BERRY ANEURYSM
benzalkonium chloride
A preservative that is widely used in
eye-drops and products such as cosmet-
ics and mouth washes.
benzocaine
A local anaesthetic
(see
anaesthesia,
local)
commonly used as an ingredient
in
over-the-counter
preparations
for
relieving the pain of conditions such as
mouth ulcers
and
sore throat.
benzodiazepine drugs
COMMON DRUGS
sleeping drugs
•Flunitrazepam •Flurazepam
• Loprazolam •Lormetazepam •Nitrazepam
• Temazepam
sedatives
•Alprazolam •Chlordiazepoxide
• Clorazepate •Diazepam •Lorazepam
• Oxazepam
A group of sedative drugs given for
short periods either as
sleeping drugs
for
insomnia
or to control the symptoms of
anxiety
(see
tranquillizer drugs).
Common
benzodiazepine drugs include diazepam,
which is used as a tranquillizer, and
nitrazepam, which is used to relieve
insomnia. Benzodiazepine drugs are also
used in the management of alcohol
withdrawal and in the short-term con-
trol of an epileptic seizure.
HOW THEY WORK
Benzodiazepine drugs promote sleep
and
relieve
anxiety
by
interfering
with chemical activity in the brain and
nervous system. This reduces the com-
munication between nerve cells and
depresses brain activity.
POSSIBLE ADVERSE EFFECTS
Adverse effects of benzodiazepines in-
clude
excessive
daytime
drowsiness,
dizziness, and forgetfulness. Unstead-
iness and slowed reactions may also
occur. If taken with alcohol, benzo-
diazepines may increase the alcohol’s
effect to a dangerous extent.
After as little as two weeks, users of a
benzodiazepine drug may become psy-
chologically and physically dependent
on the drug. For this reason, most doc-
tors are now reluctant to prescribe the
drugs unless they are absolutely neces-
sary, and then only for a maximum of
three weeks.
When benzodiazepine treatment is
stopped suddenly, withdrawal symp-
toms, such as anxiety, restlessness, and
nightmares may occur. People who have
been taking benzodiazepine drugs long
term need to have them gradually with-
drawn
over
the
course
of
several
months to prevent withdrawal symp-
toms. Benzodiazepines are sometimes
abused for their sedative effects.
benzoyl peroxide
An
antiseptic
agent used in the treatment
of
acne
and fungal skin infections (see
fungal infections
). In acne, benzoyl per-
oxide
also
works
by removing
the
surface layer of skin, thereby unblock-
ing sebaceous glands.
benzylpenicillin
A type of
penicillin drug
that is given
by injection.
bereavement
The emotional reaction following the
death of a loved one. The expression of
grief is individual to each person, but
there are recognized stages of bereave-
ment, each of which is characterized by
a particular attitude.
STAGES OF BEREAVEMENT
In the first stage of bereavement, which
may last from
three
days
to
three
months, there is often a feeling of
numbness and an unwillingness to rec-
ognize the death. These emotions are
defence mechanisms against admitting,
and therefore accepting, the loss and the
associated pain. Often, the reality of the
death does not penetrate completely at
this time, and many people continue to
behave as though the dead person were
still alive. Hallucinations, in which the
deceased person is seen or sensed, are a
common experience among the rec-
ently bereaved. This sensation can be
quite comforting for some people, but
others may find it disturbing.
Once the numbness wears off, the
person may be overwhelmed by feel-
ings of anxiety, anger, and despair that
can develop into a depressive illness
(see
depression).
Gastrointestinal distur-
bances,
insomnia,
malaise,
agitation,
and tearfulness are also common.
Gradually, but usually within two
years, the bereaved person adjusts to the
loss and begins to look more towards
the future. This process can involve
periods of pain and despair, alternating
with periods of enthusiasm and interest.
SUPPORT AND COUNSELLING
Family and friends can often provide
the support a bereaved person needs.
Outside help is sometimes required and
may be given by a social worker, health
visitor, member of the clergy, or self-
help group. For some people, when
depression, apathy, and lethargy impede
their chances of recovery, specialized
counselling
or
psychotherapy
is necessary.
(See also
stillbirth.)
beriberi
A nutritional disorder resulting from a
lack of
thiamine
(vitamin Bj) in the diet.
Thiamine, found in wholemeal cereals,
meat, green vegetables, potatoes, and
nuts, is essential for the metabolism of
carbohydrates. Without it, the brain, the
nerves, and the muscles (including the
heart muscle) are not able to function
properly. In developed countries, the ill-
ness is seen only in people who are
starving or those who have an extremely
restricted diet, such as alcoholics.
SYMPTOMS AND SIGNS
There are two forms of the illness:
“dry” and “wet” beriberi. In dry beri-
beri, thiamine deficiency mainly affects
the nerves and skeletal muscles. The
symptoms include numbness, a burning
sensation in the legs, and muscle wast-
ing. In severe cases, the affected person
becomes virtually paralysed, emaciated,
and bedridden.
In wet beriberi, the main problem is
heart failure
(the inability of the heart to
maintain efficient pumping of blood
around the body). This in turn causes
oedema
(swelling caused by fluid accu-
mulation) in the legs and sometimes
also in the trunk and face. Other symp-
toms
of wet beriberi
include
poor
appetite, rapid pulse, and breathlessness.
Without treatment, heart failure wors-
ens and can lead to death.
TREATMENT
Beriberi is treated with thiamine, given
either orally or by injection, which usu-
ally brings about a complete cure. A
permanent improvement in diet is also
required to prevent recurrence.
Bernard-Soulier syndrome
A
genetic disorder
in which platelets (the
blood cells
responsible
for
initiating
blood clotting) do not function prop-
erly. The syndrome is characterized by
abnormal bleeding in the skin and
internal organs.
berry aneurysm
An abnormal swelling that occurs at the
junction of
arteries
supplying the brain.
Berry aneurysms are usually due to a
congenital (present at birth) weakness
in the artery wall. They may occasionally
rupture, which results in a
subarachnoid
haemorrhage.
(See also
aneurysm
;
intra-
cranial aneurysm.)
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