Abdominal pain is pain that is felt in the abdomen. The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, and pancreas.

Occasionally, pain may be felt in the abdomen even though it is arising from organs that are close to, but not within, the abdominal cavity. For example, conditions of the lower lungs, the kidneys, and the uterus or ovaries can cause abdominal pain. On the other hand, it also is possible for pain from organs within the abdomen to be felt outside of the abdomen. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are called "referred" pain because the pain does not originate in the location that it is felt. Rather, the cause of the pain is located away from where it is felt.

What causes abdominal pain?

Abdominal pain is caused by inflammation (for example, appendicitis, diverticulitis, colitis ), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of this latter type of pain is the irritable bowel syndrome (IBS). It is not clear what causes the abdominal pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). These latter types of pain are often referred to as functional pain because no recognizable (visible) causes for the pain have been found – at least not yet.

Characteristics of the pain

Findings on physical examination

laboratory, radiological, and endoscopic testing, and
surgery.

Abrasions (minor)

An abrasion is a superficial rub or wearing off of the skin, usually caused by a scrape or a "brush burn." Abrasions are usually minor injuries that can be treated at home. The skin may bleed or drain small amounts at the time of the injury.

First-aid for abrasions:

Calm your child and let him/her know you can help.

Wash your hands well.

Wash the abraded area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty abrasion that is not well cleaned can cause scarring.

Apply an antiseptic lotion or cream.

Cover the area with an adhesive bandage or gauze pad if the area is on the hands or feet, or if it is likely to drain onto clothing. Change the dressing often

Check the area each day and keep it clean and dry

Avoid blowing on the abrasion, as this can cause germs to grow Specific treatment for skin wounds will be determined by your child’s physician. In general, call your child’s physician for abrasions that:

Are located close to the eye or on the face.

Are embedded with debris such as dirt, stones, or gravel.

Show signs of infection such as increased warmth, redness, swelling, or drainage.

Cover a large area of the body (such as the chest or back or an entire limb).

Allergic reaction, allergies or hay fever

Hay fever is also known as seasonal allergic rhinitis. The symptoms include sneezing, a runny nose and itchy eyes. The condition affects about one in five adults in the UK and seems to be becoming more common, especially in children.

If you have hay fever, it means that you’re allergic to pollen from grasses, weeds or trees, and also possibly to moulds that are carried in the air, usually during the spring and summer.

These plants and moulds produce allergens – substances that can cause an allergic reaction. An allergic reaction happens when your body’s immune system reacts to an allergen, for example pollen, because it mistakes it for a harmful invader such as a virus. Hay fever is the result of your immune system overreacting to pollen allergens that are airborne during spring and summer and that are harmless to most people. Hay fever, asthma, food allergy and eczema are related allergic conditions and the tendency to develop them seems to run in families. This is called atopy. It means that your body produces a certain type of antibody in response to allergens. This isn’t produced in non-allergic people.

Symptoms of hay fever

You may have one or more from a range of symptoms. These include:

Sneezing

A blocked or runny nose (rhinitis)

Itchy eyes, nose and throat

Headaches

As a result of these symptoms, you may find it difficult to concentrate or sleep properly. In some people, pollen may also trigger asthma.

If you have hay fever-type symptoms all year round, you may also be allergic to house dust mites, pet hair and moulds. This is called perennial allergic rhinitis.

Causes of hay fever

If you have hay fever, when you come into contact with pollen or the spores of moulds or fungi, your body produces an antibody called immunoglobulin E (IgE). Antibodies are usually only released to fight infection, but in this instance your body believes the pollen is harmful. This antibody acts for the immune system like a firework’s ‘touch paper’, triggering the release of chemicals from certain cells in your nose, throat and eyes when there is a lot of pollen in the air. One of these chemicals is histamine – this triggers the symptoms of hay fever.

You may be allergic to one or more types of pollen – this will determine when your symptoms are most severe. Some possible causes include:

Grass pollen – half of adults in the UK who have hay fever are allergic to grass pollen, with the varieties that are most commonly responsible being rye grass and timothy.

Tree pollen – one person in four in the UK with hay fever is allergic to birch pollen, but different trees produce pollen at varying times of the year and it depends which one you’re allergic to as to when your symptoms are worst
weeds, such as ragwort and other plants, as well as spores from fungi and moulds
Allergen

Arthritis

Overview

Arthritis is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis.

Symptoms

If you have arthritis, you may experience: â€¢Joint pain
â€¢Joint swelling
â€¢Reduced ability to move the joint
â€¢Redness of the skin around a joint
â€¢Stiffness, especially in the morning
â€¢Warmth around a joint

Treatment

Treatment of arthritis depends on the particular cause, which joints are affected, severity, and how the condition affects your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan. If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, the cause is NOT necessarily curable, as with osteoarthritis and rheumatoid arthritis. Treatment, therefore, aims at reducing your pain and discomfort and preventing further disability. It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications. In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes. Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength. Your exercise program should be tailored to you as an individual. Work with a physical therapist to design an individualized program, which should include: â€¢Low-impact aerobic activity (also called endurance exercise)
â€¢Range of motion exercises for flexibility
â€¢Strength training for muscle tone A physical therapist can apply heat and cold treatments as needed and fit you for splints or orthotic (straightening) devices to support and align joints. This may be particularly necessary for rheumatoid arthritis. Your physical therapist may also consider water therapy, ice massage, or transcutaneous nerve stimulation (TENS). Rest is just as important as exercise. Sleeping 8 to 10 hours per night and taking naps during the day can help you recover from a flare-up more quickly and may even help prevent exacerbations. You should also:

â€¢Avoid holding one position for too long.
â€¢Avoid positions or movements that place extra stress on your affected joints.
â€¢Modify your home to make activities easier. For example, have grab bars in the shower, the tub, and near the toilet.
â€¢Reduce stress, which can aggravate your symptoms. Try meditation or guided imagery. And talk to your physical therapist about yoga or tai chi.
Other measures to try include:

â€¢Apply capsaicin cream (derived from hot chili peppers) to the skin over your painful joints. You may feel improvement after applying the cream for 3-7 days.
â€¢Eat a diet rich in vitamins and minerals, especially antioxidants like vitamin E. These are found in fruits and vegetables. Get selenium from Brewer’s yeast, wheat germ, garlic, whole grains, sunflower seeds, and Brazil nuts. Get omega-3 fatty acids from cold water fish (like salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
â€¢Taking glucosamine and chondroitin — these form the building blocks of cartilage, the substance that lines joints. These supplements are available at health food stores or supermarkets. While some studies show such supplements may reduce osteoarthritis symptoms, others show no benefit. However, since these products are regarded as safe, they are reasonable to try and many patients find their symptoms improve.

MEDICATIONS

Your doctor will choose from a variety of medications as needed. Generally, the first drugs to try are available without a prescription. These include: â€¢Acetaminophen (Tylenol) — recommended by the American College of Rheumatology and the American Geriatrics Society as first-line treatment for osteoarthritis. Take up to 4 grams a day (two arthritis-strength Tylenol every 8 hours). This can provide significant relief of arthritis pain without many of the side effects of prescription drugs. DO NOT exceed the recommended doses of acetaminophen or take the drug in combination with large amounts of alcohol. These actions may damage your liver.
â€¢Aspirin, ibuprofen, or naproxen — these nonsteroidal anti-inflammatory drugs (NSAIDs) are often effective in combating arthritis pain. However, they have many potential risks, especially if used for a long time. They should not be taken in any amount without consulting your doctor. Potential side effects include heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage. In 2005, the U.S. Food and Drug Administration (FDA) asked makers of NSAIDs to include a warning label on their product that alerts users of an increased risk for heart attack, stroke, and gastrointestinal bleeding. If you have kidney or liver disease, or a history of gastrointestinal bleeding, you should not take these medicines unless your doctor specifically recommends them.
Prescription medicines include: â€¢Biologics– these are the most recent breakthrough for the treatment of rheumatoid arthritis. Such medications, including etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira), are administered by injection and can dramatically improve your quality of life. Newer biologics include Orencia (abatacept) and Rituxan (rituximab).
â€¢Corticosteroids ("steroids") — these are medications that suppress the immune system and symptoms of inflammation. They are often injected into painful osteoarthritic joints. Steroids are used to treat autoimmune forms of arthritis but should be avoided in infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.
â€¢Cyclooxygenase-2 (COX-2) inhibitors — These drugs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Talk to your doctor about whether COX-2s are right for you.
â€¢Disease-modifying anti-rheumatic drugs — these have been used traditionally to treat rheumatoid arthritis and other autoimmune causes of arthritis. These drugs include gold salts, penicillamine, sulfasalazine, and hydroxychloroquine. More recently, methotrexate has been shown to slow the progression of rheumatoid arthritis and improve your quality of life. Methotrexate itself can be highly toxic and requires frequent blood tests for patients on the medication.
â€¢Immunosuppressants — these drugs, like azathioprine or cyclophosphamide, are used for serious cases of rheumatoid arthritis when other medications have failed.
It is very important to take your medications as directed by your doctor. If you are having difficulty doing so (for example, due to intolerable side effects), you should talk to your doctor.

SURGERY AND OTHER APPROACHES

In some cases, surgery to rebuild the joint (arthroplasty) or to replace the joint (such as a total knee joint replacement) may help maintain a more normal lifestyle. The decision to perform joint replacement surgery is normally made when other alternatives, such as lifestyle changes and medications, are no longer effective. Normal joints contain a lubricant called synovial fluid. In joints with arthritis, this fluid is not produced in adequate amounts. In some cases, a doctor may inject the arthritic joint with a manmade version of joint fluid. The synthetic fluid may postpone the need for surgery at least temporarily and improve the quality of life for persons with arthritis.

Causes

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness. You may have joint inflammation for a variety of reasons, including: â€¢An autoimmune disease (the body attacks itself because the immune system believes a body part is foreign)
â€¢Broken bone
â€¢General "wear and tear" on joints
â€¢Infection (usually caused by bacteria or viruses)
Often, the inflammation goes away after the injury has healed, the disease is treated, or the infection has been cleared. With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include: â€¢Being overweight
â€¢Previously injuring the affected joint
â€¢Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)
Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people. Other types or cause of arthritis include: â€¢Adult Still’s disease
â€¢Ankylosing spondylitis
â€¢Fungal infections such as blastomycosis
â€¢Gonococcal arthritis
â€¢Gout
â€¢Juvenile rheumatoid arthritis (in children)
â€¢Other bacterial infections (nongonococcal bacterial arthritis)
â€¢Psoriatic arthritis
â€¢Reactive arthritis (Reiter syndrome)
â€¢Rheumatoid arthritis (in adults)
â€¢Scleroderma
â€¢Systemic lupus erythematosus (SLE)
â€¢Tertiary Lyme disease
â€¢Tuberculous arthritis
â€¢Viral arthritis
Tests & diagnosis First, your doctor will take a detailed medical history to see if arthritis or another musculoskeletal problem is the likely cause of your symptoms. Next, a thorough physical examination may show that fluid is collecting in the joint. (This is called an "effusion.") The joint may be tender when it is gently pressed, and may be warm and red (especially in infectious arthritis and autoimmune arthritis). It may be painful or difficult to rotate the joints in some directions. This is known as "limited range-of-motion." In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Such joint deformities are the hallmarks of severe, untreated rheumatoid arthritis. Tests vary depending on the suspected cause. They often include blood tests and joint x-rays. To check for infection and other causes of arthritis (like gout caused by crystals), joint fluid is removed from the joint with a needle and examined under a microscope. See the specific types of arthritis for further information.

Prognosis

A few arthritis-related disorders can be completely cured with treatment. Most are chronic (long-term) conditions, however, and the goal of treatment is to control the pain and minimize joint damage. Chronic arthritis frequently goes in and out of remission.

Prevention

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms. Osteoarthritis may be more likely to develop if you abuse your joints (injure them many times or over-use them while injured). Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions. Excess weight also increases the risk for developing osteoarthritis in the knees and possibly in the hips. See the article on body mass index to learn whether your weight is healthy.
Complications
â€¢Chronic pain
â€¢Lifestyle restrictions or disability
When to contact a doctor
Call your doctor if:Excess weight also increases the risk for developing osteoarthritis in the knees and possibly in the hips. See the article on body mass index to learn whether your weight is healthy. â€¢Your joint pain persists beyond 3 days.
â€¢You have severe unexplained joint pain.
â€¢The affected joint is significantly swollen.
â€¢You have a hard time moving the joint.
â€¢Your skin around the joint is red or hot to the touch.
â€¢You have a fever or have lost weight unintentionally. T

Back pain (mild, able to walk without assistance)

Blood pressure check

Burns (minor)

Cholesterol screenings

Cholesterol is a serious heart disease risk factor. Although the risk rises with the level of cholesterol, some people with relatively low values experience problems with atherosclerosis. Cholesterol is a fatlike substance found in all human and animal tissues but not in plants. We ingest cholesterol in foods from animals (e.g., meat, eggs, fish, poultry, and dairy products), or we can synthesize it in the body. If you donâ€™t eat much cholesterol, the body will make all it needs from other fats. The blood transports cholesterol in low- or high-density lipo-protein packages.

The ideal total cholesterol level is below 150 milligrams. Values from 150 to 200 should respond to a moderate reduction of saturated and hydrogenated fats in the diet. Levels from 200 to 240 call for a concentrated effort to reduce these atherogenic fats and take additional dietary measures, including increasing intake of bran and other natural foods to reduce cholesterol. Cholesterol levels that remain above 240 after dietary, exercise, and weight-loss interventions may require drug therapy, especially if other risk factors are present. Fortunately, cholesterol drugs have been proved successful at lowering levels and the incidence of heart disease. Consult your physician for details.

Low-density lipoprotein cholesterol (LDL) is the dangerous version that finds its way into the lining of the coronary arteries. It can combine with oxygen and enhance the development of plaques in arteries. High-density lipoprotein cholesterol (HDL) acts like a transport system that picks up excess cholesterol and delivers it to the liver for reprocessing or removal. Thus, higher HDL levels are protective, with a one-milligram increase associated with a 2 to 3 percent reduction in CAD. Conversely, low values are an independent risk factor. So you can have a low total cholesterol level and still have some risk if your HDL is low. You should know all three numbers (total cholesterol, LDL, and HDL), as well as your cholesterol to HDL ratio.

Another way to assess your risk is to calculate your total cholesterol to HDL ratio. A ratio under 4 (e.g., 200 divided by 50) is associated with a low risk of heart disease, whereas a ratio over 6 (e.g., 240 divided by 40) is not. All adults should be tested every 5 years unless values are borderline or high, a circumstance that calls for annual testing and treatment.

Recent research has identified two additional tests to help determine oneâ€™s risk of heart disease:

Homocysteine is often elevated in the blood of those at high risk for heart probÂ¬lems. A blood test will show if a problem exists. If it does, the solution is simple: an increase in foods containing the B vitamin folate (or a folate supplement). Folate is also important for pregnant women or those planning to become pregnant.

C-reactive protein (C-RP) is a sign of inflammatory activity that is associated with an increased risk of a heart attack (Ridker et al. 2000). C-RP may influence apoptosis or fragmentation of human coronary vascular smooth muscle cells, a key event in the development of atherosclerotic lesions and the vulnerability of plaque to rupture (Blaschke et al. 2004). But because C-RP is also associated with chronic infections and arthritis, it is viewed as a relatively moderate predictor of CAD (Danesh et al. 2004). Recent studies indicate that cholesterol-lowering statin drugs may also lower C-RP, and that those with lower C-RP levels have a greater reduction in coronary risk (Nissen et al. 2005). A blood test can determine the level. Efforts to reduce the risk may include daily intake of an aspirin, vitamin E, an alcoholic beverage, weight loss, statin therapy, and, of course, physical activity.

Common urinary tract infections

Overview

A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected.

Bladder — an infection in the bladder is also called cystitis or a bladder infection

Kidneys — an infection of one or both kidneys is called pyelonephritis or a kidney infection

Ureters — the tubes that take urine from each kidney to the bladder are only rarely the site of infection

Urethra — an infection of the tube that empties urine from the bladder to the outside is called urethritis See also:

Cystitis – noninfectious

Interstitial cystitis

Urethritis

Urinary tract infection – children

Symptoms

The symptoms of a bladder infection include:

Cloudy or bloody urine, which may have a foul or strong odor

Low fever (not everyone will have a fever)

Pain or burning with urination

Pressure or cramping in the lower abdomen (usually middle) or back

Strong need to urinate often, even right after the bladder has been emptied If the infection spreads to your kidneys, symptoms may include:

Chills and shaking or night sweats

Fatigue and a general ill feeling

Fever above 101 degrees Fahrenheit

Flank (side), back, or groin pain

Flushed, warm, or reddened skin

Mental changes or confusion (in the elderly, these symptoms often are the only signs of a UTI)

Nausea and vomiting

Severe abdominal pain (sometimes)

Treatment

Your doctor must first decide whether you have a mild or simple bladder or kidney infection, or whether your infection is more serious.

MILD BLADDER AND KIDNEY INFECTIONS

Antibiotics taken by mouth are usually recommended because there is a risk that the infection can spread to the kidneys.

For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 – 14 days (men). For a bladder infection with complications such as pregnancy or diabetes, OR a mild kidney infection, you will usually take antibiotics for 7 – 14 days.

It is important that you finish all the antibiotics, even if you feel better. People who do not finish their antibiotics may develop an infection that is harder to treat. Commonly used antibiotics include trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline, and fluoroquinolones. Your doctor will also want to know whether you could be pregnant. Your doctor may also recommend drugs to relieve the burning pain and urgent need to urinate. Phenazopyridine hydrochloride (Pyridium) is the most common of this type of drug. You will still need to take antibiotics. Everyone with a bladder or kidney infection should drink plenty of water. Some women have repeat or recurrent bladder infections. Your doctor may suggest several different ways of treating these.

Taking a single dose of an antibiotic after sexual contact may prevent these infections, which occur after sexual activity.

Having a 3-day course of antibiotics at home to use for infections diagnosed based on your symptoms may work for some women.

Some women may also try taking a single, daily dose of an antibiotic to prevent infections. See also: Catheter-associated UTI

MORE SEVERE KIDNEY INFECTIONS

If you are very sick and cannot take medicines by mouth or drink enough fluids, you may be admitted to the hospital. You may also be admitted to the hospital if you:

Are elderly

Have kidney stones or changes in the anatomy of your urinary tract

Have recently had urinary tract surgery

Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems

Are pregnant and have a fever or are otherwise ill At the hospital, you will receive fluids and antibiotics through a vein. Some people have urinary tract infections that keep coming back or that do not go away with treatment. Such infections are called chronic UTIs. If you have a chronic UTI, you may need antibiotics for a long period of time, perhaps as long as 6 months to 2 years, or stronger antibiotics may be prescribed. If a structural (anatomical) problem is causing the infection, surgery may be recommended.

Causes

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the

bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the

kidneys. Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk
of having UTIs. Women tend to get them more often because their urethra is shorter and closer to the anus than in men.

Because of this, women are more likely to get an infection after sexual activity or when using a

diaphragm for birth control. Menopause also increases the risk of a UTI.

The following also increase your chances of developing a UTI:

Diabetes

Advanced age (especially people in nursing homes)

Problems emptying your bladder (urinary retention) because of brain or nerve disorders

A tube called a urinary catheter inserted into your urinary tract

Bowel incontinence

Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine

Kidney stones

Staying still (immobile) for a long period of time (for example, while you are recovering from a hip

fracture Pregnancy

Tests & diagnosis

A urine sample is usually collected to perform the following tests:

Urinalysis is done to look for white blood cells, red blood cells, bacteria, and to test for certain

chemicals, such as nitrites in the urine. Most of the time, your doctor or nurse can diagnose an infection

using a urinalysis.

Urine culture – clean catch may be done to identify the bacteria in the urine to make sure the correct

antibiotic is being used for treatment CBC and a blood culture may be done.

The following tests may be done to help rule out problems in your urinary system that might lead to

infection or make a UTI harder to treat:

CT scan of the abdomen

Intravenous pyelogram (IVP)

Kidney scan

Kidney ultrasound

Voiding cystourethrogram

Prognosis

A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder

infection usually disappear within 24 – 48 hours after treatment begins. If you have a kidney infection, it

may take 1 week or longer for your symptoms to go away.

Prevention

Lifestyle changes may help prevent some UTIs. After menopause, a woman may use estrogen cream in the vagina area to reduce the chance of further

infections.

BATHING AND HYGIENE

Choose sanitary pads instead of tampons, which some doctors believe make infections more likely.

Change the pad each time you use the bathroom.

Do not douche or use feminine hygiene sprays or powders. As a general rule, do not use any product

containing perfumes in the genital area. Take showers instead of baths. Avoid bath oils. Keep your genital area clean. Clean your genital and anal areas before and after sexual activity. Urinate before and after sexual activity. Wipe from front to back after using the bathroom.

CLOTHING

Avoid tight-fitting pants.

Wear cotton-cloth underwear and pantyhose, and change both at least once a day.

DIET

Drink plenty of fluids (2 to 4 quarts each day).

Drink cranberry juice or use cranberry tablets, but NOT if you have a personal or family history of kidney

stones. Do NOT drink fluids that irritate the bladder, such as alcohol and caffeine.

Complications

Life-threatening blood infection (sepsis) – risk is greater among the young, very old adults, and those

whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy) Kidney damage or scarring Kidney infection When to contact a doctor Contact your health care provider if you have symptoms of a UTI. Call right away if the following

symptoms develop: Back or side pain Chills Fever Vomiting These may be signs of a possible kidney infection Also call if you have already been diagnosed with a UTI and the symptoms come back shortly after

treatment with antibiotics.

Urinary tract infection – children

Overview

A urinary tract infection (UTI) is a bacterial infection of the urinary tract. This article discusses UTIs in

children. The urinary tract includes the: Bladder Kidneys Ureters — the tubes that take urine from each kidney to the bladder Urethra — the tube that empties urine from the bladder to the outside See also: Catheter-associated UTI Urinary tract infection – adults

Symptoms

Young children with UTIs may only have a fever, poor appetite, vomiting, or no symptoms at all. Most urinary tract infections in children only involve the bladder. If the infection spreads to the kidneys, it

is called pyelonephritis and may be more serious. Symptoms of a bladder infection in children include: Blood in the urine Cloudy urine Foul or strong urine odor Frequent or urgent need to urinate General ill feeling (malaise) Pain or burning with urination Pressure or pain in the lower pelvis or lower back Wetting problems after the child has been toilet trained Symptoms that the infection may have spread to the kidneys include: Chills with shaking Fever Flushed, warm, or reddened skin Nausea Pain in the side (flank) or back Severe pain in the belly area Vomiting

Treatment

In children, UTIs should be treated quickly with antibiotics to protect the developing kidneys. Any child

under 6 months old or who has other complications should see a specialist immediately. Younger infants will usually stay in the hospital and be given antibiotics through a vein. Older infants and

children are treated with antibiotics by mouth. If this is not possible, they are admitted to the hospital

where they are given antibiotics through a vein. It is important that your child drink plenty of fluids during the time they have a urinary tract infection. Some children may be treated with antibiotics for long periods of time (as long as 6 months – 2 years), or

they may be prescribed stronger antibiotics. The health care provider may also recommend low-dose antibiotics after the first symptoms have gone

away. This type of treatment is less common now than it once was. Antibiotics commonly used in children include:

Amoxicillin or amoxicillin/clavulanic acid (Augmentin)

Cephalosporins

Doxycycline (should not be used in children under age

Nitrofurantoin

Trimethoprim-sulfamethoxazole Follow-up urine cultures may be needed to make sure that bacteria are no longer in the bladder.

Causes

Urinary tract infections (UTIs) can occur when bacteria find their way into the bladder or the kidneys.

These bacteria are normally found on the skin around the anus or sometimes around the vagina. Normally, there are no bacteria in the urinary tract itself. However, certain things can make it easier for

bacteria to enter or stay in the urinary tract. These include: A problem in the urinary tract, called vesicoureteral reflux, which is usually present at birth. This

condition allows urine to flow back up into the ureters and kidneys Brain or nervous system illnesses (such as myelomeningocele, spinal cord injury, hyrocephalus) that

make it harder to completely empty the bladder Bubble baths or tight fitting clothes (girls) Changes or birth defects in the structure of the urinary tract Not urinating (peeing) often enough during the day Wiping from back (near the anus) to front after going to the bathroom. In girls, this can bring bacteria to

the opening where the urine comes out UTIs are more common in girls, especially around age 3 when they first begin toilet training. In boys who

are not circumcised, the risk for UTIs is slightly higher before the first birthday.

Tests & diagnosis

A urine sample is needed to diagnose a UTI in children. The sample is examined under a microscope

and sent to a lab for a urine culture. In children who are not toilet trained, getting a urine sample can be difficult. The test cannot be done

using a wet diaper. Possible ways to collect a urine sample in very young children include: Urine collection bag — A special plastic bag is placed over the child’s penis or vaginal area to catch the

urine; this is not the best method because the sample may become contaminated. Catheterized specimen urine culture — A plastic tube (catheter) placed into the tip of the penis in boys,

or directly into the urethra in girls, collects urine directly from the bladder. Suprapubic urine collection — A needle is placed through the skin of the lower abdomen and muscles,

into the bladder, and used to collect urine. If this is your child’s first UTI, special imaging tests may be done to determine why the infection

happened, or to see if there is any kidney damage. Tests may include: Kidney ultrasound X-ray taken while the child is urinating (voiding cystourethrogram) These studies may be done while the child has an infection, but most often it’s done weeks to several

months afterward Your doctor will consider many things when deciding if and when a special study is needed, including: Is the child younger than 6 months? Has the child had infections in the past? Is the infection severe? Does the child have other medical illnesses? Does the child have a problem with the spinal cord or defects of the urinary tract? Has the child responded quickly to antibiotics?

Prognosis

Most children are cured with proper treatment. The treatment may continue over a long period of time. The long-term consequences of repeated UTIs in children can be serious. However, these infections can

usually be prevented.

Prevention

Avoid giving your child bubble baths

Have your child wear loose-fitting underpants and clothing

Increase your child’s intake of fluids

Keep your child’s genital area clean to prevent bacteria from entering through the urethra

Teach your child to go the bathroom several times every day

Teach your child to wipe the genital area from front to back to reduce the chance of spreading bacteria

from the anus to the urethra Long-term use of preventive (prophylactic) antibiotics may be recommended for some children who are
prone to chronic UTIs.

Complications

High blood pressure

Kidney abscess

Kidney infection (pyelonephritis)

Renal insufficiency or kidney failure

Swelling of the kidneys (hydronephrosis) When to contact a doctor Call for an appointment with your health care provider if your child’s UTI symptoms continue after

treatment or come back more than twice in 6 months. Call your health care provider if the child’s symptoms get worse, or new symptoms develop, especially: Back pain or flank pain Bad-smelling, bloody, or discolored urine Fever of 100.4Â°Fahrenheit (38Â°Celcius) rectally in infants, or over 101Â°Fahrenheit (38.3Â°Celcius) in

children Low-back pain or abdominal pain (especially below the belly button) Persistent fever Unusually frequent urination or frequent urination during the night Vomiting

Constipation three days or less

Constipation is an acute or chronic condition in which bowel movements occur less often than usual or consist of hard, dry stools that are painful or difficult to pass. Although constipation is a relative term, with normal patterns of bowel movements varying widely from person to person, generally an adult who has not had a bowel movement in three days or a child who has not had a bowel movement in four days is considered constipated. Infants who are still exclusively breastfed may go seven days without a stool.

Description

The colon (the large intestine) absorbs water while forming waste products (the stool) from digested food. Muscle contractions in the colon (peristalsis) push the stool toward the rectum. By the time the stool reaches the rectum, it is solid because most of the water has been absorbed. However, hard, dry stools and constipation occur when too much water is absorbed by the colon from the stool, which can result from the muscle of the colon contracting too slowly. Constipation is also referred to as irregularity of bowels or lack of regular bowel movements. Constipation can occur at any age and is more common among individuals who resist the urge to move their bowels at their body’s signal. This often happens when children start school or enter daycare. They may feel shy about asking permission to use the bathroom, they may be involved in more enjoyable activities and may not want to stop, or they may be rushed when using the bathroom and not have time to complete the bowel movement. Once constipation has developed and bowel movements become painful or more difficult, the child will attempt to go even less often, and the constipation will worsen. Although this condition is rarely serious, it can lead to the following:

Tearing of the mucosal membrane of the anus (especially in children), which can cause bleeding and the development of an anal fissure

Bowel obstruction

Chronic constipation

Hemorrhoids (a mass of dilated veins in swollen tissue around the anus)

Hernia (a protrusion of an organ through a tear in the muscle wall)

Spastic colitis ( irritable bowel syndrome , a condition characterized by alternating periods of diarrhea and constipation)

Laxative dependency Less commonly, chronic constipation may be a symptom of colorectal cancer , depression, diabetes, diverticulosis (small pouches in the muscles of the large intestine), lead poisoning , or Parkinson’s disease (in adults) and should be investigated by a doctor. Constipation is a common complaint in children, occurring in up to 10 percent of youngsters. It accounts for approximately 3 percent of pediatric outpatient visits and 25 percent of visits to a pediatric gastroenterologist.

Causes and symptoms

Constipation usually results from not getting enough exercise , not drinking enough fluids (especially water), delays in going to the bathroom when there is the urge to defecate, or from a diet that does not include an adequate amount of fiber-rich foods such as beans, bran cereals, fruits, raw vegetables, rice, and whole-grain breads. Eating too many dairy products such as milk, cheese, yogurt, and ice cream may also result in harder stools. Constipation in children often occurs when they hold back bowel movements for various reasons, such as when they are not ready for toilet training or are afraid of toilet training. Other less common causes of constipation include anal fissure (a tear or crack in the lining of the anus); chronic kidney failure; colon or rectal cancer; depression; hypercalcemia (abnormally high levels of calcium in the blood); hypothyroidism (underactive thyroid gland); illness requiring complete bed rest; and irritable bowel syndrome. Stress and travel can also contribute to constipation, as well as other changes in bowel habits. Constipation can also be a side effect of the use of the following medications, many of which are not commonly used by children:

Aluminum salts in antacids

Antihistamines

Antipsychotic drugs

Aspirin

Belladonna ( Atopa belladonna, a source of atropine, a medication used to relieve spasms and dilate the pupils of the eye)

Beta blockers (medications used to stabilize irregular heartbeat, lower high blood pressure, and reduce chest pain )

Blood pressure medications

Calcium channel blockers (medication prescribed to treat high blood pressure, chest pain, some types of irregular heartbeat and stroke , and some non-cardiac

Diuretics (drugs that promote the formation and secretion of urine)

Iron or calcium supplements

Narcotics (potentially addictive drugs that relieve pain and cause mood changes)

Tricyclic antidepressants (medications prescribed to treat chronic pain, depression, headaches, and other illnesses)

Treatment

Constipation is usually a temporary problem in children and no cause for concern. A child with constipation should be instructed to drink an adequate amount of water each day (six to eight glasses), exercise on a regular basis, and eat a diet high in soluble and insoluble fibers. Soluble fibers include pectin, flax, and gums; insoluble fibers include psyllium and brans from grains like wheat and oats. Fresh fruits and vegetables contain both soluble and insoluble fibers. Dietary fiber intake should be increased gradually, along with an increase in water consumption, in order to produce soft, bulky stools. Constipation in infants may be treated by the following:

If over two months of age, feeding the infant 2â€“4 ounces (60â€“120 ml) of fruit juice (grape, pear, apple, cherry, or prune) twice a day.

If over four months of age and the infant has begun solid foods, feeding the baby foods with high fiber content (such as peas, beans, apricots, prunes, peaches, pears, plums, and spinach) twice a day If changes in diet and activity fail to relieve occasional constipation, an over-the-counter laxative may be used for a few days. Preparations that soften stools or add bulk (bran, psyllium) work more slowly but are safer than Epsom salts and other harsh laxatives or herbal laxatives containing senna ( Cassia senna ) or buckthorn ( Rhamnus purshianna ), which can harm the nerves and lining of the colon. A child who is experiencing abdominal pain, nausea , or vomiting should not use a laxative. Laxatives should not be used for a long period, because the child can become dependent on them. A warm-water or mineral oil enema can relieve constipation in children with severe or stubborn cases of constipation. However, laxatives or enemas should not be given to children without instruction from a doctor. If a child has an impacted bowel, the doctor can insert a gloved finger into the rectum and gently dislodge the hardened feces.

Coughs, colds, flu

Coughs, cold & flu are all contagious viral infections. They are spread by inhaling infected airborne droplets from sneezing, coughing and speaking. A cold involves symptoms such as sore throat, mild fever, runny nose, cough, general weakness or tiredness. Coughs may be wet and productive (coughing up phlegm) or dry and hacking. During a viral infection the nasal discharge and phlegm will be clear, white or yellow in colour. If this changes to a green or brown colour it may indicate the presence of a bacterial infection, which will need to be treated by your doctor. Flu or influenza on the other hand is much more severe and debilitating. Symptoms may include all of the above accompanied by extreme joint and muscular pains, very high temperatures, nausea and vomiting.

Prevention

Regular exercise, a balanced diet and adequate sleep will help keep your immune system strong.

Regular hand washing can minimise the chance of catching a cold and spreading it to others.

An annual flu vaccination will help protect you against influenza

Treatment:

The best thing to do is to treat the symptoms and let your body recover.

Get plenty of rest and sleep and avoid stress. Refrain from exercise. You need to give your body a chance to fight the infection. Stay home from work or study if you can to avoid spreading the virus.

Drink plenty of fluids – water is best – to replace fluids that you will lose by having a fever. Avoid caffeine and alcohol based drinks Keep warm, but do not overdress. Analgesics such as aspirin or panadol will reduce fever, headache and muscular pains. Do not exceed 8 tablets in a 24 hour period. Donâ€™t give aspirin to children. Nasal congestion can be treated with medications such as â€œsudafedâ€ or combined preparations that treat fever, pain, and congestion, such as â€œcodral cold tabletsâ€. Discuss the best choice and the possible side-effects of these medications with your doctor, nurse or pharmacist before using. Try steam inhalation, which involves putting boiled water in a bowl with a few drops of eucalyptus oil, putting a towel over your head and breathing in the vapours. This can be effective for clearing your nasal passages. Do this for 10 minutes and be careful not to burn yourself. Do not use with children. Use gargles and cough lozenges as these can help soothe a sore throat The acute symptoms of a cold will generally last 2 to 7 days and for influenza approximately a week. Being sick for up to 10 days is not unusual. Sometimes a cough can go on for a few weeks â€“ if you are getting better, not worse, there is no need to worry.

Cuts (minor) when the bleeding is under control (call your doctor to ensure your tetanus shot is up to date)

Dermatologic problems (minor)

Children with atopic dermatitis, especially those with severe disease, can develop behavioral and emotional problems from the very pruritic and disabling disease. However, few controlled studies have examined the prevalence and types of psychological disturbance or the problems experienced by parents of these patients. These investigators studied psychological problems in children aged 5 to 15 years with all degrees of atopic dermatitis.

Thirty consecutive children with atopic eczema and a comparison group of 30 age-matched children with minor skin problems were evaluated by a child psychiatrist using a popular, standard questionnaire (Rutter A2 scale). The mother’s mental distress and the family’s social support were also assessed. Psychological disturbance was found in 50% of children with eczema versus 27% of controls. The rate of psychological disturbance was 53% in children with moderate eczema and 80% in those with severe eczema. The majority (80%) of atopic children with psychological problems had emotional disorders, while 20% had conduct problems. No increase in hyperactivity disorders was seen in the atopic group compared with controls. The degree of maternal emotional distress and family social support was similar in the two groups.

Comment: The 60% rate of psychological disturbance in children with moderate and severe eczema combined is alarming. Previous studies have shown rates of 38% and 29% in children with leukemia and epilepsy, respectively, and management of these conditions usually involves some type of psychological assistance. Previous studies also have shown that attention to the emotional and behavioral problems in atopic patients can lead to improvement in the skin disease. In addition to the numerous topical and oral preparations we use when treating atopic children, we should enlist the help of our colleagues trained in psychological management.

Diarrhea

Diarrhea, as we all know, is a condition in which we experience frequent watery stools (loose stools) as against normal smooth stools, in other words its increase in the liquid substance in the stools accompanied with increase in stool frequency. Diarrhea can be looked at as one of the symptoms for many types of bowel/digestive system related diseases or itself is a disease under various conditions.

In general cases, diarrhea can last anywhere from 2 days to 2 weeks (short-termed) and is not a serious condition. But you should be watchful if it is more painful, and lasts longer than 2 weeks, in that case you should see your physician for an expert advice.

What happens in Colon?

As a part of digestion, liquid content (amount of water) in the food is needed to be at higher level for its smoother digestion. Food first enters into stomach and travels to small intestine and then large intestine, during this journey most of the nutrients are absorbed by these parts.

At the end of digestion process, when the food reaches colon, body finishes absorbing almost all the possible nutrients. Colon absorbs the excess amount of water from the stool that is then pushed towards the rectum, and stored until it is thrown out of the body.

Symptoms of Diarrhea

Loose/watery stools

At times there can be abdominal pain associated with diarrhea.

Nausea

Sometimes stool contains blood

Fever

Causes of diarrhea

As already mentioned above, diarrhea can be normal (short-termed) to severe. General causes of diarrhea are:

Bacterial & Viral Infection: This is considered as one of the main causes of diarrhea. Bacterial & viral infection caused via various means such as consumption of contaminated food or drinking water cause diarrhea. This is common mainly in developing countries where separation of drinking and sewage water is a big problem. Diarrhea caused by few types of bacteria can also kill the patient if no proper medication is made available. Bacteria like E-coli, Campylobacter, Salmonella, lamblia etc. and virus like Rota-virus; herpes etc. are few names in the list.
The other reason of diarrhea is through infection, in case if the patient is suffering from other diseases, especially diseases which are related to intestinal infection. Diarrhea is experienced by patients who are suffering from serious diseases like AIDS, dysentery, Crohnâ€™s disease, inflammatory bowel diseases such as Irritable Bowel Syndrome, cholera, bowel cancer, Ischemic bowel disease, some cases of appendicitis etc.

Bodyâ€™s negative response to some elements: If your body shows negative response to some food material, then consuming it might cause you problems like diarrhea. One of the examples is consumption of milk. It has been witnessed that digestive systems of many people cannot process and digest lactose and other elemens available in milk leading to diarrhea. The best advise to those people would be to avoid consumption of any such thing.

Laxatives & other chemicals: Laxatives like magnesium (Epsom salt), phenolphthalein, cascara etc. that are used in day to day lives and also some chemicals which are part of our food, can cause diarrhea in some people.

Medicines: Certain type of medicines (including antibiotics and other drugs) cause diarrhea in patients. You should be very careful while using any new drug. If you witness a sudden problem with your bowel habits after you have started the medication that your physician suggested you, then you should stop taking medicines and contact your physician at the earliest.

Excessive consumption of alcohol: Excessive alcohol consumption can also cause diarrhea in patients. Generally excessive alcohol consumption causes chronic diarrhea, in which the bodyâ€™s ability to absorb ample amount of water gets affected.

Diarrhea can be classified in following two types:

Acute Diarrhea:

Type of diarrhea that lasts for less than 3-4 weeks. This type of diarrhea is generally cured with normal treatment and does not need any intensive medication.

Chronic Diarrhea:

Sometimes, diarrhea lasts really long and can extend from few months to a couple of years. This type of diarrhea is mainly caused due to some type of infection. In this type of diarrhea, the patient does not experience significant/intensive illness. Poor digestion (i.e. mal-absorption) of food, serious diseases like inflammatory bowel syndrome, irritable bowel syndrome, bowel cancer, prolonged alcohol consumption and effect of abnormalities are few other causes of chronic diarrhea.

Treatments for diarrhea

It is very important that the patient should consult a physician as soon as possible and should avoid taking any of the medicine that is not prescribed by physician. The treatment for diarrhea depends on the condition of the patient and cause of diarrhea (symptomatic treatment)

Most common and effective treatment available for the general type of diarrhea is to provide patient with drinks containing electrolytes. This can also be considered as oral re-hydration therapy

Patients are suggested to stay away from food and drugs that can cause increase in intensity of diarrhea. Physicians suggest following a healthy diet in portions in whole day. Milk, alcohol, certain type of antibiotics etc. substances which increases the problem should be avoided.

The patient should religiously follow medication prescribed by physician.

Dizziness

Many different terms are often used to describe what is collectively known as dizziness. Common descriptions include words such as lightheaded, floating, woozy, giddy, confused, helpless or fuzzy. Vertigo, disequilibrium and pre-syncope are the terms in use by most doctors. Dizziness is sometimes a symptom of a balance disorder.

Dizziness: Painless head discomfort with many possible causes including disturbances of vision, the brain, balance (vestibular) system of the inner ear, and gastrointestinal system. Dizziness is a medically indistinct term which laypersons use to describe a variety of conditions ranging from lightheadedness, unsteadiness to vertigo.

Dizziness is one area where doctors and patients fail to see eye to eye. People are seen by multiple specialists and end up with different opinions. You may have the impression that no one is listening to or cares about your problem. After a while you wonder if you’re imagining things. Characteristically there is great relief once a diagnosis is firmly in place. Dizziness is not different from any other problem.

Causes of Dizziness

Lightheadedness happens when there is not enough blood getting to the brain. This can happen if there is a sudden drop in your blood pressure or you are dehydrated from vomiting, diarrhea, fever, or other causes. Many people, especially as they get older, experience lightheadedness if they get up too quickly from a lying or seated position. Lightheadedness often accompanies the flu, hypoglycemia, common cold, or allergies.
Sensory nerves. These are in your skin, muscles and joints. Sensory nerves send messages to your brain about body movements and positions.

Low blood pressure, which can have multiple causes ranging from diseases of the heart to bleeding disorders that cause anemia to adverse reactions to medications

MÃ©niÃ¨re disease (fluctuating pressure of inner ear fluid [endolymph]; results in severe vertigo, ringing in the ears [tinnitus], and progressive hearing loss)

Symptoms of Dizziness

Some people may be describing a sense of light-headedness, while others simply mean they feel wobbly on their feet. They may have a feeling that the room is whirling around, although this is more properly called vertigo, especially if accompanied by nausea and vomiting.

Treatment of Dizziness

Specific treatment depends on the cause identified. Getting sufficient fluids often improves orthostatic hypotension resulting from dehydration. Drugs (such as mineralocorticoids and midodrineSome Trade Names

Inner ear conditions. Balance retraining exercises (vestibular rehabilitation) are used to treat acute vestibular neuronitis or labyrinthitis. These are exercises you learn from a physical therapist or occupational therapist and then do at home. This rehabilitation involves movements of your head and body to correct loss of balance.

Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy (VRT) is a type of physical therapy used to treat vertigo. The goal of treatment is to minimize dizziness, improve balance, and prevent falls by restoring normal function of the vestibular systemIn most cases, balance improves if the exercises are correctly and faithfully performed. Muscle tension, headaches, and fatigue will diminish, and symptoms of dizziness, vertigo, and nausea will decrease or disappear. Many times, vestibular VRT is so successful that no other treatment is required.

Dental problems of a non-serious nature

Abscessed Tooth

An abscessed tooth is one that has become infected. Tooth decay is often the culprit; when tooth decay advances deep into the tooth, it can cause destruction of the pulp, the core of the tooth. When this happens, the pulp gets infected and swollen and pus builds up near the jawbone.
Left untreated, infected pulp can cause more serious problems, including damage to surrounding tissue and bone. Root canal treatment is the most common form of treatment for an abscessed tooth. Root canal treatment involves removing the infected tissue, cleansing and sealing the canal of the tooth and restoring the tooth with a crown, or cap.

Cavities and Tooth Decay

What Is Tooth Decay?

Tooth decay is caused by a variety of things; in medical terms, cavities are called caries, which are caused by long-term destructive forces acting on tooth structures such as enamel and the tooth’s inner dentin material. These destructive forces include frequent exposure to foods rich in sugar and carbohydrates; soda, candy, ice cream-even milk-are the common culprits. Left inside your mouth from non-brushing and flossing, these materials break down quickly, allowing bacteria to do their dirty work in the form of a harmful, colorless sticky substance called plaque. The plaque works in concert with leftover food particles in your mouth to form harmful acids that destroy enamel and other tooth structures. If cavities aren’t treated early enough, they can lead to more serious problems requiring treatments such as root canal therapy.

Preventing Cavities

The best defense against cavities is good oral hygiene, including brushing with a fluoride toothpaste, flossing and rinsing. Your body’s own saliva is also an excellent cavity fighter, because it contains special chemicals that rinse away many harmful materials. Chewing a good sugarless gum will stimulate saliva production between brushing. Special sealants and varnishes can also be applied to stave off cavities from forming.
If you have any of the following symptoms, you may have a cavity:
– Unusual sensitivity to hot and cold water or foods.
– A localized pain in your tooth or near the gum line.
– Teeth that change color.

Baby Bottle Tooth Decay

Baby bottle tooth decay is caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby’s mouth. If left untreated, this can lead to premature decay of your baby’s future primary teeth, which can later hamper the proper formation of permanent teeth. One of the best ways to avoid baby bottle tooth decay is to not allow your baby to nurse on a bottle while going to sleep. Encouraging your toddler to drink from a cup as early as possible will also help stave off the problems associated with baby bottle tooth decay.

Broken, Fractured, or Displaced Tooth

A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken. If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.
First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the check near the injury. This will keep down swelling.
If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown – not the root. Next, place it in a container of milk, saline or the victim’s own saliva and keep it in the solution until you arrive at the emergency room or dentist’s office.
For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress.
If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

Fluorosis

Fluorosis is a condition in which your body has been exposed to too much fluoride. In normal doses , fluoride is a healthy compound that promotes strong teeth, which has the ability to fight cavities and other problems. But sometimes, fluorosis occurs when fluoride-containing toothpastes or rinses are swallowed, instead of expelled. Fluorosis causes a number of aesthetic problems, including abnormally darkened or stained teeth. While such problems are generally harmless to your health, they can create concerns with your appearance.

Gum Disease (Gingivitis)

Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping. Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay. Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable. If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur. Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure. Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman’s body that promote plaque production.

Impacted/Wisdom Teeth

Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems. If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: pain, inflammation, and some kinds of infections. Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one’s ability to properly bite down, speak or eat.

Plaque

Plaque is an insidious substance: a colorless, sticky film that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.

Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.

Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.

Sensitive Teeth

Many people suffer from sensitive teeth: a condition in which hot and cold foods or liquids, and even sudden puffs of air can cause discomfort and pain. Tooth sensitivity can be caused by a number of things. An unnoticed cavity or abscessed tooth can sometimes be a culprit. But over time and as you age, changes in temperature, as well as such behaviors as tooth grinding (bruxism) and overly aggressive brushing, can cause small, often microscopic cracks or fissures on the chewing surfaces of your teeth (or near the gum lines), which exposes the inner structures called dentin. Hypersensitive teeth can cause people to change their eating habits, avoid social situations, or even avoid proper oral hygiene because the simple act of brushing or rinsing causes pain. Relief can sometimes be had by using a desensitizing toothpaste, sealants, or special fillings.

Teeth Grinding (Bruxism)

Teeth grinding, also called bruxism, is often viewed as a harmless, though annoying, habit. Some people develop bruxism from an inability to deal with stress or anxiety. However, teeth grinding can literally transform your bite relationship and worse, severely damage your teeth and jaws over long periods of time. Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin.) Bruxism can also lead to chronic jaw and facial pain, as well as headaches. If no one has told you that you grind your teeth, here are a few clues that you may suffer from bruxism: Your jaw is often sore, or you hear popping sounds when you open and close your mouth. Your teeth look abnormally short or worn down. You notice small dents in your tongue.Bruxism is somewhat treatable. A common therapy involves use of a special appliance worn while sleeping. Less intrusive, though just as effective methods could involve biofeedback, and behavior modification, such as tongue exercises and learning how to properly align your tongue, teeth and lips.

Earache, ear pain

Pain in the ear can occur because of conditions within the ear, the ear canal, or affecting the visible portion of the ear (the pinna). Acute middle ear infection, medically called acute otitis media, is inflammation of

the middle ear and is the most frequent diagnosis in sick children in the U.S. The eustachian tube is shorter in children than adults which allows easy entry of bacteria and viruses into the middle ear, resulting in

acute otitis media.

Infection of the ear canal (otitis externa) is also called swimmer’s ear. Otitis externa is typically caused by bacterial infection.

Earache can also be caused by pain and inflammation of the outer portion of the ear (the pinna).

A child with a draining ear should not fly (or swim).

Also spelled "ear ache"

Symptoms of Ear Pain:

Very severe beginning, usually around midnight; caused by cold, dry wind, often East winds or a draft while driving a car; children in particular will be cranky and cry in low weak voice or scream immediately in pain;

extremely sensitive to noise; ears are hot and red; feeling as if water is in the ear; restless, anxious and very fearful; extremely thirsty; skin is hot and dry; fever increases rapidly; shivers.
Worse â€“ Motion, warm rooms, cold wind, after midnight
Better â€“ Quiet

Begins suddenly; pulsating, hammering or pounding earaches; pain comes in wave like pattern; skin is hot and sweaty; fever.
Worse â€“ Vibrations, talking, cold
Better â€“ Head elevated, quiet, rest

Severe, stabbing, wave like pain in the ears; ears seem to be blocked and are painful and red; there is ringing sound in the ears; very moody and extremely sensitive; cheek on the affected area is red in color;

children want to be carried all the time; they throw their toys around in a fit of anger; particularly for children when teething.
Worse â€“ Warmth, before midnight
Better â€“ Cold drinks, after a bout of sweating; when shown sympathy

Sudden onset; stabbing pain in the ears, also low continuous sound in the ears; reason: by getting too cold due to damp/wet cold weather; change in the weather, often during heavy snowing; low fever; tendency

of getting colds.
Worse â€“ Wetness, cold, nights
Better â€“ Warmth

Slow beginning; pounding or pulsating pain; often caused by viral infection; complexion keeps changing between pale and red; fever rises slowly.
Worse â€“ Wet/damp, cold, in the evenings, nights
Better â€“ Slow movements, cold compresses

Outer ear is red and swollen; in the beginning there is little pain in the ear; feels as though the ear has been filled with something; cannot hear properly; not thirsty.
Worse â€“ Nights
Better â€“ Cold compresses, giving sympathy

Eye irritation

Eyes are very sensitive part of body. Whenever any foreign material enters into eye, person feels irritation. There are various eye diseases. Conjunctivitis is one of the most widespread diseases in India and majority of people suffer from this disease in their lifetime. Conjunctivitis, generally known as pink eye, is a redness of the conjunctiva. The conjunctiva is a apparent mucus membrane that lines the within of the eyelid and covers the white part of the eye. Pink eye is a name commonly used to refer to all types of conjunctivitis. Conjunctivitis is a quite common condition, especially among school-going children. Children are usually not allowed to attend classes if pink eye is suspected, as it can be very infectious and may spread rapidly. Conjunctivitis rarely causes long-term vision or eye harm, but it can make the eye extremely red. There are numerous types of conjunctivitis. It is important for person to visit doctor when he suspects conjunctivitis in his eyes. Doctor will evaluate the condition to decide proper treatment. Conjunctivitis is usually caused by infection or allergic reaction. It is the most common acute eye disorder observed by primary care pediatricians and family physicians. The most common bacterial organisms causing conjunctivitis are Haemophilus Influenzae and Streptococcus pneumoniae. H. Influenzae conjunctivitis occurs in 40 to 50% of cases Symptoms The most noticeable symptom of conjunctivitis is a red or pink colored eye. Inflammation causes small blood vessels in the conjunctiva to dim, resulting in a pink or red tint to the white of the eye. This swelling is a sign of the immune system reacting to a foreign substance, irritation organisms, such as bacteria. This disease may produce symptoms such as redness in one or both eyes, itchiness in one or both eyes, blurred vision and light sensitivity, gritty feeling in one or both eyes, discharge in one or both eyes that forms a crust at night and excessive tearing. Conjunctivitis can result from viruses, Bacteria, Allergies, a chemical splash in the eye, a foreign object in the eye, and a clogged tear duct (in newborns).

Risk factors:

The major risk factor of catching conjunctivitis is being exposed to person infected with either the viral or bacterial form of conjunctivitis. Infected person may be transmittable for seven to 14 days after signs and symptoms first appear. Only doctor will be able to identify the type of conjunctivitis by asking questions and examining patientâ€™s eyes. The way eyes feel will usually reveal what type of conjunctivitis a person have. Viral conjunctivitis is linked with upper respiratory infections and colds. It usually affects only one eye, but can affect both eyes. Viral conjunctivitis causes unnecessary eye watering and a light discharge. Viral conjunctivitis is more widespread in children and tends to be much more transmittable than the bacterial type. Another type of conjunctivitis is bacterial conjunctivitis. This is caused by bacteria. Bacterial conjunctivitis affects both eyes and often produces a thicker, yellow-green discharge. It may also be related with a respiratory infection or a cold. Bacterial conjunctivitis is more common in children than in adults and can be infectious. Some babies are born with a blocked tear duct that prevents tears from draining properly. This may be one of the causes of bacterial conjunctivitis. Allergic conjunctivitis is caused by a reaction to an allergen, such as pollen, or a foreign substance. Allergic conjunctivitis affects both eyes and causes itching and redness in the eyes and sometimes the nose. The eyes may also appear swollen and tear terribly. In severe cases, the conjunctiva may appear blister-like. The eyes may also have a white, stringy mucus discharge. One more type of conjunctivitis is chemical conjunctivitis which causes redness and inflammation of the conjunctiva. It is caused by an irritant or an actual splash of a chemical into the eye, such as chlorine. The eye may produce clear mucus in reaction to the chemical agent. This type of conjunctivitis generally clears up on its own within about a day. Papillary conjunctivitis also referred as giant papillary conjunctivitis. This conjunctivitis disease is caused by inflammation due to a foreign thing in the eye. Papillary conjunctivitis can also develop from exposed sutures after having eye surgery. More commonly, it is caused by the constant use of a contact lens. The eye may become red, and bumps may form on the eyelid. These bumps, called papillae, are often larger on the back side of the upper eyelid. It usually affects both eyes and causes contact lens intolerance, itching, a heavy discharge, tearing and red bumps on the bottom of the eyelid.

Diagnosis:

Usually diagnosis is done on the basis of symptoms exhibited by patient. The doctor may take a sample of tears to do a test to find out the proper diagnosis. A bright microscope may also be used to examine the eyes in more detail.

Treatment:

Appropriate treatment is decided on the basis of type of conjunctivitis. Doctor may prescribe antibiotic eye drops if the infection is bacterial, and the infection should clear within several days. Antibiotic eye ointment, in place of eye drops, is sometimes prescribed for treating bacterial pink eye in children. Antibiotic eye drops or ointments are not applicable for the treatment of viral conjunctivitis. In the case of allergic conjunctivitis, doctor may prescribe eye drops, such as antihistamines, to lessen allergic symptoms. If people have been diagnosed with conjunctivitis, he must follow precautions to avoid spreading of the infection. These tips include: wash hands frequently. He must avoid rubbing his eyes. He must not share washcloths, towels or pillowcases. It is important that eye drops or cosmetics, he uses must be kept for personal use only. Conjunctivitis is typically a slight eye infection, but it can be more serious condition if proper care is not taken. People sometimes use home remedy to come out with disease. This is very careless approach and there may be lot of risk involve. It is always advised to get the opinion of an eye care professional and strictly follow them to control the disease.

Fever without convulsions

Convulsions that occur when a child has no fever may be caused by many conditions. Epilepsy is the best-known cause. Epilepsy is a disorder of the brain that causes repeated attacks or seizures. There are several forms of epilepsy, which are identified by the type of seizure experienced. Some forms of epilepsy cause convulsions (jerking movements or spasms of the muscles). Other types, however, do not cause convulsions. Therefore the term â€œseizureâ€ is more properly used to describe an attack of epilepsy. The cause of most types of epilepsy is not known.

Signs and Symptoms

Epilepsy must be diagnosed by a doctor. However, signs of possible epilepsy can be seen in the typical behavior that occurs in different types of seizures.

In a generalized convulsive seizure, the child suddenly loses consciousness and may cry out as the seizure starts. The body stiffens, and the child may fall. Muscle spasms cause jerking or wild thrashing movements. The child may lose control of the bladder and bowels. When spasms end, the child may fall into a deep sleep and will usually be confused and sleepy upon awakening. Sometimes there is a warning sensation (aura) before this type of seizure begins, including sleepiness, headache, yawning, or tingling in the arms and legs.

Generalized non-convulsive or absence seizures are so different from major convulsive seizures that they are often not recognized as epilepsy â€“ or may not even be noticed. The child may simply stare into space. There may be rapid blinking or fluttering of the eyes. The child remains conscious yet may be totally unaware that the seizure is occurring. If it is not recognized as a seizure, it may be mistaken for a learning disability, not paying attention, or simple daydreaming. In complex partial seizures the child remains conscious, but may sit motionless or may make repeated or unusual movements. In simple partial seizures the child is conscious and may simply feel tingling in the hands and feet. The child may also perceive bad odors, see flashing lights, or speak unintelligibly.

Home Care

Call your doctor any time a child has convulsions. Of course, you must immediately care for the child during the convulsions. The most important home care is to prevent your child from injury during the thrashing phase of convulsions. Do not put your fingers in the childâ€™s mouth. If epilepsy is diagnosed, the doctor will give instructions for caring for the child at home. Until the seizures are controlled, discourage the child from climbing high ladders or tall trees. Do not allow the child to swim alone. Otherwise, your child can and should live a normal life with only minor changes in activities.

Precaution

If you find your child unconscious, do not assume that your child has been made unconscious by a fall. Do consider the possibility that epilepsy has led to a fall and unconsciousness.

Medical Treatment

Your doctor will perform physical and neurological (nervous system) examinations. The doctor may order a variety of laboratory or diagnostic tests. A number of prescription medications that control seizures are available. The doctor may order blood tests to determine the amount and type of drug to be used. In difficult cases, your doctor may recommend consultation with a neurologist (a specialist in diseases of the nervous system).

Foot problems such as blisters, pain, in-grown toe nails, plantar warts

Ingrown nails

What are ingrown nails?

Ingrown nails, the most common toenail problem, occur when the nail borders curve into the soft tissue of nail grooves. Ingrown nails cause pressure and pain along the nail borders. The edge of the nail may cut into the skin, causing redness, swelling, pain, drainage and infection.

What causes ingrown nails?

Ingrown toenails are most commonly caused by shoe pressure. Ingrown toenails are also caused by:

Improperly trimmed nails

Crowding of toes

Repeated trauma to the feet from normal activities (such as running, walking or doing aerobics)

Heredity How can I prevent ingrown nails?

Cut your toenails after bathing, when they are soft

Trim toenails with a nail clipper straight across, slightly longer than the end of the toes

Do not round off the corners of toenails or cut down on the sides of the nails

After clipping, smooth toenails with a file or emery board

Avoid wearing tight, restrictive shoes

How can ingrown nails be treated?

Following the preventative steps above can help you avoid the need for treatment. To relieve discomfort from ingrown toenails, soak your foot in a solution of lukewarm water and salt or lukewarm soapy water. Then apply an antiseptic and bandage the area.

If self-care measures are unsuccessful or if you have a nail infection, you may need a doctor’s care. Ingrown nails may be corrected with surgery by removing part of the toenail and growth plate. Continuing to care for your nails properly and wearing well-fitting footwear can help you prevent ingrown nails from recurring.

Mycotic nails

What are mycotic nails?

Mycotic nails are nails that become infected with a fungus. The nail may be discolored (yellowish-brown or opaque), thick, brittle, and separated from the nail bed. In some cases, the nail may crumble.

What causes mycotic nails?

Fungal organisms

Dark, moist, warm environment of shoes, which promotes fungal growth

Prior injury to nail, which can predispose nail to fungal infection

How can mycotic nails be prevented?

Examine the tops and bottoms of your feet each day. If you notice blisters, cuts, scratches or other sores, care for them immediately.

If you suspect an infected toenail, soak your foot in a solution of lukewarm water and salt, or lukewarm soapy water. Then apply an antiseptic and bandage the area. Although this may relieve discomfort, it is still recommended that you call a doctor.

Wash your feet every day with mild soap and lukewarm water. Gently and thoroughly dry your feet.

Care for your toenails regularly.

Don’t wait to treat a minor foot problem.

How can mycotic nails be treated?

If you notice an infected nail, do not try to remove any part of it. Also avoid over-the-counter medications unless prescribed by your health care provider. Fungal nail infections are difficult to treat. Topical medications are available, but they only help a small number of fungal nail problems. Oral medications may be prescribed instead, including:

Griseofulvin (Fulvicin)

Terbinafine (Lamisil)

Itraconazole (Sporanox)

Headache

A headache is a pain in the head with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache, like chest pain or back ache, has many causes. All headaches are considered primary headaches or secondary headaches. Primary headaches are not associated with other diseases. Examples of primary headaches are migraine headaches, tension headaches, and cluster headaches. Secondary headaches are caused by other diseases. The associated disease may be minor or major. Tension headaches are the most common type of primary headache. As many as 90% of adults have tension headaches. Tension headaches are more common among women than men. Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the US have migraine headaches. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty more women than men have them. Migraine often goes undiagnosed or is misdiagnosed as tension or sinus headaches. Cluster headaches are a rare but important type of primary headache, affecting mainly men. The average age of cluster headache sufferers is 28-30 years, although headaches may begin in childhood. Secondary headaches may result from innumerable conditions, ranging from life threatening ones such as brain tumors, strokes, meningitis, and subarachnoid hemorrhages to less serious but common conditions such as withdrawal from caffeine and discontinuation of analgesics (pain killing medication). Many people suffer from "mixed" headache disorders in which tension headaches or secondary headaches may trigger migraine. The treatment of the headache depends on the type and severity of the headache and on other factors such as the age of the patient. Headache is also referred to as cephalgia.

Hemorrhoids

Overview

Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus.

Symptoms

Symptoms of hemorrhoids include:

Anal itching

Anal ache or pain, especially while sitting

Bright red blood on toilet tissue, stool, or in the toilet bowl

Pain during bowel movements

Treatment

Over-the-counter corticosteroid creams can reduce pain and swelling. Hemorrhoid creams with lidocaine can reduce pain. Witch hazel (applied with cotton swabs) can reduce itching. Other steps for anal itching include:

Wear cotton undergarments.

Avoid toilet tissue with perfumes or colors.

Try not to scratch the area. Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes. Stool softeners help reduce straining and constipation. For cases that don’t respond to home treatments, a surgeon or gastroenterologist can apply heat treatment, called infrared coagulation, to shrink internal hemorrhoids. This may help avoid surgery. Surgery that may be done to treat hemorrhoids includes rubber band ligation or surgical hemorrhoidectomy. These procedures are generally used for patients with severe pain or bleeding who have not responded to other therapy.

Causes

This condition is very common, especially during pregnancy and after childbirth. Hemorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful, particularly when you are sitting. The most common cause is straining during bowel movements. Hemorrhoids may result from constipation, sitting for long periods of time, and anal infections. In some cases they may be caused by other diseases, such as liver cirrhosis. Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. External hemorrhoids occur at the anal opening and may hang outside the anus.

Tests & diagnosis

A doctor can often diagnose hemorrhoids simply by examining the rectal area. If necessary, tests that may help diagnose the problem include:

Stool guaiac (shows the presence of blood)

Sigmoidoscopy

Anoscopy

Prognosis

Most treatments are effective, but to prevent the hemorrhoids from coming back, you will need to maintain a high-fiber diet and drink plenty of fluids.

Prevention

Avoid straining during bowel movements. You can help prevent hemorrhoids by preventing constipation. Drink plenty of fluids, at least eight glasses per day. Eat a high-fiber diet of fruits, vegetables, whole grains. Consider fiber supplements.

Complications

The blood in the enlarged veins may form clots, and the tissue surrounding the hemorrhoids can die. Hemorrhoids with clots generally require surgical removal. Severe bleeding may also occur. Iron deficiency anemia can result from prolonged loss of blood. Significant bleeding from hemorrhoids is unusual, however.
When to contact a doctor
Call for an appointment with your health care provider if hemorrhoid symptoms do not improve with home treatment. You should also be seen if you have rectal bleeding. Your provider may want to check for other, more serious causes of the bleeding, especially if you have never bled from hemorrhoids before. Call 911 if blood loss is significant or if you feel dizzy, lightheaded, or faint

Hepatitis

Overview

Hepatitis is inflammation of the liver.

Symptoms

The symptoms of hepatitis include:

Abdominal pain or distention

Breast development in males

Dark urine and pale or clay-colored stools

Fatigue

General itching

Jaundice (yellowing of the skin or eyes)

Loss of appetite

Low-grade fever

Nausea and vomiting

Weight loss Many people with hepatitis B or C do not have symptoms when first infected and can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested periodically.

Treatment

Your doctor will discuss possible treatments with you, depending on the cause of your liver disease. Your doctor may recommend a high-calorie diet if you are losing weight.

Causes

The disease can be caused by:

Infections from viruses (such as hepatitis A, B, or C), bacteria, or parasites

Liver damage from alcohol or poisonous mushrooms

Medications, such as an overdose of acetaminophen, which can be deadly Immune cells in the body attacking the liver and causing autoimmune hepatitis
Medications that can cause damage to the liver include methyldopa (used uncommonly for high blood pressure), isoniazid for tuberculosis, seizure medications (like valproate and phenytoin), chlorpromazine, amiodarone (for irregular heart rhythm), and certain antibiotics (including trimethoprim-sulfamethoxazole and erythromycin). If you need to take any of these, your doctor may need to check your liver function. Liver disease can also be caused by inherited disorders such as cystic fibrosis and Wilson’s disease, a condition that involves having too much copper in your body (the excess copper deposits in the liver). Other causes include:

Systemic lupus erythematosus

Rheumatoid arthritis

SjÃ¶gren syndrome

Scleroderma

Inflammatory bowel disease

Glomerulonephritis

Hemolytic anemia Hepatitis may start and resolve quickly (acute hepatitis), or cause long-term disease (chronic hepatitis). In some instances, progressive liver damage, liver failure, or even liver cancer may result.

The severity of hepatitis depends on many factors, including the cause of the liver damage and any underlying illnesses you have. Hepatitis A, for example, is generally short-lived, not leading to chronic liver problems.

Common risk factors include:

Intravenous drug use

Overdosing on acetaminophen — the dose needed to cause damage is close to the effective dose, so be careful to take it only as directed — ask your doctor what amount of acetaminophen is safe for you; if your liver disease is severe, your doctor may also tell you to avoid certain anti-inflammatory medicines

Engaging in risky sexual behaviors (like having multiple sexual partners and unprotected intercourse)

Eating contaminated foods

Traveling to an area where certain diseases are common

Living in a nursing home or rehabilitation center

Having a family member who recently had hepatitis A

Using or abusing alcohol

Being an organ transplant recipient

Having HIV or AIDS

Having received a blood transfusion before 1990 (hepatitis C blood test was not available)

Being a newborn of a mother with hepatitis B or C (can be transmitted during delivery)

Being a health care worker, including dentist and dental hygienist, because of blood contact

Receiving a tattoo See also:

Alcoholic hepatitis

Autoimmune hepatitis

Delta agent (hepatitis D)

Drug-induced hepatitis

Hepatitis A

Hepatitis B

Hepatitis C

Tests & diagnosis

A physical examination may show yellowing of the skin, an enlarged and tender liver, or fluid in the abdomen (ascites) that can become infected. Your doctor may order laboratory tests, including:

Hepatitis virus serologies

Liver function tests

Autoimmune blood markers

Abdominal ultrasound

Liver biopsy to determine severity of the liver damage

Paracentesis if fluid in your abdomen is present

Prognosis

The outlook depends on many factors, including the cause of the hepatitis and whether or not you have additional illnesses or conditions that complicate treatment or recovery. Many people recover fully. However, it may take months for the liver to heal.

Eighty percent of those with hepatitis C go on to have chronic liver disease and, possibly, liver failure (cirrhosis) or liver cancer. Hepatitis C is the number one reason for receiving a liver transplant in the United States.

Prevention

The following hepatitis vaccines are available:

Hepatitis A vaccine is available for people in high-risk groups, like day care and nursing home workers, laboratory workers, and those traveling to parts of the world where hepatitis is common. Routine childhood immunization against hepatitis A is also recommended.

Hepatitis B vaccine is now given to all infants and unvaccinated children under 18. The vaccine is available for adults at high risk, such as health care professionals, IV drug users, and those with risky sexual behavior. A shot of immunoglobulin may also prevent infection. This is true even after you have been exposed:

It may be given soon after you have had close contact (like kissing or sharing utensils) with someone who was diagnosed with hepatitis A within the last two weeks.

It should be given right away, along with the hepatitis B vaccine, to an infant born to a woman with hepatitis B. Other steps to take:

Avoid contact with blood or blood products. Take precautions if this is part of your work.

Avoid sexual contact with a person infected with hepatitis or unknown health history. Practice safe sex at all times.

Wash your hands after going to the bathroom and before handling food.

Avoid sharing plates, utensils, or bathrooms with someone who has hepatitis A.

DO NOT share razors, needles, or toothbrushes.

When traveling to endemic areas, DO NOT eat uncooked or partially cooked foods. Drink bottled water.

DO NOT use recreational IV drugs. If you are already an IV drug user, never share needles and seek help from a needle exchange or drug treatment program.

Be cautious when receiving tattoos or piercings.

DO NOT drink alcohol at the same time that you take acetaminophen. If you already have hepatitis, do not use either (to avoid further liver damage). When to get tested for hepatitis:

Get tested for hepatitis B or C if you had sexual contact or shared needles with someone who may have had one of these viruses.

Do this even if you have no symptoms.

Complications

Permanent liver damage, liver failure, or liver cancer can occur. Other complications include spontaneous bacterial peritonitis (when fluid in the abdomen becomes infected), and esophageal varices, which can bleed significantly. When to contact a doctor Seek immediate care if you:

Have symptoms related to acetaminophen or other medicines — you may need to have your stomach pumped

Vomit blood

Have bloody or tarry stools

Are confused or delirious Call your doctor if:

You have any symptoms of hepatitis or believe that you have been exposed to hepatitis A, B, or C.

You cannot keep food down due to excessive vomiting. You may need to receive nutrition intravenously (through a vein).

You feel sick and have travelled to Asia, Africa, South America, or Central America.

High-density lipoprotein (HDL) and glucose screenings for warning signs of heart attack

High-density lipoprotein (HDL) is one of the five major groups of lipoproteins (chylomicrons, VLDL, IDL, LDL, HDL) that enable lipids like cholesterol and triglycerides to be transported within the water-based bloodstream. In healthy individuals, about thirty percent of blood cholesterol is carried by HDL.[1]

It is hypothesized that HDL can remove cholesterol from atheroma within arteries and transport it back to the liver for excretion or re-utilization, which is the main reason why HDL-bound cholesterol is sometimes called "good cholesterol", or HDL-C. A high level of HDL-C seems to protect against cardiovascular diseases, and low HDL cholesterol levels (less than 40 mg/dL or about 1mmol/L) increase the risk for heart disease.[1] Cholesterol contained in HDL particles is considered beneficial for the cardiovascular health, in contrast to "bad" LDL cholesterol.

Structure and function:

HDL is the smallest of the lipoprotein particles. They are the densest because they contain the highest proportion of protein. Their most abundant apolipoproteins are apo A-I and apo A-II.[2] The liver synthesizes these lipoproteins as complexes of apolipoproteins and phospholipid, which resemble cholesterol-free flattened spherical lipoprotein particles. They are capable of picking up cholesterol, carried internally, from cells by interaction with the ATP-binding cassette transporter A1 (ABCA1). A plasma enzyme called lecithin-cholesterol acyltransferase (LCAT) converts the free cholesterol into cholesteryl ester (a more hydrophobic form of cholesterol), which is then sequestered into the core of the lipoprotein particle, eventually making the newly synthesized HDL spherical. They increase in size as they circulate through the bloodstream and incorporate more cholesterol and phospholipid molecules from cells and other lipoproteins, for example by the interaction with the ABCG1 transporter and the phospholipid transport protein (PLTP).

HDL transports cholesterol mostly to the liver or steroidogenic organs such as adrenals, ovary, and testes by direct and indirect pathways. HDL is removed by HDL receptors such as scavenger receptor BI (SR-BI), which mediate the selective uptake of cholesterol from HDL. In humans, probably the most relevant pathway is the indirect one, which is mediated by cholesteryl ester transfer protein (CETP). This protein exchanges triglycerides of VLDL against cholesteryl esters of HDL. As the result, VLDLs are processed to LDL, which are removed from the circulation by the LDL receptor pathway. The triglycerides are not stable in HDL, but degraded by hepatic lipase so that finally small HDL particles are left, which restart the uptake of cholesterol from cells.

The cholesterol delivered to the liver is excreted into the bile and, hence, intestine either directly or indirectly after conversion into bile acids. Delivery of HDL cholesterol to adrenals, ovaries, and testes is important for the synthesis of steroid hormones. Several steps in the metabolism of HDL can contribute to the transport of cholesterol from lipid-laden macrophages of atherosclerotic arteries, termed foam cells, to the liver for secretion into the bile. This pathway has been termed reverse cholesterol transport and is considered as the classical protective function of HDL toward atherosclerosis. However, HDL carries many lipid and protein species, several of which have very low concentrations but are biologically very active. For example, HDL and their protein and lipid constituents help to inhibit oxidation, inflammation, activation of the endothelium, coagulation, and platelet aggregation. All these properties may contribute to the ability of HDL to protect from atherosclerosis, and it is not yet known what are the most important. In the stress response, serum amyloid A, which is one of the acute-phase proteins and an apolipoprotein, is under the stimulation of cytokines (IL-1, IL-6), and cortisol produced in the adrenal cortex and carried to the damaged tissue incorporated into HDL particles. At the inflammation site, it attracts and activates leukocytes. In chronic inflammations, its deposition in the tissues manifests itself as amyloidosis. It has been postulated that the concentration of large HDL particles more accurately reflects protective action, as opposed to the concentration of total HDL particles.[3] This ratio of large HDL to total HDL particles varies widely and is measured only by more sophisticated lipoprotein assays using either electrophoresis (the original method developed in the 1970s) or newer NMR spectroscopy methods (See also: NMR and spectroscopy), developed in the 1990s

Q: How do you test for high cholesterol levels and diabetes?

A: Cholesterol and glucose screenings can be performed at the same time, and preparation for the tests is the same. You donâ€™t eat anything for nine to 12 hours before the tests in order for the tests to be accurate. After discussing family history and risk factors, a small amount of blood is taken. For the cholesterol test, the blood is tested to measure LDL (bad) cholesterol, HDL (good) cholesterol, total cholesterol, and triglycerides. A cholesterol level of 200 mg/dl (milligrams per deciliter) is considered high, and a level of 240 mg/dl or higher is considered high-risk for heart disease or stroke. For the glucose test, the blood is tested to measure the fasting blood glucose level. A person with a fasting blood glucose level between 100 and 125 mg/dl has pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes. Results are typically mailed within 48 hours. You should discuss the test results with your primary-care doctor, who will talk about the need for lifestyle changes or medication, or may follow up with further tests.

Q: What do the cholesterol and glucose screenings detect?

A: The cholesterol screening detects LDL (bad) cholesterol, HDL (good) cholesterol, total cholesterol, and triglyceride levels in the blood. High HDL cholesterol levels are good, because HDL cholesterol carries harmful cholesterol away from arteries and helps protect against heart attack and stroke. But high LDL cholesterol levels can greatly increase the risk of heart attack and stroke. The glucose screening detects the level of glucose in the blood and is used to diagnose pre-diabetes or diabetes. A fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes. High cholesterol and high glucose levels increase the risk of heart disease and other health issues. But both can also be managed through exercise, diet, smoking cessation, and sometimes medication. Understanding your cholesterol and glucose levels, and your risk for disease, allows you to make lifestyle changes and stay informed about your health.

Q: Who should have the screening?

A: Everyone over 20 should have a cholesterol screening every five years. Men 45 and older and women 50 and older should have one every three years. Individuals with the following risk factors should have a cholesterol screening more frequently. Talk to your doctor about your risk.

Overweight or obese

Diabetes

History of tobacco use

Family history of heart disease

Previous test results indicating high cholesterol levels Glucose screening of individuals without symptoms should be considered for adults of any age who are overweight or obese, and who have one or more additional risk factors:

Physical Inactivity

Immediate family member with diabetes

Member of high-risk ethnic population (African American, Latino, Native American, Asian American, Pacific Islander)

Women who have delivered a baby weighing more than 9 lbs or were diagnosed with gestational diabetes

Hypertension

High cholesterol levels

Women with polycystic ovarian syndrome (PCOS)Women with polycystic ovarian syndrome (PCOS) Men and women without the above risk factors but who are over 45 should have the glucose screening every three years, or more frequently depending on test results and risk status.

Q: How should I prepare for the test?

A: Youâ€™ll need to fast for nine to 12 hours before the cholesterol and glucose screenings. Fasting is important; if you do not fast, the test results will be inaccurate and you may need to have the test done again.

Q: What should I expect to experience?

A: The cholesterol and glucose screenings are fast and easy. The doctor or technician may ask you about your family history and risk factors. Then a small sample of blood will be taken. The results will be mailed to you within a few days, and youâ€™re encouraged to discuss the results with your doctor, who can explain your results and counsel you on lifestyle changes or medications, if necessary.

Q: What are the benefits and limitations of the cholesterol and glucose screenings?

A: Cholesterol and glucose screenings are a fast and cost-effective way to assess your risk for heart disease and diabetes. If you understand your risk factors, you are better able to make lifestyle changes or receive treatment that can lower your risk. The limitation of the screening is that it is up to you to discuss the results with your primary-care doctor. It is very important to discuss the results with your doctor, who can interpret the results and offer treatment options, if necessary. People who interpret their own cholesterol test results may become unnecessarily frightened or reassured

Infections (localized)

What are Infections?

Infection refers to the process by which organisms such as bacteria, fungi, or viruses enter the body and multiply. When the your immune system cannot fight these organisms off, an infection results and can cause disease.

Most infections are contracted through contact with other humans or animals, through actions such as shaking someoneâ€™s hand that is infected with a virus, drinking contaminated water, ingesting undercooked food, contracting a sexually transmitted disease, or being bitten by an animal. Poor nutrition, illness, lack of sleep, substance abuse, trauma or prolonged exposure to cold can all encourage an infection, as they lower the bodyâ€™s resistance.

Diagnosing Infections:

The diagnosis of an infection is usually based on the physical symptoms and the patientâ€™s history. A condition such as a cold or flu is easy to diagnose because most people are familiar with the symptoms. If necessary, various tests may have to be performed to detect infections.

Help for Infections:

There are various treatment options that will help to reduce the symptoms of infection. Conventional medicine, complementary therapy, or natural remediess are highly effective treatments and can be used independently or together.

How to Treat an Infection Through Conventional Medicine:

Over-the-counter (OTC) Drugs

Drugs such as benzalkonium chloride or bacitracin may be taken to treat minor bacterial skin infections.

Prescription Drugs

Serious bacterial infections may be treated with antibiotics in topical, oral, or intravenous form. Infections caused by herpes simplex and human immunodeficiency virus (HIV) are treated with antivirals.

It is important that infections are treated appropriately and that unnecessary and injudicious use of antibiotics is avoided. Many of these drugs have side effects and many are often incorrectly prescribed.

How to Treat an Infection Through Natural Remedies:

Natural remedies are also successful in fighting infections and supporting the immune system. Using treatments such as herbal and homeopathic remedies can provide you with a safe and effective antibiotic alternative which will address a wide range of physical and emotional symptoms, and ensure that you maintain optimal health. Herbal and homeopathic remedies are gentle yet effective, and help to support various systems in the body. Carefully selected ingredients such as Hypoxis rooperi (extract of African Potato), Agothosma betulina (buchu), Mentha piperita, Solidago virgaurea, and Viscum album all act as tonics to improve the bodyâ€™s functioning and strengthen the immune system. Consult a homeopath or herbalist about a remedy to suit your needs.

How to Treat an Infection Through Complementary Therapy:

Acupuncture Aruyveda Nutritional therapy Meditation All of the above complimentary therapies can help to strengthen the immune system and help to protect the body against infection.

Advice on How to Prevent Infection:

Eat healthily and incorporate all the major food groups into your diet Exercise increases natural killer cell activity, which may also help prevent infections Increase your intake of vitamins such as Vitamin A and C, and zinc Increase your exposure to fresh air and get enough sunlight each day Reduce stress by practicing relaxation techniques such as deep breathing exercises, listening to calming music, and meditating Excellent personal hygiene and sanitary habits reduce the risk of infection Practice safe sex Have yourself and your children immunized against infectious diseasesDisinfect wounds and scrapes by washing and covering the wound with a natural antiseptic ointment

Insect stings that to do not cause breathing trouble

What are stinging insects?

Stinging insects found in the United States include honeybees, yellow jackets, hornets, wasps, and fire ants. While not everyone is allergic to insect venom, reactions in the skin such as mild pain, swelling, and redness may occur with an insect sting.

Who is at risk for insect sting allergies?

Over 2 million Americans are allergic to stinging insects. The degree of allergy varies widely. Most people are not allergic to insect stings, and most insect stings result in only local itching and swelling. Many, however, will have severe allergic reactions. Severe allergic reactions to insect stings are responsible for at least 50 deaths each year in the U.S.

If you are known to be allergic to insect stings, then the next sting is 60% likely to be similar or worse than the previous sting. Since most stings occur in the summer and fall, you are at greatest risk during these months. Males under the age of 20 are the most common victims of serious insect-sting allergic reactions, but this may reflect a greater exposure to insects of males, rather than a true predisposition.

What types of insect sting reactions occur?

Nonallergic reactions

Most insect-sting reactions are not allergic and result in local pain, itching, swelling, and redness at the site of the sting. Some extension of the swelling is expected. Local treatment is usually all that is needed for this type of reaction. Disinfect the area, keep it clean, and apply ice. Topical corticosteroid creams are sometimes used to decrease inflammation, and antihistamines can help control itching. Large local reactions may involve increased swelling (that lasts for 48 hours up to one week) that may be accompanied by nausea and vomiting. Large local reactions occur in about 10% of insect stings and are not allergic in origin. Occasionally, the site of an insect sting will become infected, and antibiotics are needed.

Allergic reactions:

Systemic (body-wide) reactions are allergic responses and occur in people who have developed antibodies against the insect venom from a prior exposure. It is estimated that between 0.3%-3% of stings trigger a systemic allergic reaction. The allergic reaction to an insect sting varies from person to person. Symptoms of an allergic reaction can include itching, hives, flushing of the skin, tingling or itching inside the mouth, and nausea or vomiting. The most serious allergic reaction is called anaphylaxis, which can be fatal. Difficulty breathing, swallowing, hoarseness, swelling of the tongue, dizziness, and fainting are signs of a severe allergic reaction. These types of reactions usually occur within minutes of the sting but have been known to be delayed for up to 24 hours. Prompt treatment is essential, and emergency help is often needed

How is a severe allergic reaction immediately treated?

Honeybee stingers are barbed stingers that are left behind in the person’s skin after the initial sting. If the stinger is removed by pinching the stinger, more venom is actually injected into the skin. It is better to remove the stinger by gently lifting the stinger using a fingernail or knife edge to flick the stinger out of the skin. Other stinging insects do not leave stingers behind and this technique does not apply. An allergic reaction is treated with epinephrine (adrenaline). Several self-injectable devices are available by prescription, including Epi-Pen, ANA-Kit, and others. These devices are filled with the epinephrine to be injected in to the subcutaneous tissue or muscle, preferably into the front of the thigh. These self-injected devices usually contain only one dose and, on occasion, more than one dose is needed. Venom extractors are commercially available, but they have not been demonstrated to have any benefit. If a serious sting reaction occurs, always seek medical attention, even if epinephrine is used and all seems stable. The allergic reaction can subsequently progress and become more serious after epinephrine has worn off. Sometimes epinephrine is not enough and intravenous fluids or other treatment is needed. If you are known to be seriously allergic to insects, you must remember to carry the epinephrine at all times especially when out of reach of medical care (such as in the woods or even on an airplane). If epinephrine is not available when you are stung, contact a doctor as soon as possible. In addition to epinephrine, an oral dose of antihistamine (like Benadryl) can reduce the symptoms of an allergic reaction. Antihistamines take effect in about one hour. Ultimately, however, it is crucial to attempt to avoid the sting

How can I avoid insect stings?

Obviously, the best treatment is avoiding the insect sting. Certain precautionary measures will greatly decrease your chances of being stung. Honeybees are not aggressive and will usually not sting unless disturbed or injured. The majority of honeybee stings are on the bottom of the bare foot while stepping on the bee. Avoid walking barefoot on lawns where honeybees or other stinging insects may be present. Yellow jackets nest in the ground and in walls. Caution should be used with unusual forms in walls and mounds in the ground. Hornets and wasps often nest in bushes, in trees, and under roofs. Use caution too in these areas and in selecting employment requiring exposure to these conditions. Bright colors attract insects seeking nectar. Stinging insects are attracted to food and strong smells. Avoid open food in garbage cans, dumps, and open picnic areas. Do not wear perfumes, hair sprays, and colognes. Keep the body covered as much as possible with light-colored clothing. Insect repellents are not effective against stinging insects.

What can I do about becoming immune to insect allergy?

All people who have had a significant reaction to a stinging insect should be evaluated by an allergy specialist for possible venom immunotherapy (allergy shots that develop an immunity to insect allergy). Selected patients with significant sensitivity to insect venom and specific symptoms can undergo allergy injection therapy for stinging-insect allergy. Allergy immunotherapy against stinging insects in these selected patients is almost 100% effective. This type of treatment usually involves a gradually increasing dose of the venom over 10-20 weeks. Then a "maintenance" dosage every four to eight weeks is given. After approximately three to five years, discontinuation of the venom shot is considered. Therapy for three to five years confers long-term protection in most people. The risk of severe adverse reactions from this venom therapy is minimal (less than 0.2%), and no deaths have been reported to date.

The U.S. Department of Agriculture recommends the following:

Avoid disturbing likely beehive sites, such as large trees, tree stumps, logs, and large rocks.

If a colony is disturbed, run and find cover as soon as possible. Running in a zigzag pattern may be helpful.

Never stand still or crawl into a hole or other space with no way out.

Do not slap at the bees.

Cover as much of the head and face as possible, without obscuring vision, while running.

Once clear of the bees, remove stingers and seek medical care if necessary, especially if there is a history of allergy to bee venom.
Stinging Insect Allergies At A Glance

Severity of reactions to stings varies greatly.

Most insect stings do not produce allergic reactions.

Anaphylactic reactions are the most serious reactions and can be fatal.

Avoidance and prompt treatment are essential.

Epinephrine (available in portable, self-injectable form) is the treatment of choice for anaphylactic reactions.

In selected people, allergy injection therapy is highly effective in preventing future reactions.

The three "A’s" of insect allergy are adrenaline, avoidance, and allergist

Immunizations

Immunization, or immunisation, is the process by which an individual’s immune system becomes fortified against an agent (known as the immunogen).

When an immune system is exposed to molecules that are foreign to the body (non-self), it will orchestrate an immune response, but it can also develop the ability to quickly respond to a subsequent encounter (through immunological memory). This is a function of the adaptive immune system. Therefore, by exposing an animal to an immunogen in a controlled way, its body can learn to protect itself: this is called active immunization.

The most important elements of the immune system that are improved by immunization are the B cells (and the antibodies they produce) and T cells. Memory B cell and memory T cells are responsible for a swift response to a second encounter with a foreign molecule. Passive immunization is when these elements are introduced directly into the body, instead of when the body itself has to make these elements. Immunization can be done through various techniques, most commonly vaccination. Vaccines against microorganisms that cause diseases can prepare the body’s immune system, thus helping to fight or prevent an infection. The fact that mutations can cause cancer cells to produce proteins or other molecules that are unknown to the body forms the theoretical basis for therapeutic cancer vaccines. Other molecules can be used for immunization as well, for example in experimental vaccines against nicotine (NicVAX) or the hormone ghrelin (in experiments to create an obesity vaccine).

Immunization can be achieved in an active or passive fashion: vaccination is an active form of immunization.

Active immunization:

Main article: Active immunity

Active immunization entails the introduction of a foreign molecule into the body, which causes the body itself to generate immunity against the target. This immunity comes from the T cells and the B cells with their antibodies.

Active immunization can occur naturally when a person comes in contact with, for example, a microbe. If the person has not yet come into contact with the microbe and has no pre-made antibodies for defense (like in passive immunization), the person becomes immunized. The immune system will eventually create antibodies and other defenses against the microbe. The next time, the immune response against this microbe can be very efficient; this is the case in many of the childhood infections that a person only contracts once, but then is immune.

Artificial active immunization is where the microbe, or parts of it, are injected into the person before they are able to take it in naturally. If whole microbes are used, they are pre-treated, Attenuated vaccine. Depending on the type of disease, this technique also works with dead microbes, parts of the microbe, or treated toxins from the microbe.

Passive immunization

Main article: Passive immunity

Passive immunization is where pre-synthesized elements of the immune system are transferred to a person so that the body does not need to produce these elements itself. Currently, antibodies can be used for passive immunization. This method of immunization begins to work very quickly, but it is short lasting, because the antibodies are naturally broken down, and if there are no B cells to produce more antibodies, they will disappear.

Passive immunization occurs physiologically, when antibodies are transferred from mother to fetus during pregnancy, to protect the fetus before and shortly after birth.

Artificial passive immunization is normally administered by injection and is used if there has been a recent outbreak of a particular disease or as an emergency treatment for toxicity (for example, for tetanus). The antibodies can be produced in animals ("serum therapy") although there is a high chance of anaphylactic shock because of immunity against animal serum itself. Thus, humanized antibodies produced in vitro by cell culture are used instead if available

Joint pain

Lice, scabies or ticks

Head lice are parasitic insects found most commonly behind the ears and near the neckline at the back of the neck. The medical term for head lice infestation is Pediculus humanus capitis. There are 6 â€“ 12 millions cases of head lice in the United States every year more commonly in children than adults. Head lice infestations are actually rare in African Americans possibly because the louse prefers a specific hair shape and width. A head lice infestation can be psychologically disturbing, but head lice are not a health hazard and are not responsible for the spread of any disease

Head Lice Life Cycle:

The life cycle of the head louse has three stages: nit, nymph, and adult. The life cycle of a single louse from egg to egg is about 1 month.

Nits: Head lice eggs are called nits. Nits are laid by the adult female louse and are attached to the base of the hair shaft by strong cement. They are located close to the scalp because they require body heat for incubation. More nit characteristics:

Size – 0.8mm by 0.3mm

Shape â€“ Oval

Color – Yellow to white

Location â€“ Within 6 mm of the scalp

Duration – Nits take 6 â€“ 9 days to hatch.

Nit Picture Nymphs: When an egg hatches, it releases a nymph. The nit shell stays attached to the hair and turns a dull yellow color. The nymph looks like an adult louse but is smaller. As the nymph grows, it molts out of its exoskeleton 3 times before it becomes an adult. More nymph characteristics:

Size â€“ Variable but about the size of a pinhead

Shape â€“ Same shape as the adult louse

Color â€“ Yellow to rust-colored

Location â€“ Close to the scalp, especially behind the ears and at the neckline

Duration â€“ Nymphs become adults after about 7 days

Nymph Picture Adult: The adult louse feeds about 5 times a day by piercing the skin with its claws, injecting irritating saliva, and sucking blood. Lice do not become engorged like ticks, but their color changes to a rust color after feeding. Head lice hold onto the hair with hook-like claws found at the end of each of their 6 legs. Adult lice are active and can travel quickly. More adult characteristics:

Size â€“ The size of a pinhead. The female louse is larger than the male.

Shape â€“ Oval with 3 legs and claws at the end of each leg

Color â€“ Rust

Location â€“ Close to the scalp, especially behind the ears and at the neckline

Duration â€“ Adult lice can live up to 30 days on a personâ€™s head

Reproduction â€“ An adult female can lay up to 8 nits per day

Adult Louse Picture

Symptoms of Head Lice

Scalp itching

Sensation of something moving in the hair

Red or pustular sores on the scalp caused by scratching

Swollen lymph nodes in the front and back of the neck

Transmission of Head Lice

Head lice can be spread by direct contact with the head or hair of an infested person. The adult louse can survive up to 1-2 days without feeding on the scalp; therefore can be found on objects that have been in contact with an infested person. Examples of objects that commonly spread head lice are:

Clothing such as hats, scarves, coats, and sports uniforms

Hair care instruments such as combs, brushes, or towels

Other objects such as pillows, beds, carpet, and stuffed animals

Diagnosis of Head Lice

A head lice infestation is diagnosed by direct visualization of the lice in any portion of the life cycle. Usually there are many more nits than adults or nymphs. Finding nits within a quarter inch from the scalp confirms an infestation that needs to be treated. Nits can be distinguished from dandruff flakes as they are extremely adherent to the hair shaft, whereas dandruff can be easily moved on along the hair shaft.Medications that kill head lice are called pediculicides. All pediculicides except malathion are applied to the scalp and hair and left on for 10 minutes, then rinsed off. Pediculicides kill nymphs and adult lice, but do not destroy nits. For this reason, they may need to be reapplied 7-10 days after the first application to kill newly emerged nymphs. Because some pediculicides have significant toxicities, it is important to follow application directions carefully.

Permethrin

Permethrin is the preferred first-line treatment for head lice. Permethrin 1% (Nix) is available over the counter, and permethrin 5% (Elimite) is available by prescription. Permethrin is a cream rinse that is designed to leave a residue after rinsing that kills emerging nymphs, so reapplication is usually not needed.

Pyrethrins Plus Piperonyl Butoxide (Rid)

Rid is a shampoo that can cause an allergic reaction in people who have plant allergies, especially allergies to chrysthanthemums. Twenty to thirty percent of the eggs remain viable after treatment, so a second treatment is recommended in 7-10 days.

Lindane (Kwell)

Lindane is available only by prescription. It should only be used cautiously if a first-line treatment has failed because several cases of seizures in children have been reported.

Malathion

Malathion is a prescription lotion that is applied to the hair, left to air dry, then washed off after 8-12 hours. Because it has a high alcohol content, it is highly flammable and can cause difficulty breathing if it is ingested. For these reasons, it should only be used for resistant cases of head lice.

Oral Agents

Trimethoprim-sulfamethoxazole (Septra, Bactrim) is an oral antibiotic, given as a 10-day course, which has been shown to be effective at treating resistant infestations of head lice. Ivermectin (Stromectol) is an antiparasitic drug given as a single dose that has also been shown to effectively treat resistant head lice infestations. However, neither of these drugs is FDA approved for use as a pediculicide.

Nit Removal

Treatment with a pediculicide kills adult lice and nymphs preventing the spread of head lice infestation to other people. Removal of nits is recommended to reduce confusion about the effectiveness of treatment. Nits within 1 cm of the scalp should be physically removed by a fine toothed comb. A variety of agents are available to break down the cement holding the nit to the hair shaft including distilled white vinegar, formic acid preparations, and enzymatic nit removal systems. Using one of these agents prior to nit combing makes it easier to remove nits. Nits that are present on the hair shaft greater than 1 cm from the scalp are not considered to be viable and do not have to be removed.

Treatment of Head Lice Contacts

According to the American Academy of Pediatrics, if a case of head lice is identified, all household members should be checked for head lice. Only those with live lice or eggs within 1 cm of the scalp should be treated. It is also recommended that all hair care items and bedding belonging to the infested person be cleaned

scabies :

Overview

Scabies is a contagious skin disease caused by a species of mite that is very small.

Symptoms

Itching, especially at night

Rashes

Sores (abrasions) on the skin from scratching and digging

Thin, pencil-mark lines on the skin Mites may be more widespread on a baby’s skin, causing pimples over the trunk, or small blisters over the palms and soles. In young children, the head, neck, shoulders, palms, and soles are involved. In older children and adults, the hands, wrists, genitals, and abdomen are involved.

Treatment

Prescription medicated creams are commonly used to treat scabies infections. The most commonly used cream is permethrin 5%. Other creams include benzyl benzoate and sulfur in petrolatum. Lindane is rarely used, because of its side effects.

Creams are applied all over the body. The whole family or sexual partners of infected people may need to be treated, even if they do not have symptoms.

For difficult cases, some health care providers may also prescribe medication taken by mouth to kill the scabies mites. Ivermectin is a pill that may be used.

Itching may continue after treatment begins, but will disappear if you follow your health care provider’s
prescribed treatment plan. You can reduce itching with cool soaks and calamine lotion. Your doctor may

also recommend an oral antihistamine.

Causes

Scabies is found worldwide among people of all groups and ages. It is spread by direct contact with

infected people and less often by sharing clothing or bedding. Sometimes whole families are affected

The mites that cause scabies burrow into the skin and deposit their eggs, forming a burrow that looks like

a pencil mark. Eggs mature in 21 days. The itchy rash is an allergic response to the mite.

Tests & diagnosis

Examination of the skin shows signs of scabies. Tests include an examination under the microscope of
skin scrapings taken from a burrow.

Prognosis

Most cases of scabies can be cured without any long-term problems. A severe case with a lot of scaling
or crusting may be a sign that the person has a disease such as HIV.

Prevention

Avoid contact with infected persons.

Complications

Intense scratching can cause a secondary skin infection, such as impetigo.
When to contact a doctor
Call your health care provider if:

You have symptoms of scabies

A person you have been in close contact with has been diagnosed with scabies

Mouth blisters

Blisters in the mouth are common among children and can also occur in adults.
It is usually a harmless condition, even though it can be unpleasant.
The blisters might appear periodically and disappear by themselves. It is not known what causes them, but they can often be associated with eating sweets and chocolate.

Characteristics:

These lesions are almost always found on the "loose" tissues of the mouth; i.e. the cheek, inner lip, tongue, soft palate, floor of mouth, and sometimes the throat. They are usually small, less than one half centimeter in diameter. A reddish halo usually surrounds them. A less common form, major aphthae, can get quite large and take very long to heal. An even rarer form is the herpetiform ulcer, characterized by multiple tiny ulcerations in many parts of the mouth at once, including the firmer gum and palate tissues. Herpetiform ulcers are uncommon and often mistaken for herpes outbreaks (below).

Once youâ€™ve discovered that you have a sore, you know you will be uncomfortable for days to come. Keeping teeth brushed well and using antibacterial mouthwash helps to reduce the frequency of an oral mouth sore, but not much will prevent the onset of a fever blister. The severity of fever blisters can be lessened by getting a prescription for penciclovir, acyclovir or famciclovir as soon as the area begins to tingle or burn in the least. Taking one of these prescription medications immediately will help to reduce the length of time that the fever blister will remain and the severity or size of the blister. Possible causes of symptom: Mouth ulcers: The following medical conditions are some of the possible causes of Mouth ulcers as a symptom. There are likely to be other possible causes, so ask your doctor about your symptoms.

Mouth injury

Viral infection

Oral candidiasis

Herpes simplex

Aphthous ulcer

Anemia

Chronic infections

Dietary deficiency

Treatment options for mouth sores:

Home care remedies for mouth sores include:

Avoiding foods or beverages that may aggravate the mouth sores. This includes foods that are spicy, acidic (e.g., citrus fruits or fruit juice), sharp/crunchy (e.g., pretzels, potato chips) or too hot. Consuming alcohol or caffeine may also irritate the lining of the mouth.
Using straws. Drinking through a straw may prevent liquids from coming into contact with sensitive areas of the mouth.

Remedies for mouth blisters

The kind of blister that results from the symptoms that you have described is very common and is nothing to worry about it. You can get burned like when you drink something very hot such as coffee, tea, or hot chocolate. Many people also get such blisters or burns in their mouths, especially on the roof of their mouths, when they eat very hot food like pizza. The best way to deal with mouth blisters like this is to give it some time to heal on its own. Because of how easily an infection can be contracted through food, the mouth is amongst the fastest healing parts of the body.

Muscle aches and sprains

Muscle aches and sprains:

Muscular aches and pains are most commonly caused by tension, unaccustomed use or overuse of

muscles. More severe muscle pain accompanied by swelling and restricted movement may mean that

tendons or ligaments, as well as the muscle, have been damaged, torn, sprained or strained (possibly in

a sports or other accidental injury).

Muscle pain can also result from conditions that affect your whole body, like infections (such as the flu),

or fibromyalgia (a condition which causes muscle tenderness, sleep difficulties, tiredness and

headaches).

Before you treat, try and identify what is the most likely cause of the pain. If you suspect an injury, follow

the RICER approach immediately (see â€˜Treatment tipsâ€™ further below) and seek medical attention as soon

as possible. Speak to your pharmacist or doctor if the muscle pain is due to an illness or infection, or has

persisted for a long time.

See Your Pharmacist or Medical Professional: if you have a serious loss of movement along with the ache or pain if the pain is severe, there is swelling or the area feels warm if your pain or discomfort has not improved after treatment if the pain is from a back injury or lower back pain that spreads to your legs if pain gets worse during the day, such as knee or hip pain if you have other symptoms, such as morning joint stiffness, fever or numbness if you have muscular pain and a medical condition or take certain medicines, such as those to lower your

cholesterol level if the person is a child or elderly â€“ they may be more sensitive to some medicines if you are pregnant or breastfeeding â€“ certain medicines will not be suitable if your pain persists beyond seven days. If any of these apply, investigation of muscle aches and pains by your health professional is

recommended, even if it confirms there is nothing seriously wrong

Treatment tips for muscle aches and pains:

RICER therapy is very important in the first 48 hours after an injury, such as a sprain. R rest: no further exercise I ice: apply ice or a bag of frozen vegetables, wrapped in a towel to protect your skin, for 10â€“30 minutes

every two hours C compress: wrap with a firm, elastic bandage â€“ loosen if you feel tingling or numbness E elevate: keep the injured limb raised on a chair or cushion R refer: see a doctor or physiotherapist for a precise diagnosis and ongoing care â€“ a full recovery is more

likely with less scarring. Treatment Optionsgeneral muscle aches and pains can be relieved by a range of medicines
it may be better to avoid certain medicines when you are first injured â€“ check with your pharmacist
take pain relievers regularly for the first few days, rather than waiting for the pain
Oral pain relief medicines (analgesics)

[GENERAL SALE]

eg, paracetamol â€“ packets of 20 or fewer (Panadol range, Ethics Paracetamol, Paracare range, Pain

Clear Paracetamol, Pacimol), aspirin (Aspro range, Disprin range), ibuprofen â€“ packets of 25 or fewer

(Act-3, Nurofen range, Ethics Ibuprofen, i-Profen)

[PHARMACY ONLY]

eg, paracetamol, ibuprofen â€“ larger pack sizes, paracetamol long-lasting (Panadol Back + Neck Long

Lasting) diclofenac (Voltaren Rapid 12.5), naproxen (Sonaflam)

[PHARMACIST ONLY]

eg, diclofenac (Voltaren Rapid 25) Paracetamol, aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) relieve pain. Aspirin and

NSAIDs (which include ibuprofen, diclofenac and naproxen) also reduce inflammation (swelling). Paracetamol is a safe choice for most people but it is important not to take more than recommended. It

is an ingredient in many cold and flu remedies so be careful not to double dose. The maximum daily dose

of paracetamol for an adult is 4g (4000mg) â€“ and no more than 1g (1000mg) every four hours. Aspirin and NSAIDs are not suitable for everyone. Children under 12 years old must not take aspirin

because it can cause Reyeâ€™s syndrome â€“ a serious condition. It should also be avoided by adolescents

under 16 years old who have a viral illness.

Check with your pharmacist before taking aspirin or NSAIDs if you:

have a history of stomach problems, such as ulcers or indigestion have asthma â€“ some people with asthma find their condition is made worse by these types of medicines
have kidney problems or a heart condition take other medications have an allergy to aspirin or NSAIDs are pregnant or breastfeeding are elderly â€“ you may be at more risk of side effects are dehydrated. Sometimes aspirin and NSAIDs can cause side effects. If you develop indigestion, or unusual or

increased bleeding or bruising, stop taking them and talk to your pharmacist. Gel NSAIDs (non-steroidal anti-inflammatory drugs)

[GENERAL SALE]

eg, ibuprofen (Nurofen Gel), ketoprofen (Oruvail Gel), diclofenac (Voltaren Emulgel)

[PHARMACY ONLY]

eg, etofenamate (Rheumon Gel) NSAID gels rubbed gently over the affected area may help relieve aches, sprains and strains
gel medication can be absorbed into your bloodstream so it is important to check if NSAIDs are suitable

for you (see above) NSAID gels help general aches, sprains and strains occasionally your skin can become irritated â€“ stop use if this happens do not apply to open wounds, lips or near eyes, and wash hands after use if large amounts are used, or you are sensitive to NSAIDs, side effects may occur (see above) NSAIDs are not recommended for pregnant or breastfeeding women, or children. â€˜Heat rubsâ€™ (rubefacients)

[GENERAL SALE]

eg, Deep Heat Night Strength, Deep Heat Regular Rub, Finalgon, Hot Stuff, Ice Gel, Metsal, Tiger Balm

[PHARMACY ONLY]

eg, Perskindol heat rubs mask pain by creating warmth in the area they are applied do not apply heat rubs to open wounds, eyes, mouth or nose heat rubs may irritate the skin â€“ stop using if this happens some heat rubs are not suitable everyone â€“ check with your pharmacist massage heat rubs in for better effect, except with Finalgon Finalgon is much stronger â€“ if extreme stinging occurs, remove excess product with cooking oil or

margarine, not water. Other topical applications

[GENERAL SALE]

eg, Anti-Flamme CrÃ¨me, Anti-Flamme Extra, Percutane, Zostrix Anti-Flamme CrÃ¨me is a herbal cream to treat bruises, bumps, aches and pains Percutane contains both arnica and capsaicin to relieve joint, muscle and arthritis pain Zostrix cream contains capsaicin to relieve joint and muscle pain associated with osteoarthitis.

Nausea or dizziness, vomiting

Many people experience dizziness and vomiting, which are often the result of common gastrointestinal influenza symptoms, but they can occasionally be a symptom of a more severe condition.

Dizziness

Dizziness is a feeling that you may faint or lose balance, and vertigo may make you feel like the room is spinning out of control. Dizziness can often accompany the flu or allergies.

Vomiting

Vomiting often accompanies a gastrointestinal illness such as the flu or food poisoning. Vomiting for several hours can lead to dehydration, so it’s important to keep well hydrated to avoid this condition.

Causes Of Dizziness

Dizziness can be caused by hypoglycemia, a drop in blood pressure, common colds and the flu. Dizziness can be a symptom of a more serious condition, such as stroke, heart attack or shock.

Causes Of Vomiting

Vomiting can be caused by eating contaminated food, the flu or a sensitivity to motion (such as seasickness). Prolonged vomiting, vomiting blood or vomiting that is accompanied by fever should be treated by a medical professional. Vertigo is a condition that causes severe dizziness, nausea and vomiting.

Warning

If you experience dizziness and vomiting that accompanies a head injury, fever a stiff neck, chest pains, shortness of breath, changes in vision or fainting you should seek medical treatment, as this could be a sign of a more serious condition.

There are several common causes of nausea and vomiting. Most causes of nausea either involve the gastrointestinal tract or are triggered by feelings of dizziness (vertigo). It’s important to identify what is causing nausea in order to relieve it

Some common causes of nausea:

pregnancy

infections

food poisoning (foodborne illness)

anxiety or stress

alcohol intoxication

fatigue

brain injury

vertigo

motion sickness

carbon monoxide poisoning

reactions to medication Infections that cause nausea usually affect the gastrointestinal system, but infections that lead to shortness of breath can cause nausea by depriving the brain of oxygen. Whenever the brain is affected by an illness or injury, there is always the possibility of it causing nausea. Vertigo, anxiety, stress, and fatigue all cause nausea by affecting the brain.

Other Symptoms:

Nausea and vomiting are often associated with other signs and symptoms. Prolonged cases of vomiting can lead to symptoms of dehydration. Some other symptoms associated with nausea can be from the physiological reaction of the body to vomiting. Vomiting stimulates the vagus nerve, which leads to a decrease in pulse rate and blood pressure. That sudden drop in blood pressure sometimes causes a reciprocal adrenaline rush. Adrenaline does several things to the body – such as increasing blood pressure and pulse – which includes pulling blood from the skin and triggering sweat. For that reason, victims of nausea and vomiting will often look pale with cool, clammy skin.

Neck pain

Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives.[1] Neck pain, although felt in the neck, can be caused by numerous other spinal issues. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back. The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain. Neck pain may also arise from many other physical and emotional health issues. Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body.[2]

Major and severe causes of neck pain include:

Carotid artery dissection
Referred pain from acute coronary syndrome
Infections: retropharyngeal abscess, epiglottitis, etc.[3]
Spondylosis – degenerative arthritis and osteophytes
Spinal stenosis â€“ a narrowing of the spinal canal
Spinal disc herniation â€“ protruding or bulging discs, or if severe prolapse.Carotid artery dissection The more common and lesser neck pain causes include:

Stress â€“ physical and emotional stresses
Prolonged postures â€“ many people fall asleep on sofas and chairs and wake with sore necks
Minor injuries and falls â€“ car accidents, sporting events and day to day minor injuries
Referred pain â€“ mostly from upper back problems
Over-use â€“ muscular strain is one of the most common causes

Whiplash

Although the causes are numerous, most are easily rectified by either professional help or using self help advice and techniques.

More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosing spondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma.

Treatment

Treatment of neck pain depends on the cause. Many acute problems in the spine/neck generally resolve

themselves in as little as a few days to a few months. Persistent problems involving the cervical spine

should be evaluated by a health care practitioner. Common treatments could include medication, body

mechanics training, ergonomic reform, or physical therapy.

Conservative treatment

Exercise plus joint mobilization and/or joint manipulation has been found to be beneficial in both acute

and chronic mechanical neck disorders.[4] Neither mobilization or manipulation without exercise however

has been found to be helpful.[5][6] Mobilization is equivalent to manipulation.[7] The use of heat or cold may provide short term pain relief. Ultrasound has been shown not to be

efficacious.

Medication

Analgesics such as acetaminophen or NSAIDs are recommended for pain.[8] Muscle relaxants such as

cyclobenzaprine have not been found to be useful and are therefore not recommended.[9] Over the

counter topical creams and patches containing counterirritants have little evidence to support efficacy.

Surgery

Surgery is usually not indicated for most mechanical causes of neck pain. If neck pain is the result of

instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated

for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have

been protracted for many months and refractory to conservative treatment such as physical therapy

School physical exams

Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history â€” an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

Uses of physical examinations:

A physical examination may be provided under health insurance cover, required of new insurance customers, or stipulated as a condition of employment. In the United States, physicals are also marketed to patients as a one-stop health review, avoiding the inconvenience of attending multiple appointments with different healthcare providers. Comprehensive physical exams of this type are also known as executive physicals, and typically include laboratory tests, chest x-rays, pulmonary function testing, audiograms, full body CAT scanning, EKGs, heart stress tests, vascular age tests, urinalysis, and mammograms or prostate exams depending on gender. While elective physical exams have become more elaborate, in routine use physical exams have become less complete. This has led to editorials in medical journals about the importance of an adequate physical examination

Format and interpretation

Although providers have varying approaches as to the sequence of body parts, a systematic examination generally starts at the head and finishes at the extremities. After the main organ systems have been investigated by inspection, palpation, percussion and auscultation, specific tests may follow (such as a neurological investigation, orthopedic examination) or specific tests when a particular disease is suspected (e.g. eliciting Trousseau’s sign in hypocalcemia). With the clues obtained during the history and physical examination the healthcare provider can now formulate a differential diagnosis, a list of potential causes of the symptoms. Specific diagnostic tests (or occasionally empirical therapy) generally confirm the cause, or shed light on other, previously overlooked, causes. While the format of examination as listed below is largely as taught and expected of students, a specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight and speech. Likewise an Orthopaedic surgeon will examine the affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist. Non-specialists generally examine the genitals only upon request of the patient. A complete physical examination includes evaluation of general patient appearance and specific organ systems. It is recorded in the medical record in a standard layout which facilitates others later reading the notes. In practice the vital signs of temperature examination, pulse and blood pressure are usually measured first.

Vital signs:

The primary vital signs are: Temperature recording
Blood pressure
Pulse
Respiratory rate
Pain

Basic biometrics:

Height:

Height is the anthropometric longitudinal growth of an individual. A statiometer is the device used to measure height although often a height stick is more frequently used for vertical measurement of adults or children older than 2. The patient is asked to stand barefoot. Height declines during the day because of compression of the intervertebral discs. Children under age 2 are measured lying horizontally.

Weight:

Weight is the anthropometric mass of an individual. A scale is used to measure weight. Medical professionals generally prefer to use the SI unit of kilograms, and many medical facilities have ready-reckoner conversion charts available for professionals to use, when patients describe their weight in non-SI units. (In the US, pounds and ounces are common, while in the UK stones and pounds are frequently used; in most other countries the metric system predominates.) Body mass index (BMI) or height-weight tables, may be used to compare the relationship between height and weight, and may suggest conditions such as obesity or being overweight or underweight.

Pain:

Because of the importance of pain to the overall wellness of the patient, subjective measurement is considered to be a vital sign. Clinically pain is measured using a FACES scale which is a series of faces from ’0′ (no pain at all showing a normal happy face) to ’5′ (the worst pain ever experienced by the patient). There is also an analog scale from ’0′ to maximum ’10′. It is important to allow patients to make their own choices on a pain scale.

Prescription refills

Choose the Best Refill Option for You

Has your doctor included refills on your prescription? Check the label. If the label shows a number next to the "refills" section, that’s how many times you can get more of your medicine without going back to see your doctor.

There are several ways to refill your prescription:

In person. Go to the pharmacy where you originally filled your prescription and either wait for it or come back to pick it up at a later time.

By phone. Use the pharmacy’s phone number listed on your medication bottle to call in your refill. Most large pharmacies or chain stores have automated menus that you can use any time, day or night (though of course you’ll have to wait for store hours to pick up your refill). The voice prompts will lead you through the process. At smaller pharmacies, you may speak to the pharmacist or pharmacy technician directly.

Online. If your pharmacy lets you reorder a prescription online, you may still have to go to the store to pick it up.

By mail. People who take medication regularly (such as every day to manage a health condition) can sometimes refill prescriptions by mail. This option is convenient because you can often get your medication in batches (say, a 3-month supply of allergy pills) if your doctor gives you a prescription for that amount. Ask your doctor about this option. If you want to use the mail-order option, you’ll need to plan ahead since it may take up to 2 weeks to receive your medicine. If your prescriptions are covered by health insurance, be sure to tell the pharmacy if your insurance has changed since you last filled your prescription. If you’re not sure about the cost of your medication or the co-pay, ask

Use the Label

No matter how you choose to refill a prescription, it will be easier if you have all your prescription information handy. Most of what you need is printed on the label. The prescription label is usually wrapped around the medicine bottle. In some cases â€” especially with medicines like eye drops and skin creams â€” it may be stuck on the outer box instead. Check the box when you first get your prescription so you don’t throw it out by mistak What if know your prescription is refillable but you threw the carton away? You may have to go in person to the same pharmacy where you first got the prescription and ask them to look it up in their database. They’ll probably ask for ID and want to see your prescription card before giving you a refill.

Here’s what to look for on the label:

Pharmacy phone number. This is the number you’ll call to place the refill.

Prescription number. This number is often shown on the label as "Rx#". Although a pharmacist can look up your prescription in the computer, the refill process will go a lot faster if you have this number handy.

Refills remaining. The prescription label will tell you how many refills you have left. Most labels show a number of refills with a cutoff date. If you refill your prescription before that date, you should be able to place your order with no problem. However, if the label says something like "Refills require authorization" or if your refills have expired, you’ll need to get in touch with the doctor who prescribed the medication. Sometimes the pharmacy can do that for you, but other times the doctor will want to see you or talk to you before authorizing the pharmacy to refill the prescription.

Make Sure You Don’t Run Out

Probably the trickiest part about refilling a prescription is remembering to check when you’re running low. If you wait until you’ve taken your last pill to place your refill, and for some reason end up having to wait for it, it could be a mere annoyance â€” or a major ordeal. Missing even one daily dose of some medications can be dangerous. On the flip side, if you try to get a jump on things and place a refill weeks in advance, your insurance might not cover it. So keep your eye on the bottle and try to time your refill so the pharmacy has a few days to get things ready for you â€” especially if they’re going to need to contact your doctor.

Talk to the Pharmacist

When you pick up your refill, you’ll probably be asked if you have any questions for the pharmacist. This

is a good time to go over how you should be taking the medication â€” such as whether you should take it

with or without food. If you’re at all unsure about your medication, ask to see the pharmacist. Most

pharmacies ask you to sign a "waiver" if you don’t have questions. Since you’ve already been taking the medication for a while, you might have noticed side effects. For

example, does your acne cream leave your face red and irritated? Do you notice headaches after using

your prescription eye drops? These are all good things to mention to your pharmacist â€” especially as
people can sometimes notice new side effects even after they’ve been taking a medicine for many years. When you pick up your prescription, let your pharmacist know if you’ve started using any new

medications. Even over-the-counter medications (like cold medicines) or herbal supplements can

sometimes affect how well prescriptions work or interact with prescription medications to cause health

problems.

If the pharmacy seems busy or you don’t want to ask about something personal (like birth control) in front

of other people, call and ask to speak to the pharmacist after you leave. Mention that you just refilled

your prescription and have questions. No matter how busy they are, pharmacists are still willing and

eager to help â€” it’s their job to make sure people take their medications safely and effectively.

Pre-placement occupational medicine physicals

Occupational Medicine is the practice of medical care for employees; it may also be known as employee health services. By its nature, occupational medicine comprises many other medical fields, such as internal medicine, emergency medicine, preventive medicine, and family medicine. Occupational health techniques such as return-to-work programs, preplacement examinations, and fitness-for-duty evaluations are all part of an innovative approach to improving worker safety and productivity.

Return-to-Work Programs:

Although it was acceptable in the past for workers to remain home until they fully recovered from an injury or illness, many businesses lately are taking a new approach that involves saving money and getting employees back on the job as soon as possible. Return-to-work programs are set up to bring injured or disabled employees back on the job in some capacity. For instance, an employee might be given a light-duty job more suitable to his current ability than his original job was. Return-to-work programs cut the number of missed work days in half. Missed work leads to lower productivity and affects the company’s bottom line. These programs work when the company takes a sincere approach to employees’ health and well-being. It is important for the program to have three concepts in order to be successful: good communication among all parties involved; management’s ability to find alternatives for employees coming back to the job; and management’s buying into the concept that return-to-work programs can be helpful.

Preplacement Examinations

Sometimes prospective employees are subjected to a preplacement examination prior to employment. This physical examination determines if the applicant has the mental and physical capabilities required for the position.The use of preplacement examinations is an effective way to prevent accidents on the job, because the applicant undergoes a full physical examination complete with a medical history. While preplacement examinations will not prevent all accidents and injuries on the job, they do lessen the possibility of these events. Preplacement examinations should not be used to discriminate while hiring, but rather as a way of putting the correct person in the right position. They can be helpful in determining where an applicant may need employer support. For example, the examination may show that an applicant can’t lift more than 50 pounds without assistance. If the employer decides that this would not be a problem on the job, then accommodations can be made for this applicant.

Fitness-for-Duty Evaluations:

This evaluation is just as stated. It is an assessment of whether an employee returning to work can perform his job at the previous level without putting himself or others in a potentially unsafe situation. These evaluations are particularly useful in determining an employee’s mental health. For example, if an employee was placed on medical leave for severe emotional stress, then, based on a doctor’s evaluation, management can decide at what capacity if any the employee is ready to return to work

School physicals

What is the purpose of a school physical?

The purpose is really to get an overall picture of any childâ€™s health, and that would include looking in areas of development, both how theyâ€™re doing cognitively or in school; as well as their social development and physical development. We look at areas such as nutrition, sleep, what their dietâ€™s like, the sort of activities they participate in. We often provide what we call anticipatory guidance, which is talking about things like making sure the kids are wearing their sunscreen when theyâ€™re out in summer months; wearing their seatbelts; bicycle helmets; those sorts of things. And of course we update any immunizations that might be due.

At what age should children receive a school physical?

The kindergarten exam can be done at age 4 or 5. The immunizations that are required have to be done after the age of 4, so any time after their fourth birthday and before they start kindergarten would be a good time to come in

What should a parent bring with them to their childâ€™s physical?

We just got done talking about immunizations, and thatâ€™s the most important thing. If they have a copy of their childâ€™s immunizations, thatâ€™s very helpful. If they have a copy of any lead screen that was done when they were a child or infantâ€”thatâ€™s now required by the state of Iowaâ€”then that can save them a blood draw for lead tests and if they bring immunization records, it will also save them some shots.

Typically, what does a school physical include?

It includes talking about the childâ€™s overall health, the parentâ€™s assessment of that. We do a thorough physical examination; and then we provide, any anticipatory guidance. Of course based on the childâ€™s age, weâ€™re not going to talk about the same things with a 5-year-old that we might talk about with a 15-year-old.

Why is it important for children to have these routine physicals?

Lots of things change over the years. Family histories change, so for instance, when youâ€™re five, everyone in your family may be healthy. By the time youâ€™re 15, your father or grandfather may have had a heart attack, indicating some risk for that, and we might want to screen for cholesterol or something like that. Or high blood pressure may have developed in a parent that weâ€™d want to screen for in a child. So those things change over time and the children, of course, change as time goes by. The demands of school and things like that change and sometimes we pick up on developmental or social problems that crop up along the way.

Sexual disease exposure or uncomplicated sexually transmitted diseases (STD)

Gonorrhea :

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. It typically infects epithelia of the urethra, cervix, rectum, pharynx, or eyes, causing irritation or pain and purulent discharge. Dissemination to skin and joints, which is uncommon, causes sores on the skin, fever, and migratory polyarthritis or pauciarticular septic arthritis. Diagnosis is by microscopy, culture, or nucleic acid amplification tests. Several oral or injectable antibiotics can be used, but drug resistance is an increasing problem. N. gonorrhoeae occurs only in humans and is almost always transmitted by sexual contact. Urethral and cervical infections are most common, but infection in the pharynx or rectum can occur after oral or anal intercourse, and conjunctivitis may follow contamination of the eye. After an episode of vaginal intercourse, likelihood of transmission from women to men is about 20%, but from men to women, it may be higher. Neonates can acquire conjunctival infection during passage through the birth canal (see Infections in Neonates: Etiology), and children may acquire gonorrhea as a result of sexual abuse. In 10 to 20% of women, cervical infection ascends via the endometrium to the fallopian tubes (salpingitis) and pelvic peritoneum, causing pelvic inflammatory disease (PIDâ€”see Vaginitis and Pelvic Inflammatory Disease (PID): Pelvic Inflammatory Disease (PID)). Chlamydiae or intestinal bacteria may also cause PID. Gonorrheal cervicitis is commonly accompanied by dysuria or inflammation of Skene’s ducts and Bartholin’s glands. In a small fraction of men, ascending urethritis progresses to epididymitis. Disseminated gonococcal infection (DGI) due to hematogenous spread occurs in < 1% of cases, predominantly in women. DGI typically affects the skin, tendon sheaths, and joints. Pericarditis, endocarditis, meningitis, and perihepatitis occur rarely. Co-infection with Chlamydia trachomatis occurs in 15 to 25% of infected heterosexual men and 35 to 50% of women.

Symptoms and Sign

About 10 to 20% of infected women and very few infected men are asymptomatic. About 25% of men have minimal symptoms. Male urethritis has an incubation period from 2 to 14 days. Onset is usually marked by mild discomfort in the urethra, followed by more severe penile tenderness and pain, dysuria, and a purulent discharge. Urinary frequency and urgency may develop as the infection spreads to the posterior urethra. Examination detects a purulent, yellow-green urethral discharge, and the meatus may be inflamed. Epididymitis usually causes unilateral scrotal pain, tenderness, and swelling. Rarely, men develop abscesses of Tyson’s and Littre’s glands, periurethral abscesses, or infection of Cowper’s glands, the prostate, or the seminal vesicles. Cervicitis usually has an incubation period of > 10 days. Symptoms range from mild to severe and include dysuria and vaginal discharge. On pelvic examination, clinicians may note a mucopurulent or purulent cervical discharge, and the cervical os may be red and bleed easily when touched with the speculum. Urethritis may occur concurrently; pus may be expressed from the urethra when the symphysis pubis is pressed or from Skene’s ducts or Bartholin’s glands. Rarely, infections in sexually abused prepubertal girls cause dysuria, purulent vaginal discharge, and vulvar irritation, erythema, and edema. Pelvic inflammatory disease (PID) occurs in 10 to 20% of infected women. PID may include salpingitis, pelvic peritonitis, and pelvic abscesses and may cause lower abdominal discomfort (typically bilateral), dyspareunia, and marked tenderness on palpation of the abdomen, adnexa, or cervix. Fitz-Hugh-Curtis syndrome is gonococcal (or chlamydial) perihepatitis that occurs predominantly in women and causes right upper quadrant abdominal pain, fever, nausea, and vomiting, often mimicking biliary or hepatic disease. Rectal gonorrhea is usually asymptomatic. It occurs predominantly in men practicing receptive anal intercourse and can occur in women who participate in anal sex. Symptoms include rectal itching, a cloudy rectal discharge, bleeding, and constipationâ€”all of varying severity. Examination with a proctoscope may detect erythema or mucopurulent exudate on the rectal wall. Gonococcal pharyngitis is usually asymptomatic but may cause sore throat. N. gonorrhoeae must be distinguished from N. meningitidis, a closely related organism that is often present in the throat without causing symptoms or harm. Disseminated gonococcal infection (DGI), also called the arthritis-dermatitis syndrome, reflects bacteremia and typically manifests with fever, migratory pain or joint swelling (polyarthritis), and pustular skin lesions. In some patients, pain develops and tendons (eg, at the wrist or ankle) redden or swell. Skin lesions occur typically on the arms or legs, have a red base, and are small, slightly painful, and often pustular. Genital gonorrhea, the usual source of disseminated infection, may be asymptomatic. DGI can mimic other disorders that cause fever, skin lesions, and polyarthritis (eg, the prodrome of hepatitis B infection or meningococcemia); some of these disorders may cause genital symptoms (eg, reactive arthritisâ€”see Joint Disorders: Reactive Arthritis). Gonococcal septic arthritis is a more focal form of DGI that results in a painful arthritis with effusion, usually of 1 or 2 large joints such as the knees, ankles, wrists, or elbows. Some patients used to have or still have skin lesions of DGI. Onset is often acute, usually with fever, severe joint pain, and limitation of movement. Infected joints are swollen, and the overlying skin may be warm and red.

Diagnosis

Gram staining and culture
Nucleic acid-based testing Gonorrhea is diagnosed when gonococci are detected via microscopic examination using Gram stain, culture, or a nucleic acid-based test of genital fluids, blood, or joint fluids (obtained by needle aspiration). Gram stain is sensitive and specific for gonorrhea in men with urethral discharge; gram-negative intracellular diplococci typically are seen. Gram stain is much less accurate for infections of the cervix, pharynx, and rectum and is not recommended for diagnosis at these sites. Culture is sensitive and specific, but because gonococci are fragile and fastidious, samples taken using a swab need to be rapidly plated on an appropriate medium (eg, modified Thayer-Martin) and transported to the laboratory in a CO2-containing environment. Blood and joint fluid samples should be sent with notification to the lab or suspected gonococcal infection. Unamplified nucleic acid-based tests may be done on genital rectal or oral swabs. Most tests simultaneously detect gonorrhea and chlamydia and then differentiate between them in a subsequent specific test. Nucleic acid amplification tests (NAAT) further increase the sensitivity adequately to enable testing of urine samples in both sexes. In the US, confirmed cases of gonorrhea, chlamydial infection, and syphilis must be reported to the public health system. A serologic test for syphilis (STS) and a screening test for chlamydial infection should be done. Men with urethritis: Those with obvious discharge may be treated presumptively if likelihood of follow-up is questionable or if clinic-based diagnostic tools are not available. Samples for Gram staining can be obtained by touching a swab or slide to the end of the penis to collect discharge. Gram stain does not identify chlamydia, so urine or swab samples for NAAT are obtained. Women with genital symptoms or signs: A cervical swab should be sent for culture or nucleic acid-based testing. If a pelvic examination is not possible, NAAT of a urine sample can detect gonococcal (and chlamydial) infections rapidly and reliably. Pharyngeal or rectal exposures (either sex): Swabs of the affected area are sent for culture or nucleic acid-based tests. Arthritis, DGI, or both: An affected joint should be aspirated, and fluid should be sent for culture and routine analysis Patients with skin lesions, systemic symptoms, or both should have blood, urethral, cervical, and rectal cultures or NAAT. In about 30 to 40% of patients with DGI, blood cultures are positive during the first week of illness. With gonococcal arthritis, blood cultures are less often positive, but cultures of joint fluids are usually positive. Joint fluid is usually cloudy to purulent because of large numbers of WBCs (typically > 20,000/ÂµL). Screening: Asymptomatic patients considered at high risk of sexually transmitted diseases (STDs) can be screened by NAAT of urine samples, thus not requiring invasive procedures to collect samples from genital sites. Patients at risk include People with a history of previous STD
People with high-risk behaviors (eg, new or multiple sex partners, inconsistent use of condoms, exchange of sex for money or drugs)
Sexually active adolescents and young adults < 24 yr
Pregnant women < 24 yr

Treatment

For DGI with arthritis, a longer course of parenteral antibiotics
Concomitant treatment for chlamydial infection

Treatment of sex partners

Gonococcal arthritis does not usually require joint drainage. Initially, the joint is immobilized in a functional position. Passive range-of-motion exercises should be started as soon as patients can tolerate them. Once pain subsides, more active exercises, with stretching and muscle strengthening, should begin. Over 95% of patients treated for gonococcal arthritis recover complete joint function. Because sterile joint fluid accumulations (effusions) may persist for prolonged periods, an anti-inflammatory drug may be beneficial. /> Posttreatment cultures are unnecessary if symptomatic response is adequate. However, for patients with symptoms for > 7 days, cultures are repeated, and antimicrobial sensitivity testing is done. Patients should abstain from sexual activity until treatment is completed to avoid infecting sex partners Sex partners: All sex partners who have had sexual contact with the patient within 60 days should be tested for gonorrhea and other STDs and treated if results are positive. Sex partners with contact within 2 wk should be treated presumptively for gonorrhea (epidemiologic treatment). Expedited partner therapy (EPT) involves giving patients a prescription or drugs to deliver to their partner. EPT may enhance partner adherence and reduce treatment failure due to reinfection. It may be most appropriate for partners of women with gonorrhea or chlamydia. However, a health care visit is preferable to ascertain histories of drug allergies and to screen for other STDs

Simple, visible splinters

Sinusitis

Overview

Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection. See also: Chronic sinusitis

Symptoms

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 – 7 days of symptoms. Symptoms include:

Bad breath or loss of smell

Cough, often worse at night

Fatigue and generally not feeling well

Fever

Headache — pressure-like pain, pain behind the eyes, toothache, or facial tenderness

Nasal congestion and discharge

Sore throat and postnasal drip Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 8 weeks.

Symptoms of sinusitis in children include:

Cold or respiratory illness that has been improving and then begins to get worse

High fever, along with a darkened nasal discharge, for at least 3 days

Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving

Treatment

Try the following measures to help reduce congestion in your sinuses:

Apply a warm, moist washcloth to your face several times a day.

Drink plenty of fluids to thin the mucus.

Inhale steam 2 – 4 times per day (for example, sitting in the bathroom with the shower running).

Spray with nasal saline several times per day.

Use a humidifier. Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them beyond 3 – 5 days can actually worsen nasal congestion.

Also, for sinus pain or pressure:

Avoid flying when you are congested.

Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.

Try acetaminophen or ibuprofen. Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick.

Antibiotics may be prescribed sooner for:

Children with nasal discharge, possibly with a cough, that is not getting better after 2 – 3 weeks

Fever higher than 102.2Â° Fahrenheit (39Â° Celsius)

Severe swelling around the eyes

Headache or pain in the face At some point, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) or allergy specialist.

Other treatments for sinusitis include:

Allergy shots (immunotherapy) to help prevent the disease from returning

Avoiding allergy triggers

Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are swollen structures (such as nasal polyps) or allergies Acute sinusitis should be treated for 10 – 14 days. Chronic sinusitis should be treated for 3 – 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections. Surgery to clean and drain the sinuses may also be necessary, especially in patients whose inflammation returns, despite medical treatment. An ENT specialist (also known as an otolaryngologist) can perform this surgery. Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.

Causes

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate. When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Sinusitis can occur from one of these conditions:

Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions.

Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.

A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
Sinusitis can be:

Acute — symptoms last 2 – 8 weeks

Chronic — symptoms last much longer Acute sinusitis is caused by damage to the lining of the sinuses from surgery or infections. Chronic sinusitis may be caused by bacteria or a fungus.

The following may increase your risk or your child’s risk of developing sinusitis:

Allergic rhinitis or hay fever

Cystic fibrosis

Day care

Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.

Changes in altitude (flying or scuba diving)

Large adenoids

Tooth infections (rare)

Weakened immune system from HIV or chemotherapy

Tests & diagnosis

The doctor will examine you or your child for sinusitis by:

Looking in the nose for signs of polyps

Shining a light against the sinus (transillumination) for signs of inflammation

Tapping over a sinus area to find infection Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis. Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctor who specializes in ear, nose, and throat problems (ENT). However, these tests are not very sensitive at detecting sinusitis, and are often considered unnecessary. A CT scan of the sinuses may also be used to help diagnose sinusitis. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary. If you or your child has chronic or recurrent sinusitis, other tests may include:

Allergy testing

Blood tests for HIV or other tests for poor immune function

Ciliary function tests

Nasal cytology

Sweat chloride tests for cystic fibrosis

Prognosis

Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.

Prevention

The best way to prevent sinusitis is to avoid or quickly treat flus and colds:

Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals that could boost your immune system and help your body resist infection.

Get an influenza vaccine each year.

Reduce stress.

Wash your hands often, particularly after shaking hands with others.

Other tips for preventing sinusitis:

Avoid smoke and pollutants.

Drink plenty of fluids to increase moisture in your body.

Take decongestants during an upper respiratory infection.

Treat allergies quickly and appropriately.

Use a humidifier to increase moisture in your nose and sinuses.

Complications

Although very rare, complications may include:

Abscess

Bone infection (osteomyelitis)

Meningitis

Skin infection around the eye (orbital cellulitis) When to contact a doctor Call your doctor if:

Your symptoms last longer than 10 – 14 days or you have a cold that gets worse after 7 days

You have a fever

You still have symptoms after taking all of your antibiotics properly A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics

Skin infections (minor), skin lumps, bumps, growths or rashes

Sleep disorder

Overview

Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep.

Symptoms

The symptoms vary and depend on the specific sleep disorder.

Treatment

Treatments vary and depend on the specific sleep disorder. See:

Insomnia

Hypersomnias

Sleep terrors

Sleep walking

Causes

More than 100 different disorders of sleeping and waking have been identified. They can be grouped in four main categories:

Problems with falling and staying asleep (insomnia)

Problems with staying awake (excessive daytime sleepiness)

Problems with sticking to a regular sleep schedule (sleep rhythm problem)

Unusual behavoirs during sleep (sleep-disruptive behaviors)

PROBLEMS WITH FALLING AND STAYING ASLEEP

Insomnia includes any combination of difficulty with falling asleep, staying asleep, intermittent wakefulness and early-morning awakening. Episodes may come and go (be transient), last as long as 2 to 3 weeks (be short-term), or be long-lasting (chronic). Common factors associated with insomnia include:

Physical illness

Depression

Anxiety or stress

Poor sleeping environment such as excessive noise or light

Caffeine

Alcohol or other drugs

Use of certain medications

Heavy smoking

Daytime napping

Counterproductive sleep habits:

Early bedtimes

Excessive time spent awake in bed

Disorders include:

Psychophysiological insomnia: a condition in which stress caused by the insomnia makes it even harder to fall asleep

Delayed sleep phase syndrome: your internal clock is constantly out of synch with the "accepted" day / night phases; for example, patients feel best if they can sleep from 4AM to noon

Hypnotic-dependent sleep disorder: insomnia that occurs when you stop or become tolerant to certain types of sleep medications

Stimulant-dependent sleep disorder: insomnia that occurs when you stop or become dependent on certain types of stimulants

PROBLEMS WITH STAYING AWAKE

Disorders of excessive sleepiness are called hypersomnias. These include:

Idiopathic hypersomnia (excessive sleepiness that occurs without an identifiable cause)

Narcolepsy

Obstructive and central sleep apnea

Periodic limb movement disorder

Restless leg syndrome

PROBLEMS STICKING TO A REGULAR SLEEP SCHEDULE

Problems may also occur when you do not maintain a consistent sleep and wake schedule. This occurs when traveling between times zones and with shift workers on rotating schedules, particularly nighttime workers. Sleep disruption disorders include:

Irregular sleep-wake syndrome

Jet lag syndrome

Natural short sleeper (the person sleeps less hours than normal but has no ill effects)

Paradoxical insomnia (the person actually sleeps a different amount than they think they do)

Shift work sleep disorder

SLEEP-DISRUPTIVE BEHAVIORS

Abnormal behaviors during sleep are called parasomnias and are fairly common in children. They include:

Sleep terrors

Sleep walking

REM sleep-behavior disorder (a type of psychosis in which a person"acts out" dreams so violently that they may injure the person sleeping with them)

Tests & diagnosis

Tests vary and depend on the specific sleep disorder. A sleep study (polysomnography) may be done.

Prognosis

The outcome varies with the type of disorder. Some disorders may go away without treatment.

Prevention

The following can help prevent many sleep disorders.

Regular sleep habits (such as going to bed and waking at the same time every day)

A quiet sleep environment

Regular exercise

Staying generally fit and healthy When to contact a doctor Call for an appointment with your health care provider if lack of sleep, too much sleep, or unusual sleep behaviors are interfering with daily living.

Sore throat with no difficulty swallowing

Specialized exams including DOT, respiratory clearance and food-handler

Sunburn or minor cooking burn

Suture removal

Signs and symptoms of infection

Most wounds that are going to become infected do so 24 to 72 hours after the initial injury. Keep in mind that a slight rim of redness confined to the edge of a wound can be normal, especially if the wound is sutured. However, the area of redness should not spread. Pain and tenderness also occur normally, but the pain and swelling should be greatest during the second day and should then diminish.

Home Care

Do not wash the area for 24 hours after the wound occurrence unless otherwise directed by your physician. Then begin washing it with warm water and liquid soap one or two times each day. Baths are usually safe after 48 hours. Dress the wound as directed by your doctor. Your nurse can demonstrate for you.

Suture Removal

Sutures are ready for removal at different times, depending on the site of the wound. Have your child’s stitches/staples removed on the correct day. Stitches removed too late can leave unnecessary skin marks or even scarring. If any sutures come out early, call your child’s physician. In the meantime, reinforce the wound with tape. For some wounds or incisions, steri-strips are used in place of sutures. These look like small pieces of tape that are placed across the incision. Steri-strips will fall off on their own after about 3-4 days. They need no special care, and your child can shower or bath as discussed above.

Scars

If your child needed sutures, your child will most likely develop a scar. Scars vary in degree depending on a variety of factors. The scar can be kept to a minimum by taking the sutures out at the right time, preventing wound infections, and protecting the wound from being reinjured during the following month. The healing process goes on for 6 to 12 months, and only then will the scar assume its final appearance.

Points to Remember

Wash your hands before & after touching wound.

Pin diapers below abdominal dressing to avoid contamination.

Report any unusual appearance, bleeding, or drainage.

Carry out special wound care, as prescribed by your doctor.

Inspect wound for signs of infection: Redness, swelling, heat, pain, excess drainage.

Provide nutritious diet Call Your Doctor Immediately If

An unexplained fever (over 1000 F , or over 37.80 C ) occurs.

A red streak runs from the wound. Within 24 Hours If

Puss starts to drain from the wound.

The wound becomes more tender than it was on the second day.

A pimple starts to form where a stitch comes through the skin.

A stitch comes out early.

You have other concerns or questions.

Pregnancy testing

Upper respiratory infections

The upper respiratory infections or URIs, which are caused by bacteria and viruses, affect the important parts of the body such as the nose, the sinus and the pharynx. Upper respiratory infections can spread due to activities such as coughing, sneezing, or having personal contact with a person, who is already suffering from them. Apart from the above-mentioned organs, the airways and the windpipe are also affected by upper respiratory infections. People generally experience the upper respiratory infection symptoms, after two or three days from the time the virus spreading the infection enters your body. Though, the upper respiratory infections can occur at any time of the year, there are more chances of them affecting people in the winter season. These upper respiratory infection symptoms are observed in people of all age groups.

Symptoms of Upper Respiratory Infection

There are many upper respiratory infection symptoms and among them headaches, soreness in throat, runny nose and sneezing are most commonly observed. These symptoms generally last for about one week, and even for two weeks, in some cases. Here is a list of some more upper respiratory infection

symptoms:

Muscle and bone ache

Stuffy and blocked nose

Infections of the ear

Laryngitis

Sinusitis

Bronchitis

Fever

Cough

Common cold

Phlegm

Nasal congestion

Loss of appetite

Malaise

Sleep problems, especially in the children and infants

Vomiting

Watery eyes

Fatigue

Scratchy throat

Fussiness

Chills

Upper Respiratory Infection Causes

There are many causes of upper respiratory infections. People, who work for long hours and are totally stressed out, both physically and emotionally, stand at a greater risk of suffering from upper respiratory infections. Eating unhealthy or contaminated food, staying in places which are very crowded for a long time and smoking, are some of the major causes of upper respiratory infections. As per a research, there are hundreds of viruses which can cause these kinds of infections. Some of the prominent viruses causing the upper respiratory infections are:

Parainfluenza virus

Adenovirus

Respiratory syncytial virus

Enterovirus

Rhinovirus

Coronavirus Taking swab tests, blood tests and X-rays of the chest are some of the methods of diagnosis, that are used by doctors for detecting the upper respiratory infections. More on respiratory system functions.

Upper Respiratory Infection Treatment

The nature of the upper respiratory treatments will depend on the age and past medical history of the patient and the seriousness of the disease. Increasing the intake of liquids or fluids is an essential aspect of treatment for upper respiratory infections. Irritation in throat and nose can be easily avoided, by staying away from polluted and contaminated areas. Following the basic rules of healthy living, such as washing your hands and exercising regularly can prove to be very useful prevention methods. Proper functioning of the immune system which prevents the infections, can be sought by muscle relaxation, breathing and behavioral therapy. There are certain decongestants such as pseudoephedrine and antihistamines such as loratadine, which may be prescribed for the treatment of upper respiratory infections Antibiotics do not help in the process of killing the viruses responsible for the upper respiratory infections and in some cases, are known to cause serious side effects. Use of humidified or heated air and paracetamol or ibuprofen to reduce your fever can be helpful. Many people are of the belief that Vitamin C is useful in the treatment of upper respiratory infections, but studies have indicated that large doses of the vitamin can cause side effects. The information about upper respiratory infection symptoms, causes and treatments given above will be helpful for you in dealing with this common health problem. Follow all the instructions of your doctor, to recover fast from these infections.

Vaginal bleeding, vaginitis

Weakness (minor)

Work release or disability for completion

Disabilities have been defined in many ways. In general, disabilities are characteristics of the body, mind, or senses that, to a greater or lesser extent, affect a person’s ability to engage independently in some or all aspects of day-to-day life.

Different kinds of disabilities affect people in different ways. The same kind of disability can affect each person differently.

Many Americans will experience disability first hand.

While all disabilities are as different as the individuals who experience them, the challenges and opportunities for persons with disabilities often are similar. Disability is neither inability nor sickness:

Most persons with disabilities are as healthy as people who donâ€™t have disabilities; however, persons with disabilities are, however, at greater risk for illness

Most people with disabilities can and do work, play, learn and enjoy full healthy lives in their communities.

One of the key challenges for a person with a disability is to be seen by the public, to be portrayed in the media, treated by health care professionals, as an individual with abilities, and not just seen as a disability. Disability can become a fact of life for anyone at any time.

Today, 54 million people in the United States are living in the community with a disability. Thatâ€™s one in every five people. According to the most recent census data, around 52 million of them reside in the community (US Census Bureau 2002). Additionally, about 2 million people live in nursing homes and other long-term care facilities.

Some people are born with a disability; some people get sick or have an accident that results in a disability; and some people develop a disability as they age.

The reality is that just about everyone â€“ women, men and children of all ages, races and ethnicities â€“ will experience a disability some time during his or her lifetime.

As we age, the likelihood of having a disability of some kind increases. The likelihood of having a disability increased with age. For those 45 to 54 years old, 22.6 percent have some form of disability; for those 65 to 69 years old, the comparable estimate is 44.9 percent; and for the ol

Wound checks, minor wounds

Minor Wounds:

Most minor wounds can be treated in the home without the need for further medical attention. First aid treatment can promote recovery and prevent infection. However, further medical advice should be sought if: there is a foreign body embedded in the wound; the wound shows signs of infection; the wound has the potential for tetanus and the injured person’s immunisation is not up-to-date; the wound is from a human or animal bite.

First Aid for treating minor wounds :

If possible, wash your hands before treating the wound. Check that there is nothing in the wound. If the wound is dirty, clean it under running water. Pat dry with clean, non-fluffy material. Clean the wound from the centre out with gauze swabs or antiseptic wipes, using a fresh piece for each wipe. Cover the wound with an adhesive dressing to apply pressure and protect from infection. Elevate the wound if necessary to help control bleeding. 1.Check there is nothing embedded in the wound and clean and dry it. 2.Clean the wound with antiseptic wipes or swabs, then cover it with a dressing for protection and to apply pressure. 3.Raise the wound if necessary to reduce blood flow to the affected area. If there is gravel or grit in the world If there is loose debris on the wound this can be easily washed away with water or taken off by gently dabbing with clean gauze. lf there are small bits of debris embedded into the wound these should be treated as foreign bodies. Gently cover with a clean dressing and bandage the dressing into place, taking care not to press on the embedded debris. Raise the injured part if appropriate and seek medical advice.

Bruising:

A bruise is the sign of an internal bleed. Usually caused by direct impact, bruises are sometimes painful but generally heal swiftly with little intervention needed.

A bruise goes through several changes in appearance as it heals and may not appear for some time, even days, after the accident. Initially, the injured part may be red from the impact; over time this may become blue as blood seeps into the injured tissue; as it heals it becomes brown and then fades to yellow.

Severe bruising can also be the sign of serious internal bleeding. If bruising is extensive and is accompanied by any of the following signs and symptoms assume that a serious internal bleed is present. Treat the injured person for shock and seek medical help.

Signs and symptoms of internal bleeding :

Casualty is known to have had an accident (not necessarily in the immediate past)

Signs and symptoms of shock

Bruising

Boarding – this most commonly occurs where there is bleeding into the stomach area; the quantity of blood combined wirh the tissues swelling results in a rigidity to the tissues

Swelling

Bleeding from body orifices Most bruises, however, are not serious. First aid can reduce pain and promote recovery from an uncomfortable bruise.

Treatment of minor bruising :

Check for underlying injuries such as broken bones or sprains.

Apply a cold compress to the site of the bruise to reduce swelling.

Raise and support the injured part as appropriate.