Scabies

The following is an article submitted by Dr Maria Callus. Dr Callus is a trainee in the Malta Specialist Training Programme in Family Medicine. She works at Mater Dei Hospital, Floriana Health Centre, and district clinics (bereġ).

Scabies is a skin disease caused by the tiny parasite Sarcoptes scabies.T he disease is usually transmitted by direct skin-to-skin contact, with a higher risk with  a prolonged contact. However it can also be transmitted from objects including bedding and clothing.

The female parasite burrows under the skin and begins laying eggs within 2-3hours and generally lays 2-3eggs per day. The eggs hatch into adult mites within 10 days.

Symptoms usually appear approximately 4 weeks from the time of contact. Signs and symptoms include intense itching and superficial burrows. Itching is usually made worse by warmth and is usually experienced as being worse at night. Affected areas usually include the hands, feet, wrists, elbows, back and external genitalia.

A number of medications are effective in treating scabies, however tretment often involves the entire household to prevent re-infection. Permethrin (a special shampoo) is the most effective treatment for scabies. It is applied from the neck downwards and left for 8 to 14 hours. It is then showered off in the morning. One application is usually sufficient for mild infecions. For moderate-to-severe infection, another dose is applied 7-14 days later.

Bedding and clothing should be washed and dried at very hot settings or dry-cleaned.

Complications are not common but may include secondary bacterial infections caused by aggressive scratching.

Dr M. Callus

References

http://www.cdc.gov/parasites/scabies/

http://www.mayoclinic.com/health/scabies/DS00451

http://www.aad.org/skin-conditions/dermatology-a-to-z/scabies/

Id-dimensja

Id-dimensja hija meta l-funzjoni tal-moħħ tmur lura b’mod ġenerali fuq perjodu ta’ żmien. Din taffettwa ir-raġunar u l-imġiba tal-individwu. Iktar ma jgħaddi ż-żmien iktar issir komuni, b’hekk madwar 35% tal-anzjani ta’ ’l fuq minn 85 sena eta’ għandhom xi forma jew oħra ta’ dimensja. Ħafna jassoċjaw id-dimensja mal-Alzheimer’s. Tajjeb li wieħed jgħid li l Alzheimer’s (li hi marda tan-nervituri tal-moħħ) hi biss waħda mill-kawżi tad-dimensja, kawżi oħrajn jinkludu problemi fiċ-ċirkolazzjoni tal-moħħ, problemi newroloġiċi fil-kontroll tal-muskoli, abbuż tal-alkoħol, tirojde taħdem bil-mod, nuqqas ta’ vitamina B12, u ‘mad cow disease’.

Kif jinduna wieħed li xi ħadd jiġi minnu (jew hu stess) jista’ jkollu l-bidu tad dimensja? Dawn li ġejjin huma l-iktar sinjali komuni ta’ din il-marda.

• Telf ta’ memorja, speċjalment dik riċenti. B’hekk jintesew konverżazzjonijiet li saru dakinhar jew il-ġurnata ta’ qabel jew fejn tpoġġa xi oġġett li jintuża spiss bħaċ-ċwievet.

• Problemi biex tinstab it-triq lura d-dar jew biex tinstab kamra partikulari fid-dar.

• Problemi biex jintgħarfu oġġetti jew persuni familjari (ma jagħrafx lil uliedu).

• Tibda tħawwad fil-kliem.

• Tmur lura fis-somom (ma tiħux biżżejjed flus biex tixtri).

• Jibda jsibha diffiċli jagħmel azzjonijiet sempliċi (per eż. jiftaħ bott bil-kamin).

• Diffikultà fl-ippjanar.

• Tibdil fil-personalità u burdati.

• Il-mod tal-irqad ma jibqax dak li kien (jista’ jżid jew jonqos).

• Iżid jew jonqos fl-aptit.

• Alluċinazzjonijiet (per eż. jisma’ ilħna).

Il-prevenzjoni tad-dimensja tinvolvi dieta bilanċjata, ħajja attiva kemm fiżikament u kif ukoll mentalment, u l-kontroll ta’ fatturi li jistgħu jġibu problemi ċirkolatorji (per eż. pressjoni għolja). Fir-rigward ta’ kura din tinvolvi kura ta’ fatturi li jistgħu ikunu qed iġibu id-dimensja, bħal pereżempju l-alkoħoliżmu jew mard tat-tirojde. Jeżistu wkoll mediċini speċifiċi għad-dimensja nnifisha, liema mediċini però l-għan tagħhom hu li jrażżnu id-dimensja. Sfortunatament ħafna drabi ladarba id-dimensja tkun qabdet l-individwu, din ma titilqux. Għalhekk importanti ħafna l-għajnuna ta’ qraba, ħbieb, għaqdiet volontarji u servizzi soċjali.


Dr A. Cordina