Night shifts may be responsible for your sleep disorder 

if you are a doctor ,policeofficer ,factory woorker or anyone have to work night shifts or rotating shifts you are unfortunately exposed to have work shift sleep disorder. 

generally not all who work night or rotating shifts suffer from this disorder but whom suffer from it are at higher risk of accidents due to the lack of sleep &concentration ,lack of energy .be more irritable &anxiety and affects the body overall health condition. 

signs of work shift sleep disorder 

feeling redundant desire to sleep during your work time . 

insomnia and unable to fall asleep when back home. 

loss of energy and unability to concentrate. 

?why you feel asleep during your night shifts 

inside everyone of us there is a biological clock that is controlled by acenter in our brain ,this clock is programmed that the body rest time is at night and is stimulated during daytime by sunlight when you work at night you work against your nature ,and the biological clock take time to use to new situation.but this is different from person to another ,some people adapt easily than others.but it become harder when you work rotating shifts as the biological clock feel more confused . 

here are some advises to avoid &treat wok shift sleep disorder and give you better sleep time 

try not to take many night shifts in connection but separate them with several days to give yourself a chance to have sleep &repair your body. 

try to avoid rotating shifts as possible ,if you can't start your schedule by day shifts then evening then night ones act not vice versa. 

avoid long distances travel that take from your sleep time 

-during your night shift ,make your workplace brightly-lighted  

you could have one cup of coffee or tea in the start of your night shift but don't exceed that to be able to sleep when you erturn home. 

avoid bright light in your way back home , wear ahat &sun glassesto keep away sunlight and don't stop in your way to make any tasks. 

committe to specific time for sleeping &waking up. 

 ask your family to keep a quiet atmosphere while you are sleeping. 

make your sleeping room dark when you try to sleep at daytime as sunlight stimulates brain while you are trying to sleep. 

if this tips doesn't help you with your work sleep disorders 

you would better discuss that with your doctor ,he may prescribe you medications that make you alert at time of work and help you sleep at sleeping time ,but it is better to try this tips for sometime before taking medications. 

Dr.:Reham El_Sayed

DMI Team

Source: Webmd

Cold Urticaria!

It's an allergy to cold temperatures.It's of a high medical importance in the cold countries. 

Occurs in minutes or even seconds after exposure to a cold stimulus "cold air,cold water,etc..". 

:Symptoms 

:general 

Reddish, itchy welts on the area of skin that was exposed to cold . vary in size from about 7 mm - 27 mm or larger ! 

Swelling of hands when holding cold objects. 

Swelling of lips when eating cold foods. 

:In rare cases 

severe swelling of the tongue and throat that can block breathing 

:Severe reactions 

In some people, reactions affect the whole body . This is known as a systemic reaction: 

Fainting  

Chills 

Fast heartbeat 

Swelling of limbs or trunk 

The worst reactions occur with full skin exposure, such as swimming in cold water. 

A massive release of histamine and other immune system chemicals causes a sudden drop in blood pressure that can lead to fainting, shock and, in rare cases, death. 

In the case of cold-water swimming, drowning can be caused by loss of consciousness. 

The severity of cold urticaria symptoms varies widely. Some people have minor reactions to cold, while others have severe reactions. It's also impossible to say whether it will get better over time. In some cases, cold urticaria goes away on its own after several months. In other cases, it lasts many years ! 

:Causes 

The cause of cold urticaria isn't clear. 

-Certain people appear to have overly sensitive skin cells 

-either due to an inherited trait 

-or caused by a virus or other illness. 

Exposure to cold triggers the release of histamine and other immune system chemicals into the skin. These chemicals are the responsible for the symptoms. 

When to occur for example ?? 

only in the susceptible people 

-Cold weather: Exposure to cold or cool air for more than a few minutes can trigger a reaction. 

-Swimming:can be dangerous specially with the systemic reaction.An allergy medication before entering the water is necessary. 

-Air Conditioning: Entering a cool building during a summer day can result in an allergic reaction to exposed areas of skin, congestion from breathing the cool air and possibly feeling fatigued. 

-Cold Foods/Drinks: Eating or drinking cold or cool substances such as ice cream,may result in the individuals tongue and surrounding tissues swelling. 

:-others 

:Types & Risk factors 

Cold urticaria can occur in any age group, whether in female or male. But it's more likely to have cold urticaria if: 

:*You're a child or young adult. 

A type of urticaria called primary acquired urticaria occurs in children and young adults. 

This is the most common type of urticaria, and it usually improves on its own within two to three years. 

*:You have an underlying health condition. 

Known as secondary acquired urticaria, this less common type of cold urticaria can be caused by an underlying health problem, such as rheumatoid arthritis, hepatitis or cancer. 

:*You have certain inherited traits. 

Rarely, cold urticaria is associated with an inherited condition called familial cold autoinflammatory syndrome. This condition causes painful wheals and flu-like symptoms after exposure to cold. 

:Treatment 

There is no cure for cold urticaria, but treatment is supportive. 

The most important treatment is to stay warm. 

Warming up immediately after exposure to cold temperatures usually helps control the welts before they get worse. Although, the welts do not instantaneously disappear after warming the affected area(s), warming up afterwards reduces the time it takes for the welts to go away. 

Prevention There's no way to avoid getting cold urticaria in the first place, but you can help prevent symptoms by taking medications as prescribed and avoiding cold temperatures, especially cold exposure to unprotected skin. 

:Medications can help prevent and reduce symptoms. 

Antihistamines 

Antidepressants,to treat anxiety and depression. 

These medications won't cure cold urticaria , they'll only ease symptoms. 

If you have cold urticaria because of an underlying health problem, you may need medications or other treatment for that condition as well. 

Take Care

Dr: Rokya Elmahdawy      

DMI Team

 Source:Mayoclinic

Tonsillitis

Tonsils are 2 balls of lymphatic tissue on both sides of the throat, above and behind the tongue. They are part of the immune system, which helps the body fight infection. However, the basic roles of the tonsils in immunity is not clear yet! 

:Causes 

tonsillitis is caused by a virus, and this is the most frequent.But may occur as a result of the same bacteria that cause sore throat, and in other rare cases where the general health situation is not good ,the cause may be fungal infection or a parasite! 

Viral infections are more common than bacterial infections in all seasons, but bacterial infections are usually most common during the winter 

Although there is no evidence that exposure to cigarette smoke can cause tonsillitis, but the children of smokers are conducting a tonsillectomy more than others. 

The modes of transmission of this infection is the exposure to the infected persons' droplets, either directly or indirectly via any tool or surface that received the droplets. 

:Symptoms 

The most common symptom is sore throat . 

Redness and swelling of the tonsils, with patches or completely covered by pus 

High temperature. 

headache. 

Malaise. 

* Viral symptoms are similar to the symptoms of common cold: runny nose, sneezing, cough and sore throat. 

* Bacterial symptoms: sore throat and high "sudden" elevated temperature, swollen tonsils with no symptoms of common cold. 

The attack resolves on it's own in 4-10 days and longer in the bacterial cases. 

Tonsillitis occurs mostly in the childern equally in both female&male.May occur in the adults who didn't do tonsillectomy in their childhood.But doing this operation for the elderly has alot of risks for bleedin and pain. 

:Complications 

* Frequent throat infections. 

* Inflammation of the tonsils caused by bacteria and not treated, lead to complications, such as ear infections and sinus or abscess outside the tonsils. 

More serious complications may occur, such as rheumatic fever, especially with the lack of commitment to the treatment and antibiotics. 

* Chronic inflammation, which leads to upper airway obstruction, and other problems, such as snoring, nasal congestion, and breathing through the mouth. 

:Surgery 

Tonsillectomy is an operation common for children, but it's not commonly operated as it was before. 

The operation reduces the exposure of your child to throat infections caused by inflammation of the tonsils, but these infections get lesser to occur to the child by getting older,even without surgery. 

It's preferred for children who have serious complications with recurrent resistant infections that do not respond to other treatments, especially when they affect the daily life, such as frequent absenteeism from school or because of problems with sleep.Taking the decisions should be after careful consideration for the child health. 

However,it's not believed to be the most suitable solution,this operation may be the ideal solution for some cases like: 

* Episodes of inflammation occur 5 times or more during the year 

* Episodes of inflammation of a 3 or 4 times during the year for several consecutive years. 

* Inflammation continued for 3 months despite treatment. 

*Obstructed air passages. 

* Difficulty in swallowing. 

* Difficulty in speaking. 

* Bleeding tonsils 

The child will be subjected to general anesthesia, discharged from the hospital in 1 day and may remain for one night only. The child, after this surgery should receive care for rest and food. 

Tiredness for several days is normal, but he slowly regains his activity,and supposed to return to school in one week and return to full daily activities within two weeks. 

* It's preferred the child not to be very young. 

:Risk of surgery 

Bleeding after the operation is simple and common, especially with the fall of the crust over the wound. 

Other complications, but much less common, including bleeding and problems with anesthesia, and these occur during the operation. 

:Prevention and treatment 

*Prevention 

The best prevention is to follow basic health precautions, hygiene, and the following steps are useful, especially for children: 

* Avoid close contact with others who are suffering from the disease if possible, keep your child away from the infected children. 

* Remind your child repeatedly the importance of washing hands, and do not share toothbrushes or eating utensils with other children. 

Washing and disinfection of surfaces and toys .* 

* Do not smoke near your child. 

*Treatment 

*Viral infections 

Usually go away on its own. Antibiotics are not effective in the treatment. 

May be useful home remedies such as gargling with salt water, drinking warm tea. 

Analgesics such as ibuprofen 

Do not give aspirin to those who are without the century! This general advice is not specific only for tonsilitis. 

*Bacterial infections 

Doctor prescribes antibiotics, and full commitment to take the full dose is a must, even if the symptoms disappeared and the state of health improved ! Otherwise, the bacteria will become resistant and these antibiotics are not effective, so it becomes more dangerous bacteria, causing health problems, for example, rheumatic fever in the heart. 

By:Dr. Rokaya Almehdawy

DMI Team

source: 

Webmd