Categories
Ailmemts & Remedies

Pain

Definition:
Pain is an unpleasant feeling often caused by intense or damaging stimuli, such as stubbing a toe, burning a finger, putting alcohol on a cut, and bumping the “funny bone”. The International Association for the Study of Pain‘s widely used definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

CLICK & SEE

Everyone feels pain at some point in their lives. Unfortunately, there is no machine to objectively assess pain. Physicians have to rely on what the patient says. Sensitivity to pain varies – acute pain may make a person only grit her teeth and wince whereas the same injury can produce “severe, unbearable pain” with weeping and wailing in others.

Pain forces a person to take notice of a body part they had probably taken for granted. This is particularly true of acute pain such as a toothache, sinusitis, appendicitis or urinary tract infection.

Our bodies are plentifully supplied with “nociceptors” in the skin, bones, muscles and internal organs. Noxious stimuli, (either injury or infection) activates them. They release electrical currents and biochemical agents. These travel along the nerves, up the spinal cord and eventually reach certain areas in the brain. The reaction occurs in a flash and the perception of pain is instantaneous

Pain motivates the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or disease.

Symptoms:
Pain may occur with other symptoms depending on the underlying disease, disorder or condition. For instance, if your pain is due to arthritis, you may experience pain in more than one joint. Pain due to a compressed nerve in the lower back can even lead to loss of bladder control. Pain is often a major symptom of fibromyalgia, which is also characterized by fatigue and sleep problems.

Symptoms that might occur along with pain:

The range of symptoms that may occur with pain include:

*Depression
*Flu-like symptoms (fever, chills, sore throat, fatigue, headache, cough)
*Inability to concentrate
*Loss of appetite
*Muscle spasms
*Numbness
*Sleep disturbances
*Unexpected weight loss

There are certain Serious symptoms that might indicate a life-threatening condition:
In some cases, pain may occur with other symptoms that might indicate a serious or life-threatening condition, such as a heart attack. Seek immediate medical care  if you, or someone you are with, have any of these serious symptoms, with or without pain, including:

*Bleeding symptoms, such as bloody urine or bloody stools
*Change in consciousness or alertness; confusion
*Chest pain radiating to the arm, shoulder, neck or jaw
*Difficulty breathing, wheezing, or shortness of breath
*High fever (higher than 101 degrees Fahrenheit)
*Increased or decreased urine output
*Loss of bladder or bowel control
*Progressive weakness and numbness
*Redness, warmth or swelling
*Seizures
*Stiff neck and headache, with or without nausea or vomiting
*Weakness or lethargy

Causes:
Hundreds of diseases, disorders and conditions can cause pain, such as inflammatory syndromes, malignancy, trauma, and infection. In some cases, pain may be a symptom of a serious or life-threatening condition, such as a heart attack or cancer.

The experience of pain is invariably tied to emotional, psychological, and cognitive factors.

Pain can be due to a wide variety of diseases, disorders and conditions that range from a mild injury to a debilitating disease. Pain can be categorized as acute, chronic, referred, cancer, neuropathic, and visceral.

Acute pain is experienced rapidly in response to disease or injury. Acute pain serves to alert the body that something is wrong and that action should be taken, such as pulling your arm away from a flame. Acute pain often resolves within a short time once the underlying condition is treated.

Chronic pain is defined as lasting more than three months. Chronic pain often begins as acute pain that lingers beyond the natural course of healing or after steps have been taken to address the cause of pain.

Referred pain is pain that originates in one part of the body but is felt in another part of the body.

Cancer pain is due to malignancy.

Neuropathic pain is caused by damage to the nervous system and is often perceived as tingling, burning, and pins-and-needles sensations called paresthesias.

Visceral pain is caused by a problem with the internal organs, such as the liver, gallbladder, kidney, heart or lungs.

Recent studies have found that some people with chronic pain may have low levels of endorphins in their spinal fluid. Endorphins are neurochemicals, similar to opiate drugs (like morphine), that are produced in the brain and released into the body in response to pain. Endorphins act as natural pain killers. Chronic pain most often affects older adults, but it can occur at any age. Chronic pain can persist for several months to years.

Complications:
Complications associated with pain depend on the underlying disease, disorder or condition. For example, pain resulting from a degenerative condition such as multiple sclerosis can lead to inactivity and its associated complications. Fortunately, pain can often be alleviated or minimized by physical therapy, basic self-help measures, and following the treatment plan outlined by your doctor.

However, in some cases the degree and duration of your pain may become overwhelming and affect your everyday living. Research into the diagnosis and treatment of chronic pain is ongoing, so contact your health care professional for the latest information.

Over time, pain can lead to complications including:

*Absenteeism from work or school
*Dependence on prescription pain medication
*Pain that does not respond to treatment (intractable pain)
*Permanent nerve damage (due to a pinched nerve) including paralysis
*Physiological and psychological response to chronic pain
*Poor quality of life

Diagnosis:
A person’s self-report is the most reliable measure of pain, with health care professionals tending to underestimate severity.A definition of pain widely employed in nursing, emphasizing its subjective nature and the importance of believing patient reports, was introduced by Margo McCaffery in 1968: “Pain is whatever the experiencing person says it is, existing whenever he says it does”. To assess intensity, the patient may be asked to locate their pain on a scale of 0 to 10, with 0 being no pain at all, and 10 the worst pain they have ever felt. Quality can be established by having the patient complete the McGill Pain Questionnaire indicating which words best describe their pain.

As an aid to diagnosis:
Pain is a symptom of many medical conditions. Knowing the time of onset, location, intensity, pattern of occurrence (continuous, intermittent, etc.), exacerbating and relieving factors, and quality (burning, sharp, etc.) of the pain will help the examining physician to accurately diagnose the problem. For example, chest pain described as extreme heaviness may indicate myocardial infarction, while chest pain described as tearing may indicate aortic dissection.

Physiological measurement of pain:
fMRI brain scanning has been used to measure pain, giving good correlations with self-reported pain.

Hedonic adaptation:
Hedonic adaptation means that actual long-term suffering due to physical illness is often much lower than expected.

Legal awards for pain and suffering:
One area where assessments of pain are effectively required to be made is in legal awards for pain and suffering. In the Western world these are typically discretionary awards made by juries and are regarded as difficult to predict, variable and subjective, for instance in the US, UK, Australia and New Zealand.

Treatment:
Inadequate treatment of pain is widespread throughout surgical wards, intensive care units, accident and emergency departments, in general practice, in the management of all forms of chronic pain including cancer pain, and in end of life care. This neglect is extended to all ages, from neonates to the frail elderly. African and Hispanic Americans are more likely than others to suffer needlessly in the hands of a physician; and women’s pain is more likely to be undertreated than men’s.

The International Association for the Study of Pain advocates that the relief of pain should be recognized as a human right, that chronic pain should be considered a disease in its own right, and that pain medicine should have the full status of a specialty. It is a specialty only in China and Australia at this time. Elsewhere, pain medicine is a subspecialty under disciplines such as anesthesiology, physiatry, neurology, palliative medicine and psychiatry. In 2011, Human Rights Watch alerted that tens of millions of people worldwide are still denied access to inexpensive medications for severe pain.

A number of medications can be used to treat acute pain. Many of these are available OTC (over the counter). Commonly used medication is paracetemol (10 mg /kg/dose in children 500 mg per dose in adults). It can be repeated every four hours. Paracetemol helps with fever as well, so if the aches and pains are due to seasonal flu, there is rapid improvement. It also blocks the areas of the brain that recognise pain. NSAIDs (non steroidal anti inflammatory drugs) like ibuprofen (Brufen) and nalidixic acid relieve pain but do not have much effect on fever. They act by blocking prostaglandin, one of the chemicals responsible for feeling pain. Topical anti-inflammatory medications, particularly those containing capsaicin are very effective. They should be applied lightly over the painful area followed by an ice pack.

More often chronic pain is due to the various types of arthritis (rheumatoid, osteoarthritis), autoimmune diseases, gout and mechanical problems like a disc prolapse. It needs to be diagnosed correctly so that appropriate treatment can be started. The medications taken may be steroids, opiods or the coxib group of drugs.

Acute pain is usually managed with medications such as analgesics and anesthetics. Caffeine when added to pain medications provides some additional benefit. Management of chronic pain, however, is much more difficult and may require the coordinated efforts of a pain management team, which typically includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, physician assistants, and nurse practitioners.

Sugar taken orally reduces the total crying time but not the duration of the first cry in newborns undergoing a painful procedure (a single lancing of the heel). It does not moderate the effect of pain on heart rate and a recent single study found that sugar did not significantly affect pain-related electrical activity in the brains of newborns one second after the heel lance procedure. Sweet oral liquid moderately reduces the incidence and duration of crying caused by immunization injection in children between one and twelve months of age.

The brain has to be retrained in its perception and response to pain. This can be done with a combination of physiotherapy and aerobic exercise. Judiciously used, these interventions help to reduce long-term dependence on pain medication.

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.healthgrades.com/right-care/bones-joints-and-muscles/pain–symptoms
http://www.telegraphindia.com/1141229/jsp/knowhow/story_5590.jsp
http://en.wikipedia.org/wiki/Pain

Advertisements
Categories
Ailmemts & Remedies

Ear Health

Waxy ears:
One of the most common complaints seen by GPs is a blocked ear, usually caused by wax that has been pushed into the ear by a cotton bud.
click to see the picture
As well as the blocked sensation, waxy ears can reduce hearing, cause a ringing sound (tinnitus) and, occasionally, pain.
click to see
There’s no need to clean your ears with a cotton bud. The ear has its own internal cleaning mechanism. Fats and oils in the ear canal trap any particles and transport them out of the ear as wax. This falls out of the ear without us noticing.

When we try to clean the ear, this wax gets pushed back and compacted. There’s also no need to dry ears with a towel, cotton buds or tissue paper. Let them dry naturally or gently use a hair-drier on low heat.

Olive oil can help to soften the wax and enable it to come out. Apply two drops in each ear twice a day. Wax-softening drops can also be bought from a pharmacist.

Sometimes, the wax needs to be syringed out by a GP or practice nurse.

Itchy ears:-
These can be irritating, and when ears are affected with eczema or psoriasis they can cause constant discomfort. But scratching or poking damages the ear’s sensitive lining, allowing infection in, called otitis externa.

click to see the picture

The immune system normally responds to harmful substances such as bacteria, viruses and toxins by producing symptoms such as runny nose and congestion, post-nasal drip and sore throat, and itchy ears and eyes. An allergic reaction can produce the same symptoms in response to substances that are generally harmless, like dust, dander or pollen. The sensitized immune system produces antibodies to these allergens, which cause chemicals called histamines to be released into the bloodstream, causing itching, swelling of affected tissues, mucus production, hives, rashes, and other symptoms. Symptoms vary in severity from person to person.

This can also happen when ears gets waterlogged through swimming. The ear canal swells, becoming narrow and painful. Hearing becomes a problem and discharge often appears.

Treatment requires antibiotic drops and strong painkillers. In severe cases, the ear needs to be cleaned by an ear specialist.

Piercing:-
Anything that damages the skin can allow infection in. This is often the case with ear piercing, especially when the skin isn’t cared for properly during or after the piercing. Follow care advice carefully.
click to see the picture
Many people are allergic to certain inexpensive metals, such as nickel, which can make the outside of the ear swell and feel uncomfortable.

Sunburn:-
The tops of the ears are exposed to the sun and sensitive to its harmful UV rays. Skin cancer affects ears, too.

Make sure you apply suncream and wear a hat that keeps your ears in the shade.

You may click to see :Herbal Remedies For Ear Infections

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/ears1.shtml
http://www.qualityhealth.com/health-encyclopedia/multimedia/foreign-object-ear
http://www.urgentcarect.com/Services.aspx
http://www.nytimes.com/imagepages/2007/08/01/health/adam/19316Allergysymptoms.html
http://thebeautybrains.com/2009/11/15/what-should-i-do-about-my-ear-infection/

Enhanced by Zemanta
Categories
Diagnonistic Test

Pulmonary Function Tests

[amazon_link asins=’145114380X,0323085059,0198702469,0702035203,1451107137,159103440X,1848822308,1609714865,0323020062′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’04ef9c5a-5f9f-11e7-9bf8-773863ad328b’]

Alternative Names: PFTs; Spirometry; Spirogram; Lung function tests
Definition:Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move oxygen into the blood. These tests can tell your doctor what quantity of air you breathe with each breath, how efficiently you move air in and out of your lungs.
.CLICK & SEE
Pulmonary Function Testing has been a major step forward in assessing the functional status of the lungs as it relates to :

1.How much air volume can be moved in and out of the lungs
2.How fast the air in the lungs can be moved in and out
3.How stiff are the lungs and chest wall – a question about compliance
4.The diffusion characteristics of the membrane through which the gas moves (determined by special tests)
5.How the lungs respond to chest physical therapy procedures

Pulmonary Function Tests are used for the following reasons :

1.Screening for the presence of obstructive and restrictive diseases

2.Evaluating the patient prior to surgery – this is especially true of patients who :
a. are older than 60-65 years of age
b. are known to have pulmonary disease
c. are obese (as in pathologically obese)
d. have a history of smoking, cough or wheezing
e. will be under anesthesia for a lengthy period of time
f. are undergoing an abdominal or a thoracic operation

Note
: A vital capacity is an important preoperative assessment tool. Significant reductions in vital capacity (less than 20 cc/Kg of ideal body weight) indicates that the patient is at a higher risk for postoperative respiratory complications. This is because vital capacity reflects the patient’s ability to take a deep breath, to cough, and to clear the airways of excess secretions.

3.Evaluating the patient’s condition for weaning from a ventilator. If the patient on a ventilator can demonstrate a vital capacity (VC) of 10 – 15 ml/Kg of body weight, it is generally thought that there is enough ventilatory reserve to permit (try) weaning and extubation.

4.Documenting the progression of pulmonary disease – restrictive or obstructive

5.Documenting the effectiveness of therapeutic intervention

How do you prepare for the test?
Do not eat a heavy meal before the test. Do not smoke for 4 – 6 hours before the test. You’ll get specific instructions if you need to stop using bronchodilators or inhaler medications. You may have to breathe in medication before the test.

No other preparation is necessary.

How the Test Will Feel ?
Since the test involves some forced breathing and rapid breathing, you may have some temporary shortness of breath or light-headedness. You breathe through a tight-fitting mouthpiece, and you’ll have nose clips.

What happens when the test is performed?
This testing is done in a special laboratory. During the test, you are instructed to breathe in and out through a tube that is connected to various machines.

A test called spirometry measures how forcefully you are able to inhale and exhale when you are trying to take as large a breath as possible. The lab technicians encourage you to give this test your best effort, because you can make the test result abnormal just by not trying hard.

A separate test to measure your lung volume (size) is done in one of two ways. One way is to have you inhale a small carefully measured amount of a specific gas (such as helium) that is not absorbed into your bloodstream. This gas mixes with the air in your lungs before you breathe it out again. The air and helium that you breathe out is tested to see how much the helium was diluted by the air in your lungs, and a calculation can reveal how much air your lungs were holding in the first place.

The other way to measure lung volume is with a test called plethysmography. In this test, you sit inside an airtight cubicle that looks like a phone booth, and you breathe in and out through a pipe in the wall. The air pressure inside the box changes with your breathing because your chest expands and contracts while you breathe. This pressure change can be measured and used to calculate the amount of air you are breathing.

Your lungs’ efficiency at delivering oxygen and other gases to your bloodstream is known as your diffusion capacity. To measure this, you breathe in a small quantity of carbon monoxide (too small a quantity to do you any harm), and the amount you breathe out is measured. Your ability to absorb carbon monoxide into the blood is representative of your ability to absorb other gases, such as oxygen.

Some patients have variations of these tests-for example, with inhaler medicines given partway through a test to see if the results improve, or with a test being done during exercise. Some patients also have their oxygen level measured in the pulmonary function lab (see “Oxygen saturation test,” page 29).

Why the Test is Performed  ?

Pulmonary function tests are done to:
*Diagnose certain types of lung disease (especially asthma, bronchitis, and emphysema)
*Find the cause of shortness of breath
*Measure whether exposure to contaminants at work affects lung function
It also can be done to:

*Assess the effect of medication
*Measure progress in disease treatment
*Spirometry measures airflow. By measuring how much air you exhale, and how quickly, spirometry can evaluate a broad range of lung diseases.

Lung volume measures the amount of air in the lungs without forcibly blowing out. Some lung diseases (such as emphysema and chronic bronchitis) can make the lungs contain too much air. Other lung diseases (such as fibrosis of the lungs and asbestosis) make the lungs scarred and smaller so that they contain too little air.

Testing the diffusion capacity (also called the DLCO) allows the doctor to estimate how well the lungs move oxygen from the air into the bloodstream.

Risk Factors:
The risk is minimal for most people. There is a small risk of collapsed lung in people with a certain type of lung disease. The test should not be given to a person who has experienced a recent heart attack, or who has certain other types of heart disease.

Must you do anything special after the test is over?
Nothing.

Normal Results:
Normal values are based upon your age, height, ethnicity, and sex. Normal results are expressed as a percentage. A value is usually considered abnormal if it is less than 80% of your predicted value.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean:
Abnormal results usually mean that you may have some chest or lung disease.

Considerations:
Your cooperation while performing the test is crucial in order to get accurate results. A poor seal around the mouthpiece of the spirometer can give poor results that can’t be interpreted. Do not smoke before the test.

How long is it before the result of the test is known?
Your doctor will receive a copy of your test results within a few days and can review them with you then.

Resources:
https://www.health.harvard.edu/diagnostic-tests/pulmonary-function-testing.htm
http://www2.nau.edu/~daa/lecture/pft.htm
http://www.nlm.nih.gov/medlineplus/ency/article/003853.htm

Reblog this post [with Zemanta]
Categories
Diagnonistic Test

Pleural Fluid Sampling (or Thoracentesis)

Pleural effusion Chest x-ray of a pleural effu...
Image via Wikipedia

[amazon_link asins=’B01J8WALE0,B00GNOPG8S,1331951720,1893441776,B01MXOPZIB,B01J2IC12U,B01J37411E,B009KT2GWM,B01J2GLUVU’ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’316e2df4-5fab-11e7-aab1-4db380a805de’]


Definition:
Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall (show radiograph 1). However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion (show radiograph 2). Thoracentesis is done to collect a sample of the fluid, which can help determine why the pleural effusion developed.
CLICK & SEE
Some infections and diseases cause fluid to accumulate in the space between the lung and the rib cage or between the lung and the diaphragm. This collection of fluid is called a pleural effusion. A pleural effusion might be detected on a chest x-ray. Sampling this fluid is important because it enables doctors to understand what caused the fluid to collect and how to treat the problem. The fluid can be sampled with a needle.

Reasons for Thoracentesis: — A thoracentesis is performed to determine the cause of a pleural effusion. In some cases, a physician may perform thoracentesis to relieve symptoms caused by the pleural effusion, including shortness of breath and low blood oxygen levels. A pleural effusion may be detected during a physical examination or on a chest x-ray.

Pleural effusion can be caused by many different conditions, including infections, heart failure, cancer, or tuberculosis. In some cases, blood or other fluid may be leaking into the pleural space from another part of the body, causing the effusion. By examining the fluid and the types of cells it contains, the cause of the effusion can usually be determined.

In general, there is no reason a thoracentesis cannot be performed. The procedure is more easily performed and complications are fewer when the pleural effusion is large. Special consideration may be necessary in patients who are on respirators.

Patients who have a bleeding disorder or who are on medications that affect blood clotting may need extra care to minimize the risk of bleeding. Patients should tell their healthcare provider if they have a history of bleeding problem or if they are taking medicine that decreases blood clotting. In some cases, a blood test will be taken prior to the procedure to exclude any blood clotting abnormalities caused by disease or medications.

Procedure: A thoracentesis involves the following steps:

*The patient will be placed in a position that allows the doctor to easily access the effusion. Usually, the patient is asked to sit upright during the procedure. It is important to remain still during the procedure so that the fluid does not shift.

*The skin is cleaned with an antibacterial solution in the area where the needle will be inserted.

*A small amount of numbing medicine (a local anesthetic, similar to novocaine) is injected into the area. This medicine helps minimize discomfort during the procedure.

*A slightly larger needle is inserted in the same location. A syringe is attached to this needle and is used to withdraw fluid from around the lung. Patients who have symptoms from the effusion (eg, shortness of breath) may have a large amount of fluid removed, which allows the lung to re-expand.

*The needle is removed and pressure is briefly applied to the insertion site.

How do you prepare for the test?
You will need to sign a consent form giving your doctor permission to perform this test. Some patients have this test done in a doctor’s office, while others are admitted to the hospital for it. Generally your doctor will decide whether you need to be in the hospital based on your medical condition. A chest x-ray or an ultrasound is done before the procedure.

Tell your doctor if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist’s office. If you take aspirin, nonsteroidal anti-inflammatory drugs, or other medicines that affect blood clotting, talk with your doctor. It may be necessary to stop or adjust the dose of these medicines before your test.

What happens when the test is performed?
You wear a hospital gown and sit on a bed or table leaning forward against some pillows. The doctor listens to your lungs with a stethoscope and may tap on your back to find out how much fluid has collected.

Soap is used to disinfect an area of skin on one side of your back. A small needle is used to numb a patch of skin between two of your lower ribs. The numbing medicine usually stings for a second. A needle on an empty syringe is then inserted into the fluid pocket. Usually this pocket is around one inch below the skin surface. You might feel some minor pressure as the needle is inserted. Depending on the quantity of fluid that the doctor plans to remove, either the syringe itself is filled or soft plastic tubing is used to remove fluid into a collection bag or jar. While the doctor is attaching the tubing, he or she might ask you to hum out loud. This humming is for your safety: It prevents you from taking a deep breath, which could expand your lung, causing it to touch the needle.

It sometimes takes 15 minutes or longer to remove the necessary amount of fluid. Most patients feel no discomfort during this time, although a few patients feel some chest pain at the end of the procedure as their lung expands and touches the chest wall. After the fluid is removed, a bandage is placed on your back.

Risk Factors:
This procedure carries a few serious risks, but most patients have no complications. If the needle touches the lung it may create an air leak, which is seen on the x-ray and might require you to stay in the hospital for a few days. Some patients with this complication need to have a plastic tube (called a chest tube) inserted between two ribs. The tube uses vacuum pressure to keep the lung expanded until it has healed.

In most cases, a thoracentesis is performed without complications. Most complications are minor and resolve on their own or are easily treated. Potential complications include the following:

*Pain — Some discomfort may occur when the needle is inserted. Using a local anesthetic helps to reduce the pain. Pain generally resolves once the needle is removed.

*Bleeding — A blood vessel may be nicked as the needle is inserted through the skin and chest wall, causing bleeding. The bleeding is usually minor and stops on its own, although it may cause bruising around the puncture site. In rare cases, bleeding into or around the lung may occur, requiring drainage or surgery.

*Infection
Infection can occur if bacteria are introduced by the needle puncture. Using disinfectant solution to clean the area and using sterile technique during the procedure minimizes this risk.

*Pneumothorax or collapsed lung Occasionally, the needle used to obtain a fluid sample can puncture the lung. The hole created by the puncture usually seals quickly on its own. If it does not, air can build up around the lung, causing the lung to collapse. This is called a pneumothorax. When a pneumothorax occurs, a chest tube may be used to drain the air and allow the lung to re-expand.

A pneumothorax may also occur if the lung fails to expand when fluid is withdrawn. This is considered to be a drainage-related pneumothorax, and is the most common type of pneumothorax to occur when ultrasound is used for needle placement. Drainage-related pneumothorax is most commonly caused by disorders of the surface lining of the lung and not by the puncture needle. Treatment is rarely needed.

Pneumothorax occurs in less than 12 percent of procedures. Those that do occur are usually small and resolve on their own. A chest tube to helps re-expand the lung is necessary only if the pneumothorax is large, continues to expand, or causes symptoms.

*Liver or spleen puncture — In very rare cases, the liver or spleen may be punctured during thoracentesis. Sitting upright and remaining still during the procedure helps to keep the liver and spleen away from the insertion area and minimizes the risk of this complication.

Must you do anything special after the test is over?
You will need to have an x-ray taken after the sampling is completed. Your breathing should feel the same (or better) after the procedure.

How long is it before the result of the test is known?
The fluid may be tested for a variety of things, including infection and cancer. Cells in the fluid will be examined. It may be several days before full results are available.

Where you may get more information:-Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two patients are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a provider who is familiar with your individual situation.

This discussion will be updated as needed every four months on our web site (www.uptodate.com/patients). Additional topics as well as selected discussions written for healthcare professionals are also available for those who would like more detailed information.

Some of the most pertinent include:
Professional  Level Information:-
Diagnostic thoracentesis 
An overview of medical thoracoscopy
Diagnostic evaluation of a pleural effusion in adults
Imaging of pleural effusions in adults
Management of malignant pleural effusions

A number of web sites have information about medical problems and treatments, although it can be difficult to know which sites are reputable. Information provided by the National Institutes of Health, national medical societies and some other well-established organizations are often reliable sources of information, although the frequency with which they are updated is variable.

*American Thoracic Society
(www.thoracic.org)

*American Lung Association
(lungusa.org)

*National Heart Lung & Blood Institute
(www.nhlbi.nih.gov/index.htm)

*National Library of Medicine
(www.nlm.nih.gov/medlineplus/healthtopics.html)

Resources:
https://www.health.harvard.edu/diagnostic-tests/pleural-fluid-sampling.htm
http://www.uptodate.com/patients/content/topic.do?topicKey=~0aPG4xpnulisDf

Reblog this post [with Zemanta]
Categories
Ailmemts & Remedies

Bone Fracture

DEFINITION:-
If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture)….>…..click & see

A stress fracture .>....(click & see)...is a hairline crack ->. (click & see).….in the bone that develops because of repeated or prolonged forces against the bone.

A bone fracture (sometimes abbreviated FRX or Fx or Fx) is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis, certain types of cancer or osteogenesis imperfecta. Although fractures are commonly referred to as bone breaks, the word break is not part of formal orthopaedic terminology.

Fractures, broken bones–you can call it what you wish, it means the same thing–are among the most common orthopedic problems, about 6.8 million come to medical attention each year in the United States. The average citizen in a developed country can expect to sustain two fractures over the course of their lifetime.

Fractures happen because an area of bone is not able to support the energy placed on it (quite obvious, but it becomes more complicated). Therefore, there are two critical factors in determining why a fracture occurs:

*the energy of the event

*the strength of the bone

The energy can being acute, high-energy (e.g. car crash), or chronic, low-energy (e.g. stress fracture). The bone strength can either be normal or decreased (e.g. osteoporosis). A very simple problem, the broken bone, just became a whole lot more complicated!

Different Types of Fractures:-
A doctor may be able to tell whether a bone is broken simply by looking at the injured area. But the doctor will order an X-ray to confirm the fracture and determine what type it is.

Reassure your child that, with a little patience and cooperation, getting an X-ray to look at the broken bone won’t take long. Then, he or she will be well on the way to getting a cool — maybe even colorful — cast that every friend can sign.

For little ones who may be scared about getting an X-ray, it might help to explain the process like this: “X-rays don’t hurt.

……....CLICK & SEE

Doctors use a special machine to take a picture to look at the inside of your body. When the picture comes out, it won’t look like the ones in your photo album, but doctors know how to look at these pictures to see things like broken bones.”However, a fracture through the growing part of a child’s bone (called the growth plate) may not show up on X-ray. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn’t show a break.

You may click to see the different pictures of broken bones

Children’s bones are more likely to bend than break completely because they’re softer. Fracture types that are more common in kids include:

*buckle or torus fracture: one side of the bone bends, raising a little buckle, without breaking the other side

*greenstick fracture: a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick)

Mature bones are more likely to break completely. A stronger force will also result in a complete fracture of younger bones.

A complete fracture may be a:

*closed fracture: a fracture that doesn’t break the skin

*open (or compound) fracture: a fracture in which the ends of the broken bone break through the skin (these have an increased risk of infection)

*non-displaced fracture: a fracture in which the pieces on either side of the break line up

*displaced fracture: a fracture in which the pieces on either side of the break are out of line (which might require surgery to make sure the bones are properly aligned before casting)

Other common fracture terms include:

*hairline fracture: a thin break in the bone
*single fracture: the bone is broken in one place
*segmental: the bone is broken in two or more places in the same bone
*comminuted fracture: the bone is broken into more than two pieces or crushed

CAUSES:-
The following are common causes of broken bones:

*Fall from a height

*Motor vehicle accidents

*Direct blow

*Child abuse

*Repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip

In children:-
In children, whose bones are still developing, there are risks of either a growth plate injury or a greenstick fracture.

*A greenstick fracture occurs because the bone is not as brittle as it would be in an adult, and thus does not completely fracture, but rather exhibits bowing without complete disruption of the bone’s cortex.

*Growth plate injuries, as in Salter-Harris fractures, require careful treatment and accurate reduction to make sure that the bone continues to grow normally.

*Plastic deformation of the bone, in which the bone permanently bends but does not break, is also possible in children. These injuries may require an osteotomy (bone cut) to realign the bone if it is fixed and cannot be realigned by closed methods.

SYMPTOMS:

*A visibly out-of-place or misshapen limb or joint

*Swelling, bruising, or bleeding

*Intense pain

*Numbness and tingling

*Broken skin with bone protruding

*Limited mobility or inability to move a limb

TREATMENT:-
FIRST AID :

*Check the person’s airway and breathing. If necessary, call 911 and begin rescue breathing, CPR, or bleeding control.Keep the person still and calm.

*Examine the person closely for other injuries.

*In most cases, if medical help responds quickly, allow the medical personnel to take further action.

*If the skin is broken, it should be treated immediately to prevent infection. Don’t breathe on the wound or probe it. If possible, lightly rinse the wound to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings.

*If needed, immobilize the broken bone with a splint or sling. Possible splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.

*Apply ice packs to reduce pain and swelling.

*Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches above the head, and cover the person with a coat or blanket. However, DO NOT move the person if a head, neck, or back injury is suspected.

CHECK BLOOD CIRCULATION:-
Check the person’s blood circulation. Press firmly over the skin beyond the fracture site. (For example, if the fracture is in the leg, press on the foot). It should first blanch white and then “pink up” in about two seconds. Other signs that circulation is inadequate include pale or blue skin, numbness or tingling, and loss of pulse. If circulation is poor and trained personnel are NOT quickly available, try to realign the limb into a normal resting position. This will reduce swelling, pain, and damage to the tissues from lack of blood.

TREAT BLEEDING:-
*Place a dry, clean cloth over the wound to dress it.

*If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop

the bleeding unless it is life-threatening.

DO NOT:-
*DO NOT move the person unless the broken bone is stable.

*DO NOT move a person with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the

person, pull the person to safety by his clothes (such as by the shoulders of a shirt, a belt, or pant-legs).

*DO NOT move a person who has a possible spine injury.

*DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered.

*DO NOT try to reposition a suspected spine injury.

*DO NOT test a bone’s ability to move.

Call immediately for emergency medical assistance if:
Call 911 if:

*There is a suspected broken bone in the head, neck, or back.

*There is a suspected broken bone in the hip, pelvis, or upper leg.

*You cannot completely immobilize the injury at the scene by yourself.

*There is severe bleeding.

*An area below the injured joint is pale, cold, clammy, or blue.

*There is a bone projecting through the skin.

Even though other broken bones may not be medical emergencies, they still deserve medical attention. Call your health care  provider to find out where and when to be seen.

If a young child refuses to put weight on an arm or leg after an accident, won’t move the arm or leg, or you can clearly see a deformity, assume the child has a broken bone and get medical help.

First aid for fractures includes stabilizing the break with a splint in order to prevent movement of the injured part, which could sever blood vessels and cause further tissue damage. Waxed cardboard splints are inexpensive, lightweight, waterproof and strong. Compound fractures are treated as open wounds in addition to fractures.

At the hospital, closed fractures are diagnosed by taking an X-ray photograph of the injury.

Since bone healing is a natural process which will most often occur, fracture treatment aims to ensure the best possible function of the injured part after healing. Bone fractures are typically treated by restoring the fractured pieces of bone to their natural positions (if necessary), and maintaining those positions while the bone heals. To put them back into the natural positions, the doctor often “snaps” the bones back into place. This process is extremely painful without anesthesia, about as painful as breaking the bone itself. To this end, a fractured limb is usually immobilized with a plaster or fiberglass cast which holds the bones in position and immobilizes the joints above and below the fracture. If being treated with surgery, surgical nails, screws, plates and wires are used to hold the fractured bone together more directly. Alternatively, fractured bones may be treated by the Ilizarov method which is a form of external fixator.

Occasionally smaller bones, such as toes, may be treated without the cast, by buddy wrapping them, which serves a similar function to making a cast. By allowing only limited movement, fixation helps preserve anatomical alignment while enabling callus formation, towards the target of achieving union.

Surgical methods of treating fractures have their own risks and benefits, but usually surgery is done only if conservative treatment has failed or is very likely to fail. With some fractures such as hip fractures (usually caused by osteoporosis or Osteogenesis Imperfecta), surgery is offered routinely, because the complications of non-operative treatment include deep vein thrombosis (DVT) and pulmonary embolism, which are more dangerous than surgery. When a joint surface is damaged by a fracture, surgery is also commonly recommended to make an accurate anatomical reduction and restore the smoothness of the joint. Infection is especially dangerous in bones, due to their limited blood flow. Bone tissue is predominantly extracellular matrix, rather than living cells, and the few blood vessels needed to support this low metabolism are only able to bring a limited number of immune cells to an injury to fight infection. For this reason, open fractures and osteotomies call for very careful antiseptic procedures and prophylactic antibiotics.
Sometimes bones are reinforced with metal, but these fracture implants must be designed and installed with care. Stress shielding occurs when plates or screws carry too large of a portion of the bone’s load, causing atrophy. This problem is reduced, but not eliminated, by the use of low-modulus materials, including titanium and its alloys. The heat generated by the friction of installing hardware can easily accumulate and damage bone tissue, reducing the strength of the connections. If dissimilar metals are installed in contact with one another (i.e., a titanium plate with cobalt-chromium alloy or stainless steel screws), galvanic corrosion will result. The metal ions produced can damage the bone locally and may cause systemic effects as well.

Herbal Treatment For Bone Broken for quicker bone groth & healing:-

By eating garlic buds, frying it in ghee joins the broken bone and releives the fracture pain. Eat Agar Agar – sea weed boiled with water. Eat the powder of Vajiram – Pirandai.

Prevention:
*Wear protective gear while skiing, biking, roller blading, and participating in contact sports. This includes helmets, elbow pads, knee pads, and shin pads.

*Create a safe home for young children. Gate stairways and keep windows closed.

*Teach children how to be safe and look out for themselves.

*Supervise children carefully. There is no substitute for supervision, no matter how safe the environment or situation appears to be.

*Prevent falls by not standing on chairs, counter tops, or other unstable objects. Remove throw rugs and electrical cords from floor surfaces. Use handrails on staircases and non-skid mats in bathtubs. These steps are especially important for the elderly.

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://en.wikipedia.org/wiki/Bone_fracture
http://www.herbalking.in/diseases_b.htm#bonebroken
http://orthopedics.about.com/cs/otherfractures/a/fracture.htm
http://kidshealth.org/parent/general/aches/broken_bones.html

Reblog this post [with Zemanta]