Tag Archives: Physical examination

Ruptured spleen

Definition:
The spleen is a soft plum-coloured organ, packed with blood-filled tissues and covered by a smooth membrane. It’s located in the abdomen just beneath the left side of the diaphragm, under the ribs, and is shaped like a loosely clenched fist.
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The spleen’s vulnerable location and softness means it’s at risk of injury. A severe blow to the stomach area can squash the spleen, splitting or tearing its covering membrane and the tissue inside and allowing blood to rapidly leak out – rather like a squashed tomato.

A ruptured spleen is a serious condition that can occur when your spleen experiences a trauma. With enough force, a blow to your abdomen — during a sporting mishap, a fistfight or a car crash, for example — might lead to a ruptured spleen. Without emergency treatment, a ruptured spleen can cause life-threatening internal bleeding.

Though some ruptured spleens require emergency surgery, others with ruptured spleens can be treated with several days of hospital care.

You may click to seedifferent pictures of  Ruptured spleen

Symptoms
The abdomen usually feels tender and painful when the spleen ruptures. Blood leaks into the abdomen, causing irritation with subsequent tenderness and pain. Classically, a patient with a ruptured spleen describes feeling left shoulder-tip pain (this pain comes from irritation of the diaphragm by the spilt blood).

If the leak of blood is gradual, symptoms may not occur until the blood supply to the body is diminished. This will result in low blood pressure and light-headedness, blurred vision, confusion and loss of consciousness, as the oxygen supply to the heart and brain is affected. If blood loss is rapid, the person may suddenly collapse.

Causes:
A ruptured spleen is the most common serious complication of an abdominal injury and may occur as a consequence of road traffic accidents, sports injuries and violent, physical attacks.

*Injury to the left side of the body. A ruptured spleen is typically caused by a blow to the left upper abdomen or the left lower chest, such as might happen during sporting mishaps, fistfights and car crashes.

*An injured spleen may rupture soon after the abdominal trauma or, in some cases, days or even weeks after the injury.An enlarged spleen. Your spleen can become enlarged when blood cells accumulate in the spleen. An enlarged spleen can be caused by various underlying problems, such as mononucleosis and other infections, liver disease and blood cancers.

Complications: A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.

Diagnosis:
Normal procedures  to diagnose a ruptured spleen include:

*A physical exam. During a physical exam  doctor will use his or her hands to place pressure on your abdomen to determine the size of your spleen and whether you’re experiencing any abdominal tenderness.

*Drawing fluid from  abdomen.  The Doctor may use a needle to draw a sample of fluid from the abdomen. If the sample reveals blood in the abdomen,  the patient may be referred for emergency treatment.

*Imaging tests of  the abdomen. If your diagnosis isn’t clear, the doctor may recommend an abdominal computerized tomography (CT) scan or another imaging test to identify or rule out other possible causes as per symptoms.

Treatment :
Untreated, a ruptured spleen can be rapidly fatal, so it requires urgent medical and surgical treatment.

Fluids must quickly be given through an intravenous drip in order to maintain the circulation to the organs of the body (including a blood transfusion) and emergency surgery is performed to stop the leak of blood.

Sometimes, if the rupture is only small, it’s possible for the surgeon to repair the spleen. However, usually the entire spleen needs to be removed in an operation called a splenectomy.

The spleen plays an important part in protecting the body against infection. In particular it clears a type of bacteria known as pneumococcus from the body. So it’s important that those who’ve had their spleen removed take extra precautions to protect themselves against infection. In particular, they should be vaccinated against pneumococcal infection.

Prognosis:
Splenic rupture permits large amounts of blood to leak into the abdominal cavity, possibly resulting in shock and death. Patients typically require emergency surgery, although it is becoming more common to simply monitor the patient to make sure the bleeding stops by itself and to allow the spleen to heal itself. Rupture of a normal spleen can be caused by trauma, for example, in an accident. If an individual’s spleen is enlarged, as is frequent in mononucleosis, most physicians will not allow activities (such as contact sports) where injury to the abdomen could be catastrophic.

Prevention
The spleen is a useful organ and it is essential to life. It is sometimes removed (splenectomy) in those who have blood disorders, such as thalassemia or hemolytic anemia. If the spleen is removed, a person must receive certain immunizations to help prevent infections that the spleen normally fights.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/rupturedspleen1.shtml
http://en.wikipedia.org/wiki/Ruptured_spleen
http://www.mayoclinic.com/health/ruptured-spleen/DS00872

how-to-treat-torn-ruptured-spleen-photo

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Dupuytren’s contracture

Definition:
Dupuytren’s contracture is a painless thickening and contracture of tissue beneath the skin on the palm of the hand and fingers.
...CLICK & SEE THE PICTURES
It is  a disease of the palmar fascia (thin but tough layer of fibrous tissue between the skin of the palm and the underlying flexor tendons of the fingers) resulting in progressive thickening and contracture of fibrous bands on the palmar surface of the hand and fingers.  Fasciitis implies inflammation of the fascia, and contracture implies thickening and tightening of the diseased fascia.  Basically, the tissue on the palm side of the hand thickens (can become as thick as 0.5cm) and essentially “shrinks” and produces a tightness in the area of the hand which the diseased tissue overlies.  It occurs most often in the fourth and fifth digits (ring and small fingers).  It is a very common problem and often arises in the hands of middle aged persons;  however, it can be seen as early as the twenties.  This entity does run in families in some cases.  It is seven times more common in men than women.  It has been associated with diabetes and can be seen in alcoholics with cirrhosis of the liver.  It has also been associated with epilepsy but may be a result of the use of anticonvulsant drugs rather than the presence of epilepsy itself.  The underlying cause is unknown.

You may click to see the picture

Dupuytren contracture varies in its rate of progression from minor skin puckering for many years to rapid contracture (fixed flexed position) of fingers.

People of northern European descent are more often affected and it can run in families. Men are affected more often than women and the condition is most likely to occur over the age of 40.

Causes:
The cause is unknown, but minor injury and your genes may make you more likely to develop this condition. It can run in families. It’s not caused by a person’s type of job or work environment, manual work or vibrating tools.

One or both hands may be affected. The ring finger is affected most often, followed by the little, middle, and index fingers.

A small, painless nodule develops in the connective tissue on the palm side of the hand and eventually develops into a cord-like band. In severe cases, it’s difficult or even impossible to extend the fingers.

The condition becomes more common after the age of 40. Men are affected more often than women. Risk factors are alcoholism, epilepsy, pulmonary tuberculosis, diabetes, and liver disease.

Symptoms:
Dupuytren contracture initially may cause only a minor painless lump in the palm of the hand near the base of the finger(s). Dupuytren contracture most commonly affects the ring (fourth) finger, but it can affect any and all fingers.Pain and the position of the fingers may make it difficult to perform everyday activities with the hand.The appearance of the deformity can cause distress.Dupuytren contracture can also affect one or both hands.

CLICK TO SEE PICTURE

Dupuytren contracture is seldom associated with much, if any, pain unless the affected fingers are inadvertently forcefully hyperextended.

The ring finger is affected most often, although any finger can be involved. In 50 per cent of cases both hands are affected. It can affect the toes and soles of the feet, but this is rare.

Diagnosis:
Dupuytren’s contracture is diagnosed by the doctor during the physical examination of the affected hand.

A physical examination of the palm by touch (palpation) confirms the presence of thickened scar tissue (fibrosis) and contracture. Restriction of motion is common.

Previous burns or hand injury can lead to scar formation in the palm of the hand which can mimic true Dupuytren contracture.

Treatment:
Often, treatment isn’t needed if the symptoms are mild. Exercises, warm water baths, or splints may be helpful.

If normal hand function is affected, surgery is usually recommended to release the contracture and improve the hand’s function.

There are three main surgical options:
•Open fasciotomy – opening the skin and cutting the thickened tissue
•Needle fasciotomy – pushing a needle through the skin to cut the thickened tissue
•Open fasciectomy – cutting open the skin and removing the thickened tissue

Prognosis: The disorder progresses at an unpredictable rate. Surgical treatment can usually restore normal movement to the fingers. The disease can recur following surgery in some cases.

Prevention:
Since the precise cause of Dupuytren’s contracture is unknown, it’s difficult to prevent.
Awareness of risk factors may allow early detection and treatment.
Avoiding excessive intake of alcohol may help to reduce the risk of it developing in susceptible individuals.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/dupuytrens1.shtml
http://www.med.und.edu/users/jwhiting/dupdef.html
http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm
http://www.medicinenet.com/dupuytren_contracture/article.htm

http://www.prlog.org/10501551-who-first-described-dupuytrens-contracture.html

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Smell Disorder

 

 

Introduction:
Our sense of smell & taste helps us enjoy life. We delight in the aromas of our favorite foods or the fragrance of flowers. Our sense of smell also is a warning system, alerting us to danger signals such as a gas leak, spoiled food, or a fire. Any loss in our sense of smell can have a negative effect on our quality of life. It also can be a sign of more serious health problems.

Roughly 1–2 percent of people in North America say that they have a smell disorder. Problems with smell increase as people get older, and they are more common in men than women. In one study, nearly one-quarter of men ages 60–69 had a smell disorder, while about 11 percent of women in that age range reported a problem.

Many people who have smell disorders also notice problems with their sense of taste.

CLICK & SEE

Other Names:
Loss of smell; Anosmia.

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How do we smell?
Our sense of smell—like our sense of taste—is part of our chemosensory system, or the chemical senses  or the chemosenses.Sensory cells in our nose, mouth, and throat have a role in helping us interpret smells, as well as taste flavors. Microscopic molecules released by the substances around us (foods, flowers, etc.) stimulate these sensory cells. Once the cells detect the molecules they send messages to our brains, where we identify the smell. Olfactory, or smell nerve cells, are stimulated by the odors around us–the fragrance of a gardenia or the smell of bread baking. These nerve cells are found in a small patch of tissue high inside the nose, and they connect directly to the brain. Our sense of smell is also influenced by something called the common chemical sense. This sense involves nerve endings in our eyes, nose, mouth, and throat, especially those on moist surfaces. Beyond smell and taste, these nerve endings help us sense the feelings stimulated by different substances, such as the eye-watering potency of an onion or the refreshing cool of peppermint. It’s a surprise to many people to learn that flavors are recognized mainly through the sense of smell. Along with texture, temperature, and the sensations from the common chemical sense, the perception of flavor comes from a combination of odors and taste. Without the olfactory cells, familiar flavors like coffee or oranges would be harder to distinguish....CLICK & SEE

 

Types of smell disorders:
People who experience smell disorders experience either a loss in their ability to smell or changes in the way they perceive odors. As for loss of the sense of smell, some people have hyposmia, which is when their ability to detect odor is reduced. Other people can’t detect odor at all, which is called anosmia. As for changes in the perception of odors, some people notice that familiar odors become distorted. Or, an odor that usually smells pleasant instead smells foul. Still other people may perceive a smell that isn’t present at all.You may click to see :Smell Dysfunction Glossary of Terms….
Sniff Test May Signal Disorders’ Early Stages ….

Symptoms:
Smell disorder  symptoms are : Reduced sense of smell, Anosmia, Olfactory dysfunction, Loss of smell, Lack of sense of smell in children, Paraosmia due to amebic meningitis or other types.

There are various symptoms related to “smell”. Having a particular smell or odor can be a serious symptom. There are various odor symptoms such as body odor, urine odor, stool odor, and other odor symptoms. The sense of smell can be subject to loss of smell, loss of taste, or other nose symptoms….


Considerations:

The loss of smell can occur as a result of nasal congestion or blockage of the nose and isn’t serious, but it can sometimes be a sign of a nervous system (neurological) condition.

Temporary loss of the sense of smell is common with colds and nasal allergies, such as hay fever (allergic rhinitis). It may occur after a viral illness.

Some loss of smell occurs with aging. In most cases, there is no obvious or immediate cause, and there is no treatment.

The sense of smell is often lost with disorders that prevent air from reaching the part of the nose where smell receptors are located (the cribriform plate, located high in the nose). These disorders may include nasal polyps, nasal septal deformities, and nasal tumors.

Other disorders that may cause a loss of the sense of smell include:

The sense of smell also enhances your ability to taste. Many people who lose their sense of smell also complain of a loss of the sense of taste. Most can still tell between salty, sweet, sour, and bitter tastes, which are sensed on the tongue. They may not be able to tell between other flavors. Some spices (such as pepper) may affect the nerves of the face and may be felt rather than smelled.

Causes:
Smell disorders have many causes, with some more obvious than others. Most people who develop a smell disorder have experienced a recent illness or injury. Common causes of smell disorders are:

*Disorders of the endocrine system
*Head trauma
*Nervous disorders
*Nutritional disorders
*Tumors of the head or brain
*Many medications may change or decrease the ability to detect odors.
*Sinus and other upper respiratory infections
*Polyps in the nasal cavities
*Frontal head injuries
*Hormonal disturbances
*Dental problems
*Exposure to certain chemicals, such as insecticides and solvents
*Numerous medications, including some common antibiotics and antihistamines
*Radiation associated with the treatment of head and neck cancers
*Aging
*Other health issues that affect the nervous system, such as Parkinson’s disease or Alzheimer’s disease

In the year 2009, the FDA warned consumers to stop using several popular cold remedies because they could result in the loss of smell. Smoking also can interfere with our sense of smell.

Most people who develop a smell disorder have recently experienced an illness or an injury. Common triggers are upper respiratory infections and head injuries.  Some medicines have also been associated with smell disorders. People with head and neck cancers who receive radiation treatment are also among those who experience problems with their sense of smell.

Associated conditions
* Dysosmia
* Kallmann syndrome
* Zinc deficiency
* Cadmium Poisoning
* Holoprosencephaly
* Primary amoebic meningoencephalitis caused by Naegleria fowleri
* Refsum disease
* CHARGE syndrome
* Ageusia

Diagnosis:
Both smell and taste disorders are treated by an otolaryngologist, a doctor who specializes in diseases of the ear, nose, throat, head, and neck. Some tests are designed to measure the smallest amount of odor that patients can detect. Another common test consists of a booklet of sheets that contain tiny beads filled with specific odors.In fact, an easily administered “scratch and sniff” test allows a person to scratch pieces of paper treated to release different odors, sniff them, and try to identify each odor from a list of possibilities. In this way, doctors can easily determine whether patients have hyposmia, anosmia, or another kind of smell disorder.

CLICK & SEE

An accurate assessment of your smell disorder will include, among other things, a physical examination of your ears, nose, and throat; a review of your health history, such as exposure to toxic chemicals or trauma; and a smell test supervised by a health care professional.

Risk Factors:
Like all of our senses, our sense of smell plays an important part in our lives.When smell is impaired, some people change their eating habits. Some may eat too little and lose weight while others may eat too much and gain weight. Food becomes less enjoyable and people may use too much salt to improve the taste. This can be a problem for people with certain medical conditions, such high blood pressure or kidney disease. In severe cases, loss of smell can lead to depression.

The sense of smell often serves as a first warning signal, alerting us to the smoke of a fire or the odor of a natural gas leak and dangerous fumes. Perhaps more important is that our chemosenses are sometimes a signal of serious health problems. Obesity, diabetes, hypertension, malnutrition, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and Korsakoff’s psychosis are all accompanied or signaled by chemosensory problems like smell disorders.

Presentation
Anosmia or smell disorder can have a number of detrimental effects. Patients with sudden onset anosmia may find food less appetizing, though congenital anosmics rarely complain about this. Loss of smell can also be dangerous because it hinders the detection of gas leaks, fire, and spoiled food. The common view of anosmia as trivial can make it more difficult for a patient to receive the same types of medical aid as someone who has lost other senses, such as hearing or sight.

Losing an established and sentimental smell memory (e.g. the smell of grass, of the grandparents’ attic, of a particular book, of loved ones, or of oneself) has been known to cause feelings of depression.

Loss of olfaction may lead to the loss of libido, though this usually does not apply to congenital anosmics.

Often people who have congenital anosmia report that they pretended to be able to smell as children because they thought that smelling was something that older/mature people could do, or did not understand the concept of smelling but did not want to appear different from others. When children get older, they often realize and report to their parents that they do not actually possess a sense of smell, often, to the surprise of their parents.

Zicam controversy
On June 16, 2009, the U.S. Food and Drug Administration sent a warning letter to Matrixx Initiatives, manufacturer of an over-the-counter nasal spray for the common cold, Zicam. The FDA cited complaints that the product caused anosmia. The manufacturer strongly denies these allegations, but has recalled the product and has stopped selling it.

Treatment:
Some people experience relief from smell disorders. Since certain medications can cause a problem, adjusting or changing that medicine may ease its effect on the sense of smell. Others recover their ability to smell when the illness causing their olfactory problem resolves. For patients with nasal obstructions such as polyps, surgery can remove the obstructions and restore airflow. Not infrequently, people enjoy a spontaneous recovery because olfactory neurons may regenerate following damage.

Home Care:
Treating the cause of the problem may correct loss of the sense of smell. Treatment can include:

*Antihistamines (if the condition is related to allergy)
*Changes in medication
*Surgery to correct blockages
*Treatment of other disorders
*Avoid using too many nasal decongestants, which can lead to recurring nasal congestion.

If you lose your sense of smell, you may have changes in taste. But, adding highly seasoned foods to your diet can help stimulate the taste sensations that you still have.

Improve your safety at home by using smoke detectors and electric appliances instead of gas ones. You may not be able to smell gas if there is a leak. Or, install equipment that detects the presence of gas fumes in the home.

There is no treatment for loss of smell due to aging.

If you have a loss of smell due to a recent viral upper respiratory infection, be patient. The sense of smell may return to normal without treatment.

Click to see:Herbs for Loss of Smell & Taste

Click to learn more about : Treatments for a Loss of Sense of Smell

Research:
The National Institute on Deafness and Other Communication Disorders (NIDCD) supports basic and clinical investigations of smell and taste disorders at institutions across the nation. Some of these studies are conducted at chemosensory research centers, where scientists are making discoveries that help them understand our olfactory system and may lead to new treatments for smell disorders.

Some of the most recent research into our sense of smell is also the most exciting. In 2004, NIDCD grantee Linda B. Buck, Ph.D., together with Richard Axel, M.D., received the Nobel Prize in Physiology or Medicine for their discovery of a family of about 1,000 olfactory receptor genes that encode the receptors found on olfactory sensory neurons—one receptor per neuron. Recent studies on how olfactory sensory neurons recognize odors, aided by new technology, are revealing how our olfactory system detects and identifies the differences between the many chemical compounds that form odors.

Like our sense of taste, our sense of smell can be damaged by certain medicines. However, other medications, especially those prescribed for allergies, may improve the sense of smell. NIDCD-supported scientists are working to find out why this is so in an effort to develop drugs that can help restore a person’s sense of smell.

NIDCD-supported researchers have found that the loss of smell affects the choices an older person makes about eating certain foods. Food choices impact diet and overall health. They are looking at how and why this takes place in order to develop more effective ways to help older people—especially those with chronic illnesses—cope better with problems with smell and to maintain proper nutrition.

Olfactory sensory neurons—as well as sensory cells that help us taste—are the only sensory cells that our bodies regularly replace. Scientists are exploring why and how this happens in order that they might find ways to replace other damaged sensory and nerve cells.

NIDCD-supported chemosensory scientists are exploring how to:

*Promote the regeneration of sensory and nerve cells.
*Understand the effects of the environment (such as gasoline fumes, chemicals, and extremes of relative humidity and temperature) on smell and taste.
*Prevent the effects of aging on smell and taste.
*Prevent infectious agents and toxins from reaching the brain through the olfactory nerve.
*Develop new diagnostic tests for taste and smell disorders.
*Understand associations between chemosensory disorders and altered food intake in aging as well as in various chronic illnesses.
*Improve treatment methods and rehabilitation strategies.

MORE INFORMATION:-

Click For more information NIDCD Information Clearinghouse.

The NIDCD maintains a directory of organizations that can answer questions and provide printed or electronic information about hearing, balance, smell, taste, voice, speech, and language. This directory is available at www.nidcd.nih.gov/directory.

To find organizations with information specifically about smell disorders, click on Smell and Taste in the “Browse by Topic” list.

For more information, additional addresses and phone numbers, or a printed list of organizations, contact:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free Voice: (800) 241-1044 begin_of_the_skype_highlighting              (800) 241-1044      end_of_the_skype_highlighting
Toll-free TTY: (800) 241-1055
Fax: (301) 770-8977
E-mail: nidcdinfo@nidcd.nih.gov
NIH Publication No. 09-3231
Updated July 2009

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://health.nytimes.com/health/guides/symptoms/smell-impaired/overview.html
http://www.righthealth.com/topic/Disorders_Smell/overview/healthocrates20?fdid=healthocrates_a1e23a7936222b32cbffcf28f010c155
http://www.medicinenet.com/smell_disorders/article.htm
http://www.wrongdiagnosis.com/sym/smell_symptoms.htm#intro

http://en.wikipedia.org/wiki/Anosmia

Dealing with Sexual Assault

We perceive India as a safe, tradition bound country that honours women and loves children. Yet, our cities are becoming famous, even internationally, for molestation and rape. The number of cases reported has increased 700 per cent since Independence. And this is probably only the tip of the iceberg.CLICK & SEE

Shame, family pressures, social stigma, economic vulnerability and lack of knowledge of legal procedures coerce a victim into silence. To make things worse, the victim is often regarded by our inadequately educated, underpaid and insensitive police personnel as the one at “fault”.

Rape is traditionally considered a crime against women. But times are changing. Horror stories abound about homosexual sexual predators targeting, kidnapping and victimising young boys. The victims range from six-month-olds to 80-year-olds. The perpetuators of rape, however, are almost always male.

Around 80 per cent of the crime is committed by someone known to the victim. Often, the abuser is a member of the victim’s family or belongs to his or her circle of acquaintances. In such cases, the crime is perpetuated in a known place, in either of their homes or that of a friend, relative or neighbour.

Today, children of both sexes are in danger, in exclusive neighbourhoods as well as the slums. Their lack of knowledge, inexperience and trusting nature make them ideal victims. Many of these attacks are not random but well planned by a predator known to the victim.

Police complaints are often followed by unwelcome media publicity. There are no “special victim units” in the police force yet, that may be trained to handle such cases with discretion and empathy. The guidelines provided deal mostly with the rape of women. The concept of male or child rape is new and the level of expertise in dealing with this is low.

Despite this, if a parent or the victim wishes to prosecute the assailant, a physical medical examination, documentation of the evidence and registration of an FIR (First Information Report) must be done.

Even otherwise, a thorough medical examination must be undertaken as soon as possible to treat and record lacerations and injuries, both external and internal.

The greatest fear about sexual assault is that of acquiring STDs. The number infected varies between 5 and 10 per cent. Infection depends upon several factors, such as the type of sexual contact, number of assailants, and whether or not they had an STD at the time of the assault.

The risk of contracting STDs can be reduced by taking medication as a preventive measure. Immediate and effective treatment options are available for some STDs such as hepatitis B, gonorrhea, syphilis, herpes, chlamydia and trichomonas vaginalis.

The regimen recommended is a single injection of ceftriaxone, plus an oral dose of azithromycin, plus either secnidazole, tinidazole or metronidazole. Herpes can be tackled with a five or seven-day course of acyclovir.

The risk of acquiring HIV infection is less than 1 per cent. However, it is important for medico-legal reasons to document the HIV status immediately. The test should be repeated after six months and then a year. A 28-day regimen of zidovudine and lamivudine provides post-exposure prophylaxis for HIV and should be started as soon as possible, preferably within 72 hours.

Injuries and lacerations require a single booster dose of tetanus toxoid. Hepatitis B can be sexually transmitted. Most children today have received three doses of the vaccine as part of their immunisation schedule and are thus protected against the infection. In that case, only a booster dose needs to be given. If the victim has not been immunised in childhood, immunoglobulin needs to be given. In addition, three doses of the vaccine must be given — immediately after the incident, after a month and after six months.

Prophylactic treatment against syphilis is not advised. Instead, a blood test can be done after three months to ascertain if infection has occurred.

Counselling, psychiatric evaluation and support are necessary for the victim as well as his or her family to overcome the trauma.

To protect children —

• Make them learn addresses and phone numbers by heart

• Teach them certain body parts are not to be touched

• Discourage them from talking to strangers

• Do not send them anywhere alone, especially after dark

• Escort them to and from school bus stops

• Encourage physical fitness and teach them martial arts

• Teach them to trust their survival instincts and, if needed, run in the opposite direction as fast as they can, shouting all the way.

For adults, the best bet is —

*To have peepholes in the front door

*Avoid dark and deserted areas

*Be physically fit and able to run fast.

Source: The Telegraph ( Kolkata, India)

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Acute Cholecystitis

Alternative Names: Cholecystitis – acute

Definition: Acute cholecystitis is a sudden inflammation of the gallbladder that causes severe abdominal pain.

 

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You may Click  See also: Chronic cholecystitis

Causes :-
In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness, alcohol abuse and, rarely, tumors of the gallbladder may also cause cholecystitis.

Acute cholecystitis causes bile to become trapped in the gallbladder. The build up of bile causes irritation and pressure in the gallbladder. This can lead to bacterial infection and perforation of the organ.

Gallstones occur more frequently in women than men. Gallstones become more common with age in both sexes. Native Americans have a higher rate of gallstones.

Symptoms :-

The main symptom is abdominal pain that is located on the upper right side or upper middle of the abdomen. The pain may:

*Be sharp, cramping, or dull
*Come and go
*Spread to the back or below the right shoulder blade
*Be worse after eating fatty or greasy foods
*Occur within minutes of a meal
*Shortness of breath due to pain when inhaling

Other symptoms that may occur include:
*Abdominal fullness
*Clay-colored stools
*Excess gas
*Fever
*Heartburn
*Indigestion
*Nausea and vomiting
*Yellowing of skin and whites of the eyes (jaundice)
*Stiff abdomen muscles, specially on the right side
*Chills

Diagnosis:
Because the symptoms of acute cholecystitis can resembles symptoms of other illness, it is sometimes difficult to diagnose. If doctor suspects Cholecystitis after a carefull physical examination, he or she may perform some of the following tests:-

Blood Test:-
*Amylase and lipase
*Bilirubin
*Complete blood count ( CBC) — may show a higher-than-normal white blood cell count
*Liver function tests

Imaging tests that can show gallstones or inflammation include:

*Abdominal ultrasound
*Abdominal CT scan
*Abdominal x-ray
*Oral cholecystogram
*Gallbladder radionuclide scan
.

Treatment:-

Seek immediate medical attention for severe abdominal pain.

In the emergency room, patients with acute cholecystitis are given fluids through a vein and antibiotics to fight infection.

Although cholecystitis may clear up on its own, surgery to remove the gallbladder (cholecystectomy) is usually needed when inflammation continues or recurs. Surgery is usually done as soon as possible, however some patients will not need surgery right away.

Nonsurgical treatment includes pain medicines, antibiotics to fight infection, and a low-fat diet (when food can be tolerated).

Emergency surgery may be necessary if gangrene (tissue death), perforation, pancreatitis, or inflammation of the common bile duct occurs.

Occasionally, in very ill patients, a tube may be placed through the skin to drain the gallbladder until the patient gets better and can have surgery.

For Alternative Medication  you may click to see:->
*Cholecystitis as related to Herbal Medicine :
*An alternative approach to acute cholecystitis :
*Acute cholecystitis – Traditional Chinese Medicine, Nature therapy :

Prognosis:-Patients who have surgery to remove the gallbladder are usually do very well.

Possible Complications:-
*Empyema (pus in the gallbladder)
*Gangrene (tissue death) of the gallbladder
*Injury to the bile ducts draining the liver (a rare complication of cholecystectomy)
*Pancreatitis
*Peritonitis (inflammation of the lining of the abdomen)

When to Contact a Medical Professional:

*Call your health care provider if severe abdominal pain persists.
*Call for an appointment with your health care provider if symptoms of cholecystitis recur after an acute episode.

Prevention :
Removal of the gallbladder and gallstones will prevent further attacks. Follow a low-fat diet if you are prone to gallstone attacks.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm

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