Tonsilitis

Tonsillitis is inflammation of the tonsils, typically of rapid onset.^[1] It is a type of pharyngitis.^[7] Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and large lymph nodesaround the neck.^[1] Complications include peritonsillar abscess.^[2]

Tonsillitis is most commonly caused by a viral infection, with about 5% to 40% of cases caused by a bacterial infection.^[4][5] When caused by the bacterium group A streptococcus, it is referred to as strep throat.^[8] Rarely bacteria such as Neisseria gonorrhoeae, Corynebacterium diphtheriae, or Haemophilus influenzae may be the cause.^[4] Typically the infection is spread between people through the air.^[5] A scoring system, such as the Centor score, may help separate possible causes.^[4] Confirmation may be by a throat swab or rapid strep test.^[4]

Treatment efforts involve improving symptoms and decreasing complications.^[4] Paracetamol (acetaminophen) and ibuprofen may be used to help with pain.^[4] If strep throat is present the antibiotic penicillinby mouth is generally recommended.^[4] In those who are allergic to penicillin, cephalosporins or macrolides may be used.^[4] In children with frequent episodes of tonsillitis, tonsillectomy modestly decreases the risk of future episodes.^[9]

About 7.5% of people have a sore throat in any three-month period and 2% of people visit a doctor for tonsillitis each year.^[6] It is most common in school aged children and typically occurs in the fall and winter months.^[4][5] The majority of people recover with or without medication.^[4]In 40% of people, symptoms resolve within three days, and in 80% symptoms resolve within one week, regardless of if streptococcus is present.^[3] Antibiotics decrease symptom duration by approximately 16 hours.^[3]

Typhoid fever

Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms.^[3] Symptoms may vary from mild to severe and usually begin six to thirty days after exposure.^[1][2]Often there is a gradual onset of a high fever over several days.^[1]Weakness, abdominal pain, constipation, and headaches also commonly occur.^[2][6] Diarrhea is uncommon and vomiting is not usually severe.^[6]Some people develop a skin rash with rose colored spots.^[2] In severe cases there may be confusion.^[6] Without treatment, symptoms may last weeks or months.^[2] Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others.^[4]Typhoid fever is a type of enteric fever along with paratyphoid fever.^[3]

The cause is the bacterium Salmonella Typhi, also known as Salmonella enterica serotype Typhi, growing in the intestines and blood.^[2][6] Typhoid is spread by eating or drinking food or water contaminated with the fecesof an infected person.^[4] Risk factors include poor sanitation and poor hygiene.^[3] Those who travel to the developing world are also at risk^[6]and only humans can be infected.^[4] Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow.^[2][3][5] Culturing the bacterium can be difficult.^[10] Bone marrow testing is the most accurate.^[5] Symptoms are similar to that of many other infectious diseases.^[6] Typhus is a different disease.^[11]

A typhoid vaccine can prevent about 30% to 70% of cases during the first two years.^[7] The vaccine may have some effect for up to seven years.^[3]It is recommended for those at high risk or people traveling to areas where the disease is common.^[4] Other efforts to prevent the disease include providing clean drinking water, better sanitation, and better handwashing.^[2][4] Until it has been confirmed that an individual's infection is cleared, the individual should not prepare food for others.^[2] Treatment of disease is with antibiotics such as azithromycin, fluoroquinolones or third generation cephalosporins.^[3] Resistance to these antibiotics has been developing, which has made treatment of the disease more difficult.^[3]

In 2015, there were 12.5 million new cases worldwide.^[8] The disease is most common in India.^[3] Children are most commonly affected.^[3][4] Rates of disease decreased in the developed world in the 1940s as a result of improved sanitation and use of antibiotics to treat the disease.^[4] Each year in the United States, about 400 cases are reported and it is estimated that the disease occurs in about 6,000 people.^[6][12] In 2015, it resulted in about 149,000 deaths worldwide – down from 181,000 in 1990 (about 0.3% of the global total).^[9][13] The risk of death may be as high as 20% without treatment.^[4] With treatment, it is between 1 and 4%.^[3][4] The name typhoid means "resembling typhus" due to the similarity in symptoms.^[14]

Knee Replacement

Knee replacement, also known as knee aplasty , is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis,^[1] and also for other knee diseases such as rheumatoid arthritis and psoriaticarthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long-standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement

Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly.

Knee replacement surgery can be performed as a partial or a total knee replacement.^[2] In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.

The operation typically involves substantial postoperative pain, and includes vigorous physical rehabilitation. The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility.^[3]

Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes mellitusand is a leading cause of blindness.^[1]

It affects up to 80 percent of people who have had diabetes for 20 years or more.^[2] At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes.^[3] The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy.^[4] Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years.^[5]

Diabetes Mellitus

Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.^[7] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.^[2] If left untreated, diabetes can cause many complications.^[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.^[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.^[2]

Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.^[8]There are three main types of diabetes mellitus:^[2]

• Type 1 DM results from the pancreas's failure to produce enough insulin.^[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".^[2] The cause is unknown.^[2]
• Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.^[2] As the disease progresses a lack of insulin may also develop.^[9] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".^[2] The most common cause is excessive body weight and insufficient exercise.^[2]
• Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.^[2]

Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.^[2]Control of blood pressure and maintaining proper foot care are important for people with the disease.^[2] Type 1 DM must be managed with insulin injections.^[2] Type 2 DM may be treated with medications with or without insulin.^[6] Insulin and some oral medications can cause low blood sugar.^[10] Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM.^[11] Gestational diabetes usually resolves after the birth of the baby.^[12]

Diabetes