Written work – English proofreading.

Written work is so very important in our scheme of things. Not only from the examination point of view, but even in our daily routine also, its importance can be seen. What one wishes to convey to others would be clearly understood only if it has been neatly so written with proper marks of punctuation, capital letters etc., for which handwriting has to be very legible, readable and all above that clear and bold.
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Terrify – English Proofreading

It is used as a verb. Remember that the ending of terrify is spelled –ify.
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Actinomycosis

Actinomycosis is an infection caused by a bacterium Actinomyces israelii

commonly  affects the face and neck, that produces abscesses and draining sinuses.

This bacterium cause infection when it is introduced into the soft tissues by trauma, surgery or another infection. Once it  the tissues, it  form an abscess that develops into a  red to reddish purple or lump. When the abscess breaks through the skin, it forms pus-discharging sinus.

There are at least five (5) types of actinomycosis:

1. Cervicofacial actinomycosis occurs in the mouth, neck and head region. The bacterium enters through the periodontium (the tissues  supporting the teeth), soft tissue wounds or salivary gland ducts. It is believed that majority of  infection arise after a tooth extraction, from tooth decay or abscess, as a part of periodontal disease, from a penetrating jaw trauma, poor dental hygiene, or mucosal injuries.
2. Cervicofacial actinomycosis develops as a hard nodule with overlying skin turning red and in the mouth it appears as swelling . Abscesses develop within and eventually drain to the surface discharging sulfur granules, masses of filaments (long, threadlike structure)  may be found in the pus.
3. Thoracic actinomycosis involves the lungs and mediastinum . The disease may present with  fever, cough, and expectoration. The patient  loses weight , develops night sweats and shortness of breath. Multiple sinuses may extend through the chest wall, to the heart, or into the abdominal cavity.
4. Abdominal actinomycosis are mostly following surgery such as laparotomy, perforated ulcer, or gallbladder inflammation. Infection usually begins in the gastrointestinal tract and spreads to the abdominal wall. Develops spiking fever and chills, intestinal colic, vomiting, and weight loss. This is type often  mistaken for Crohn’s disease, malignancy, tuberculosis, Amebiasis or chronic appendicitis.
5. Pelvic actinomycosis affects mainly  the women and may cause lower abdominal pain, fever, and bleeding between menstrual cycle. This form of the infection has been associated with the use of IUDs (intra-uterine devices).

Document by: Dr. C S Sirka, Group Editor, www.manuscriptedit.com

Manuscriptedit.com’s analysis on Staphylococcal scalded skin syndrome

Staphylococcal scalded skin syndrome is also known as Ritter disease, it is characterized by redness & superficial blistering skin disorders caused by the exfoliative toxins(ET) released from  strains of Staphylococcus aureus.

Separation in  the epidermis is beneath the granular cell layer &  results in sheet like desquamation . Two types of staphylococcal scalded skin syndrome  exist: a localized form, in which there is only patchy involvement of the epidermis, and a generalized form, in which entire / large areas of the skin is  involved.

Two exfoliative toxins (ET-A and ET-B) have been isolated till now, but the exact mechanism by which they cause exfoliation is not clear. The toxins  act as proteases that target the desmoglein-1, important  for cell-to-cell attachment in the  epidermis. It is believed  that immature renal function in children  may contribute to impaired clearance of circulating exotoxins, contributing to the  extensive disease, other theories suggested are exfoliative toxins  possess a superantigenic activity which is also responsible for detachment  of skin.

Initial studies suggested that phage l group II S aureus (subtypes 3A, 3B, 3C, 55 and 71) were solely responsible for exfoliative toxin production, but it is now known that all phage groups are capable of producing  exfoliative toxin and can  cause staphylococcal scalded skin syndrome.

Staphylococcal scalded skin syndrome differs from the toxic epidermal necrolysis (TEN), in the cleavage site, in staphylococcal scalded skin syndrome the cleavage is at  granular layer of epidermis, as opposed to TEN, where there is  necrosis of the full thickness of epidermal layer.

The mortality rate from staphylococcal scalded skin syndrome (SSSS) in children is very low (1-5%), unless associated sepsis.  In adult it  is higher (as high as 50-60%).Children are more at risk because of lack of immunity and immature renal clearance capability. Passive transferred antibody to infants is through  breast milk & are thought to be partially protective.

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