Dr Tenielle Raman

Hidradenitis Suppurativa (HS): More Than Just “Boils”

Hidradenitis Suppurativa is a chronic inflammatory skin condition that causes painful lumps under the skin, usually in areas where skin rubs together.

What causes HS?
The exact cause isn’t fully understood, but it occurs when hair follicles become blocked and inflamed, leading to recurrent painful nodules and abscesses. It is not caused by poor hygiene and is not contagious.

Risk factors

• Family history of HS
• Being female
• Smoking
• Overweight or obesity
• Hormonal influences
• Associated conditions such as Polycystic O***y Syndrome, Metabolic Syndrome, and Inflammatory Bowel Disease

Common symptoms
• Painful lumps under the skin
• Recurrent “boils” or abscesses
• Drainage of pus or fluid
• Sinus tracts (tunnel-like scars under the skin)
• Scarring over time

These typically occur in the armpits, groin, buttocks, under the breasts, and inner thighs.

Common triggers
• Friction and tight clothing
• Sweating and heat
• Smoking
• Hormonal changes
• Stress

How is HS diagnosed?
Diagnosis is usually clinical, based on the appearance, location, and recurrence of lesions. Sometimes tests are done to rule out infection or other skin conditions.

Management options
While HS is chronic, early treatment can significantly improve symptoms.

Treatment may include:
• Topical or oral antibiotics
• Anti-inflammatory medications
• Hormonal therapy in selected patients
• Biologic therapy for severe disease
• Pain management
• Surgical drainage or removal of chronic lesions

Lifestyle measures that help:
• Smoking cessation
• Weight management
• Gentle skin care and loose clothing

If you experience recurrent painful “boils” in the same areas, consult your doctor early. Early diagnosis can help prevent scarring and improve quality of life.

🌍 World Prematurity Day 💜

Today we honour the tiniest fighters — our premature babies — and the incredible teams who help them thrive.

A heartfelt thank you to the dedicated gynecologists, pediatricians, nurses, and NICU nurses who show extraordinary skill, compassion and strength every single day. Your hands hold more than tiny lives — they hold hope, healing and a future.

💜 Here’s to the heroes who care for our little miracles.
💜 Here’s to the families who stay strong.
💜 And here’s to raising awareness for premature birth worldwide.

Typhoid fever is a serious bacterial infection caused by Salmonella typhi.
Typhoid fever typically develops 1–3 weeks after exposure. Symptoms may vary from mild to severe and often progress gradually.

Common signs and symptoms include:
Persistent high fever (often up to 39–40°C)
Headache and body aches
Weakness and fatigue
Loss of appetite
Abdominal pain and discomfort
Diarrhoea or constipation (may alternate)
Nausea and vomiting
Rash on the chest or abdomen (in some cases)
Enlarged spleen or liver in advanced disease

If untreated, complications such as intestinal perforation, bleeding, and severe infection (sepsis) can develop — which may be life-threatening.

Risk Factors
Consumption of contaminated food or water
Poor sanitation or inadequate sewage disposal
Travel to or residence in areas with high typhoid prevalence
Close contact with an infected person or carrier
Lack of vaccination against typhoid fever
Eating raw or undercooked foods, especially street foods or salads washed with unsafe water
Children and young adults are more vulnerable, although anyone can be affected.

Treatment
Prompt treatment is essential to prevent complications.

Antibiotic therapy is the mainstay of treatment (commonly azithromycin, ceftriaxone, or ciprofloxacin — depending on resistance patterns).
Hydration with oral or intravenous fluids to prevent dehydration.
Fever management with antipyretics and supportive care.
Nutritional support to restore energy and aid recovery.
In severe or resistant cases, hospitalization may be required for close monitoring and intravenous antibiotics.

Preventing typhoid fever relies on:
Vaccination (recommended for those living in or travelling to high-risk areas)
Safe food and water practices:
Drink only bottled or boiled water
Avoid raw fruits and vegetables that cannot be peeled
Eat foods that are thoroughly cooked and served hot
Good hand hygiene: wash hands with soap and clean water, especially before eating and after using the toilet

Typhoid fever remains a preventable and treatable infection. Early recognition of symptoms, timely medical care, vaccination, and improved sanitation is key.

Stroke Awareness: Recognising the Signs and Acting Promptly 🧠⚡

A stroke is a medical emergency resulting from an interruption of cerebral blood flow, leading to brain tissue hypoxia and potential permanent neurological damage. Prompt recognition and intervention are crucial to reduce morbidity and mortality.

🔹 Risk Factors

Stroke risk is increased by several modifiable and non-modifiable factors:

Modifiable risk factors:

Hypertension (most significant risk factor)

Diabetes mellitus

Dyslipidaemia

Atrial fibrillation and other cardiac arrhythmias

Smoking and excessive alcohol consumption

Obesity and physical inactivity

Carotid artery disease

Non-modifiable risk factors:

Increasing age (particularly >55 years)

Male s*x

Family history of cerebrovascular disease

Previous transient ischaemic attack (TIA) or stroke

🔹 Clinical Presentation

Symptoms depend on the vascular territory affected but typically have an abrupt onset.
Key features include:

Unilateral weakness or numbness of the face, arm, or leg

Facial asymmetry (facial droop)

Dysarthria or aphasia (slurred or impaired speech)

Sudden visual disturbance in one or both eyes

Sudden dizziness, loss of coordination, or gait disturbance

Sudden severe headache with no known cause (suggestive of haemorrhagic stroke)

The FAST mnemonic remains an effective screening tool in both clinical and community settings:

F – Face: Ask the patient to smile – look for facial droop.

A – Arm: Ask them to raise both arms – observe for weakness or drift.

S – Speech: Listen for slurred, incoherent, or absent speech.

T – Time: Urgent medical attention is essential – time is brain.

🔹 Immediate Steps When Stroke Is Suspected

Call emergency services immediately

Document the exact time of symptom onset — critical for determining eligibility for thrombolytic therapy.

Ensure airway patency, breathing, and circulation (ABCs).

Position the patient safely — ideally lying on their side if decreased level of consciousness or vomiting occurs.

Do not administer food, fluids, or medications until swallowing safety is assessed.

Monitor vital signs and prepare for urgent transfer to a facility capable of neuroimaging and stroke management.

Rapid recognition and referral are key to optimizing outcomes in acute stroke. Early intervention — including thrombolysis or thrombectomy where indicated — can significantly reduce disability and improve recovery potential.