Antihistamines are medications used to treat allergic reactions. Antihistamines work by antagonizing the histamine receptors in order to prevent the binding of histamine in the histamine receptors; thereby preventing the effects of histamine in the inflammatory cascade.

Antihistamine is the usual first line of drug in the treatment of most allergic reactions. Aside from its anti allergy effects, antihistamines may be used for antihistamine side effects such as sedating pediatric clients.

Uses of Antihistamines

Antihistamines are used for the following indications:

1. Rhinitis (with symptoms of watery eyes, stuffy nose, sneezing, etc.)
2. Sinusitis
3. Seasonal allergies
4. Hay fever
5. Skin allergies brought by contact dermatitis
6. Food allergies
7. Insomnia
8. Pediatric sedation
9. Preparation for deworming to prevent the inadvertent movement of Ascaris into the lungs and other openings in the body.

Antihistamine Side effects

Antihistamine side effects are related to the antagonistic activity of the drugs to histamine and receptor sites. Antihistamine side effects are relatively mild, but some may require interventions. Antihistamine side effects include:

1. Drowsiness

Drowsiness is the most common antihistamine side effect. Drowsiness is related to the poor binding of histamine in the brain thereby leading to sedation also because of blocking the acetylcholine receptor sites. When acetylcholine does not bind to receptor sites, the nerve impulses tend to be limited, leading to sedation.

Make sure to avoid taking antihistamine in times when concentration is needed such as when driving, operating machineries and the like. In case antihistamine is needed, never drive or operate. Also, take at bedtime to prevent sleepiness during the day. Because of possible drowsiness as antihistamine side effect, physicians also prescribe antihistamines for treating insomnia.

2. Dry mouth and nose

Dry mouth and nose is related to the anticholinergic activity of antihistamines. The cholinergic receptors are responsible for the moisture of the mucous membranes.

3. Nausea and vomiting

The side effects of blocking the acetylcholine receptors also lead to blocking of the functions in the smooth muscles in the stomach leading to stomach upset.

4. Dizziness

Dizziness as antihistamine side effects may also be related to the impaired nerve impulse transmission in the brain as a result of blocking the acetylcholine receptor sites.

5. Difficulty in urination

The acetylcholine receptors are also found in the bladder, which allows the smooth muscles to contract and assist in urination. When acetylcholine is not used, it leads to poor contraction of the smooth muscles in the bladder, leading to difficulty of urination and urinary retention as antihistamine side effects.

6. Constipation

Constipation is another potential antihistamine side effect because of the inhibition of acetylcholine in the gut.

7. Blurred vision

Blurred vision is a result of the inhibition in the nerve impulses from the optic nerve to the brain, which leads to poor vision as antihistamine side effect.

8. Restlessness

Restlessness may also be an antihistamine side effect because of imbalanced nerve impulse transmission in the brain. Restlessness may be especially apparent in children and infants taking antihistamines.

9. Confusion and impaired concentration

These antihistamine side effects may be linked to the limited activity of acetylcholine in the brain leading to slowed nerve impulse transmission. Patients taking antihistamines may experience difficulty concentrating and confusion, which makes it unsafe to use in people who drive or operate heavy machineries.

10. The antihistamine side effects tend to be mild and can be managed accordingly. Patients needing antihistamines may reduce antihistamine side effects by choosing new generations, which produce less side effect. It is also important to change antihistamine type every three months to prevent possible drug tolerance.

Aloe vera is a natural herb, which contains essential substances: latex and gel, used for their medicinal purposes. Aloe latex is the yellow component found just under the skin of the aloe plant. The aloe gel is the clear, jelly-like component of the plant. Aloe vera is manufactured into oral preparations as juice or skin applications.

Aloe Vera Uses

Aloe vera gel and latex oral preparations are used for the management of certain conditions such as:

• Osteoarthritis
• Fever
• Itching
• Inflammatory bowel disorders such as ulcerative colitis
• General tonic
• Peptic ulcers
• Diabetes
• Asthma
• Prevention of radiation side-effects
• Constipation
• Colds
• Epilepsy
• Depression
• Varicose veins
• Hemorrhoids
• Vision problems including glaucoma

Aloe vera gel skin preparations are used for certain skin conditions such as:

• Sunburn
• Burns
• Frostbite
• Cold sores
• Psoriasis
• Bed sore treatment
• Surgical wound healing

The use of aloe vera food supplements is generally safe and does not produce side effects similar to those of apple cider vinegar. However, studies have shown that taking aloe vera latex in high doses may lead to potential side effects.

Aloe Vera juice side effects

The side effects from taking aloe vera juice are largely dependent on the aloe vera latex. The aloe vera gel rarely causes any side effects, but the presence of aloe vera latex may lead to some. Aloe Vera juice side effects may include:

1. Burning of the skin

Burning of the skin is a localized side effect which may result from using skin applications of aloe vera juice. This may occur when the skin is not cleaned before the application of another layer of the aloe vera juice.

2. Itching

Itching is also a possible local reaction of the skin following the application of aloe vera. This is not related to any allergic reaction because people with no allergies to aloe vera may still experience this aloe vera juice side effect.

3. Stomach pain or abdominal cramps

Patients who are taking large amounts of aloe vera juice daily may experience abdominal disturbances.

4. Allergic reactions

Those people allergic to plants belonging in the Liliaceae family such as tulips, lilies, hyacinths, onions, and garlic may also be allergic to aloe vera and experience allergic reactions.

5. Diarrhea

Diarrhea is also a common aloe vera juice side effect and people who take large daily doses of aloe vera juice may experience this.

6. Kidney Problems

Kidney problems may result as a side effect, as a result of the ingestion of the latex component of aloe vera, which is harmful for the kidneys.

7. Hematuria

Hematuria, or blood in the urine, may also be an aloe vera juice side effect and may be a sign of kidney problem.

8. Liver problems

Although rare, this aloe vera juice side effect may occur when aloe latex is taken, especially in excessive amounts.

9. Hypokalemia

Problems in the kidneys may reduce the level of potassium in the blood. Potassium is very important in nerve impulse transmission, especially in the heart.

10. Muscle weakness

Weakness of the muscles may also develop as a side effect of aloe vera juice. This is a result of reduced potassium in the blood. Potassium is responsible for the nerve impulse transmission required for muscle contraction.

11. Weight loss

People experiencing recurrent diarrhea, as a result of taking aloe vera juice, may experience sudden weight loss.

12. Heart problems

Changes in potassium levels in the blood may lead to cardiac arrhythmias that are potentially life-threatening. Cardiac arrhythmias may be the most severe side effect produced by aloe vera juice because of aloe vera latex.

In addition, taking aloe latex of 1 gram per day for several days may be fatal for people. Patients who would like to take aloe vera juice should carefully review the indications and the dosage in order to prevent these aloe vera juice side effects.

What is Cervical Erosion?

Cervical Erosion or medically known as cervical ectropion (ectropy) is a condition wherein the endocervix protrudes out through the external os. The outer portion of the cervix is lined by simple squamous epithelium, whereas the inner part is lined with columnar epithelium. The protrusion of the columnar epithelium marks cervical erosion. Cervical cells also undergo squamous metaplasia and changes from simple squamous into stratified squamous epithelium. In more simple terms, changes happen in cell characteristics of the cervix making the cervix appear protruded.

Cervical erosion is not a form of cervical cancer, but the symptoms are similar to early stage of cervical malignancy. Cervical erosion is a normal change in the cervix, but may appear inflamed, red and seems eroded although there is no actual erosion of the cervix. The term erosion is only used to describe the change in the cervix.

Because it is likened to cervical cancer, further tests should be done to rule out any malignancy.

Pathogenesis of Cervical erosion

At a young age, the cervix is lined by simple squamous epithelium. Increase in estrogen during puberty, intake of contraceptive pill and pregnancy opens the cervical os and exposes the endocervical columnar epithelium on the cervical opening. When this happens, the endocervix is exposed to the acidic environment of the vagina, causing the cells to undergo metaplasia and changes it into stratified squamous epithelium.

Symptoms

Most women do not have symptoms of cervical erosion. As discussed, cervical erosion is not an abnormality, but is sometimes associated with the following symptoms:

1. Excessive, non-purulent discharge from the vagina because of exposure of mucus secreting glands located in the columnar epithelium
2. Post-coital bleeding or bleeding after sexual intercourse because of trauma to the blood vessels located in the columnar epithelium. Pregnant women complaining of vaginal spotting or bleeding should be asked for sexual intercourse for the past twelve hours. Bleeding may be a result of injury to the ectropion and not actually a sign of threatened abortion.
3. Bleeding between periods
4. Non-foul smelling, clear to yellowish, slippery vaginal discharge
5. Some women may experience backache
6. Internal examination may reveal a bright red external os and soft to granular texture upon palpation.

These symptoms are not of any concern. However, during infection of the reproductive organs, a woman may experience foul-smelling and purulent discharges not associated with cervical erosion.

Causes of cervical erosion

Cervical erosion is not an abnormal condition. Reasons for ectropy are due to increase in estrogen levels as seen in:

Puberty

Puberty starts the menstrual cycle of a young woman. During this time, estrogen levels increase leading to changes in cervical characteristics.

Oral Contraceptive Pill Intake

Contraceptive pills contain small amounts of progesterone and estrogen to prevent ovulation. The presence of estrogen leads to erosion.

Pregnancy

Estrogen levels increase dramatically during pregnancy for the growth and protection of the fetus. Cervical erosion usually disappears six months after delivery.

Hormone Replacement Therapy

Estrogen administration during menopause may also lead to cervical erosion because of high levels of estrogen in the body.

However, some reasons not associated with increased estrogen levels also lead to cervical erosion such as:

Fetal exposure to estrogen

Persistence of squamous columnar epithelium and squamous epithelium junction happens during intrauterine life because of exposure of the fetus to high levels of maternal estrogen. About 30% of female babies may experience it. It disappears while the child is growing up. But puberty again increases the risk of developing it.

Trauma

Sexual intercourse causes trauma and scarring to the cervix leading to cervical ectropy. Frequent use of tampons may also irritate the external cervical os.

Mucopurulent Cervicitis

Excessive secretion of discharges due to inflammation of the cervix increases the size of the cervical ectropion.

Infection

Presence of sexually transmitted diseases such as syphilis or herpes may lead to cervical metaplasia. However, recent studies have shown that infections do not lead to erosion; rather, cervical erosion increases the risk for infection because the cells in the cervix are more sensitive than before.

Diagnosis of cervical erosion

To rule out presence of malignancy, certain tests such as Pap smear and cervical biopsy can be done. Pap smears and biopsies determine the characteristics of the cells in the cervix and may show stratified squamous epithelium as a sign of cervical erosion. Colposcopy is also done to visualize the cervical area. In addition, physical examination of the cervix such as palpation is done to further characterize the texture of the cervical erosion.

Treatment of cervical erosion

Since cervical erosion is not a disease, it does not require treatment. However, bleeding after sexual intercourse or presence of mucopurulent discharge may be disturbing to some women. In these cases, certain managements can be done. The following outlines the most common management for cervical erosion:

Discontinue Oral Contraceptive Pills

Managing the cause involves removing the underlying cause such as the use of estrogen pills. Other forms of contraception may be used according to client preference and suggestion of the gynecologist.

Ablation Therapy

Ablation therapy focuses on destroying the columnar cervical cells. This will allow the simple squamous cell to grow in replacement of the destroyed cells. This treatment involves the use of a heated probe to destroy up to four mm of the stratified epithelium. Local anesthetics are placed prior to the ablation.

Ablation therapy may include the following procedures:

1.Electrocautery

The cervical cells are destroyed by using high temperature produced by electricity on a needle-like instrument.

2.Diathermy

The cervical os is exposed to high temperatures to damage the cells.

Cryocautery

The cervix is exposed to extremely cold temperatures to destroy the cells. Application of cold nitrous oxide gas is usually performed.

Antibiotics

In the presence of infection, antibiotic therapy is prescribed.

In cases of any malignancy, conization of the cervix and removal of the uterus (if affected) is done. These procedures are for presence of malignancy only and it should be known that cervical erosion is not a malignancy.

Post-operative Management of Cervical Erosion

The site of cautery or ablation heals at an average of five to eight weeks. During this time, the patient should be advised to avoid sexual contact until the surgical site has completely healed. Use of tampons and vaginal douches should also be avoided. The patient is also advised to return for follow-up check-up for re-assessment.

Gallbladder removal or medically known as cholecystectomy has been one of the most common surgical procedure because of increasing number of people suffering from gallbladder and liver problems. Along with gallbladder surgery, gallbladder removal side-effects may be one of the concerns of patients undergoing it. Having knowledge about the surgery as well as the side-effects of the procedure usually helps in relieving anxiety and increase the confidence of people undergoing cholecystectomy.

Cholecystectomy is a surgical procedure involving the removal of the gallbladder. The gallbladder is responsible for storing bile that is produced by the liver. When a person takes in food that contains fats, the gallbladder contracts in order to release bile in the duodenum. Bile is very important in the digestion of fats. Without it, there may be fat indigestion and other problems related to it. The gallbladder is a pear shaped organ that is connected to the liver and to the duodenum by the bile ducts. In cases that stones have formed in the gallbladder, the stones obstruct the flow of bile as well as causing inflammation in the gallbladder leading to severe epigastric pain that may radiate to the back. The presence of gallstones and inflammation of the gallbladder requires surgical removal in order to relieve intense pain. These conditions are not easily treated using medical interventions, so surgical intervention is the treatment of choice.

Gallbladder removal may involve open surgery or laparoscopic surgery. Generally, laparoscopic surgery is less invasive because only small incisions are done rather than a large incision on the abdomen. Laparoscopic surgery may also have fewer initial side-effects than open cholecystectomy. Nevertheless, when the gallbladder is removed, it usually produces various gallbladder removal side effects.

Gallbladder Removal Side effects

1. Pain

The initial gallbladder removal side effect is the occurrence of pain. During the surgical procedure, an incision is made on the skin as well on the adjacent tissues in order to remove the organ. Because of the tissue injury, the inflammatory response is initiated leading to pain, swelling and redness. Pain is usually managed by administering pain medications at regular intervals until the patient no longer complain of pain. Pain is usually managed because the presence of pain may limit the breathing of the patient.

2. Bloating and Abdominal Distention

These are common gallbladder removal side effects as a result of laparoscopic surgery. During surgery, carbon dioxide is pumped on the abdominal cavity like a balloon in order to have better visualization of the abdomen. The carbon dioxide pumped normally causes bloating and distention, but it usually disappears in a few hours to days.

3. Shortness of Breath

After surgery, lung expansion and diaphragmatic descent normally compress the abdominal cavity that may lead to intensified pain on the surgical site. Because of this, patients limit their breathing in order to prevent pain. In order to address this, patients are taught on proper splinting of the incision site during deep breathing exercises.

4. Indigestion

Indigestion is also a common gallbladder removal side effect. This results because of the absence of adequate amount of bile to digest fats. Fats are very difficult to digest and it may lead to indigestion. Indigestion usually manifests as abdominal pain, diarrhea, nausea and vomiting. In order to prevent this, patients should be cautious in their food intake avoiding fatty foods. Other irritating foods such as caffeine should also be avoided in order to prevent further irritation of the gut. Guarana is a specific herb that contains high amounts of caffeine that may lead to guarana side effects such as abdominal pain in cases of gallbladder removal.

5. Diarrhea

Diarrhea is also a common gall bladder side effect as a result of absence of bile that digests the fats when it is needed because bile constantly is released in the intestines. Patients are instructed to assume a low fat diet in order to prevent diarrhea.

6. Irritable Bowel syndrome

Since bile is no longer stored in the gallbladder, the bile from the liver is continuously released into the intestines. Because of this, the gut is constantly irritated even in the absence of food leading to recurrent diarrheal episodes.

Before undergoing the procedure, patients should be taught on these various gallbladder removal side effects in order for them to assume a proper lifestyle as soon as the gallbladder is removed.