The non-cholera vibrios do not cause cholera and include V. parahaemolyticus, Non-O1 V. cholerae, V. vulnificus, V. alginolyticus etc.

Mode of transmission of non-cholera vibrios:

The mode of transmission of non-cholera vibrios is usually by ingestion of seawater of ingestion of undercooked shellfish infested with non-cholera vibrios, because non-cholera vibrios can reach high concentrations in the tissues of shellfish.

Symptoms of non-cholera vibrios infection:

There are two major types of syndromes gastrointestinal illness and soft tissue infections. Very rarely V. vulnificus can lead to sepsis in immune compromised individuals.

The World Health Organization (WHO) and many other organizations around the world such as National Diabetes Data Group of United States have issued diagnostic criteria for diabetes mellitus based on certain facts such as (1) the spectrum of fasting plasma glucose (FPG) and the response to an oral glucose load (OGTT or oral glucose tolerance test) varies among different normal individuals, and (2) diabetes mellitus should be diagnosed if the level of blood glucose is at or higher, at which diabetes-specific complications occur.

For example the criteria for diagnosis of diabetes mellitus given below may not be applicable to Native Americans (Pima Indian population) because the prevalence of retinopathy (a complication of diabetes) begins to increase at fasting plasma glucose of more than 6.4 mmol/Liter (116 mg/100 ml of blood).

The results of medical negligence – or clinical negligence as it is sometimes referred to as – can be devastating both or the patient directly affected by it, but also for their families. Illness or disease itself is hard enough to cope with without the additional emotional strain and possible physical impact caused by failures in diagnosis or treatment. Medical negligence refers to any part of the care or treatment of a patient, from the initial diagnosis stage to the actual treatment and then the after care, where medical staff fails to meet the required standards of service. Should this apply to your case you are entitled to seek and explanation at least, and possibly even financial compensation.

Once you are confident that you have a legitimate claim for negligence and have decided to proceed with the claim, you will need to look into obtaining legal representation to help you with your compensation case. Ideally, you should look to secure a lawyer specialising in this area of the law, as there are a number of these available and many of them take cases on a no-win no-fee basis. It is important that you have proper legal representation, because claims for medical negligence are resisted very strongly by the medical profession.

Diabetes can be called an iceberg disease, as there are many individuals with diabetes who do not know they have diabetes, because they do not have any diabetes symptoms. By the time diabetes becomes symptomatic it may take several years. So screening is an important tool for diagnosis of diabetes among asymptomatic individuals and for prevention of complications and morbidity due to diabetes. It is to note that approximately 50% of patients have some diabetes related complication at the time of diagnosis, especially in type-2 diabetes, hence screening is very important.

Testing of Fasting Plasma Glucose (FPG) for screening of diabetes is recommended, especially for type-2 diabetes, because (1) there are large number of people who meet the criteria for diagnosis of diabetes, but unaware that they have diabetes, as they are asymptomatic, (2) approximately 50% of individuals with type-2 diabetes have one or more diabetes complications at the time of diagnosis (3) epidemiologic studies have proved that type-2 diabetes may be present asymptomatically for up to a decade before diagnosis made and (4) appropriate management of type-2 diabetes can favorably alter the natural history of diabetes and become beneficial for the patient.

The type-1 diabetes is also called IDDM or insulin-dependent diabetes mellitus, as the patient must be treated (supplemented) with exogenous insulin, due to destruction of beta cells of pancreas which secrete insulin. As the insulin secreting beta cells are destroyed the pancreas (beta cells of pancreas) can not produce insulin and must be supplied from outside.

Autoimmune cause of type 1 diabetes:

The main cause of type diabetes is autoimmune (“immune-mediated form” of type I diabetes mellitus). Due to autoantibodies directed against the insulin secreting beta cells of pancreas, in the patient’s blood the beta cells are destroyed by the autoantibodies. The numbers of beta cells of pancreas are normal at the time of birth, but months or years after birth due to development of autoantibodies the destruction of beta cells of pancreas starts. The time taken for destruction of beta cells of pancreas may vary from patient to patient.

More than 95% of patient with type-1 diabetes develop the disease before 25 years of age. The onset of type 1 diabetes is usually acute (developing over a period of a few days to weeks). The acuteness of type 1 diabetes is destruction of more than 80% of beta cells of pancreas. The pancreas can maintain supply of insulin if beta cell mass of at least 20% is functioning and if the functional beta cell mass falls below 20% the clinical symptoms of diabetes develop.

The types of diabetes with known causes are included and grouped in “other specific types of diabetes”. The “other specific types of diabetes” was previously known as MODY or maturity onset of diabetes of the young. The causes of “other specific types of diabetes” are several and varied and ranges from genetic defect to defect in insulin function to infection to drug or chemical-induced. The known causes of the “other specific types of diabetes” are discussed below.

Genetic defects of beta-cell function:

Diabetes due to genetic defect in beta-cell of pancreas function generally appears before the age of 25 years and with mild hyperglycemia. The genetic defect in beta-cell of pancreas function may be due to mutation in different (several) locations and mutation at different location causes different types of diabetes.

Causes of type 2 diabetes are multifactorial and complex. Insulin resistance and abnormal insulin secretion are at the center to the development of type 2 diabetes. Many studies suggest that insulin resistance occurs before an insulin secretory defect and diabetes develops only when insulin secretion becomes inadequate. The genetic factor in development of type 2 diabetes is very strong in compare to type-1 diabetes. Environmental factors also play a strong role in causation of type-2 diabetes.

Genetic factor in causation of type 2 diabetes:

The genetic factor in causation of type 2 diabetes is very strong. The concordance of type 2 diabetes in identical twins is between 70% and 90%. If both parents have type 2 diabetes, the risk of development of type-2 diabetes among children is approximately 40%. Many first degree relatives of type-2 diabetes patients have reduced glucose utilization in skeletal muscles without diabetes, due to insulin resistance.

The exact cause of gestational diabetes in not clear and there is several theories which try to explain the cause of gestational diabetes, but gestational diabetes is not due to lack of insulin as is the case in type-2 diabetes, although the pathophysiologically is similar to type II diabetes.

Insulin resistance increases during pregnancy, may be due to blocking effects of other hormones on the insulin. Due to increase insulin resistance the secretion of insulin is increased to maintain the metabolism of glucose. The pregnant woman’s hunger increased due to increased insulin, eating more as a result. Increased level of insulin causes reduction of number of insulin receptors which increases the insulin resistance further, thus creating a vicious cycle.

Many countries have strict rules regarding HIV positive and symptomatic AIDS patients and do not allow entry to their countries, although there is no data which suggests that these restrictions can/have reduced HIV transmission. In general HIV testing is required who wish to study/work abroad or wish to stay for more than 3 months. Some countries do not accept any HIV testing done in the traveler’s home country and border/airport officials have power to send back the traveler if they find any anti-retroviral medication (such as zidovudin) with the traveler. Some countries accept HIV testing report of less than 6 months old. If you are traveling to a particular country, you should get the latest information (because the rules may be changed frequently) on HIV testing requirement from the particular country’s embassy.

BPH or Benign Prostatic Hyperplasia is a common health problem among males of more than 55 years of age. Benign changes (as well as malignant) in the prostate increase with age especially after the age of 55 years. Routine autopsies done in the eighth decade of life shows hyperplastic changes in prostate gland in more than 90% of men and malignant changes seen in more than 70% in prostate gland of men.

Anatomy of prostate gland:

To understand the symptoms of BPH, it is important to understand the anatomy and pathology of prostate gland.

Symptoms of BPH:

The symptoms of BPH are mainly of urinary symptoms and include hesitancy in urination, intermittent voiding of urine, a diminished urine stream, incomplete emptying of urine, and postvoid leakage of urine. It should be kept in mind that the severity of symptoms does not always depend on the size of prostate gland (i.e. bigger size does not always mean more sever symptoms). Resistance to urine flow generally reduces bladder compliance and lead to urgency, nocturia (passing of urine during sleep at night), and ultimately urinary retention. Infection, tranquilizing drugs, antihistamines, and alcohol may also precipitate urinary retention. BPH does not produce pain and pain is generally indicative of prostatitis.