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Bronchiolitis

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What is Bronchiolitis?

Bronchiolitis is an acute viral respiratory condition that affects mostly children between 6 months to 2 years of age. The virus causing the illness often triggers common cold symptoms like irritation of the upper airway and the nose. Narrowing of bronchioles (or tiny airways) and inflammation can also occur. Bronchiolitis is a seasonal illness which presents itself mainly between the period of November and April and differs from Bronchitis in that the latter often influences larger airways.

The condition can be triggered by numerous viruses however, the RSV or Respiratory Syncytial Virus is usually responsible. The virus is extremely contagious with almost all children being infected by it at some point. While some develop lower airway conditions like pneumonia or bronchiolitis, while most will only be affected by common colds.

Bronchiolitis Symptoms

At the onset of bronchiolitis, children will experience slight coughs, runny nose and low fevers over a period of one to three days. After this period, coughing becomes deeper and raspier, breathing becomes shallow, noisy and rapid and wheezing can occur. Symptoms will depend on the severity or extent of the infection. During infancy bronchiolitis can disrupt feeding because infants tend to be agitated and restless. The loss of appetite should improve as the condition clears. Most times there is no need for hospitalization or special medication. Hospitalization is needed in cases where infants experience severe symptoms.

Monitor children’s breathing, feeding habits and other activities, make note of changes that could indicate this or any condition. Breathing can be aggravated by constant crying and fussiness so it is important to keep infected children as calm as possible. Increased liquid intake is recommended to prevent dehydration; pairing liquids with a humidifier will also help with eliminating secretions.

Bronchiolitis Treatment

Some decongestants or cough syrup/medications that can be bought over the counter (OTCs) are sufficient. Antibiotics will not change the course of the illness nor will it lessen the time but they can be prescribed if the condition is accompanied by another infection. An oral bronchodilator can be used as well. Bronchodilators work by dilating the bronchioles and bronchi, this decreases airway restriction to facilitate air flow.

Children with RSV can spread the virus extensively through secretions. The virus can easily be passed on from humans as well as inanimate objects. Wash hands regularly, both before and after handling baby and sanitize areas that come in contact with mucous or secretions to control transmission.

Bronchiolitis is seldom a permanent condition when contracted by infants and children although some 30 percent (or more) will develop asthma or asthma related difficulties at a later stage in life. It is possible that the airway damages caused by RSV increases the risk of developing wheezing or asthma but RSV’s real contribution to this is unknown.

Bear in mind that although most cases can be treated at home, due to the victim’s age it is best to consult a doctor immediately if any of the symptoms occur or if mild symptoms being to worsen. Gain approval before administering any medication (including OTC) to avoid complicating the issue.

Animal Bites

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If your child has been bitten by any animal, wild or domestic, do the following:

  • Clean the wound at once with water and mild soap.
  • If the wound is severe – with large tears or perforations, handle it as you would any large wound.
  • Contact your child’s doctor as soon as possible.

Concerns About Rabies

The major concern after the bite wound is treated is whether or not the child will need specific treatment to prevent rabies (a viral infection that is nearly always fatal). If the wild animal has been caught, it will be killed and its brain examined microscopically for evidence of this disease. While awaiting the results of this examination – or more commonly, if the animal is not captured and its brain cannot be evaluated – a decision must be made whether or not to begin a rabies vaccination series. This will depend to a large degree on the type of animal involved and the circumstances of the bite.

In most parts of the United States, bites from wild rodents such as squirrels, rats, chipmunks, mice, and rabbits usually will not be treated with rabies vaccination. However, your child’s doc-tor may consult the local public-health authority for specific advice. On the other hand, skunks, raccoons, opossums, bats, and all wild carnivores should always be considered potentially rabid (rabies carrying) and should never be touched, even in a park or other setting where they are accustomed to receiving food from human hands. A bite from one of these animals – especially if the animal was not provoked or defending itself – is more likely to rinse concerns about rabies.

Bites from domestic animals (dogs, cats, etc.) are more common but rarely cause rabies. If someone is bitten by a domestic animal, treat the wound as described above. The animal will usually be available for observation, and public-health officials may quarantine it for ten to fourteen days. If the animal appears normal at the end of the quarantine, no rabies vaccination is required. But if the animal becomes ill, it will be promptly sacrificed and its brain examined microscopically for rabies. Rabies treatment and vaccination should be started as soon as a quarantined animal is found to be ill, and not delayed while awaiting results of the brain examination.

When purchased from pet stores, mice, rats, gerbils, and hamsters are not known to transmit rabies.

Wild animals that have been raised as pets – such as raccoons, skunks, foxes, wolves, ferrets, and small wildcats can carry rabies even if they have appeared healthy in captivity for long periods. This is particularly true of skunks, which have had rabies virus isolated from their saliva even when born in captivity.

Preventing Dog Bites

  • Before you get a dog, consider the breed and gender. Female dogs and neutered males are less likely to bite than non-neutered males. Some breeds of dogs are more aggressive than others.
  • Teach children how to treat a dog properly. Prodding, poking, and tail pulling may provoke a bite even from the most mild-mannered canine. This also can occur if a sleeping dog is jolted awake by a child or if a child tries to play with a dog that is eating. If you have one or more active toddlers who might not understand these ground rules, you might consider waiting until they are more mature before getting a dog.

Human Bites

These bites commonly become infected because they are likely to be heavily contaminated by bacteria, which are abundant in saliva. In addition, the victim may be reluctant to seek medical help because of legal concerns or embarrassment.

Treatment for a human bite is the same as that outlined for animal bites. Human bite wounds are rarely sutured because of the contamination risk noted above. These wounds should be vigorously irrigated and then left open. Antibiotics are usually required for all but the most minor wounds.

Tick Bites

While tick bites are generally insignificant in and of themselves, some ticks transmit infections that can be serious, including Lyme disease and Rocky Mountain spotted fever. Generally, most tick-borne diseases are transmitted only after the tick has remained attached to the skin for many hours. For example, transmission of Lyme disease is unusual if the tick re-mains attached less than 24 to 48 hours.

Another, less common tick-borne illness is tick paralysis, which usually afflicts children. Weakness and paralysis begin in the legs and progress upward with increasing severity as long as the tick is attached. Eventually difficulty with speech and swallowing and respiratory problems occur; rarely, death may result. Tick removal reverses this disorder.

Marine Animals

Stingray Stings

A jagged wound that is immediately and intensely painful; the worst pain occurs after about an hour and then gradually subsides over a period of up to two days.

Treatment Stingray venom breaks down when warm but is stable and persistent when cool. First aid consists of applying hot water from the faucet – as hot as one can tolerate without causing a burn – to the affected area. This will promptly decrease the pain, but discomfort will recur as soon as the area (generally the leg or foot) is allowed to cool. Frequent heat application is necessary for a day or two to control the pain.

Infection may occur if the venom and barb fragments (or the entire spine) remain in the wound. Usually these are removed by irrigating with hot water, and most wounds do not become infected. A tetanus booster is recommended if none has been given during the previous five years.

Prevention

Stingrays partially submerge themselves in sandy shallow water in sheltered bays, lagoons, and river mouths. The animal’s whip like tail has several (one to four) barbs (spines) that are covered with mucous venom. The tail reflexively whips upward when the ray is touched.

To prevent being stung, bathers should shuffle (not step) when walking in shallow water. This disturbs the stingray, and it will flee before one has a chance to step on it.

Jellyfish and Fire Coral

These two marine animals have a tiny venom-containing capsule (nematocyst) on the outer surface of their tentacles or near the mouth. Contact with a swimmer causes the capsule to penetrate the skin and diffuse venom into it. The attached capsule can discharge repeatedly when it’s exposed to water.

The nematocyst sting is generally quite painful but rarely causes serious medical problems. However, a person who is stung multiple times may develop symptoms such as vomiting, extreme weakness, bloody urine, or fainting.

For treatment of a severe reaction resulting from multiple stings, go to an emergency facility for prompt medical attention.

Less severe stings can be managed at home. The best way to neutralize the nematocysts is to apply liberal amounts of vinegar for 30 minutes. Large tentacles should be removed using gloves. Remaining nematocyst scan be removed by applying shaving foam and gently shaving the area.

Starfish

Starfish have thorny spines that are coated with slimy venom. When the spines penetrate a victim’s skin, the venom seeps into the wound.

Immediate, intense burning pain at the wound site; the venom rarely causes a more serious reaction.

As with stingray venom, heat will hasten pain resolution.

Sea Urchins

These creatures have venom-bearing spines that are long, sharp, and brittle and can break off in the skin. Purple pigment from the spine can leach into skin and appear to be a retained spine fragment.

There is intense burning pain where the skin has been penetrated.

If a spine fragment remains in the skin, it should be removed by a physician, because unnecessary pain and further tissue damage can result from attempts to take it out without adequate local anesthetic.

Immersion in hot water will decrease pain, as previously described for stingrays and starfish. X-rays may be needed to determine whether any spine fragments remain in the skin. Antibiotics and a tetanus booster will be given if necessary.

Measles

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What are Measles?

Measles, referred to by the up-tempo medics as rubeola, is caused by a virus. In this disorder, infection commonly comes from another person, either by way of throat or nasal discharges that could have contaminated toys or other items. Probably most cases are due to the inhalation of microscopic moisture particles, to which cling millions of measles terms.

It takes anywhere from eight to fourteen days for symptoms to develop. Measles is highly contagious, and the most common age affected is the two to fourteen year old group. Unless immunized, nearly every child contracts measles by age ten.

Measles Symptoms

An early indication of measles is usually symptoms similar to those of a common cold. A fever is the usual start. This may be fairly high, ranging from 38.3 to 40.0°C (101 to 104°F.) It’s generally higher just before the skin rash appears, when it may subside. Often there is a sore throat and a discharge from the nose, much like a cold. Frequently the patient has a barking cough. Often the measles become sore, and they may discharge pus in the corners. A headache is mother possible accompanying symptom. Light may be painful. Often the lymph glands in the neck swell and are sore.

Koplik’s spots are whitish spots on a reddish background, located on the pink membrane lining the mouth and cheeks. They start toward the back opposite the molars, and may spread to cover the gums and large areas of the mouth. They are diagnostic of measles, appearing on about the third or fourth day, but generally subside as the skin rash appears.

About the fifth day of the disease, a pink, blotchy, irregular rash appears. This quickly darkens to fiery red and adjoining parts join up, often to produce a widespread redness. It starts behind the ears and face, quickly spreads to the chest and abdominal region, and finally extends to the limbs.

It usually lasts about seven days, and may be itchy. Finally, the skin comes adrift in a fine powdery form over the next two to three days, and a light brown-colored pigmentation may remain.

The germ may travel to various parts of the body and produce complications. Infected ears may occur early, and cause considerable pain. The throat and lungs may be infected, not only with the measles virus, but others are often superimposed.

The most serious is an infection of the brain called encephalitis. This may follow Vaccination against the measles virus is a vital routine for all youngsters.

Fatigue, increasing lethargy and convulsions may be the first sign. This happens to about one child in 3,000 cases. Its severity and mortality rate alone make immunization against measles highly worthwhile. It may cause serious brain damage later on.

In recent years more interest has focused on the long-term risks of measles. It’s possible for the virus to lie dormant in the brain for many years, and anywhere from one to twelve years later for its terrible effects to suddenly emerge. Within a day or two it may convert a seemingly normal child into a permanent mentally defective youngster, unable to care for himself, probably partially paralyzed and a major medical problem for the rest of time.

One has only to witness such a case to realize the value of childhood immunization. As I have seen such patients, I’m personally convinced of the absolute value of immunization during infancy.

Measles Treatment

Most cases respond well to simple home remedies. Ideally, the patient should be put to bed while the temperature and rash last. Also, isolate the patient to limit the spread of the disease. Simple sponging with cool water and drinking plenty of fluids will bring down elevated temperatures and help whisk away dead germs from the system. Chilled water, cold fruit juices, lemonade, broth are all suitable.

Soft, easily digestible food is best, but there are no restrictions. If the eyes are involved, cleansing them with saline sponges (or bits of cottonwood) will help. Protection from direct sunlight is also advisable, but darkness is not necessary.

Give TV the go-by for a few days. Warm, moist air in the room (e.g. a toiling kettle), and a simple cough linctus helps if there is a cough or stuffed-up nose and chest. Any secretions from the nose or throat are best cleansed with paper tissues that should be carefully wrapped and burnt or destroyed, since discharges are highly infectious. Care with hand washing is a good idea to avoid contamination of toys and persons.

Paracetamol elixir (consult label for dosage) will help reduce elevated temperatures, but do not overdose.

What about the outcome? Uncomplicated cases invariably do well. But if symptoms persist, or if any of the complications mentioned do occur (especially encephalitis), medical attention from the doctor is essential, and the outcome will depend on how the patient responds to treatment.

Spastics

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A fairly common condition has the general umbrella name of cerebral palsy, and spasticity is one of these. It is an after- effect from damage to the brain that may have occurred after conception, in the antenatal days, just before or during labour, or afterward. There are many causes, frequently overlooked at the time, and most likely never to be discovered.

Spastics Symptoms

There may be only a few, or conversely there may be many and marked ones. These may range from paralysis of various muscle groups or entire sections of the body, weakness, lack of coordination, plus strange, jerky movements. Mental retardation is a common accompaniment, and there are often defects of the patient’s ability to see, talk, or hear. There may be various emotional disturbances and strange, convulsive movements of body, limbs and head.

It is fairly common, and this is why you are perpetually hearing about it in the various media. Some are severely affected, while others are only mildly afflicted. It is said in broad terms that about one third make fairly good improvement with suitable therapy. Another third are mentally retarded and there is little future for them. About 16 per cent are very severely involved and may be bedridden more or less permanently.

Spastics Causes

These are legion. They range from various viral or bacterial infections antenatally or postnatally; X-rays during pregnancy have been incriminated, and loss of blood before labour. Afterward the infant may have suffered from a brain infection, such as meningitis, encephalitis or some other infection with the myriad viruses that afflict children.

Spastics Treatment

This can often be terribly difficult and frustrating for the family. The child may be kept at home, probably bedridden, and the parents make it their lifework caring for the patient. Some become associated with special care centres that look after them. Others attend special day schools geared to care for and educate them. Physical therapy, speech training, psychological care, all play a part, and each can give some assistance in what is usually a very difficult and harrowing disability to manage.


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