December 2, 2023

When I was in my residency training, we had a patient who presented with all the typical signs of tetanus, like irritability, spasm, muscle stiffness, and lockjaw.

He did not have any open wound and thankfully his limbs were intact. He only had a few small dark pinhead lesions in two or three of his fingers. He incurred minor injuries during the New Year’s festivities when he and his friends lit firecrackers, but he did not seek any consult or treatment for the said wounds.

Tetanus is caused by toxins produced by the bacterium clostridium tetani. Spores of the tetanus bacteria can thrive in contaminated soil, dust, and animal feces for several years. The force of the firecrackers can drive contaminated particles into deep closed wounds that favor growth and proliferation of tetanus bacteria and subsequent production of the toxins.

Signs and symptoms of tetanus appear as soon as two days after infection or as long as 50 days. Immediate wound care and cleansing is necessary. Vaccination is also given.

Hospitalization is required in most cases. Severe cases may need a machine to assist in breathing.

Medications include antibiotics, muscle relaxants, sedatives, and drugs to control seizures. Ten to 20 percent of cases die from complications of tetanus.

Infection with clostridium tetani does not confer immunity. Vaccination is necessary to prevent tetanus.

In the Hope Theory developed by Dr. Charles Snyder, an American psychologist, hope is defined as the belief that your future will be better than the present and that you have the ability to make it happen. As compared to a wish, hope involves both the attitude of optimism and the intention to do something to achieve a goal.
study by Long, et al. published in the journal “Global Epidemiology” in 2020 showed positive associations between hope and subsequent health and well-being outcomes. The association was not only in psychological and social well-being but also in physical health and health behavior.

Hope brings about positive emotions, stronger sense of purpose, less depression, and less loneliness.

Wishing everyone a happy New Year. May love, hope, peace and joy mixed with thankfulness fill all our days in 2023 and all the years to come.

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