H1N1 influenza (swine flu)
H1N1 influenza, also known as "swine flu," is a newly identified virus that can spread from people who are infected to others through coughs and sneezes. When people cough or sneeze, they spread germs through the air or onto surfaces that other people may touch. H1N1 influenza is not transmitted from pigs to humans or from eating pork products. H1N1 influenza is a new virus to human populations, so people's bodies have little ability to fight H1N1 infection. To avoid spreading illness to others, people with symptoms of the flu should stay at home until any fever has been gone for at least 24 hours without the use of fever-reducing medicines.
When should I seek medical care?
Use the same judgment you would use during a typical flu season. Do not seek medical care if you are not ill or have mild symptoms for which you would not ordinarily seek medical care. If you have more severe symptoms of fever, cough, sore throat, body aches or are feeling more seriously ill, call your health care provider to discuss your symptoms and if you need to be evaluated.
If the following flu-like symptoms are mild, medical attention is not typically required.
* Runny nose or nasal stuffiness
* Low-grade fever for less than 3 days
* Mild headache
* Body aches
* Mild stomach upset
If the following flu-like symptoms are mild, medical attention is not typically required.
* Runny nose or nasal stuffiness
* Low-grade fever for less than 3 days
* Mild headache
* Body aches
* Mild stomach upset
What are the symptoms of H1N1 flu (swine flu)?
The symptoms of H1N1 flu in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people with H1N1 flu also reported diarrhea and vomiting. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Similar to seasonal flu, swine flu may make chronic medical conditions worse.
How do I get Tamiflu or Relenza?
Health care providers can prescribe Tamiflu or Relenza after examining a patient and determining that person is sick enough to need the medication. Do not try to buy Tamiflu or Relenza from companies offering the drugs online without a prescription. If your doctor prescribes Tamiflu for you, do not give your medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Are there medicines to treat H1N1 flu (swine flu)?
Yes, the antiviral oseltamivir or zanamivir (brand names Tamiflu and Relenza) can treat infection with H1N1 influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within two days of symptoms).
If you get sick with influenza
* If you get sick, Public Health - Seattle & King County strongly recommends that you stay home from work or school so you can get better and keep others from getting sick.
* Also, if you get sick with influenza, remain at home and avoid contact with others until you've had no fever for 24 hours.
* Also, if you get sick with influenza, remain at home and avoid contact with others until you've had no fever for 24 hours.
When using facemasks:
* Change masks when they become moist
* Do not leave masks dangling around the neck
* Throw away used masks
* After touching or throwing away a used mask, wash hands or use alcohol sanitizer
* Do not leave masks dangling around the neck
* Throw away used masks
* After touching or throwing away a used mask, wash hands or use alcohol sanitizer
Can I go to large gatherings, like concerts and sports events?
To date, the severity of the H1N1 flu outbreak appears to similar to a regular winter flu season. Make decisions about going to large gatherings as you would during a winter flu outbreak. If you want to do everything you can to avoid catching H1N1 flu virus, then avoid large gatherings. It is especially important not to participate in group gatherings if you are ill or have symptoms of influenza.
Public Health does not recommend the use of masks except for the following people:
* Sick people if they must be near others at home, or if they must leave the home (such as for an appointment with a health care provider).
* Caregivers of a people ill with influenza – when the caregiver leaves their home. This is to prevent spreading flu to others in case the caregiver is in the early stages of infection.
Whenever possible, do not rely on the use of facemasks or respirators alone to provide respiratory protection against novel influenza virus infection. The best way to prevent exposure to influenza is to avoid contact with ill people. Other steps include avoiding crowded setting and washing your hands frequently.
* Caregivers of a people ill with influenza – when the caregiver leaves their home. This is to prevent spreading flu to others in case the caregiver is in the early stages of infection.
Whenever possible, do not rely on the use of facemasks or respirators alone to provide respiratory protection against novel influenza virus infection. The best way to prevent exposure to influenza is to avoid contact with ill people. Other steps include avoiding crowded setting and washing your hands frequently.
HEALTH PROTECTION TIPS
What can I do to protect myself and my family?
Take these everyday steps to protect your health:
* Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Get a H1N1 influenza vaccine. The H1N1 influenza vaccine is not available yet, but it may be available in mid-October. In King County H1N1 vaccine will be distributed using Public Health clinics, private providers and pharmacies. Individuals and families can get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine.
* Get your seasonal flu vaccine. The H1N1 influenza vaccine does not replace seasonal flu vaccine. It is important that people in high risk groups for seasonal flu get their seasonal influenza shot so that they are protected. Older individuals are at higher risk for seasonal flu and Public Health recommends they get the flu vaccine every years.
* If you don't have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. This is to avoid contact with other people as much as possible, including trips to the store. Prepare to get by for at least two weeks on what you have at home.
Take these everyday steps to protect your health:
* Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Get a H1N1 influenza vaccine. The H1N1 influenza vaccine is not available yet, but it may be available in mid-October. In King County H1N1 vaccine will be distributed using Public Health clinics, private providers and pharmacies. Individuals and families can get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine.
* Get your seasonal flu vaccine. The H1N1 influenza vaccine does not replace seasonal flu vaccine. It is important that people in high risk groups for seasonal flu get their seasonal influenza shot so that they are protected. Older individuals are at higher risk for seasonal flu and Public Health recommends they get the flu vaccine every years.
* If you don't have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. This is to avoid contact with other people as much as possible, including trips to the store. Prepare to get by for at least two weeks on what you have at home.
Should I wear a mask?
Facemasks (surgical masks) may prevent the wearer from coughing on others, and may protect the nose and mouth of the wearer from contact with other people's coughs. They do not offer complete protection because they do not fit tightly to the face, allowing very small air particles to leak in around the edge of the mask.
H1N1 vaccine
Public Health recommends that people get vaccinated for H1N1 influenza and seasonal influenza. H1N1 and seasonal flu are different viruses that require different vaccines.A vaccine for H1N1 influenza is being developed, and vaccine manufacturers expect to have it ready in mid-October. Federal officials believe there will be enough H1N1 vaccine for everyone who wants it later this year. Initial supplies of vaccines will go to people most likely to get the virus. They include:
* Pregnant women
* Children and young adults 6 months to 24 years of age
* Persons ages 25-64 years old with health conditions that could make them dangerously ill from the flu (such as those with heart disease, diabetes, asthma, or anyone with a lowered immunity)
* Household members and caregivers of children younger than 6 months in age; and
* Healthcare workers and emergency medical service providers
People in these five high-risk groups should make every effort to get the H1N1 vaccine as soon as it becomes available.In King County, individuals and families will be able to get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine, such as Public Health clinics, private health care providers and pharmacies.The H1N1 influenza vaccine does not protect against seasonal flu. Public Health recommends that everyone at risk for seasonal flu, including seniors, gets the seasonal flu vaccine. Seasonal flu vaccine is available now at some pharmacies and clinic locations.
* Pregnant women
* Children and young adults 6 months to 24 years of age
* Persons ages 25-64 years old with health conditions that could make them dangerously ill from the flu (such as those with heart disease, diabetes, asthma, or anyone with a lowered immunity)
* Household members and caregivers of children younger than 6 months in age; and
* Healthcare workers and emergency medical service providers
People in these five high-risk groups should make every effort to get the H1N1 vaccine as soon as it becomes available.In King County, individuals and families will be able to get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine, such as Public Health clinics, private health care providers and pharmacies.The H1N1 influenza vaccine does not protect against seasonal flu. Public Health recommends that everyone at risk for seasonal flu, including seniors, gets the seasonal flu vaccine. Seasonal flu vaccine is available now at some pharmacies and clinic locations.
First swine flu victim had cancer
swine flu virus
A woman with cancer is the first person from NI to die of swine flu
A woman who became the first person in Northern Ireland to die of swine flu had been suffering from cancer for almost five years.Caroline Hoy from Ahoghill died at Belfast City Hospital on Thursday night.The mother of two young children had been diagnosed with terminal cancer before she contracted swine flu.
Mrs Hoy was buried after a funeral service at Trinity Presbyterian Church in the County Antrim village on Sunday.Lee Porter, a soldier from Coleraine, County Londonderry, died from swine flu at a hospital in Surrey on 31 July.In the Republic of Ireland, two people have died of swine flu.A man from the east of Ireland died last week. He did not have an apparent underlying medical condition.Earlier this month, an 18-year-old woman from Sligo died from the virus at Tallaght Hospital. She had an underlying medical condition.Isolated In Northern Ireland, the Department of Education said last week that it had compiled instructions for schools and advice for parentIf a child shows symptoms, the department said, he or she should be taken from class and isolated from other children while waiting for someone to take them home."Because the flu is likely to spread through the community anyway, schools are advised not to close during an outbreak, apart from exceptionalcircumstances where they cater for children who are particularly vulnerable to infection or are very short of staff," the department said.The circular to schools said pregnant teachers or those recovering from illness were regarded as an "at risk" group and are told to avoid close contact with swine flu sufferers.However, the department said pregnant teachers were not at a higher risk in school than in their out-of-work life.
A woman with cancer is the first person from NI to die of swine flu
A woman who became the first person in Northern Ireland to die of swine flu had been suffering from cancer for almost five years.Caroline Hoy from Ahoghill died at Belfast City Hospital on Thursday night.The mother of two young children had been diagnosed with terminal cancer before she contracted swine flu.
Mrs Hoy was buried after a funeral service at Trinity Presbyterian Church in the County Antrim village on Sunday.Lee Porter, a soldier from Coleraine, County Londonderry, died from swine flu at a hospital in Surrey on 31 July.In the Republic of Ireland, two people have died of swine flu.A man from the east of Ireland died last week. He did not have an apparent underlying medical condition.Earlier this month, an 18-year-old woman from Sligo died from the virus at Tallaght Hospital. She had an underlying medical condition.Isolated In Northern Ireland, the Department of Education said last week that it had compiled instructions for schools and advice for parentIf a child shows symptoms, the department said, he or she should be taken from class and isolated from other children while waiting for someone to take them home."Because the flu is likely to spread through the community anyway, schools are advised not to close during an outbreak, apart from exceptionalcircumstances where they cater for children who are particularly vulnerable to infection or are very short of staff," the department said.The circular to schools said pregnant teachers or those recovering from illness were regarded as an "at risk" group and are told to avoid close contact with swine flu sufferers.However, the department said pregnant teachers were not at a higher risk in school than in their out-of-work life.
Types of ulcers
There are mainly three types of ulcers. They are:
* Peptic ulcer
* Gastric ulcer
* Duodenal ulcer
Peptic ulcer: Peptic ulcer affects the lining of the stomach. it happens when the ulcers are
exposed to pepsin.
Gastric ulcer: An ulcer is called gastric when the peptic ulcer is present in the stomach.
Duodenal ulcer: An ulcer is called duodenal when the ulcer is in the duodenum. it is usually
found in the beginning of the small intestine.
* Peptic ulcer
* Gastric ulcer
* Duodenal ulcer
Peptic ulcer: Peptic ulcer affects the lining of the stomach. it happens when the ulcers are
exposed to pepsin.
Gastric ulcer: An ulcer is called gastric when the peptic ulcer is present in the stomach.
Duodenal ulcer: An ulcer is called duodenal when the ulcer is in the duodenum. it is usually
found in the beginning of the small intestine.
What is ulcer?
The human stomach contains enumerable muscles which carry out the process of digestion and
convert the different forms of food into digestive fluids. These digestive fluids are known
as pepsin and hydrochloric acid. These fluids make the food digest in the stomach.
The ulcer in the stomach might be the result of the disparity in the digestive fluids. The
over production of pepsin or hydrochloric acid might cause ulcer.
The over production of acids inside the stomach might harm the line up of the stomach and
cause ulcers in the stomach.
convert the different forms of food into digestive fluids. These digestive fluids are known
as pepsin and hydrochloric acid. These fluids make the food digest in the stomach.
The ulcer in the stomach might be the result of the disparity in the digestive fluids. The
over production of pepsin or hydrochloric acid might cause ulcer.
The over production of acids inside the stomach might harm the line up of the stomach and
cause ulcers in the stomach.
Peptic ulcer
An eroded lesion in the gastric intestinal mucous is called Peptic ulcer. An ulcer may form
in any part of the digestive tract, which is exposed to acid gastric juice, but is usually
found in the stomach and the duodenum. The ulcer located in the stomach is known as gastric
ulcer and that located in the duodenum is called a duodenal ulcer. Usually both are group
together are termed peptic ulcer.
Symptoms of Peptic Ulcer
# Peptic UlcerThe most common symptoms of peptic ulcer are sharp and severe pain and
discomfort in the upper central abdomen. The pain is commonly described as burning or gnawing in character.
# Gastric ulcer pain usually occurs an hour after meals, but rarely at night.
# Duodenal ulcer pain usually occurs between meals when the stomach is empty and is relieved
by food especially milk, often described as hunger pain.
# As the disease progresses there is distension of the stomach due to excessive flatulence,
besides mental tension, insomnia and a gradual weakening of the body. It may cause
constipation with gradual blood in the stools.
in any part of the digestive tract, which is exposed to acid gastric juice, but is usually
found in the stomach and the duodenum. The ulcer located in the stomach is known as gastric
ulcer and that located in the duodenum is called a duodenal ulcer. Usually both are group
together are termed peptic ulcer.
Symptoms of Peptic Ulcer
# Peptic UlcerThe most common symptoms of peptic ulcer are sharp and severe pain and
discomfort in the upper central abdomen. The pain is commonly described as burning or gnawing in character.
# Gastric ulcer pain usually occurs an hour after meals, but rarely at night.
# Duodenal ulcer pain usually occurs between meals when the stomach is empty and is relieved
by food especially milk, often described as hunger pain.
# As the disease progresses there is distension of the stomach due to excessive flatulence,
besides mental tension, insomnia and a gradual weakening of the body. It may cause
constipation with gradual blood in the stools.
Treatment of Peptic Ulcer by Nature Cure:
# Diet is of utmost importance in the treatment of ulcer. Milk cream, butter, fruits and
fresh, raw and boiled vegetables, natural foods and natural vitamin supplements are the best
diet for an ulcer patient. The most effective remedy for peptic ulcers are bananas and milk
which are considered an ideal diet for the patients who are in an advanced state of the
disease.Almond milk made from blanched almonds in a blender is very beneficial. The other
ways of treating Peptic ulcer are as follows
# Raw goat`s milk is also highly beneficial, since it actually helps to heal peptic ulcer.
# Cabbage is regarded as another useful home remedy for peptic ulcers. Cabbage is boiled in
water. This water is allowed to cool and taken twice daily.
# The leaves of kalyana murangal tree, which is a variety of drumstick found in South India,
have also proved helpful in the healing of ulcers. The leaves of this tree are ground into a
paste and taken mixed with yogurt daily.
# Raw vegetables juices, particularly carrot and cabbage juices are beneficial in the
treatment of peptic ulcers. Carrot juice may be taken either alone or in combination with
spinach or beet and cucumber. The formula proportions in case of the first combination are
300 ml. of carrots and 200 ml. of spinach, and in case of the second combination, 300 ml. of
carrots and three ounces each of beets and cucumbers to make half a litre of juice.
# The ulcer patient should drink 8 to 10 glasses of water every day. However, he should not
drink water during or with meals, but only half an hour before or one hour after he has
eaten.
# A patient should bathe, preferably in cold water, twice daily.
# Alternate hot and cold hip baths for 10 to 15 minutes and a mud pack applied over the lower
abdomen for half an hour daily will also help the ulcers to heal. The hip bath or the mud
pack should be taken on an empty stomach and should be followed by a walk.
# In case of hemorrhage in the stomach, a rectal enema should be administered four times
daily. In case of abdominal or stomach pain, hot packs should be placed on the abdomen. A hot
pack should also be placed between the shoulder blades.
# Diet is of utmost importance in the treatment of ulcer. Milk cream, butter, fruits and
fresh, raw and boiled vegetables, natural foods and natural vitamin supplements are the best
diet for an ulcer patient. The most effective remedy for peptic ulcers are bananas and milk
which are considered an ideal diet for the patients who are in an advanced state of the
disease.Almond milk made from blanched almonds in a blender is very beneficial. The other
ways of treating Peptic ulcer are as follows
# Raw goat`s milk is also highly beneficial, since it actually helps to heal peptic ulcer.
# Cabbage is regarded as another useful home remedy for peptic ulcers. Cabbage is boiled in
water. This water is allowed to cool and taken twice daily.
# The leaves of kalyana murangal tree, which is a variety of drumstick found in South India,
have also proved helpful in the healing of ulcers. The leaves of this tree are ground into a
paste and taken mixed with yogurt daily.
# Raw vegetables juices, particularly carrot and cabbage juices are beneficial in the
treatment of peptic ulcers. Carrot juice may be taken either alone or in combination with
spinach or beet and cucumber. The formula proportions in case of the first combination are
300 ml. of carrots and 200 ml. of spinach, and in case of the second combination, 300 ml. of
carrots and three ounces each of beets and cucumbers to make half a litre of juice.
# The ulcer patient should drink 8 to 10 glasses of water every day. However, he should not
drink water during or with meals, but only half an hour before or one hour after he has
eaten.
# A patient should bathe, preferably in cold water, twice daily.
# Alternate hot and cold hip baths for 10 to 15 minutes and a mud pack applied over the lower
abdomen for half an hour daily will also help the ulcers to heal. The hip bath or the mud
pack should be taken on an empty stomach and should be followed by a walk.
# In case of hemorrhage in the stomach, a rectal enema should be administered four times
daily. In case of abdominal or stomach pain, hot packs should be placed on the abdomen. A hot
pack should also be placed between the shoulder blades.
Causes of Peptic Ulcer:
# Peptic ulcers results from hyperacidity, It can be potentially dangerous and, under certain
circumstances, it may eat its way through the lining of the stomach or duodenum producing,
first, irritation of the stomach wall and eventually an ulcer
# Dietetic indiscretion, like overeating, taking of heavy meals or highly spiced foods,
coffee, alcohol and smoking are the main factors contributing to this condition.
# The ingestion of certain drugs, particularly aspirin, food poisoning, infections like
influenza and septicemia and gout may also cause ulcers.
# Emotional stress or nervous tension also plays a major role in the formation of ulce
# Peptic ulcers results from hyperacidity, It can be potentially dangerous and, under certain
circumstances, it may eat its way through the lining of the stomach or duodenum producing,
first, irritation of the stomach wall and eventually an ulcer
# Dietetic indiscretion, like overeating, taking of heavy meals or highly spiced foods,
coffee, alcohol and smoking are the main factors contributing to this condition.
# The ingestion of certain drugs, particularly aspirin, food poisoning, infections like
influenza and septicemia and gout may also cause ulcers.
# Emotional stress or nervous tension also plays a major role in the formation of ulce
What is the treatment?
To treat a gastric ulcer the doctor may prescribe drugs that will lower the rate of stomach
acid secretion or protect the mucous tissues that line the stomach. Surgical treatment of
ulcers is usually recommended if the doctor suspects complications and malignancies. Possible
complications of untreated ulcers include hemorrhaging, a perforation of the stomach wall,
and an obstruction (ulcer scarring that prevents passage of food).
The doctor may also recommend treatment to eliminate H. pylori in order to prevent ulcer
recurrences. Without such treatment there is an eighty percent chance the ulcer will reoccur
within one year. The usual regimen used to eliminate the bacterium is a combination of
tetracycline, bismuth subsalicylate (Pepto-Bismol), and metronidazole (Metizol).
Self-care tips
Patients with gastric ulcers can make several lifestyle changes to prevent their recurrence,
including avoiding unnecessary use of aspirin and NSAIDs, giving up smoking, and cutting down
on alcohol, tea, coffee, and sodas containing caffeine. Other preventative measures include
eating balanced, nutritious meals, learning how to manage stress, getting plenty of rest and
exercising as recommended.
To treat a gastric ulcer the doctor may prescribe drugs that will lower the rate of stomach
acid secretion or protect the mucous tissues that line the stomach. Surgical treatment of
ulcers is usually recommended if the doctor suspects complications and malignancies. Possible
complications of untreated ulcers include hemorrhaging, a perforation of the stomach wall,
and an obstruction (ulcer scarring that prevents passage of food).
The doctor may also recommend treatment to eliminate H. pylori in order to prevent ulcer
recurrences. Without such treatment there is an eighty percent chance the ulcer will reoccur
within one year. The usual regimen used to eliminate the bacterium is a combination of
tetracycline, bismuth subsalicylate (Pepto-Bismol), and metronidazole (Metizol).
Self-care tips
Patients with gastric ulcers can make several lifestyle changes to prevent their recurrence,
including avoiding unnecessary use of aspirin and NSAIDs, giving up smoking, and cutting down
on alcohol, tea, coffee, and sodas containing caffeine. Other preventative measures include
eating balanced, nutritious meals, learning how to manage stress, getting plenty of rest and
exercising as recommended.
What are the symptoms?
The symptoms of gastric ulcers include indigestion and heartburn in the middle of the upper
abdomen, nausea and loss of appetite, weight loss and repeated episodes of gastrointestinal
bleeding. About 30% of patients with gastric ulcers are awakened by pain at night. Many
patients have periods of chronic ulcer pain alternating with symptom-free periods that last
for several weeks or months. The pain may be relieved by eating or taking antacids, and may
get worse a couple of hours after meals or before meals.
If the gastric ulcer is bleeding, the patient may vomit bright red blood or digested blood
that looks like brown coffee grounds and have black, tarry bowel movements.
How is it diagnosed?
To diagnose a gastric ulcer, the doctor may first examine the patient and look at the medical
history. The doctor may suspect gastric ulcers based on risk factors such as male sex, age
over 45, location of pain, anemia, history of using NSAIDs, history of heavy smoking and
alcohol use, and family history of ulcers or stomach cancer.
The doctor may perform an endoscopy and imaging studies to determine if the patient has a
gastric ulcer. An endoscopy is considered the best procedure for diagnosing gastric ulcers
and for taking samples of stomach tissue for biopsies. An endoscope is a slender tube-shaped
instrument that allows the doctor to view the tissues lining the stomach and duodenum.
The doctor may also test for H. pylori because almost all ulcer patients who are not taking
NSAIDs are infected. Noninvasive tests include blood tests for immune response and a breath
test. The doctor may also take a blood test to see if the patient is anemic due to a bleeding
ulcer.
The symptoms of gastric ulcers include indigestion and heartburn in the middle of the upper
abdomen, nausea and loss of appetite, weight loss and repeated episodes of gastrointestinal
bleeding. About 30% of patients with gastric ulcers are awakened by pain at night. Many
patients have periods of chronic ulcer pain alternating with symptom-free periods that last
for several weeks or months. The pain may be relieved by eating or taking antacids, and may
get worse a couple of hours after meals or before meals.
If the gastric ulcer is bleeding, the patient may vomit bright red blood or digested blood
that looks like brown coffee grounds and have black, tarry bowel movements.
How is it diagnosed?
To diagnose a gastric ulcer, the doctor may first examine the patient and look at the medical
history. The doctor may suspect gastric ulcers based on risk factors such as male sex, age
over 45, location of pain, anemia, history of using NSAIDs, history of heavy smoking and
alcohol use, and family history of ulcers or stomach cancer.
The doctor may perform an endoscopy and imaging studies to determine if the patient has a
gastric ulcer. An endoscopy is considered the best procedure for diagnosing gastric ulcers
and for taking samples of stomach tissue for biopsies. An endoscope is a slender tube-shaped
instrument that allows the doctor to view the tissues lining the stomach and duodenum.
The doctor may also test for H. pylori because almost all ulcer patients who are not taking
NSAIDs are infected. Noninvasive tests include blood tests for immune response and a breath
test. The doctor may also take a blood test to see if the patient is anemic due to a bleeding
ulcer.
What causes it?
A gastric ulcer develops when stomach acids and digestive juices injure the stomach’s lining
of protective mucus. Gastric ulcers most commonly are caused by the use of nonsteroidal
anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen. Aspirin is the
NSAID most likely to cause ulcers. The widespread use of NSAIDs may be why the incidence of
gastric ulcers in the United States is rising.
Gastric ulcers may also develop from the presence of bacteria called Helicobacter pylori (H.
pylori), decreased resistance of the lining of the stomach to gastric acids, increased
production of gastric acids and infection, certain types of medication, and disorders that
cause over secretion of stomach juices. Ulcer can also be caused by the use of tobacco,
alcohol and caffeine.
A gastric ulcer develops when stomach acids and digestive juices injure the stomach’s lining
of protective mucus. Gastric ulcers most commonly are caused by the use of nonsteroidal
anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen. Aspirin is the
NSAID most likely to cause ulcers. The widespread use of NSAIDs may be why the incidence of
gastric ulcers in the United States is rising.
Gastric ulcers may also develop from the presence of bacteria called Helicobacter pylori (H.
pylori), decreased resistance of the lining of the stomach to gastric acids, increased
production of gastric acids and infection, certain types of medication, and disorders that
cause over secretion of stomach juices. Ulcer can also be caused by the use of tobacco,
alcohol and caffeine.
Gastric Ulcer
Also called: Stomach Ulcer
What is it?
A gastric ulcer, also called a stomach ulcer, is a raw, eroded area in the lining of the
stomach.
Who gets it?
About two percent of the adult population in the United States has active ulcers, and about
ten percent will develop ulcers at some point in their lives. Of the approximately 500,000
new cases of ulcers in the United States each year, about sixteen percent are gastric ulcers.
Gastric ulcers are most common in males between the ages of 55 and 70.
Gastric ulcers occur in people who take anti-inflammatory drugs, such as aspirin, ibuprofen,
and naproxen; drink alcohol; smoke tobacco; have a high caffeine intake and often feel
stressed.
What is it?
A gastric ulcer, also called a stomach ulcer, is a raw, eroded area in the lining of the
stomach.
Who gets it?
About two percent of the adult population in the United States has active ulcers, and about
ten percent will develop ulcers at some point in their lives. Of the approximately 500,000
new cases of ulcers in the United States each year, about sixteen percent are gastric ulcers.
Gastric ulcers are most common in males between the ages of 55 and 70.
Gastric ulcers occur in people who take anti-inflammatory drugs, such as aspirin, ibuprofen,
and naproxen; drink alcohol; smoke tobacco; have a high caffeine intake and often feel
stressed.
Symptoms
The classic symptom is pain in the epigastric area present two to three hours after a meal. It is a burning, painful, gnawing or aching sensation, with fullness or bloating, even awakening the patient from sleep. It is relieved by intake of food or antacids. The severity of the pain varies, and recurrence is common with periods of remission. Any change in the pattern of the pain may herald complications — constant pain unrelieved by any agent may suggest perforation, or adherence to the pancreas behind. Many patients with DU have no symptoms. There is often poor correlation between symptoms and healing. Surprisingly, duodenal ulcers never turn malignant. Complications are similar to gastric ulcer.
Diagnosis
Pain in the epigastric region and a little to the right side and below it, if relieved by food or antacids, is in favour of DU. Double contrast barium and endoscopy are helpful in diagnosis. Small ulcers missed by barium can be picked up by endoscopy.
The classic symptom is pain in the epigastric area present two to three hours after a meal. It is a burning, painful, gnawing or aching sensation, with fullness or bloating, even awakening the patient from sleep. It is relieved by intake of food or antacids. The severity of the pain varies, and recurrence is common with periods of remission. Any change in the pattern of the pain may herald complications — constant pain unrelieved by any agent may suggest perforation, or adherence to the pancreas behind. Many patients with DU have no symptoms. There is often poor correlation between symptoms and healing. Surprisingly, duodenal ulcers never turn malignant. Complications are similar to gastric ulcer.
Diagnosis
Pain in the epigastric region and a little to the right side and below it, if relieved by food or antacids, is in favour of DU. Double contrast barium and endoscopy are helpful in diagnosis. Small ulcers missed by barium can be picked up by endoscopy.
Duodenal Ulcer
This is more classical and common. The ulcer penetrates deep into the mucosa. More than 95% occur in the first part of the duodenum. About 60% of ulcers recur within one year and 90% within two years.
* Cause
* Symptoms
* Diagnosis
* Medical Management
Causative factors
These are not known for sure. The number of acid-secreting cells is high, with greater outpouring of acid. Excessive acid flow is consequential, in comparison to gastric ulcer where defective mucosal resistance is the cause. Genetic factors appear to be important. Alcohol and cigarettes are potent causative and aggravating factors. Others are chronic usage of painkiller drugs, poor lifestyle, a bacteria known as helicobacter pylori found in a number of patients with DU, skipping meals (which allows acid to irritate the lining, the outflow being aggravated by stress on an empty stomach) and, most important, the mind. Stress produces and aggravates duodenal ulcer in any situation. Of this there is no doubt. All patients experience increase in pain with stress.
* Cause
* Symptoms
* Diagnosis
* Medical Management
Causative factors
These are not known for sure. The number of acid-secreting cells is high, with greater outpouring of acid. Excessive acid flow is consequential, in comparison to gastric ulcer where defective mucosal resistance is the cause. Genetic factors appear to be important. Alcohol and cigarettes are potent causative and aggravating factors. Others are chronic usage of painkiller drugs, poor lifestyle, a bacteria known as helicobacter pylori found in a number of patients with DU, skipping meals (which allows acid to irritate the lining, the outflow being aggravated by stress on an empty stomach) and, most important, the mind. Stress produces and aggravates duodenal ulcer in any situation. Of this there is no doubt. All patients experience increase in pain with stress.
Using the UCI Datasets with jRuby and WEKA
The UCI Machine Learning Repository is one address which should be in every machine-learner's Bookmarks list. The repository (as of now!) holds 177 datasets which have been used as applications and to test machine learning and data-mining algorithms for several decades. Some of the datasets are relatively small and well explored, suitable for evaluating a new algorithm, but some of the datasets are large, and present a real data-mining challenge. For instance, the Soybean dataset was contributed in 1988 and has around 600 instances in total, whereas the Poker Hand dataset was contributed in 2007 and has over a million instances. There are datasets covering a wide variety of applications, from classification of attribute-value data, such as the Mushroom dataset, to regression on numeric data, such as the Auto MPG dataset. My favourites are the various Molecular Biology datasets and the subset of the NASA dataset of Volcanoes on Venus.
Working with these datasets is a useful exercise to learn about different machine-learning applications, and particularly for exploring the capabilities of learning algorithms with which you are unfamiliar. You can compare your own experimental results with those of previous researchers, and make sure you are using the algorithms correctly. Also, if and when you create your own learning algorithm, you can evaluate its performance on these standard datasets, and hence compare it with previous algorithms.
However, the format of the datasets is not consistent, although most of the data can be viewed in standard text editors. Before we can begin exploring these datasets within a toolkit such as WEKA, we must convert the data into a format that WEKA can understand. One way would be to write a tool to convert the original data format into WEKA's ARFF file format, and then work with the graphical tool. A different way, which follows on from my previous post, is to use jRuby to talk directly to WEKA; jRuby can then be used to read in and analyse the custom data format, before developing and evaluating machine-learning algorithms through the WEKA API.
Reading UCI Datasets
Using WEKA with files like the UCI datasets means converting an external data format into the internal format used within WEKA. As I covered in my previous post, WEKA instances must be constructed using a set of Attribute instances, where each Attribute describes its name, type (numeric or nominal) and the range of values it can hold, if nominal. Setting up these attributes is the tedious step. You have to look in the description of the data, and extract the attributes names, type and values, then code it into Ruby. The following was created using information from the 'names' file of the Mushroom dataset, to create an array of Attributes and a Label attribute:
The 'data' file of the Mushroom dataset contains lines of characters, in the following format:
Each line represents one instance, which later we will need to convert into a WEKA instance. The trick with the WEKA instances is that each must be linked to the dataset in which it lies. When I load the data, I don't know which dataset I will want each line to be added to. So, I construct instances of the following class as I read in the data. The class has a method which will build an instance and put it in the appropriate dataset, when called.
The above code will produce an array, DataSet, containing the items from the original dataset.
Comparing Algorithms
WEKA contains a huge number of algorithms. Just to name two, there is J48 for building decision-tree classifiers, and IB1 for constructing an instance-based classifier. Which one should we use? The answer to that question can be complex, and depends a lot on how intelligible we want the machine-learning model to be (decision trees and rules are much better for explaining outcomes than neural networks, for example). But a straightforward empirical question is to ask which of the two produces the best result on a given dataset. There is a fairly standard set of comparison techniques in machine learning, all based around the idea of a held-out test set, which is a dataset not used in training the model.
A held-out test set is required to prevent the following algorithm being the best learning algorithm:
The simplest approach is to split the complete dataset into a Training and a Test partition. We build the classifiers on the Training set and then evaluate both on the same Test set. In this way, the only variable is the type of learning algorithm - the training data and test data are the same. (A more precise way of evaluating algorithms is based on cross validation.)
Constructing the datasets
In the earlier section, we used a function to construct an array of UciInstance objects from the data file. To build the training and test sets, we first partition that array into two sections, based on a target proportion. Then we need to construct a WekaTrainingSet and WekaTestSet, which are instances of the WEKA Instances class.
Constructing the models
Building the models is simple using WEKA's API. We simply create instances of the classifiers and train them on the training set:
Evaluating
The evaluation procedure can be wrapped into a function which takes a classifier and a dataset, and returns the percentage of the dataset which the classifier has got correct:
Result
When the above is run, we get an output like:
Training set size: 787
Test set size: 7337
Performance of IB1 is: 100.0%
Performance of J48 is: 99.90459315796647%
which tells us that both algorithms do very well on the test set when trained on only 10% of the original dataset.
Summary
That is a lot of work, initially, to set up the functions to interact with WEKA. Looking back, we see that UciInstance, evaluate_classifier, and the code to convert an array of UciInstance objects into an example of WEKA Instances are all reusable pieces of code. They can be packaged up into a library file to be used in future work with WEKA and similar datasets.
Working with these datasets is a useful exercise to learn about different machine-learning applications, and particularly for exploring the capabilities of learning algorithms with which you are unfamiliar. You can compare your own experimental results with those of previous researchers, and make sure you are using the algorithms correctly. Also, if and when you create your own learning algorithm, you can evaluate its performance on these standard datasets, and hence compare it with previous algorithms.
However, the format of the datasets is not consistent, although most of the data can be viewed in standard text editors. Before we can begin exploring these datasets within a toolkit such as WEKA, we must convert the data into a format that WEKA can understand. One way would be to write a tool to convert the original data format into WEKA's ARFF file format, and then work with the graphical tool. A different way, which follows on from my previous post, is to use jRuby to talk directly to WEKA; jRuby can then be used to read in and analyse the custom data format, before developing and evaluating machine-learning algorithms through the WEKA API.
Reading UCI Datasets
Using WEKA with files like the UCI datasets means converting an external data format into the internal format used within WEKA. As I covered in my previous post, WEKA instances must be constructed using a set of Attribute instances, where each Attribute describes its name, type (numeric or nominal) and the range of values it can hold, if nominal. Setting up these attributes is the tedious step. You have to look in the description of the data, and extract the attributes names, type and values, then code it into Ruby. The following was created using information from the 'names' file of the Mushroom dataset, to create an array of Attributes and a Label attribute:
# Convert provided arguments into a FastVector
# -- use mainly in making nominal attributes
def make_vector *args
atts = FastVector.new(args.length)
args.each {|arg| atts.addElement arg}
return atts
end
# == Create the attributes
Attributes = [
Attribute.new("cap-shape", make_vector("b", "c", "x", "f", "k", "s")),
Attribute.new("cap_surface", make_vector("f", "g", "y", "s")),
Attribute.new("cap_colour", make_vector("n", "b", "c", "g", "r", "p", "u", "e", "w", "y")),
Attribute.new("bruises?", make_vector("t", "f")),
Attribute.new("odour", make_vector("a", "l", "c", "y", "f", "m", "n", "p", "s")),
Attribute.new("gill-attachment", make_vector("a", "d", "f", "n")),
Attribute.new("gill-spacing", make_vector("c", "w", "d")),
Attribute.new("gill-size", make_vector("b", "n")),
Attribute.new("gill-colour", make_vector("k", "n", "b", "h", "g", "r", "o", "p", "u", "e", "w", "y")),
Attribute.new("stalk-shape", make_vector("e", "t")),
Attribute.new("stalk-root", make_vector("b", "c", "u", "e", "z", "r", "?")),
Attribute.new("stalk-surface-above-ring", make_vector("f", "y", "k", "s")),
Attribute.new("stalk-surface-below-ring", make_vector("f", "y", "k", "s")),
Attribute.new("stalk-colour-above-ring", make_vector("n", "b", "c", "g", "o", "p", "e", "w", "y")),
Attribute.new("stalk-colour-below-ring", make_vector("n", "b", "c", "g", "o", "p", "e", "w", "y")),
Attribute.new("veil-type", make_vector("p", "u")),
Attribute.new("veil-colour", make_vector("n", "o", "w", "y")),
Attribute.new("ring-number", make_vector("n", "o", "t")),
Attribute.new("ring-type", make_vector("c", "e", "f", "l", "n", "p", "s", "z")),
Attribute.new("spore-print-colour", make_vector("k", "n", "b", "h", "r", "o", "u", "w", "y")),
Attribute.new("population", make_vector("a", "c", "n", "s", "v", "y")),
Attribute.new("habitat", make_vector("g", "l", "m", "p", "u", "w", "d"))
]
Label = Attribute.new("class", make_vector("p", "e"))
The 'data' file of the Mushroom dataset contains lines of characters, in the following format:
p,x,s,n,t,p,f,c,n,k,e,e,s,s,w,w,p,w,o,p,k,s,u
e,x,s,y,t,a,f,c,b,k,e,c,s,s,w,w,p,w,o,p,n,n,g
e,b,s,w,t,l,f,c,b,n,e,c,s,s,w,w,p,w,o,p,n,n,m
p,x,y,w,t,p,f,c,n,n,e,e,s,s,w,w,p,w,o,p,k,s,u
e,x,s,g,f,n,f,w,b,k,t,e,s,s,w,w,p,w,o,e,n,a,g
Each line represents one instance, which later we will need to convert into a WEKA instance. The trick with the WEKA instances is that each must be linked to the dataset in which it lies. When I load the data, I don't know which dataset I will want each line to be added to. So, I construct instances of the following class as I read in the data. The class has a method which will build an instance and put it in the appropriate dataset, when called.
class UciInstance
attr_reader :features, :label
def initialize(features, class_label)
@features = features
@label = class_label
end
# Convert raw data into WEKA Instance and add to dataset
# -- assumes features.length == Attributes.length
def make_instance dataset
instance = Instance.new(Attributes.length + 1)
Attributes.length.times do |i|
instance.setValue(Attributes[i], features[i])
end
instance.setValue(Label, label)
instance.setDataset dataset
dataset.add instance
end
end
# -- routine to read in a UCI dataset, and return a list of UciInstances
# -- modify the parts to extract the features and class label, based on
# input data format
def read_csv filename
data = []
File.open(filename, "r") do |f|
f.each_line do |line|
items = line.rstrip.split(",")
features = items[1, items.length-1]
class_label = items[0]
data << UciInstance.new(features, class_label)
end
end
return data
end
DataSet = read_csv("agaricus-lepiota.data")
The above code will produce an array, DataSet, containing the items from the original dataset.
Comparing Algorithms
WEKA contains a huge number of algorithms. Just to name two, there is J48 for building decision-tree classifiers, and IB1 for constructing an instance-based classifier. Which one should we use? The answer to that question can be complex, and depends a lot on how intelligible we want the machine-learning model to be (decision trees and rules are much better for explaining outcomes than neural networks, for example). But a straightforward empirical question is to ask which of the two produces the best result on a given dataset. There is a fairly standard set of comparison techniques in machine learning, all based around the idea of a held-out test set, which is a dataset not used in training the model.
A held-out test set is required to prevent the following algorithm being the best learning algorithm:
- When learning, remember every training instance and its classification.
- When tested, see if the test instance is one of the ones we know.
- If it is, then return the classification we already know.
- If it is not, then return a random result.
The simplest approach is to split the complete dataset into a Training and a Test partition. We build the classifiers on the Training set and then evaluate both on the same Test set. In this way, the only variable is the type of learning algorithm - the training data and test data are the same. (A more precise way of evaluating algorithms is based on cross validation.)
Constructing the datasets
In the earlier section, we used a function to construct an array of UciInstance objects from the data file. To build the training and test sets, we first partition that array into two sections, based on a target proportion. Then we need to construct a WekaTrainingSet and WekaTestSet, which are instances of the WEKA Instances class.
# Randomly partition given array of items into two arrays, using given proportion
def split_array(array, proportion)
array1, array2 = [], []
array.each do |item|
if rand < proportion
array1 << item
else
array2 << item
end
end
return [array1, array2]
end
TrainingSet, TestSet = split_array(DataSet, 0.1)
WekaTrainingSet = Instances.new("Mushrooms training dataset",
make_vector(*(Attributes.clone << Label)),
TrainingSet.length)
WekaTrainingSet.setClassIndex(WekaTrainingSet.numAttributes() - 1)
WekaTestSet = Instances.new("Mushrooms test dataset",
make_vector(*(Attributes.clone << Label)),
TestSet.length)
WekaTestSet.setClassIndex(WekaTestSet.numAttributes() - 1)
TrainingSet.each { |instance| instance.make_instance(WekaTrainingSet) }
TestSet.each { |instance| instance.make_instance(WekaTestSet) }
puts "Training set size: #{WekaTrainingSet.numInstances}"
puts "Test set size: #{WekaTestSet.numInstances}"
Constructing the models
Building the models is simple using WEKA's API. We simply create instances of the classifiers and train them on the training set:
# == kNN classifier
include_class "weka.classifiers.lazy.IB1"
ib1 = IB1.new
ib1.buildClassifier WekaTrainingSet
# == J48 classifier
include_class "weka.classifiers.trees.J48"
j48 = J48.new
j48.buildClassifier WekaTrainingSet
Evaluating
The evaluation procedure can be wrapped into a function which takes a classifier and a dataset, and returns the percentage of the dataset which the classifier has got correct:
# Check result of classifying each instance against the target result
# and return percentage correct
def evaluate_classifier(classifier, testset)
num_correct = 0
testset.numInstances.times do |i|
begin
if testset.instance(i).classValue == classifier.classifyInstance(testset.instance(i))
num_correct += 1
end
rescue java.lang.Exception
end
end
return 100*num_correct.quo(testset.numInstances)
end
puts "Performance of IB1 is: #{evaluate_classifier(ib1, WekaTestSet)}%"
puts "Performance of J48 is: #{evaluate_classifier(j48, WekaTestSet)}%"
Result
When the above is run, we get an output like:
Training set size: 787
Test set size: 7337
Performance of IB1 is: 100.0%
Performance of J48 is: 99.90459315796647%
which tells us that both algorithms do very well on the test set when trained on only 10% of the original dataset.
Summary
That is a lot of work, initially, to set up the functions to interact with WEKA. Looking back, we see that UciInstance, evaluate_classifier, and the code to convert an array of UciInstance objects into an example of WEKA Instances are all reusable pieces of code. They can be packaged up into a library file to be used in future work with WEKA and similar datasets.
