People with Down syndrome often have a characteristic facial appearance that includes a flattened appearance to the face, outside corners of the eyes that point upward (upslanting palpebral fissures), small ears, a short neck, and a tongue that tends to stick out of the mouth. Affected individuals may have a variety of birth defects. Many people with Down syndrome have small hands and feet and a single crease across the palms of the hands. About half of all affected children are born with a heart defect. Digestive abnormalities, such as a blockage of the intestine, are less common.
Vrs Fa 18e Cracked Tongue
Anemia caused by an iron deficiency is manifested as paleness of the oral mucosa[55], generalized oral mucosal atrophy, pricking[56,57], atrophic glossitis with tongue pain[57] and angular cheilitis[43,55]. The deficiency of vitamin B12 is manifested in the oral cavity as a painful atrophy of the oral mucosa and the tongue, recurrent aphthous ulcerations[58,59], angular cheilitis, oral candidiasis, diffuse erythematous stomatitis and pale yellowish mucosa, especially on the palate[60]. Patients can also complain of altered taste, a burning sensation in the mouth and dysphagia[43]. If anemia is caused by a folate deficiency, the manifestations in the oral cavity are the same as in anemia caused by vitamin B12 deficiency but without neurological symptoms[43]. In more severe cases, ulcerative stomatitis and pharyngitis[43] are also detected.
Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized with Kawasaki disease annually. According to U.S. and Japanese guidelines, Kawasaki disease is a clinical diagnosis. Classic (typical) Kawasaki disease is diagnosed based on the presence of a fever lasting five or more days, accompanied by four out of five findings: bilateral conjunctival injection, oral changes such as cracked and erythematous lips and strawberry tongue, cervical lymphadenopathy, extremity changes such as erythema or palm and sole desquamation, and polymorphous rash. Incomplete (atypical) Kawasaki disease occurs in persons with fever lasting five or more days and with two or three of these findings. Transthoracic echocardiography is the diagnostic imaging modality of choice to screen for coronary aneurysms, although other techniques are being evaluated for diagnosis and management. Treatment for acute disease is intravenous immunoglobulin and aspirin. If there is no response to treatment, patients are given a second dose of intravenous immunoglobulin with or without corticosteroids or other adjunctive treatments. The presence and severity of coronary aneurysms and obstruction at diagnosis determine treatment options and the need, periodicity, and intensity of long-term cardiovascular monitoring for potential atherosclerosis.
Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.
Exposure adjustment. Safety guards of the types described in subparagraphs (3) and (4) of this paragraph, where the operator stands in front of the opening, shall be constructed so that the peripheral protecting member can be adjusted to the constantly decreasing diameter of the wheel. The maximum angular exposure above the horizontal plane of the wheel spindle as specified in paragraphs (b) (3) and (4) of this section shall never be exceeded, and the distance between the wheel periphery and the adjustable tongue or the end of the peripheral member at the top shall never exceed one-fourth inch. (See Figures O-18, O-19, O-20, O-21, O-22, and O-23.)
CBD oil comes in many different strengths, and people can utilize it in many different ways. For example, they can apply it directly to the skin, place a drop under their tongue, or add it to creams or lotions.
Scarlet fever, also known as Scarlatina, is an infectious disease caused by Streptococcus pyogenes a Group A streptococcus (GAS).[3] The infection is a type of Group A streptococcal infection (Group A strep). It most commonly affects children between five and 15 years of age.[1] The signs and symptoms include a sore throat, fever, headache, swollen lymph nodes, and a characteristic rash.[1] The face is flushed and the rash is red and blanching.[5] It typically feels like sandpaper and the tongue may be red and bumpy.[1] The rash occurs as a result of capillary damage by exotoxins produced by S.pyogenes.[6] On darker-pigmented skin the rash may be hard to discern.[7]
It generally hurts to swallow.[1] Not all cases however, present with a fever, the degree of tiredness may vary, the sore throat and tongue changes might be slight or absent, and the rash can be patchy rather than diffuse in some.[5][page needed] Cough, hoarseness, runny nose, diarrhea, and conjunctivitis are typically absent in scarlet fever; such symptoms indicate what is more likely a viral infection.[13]
Strep throat is usually associated with fatigue and a fever of over 39 C (102.2 F).[13] The tonsils may appear red and enlarged and are typically covered in exudate.[12] The throat may be red with small red spots on the roof of the mouth.[4] The uvula can look red and swollen.[5] 30% to 60% of cases have associated enlarged and tender lymph nodes in the neck.[5] During the first two days of illness the tongue may have a whitish coating from which red swollen papillae protrude, giving the appearance of a "white strawberry tongue".[5] After four to five days when the white coating sheds it becomes a "red strawberry tongue".[5] The symptomatic appearance of the tongue is part of the rash that is characteristic of scarlet fever.[14][15][16]
Scarlet fever might appear similar to Kawasaki disease, which has a characteristic red but not white strawberry tongue, and staphylococcal scarlatina which does not have the strawberry tongue at all.[12] Other conditions that might appear similar include impetigo, erysipelas, measles, chickenpox, and hand-foot-and-mouth disease, and may be distinguished by the pattern of symptoms.[4]
Fissured tongue, or scrotal tongue or lingua plicata, is a common manifestation of the tongue which is distinguished by a deep, prominent groove on the dorsum of the tongue.6 Fissures on the tongue vary in depth and can be shallow or deep. A cracked tongue can trap food, it can lead to localized inflammation, a burning sensation of the tongue and bad breath.7,8
There is a paucity of data relating to the prevalence and factors associated with fissured tongue among Afghan adults living in Afghanistan. A point to consider is the access to health services which is particularly poor in parts of rural Afghanistan.19 This study was conducted to highlight the impact of limited access to health services in these areas. The aim of this study was to determine the prevalence and factors associated with fissured tongue among patients visiting an outpatient clinic in Andkhoy, Afghanistan.
The study samples from permanent residents of Andkhoy district. Data was obtained from 1182 patients. Due to the unavailability of previous estimate of prevalence of the correlates of fissured tongue among outpatients in Andkhoy city and considering the prevalence of fissured tongue and their associated factors in similar setting, the number of subjects is due to be 600, and after taking into account the design effect (DE=2) of cluster sampling, the final sample size is expected to reach to 1200 which is reasonable for achieving study objectives. This study was conducted in accordance with the Declaration of Helsinki.
Statistical analysis was performed using SPSS software ver. 22.0 (IBM, Armonk, NY, USA). A descriptive analysis was conducted on participant characteristics using frequencies, means, standard deviation (SD) and 95% CI (confidence interval). Chi-square tests were done to investigate the associations between fissured tongue and socio-demographic variables, include, age, sex, education, occupation, tobacco use (cigarette smoking and nass use); systemic diseases, namely, hypertension and DM. Univariate associations between fissured tongue and each of the above-mentioned variable variables were first assessed using a series of univariate logistic regression analyses. All variables that might be a risk factor or might lead to fissured tongue were considered as the independent variables including sex, age groups, education level, marital status, occupation, smoking, nass use, hypertension and DM. Any variable was significantly associated with fissured tongue in the univariate logistic regression analysis were selected as a candidate for the multivariate analysis. P value of
Most participants with fissured tongue were asymptomatic. In our study, the most common type of fissured tongue was the central longitudinal pattern (42.9%), whereas the lateral longitudinal pattern was the least tongue fissured type in the study sample (8.4%). The distribution patterns of fissured tongue in our study is shown in (Figure 1).Figure 1 The distribution patterns of fissured tongue among study participants.
It is worthy to note that this is the first study to investigate the prevalence and factors associated with fissured tongue among outpatients in Andkhoy City, Afghanistan. The findings suggest that fissured tongue is common in this population, with more than one quarter (27.2%) patients having fissured tongue. The findings of our study suggested that the prevalence of fissured tongue was high among outpatients in Afghanistan, with males having a significantly higher prevalence than females, and were also associated with housewives, nass users, non-smokers, hypertensive and diabetic patients. In multivariate analysis, male gender, DM, and nass use were the variables most strongly associated with fissured tongue. 2ff7e9595c
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