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Pneumothorax

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What is Pneumothorax?

This means that air has managed to seep into the pleural space, and as a result the lung is not expanding normally with breathing. It is not common with children, although it sometimes occurs with newborn babies. In this case it is a surgical emergency usually dealt with on the spot by doctors as breathing difficulty and blueness can be present.

Sometimes it occurs in older children from a variety of causes, maybe as a complication of some other lung disease, or even a foreign object in the lung that works its way to the lung surface, allowing air to escape. Most cases are mild as the air is reabsorbed and the child recovers, but, as we have said before, in any situation where there is any breathing difficulty, prompt medical care is essential.

Turner’s Syndrome

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This is a genetic abnormality in which the girl lacks a sex chromosome. It is a rare condition, and amenorrhoea and lack of normal development of the secondary sex characteristics are the typical features. Examination of the pelvis by Iaparoscopy may show the ovaries to be represented by white fibrous streaks. The organs are virtually missing. There may be evidence of other genetic and congenital abnormalities.

Turner’s Syndrome Symptoms

Often the patient’s condition is not recognised until the age of puberty, when she fails to mature sexually. Sometimes there is webbing of the neck, and dwarfism may be in evidence. After the age when sexual maturity would have been expected, the patient is seen as a short person, seldom growing to more than 150 cm, but often less. The breasts are totally undeveloped. The genitals show poor development; pubic and underarm hair is sparse. Webbing of the neck is usually marked. Mental capacity may be poor.

Turner’s Syndrome Treatment

Any developmental abnormality that can be corrected should be attended to. The neck webbing may be corrected by reconstructive surgery in some. Adequate secondary sexual characteristics may be encouraged by the use of female hormones. Unfortunately, quite a few develop facial hairs in time. Lack of height is a major embarrassment to these girls, for they seldom reach a height of more than 140-145 cm.
With modern technology, growth hormone produced artificially by recombinant DNA technology, and injected regularly, may produce dramatic improvements in height. Some girls with this syndrome have recorded growth rates of between three and seven centimetres a year. This is given to undersized girls when the so-called “growth spurt” would be expected, usually before the age of 16 years.

Sprue

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This is an intestinal mal absorption syndrome affecting some people who live or who have lived in tropical areas. India, Pakistan, Burma, Sri Lanka, China, Indonesia and Puerto Rico are the most commonly affected countries. Some cases have been reported in North America, the West Indies, Southern Europe and the Middle East.

It commonly occurs in middle life, the sexes being equally affected. Nearly all have a history of tropical living for a period, although the attack may come on years later. The bowel fails to absorb fats and certain starches.

The main symptom is diarrhoea, with pale, frothy, foul-smelling and greasy bowel actions. A high-fat diet aggravates, as does stress. Indigestion, flatulence, abdominal cramps, weight loss (often marked), pallor and wasting take place. There is often irritability, abnormal sensations in the skin (paraesthesia) and muscle cramps. Vitamin deficiencies, abdominal distension and mild oedema (swelling of the extremities) may occur. As fat absorption is impaired, often the correct absorption of vitamins and other nutritional essentials starts to become impaired also.

Sprue Treatment

Proper medical supervision is essential, both to form a diagnosis, and then to supervise the correct therapy. Control of the diarrhoea and replacement of vitamins and minerals and controlling complications such as dehydration are necessary.

Antibiotics (the tetracyclines) and the insoluble sulfonamides usually control the diarrhoea, but may have to be given for many months.

Folic acid often gives remarkably effective benefits for the intercurrent anaemia. Diet is also important.

First Aid Eye

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In general, any direct injury to the eye – cut or puncture, blow with a ball or fist, or debris in the eye – should have immediate medical attention if there is significant pain, and/or loss of vision. If pain is minor and no serious injury is obvious, contact the doctor to determine whether your child should be seen in an emergency facility or the doctor’s office.

Eye Treatment

  • Until it is seen by a doctor, keep the eye closed. This is a natural response to eye injury and helps reduce discomfort.
  • If the eye has been penetrated or cut open, take the child directly to the emergency room. If there is fluid oozing from the eye, transfer the child lying flat on his back so additional fluid will not escape.
  • Hold a simple shield, such as a paper cup, over the eye to protect it but don’t exert any pressure on the eye.

Chemicals in the Eye

Take prompt action whenever any chemical has splashed into the eye.

Although many materials will cause only minor irritation, some can result in serious injury or blindness if not attended to immediately. Start immediate and continued flushing with lukewarm water. A gentle flow of water should run into the affected eye(s). Hold the child under a tap or hose or carefully pour water from a glass or pitcher into the eye(s) with the child lying down. If only one eye is involved, hold the child on her side with the affected eye down so none of the chemical can accidentally flow into the other eye. You will probably need to have another adult hold the eye open while you pour the water. Use the following formula guidelines to determine how long to irrigate the eye:

  • alkaline materials: 20 minutes
  • acids: 10 minutes
  • less reactive chemicals: 5 minutes

After the eye(s) has been irrigated, seek medical attention as soon as possible.

Alkaline materials can penetrate deeply and cause serious damage. Examples of alkaline materials are drain cleaners, oven cleaners, and bleach. Look for these words on product labels:

  • lye
  • sodium hydroxide
  • potassium hydroxide
  • ammonia
  • calcium oxide
  • trisodium phosphate
  • wood ash

Acids tend to cause more localized tissue damage but can still cause significant injury. Examples of acids are automobile battery fluid, toilet bowl cleaners, and swimming pool acid. Look for these words on product labels:

  • sulfuric acid
  • hydrochloric acid
  • phosphoric acid
  • hydrofluoric acid
  • oxalic acid

Less dangerous chemicals should be washed out of the eye also. Most of these materials will cause only mild redness, stinging, and temporary swelling involving the conjunctiva (the thin, clear tissue lining the white surface of the eyeball and inner surfaces of the eyelid). Irrigation will lessen the irritation and probably prevent the child from rubbing the eye and aggravating the soreness. Examples of less dangerous chemicals include food, alcohol, and household soaps.


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