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Saturday, 30 November 2013

Shingles - The Diagnosis and Do's and Do not's list

Shingles also known as herpes zoster or zona is defined as a viral disease with condition of a painful, blistering skin rash on one side of the body of  that can continue to be painful even after the rash have long disappeared(1), as a result of varicella-zoster viral causes of a nerve and skin inflammation.
Diagnosis
Diagnosis are depending to the rash location if it is in one side of the body and erupts along one of the many nerve paths in cells of the dorsal root ganglion with the emphasis on early treatment, may reduce the severity of a shingles attack and reduce the incidence of complications. The confirmation of the diseases may be included sharp and burning pain, history of chickenpox or chickenpox vaccinr, the patient is over 50 years of age, etc.
Other researchers supported the potential of developing FTIR microspectroscopy as a simple, reagent free method for the early detection and accurate differentiation of different stages during the development of herpes virus infection(12)

V. Prevention
A. The Do's and Do not's list 
1. Unhealthy diet
Unhealthy diet such as American typical diet can cause imbalance of nutrients in the body of that can lead to nutrient deficiencies with excessed fat building up. Aging is associated with declined immune function, particularly T cell-mediated activity, which contributes to increased morbidity and mortality from infectious disease and cancer in the elderly. Studies have shown that nutritional intervention may be a promising approach to reversing impaired immune function and diminished resistance to infection with aging(13) of that can lead to immune deficiency causes of shingle.

2. Smoking
Even though there are no direct evidence the smoking can caused increased risk of shingle, but some researchers suggested that there is an association between cigarette smoking and the depression of immune function by studies of 35 subjects before, and three months after, they had ceased to smoke cigarettes. The studies included tests of natural killer cell (NK) activity against several target cells and the measurement of immunoglobulin levels in sera and saliva. Similar tests were conducted on 29 control subjects who continued to smoke. The results indicated a significant decrease in lymphocyte counts and a significant increase in NK activity against cultured melanoma cells in subjects who ceased smoking(14)

3. Excessive alcohol drinking
Long-term alcohol consumption leads to altered inflammatory cell and adaptive immune responses with associated pathologies and increased incidence of infections(15). 

4. Take your vaccine
The zoster vaccine was approved by the US Food and Drug Administration in 2006 and is indicated for prevention of herpes zoster in immunocompetent persons aged 60 years and older. The herpes zoster vaccine provides physicians with an effective means for reducing a patient's risk for developing shingles and its attendant complications. No significant safety concerns regarding the vaccine have been identified. Indications for use of the attenuated-virus vaccine in special subpopulations continue to evolve(16). Others suggested that Zoster vaccine recipients who developed herpes zoster had a shorter illness duration and severity than placebo recipients who developed herpes zoster. Zoster vaccine had continuing efficacy in a Shingles Prevention Study subpopulation followed for 7 years post-vaccination. Zoster vaccine was generally well tolerated in older adults. In older adults, the zoster vaccine has the potential to significantly reduce the herpes zoster burden of illness by decreasing the incidence of herpes zoster or reducing its severity(17).

5. Avoid contact to people with chickenpox
If you have not had chickenpox before, exposed yourself to people who have chickenpox can cause increased risk of Shingles.

6. Eat your fruits and vegetable
Fruits and vegetables contain high amount of nutrients and antionxidants of which can increase the function of immune system in fighting not only the forming of free radicals but also viral and bacterial causes of infection and inflammation.

7. Moderate exercise
Extreme exercise can weaken the immune system, but  moderate exercise enhance them. Clinical data support the concept that heavy exertion increases the athlete's risk of URTI because of negative changes in immune function and elevation of the stress hormones, epinephrine, and cortisol. On the other hand, there is growing evidence that moderate amounts of exercise may decrease one's risk of URTI through favorable changes in immune function without the negative attending effects of the stress hormones(18).

8. Relaxation
Stress is often associated with an increased occurrence of autonomic, cardiovascular, and immune system pathology. Dr. Gopal A, and the team at the Lady Hardinge Medical College in the study of sixty first-year MBBS students randomly assigned to yoga group and control group (30 each). The yoga group underwent integrated yoga practices for 35 minutes daily in the presence of trained yoga teacher for 12 weeks. Control group did not undergo any kind of yoga practice or stress management, showed that Yoga resists the autonomic changes and impairment of cellular immunity seen in examination stress(19)

9. Etc. 

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/16936604
(12) http://www.ncbi.nlm.nih.gov/pubmed/21611647 
(13) http://www.ncbi.nlm.nih.gov/pubmed/22500273
(14) http://www.ncbi.nlm.nih.gov/pubmed/6633406
(15) http://www.ncbi.nlm.nih.gov/pubmed/20020329 
(16) http://www.ncbi.nlm.nih.gov/pubmed/18166463 
(17) http://www.ncbi.nlm.nih.gov/pubmed/20104941 
(18) http://www.ncbi.nlm.nih.gov/pubmed/8164529 
(19) http://www.ncbi.nlm.nih.gov/pubmed/21654972