, and the fact that many other infections can be acquired from contaminated food and beverages, immunization against typhoid should not in any way limit the importance of following food and water precautions.
Transmission:
Upon ingestion, typhoid bacilli rapidly penetrate the small intestinal mucosa by transcytosis through M cells and enterocytes, and are taken up by macrophages or diffuse into mesenteric lymph nodes. A primary bacteraemia follows and the pathogen rapidly attains intracellular haven throughout the reticuloendothelial system. This is followed by a sustained secondary bacteraemia associated with clinical illness. S. typhi also shows remarkable predilection for the gall-bladder, where infection tends to become chronic especially in individuals with a pathologic gall-bladder condition.
The disease is almost exclusively transmitted by food and water contaminated by the faeces and urine of infected people and those that are carriers. Polluted water is the most common source of typhoid transmission. In addition, shellfish taken from sewage-contaminated beds, vegetables fertilized with night-soil and eaten raw, contaminated milk and milk products also have been shown to be a source of infection. People can transmit the disease as long as the bacteria remain in their body; most people are infectious prior to and during the first week of convalescence, but 10% of untreated patients will discharge bacteria for up to 3 months. In addition, 2–5% of untreated patients will become permanent, lifelong carriers of the bacteria in their gall-bladder. Usually 10% of the cases can be reduced to less than 1% with appropriate antibiotic therapy. However, strains resistant to chloramphenicol and other recommended antibiotics (ampicillin, cotrimoxazole and even ciprofloxacin) have become prevalent in recent years.
Vaccine:
The two most commonly used are: - oral typhoid vaccine and a single-dose injectable vaccine. These two produces fewer side effects than the older two-dose injectable vaccines. Both vaccines are equally effective and offer 65% to 75% protection against the disease. It is also important to note that, at present no vaccine offers 100% immunity.
The oral vaccine (Vivotif) contains a live but weakened strain of the Salmonella bacteria that causes typhoid fever. The vaccine consists of four capsules that are taken every other day over a one-week period. The capsule protects the vaccine against stomach acid so it remains active when it reaches the intestine where the immunity develops. The oral vaccine can be given either as a first-time dose or as a booster dose. The protection should last about 5 years, at which time another booster dose may be needed. The oral vaccine is not recommended for children under 6 years old.
The single-dose injectable vaccine, (Typhim VI) contains capsular polysaccharide antigen given as a single 0.5 cc/ml intramuscular injection. Immunity is conferred seven days after vaccination and should last for 2 years. Subsequent booster doses are recommended at 2-year intervals. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. Side effects, while greater than those of the oral vaccine, are much less than those experienced with the old 2-dose injectable vaccine.
The safety of typhoid vaccine during pregnancy is unknown. If typhoid immunization is necessary during pregnancy, the injectable polysaccharide vaccine (Typhim Vi) is probably preferable, because it does not contain live bacteria. Oral typhoid vaccine is safe in HIV-infected individuals as long as their CD4 lymphocyte counts remain above 200.
Breastfeeding is probably protective against typhoid fever in infants.
Due to limited efficacy of the typhoid vaccine, and the fact that many other infections can be acquired from contaminated food and beverages, immunization against typhoid should not in any way limit the importance of following food and water precautions.
Sunday, June 8, 2008
DEMOCRATIC PRIMARY' 08 FINAL
FINAL UPDATE OF DEM'S PRESIDENTIAL PRIMARY OUTCOME(2008):
** super delegate numbers **
- Feb. 5: Clinton 260-170 Obama
- Feb. 28 (after Obama's winning streak of 11-straight contests): Clinton 254-204 Obama
- March 6 (after OH/TX/RI/VT): 254 Clinton-215 Obama
- March 14 (After Obama's wins in WY 3/8; MS 3/11): Clinton 253-217 Obama
- March 31: Clinton 255-222 Obama
- April 15: Clinton 257-231 Obama
- April 23 (the day after the PA primary): Clinton 263-239 Obama
- April 30: Clinton 268-248 Obama
- May 5: (day before Indiana/NC primaries): Clinton 272.5-256 Obama
- May 12: Obama 279-276.5 Clinton
- May 13:Clinton added 20(in West Virginia{28}): Obama added 8
- May 20 : (Kentucky:Clinton 37-14 Obama {51}: Oregon:Obama 31-21 Clinton {52}
-June 1 : (Puerto Rico:Clinton 38-17 Obama {55}
-June 3 : (Montana:Obama 9-7 Clinton {16}: South Dakota:Clinton 8-7 Obama {15})
Total number of delegates for 2008 primary:
Barack Obama-2,158.5(100% of the 2,118 needed)
Hillary Clinton-1,920(90.7% of the 2,118 needed)
**Florida and Michigan delegates fully seated, but with ONE-HALF voting power compromise due to Democratic Party rules violations**
***AND BARACK OBAMA MAKES HISTORY BY BECOMING THE WINNER TO REPRESENT THE DEMOCRATIC PARTY FOR 2008 WHITE HOUSE***
** super delegate numbers **
- Feb. 5: Clinton 260-170 Obama
- Feb. 28 (after Obama's winning streak of 11-straight contests): Clinton 254-204 Obama
- March 6 (after OH/TX/RI/VT): 254 Clinton-215 Obama
- March 14 (After Obama's wins in WY 3/8; MS 3/11): Clinton 253-217 Obama
- March 31: Clinton 255-222 Obama
- April 15: Clinton 257-231 Obama
- April 23 (the day after the PA primary): Clinton 263-239 Obama
- April 30: Clinton 268-248 Obama
- May 5: (day before Indiana/NC primaries): Clinton 272.5-256 Obama
- May 12: Obama 279-276.5 Clinton
- May 13:Clinton added 20(in West Virginia{28}): Obama added 8
- May 20 : (Kentucky:Clinton 37-14 Obama {51}: Oregon:Obama 31-21 Clinton {52}
-June 1 : (Puerto Rico:Clinton 38-17 Obama {55}
-June 3 : (Montana:Obama 9-7 Clinton {16}: South Dakota:Clinton 8-7 Obama {15})
Total number of delegates for 2008 primary:
Barack Obama-2,158.5(100% of the 2,118 needed)
Hillary Clinton-1,920(90.7% of the 2,118 needed)
**Florida and Michigan delegates fully seated, but with ONE-HALF voting power compromise due to Democratic Party rules violations**
***AND BARACK OBAMA MAKES HISTORY BY BECOMING THE WINNER TO REPRESENT THE DEMOCRATIC PARTY FOR 2008 WHITE HOUSE***
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