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Ailmemts & Remedies

Pilonidal sinus

Alternative Names:pilonidal cyst, pilonidal abscess or sacrococcygeal fistula

Definition:
A pilonidal sinus is a dimple in the skin in the crease of your child’s buttocks.

This may be noted at birth as a depression or hairy dimple and be present for many years without any symptoms.
Pilonidal sinus affect men more often and most commonly occur in young adults.


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Two pilonidal cysts in the natal cleft
A pilonidal sinus may also occur due to a blockage in the hair follicles, often associated with an ingrown hair.
In both situations, hair acts as a foreign body, which may produce an infection. The infection may spread into the tissues of your child’s buttocks and produce an abscess (collection of pus under the skin) at a site several inches away from the sinus.

Pilonidal means “nest of hair”, and is derived from the Latin words for hair (“pilus”) and nest (“nidus”).The term was used by Herbert Mayo as early as 1830. R.M. Hodges was the first to use the phrase “pilonidal cyst” to describe the condition in 1880.

Symptoms:
A pilonidal sinus may cause no noticeable symptoms (asymptomatic). The only sign of its presence may be a small pit on the surface of the skin.

When it’s infected, a pilonidal sinus becomes a swollen mass (abscess). Signs and symptoms of an infected pilonidal cyst include:

*Pain
*Localized swelling
*Reddening of the skin
*Drainage of pus or blood from an opening in the skin (pilonidal sinus)
*Foul smell from draining pus

Hair protruding from a passage (tract) below the surface of the skin that connects the infected pilonidal cyst to the opening on the skin’s surface (a pilonidal sinus) — more than one sinus tract may form
Fever (uncommon)

Causes:
Quite why it happens isn’t entirely clear. When they occur in the cleft between the buttocks, one popular explanation is that there’s a developmental defect in the direction that the hair grows – that is, the hair grows inwards rather than outwards.

One proposed cause of pilonidal cysts is ingrown hair. Excessive sitting is thought to predispose people to the condition because they increase pressure on the coccyx region. Trauma is not believed to cause a pilonidal cyst; however, such an event may result in inflammation of an existing cyst. However there are cases where this can occur months after a localized injury to the area. Some researchers have proposed that pilonidal cysts may be the result of a congenital pilonidal dimple. Excessive sweating can also contribute to the cause of a pilonidal cyst.

The condition was widespread in the United States Army during World War II. More than eighty thousand soldiers having the condition required hospitalization.  It was termed “jeep seat or “Jeep riders’ disease”, because a large portion of people who were being hospitalized for it rode in jeeps, and prolonged rides in the bumpy vehicles were believed to have caused the condition due to irritation and pressure on the coccyx.

Risk Factors:
Certain factors can make you more susceptible to developing pilonidal cysts. These include:

*Obesity
*Inactive lifestyle
*Occupation or sports requiring prolonged sitting
*Excess body hair
*Stiff or coarse hair
*Poor hygiene
*Excess sweating

Complications:
If a chronically infected pilonidal cyst isn’t treated properly, there may be an increased risk of developing a type of skin cancer called squamous cell carcinoma.

Differential diagnosis
A pilonidal sinus can resemble a dermoid cyst, a kind of teratoma (germ cell tumor). In particular, a pilonidal cyst in the gluteal cleft can resemble a sacrococcygeal teratoma. Correct diagnosis is important because all teratomas require complete surgical excision, if possible without any spillage, and consultation with an oncologist.

Treatment :
Treatment may include antibiotic therapy, hot compresses and application of depilatory creams.

In more severe cases, the cyst may need to be lanced or surgically excised (along with pilonidal sinus tracts). Post-surgical wound packing may be necessary, and packing typically must be replaced twice daily for 4 to 8 weeks. In some cases, one year may be required for complete granulation to occur. Sometimes the cyst is resolved via surgical marsupialization.

Surgeons can also excise the sinus and repair with a reconstructive flap technique, which is done under general anesthetic. This approach is mainly used for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence.

Picture of Pilonidal cyst two days after surgery.

A novel and less destructive treatment is scraping the tract out and filling it with fibrin glue. This has the advantage of causing much less pain than traditional surgical treatments and allowing return to normal activities after 1–2 days in most cases.

Pilonidal cysts recur and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress.

Prevention:
To prevent future pilonidal sinus from developing:

*Clean the area daily with glycerin soap, which tends to be less irritating. Rinse the area thoroughly to remove any soapy residue. Washing briskly with a washcloth helps keep the area free of hair accumulation.

*Keep the area clean and dry. Powders may help, but avoid using oils or herbal remedies.
Avoid sitting for long periods of time.

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/Pilonidal_sinus
http://www.mayoclinic.com/health/pilonidal-cyst/DS00747
http://www.bbc.co.uk/health/physical_health/conditions/pilonidalsinus.shtml
http://www.childrenshospital.org/az/Site923/mainpageS923P0.html

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Categories
Ailmemts & Remedies

Hand, Foot and Mouth Disease

Alternative Name: Coxsackievirus infection

Definition:
Hand-foot-mouth disease is a relatively common infection viral infection that usually begins in the throat.

A similar infection is herpangina.

Many people panic when they’re told they have hand, foot and mouth disease. They think they’ve got the infection that affects cattle, sheep and pigs, but the animal infection is called foot-and-mouth disease and is completely unrelated.

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It is a mild, contagious viral infection common in young children. Characterized by sores in the mouth and a rash on the hands and feet, hand-foot-and-mouth disease is most commonly caused by a coxsackievirus.

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There’s no specific treatment for hand-foot-and-mouth disease. You can reduce your risk of infection from hand-foot-and-mouth disease by practicing good hygiene, such as washing your hands often and thoroughly

Symptoms:
Hand-foot-and-mouth disease may cause all of the following signs and symptoms or just some of them. They include:

*Feeling of being unwell (malaise)
*Painful, red, blister-like lesions on the tongue, gums and inside of the cheeks
*A red, nonitchy, possibly blistery rash on palms of the hands and soles of the feet, and sometimes the buttocks
*Irritability in infants and toddlers
*Fever
*Headache
*Loss of appetite
*Rash with very small blisters on hands, feet, and diaper area; may be tender or painful if pressed
*Sore throat
*Ulcers in the throat (including tonsils), mouth, and tongue

The usual period from initial infection to the onset of signs and symptoms (incubation period) is three to seven days. A fever is often the first sign of hand-foot-and-mouth disease, followed by a sore throat and sometimes a poor appetite and malaise. One or two days after the fever begins, painful sores may develop in the mouth or throat. A rash on the hands and feet and possibly on the buttocks can follow within one or two days.

Causes:
Hand-foot-and-mouth disease (HFMD) is most commonly caused by coxsackievirus A16, a member of the enterovirus family.

The disease is not spread from pets, but it can be spread by person to person. You may cacth it if you come into direct contact with nose and throat discharges, saliva, fluid from blisters, or the stools of an infected person. You are most contagious the first week you have the disease.

The time between infection and the development of symptoms is about 3 – 7 days.

Oral ingestion is the main source of coxsackievirus infection and hand-foot-and-mouth disease. The illness spreads by person-to-person contact with nose and throat discharges, saliva, fluid from blisters, or the stool of someone with the infection. The virus can also spread through a mist of fluid sprayed into the air when someone coughs or sneezes.

Hand-foot-and-mouth disease is most common in children in child care settings because of frequent diaper changes and potty training, and because little children often put their hands in their mouths.

Although your child is most contagious with hand-foot-and-mouth disease during the first week of the illness, the virus can remain in his or her body for weeks after the signs and symptoms are gone. That means your child still can infect others.

Some people, particularly adults, can pass the virus without showing any signs or symptoms of the disease.

Outbreaks of the disease are more common in summer and autumn in the United States and other temperate climates. In tropical climates, outbreaks occur year-round.

Risk Factors:
The most important risk factor is age. The infection occurs most often in children under age 10, but can be seen in adolescents and occasionally adults.

Children in child care centers are especially susceptible to outbreaks of hand-foot-and-mouth disease because the infection spreads by person-to-person contact, and young children are the most susceptible.

Children usually develop immunity to hand-foot-and-mouth disease as they get older by building antibodies after exposure to the virus that causes the disease. However, it’s possible for adolescents and adults to get the disease

Diagnosis:
A history of recent illness and a physical examination, demonstrating the characteristic vesicles on the hands and feet, are usually sufficient to diagnose the disease.

However the doctor will likely be able to distinguish hand-foot-and-mouth disease from other types of viral infections by evaluating:

*The age of the affected person
*The pattern of signs and symptoms
*The appearance of the rash or sores
*A throat swab or stool specimen may be taken and sent to the laboratory to determine which virus caused the illness.(this test may not always needed)

Treatment:
There is no specific treatment for the infection other than relief of symptoms.Most people need no specific medical treatment and are better within a week or so. Complications are rare, but occasionally it can lead to mild viral meningitis.

Treatment with antibiotics is not effective, and is not indicated. Over-the-counter medicines, such as Tylenol (acetaminophen) can be used to treat fever. Aspirin is no longer recommended for children under 16, because of a possible link with a serious problem called Reye’s syndrome.

Salt water mouth rinses (1/2 teaspoon of salt to 1 glass of warm water) may be soothing if the child is able to rinse without swallowing. Make sure your child gets plenty of fluids. Extra fluid is needed when a fever is present. The best fluids are cold milk products. Many children refuse juices and sodas because their acid content causes burning pain in the ulcers.

You can also try giving them soft cold foods such as yoghurt or ice cream, and plenty of cold drinks, to ease the discomfort of a soft mouth.

Children are sometimes excluded from nursery or school during the first few days of the illness in an attempt to prevent it spreading, but this can be difficult as the viruses that cause it are widespread in the community.

Prognosis: Generally, complete recovery occurs in 5 to 7 days.

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/handfootmouth.shtml
http://www.mayoclinic.com/health/hand-foot-and-mouth-disease/DS00599
http://healthtools.aarp.org/adamcontent/hand-foot-mouth-disease?CMP=KNC-360I-GOOGLE-HEA&HBX_PK=hand_foot_mouth_disease&utm_source=Google&utm_medium=cpc&utm_term=hand%2Bfoot%2Bmouth%2Bdisease&utm_campaign=G_Diseases%2Band%2BConditions&360cid=SI_148905163_5812331101_1

http://www.hpb.gov.sg/health_articles/hfmd/