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Heart Disease

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In today’s Western form of civilization, heart disease is extremely common. It is generally referred to as coronary heart disease. For a variety of reasons that seem more common in people living in advanced Western countries, the coronary arteries are very prone to gradual destruction. This is usually seen in a build-up in the vessel linings. Increasing amounts of material are laid down internally in the vessels. The vessels become narrower and narrower, and the amount of blood that can flow through them is correspondingly reduced.

This flow of blood becomes so poor in many people that the heart is quite incapable of carrying out its normal duties, and this is evident by the appearance of pain felt over the chest wall in front of the heart.

If sudden demands are made on the heart, such as when exercise is being performed, and the heart is forced to beat more rapidly to convey adequate amounts of oxygenated blood to the tissues, it is unable to do so. Increasingly severe pain is felt. This is the well-known discomfort of angina. This often forces the person to stop what they are doing, and take a rest. The heart action reduces until it can cope, and the pain then disappears as adequate oxygen again reaches the heart tissues, enabling the pain-producing carbon dioxide and metabolites to be carried away. Alternatively, the patient may take a tablet that has the effect of artificially enlarging the coronary blood vessels, so permitting a more rapid blood flow through the heart tissues. The net result is the same.

This is why it is common to see some older people (most often men) carrying a little pillbox around with them at all times. If they have to undertake activity they feel will produce anginal pains, they will slowly suck a tablet under the tongue. This usually contains glyceryl trinitrate. It is rapidly absorbed by the blood from the oral cavity and conveyed to the heart, where it rapidly acts on the vessels, allowing them to dilate, and so increase the blood circulation through the cardiac muscle.

How to Prevent Heart Disease

There are many general measures that the anginal patient can carry out, and which may effectively assist in keeping symptoms at a minimum level.

Avoiding the known precipitating factors will help immeasurably. The patient should make an effort to avoid undue exercise that is known to produce symptoms. Similarly, social and environmental predisposing factors must be avoided.

It is best to avoid circumstances where emotional crises and flaring tempers are involved, for this will only breed more and greater problems if allowed to persist.

It would be best if the patient could adopt a philosophical attitude to life in general, accept the position and make the most of the remaining years of life.

Meals of moderate size and easily digestible food, preferably low fat in content and free from fried foods, are best. If’ there is obvious overweight, sticking to a 4200 kJ (1000-calorie)-a-day diet for a while will help lower the weight and so diminish the risk factors.

Regular sleep often assists. Eight hours a night is preferable. Sometimes, with carp- onset of the symptoms, a period of bed rest may be advisable. Gearing life to meet one’s ability at coping is essential. The same applies to work, with due retard to the social and economic circumstances of the individual.

Alcohol drinking should be discontinued permanently. While alcohol will not aggravate the condition, reduction or cessation of alcoholic drinks is always an aid to one’s better health.

Electrocution

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Electrocution may present as a vital emergency, for as long as the victim is in contact with the electrical current, the heart is being damaged, and this may be irreversible. The main danger for first aiders is in disconnecting the power and making certain that they, too, are not electrocuted.

Burns are usually small, oval, sharply demarcated painless areas on the skin that take a long time to heal, and probably many weeks before the scab lifts off.

Make certain that electrical cords are kept in good repair. Money spent in having frayed ends to electrical gear repaired is not wasted. It may be lifesaving. Teach children from an early age the risks of tampering with electrical gadgets, connections and sockets, especially those placed near the floor. It’s now possible to place protective covers over these to avoid metal items being poked down the holes.

Electrocution Symptoms

  • The patient may be unconscious, and the heart and breathing may have ceased.
  • Evidence of continuing connection with the source may be apparent.
  • Patient may be paralyzed due to the current.
  • Unconsciousness and death.
  • Heart and respiratory failure may occur rapidly and be irreversible.

Electrocution Treatment

  1. Check for danger, and make patient safe. Call for immediate help.
  2. Disconnect the source of current, if this can be safely done. Avoid becoming involved with the current yourself, for this could be disastrous. (It has happened.) See precautions below.
  3. Check for the respiration and pulse of patient. Pulse is felt at the neck. If neither pulse nor respiration is present, embark immediately on resuscitation. This will involve external cardiac massage (to restart the heartbeat), and mouth-to-mouth resuscitation if breathing has stopped. It is an advantage to have a trained assistant.
  4. When vital signs are re-established, treat burns if necessary.

It is essential that great care be taken in cases where electrocution is suspected. If easily reached, switch off the current or, alternatively, pull the cord from the socket. Under no circumstances cut the cord, for this could electrocute you. If this is not possible, it is essential to remove the patient from the current. This is a dangerous procedure, and adequate insulation is vital. Thick rubber gloves, a heavy piece of clothing such as a coat, piece of dry wood or rolled-up newspaper may be used. Stand on a dry surface. It may be possible to kick the victim away from the current source.

Water is a ready conductor of electric currents, and it is vital to remember this. Wet floors could be dangerous. Never use water on an electrical fire until the power has been cut off; rather try to smother it. If high voltage is involved, keep clear until this has been disconnected by the authorities.

It may be necessary to treat electrical burns afterwards, but getting the patient free from the current and artificially resuscitating them is the first essential.

Liver Disease

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Some people turn yellow when their liver becomes infected. This is called jaundice, and it means that the liver cells have become infected and inflamed. A pigmented product called bilirubin that is produced in the liver and normally passed into the bowel for elimination is blocked as the inflamed cells and canals jam up.

More and more is channeled into the bloodstream, giving the skin and normally white parts of the body (such as the whites of the eyes) a yellowish tinge.

Liver Disease Causes

The most common type of liver disease is infectious hepatitis, or hepatitis A. It’s caused by a virus believed to be transmitted from infected fecal matter to food that subsequently finds its way into the system. Infectious particles of the hepatitis A virus are seen with the aid of an electron microscope. Symptoms can occur anywhere from 30 to 40 days after infection.

This is a similar kind, but it seems to act much more slowly, taking anywhere from 40 to 110 days (average 65 days) to produce symptoms. It is probably transmitted in a different way, and once it was believed to occur if infected needles or blood were used. Now researchers have found that the virus may be transmitted from person to person in a multitude of ways.

A product in the blood that pinpointed accurate diagnosis was first discovered in an Australian aboriginal, and for many years it was called Australian antigen. But now it is known as the hepatitis B (surface) antigen. When trying to confirm the diagnosis, doctors seek this particular element in the blood of the patient.

Liver Disease Symptoms

Often symptoms start abruptly, with fevers, headaches, aches and pains all over, loss of appetite and vomiting. After two to five days, a yellowing of the skin or eyes may occur, and this gives the signal that hepatitis may be present. However, this is not always so, and many cases occur in which there are only a few symptoms. Often the upper part of the abdomen is painful. This indicates the liver or spleen, two large organs tucked up under the ribs, are affected and swollen.

With symptoms of this kind, a wise parent will call the doctor. Diagnosis is often difficult, although if there is a local epidemic, it is much easier to predict. The doctor will most probably order special tests to confirm the diagnosis.

Liver Disease Treatment

There is no specific drug in use, but the doctor will give advice on the best routine to follow. Also, the doctor’s supervision is advisable, for serious complications may take place in which hospital care may become necessary. Fortunately the majority of cases does well with simple measures, and get well before long.

Reducing physical activity with a few days in bed gives the body’s recuperative powers the best chance to work at maximum capacity. Plenty of fluids, especially fruit juices with added powdered glucose D provide food in an easy digestible form and help allay nausea. Fluids help rid toxins and dead germs from the system. They also help reduce fevers. There are no strict food restrictions, but high-fat-content meals are usually unpalatable.

Most cases do well, especially those in whom the infection has been mild – this is so in most instances. However, hospital care is sometimes necessary, especially if symptoms are severe, and the youthful patient is not able to take normal food by mouth.

Hepatitis B is a far more severe and dangerous disorder, and the outlook is often much poorer.

A vaccine offering protection against hepatitis B is now available, and is given to persons at risk. The main risk is in mothers infecting their babies during pregnancy.

There is no vaccine for hepatitis A, but those coming into contact with the disease may gain protection by an injection of special serum containing the protective elements called gamma globulin. The doctor arranges this for you.

Colds

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Colds (upper-respiratory infection or URI) are the most common acute illness in children, especially among infants and toddlers. Most are caused by one of a large assortment of viruses. (There are, for example, more than 100 types of the rhinovirus, which is but one of the viruses that can cause a cold.) Some URIs are caused by bacteria, but more often these organisms are invaders that infect specific locations, such as the ear sinuses, during or shortly after a cold caused by a virus.

Colds tend to be relatively uncommon during the first several weeks of a baby’s life because an infant derives some protection against many viruses from antibodies transferred from the mother prior to birth. Breast-fed babies also receive protection from antibodies in mother’s milk. Eventually infants must begin developing their own immunity through exposure to the numerous viruses (and occasional bacteria) that cause colds.

The frequency of colds is directly influenced by exposure to other children (and adults) who are spreading the viruses. Children in day care who are members of large families tend to have more frequent URIs. Colds can occur year-round, although they are more common during winter months – more specifically as a result of frigid weather but as an indirect result of people gathering indoors during those months.

Cold Symptoms

The familiar discomforts of a runny nose, sneezing, a dry (king cough, and a low-grade fever) are the most common symptoms in children adults. Mild irritation of the conjunctiva – the membrane that covers the surface of the eyeball and the eyelids – and increased tearing may also be present. Infants may, in addition, show signs of irritability.

The nasal drainage typically is clear and watery at first and then may become thicker and discolored (yellowish or green). Usually it returns to a clear, thin consists as the cold resolves. In an infant, mucus blocking nasal passages could cause difficulty with nursing. Persistent discolored drainage may be a warning that a bacterial infection is present.

If present, fever tends to occur early in the illness and would lasts for a few hours or up to three days. A fever that recurs after being gone for more than 24 hours may irate that a secondary infection has developed. Infants younger than three months may have no fever at this age-group; a rectal temperature higher than 100.4 degree Fahrenheit is significant and you should prompt a call to your physician.

Additional cold symptoms may include a dry throat, headache, tiredness, and/or loss of apts. When the throat is sore, lymph nodes in the neck enlarge and become tender. An infection of the NW with group A beta-hemolytic streptococcus – most commonly known as strep throat – is a specific bacterial illness that should be treated with appropriate antibiotics.

Cold Treatment

Since most colds are caused by viruses, they are usually self-limited, that is, they go away by themselves within two to seven days, although some symptoms may last as long as two weeks. Unless there is specific evidence that bacteria are involved, antibiotics will not help a cold resolve more quickly. The best approach is to provide supportive care and observe your child for any complications. Adequate or increased fluid intake (water or juice) might help keep drainage from becoming thick and difficult to clear. Breast or formula feedings can be maintained or even increased in frequency. Solids may be continued if your child is interested in them, but don’t force the issue. Appetite sometimes decreases during a cold (especially when the body’s temperature is elevated), and it is not uncommon for an infant or child to lose a little weight during a cold.

Acetaminophen (Tylenol and other brands) can be given as often as every four hours to reduce fever if your child appears uncomfortable. As an alternative, ibuprofen (Children’s Motrin, Children’s Advil, and other brands) can be given every six to eight hours to reduce fever and in some children appears to be more effective. (Aspirin should not be used during an acute illness because of its reported link with a rare but serious disorder of the liver and brain called Reye’s syndrome.) Irritability will typically improve and activity will increase as the fever resolves.

Decongestants such as pseudoephedrine (Sudafed and several other formulations) may – or may not – reduce nasal congestion and help your child feel more comfortable. Their effectiveness varies widely with the particular child and illness. Similarly, antihistamines such as diphenhydrarnine (Benadryl and other brands) or chlorpheniramine (Chlor-Trimeton and many other formulations) may also be useful in keeping the nose dry, especially when allergies are involved. These and other antihistamines often cause sleepiness. In babies and children younger than two years of age, side effects can be more unpredictable, so it is wise to contact your child’s doctor before using these medications. In very young infants, the use of saline nose drops and suctioning the nose with a bulb syringe is recommended to allow easier breathing. Some recent research has suggested that decongestants and antihistamines are unlikely to relieve cold symptoms in infants and young children. Decongestant nose drops, which directly shrink the lining of the nose, are sometimes helpful in older children who are very congested, especially when it interferes with sleep. These drops should be used only for short periods of time. If used regularly for more than two or three consecutive days, the drops may not only lose their effectiveness but may create a rebound effect, in which the nose becomes even more congested when the last dose wears off.

If coughing is disruptive, especially at night, a cough syrup containing guaifenesin (an expectorant that tends to loosen secretions) and/or dextromethorphan (a cough suppressant) may provide a few hours of relief. If a nonprescription preparation is not effective, your child’s doctor may prescribe a stronger formulation after seeing your child.

Potential Complications with Colds

While most colds resolve without any great difficulty within seven to ten days, in some instances bacteria infect certain areas of the body during a cold, resulting in more serious or prolonged illness. Potential secondary bacterial infections (sometimes called super infections because they are superimposed on the viral infection) can include:

  • Otitis media – infection of the middle ear (the space behind the eardrum), usually manifested as pain and/or fever (see ear infections).
  • Sinusitis – infection of one or more of the air-filled cavities within the head usually manifested as localized headache and/or persistent discolored (yellow or green) drainage from the nose (see sinusitis).
  • Conjunctivitis – infection of the linings of one or both eyes (known as the conjunctivae), causing irritation, redness, crusting, and discolored drainage (see conjunctivitis).
  • Bronchitis – infection of the upper airway producing an ongoing cough, often accompanied by thick, discolored phlegm.
  • Pneumonia – infection of a localized or widespread area in one or both lungs, manifested as fever, fatigue, coughing (mild or frequent and intense), and in severe cases rapid or labored breathing. (Note: pneumonia only rarely arises in connection with a cold. Most pneumonia develops suddenly and spontaneously, without prior symptoms.)

Cold Prevention

No available vaccine will prevent infants and children from developing colds, so the most effective preventive measures are those that separate the child from viruses. To limit exposure of viruses, infants should spend little, if any time, in day-care settings, nurseries, and crowded public places when they have a cold. Hand washing is perhaps the best way to ream the risk of passing the infection to others, since viruses are often spread by direct touch. Infected droplets from the nose or chest may be present on a child’s skin (especially if hands have contacted nose or mouth), or droplets may become airborne during sneezing axe coughing, eventually landing on clothes, toys, or other objects. When another child or adult touches any of these items (or the infected child himself), the viruses can be picked up on the fingers and unwittingly into the uninfected person’s mouth or nose, if their hands have not been washed.

Over the years there has been considerable discussion about the role of vitamin C (ascorbic acid) in colic prevention and treatment. While medical evidence suggests that vitamin C will prevent a cold, it may increase the intensity or duration of symptoms. Using vitamins for this purpose in children is not a suggested practice. Doses in great excess of the recommend daily allowance (RDA) are not advisable. Check dosage outlines with your child’s physician before using supplies of vitamin C.

When to Call the Doctor

Most colds can be managed at home without any input from or examination by your child’s physician. However, there are a few exceptions to this general rum. Call your child’s doctor, regardless of the hour, if :

  • a baby younger than three months of age has a fever of 100.4°F or higher (taken rectally).
  • your infant or child appears unusually restless, unresponsive, or is extremely irritable and won’t stop crying despite your efforts to comfort her.
  • your infant or child appears to have difficulty breathing. This would be manifested by noisy, labored breaths and in some cases by visible inward movement of the spaces between the ribs.

You should call your child’s doctor during office hours if:

  • a cold lasts more than 7 to 10 days.
  • nasal drainage is persistently thick.
  • your older child complains of significant ear or throat pain.

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