What is causing this headache?

H

eadaches are one of the most common medical complaints; most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender.

The World Health Organization (WHO) reports that almost half of all adults worldwide will experience a headache in any given year.

A headache can be a sign of stress or emotional distress, or it can result from a medical disorder, such as migraine or high blood pressure, anxiety, or depression. It can lead to other problems. People with chronic migraine headaches, for example, may find it hard to attend work or school regularly.

Causes

Headache is a common complaint worldwide.

A headache can occur in any part of the head, on both sides of the head, or in just one location.

There are different ways to define headaches.

The International Headache Society (IHS) categorize headaches as primary, when they are not caused by another condition, or secondary, when there is a further underlying cause.

Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive.

This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in chemical activity in the brain.

Common primary headaches include migraines, cluster headaches, and tension headaches.

Secondary headaches

Secondary headaches are symptoms that happen when another condition stimulates the pain-sensitive nerves of the head. In other words, the headache symptoms can be attributed to another cause.

A wide range of different factors can cause secondary headaches.

These include:

·         alcohol-induced hangover

·         brain tumor

·         blood clots

·         bleeding in or around the brain

·         "brain freeze," or ice-cream headaches

·         carbon monoxide poisoning

·         concussion

·         dehydration

·         glaucoma

·         teeth-grinding at night

·         influenza

·         overuse of pain medication, known as rebound headaches

·         panic attacks

·         stroke

As headaches can be a symptom of a serious condition, it is important to seek medical advice if they become more severe, regular, or persistent.

For example, if a headache is more painful and disruptive than previous headaches, worsens, or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes, and stiffness in the neck, a doctor should be contacted immediately.

Types

There are different types of headache.

Tension headaches

Eating something very cold can lead to a "brain freeze."

Tension headaches are the most common form of primary headache. Such headaches normally begin slowly and gradually in the middle of the day.

The person can feel:

·         as if they have a tight band around the head

·         a constant, dull ache on both sides

·         pain spread to or from the neck

Tension-type headaches can be either episodic or chronic. Episodic attacks are usually a few hours in duration, but it can last for several days. Chronic headaches occur for 15 or more days a month for a period of at least 3 months.

Migraines

A migraine headache may cause a pulsating, throbbing pain usually only on one side of the head. The aching may be accompanied by:

·         blurred vision

·         light-headedness

·         nausea

·         sensory disturbances known as auras

Migraine is the second most common form of primary headache and can have a significant impact on the life of an individual. According to the WHO, migraine is the sixth highest cause of days lost due to disability worldwide. A migraine can last from a few hours to between 2 and 3 days.

Rebound headaches

Rebound or medication-overuse headaches stem from an excessive use of medication to treat headache symptoms. They are the most common cause of secondary headaches. They usually begin early in the day and persist throughout the day. They may improve with pain medication, but worsen when its effects wear off.

Along with the headache itself, rebound headaches can cause:

·         neck pain

·         restlessness

·         a feeling of nasal congestion

·         reduced sleep quality

Rebound headaches can cause a range of symptoms, and the pain can be different each day.

Cluster headaches

Cluster headaches usually last between 15 minutes and 3 hours, and they occur suddenly once per day up to eight times per day for a period of weeks to months. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years.

The pain caused by cluster headaches is:

·         one-sided

·         severe

·         often described as sharp or burning

·         typically located in or around one eye

The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny.

Thunderclap headaches

These are sudden, severe headaches that are often described as the "worst headache of my life." They reach maximum intensity in less than one minute and last longer than 5 minutes.

A thunderclap headache is often secondary to life-threatening conditions, such as intracerebral hemorhage, cerebral venous thrombosis, ruptured or unruptured aneurysms, reversible cerebral vasoconstriction syndrome (RVS), meningitis, and pituitary apoplexy.

People who experience these sudden, severe headaches should seek medical evaluation immediately.

Treatment

The most common ways of treating headaches are rest and pain relief medication.

Generic pain relief medication is available over the counter (OTC), or doctors can prescribe preventative medication, such as tricyclic antidepressants, serotonin receptor agonists, anti-epileptic drugs, and beta-blockers.

It is important to follow the doctor's advice because overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reducing or stopping pain relief medication. In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively.

Alternative treatments

Acupuncture is an alternative therapy that may help relieve headaches.

Several alternative forms of treatment for headaches are available, but it is important to consult a doctor before making any major changes or beginning any alternative forms of treatment.

Alternative approaches include:

·         acupuncture

·         cognitive behavior therapy

·         herbal and nutritional health products

·         hypnosis

·         meditation

Research has not provided evidence to confirm that all these methods work.

Sometimes, a headache may result from a deficiency of a particular nutrient or nutrients, especially magnesium and certain B vitamins. Nutrient deficiencies can be due to a poor quality diet, underlying malabsorption issues, or other medical conditions.

Home remedies

A number of steps can be taken to reduce the risk of headaches and to ease the pain if they do occur:

1.           Apply a heat pack or ice pack to your head or neck, but avoid extreme temperatures.

2.           Avoid stressors, where possible, and develop healthy coping strategies for unavoidable stress.

3.           Eat regular meals, taking care to maintain stable blood sugar.

A hot shower can help, although in one rare condition hot water exposure can trigger headaches. Exercising regularly and getting enough rest and regular sleep contributes to overall health and stress reduction.

Symptoms

Headaches can radiate across the head from a central point or have a vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly. They can last from less than an hour up to several days.

The symptoms of a headache depend to some extent on what type of headache it is.

Tension headache: There may be general, mild to moderate pain that can feel like a band around the head. They tend to affect both sides of the head.

Migraine headache: There is often a severe throbbing pain in one part of the head, often the front or the side. There may be nausea and vomiting, and the person may feel especially sensitive to light or noise.

Cluster headaches: These can cause intense pain, often around one eye. They usually happen around a particular time of year, possibly over a period of 1 to 2 months.

Diagnosis

A doctor will usually be able to diagnose a particular type of headache through a description of the condition, the type of pain, and the timing and pattern of attacks. If the nature of the headache appears to be complex, tests may be carried out to eliminate more serious causes.

Further testing could include:

·         blood tests

·         X-rays

·         brain scans, such as CT and MRI

The WHO points out that headaches are often not taken seriously because they are sporadic, most headaches do not lead to death, and they are not contagious.

They call for more resources to be allocated for the treatment of headache disorders, because of the huge health burden they represent.

 Source: MedicalNewsToday

How do penicillins work?

P

enicillins are a group of antibacterial drugs that attack a wide range of bacteria. They were the first drugs of this type that doctors used. The discovery and manufacture of penicillins have changed the face of medicine, as these drugs have saved millions of lives.

Penicillium fungi are the source of penicillin, which people can take orally or via injection.

People across the globe now widely use penicillins to treat infections and diseases.

Fast facts on penicillin

·     Penicillins were the first antibiotic that doctors used.

·     There are several antibiotics in the penicillin class.

·     Experts credit Alexander Fleming with discovering penicillins.

·     Penicillin works by interfering with bacteria cell walls.

·     Less than 1 percent of people are dangerously allergic to penicillin.

Function

Penicillins work by bursting the cell wall of bacteria.

Drugs in the penicillin class work by indirectly bursting bacterial cell walls. They do this by acting directly on peptidoglycans, which play an essential structural role in bacterial cells.

Peptidoglycans create a mesh-like structure around the plasma membrane of bacterial cells, which increases the strength of the cell walls and prevents external fluids and particles from entering the cell.

When a bacterium multiplies, small holes open up in its cell walls as the cells divide. Newly-produced peptidoglycans then fill these holes to reconstruct the walls.

Penicillins block the protein struts that link the peptidoglycans together. This prevents the bacterium from closing the holes in its cell walls.

As the water concentration of the surrounding fluid is higher than that inside the bacterium, water rushes through the holes into the cell and the bacterium bursts.

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History

People generally attribute the discovery of penicillins to Alexander Fleming. The story goes that he returned to his laboratory one day in September 1928 to find a Petri dish containing Staphylococcus bacteria with its lid no longer in place.

The dish had become contaminated with a blue-green mold called Penicillium notatum. Fleming noted that there was a clear ring surrounding the mold where the bacteria had been unable to grow.

By discovering this mold and recognizing its use, Fleming set the wheels in motion to create one of the most useful drugs in medical history.

In March 1942, Anne Miller became the first civilian to receive successful treatment with penicillin. She narrowly avoided death following severe infection after a miscarriage.

Although Fleming technically discovered the first antibiotic, scientists had to do a lot of work before penicillins could become available for general use.

Scientists with a superior laboratory and a deeper understanding of chemistry than Fleming carried out the bulk of the work. Howard Florey, Norman Heatley, and Ernst Chain performed the first in-depth and focused studies on the drug.

In Fleming's Nobel Prize acceptance speech, he warned that the overuse of penicillins might, one day, lead to bacterial resistance. This has since become a problem.

Resistance

Contrary to popular opinion, it is not the person who develops resistance to penicillins but the bacteria itself.

Bacteria have been around for billions of years. During this time, they have endured extreme environments and, as a result, are highly adaptable. They also regenerate very rapidly, making relatively quick genetic changes possible across a population.

There are three common ways in which bacteria can develop an immunity to penicillin:

·         Penicillinase: Bacteria are sometimes able to produce penicillinase, an enzyme that degrades penicillins. This ability can spread throughout the bacterial population via a small ring of DNA in a process called conjugation. This is the bacterial equivalent of sexual reproduction, where individual organisms share new genetic information between them.

·         Altered bacterial structure: Some bacteria can subtly change the format of the penicillin-binding proteins in their peptidoglycan wall so that penicillins can no longer bind to it.

·         Penicillin removal: Other bacteria develop systems to export penicillins. Bacteria have efflux pumps that they use to release substances from the cell. The repurposing of some of these pumps can allow the cell to dispose of penicillins.

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Side effects

Nausea is a common side effect of taking penicillins.

The most commmon side effects of taking penicillins include:

·         diarrhea

·         nausea

·         a headache

·         skin rashes and hives

Less common side effects include:

·         shortness of breath or irregular breathing

·         joint pain

·         sudden lightheadedness and fainting

·         puffiness and redness of the face

·         scaly, red skin

·         vaginal itching and discharge, due to either a yeast infection or bacterial vaginosis

·         sore mouth and tongue, sometimes with white patches

·         abdominal cramps, spasms, tenderness, or pain

Rare side effects include:

·         anxiety, fear, or confusion

·         a sense of impending doom

·         hallucinations

·         yellowing of the eyes and skin

·         a sore throat

·         unusual bleeding

·         diarrhea and reduced urination

·         convulsions

Risks

Although the use of penicillins is widespread, some issues or contraindications can occur, as with any drug:

·         Breast-feeding: People who are breast-feeding may pass small amounts of penicillin to the child. This can result in the child experiencing allergic reactions, diarrhea, fungal infections, and skin rash.

·         Interactions: Some other drugs can interact with penicillins. Checking with a doctor before taking multiple medications is vital.

·         Bleeding problems: Some penicillins, such as carbenicillin, piperacillin, and ticarcillin, can make pre-existing bleeding problems worse.

·         Oral contraceptives: Penicillins can interfere with birth control pills, increasing the risk of unwanted pregnancy.

·         Cystic fibrosis: People with cystic fibrosis are more prone to fever and skin rashes when taking piperacillin.

·         Kidney disease: Individuals with kidney disease have an increased risk of side effects.

·         Methotrexate: Methotrexate disrupts cell growth and can treat several conditions, including leukemia and some autoimmune diseases. Penicillins prevent the body from disposing of this drug, potentially leading to severe complications.

·         Phenylketonuria: Some stronger, chewable amoxicillin tablets contain high levels of aspartame that the body converts to phenylalanine. This is dangerous for anyone with phenylketonuria.

·         Gastrointestinal problems: Patients with a history of stomach ulcers or other intestinal diseases might be more likely to develop colitis when taking penicillins.

Penicillin allergy

Some people have an allergy to penicillins.

Allergic reactions to penicillin typically lead to hives, wheezing, and swelling, particularly of the face.

Around 10 percent of people report an allergy to penicillins but the real figure is closer to 1 percent, and only around 0.03 percent exhibit life-threatening allergic responses.

Alcohol and penicillin

Certain antibiotics, such as metronidazole and tinidazole, have severe reactions with alcohol. However, this is not the case with penicillins.

Penicillins have saved countless lives throughout their history of use in medicine. However, doctors are now worried about the increase in antibiotic resistance. Only time will tell how the antibiotics of the future will overcome this hurdle.

Source: MedicalNewsToday