Headaches

What is a headache?

• Headaches involve mild to severe pain in one or more parts of the head as well as the back of the neck. There are many different types of headache patterns and a variety of causes. While painful and annoying, the majority of headaches do not indicate a serious disorder and, in non-chronic cases, may be relieved by medicines and/or changes in lifestyle.

What causes headaches?

• There is no single cause of headaches. A number of causes have been identified which fall into two general categories.
• 
  Tension headache
  This type of headache results from contraction of head and neck muscles. It is the most common form of headache and accounts for 70 per cent of headaches. It can occur in people of either sex and at any age but it is most common in adults and adolescents.
• 
  Tension headache usually occurs in isolated incidents but can become chronic for some people. Possible causes of muscle contraction associated with tension headaches include:
  stress.
  fatigue.
  poor posture.
  eye strain.
  tobacco and alcohol use.
  in women, hormonal changes occurring before and after a menstrual period.

Migraine headache

• 
  Migraine is the cause of 20 per cent of all headaches. This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels.
• 
  Migraine is usually experienced as a throbbing pain on one side of the head with an associated feeling of sickness and sensitivity to light and sound.
  Migraines are known to affect more women than men and are often chronic. Below are some of the factors that have been identified as being associated with migraines:
  family history of migraine.
• 
  prolonged muscle tension and stress.
• 
  alcohol use.
• 
  smoking or exposure to tobacco smoke.
• 
  lack of sleep.
• 
  for women, menstrual periods and the use of oral contraceptives.
• 
  certain foods such as chocolate, nuts and fermented or pickled condiments, as well as foods containing the amino acid tyramine (aged cheese, red wine, smoked fish) and foods containing preservatives and artificial sweeteners.

What are the symptoms of tension and migraine headaches?

• 
  Tension headache
  
• Pain is often felt in the generalised area of the head and neck as opposed to on one side.
  Pain may also be situated in the back of the head and neck and feel like a 'tight band'.
  Sometimes accompanied by muscle tightness in back of neck.
• 
  Of relatively short duration if treated in time.
• 
  Migraine headache
  Throbbing, pulsating feeling usually worse on one side of the head.
• 
  Pain may be dull or severe and often begins in the morning, gradually worsening in an hour or so.
• 
  Pain may be accompanied by other symptoms such as nausea, vomiting, vertigo-like feeling and visual disturbances.
• 
  Sensitivity to loud noises and light.
• 
  Commonly lasts from a few hours to one or two days in some cases.

When should you consult a doctor?

• Most people with isolated tension headaches usually avail themselves to over-the-counter pain relievers and anti-inflammatories, or self-treatment such as relaxation and sleep.
• However, for chronic headaches contact your GP to discuss possible causes and prevention.
  
• If any of the below symptoms are present your GP should be contacted immediately:
  a sudden, severe headache accompanied by nausea and vomiting.
  persistent and recurring headaches accompanied by memory problems, difficulty concentrating and tiredness.
• 
  a high fever with neck stiffness (unable to bend the chin down to the chest).
  convulsions (fits).
• 
  persistent vision disturbances (light flashes).
• 
  trouble controlling arms and legs.
• 
  loss of feeling in the arms and legs.
• 
  tiredness and apathy with difficulty communicating.

How does the doctor make a diagnosis?

• 
  An accurate history of any previous illnesses, family background, diet and lifestyle is crucial to help the doctor decide whether to perform further tests and to advise on treatment.
  The doctor will ask for information about the headache, its length, duration, location, associated features, quality and causative factors.
• 
  For headaches with indication of a chronic or more serious disorder, the following diagnostic procedures might be performed, usually following assessment by a specialist:
• 
  head CT (computerised tomography) scan.
• 
  head MRI (magnetic resonance imaging).
• 
  sinus X-rays.
• 
  temporal artery biopsy.
• 
  lumbar puncture.

What kind of treatment is available?

• 
  A 'headache' diary is very useful to help your doctor figure out what kind of treatment is most appropriate for your diagnosis.
• 
  The easiest way to do this is to write the dates of headaches on a calendar.
• 
  Make a note of when the pain started and how long it lasts. Note down any additional factors that seem important such as what has been drunk and eaten, the intake of medicines, daily activities, details about periods if you are a woman, and weather conditions.
• 
  It is a good idea to keep up the diary for between one and two months so that any patterns can be identified. By establishing what triggers the headaches, it is possible to learn to avoid factors that cause them.
• 
  If you are unable to find a connection it might be a good idea to show the diary to a doctor, who may be able to ask pertinent questions that will help identify a pattern.
  While each person will require their own form of treatment, generally over-the-counter pain relievers such as paracetamol (eg Panadol), aspirin (eg Aspro clear) and ibuprofen (eg Nurofen) are quite helpful in relieving the symptoms of tension-like headaches.
• Prescription medicines may be helpful for other types of headache pain such as chronic migraines.
• 
  In migraine, the most effective treatment is an explanation of the problem and identifying and avoiding trigger factors. There are various treatments available for relieving acute attacks, starting with over-the-counter painkillers such as paracetamol or ibuprofen. These are most effective if taken as early as possible into the attack, preferably in a soluble form.
• 
  Some OTC medicines designed specifically for migraine also contain an antisickness medicine such as buclizine. If OTC painkillers are ineffective your doctor may prescribe alternative treatments containing different antisickness medicines, stronger painkillers, or one of a group of antimigraine medicines called triptans, eg sumatriptan (Imigran) or zolmitriptan (Zomig).
• 
  Your doctor may prescribe a preventive treatment if migraine attacks are especially frequent. The strongest evidence for preventive treatment of migraine is available for sodium valproate (eg Epilim) (unlicensed use) and beta-blockers such as propranolol (eg Inderal LA).
• 
  For people experiencing burning sensations in the stomach or for those already diagnosed with a stomach ulcer, NSAIDs such as ibuprofen and medicines containing acetylsalicylic acid such as aspirin should be avoided. Aspirin should not be given to children under 16 years of age, unless on the advice of a doctor.
• 
  NOTE: The above mentioned medicines should not be given to children unless you are advised to do so by your GP.

What can you do to help yourself?

• 
  If the doctor has examined you without finding any serious cause for the headaches, these tips should prove helpful:
• 
  avoid excessive use of alcohol and tobacco.
• 
  engage in correct posture while sitting and working. The type of chair you use is important. It should be one that maximises comfort and good posture and may need to be adjusted to suit your needs.
• 
  perform relaxation techniques on a consistent basis.
• 
  get plenty of fresh air and exercise.
• 
  some people find that taking the natural herbal treatment Feverfew is very effective at reducing or preventing their headaches occurring. This needs to be taken daily – even if no headache is present – to have an effect. Consult your GP before starting this.
• 
  For migraine headaches, symptoms may be reduced by:
• 
  resting in a quiet room with the lights turned off.
• 
  avoiding food or drink in your diet that have been identified as having possible factors associated with migraine headaches.

How to cure a headache naturally:

• Headaches, as we all know, are a common occurrence. Especially in these day as the pace of business just seems to be getting faster and faster. It's very easy to just take an aspirin or ibuprofen and forget about it but that's not always the healthy thing to do. Headaches are usually the result of stress, dehydration, poor or shallow breathing and poor diet. Headaches can be quite the annoyance and usually show up at the worst time. If you can spare yourself five or ten minutes, you can cure your own headache and feel much better using this technique.

Instructions:

1. First things you can do is drink the water. Many times when we take a pill to relieve the headache we wash it down with a glass of water And it's actually the water that brings the relief first.
2. Next sit down in a comfortable spot if you can find one. Now you're going to close your eyes and take a deep breath.
3. As you breath in, imagine that you are breathing in fresh cool energy through the top of your head. Breath it down into the center of your body.
4. As you breath out, imagine the energy flowing out the bottom of your feet, flushing out and clearing the pain and stress from your body. Repeat this at least 5 times
   

Body Temperature

• There is no single number that represents a healthy or normal body temperature (normothermia or euthermia). When measured, the result will depend on what time of day it is and the activity that was done prior to measurement. Temperature readings can be taken orally, rectally or from under the arm. Measurements taken from body cavities are usually slightly higher than those that are taken orally. Measurements taken orally will also be slightly higher than those taken from the skin. The typical oral body temperature for healthy men and women is in Celsius is 34.4° , or in 94 ° Fahrenheit while normal internal temperature readings are accepted to be 36.1° C or 98.7° F.
• 

• Basal body temperature is the lowest temperature the body reaches during rest or sleep. It can be measured as soon as an individual has woken up and before any physical activity has taken place. Basal body temperature varies greatly in women during different pints in the meststrual cycle and can be used in family planning as an indicator of ovulation and peak days for conception.

• If the temperature of the body is found to be too high or too low, the person may be suffering from Hyperthermia or Hypothermia respectively or a fever. The body maintains a set temperature through regulation by the Hypothalamus (part of the brain that controls the body temperature). A raise in this set point results in a fever, which is usually an indicator or a disease or infection that the body is fighting. When the body temperature is raised without the consent of the hypothalamus, it is known as Hyperthermia.
• 
  
• Hyperthermia occurs when the body absorbs more heat than it is able to dissipate. It is usually brought about by lengthy exposure to high temperatures. The heat regulating mechanisms of the body will become overwhelmed and cause temperature to climb. Once the body reaches 40 C (104 F), immediate medical treatment is required. Symptoms of Hyperthermia include confusion, fatigue and headache and dry, red skin. Mild hyperthermia is known as heat exhaustion while severe hyperthermia is called heat stroke.
• Treatment for Hyperthermia involves rehydration and cooling the body. This can be achieved through moving out of direct sunlight indoors or into a shaded area, drinking water, removing articles of clothing that may be keeping heat on the body or simply washing exposed skin with cool water.
• Hypothermia occurs when body temperature falls below the norm that is needed for metabolic reactions and bodily functions to be carried out. It is usually a result of prolonged exposure to cold water or air.

Instruments for measuring body temperature

Glass or thermometers

These can be placed under the armpit or under the tongue to find measure body temperature. Breaking a glass thermometer in the couth can be dangerous as the contents (mercury or alcohol) can be poisonous.

Electronic thermometers

Are made from solid plastic and use a metallic sensor to measure temperature. They have a digital display field and are easy to read.

Plastic thermometer strip

Can be placed on the forehead to give local reading. This measurement can be affected by the surrounding temperature

Ear thermometers

Measure body temperature by using infrared head emission in the ear. This takes only one second making them very popular for use with children.

Blood

Blood is a liquid tissue. Suspended in the watery plasma are seven types of cells and cell fragments.

• red blood cells (RBCs) or erythrocytes
• platelets or thrombocytes
• five kinds of white blood cells (WBCs) or leukocytes
• Three kinds of granulocytes
  • neutrophils
  • eosinophils
  • basophils
• Two kinds of leukocytes without granules in their cytoplasm
• lymphocytes
• monocytes

Functions of the blood

Blood performs two major functions:

• transport through the body of
  • oxygen and carbon dioxide
  • food molecules (glucose, lipids, amino acids)
  • ions (e.g., Na⁺, Ca²⁺, HCO₃⁻)
  • wastes (e.g., urea)
  • hormones
  • heat
• defense of the body against infections and other foreign materials. All the WBCs participate in these defenses.

The formation of blood cells (cell types and acronyms are defined below)

All the various types of blood cells

• are produced in the bone marrow (some 10¹¹ of them each day in an adult human!).
• arise from a single type of cell called a hematopoietic stem cell — an "adult" multipotent stem cell.

These stem cells

• are very rare (only about one in 10,000 bone marrow cells);
• are attached (probably by adherens junctions) to osteoblasts lining the inner surface of bone cavities;
• express a cell-surface protein designated CD34;
• produce, by mitosis, two kinds of progeny:
  • more stem cells (A mouse that has had all its blood stem cells killed by a lethal dose of radiation can be saved by the injection of a single living stem cell!).
  • cells that begin to differentiate along the paths leading to the various kinds of blood cells.

Which path is taken is regulated by

• the need for more of that type of blood cell which is, in turn, controlled by appropriate cytokines and/or hormones.

For example, Interleukin-7 (IL-7) is the major cytokine in stimulating bone marrow stem cells to start down the "lymphoid" path leading to the various lymphocytes (mostly B cells and T cells).

Some of the cytokines that drive the differentiation of the "myeloid" leukocytes are

• Erythropoietin (EPO), produced by the kidneys, enhances the production of red blood cells (RBCs).
• Thrombopoietin (TPO), assisted by Interleukin-11 (IL-11), stimulates the production of megakaryocytes. Their fragmentation produces platelets.
• Granulocyte-macrophage colony-stimulating factor (GM-CSF), as its name suggests, sends cells down the path leading to both those cell types. In due course, one path or the other is taken.
• Under the influence of granulocyte colony-stimulating factor (G-CSF), they differentiate into neutrophils.
• Further stimulated by interleukin-5 (IL-5) they develop into eosinophils.
• Interleukin-3 (IL-3) participates in the differentiation of most of the white blood cells but plays a particularly prominent role in the formation of basophils (responsible for some allergies).
• Stimulated by macrophage colony-stimulating factor (M-CSF) the granulocyte/macrophage progenitor cells differentiate into monocytes, macrophages, and dendritic cells (DCs).

Red Blood Cells (erythrocytes)

The most numerous type in the blood.

• Women average about 4.8 million of these cells per cubic millimeter (mm³; which is the same as a microliter [µl]) of blood.
• Men average about 5.4 x 10⁶ per µl.
• These values can vary over quite a range depending on such factors as health and altitude. (Peruvians living at 18,000 feet may have as many as 8.3 x 10⁶ RBCs per µl.)

RBC precursors mature in the bone marrow closely attached to a macrophage.

• They manufacture hemoglobin until it accounts for some 90% of the dry weight of the cell.
• The nucleus is squeezed out of the cell and is ingested by the macrophage.
• No-longer-needed proteins are expelled from the cell in vesicles called exosomes.

This scanning electron micrograph shows the characteristic biconcave shape of red blood cells.

Thus RBCs are terminally differentiated; that is, they can never divide. They live about 120 days and then are ingested by phagocytic cells in the liver and spleen. Most of the iron in their hemoglobin is reclaimed for reuse. The remainder of the heme portion of the molecule is degraded into bile pigments and excreted by the liver. Some 3 million RBCs die and are scavenged by the liver each second.

Red blood cells are responsible for the transport of oxygen and carbon dioxide.

Oxygen Transport

In adult humans the hemoglobin (Hb) molecule

• consists of four polypeptides:
  • two alpha (α) chains of 141 amino acids and
  • two beta (β) chains of 146 amino acids
• Two each of these is attached the prosthetic group heme.
• There is one atom of iron at the center of each heme. [View]
• One molecule of oxygen can bind to each heme.

The reaction is reversible.

• Under the conditions of lower temperature, higher pH, and increased oxygen pressure in the capillaries of the lungs, the reaction proceeds to the right. The purple-red deoxygenated hemoglobin of the venous blood becomes the bright-red oxyhemoglobin of the arterial blood.
• Under the conditions of higher temperature, lower pH, and lower oxygen pressure in the tissues, the reverse reaction is promoted and oxyhemoglobin gives up its oxygen.

The pressure of oxygen in the lungs is 90–95 torr; in the interior tissues it is about 40 torr. Therefore, only a portion of the oxygen carried by the red blood cells is normally unloaded in the tissues. However, vigorous activity can lower the oxygen pressure in skeletal muscles below 40 torr, which causes a large increase in the amount of oxygen released. This effect is enhanced by the high concentration of carbon dioxide in the muscles and the resulting lower pH (7.2). The lower carbon dioxide concentration (and hence higher pH) at the lungs promotes the binding of oxygen to hemoglobin and hence the uptake of oxygen.

Temperature changes also influence the binding of oxygen to hemoglobin. In the relative warmth of the interior organs, the curve is shifted to the right (like the curve for pH 7.2), helping to unload oxygen. In the relative coolness of the lungs, the curve is shifted to the left, aiding the uptake of oxygen.

Carbon Dioxide Transport

Carbon dioxide (CO₂) combines with water forming carbonic acid, which dissociates into a hydrogen ion (H⁺) and a bicarbonate ions:CO₂ + H₂O ↔ H₂CO₃ ↔ H⁺ + HCO₃⁻

95% of the CO₂ generated in the tissues is carried in the red blood cells:

• It probably enters (and leaves) the cell by diffusion through the plasma membrane assisted by facilitated diffusion through transmembrane channels in the plasma membrane. (One of the proteins that forms the channel is the D antigen that is the most important factor in the Rh system of blood groups.)
• Once inside, about one-half of the CO₂ is directly bound to hemoglobin (at a site different from the one that binds oxygen).
• The rest is converted — following the equation above — by the enzyme carbonic anhydrase into
  • bicarbonate ions that diffuse back out into the plasma and
  • hydrogen ions (H⁺) that bind to the protein portion of the hemoglobin (thus having no effect on pH).

Only about 5% of the CO₂ generated in the tissues dissolves directly in the plasma. (A good thing, too: if all the CO₂ we make were carried this way, the pH of the blood would drop from its normal 7.4 to an instantly-fatal 4.5!)

When the red cells reach the lungs, these reactions are reversed and CO₂ is released to the air of the alveoli.

Anemia

Anemia is a shortage of

• RBCs and/or
• the amount of hemoglobin in them.

Anemia has many causes. One of the most common is an inadequate intake of iron in the diet.

White Blood Cells (leukocytes):

White blood cells

• are much less numerous than red (the ratio between the two is around 1:700);
• have nuclei;
• participate in protecting the body from infection;
• consist of lymphocytes and monocytes with relatively clear cytoplasm, and three types of granulocytes, whose cytoplasm is filled with granules.

Lymphocytes:

There are several kinds of lymphocytes (although they all look alike under the microscope), each with different functions to perform . The most common types of lymphocytes are

• B lymphocytes ("B cells"). These are responsible for making antibodies.
• T lymphocytes ("T cells"). There are several subsets of these:
  • inflammatory T cells that recruit macrophages and neutrophils to the site of infection or other tissue damage
  • cytotoxic T lymphocytes (CTLs) that kill virus-infected and, perhaps, tumor cells
  • helper T cells that enhance the production of antibodies by B cells

Although bone marrow is the ultimate source of lymphocytes, the lymphocytes that will become T cells migrate from the bone marrow to the thymus [View] where they mature. Both B cells and T cells also take up residence in lymph nodes, the spleen and other tissues where they

• encounter antigens;
• continue to divide by mitosis;
• mature into fully functional cells.

Monocytes:

Monocytes leave the blood and become macrophages and some types of dendritic cells.

This scanning electron micrograph (courtesy of Drs. Jan M. Orenstein and Emma Shelton) shows a single macrophage surrounded by several lymphocytes.

Macrophages are large, phagocytic cells that engulf

• foreign material (antigens) that enter the body
• dead and dying cells of the body.

Neutrophils:

The most abundant of the WBCs. This photomicrograph shows a single neutrophil surrounded by red blood cells.

Neutrophils squeeze through the capillary walls and into infected tissue where they kill the invaders (e.g., bacteria) and then engulf the remnants by phagocytosis.

This is a never-ending task, even in healthy people: Our throat, nasal passages, and colon harbor vast numbers of bacteria. Most of these are commensals, and do us no harm. But that is because neutrophils keep them in check.

However,

• heavy doses of radiation
• chemotherapy
• and many other forms of stress

can reduce the numbers of neutrophils so that formerly harmless bacteria begin to proliferate. The resulting opportunistic infection can be life-threatening.

Eosinophils:

The number of eosinophils in the blood is normally quite low (0–450/µl). However, their numbers increase sharply in certain diseases, especially infections by parasitic worms. Eosinophils are cytotoxic, releasing the contents of their granules on the invader.

Basophils:

The number of basophils also increases during infection. Basophils leave the blood and accumulate at the site of infection or other inflammation. There they discharge the contents of their granules, releasing a variety of mediators such as:

• histamine
• serotonin
• prostaglandins and leukotrienes

which increase the blood flow to the area and in other ways add to the inflammatory process. The mediators released by basophils also play an important part in some allergic responses such as

• hay fever and
• an anaphylactic response to insect stings.

Platelets:

Platelets are cell fragments produced from megakaryocytes.

Blood normally contains 150,000–400,000 per microliter (µl) or cubic millimeter (mm³). This number is normally maintained by a homeostatic (negative-feedback) mechanism [Link].

If this value should drop much below 20,000/µl, there is a danger of uncontrolled bleeding.

Some causes:

• certain drugs and herbal remedies;
• autoimmunity. [Link]

When blood vessels are cut or damaged, the loss of blood from the system must be stopped before shock and possible death occur. This is accomplished by solidification of the blood, a process called coagulation or clotting.

A blood clot consists of

• a plug of platelets enmeshed in a
• network of insoluble fibrin molecules.

Plasma:

Plasma is the straw-colored liquid in which the blood cells are suspended.

Composition of blood plasma

Component	Percent
Water	~92
Proteins	6–8
Salts	0.8
Lipids	0.6
Glucose (blood sugar)	0.1

Plasma transports materials needed by cells and materials that must be removed from cells:

• various ions (Na⁺, Ca²⁺, HCO₃⁻, etc.
• glucose and traces of other sugars
• amino acids
• other organic acids
• cholesterol and other lipids
• hormones
• urea and other wastes

Most of these materials are in transit from a place where they are added to the blood (a "source")

• exchange organs like the intestine
• depots of materials like the liver

to places ("sinks") where they will be removed from the blood.

• every cell
• exchange organs like the kidney, and skin.

Serum Proteins:

Proteins make up 6–8% of the blood. They are about equally divided between serum albumin and a great variety of serum globulins.

After blood is withdrawn from a vein and allowed to clot, the clot slowly shrinks. As it does so, a clear fluid called serum is squeezed out. Thus:

Serum is blood plasma without fibrinogen and other clotting factors.

The serum proteins can be separated by electrophoresis.

• A drop of serum is applied in a band to a thin sheet of supporting material, like paper, that has been soaked in a slightly-alkaline salt solution.
• At pH 8.6, which is commonly used, all the proteins are negatively charged, but some more strongly than others
  
• A direct current can flow through the paper because of the conductivity of the buffer with which it is moistened.
• As the current flows, the serum proteins move toward the positive electrode.
• The stronger the negative charge on a protein, the faster it migrates.
• After a time (typically 20 min), the current is turned off and the proteins stained to make them visible (most are otherwise colorless).
• The separated proteins appear as distinct bands.
• The most prominent of these and the one that moves closest to the positive electrode is serum albumin.
• Serum albumin
  • is made in the liver
  • binds many small molecules for transport through the blood
  • helps maintain the osmotic pressure of the blood
• The other proteins are the various serum globulins.
• They migrate in the order
• alpha globulins (e.g., the proteins that transport thyroxine and retinol [vitamin A])
• beta globulins (e.g., the iron-transporting protein transferrin)
• gamma globulins.
• Gamma globulins are the least negatively-charged serum proteins. (They are so weakly charged, in fact, that some are swept in the flow of buffer back toward the negative electrode.)
• Most antibodies are gamma globulins.
• Therefore gamma globulins become more abundant following infections or immunizations.

  If a precursor of an antibody-secreting cell becomes cancerous, it divides uncontrollably to generate a clone of plasma cells secreting a single kind of antibody molecule. The image shows — from left to right — the electrophoretic separation of:

1. normal human serum with its diffuse band of gamma globulins;
2. serum from a patient with multiple myeloma producing an IgG myeloma protein;
3. serum from a patient with Waldenström's macroglobulinemia where the cancerous clone secretes an IgM antibody;
4. serum with an IgA myeloma protein.
5. Gamma globulins can be harvested from donated blood (usually pooled from several thousand donors) and injected into persons exposed to certain diseases such as chicken pox and hepatitis. Because such preparations of immune globulin contain antibodies against most common infectious diseases, the patient gains temporary protection against the disease

Serum Lipids:

Because of their relationship to cardiovascular disease, the analysis of serum lipids has become an important health measure.

The table shows the range of typical values as well as the values above (or below) which the subject may be at increased risk of developing atherosclerosis.

LIPID	Typical values (mg/dl)	Desirable (mg/dl)
Cholesterol (total)	170–210
LDL cholesterol	60–140
HDL cholesterol	35–85	>40
Triglycerides	40–160

• Total cholesterol is the sum of
  • HDL cholesterol
  • LDL cholesterol and
  • 20% of the triglyceride value
• Note that
  • high LDL values are bad, but
  • high HDL values are good.
• Using the various values, one can calculate a
  cardiac risk ratio = total cholesterol divided by HDL cholesterol
• A cardiac risk ratio greater than 7 is considered a warning.

Nutrition (EAT HEALTHY)

• Eating healthy foods is one of the greatest ways you can live healthy and combat developing a disease. Some diseases are genetic and there's not much you can do about that. But others likeDiabetes 2, Lung Cancer, and Heart Disease and might be prevented with the proper diet. Below is a list of healthy foods and some of the body parts they affect.
• 

Boron (for Bones)

1. Boron Is a mineral that is important forcalcium absorption. For women, this mineral seems to play an important role in enhancing the activity of estrogen cells, which is important for the formation of strong bones.
2. Boron can be found in grapes, pears, apples, peas, broccoli, peanuts and raisins.

Vitamin C (for Skin)

1. Vitamin C helps the body make collagen (Collagen helps keep the skin firm), increases oxygen flow to the skin, heals scar tissue, cuts and bruises.
2. Vitamin C can be found in broccoli, strawberries, citrus fruits, green peppers, brussels sprouts, honeydew, and cantaloupe.

Omega 3 Essential Fatty Acids (for Heart)

1. Omega 3 Essential Acids lower the "bad" cholesterol levels, blood pressureand triglyceride levels while raising "good" cholesterol levels. This will help lower the risk for heart disease.
2. Omega 3 Essential Acids can be found in cold water fish such as salmon, mackerel and sardines.

Copper (for Joints)

1. Copper is a mineral that is essential for the functioning of an enzyme responsible for strengthening bones and joints.
2. Copper can be found in liver, seafood, nuts and seeds.

Acidophilus (for Vagina)

1. Acidophilus helps restore a natural balance between good and bad bacteria in the vagina, helping to ward off infection.
2. Acidophilus can be found in yogurt.
3. 

Zinc (for Ears)

1. Experts believe hearing loss associated with tinitis (ringing in the ears) may be linked to a zinc deficiency in the tissue of the inner ear.
2. Zinc can be found in oysters, chicken, beef and lamb.

Indole-3-Carbinol (for Breasts)

1. Indol-3-Carbinol is a naturally occurring phytochemical. Lab studies have found that it halts the growth of tumor cells (see cancer).
2. Indol-3-Carbinol can be found in broccoli, kale, cabbage and turnips.

Biotin (for Nails)

1. Biotin, also called B7 or vitamin H, helps correct dry, brittle nails by increasing their ability to absorb water.
2. Biotin can be found in eggs, fish, milk, cheese, whole-grain cereals, cabbage, and potatoes.

Amino Acids (for Hair)

1. The Amino Acids Cystine, methionine, and cysteine are very important for hair growth and repair.
2. Amino acids, the building blocks ofprotein can be found in chicken,turkey, beef, eggs, cheese and nuts.

Beta Carotene (for Eyes)

1. Beta Carotene is a vitamin that acts as an antioxidant. It breaks down cancer-causing chemicals that may damage eye tissues, and helps prevent macular degeneration and cataracts.
2. Beta Carotene can be found in carrots, sweet potatoes, broccoli and yams.

Calcium(For Gums, Teeth, Bones)

1. Calcium is a mineral that helps keep your teeth strong and white.
2. Calcium can be found in almonds, white beans, and milk.

Eating Light and Healthy:

• Eating light and healthy is a key component to better health. Below are some tools to help you eat light and healthy.
• 1. Eat a healthy breakfast. People who eat breakfast usually feel less hungry throughout the day. An example of a healthy breakfast is: 1 cup oatmeal, 1 ounce walnuts, and 1 ounce raisins.
  2. Drink a glass of water or tea before a meal. This will help you curb your appetite and cause you to eat less.
  3. Eat complex carbohydrates. Complex carbohydrates are low in fat, fast-burning, and rich in vitamins and minerals. Some examples of complex carbohydrates are: whole grain cereals, rice, bread, pasta, beans, nuts and some types of fruits and vegetables.
  4. Sit down while you eat. It is too easy to overeat while you are standing.
  5. Exercise. Exercise burns calories and suppresses your appetite.
  6. Don't give up! If you are having a hard time following good eating habits, continue to try. Hard work pays off!
  7. Think about eating light and healthy every day. The first couple days will be difficult, but once you've done it over and over again, it will become second nature and you will have an easier time eating healthy.
  8. There's no such thing as cheating. If you can't eat healthy and light everyday, think of the days that you eat 'unhealthy' as wandering and not cheating. Wandering is not wrong or bad. It is a normal way to eat.
  9. Eat less more often. If you eat less and more often, you won't feel like you are 'starving' yourself. The key words are 'eat less'.

Fever

What is a Fever?

• A fever is defined as a temperature 1° or more above the normal 98.6 degrees Fahrenheit (F) or 37 degrees Celsius (C). Mild or short-term elevations in body temperature are common with minor infections.
• High fevers, with temperatures of 103° and above, can signal a potentially dangerous infection. Contact your doctor in case of a high fever or if a lower fever doesn't resolve with simple treatments.
• Fever is a symptom of a disease or infection. It is not a disease. Fever helps the body fight infections by making the body's defense systems work more efficiently. Bacteria and viruses cannot live at higher temperatures and are killed by fever. If your child has a fever he will look hot and flushed, though may complain of feeling cold and be shivering.

What are the signs and symptoms of a Fever?

• There are different symptoms of a fever. The symptoms of a fever depends on what is causing it. Sometimes a fever can cause a chill. A chill occurs because when the brain raises the body's "thermostat," the body responds by shivering to raise the temperature. Shivering produces heat in the body. Once the temperature goes up, the person often feels warm. When the fever goes away, the person may start to sweat.

What causes a Fever?

• Fever can be caused by many conditions. Some conditions that cause them are: infections such asstrep throat, pneumonia, flu and chickenpox, tissue injuries, silicosis, tumors or cancer diseases that cause inflammation, rheumatoid arthritis,medications, and being in a hot environment for too long.

Risks during a Fever

• The main risk of mild or moderate fevers is dehydration. When a person has a fever, they need more fluids than usual. A fever greater than 106 degrees Fahrenheit can result in brain damage and possibly death. Fevers greater than 106 degrees are very unusual.

Why Drink Plenty of Fluids

• It is important to drink fluids when you have a fever. It is important because fever causes considerable fluid loss through the skin and perspiration. Because it is difficult to measure fluid loss, it is good to drink 1 to 2 quarts of extra fluid each day that you have a fever.

How are Fevers diagnosed?

• A thermometer is used to measure the body temperature. The temperature can be taken in the mouth, rectum, ear, or under the arm.

How are Fevers treated?

• Treatment is usually directed at whatever is causing the fever. Some steps that can help bring down a fever or comfort a person include the following: Acetaminophen or ibuprofen can help reduce a fever. Fevers greater than 106 degrees F are very serious. These high fevers need to be treated in the hospital. If you believe you may have a fever, please consult your doctor.

Can Fevers be prevented?

• Generally no.

Fever Seizures

• A child with a high fever may have a febrile seizure. Symptoms of a seizure include shaking or jerking of the arms and legs, a fixed stare or the eyes rolling back, drooling, heavy breathing, and the skin turning blue. If your child has a febrile seizure, contact your doctor immediately.

The majority of children with febrile seizures have rectal temperatures greater than 102 degrees F. Most febrile seizures occur during the first day of a child's fever. Children prone to febrile seizures are not considered to have epilepsy, since epilepsy is characterized by recurrent seizures that are not triggered by fever.

Blood Clotting

• When blood vessels are cut or damaged, the loss of blood from the system must be stopped before shock and possible death occur. This is accomplished by solidification of the blood, a process called coagulation or clotting.

A blood clot consists of :

• 
  a plug of platelets enmeshed in a


• 
  network of insoluble fibrin molecules.

Platelet aggregation and fibrin formation both require the proteolytic enzyme thrombin. Clotting also requires

• calcium ions (Ca2+)(which is why blood banks use a chelating agent to bind the calcium in donated blood so the blood will not clot in the bag).


• 
  about a dozen other protein clotting factors. Most of these circulate in the blood as inactive precursors. They are activated by proteolytic cleavage becoming, in turn, active proteases for other factors in the system.


• 
  By tradition, these factors are designated by Roman numerals. I find this somewhat confusing and will use Arabic numerals instead.

Initiating the Clotting Process:

• 
  Damaged cells display a surface protein called tissue factor (TF)


• 
  Tissue factor binds to activated Factor 7.


• 
  The TF-7 heterodimer is a protease with two substrates:
  Factor 10 and
  Factor 9


• 
  Let's follow Factor 10 first.


• 
  Factor 10 binds and activates Factor 5. This heterodimer is called prothrombinase because it is a protease that converts prothrombin (also known as Factor II) to thrombin.


• 
  Thrombin has several different activities. Two of them are:


• 
  proteolytic cleavage of fibrinogen (aka "Factor I") to form:
  soluble molecules of fibrin and a collection of small
  fibrinopeptides
  activation of Factor 13 which forms covalent bonds between the soluble fibrin molecules converting them into an insoluble meshwork — the clot.(Thrombin and activated Factors 10 ("Xa") and 11 ("XIa") are serine proteases.

Amplifying the Clotting Process:

• The clotting process also has several positive feedback loops which quickly magnify a tiny initial event into what may well be a lifesaving plug to stop bleeding.


• 
  The TF-7 complex (which started the process) also activates Factor 9.


• 
  Factor 9 binds to Factor 8, a protein that circulates in the blood stabilized by another protein, von Willebrand Factor (vWF).


• 
  This complex activates more Factor 10.


• 
  As thrombin is generated, it activates more
  Factor 5
  Factor 8, and


• 
  Factor 11 (all shown above with green arrows).


• 
  Factor 11 amplifies the production of activated Factor 9.


• Thus what may have begun as a tiny, localized event rapidly expands into a cascade of activity.

Platelets:

• Platelets are cell fragments produced from megakaryocytes. Blood normally contains 150,000 to 400,000 per microliter (µl). If this value should drop much below 20,000/µl, there is a danger of uncontrolled bleeding.


• This is because of the essential role of platelets
  in maintaining the integrity of the adherens junctions that provide a tight seal between the endothelial cells that line the blood vessels;


• 
  in forming a clot where blood vessels have been broken. When blood vessels are damaged, fibrils of collagen in the extracellular matrix (ECM) are exposed.


• Platelets then begin to adhere to the collagen through the action of
  specific receptors for collagen present on their plasma membrane
  von Willebrand factor which links the platelets to the collagen.


• 
  These actions cause a plug of platelets to form at the site.


• 
  The bound platelets release
  ADP and thromboxane A2, which recruit and activate still more platelets circulating in the blood. (This role of thromboxane accounts for the beneficial effect of low doses of aspirin — a cyclooxygenase inhibitor — in avoiding heart attacks.)


• 
  tissue factor :
  serotonin, which enhances their clumping and promotes constriction of the blood vessel.
  ReoPro® is a monoclonal antibody directed against platelet receptors.


• It inhibits platelet aggregation and appears to reduce the risk that "reamed out" coronary arteries (after coronary angioplasty) will plug up again.

Bleeding Disorders:

• A deficiency of a clotting factor can lead to uncontrolled bleeding.


• 
  The deficiency may arise because


• 
  not enough of the factor is produced or


• 
  a mutant version of the factor fails to perform properly




• Examples:


• von Willebrand disease (the most common)
  hemophilia A for factor 8 deficiency
  hemophilia B for factor 9 deficiency.
  hemophilia C for factor 11 deficiency


• In some cases of von Willebrand disease, either a deficient level or a mutant version of the factor eliminates its protective effect on factor 8.


• The resulting low level of factor 8 mimics hemophilia A.Why do all the human bleeding disorders involve factors in amplification pathways? Probably because they are the only deficiencies that can be tolerated. Loss of the genes for
  tissue factor or
  factor 7 in knockout mice is lethal.




• Hemophilia A and B:
  The genes encoding factors 8 and 9 are on the X chromosome. Thus their inheritance is X-linked.


• 
  Like other X-linked disorders, hemophilia A and B are found almost exclusively in males because they inherit just a single X chromosome, and if the gene for factor 8 (or 9) on it is defective, they will suffer from the disease.


• 
  Queen Victoria of the UK was a carrier of a mutant factor 9 gene and passed it on to several of her descendants. Link to a discussion and pedigree.


• 
  There are many different mutant versions of the genes for factors 8 and 9. Although some produce only a minor effect on the function of their protein, others fail to produce any functioning clotting factor.

Treating Hemophilia A and B:

• What can be done?


• 
  Factor 8 and 9 can be extracted from donated blood, usually pooled from several thousand donors, and purified. Injections of this material can halt episodes of bleeding in hemophiliacs and have allowed countless young men to live relatively normal lives.


• 
  However, in the early 1980s, blood contaminated with the human immunodeficiency virus (HIV) was unknowingly used to manufacture preparations of factors 8 and 9. In some areas, 90% or more of the hemophiliacs became infected by these contaminated preparations. Many have since died of AIDS.The future now looks brighter because:
  all donated blood is now tested to see if the donor has been infected with HIV (as well as hepatitis B and C);


• 
  plasma-derived preparations of factors 8 and 9 are now treated with heat and/or solvents to destroy any viruses that might be present;
  recombinant factor 8 and recombinant factor 9 made by genetic engineering are now available.


• 
  These recombinant factors are made by inserting the DNA encoding the human protein into mammalian cells grown in culture E. coli cannot be used because these factors are glycoproteins, and E. coli lacks the machinery to attach carbohydrate properly.


• 
  And the team that brought us Dolly reported in the 19 December 1997 issue of Science that they have succeeded in cloning female sheep transgenic for the human factor 9 gene. The human gene is coupled to the promoter for the ovine (sheep) milk protein beta-lactoglobulin. When the lambs mature, it is hoped that they will secrete large amounts of human factor 9 in their milk, which can then be purified for human therapy.


• 
  Several attempts have also been made to try to cure hemophilia by gene therapy. It is difficult to see how even the most worried critics of genetic engineering can fail to approve its potential to save the lives of thousands of hemophiliacs in the years to come.

Controlling Clotting:

• While the ability to clot is essential to life, the process must be carefully regulated. Inappropriate clot formation, especially in the brain or lungs, can be life-threatening.
  Antithrombin III:


• As its name suggests, this plasma protein (a serpin) inhibits the formation of thrombin.
  It does so by binding to and thus inactivating:
  prothrombin
  factor 9
  factor 10


• 
  Heparin is a mixture of polysaccharides that bind to antithrombin III, inducing an allosteric change that greatly enhances its inhibition of thrombin synthesis. Some surgical patients, especially those receiving hip or heart valve replacements, and people at risk of ischemic stroke (clots in the brain), are given heparin.
  Protein C
  With its many clotting promoting activities, it is probably no accident that thrombin sits at the center of the control mechanism.


• 
  Excess thrombin binds to cell-surface receptors called thrombomodulin.
  The resulting complex activates a plasma protein called Protein C and its cofactor Protein S.


• 
  Together these inhibit further thrombin formation
  directly — by inactivating Factor 5 and
  indirectly — by inactivating Factor 8.Some inherited disorders that predispose to spontaneous clots, especially in the leg veins:




• 
  inherited deficiency of Protein C or Protein S;


• 
  inherited mutation in the Factor 5 gene producing a protein that no longer responds to the inhibitory effect of Protein C.


• 
  Recombinant Protein C is now available to treat people threatened with inappropriate clotting, e.g., as a result of widespread infection (sepsis).

Vitamin K:

• Vitamin K is a cofactor needed for the synthesis (in the liver) of


• 
  factors 2 (prothrombin), 7, 9, and 10


• 
  proteins C and S


• So a deficiency of Vitamin K predisposes to bleeding.


• 
  Conversely, blocking the action of vitamin K helps to prevent inappropriate clotting.
  Warfarin (aka coumadin) is sometimes prescribed as a "blood thinner" because it is an effective vitamin K antagonist.


• (Warfarin is also used as a rat poison because it can cause lethal (internal) bleeding when eaten.)


• Dissolving clots:


• 
  Plasma contains plasminogen, which binds to the fibrin molecules in a clot. Nearby healthy cells release tissue plasminogen activator (TPA), which also binds to fibrin and, as its name suggests, activates plasminogen forming plasmin. Plasmin (another serine protease) proceeds to digest fibrin, thus dissolving the clot.


• 
  Recombinant human TPA is now produced by recombinant DNA technology. Injected within the first hours after a heart attack, it has saved many lives by dissolving the clot blocking the coronary artery and restoring blood flow before the heart muscle becomes irreversibly damaged. It is also used for people who suffer an ischemic stroke; that is, a clot in the brain. (It must not, of course, be used for hemorrhagic strokes, that is, a burst blood vessel!)


• Angiogenesis:
  Thrombin (as well as factors 7 and 10) promotes healing by stimulating the growth of new blood vessels at the site of damage.

Hepatitis

The word hepatitis simply means an inflammation of the liver without pinpointing a specific cause. Someone with hepatitis may:

• have one of several disorders, including viral or bacterial infection of the liver
• have a liver injury caused by a toxin (poison)
• have liver damage caused by interruption of the organ's normal blood supply
• be experiencing an attack by his or her own immune system through an autoimmune disorder
• have experienced trauma to the abdomen in the area of the liver

Hepatitis is most commonly caused by one of three viruses:

1. the hepatitis A virus
2. the hepatitis B virus
3. the hepatitis C virus

In some rare cases, the Epstein Barr Virus (which causesmononucleosis) can also result in hepatitis because it can cause inflammation of the liver. Other viruses and bacteria that also can cause hepatitis include hepatitis D and E, chickenpox, andcytomegalovirus (CMV).

Hepatitis A

In children, the most common form of hepatitis is hepatitis A (also called infectious hepatitis). This form is caused by the hepatitis A virus (HAV), which lives in the stools (feces or poop) of infected individuals. Infected stool can be present in small amounts in food and on objects (from doorknobs to diapers).

HAV is spread:

• when someone ingests anything that's contaminated with HAV-infected stool (this makes it easy for the virus to spread in overcrowded, unsanitary living conditions)
• in water, milk, and foods, especially in shellfish

Because hepatitis A can be a mild infection, particularly in children, it's possible for some people to be unaware that they have had the illness. In fact, although medical tests show that about 40% of urban Americans have had hepatitis A, only about 5% recall being sick. Although the hepatitis A virus can cause prolonged illness up to 6 months, it typically only causes short-lived illnesses and it does not cause chronic liver disease.

Hepatitis B
Hepatitis B (also called serum hepatitis) is caused by the hepatitis B virus (HBV). HBV can cause a wide spectrum of symptoms ranging from general malaise to chronic liver disease that can lead to liver cancer.

HBV spreads through:

• infected body fluids, such as blood, saliva, semen, vaginal fluids, tears, and urine
• a contaminated blood transfusion (uncommon in the United States)
• shared contaminated needles or syringes for injecting drugs
• sexual activity with an HBV-infected person
• transmission from HBV-infected mothers to their newborn babies

Hepatitis C
The hepatitis C virus (HCV) is spread by direct contact with an infected person's blood. The symptoms of the hepatitis C virus can be very similar to those of the hepatitis A and B viruses. However, infection with HCV can lead to chronic liver disease and is the leading reason for liver transplant in the United States.

The hepatitis C virus can be spread by:

• sharing drug needles
• getting a tattoo or body piercing with unsterilized tools
• blood transfusions (especially ones that occurred before 1992; since then the U.S. blood supply has been routinely screened for the disease)
• transmission from mother to newborn
• sexual contact (although this is less common)

Hepatitis C is also a common threat in kidney dialysis centers. Rarely, people living with an infected person can contract the disease by sharing items that might contain that person's blood, such as razors or toothbrushes.

Diagnosis

All of these viral hepatitis conditions can be diagnosed and followed through the use of readily available blood tests.

Signs and Symptoms

Hepatitis, in its early stages, may cause flu-like symptoms, including:

• malaise (a general ill feeling)
• fever
• muscle aches
• loss of appetite
• nausea
• vomiting
• diarrhea
• jaundice (a yellowing of the skin and whites of the eyes)

But some people with hepatitis may have no symptoms at all and may not even know they're infected. Children with hepatitis A, for example, usually have mild symptoms or have no symptoms.

If hepatitis progresses, its symptoms begin to point to the liver as the source of illness. Chemicals normally secreted by the liver begin to build up in the blood, which causes:

• jaundice
• foul breath
• a bitter taste in the mouth
• dark or "tea-colored" urine
• white, light, or "clay-colored" stools

There can also be abdominal pain, which may be centered below the right ribs (over a tender, swollen liver) or below the left ribs (over a tender spleen).

Contagiousness

• Hepatitis A, hepatitis B, and hepatitis C are all contagious.

The hepatitis A virus can be spread in contaminated food or water, as well as in unsanitary conditions in child-care facilities or schools. Toilets and sinks used by an infected person should be cleaned with antiseptic cleansers. People who live with or care for someone with hepatitis should wash their hands after contact with the infected person. In addition, when traveling to countries where hepatitis A is prevalent, your child should be vaccinated with at least two doses of the hepatitis A vaccine.

The hepatitis B virus can be found in virtually all body fluids, though its main routes of infection are through sexual contact, contaminated blood transfusions, and shared needles for drug injections. Household contact with adults with hepatitis B can put people at risk for contracting hepatitis. But frequent hand washing and good hygiene practices can reduce this risk.

All kids in the United States are routinely vaccinated against hepatitis B at birth and use of the hepatitis B vaccine can greatly decrease the incidence of this infection. Ask your doctor about this vaccine. Even adults can be vaccinated if they feel they're at risk.

The hepatitis C virus can be spread through shared drug needles, contaminated blood products, and, less commonly, through sexual contact. Although hepatitis C can be spread from a mother to her fetus during pregnancy, the risk of passing hepatitis C to the fetus isn't very high (about 5%). If you're pregnant, contact your doctor if you think you may have been exposed to hepatitis C.

Over the past several years, improved medical technology has almost eliminated the risk of catching hepatitis from contaminated blood products and blood transfusions. But as tattoos and acupuncture have become more popular, the risk of developing hepatitis from improperly sterilized equipment used in these procedures has increased. Shared needles in drug use and shared straws in cocaine use are two very common ways for hepatitis C to spread.

Prevention

In general, to prevent viral hepatitis you should:

• Follow good hygiene and avoid crowded, unhealthy living conditions.
• Take extra care, particularly when drinking and swimming, if you travel to areas of the world where sanitation is poor and water quality is uncertain.
• Never eat shellfish from waters contaminated by sewage.
• Remind everyone in your family to wash their handsthoroughly after using the toilet and before eating.
  
• Use antiseptic cleansers to clean any toilet, sink, potty-chair, or bedpan used by someone in the family who develops hepatitis.

Because contaminated needles and syringes are a major source of hepatitis infection, it's a good idea to encourage drug awareness programs in your community and schools. At home, speak to your child frankly and frequently about the dangers of drug use. It's also important to encourage abstinence and safe sex for teens, in order to eliminate their risk of hepatitis infection through sexual contact.

A hepatitis A vaccine is available to kids 12 months and older. In the past, the vaccine was only recommended to those at high risk for the disease (such as those who lived in or traveled to locations with high rates of HAV), but now the vaccine is available to anyone who desires immunity to hepatitis A.

If you're planning to travel abroad, consult your doctor in advance so you and your family have enough time to complete the required immunizations. The vaccine is especially useful for staff of child-care facilities or schools where they may be at risk of exposure.

There's also a hepatitis B vaccine, which should be given to both children and adults as part of routine immunization.

Unfortunately, there's no vaccine for hepatitis C — animal studies indicate that it may not be possible because the virus doesn't cause the kind of response that would be needed for a vaccine to be successful.

Duration

For viral hepatitis, the incubation period (the time it takes for a person to become infected after being exposed) varies depending on which hepatitis virus causes the disease:

• For hepatitis A, the incubation period is 2 to 6 weeks.
• For hepatitis B, the incubation period is between 4 and 20 weeks.
• For hepatitis C, it's estimated that the incubation period is 2 to 26 weeks.

Hepatitis A is usually active for a short period of time and once a person recovers, he or she can no longer pass the virus to other people. It's practically unheard for people to become chronic carriers of hepatitis A. Almost all previously healthy persons who develop hepatitis A will completely recover from their illness in a few weeks or months without long-term complications.

With hepatitis B, 85% to 90% of patients recover from their illness completely within 6 months, without long-term complications.

However, 75% to 85% of those who are infected with hepatitis C do not recover completely and are more likely to continue to have a long-term infection. People with hepatitis B (the percentage who don't recover completely) or hepatitis C who continue to be infected can go on to develop chronic hepatitis and cirrhosis of the liver (the chronic degeneration and disruption of the structure of the liver). Some people with hepatitis B or C may also become lifelong carriers of these viruses and can spread them to other people.

Treatment

When symptoms are severe or laboratory tests show liver damage, it's sometimes necessary for hepatitis to be treated in the hospital. Here's a quick look at the treatments available for the various hepatitis viruses:

• There are no medications used to treat hepatitis A because it's a short-term infection that goes away on its own.
• Hepatitis B can sometimes be treated using medications. Four drugs are approved for use in adults with hepatitis B, but there hasn't been enough research yet on their use in children. However, you can talk to your child's doctor about a drug that may be available in some centers on a research basis for children.
• The treatment of hepatitis C has improved significantly with the use of two medications, only one of which is approved for use in children. Another more effective drug isn't approved for children yet but is available for kids in some centers on a research basis. In those adults who've just been infected with hepatitis C (by accidental needle injury, for example), combination therapy with the two drugs is the treatment of choice and can eliminate the virus in about 50% of the people infected.

Children with mild hepatitis may be treated at home. Except for using the bathroom, they should rest in bed until the fever and jaundice are gone and their appetite is normal. Kids with a lack of appetite should try smaller, more frequent meals and fluids that are high in calories (like milkshakes). They should also eat healthy foods rich in protein and carbohydrates and drink plenty of water.

When to Call the Doctor

Call the doctor if your child:

• has symptoms of hepatitis
• attends a school or child-care facility where someone has hepatitis
• has been exposed to a friend or relative with the illness

If you have an older child who volunteers at a first-aid station, hospital, or nursing home, be sure that he or she is aware of proper safety procedures for preventing contact with blood or body fluids. You may also want to have your child immunized against the hepatitis B virus. Call your doctor if you believe your child may have been exposed to a patient with hepatitis.

If you already know your child has hepatitis, call your doctor if you notice any of the following symptoms, which may be signs of their liver condition worsening:

• confusion or extreme drowsiness
• skin rash
• itching

Also, monitor your child's appetite and digestive functions, and call the doctor if your child's appetite decreases, or if nausea, vomiting, diarrhea, or jaundice increase.