Author Archives: Paula.KGS

Syringomyelia

This is an uncommon disease of the nervous system occurring in either sex, with symptoms manifesting themselves during the period of most rapid growth. It is rare after the age of thirty. Cavities occur in the spinal cord and produce symptoms. It is believed to be due to an inherited defect in brain development.

Syringomyelia Symptoms

The most common and typical features are a loss of some sensations. This is generally the appreciation of heat and pain, most frequently in the upper limbs. It begins insidiously and without any obvious warning. The patient may discover burns on the fingers from a lighted match without noticing it. As the condition deteriorates, the area covered by this sensory loss gradually increases, until it may equal the area covered by the sleeve of a coat. Generally, the patient is aware of subjective sensations. Dull pains may sometimes occur.

About half of the cases also show wasting of the muscles. This usually affects the muscles of the hands and the inner side of the forearms, and generally takes place on both sides concurrently. It may become very noticeable. Resulting from the muscle wasting, contractures may develop and a claw hand deformity occurs. The legs are usually not affected to such an extent, but a slight stiffness or spasticity might occur. Some might show spinal curvature from effects on the thoracic muscles. The bones may become brittle as the calcium tends to be withdrawn from them.

Provided the condition is diagnosed early, the patient may undergo Gardner’s operation, in which the spinal cord is plugged. Good results are reported when this operation is carried out successfully. Unless this is done, the disease progresses slowly. Life is not shortened, but a considerable degree of disability may take place, and may make the life of the patient difficult.

Smear Test

Undergoing a smear test is very simple from the patient’s point of view. In fact, it is often carried out in conjunction with a routine pelvic examination, which commonly occurs during an antenatal visit, or a check when a repeat prescription of the pill is being requested, or for any other reason.

It is perfectly painless, and adds only a couple of minutes to the routine pelvic check. Most doctors carry out a breast examination at the same time, as it is convenient to combine the two.

A speculum is inserted into the vaginal canal. This instrument allows a clear view of the cervix, located at the far end of the vaginal canal. A good light is necessary. The doctor then inserts a wooden or plastic device called a spatula. By making a rotational movement of the spatula against the cervix through 360 degrees, a thin smear of superficial cells is secured.

These are then transferred to a glass slide, sprayed with a fixing aerosol or placed in a special solution, then packaged ready for dispatch to the pathology laboratory. Here experts will promptly examine the slide, after it has been stained. under the microscope.

The entire exercise takes a very short time as far as the patient is concerned, although the follow-on work is far more time-consuming. Usually the doctor checks a variety of details from the patient, for this assists the pathologists in making their decisions, and alerts them to possible hazards.

Shortly after, the report from the pathologist will be sent to the doctor. Of course, the majority will be perfectly normal. Sometimes other pathology is discovered, quite apart from any suggestion of cancer. General inflammatory changes in the vagina and cervix may he picked up. Infections due to monilia or trichomonas are also commonly found.

This is a bonus extra, and the doctor can recommend treatment for these if they were not previously known.

Sometimes the smear is unsatisfactory for various technical reasons. and a repeat may be recommended.

But the chief result that spells concern is a “positive smear.” This means the pathologist has discovered cells that are either suspicious of cancer (called “dysplasia”), or are downright positive.

If there is any doubt, a repeat should be carried out soon after, either to confirm or deny the possibility.

But if the result is a definite positive, then immediate action is essential. The patient is alerted, and a cone biopsy is recommended.

This means hospital for a short time. In some centers this is preceded by a colposcopic examination. The doctor examines the cervix under the direct vision of a colonoscope, an instrument that gives a greatly magnified on-site enlargement of the cervix.

By this means, it is often possible to actually delineate the abnormal areas. Some doctors paint a special fluid onto the cervix, and note if there is a color change. Today, the “wart virus” (short for papilloma virus) is believed to be the cause of many (probably most) cases of cervical cancer. Entering the superficial cells, it alters the nucleus, turning the entire cells (and subsequent ones) into cancerous ones. This can quickly spread. The presence of wart virus will often increase the chance of the diagnosis of cancer being made because of the relationship between the two.

By the use of a device called the “cerviscope,” a color photograph is made of the cervix. This is kept for later referral, and rechecking at a later date to compare “then” with “now.” In medicine, this is often vital.

This is followed by a cone biopsy. A cone of tissue is removed surgically. In recent times, the laser scalpel is often used. This is claimed to give a cleaner, more precise incision. and greatly reduce bleeding. The biopsy will include the affected part of the cervix. This tissue is then completely examined by the pathologist to ascertain the extent of the possible early cancer. It also indicates if it has been totally removed.

Although smear tests are most commonly carried out by family doctors and general practitioners, further investigations, biopsies and so on are done by gynecologists.

Snoring

A harsh noise produced by vibration of the soft palate and uvula of a sleeping child who is breathing pre-dominantly through the mouth. Not all noisy breathing is snoring. Nasal congestion and wheezing, for example, also generate sounds during sleep, but these are often heard during waking hours as well.

Snoring occurs for a number of reasons, most of which are not causes for concern. One of the most common causes is relaxation of the muscles and tissues in the back of the mouth, which allows them to vibrate while the child is inhaling or exhaling. Since the position of the head affects the vibration of these structures, simply moving the child can reduce or eliminate the snoring. This type of snoring can occur whether a child is breathing through the mouth or the nose.

Children with nasal congestion, whether caused by upper-respiratory infection or allergy, will breathe through the mouth at night and thus be more likely snore. Over-the-counter decongestants and antihistamines are often not effective in children, but if one an these preparations helps a child breathe more easily through the nose, a bedtime dose could help alleviate the snoring. Unfortunately, decongestants (such as phenylerine or pseudoephedrine) sometimes have a stimuli effect and actually interfere with sleep. While antihistamines (such as diphenhydramine or chlorphern-ramine) usually make children drowsy, occasionally these drugs cause an increase in activity. You may wants give a test dose during the day to see how your child responds.

If a child’s tonsils are unusually large, they may actually touch each other in the back of the mouth. This can cause not only loud snoring during sleep but also short periods of apnea, or cessation of breathing, lasting for several seconds. If the child has a pattern of continuous loud snoring and episodes of apnea, have him checked by your primary, care physician or an ENT (ear, nose, and throat) specialist. Tonsils and/or adenoids large enough to cause snoring and obstruct breathing at night can lead to serious problems involving the heart and lungs. Tonsillectomy and/or adenoidectomy may be necessary to correct this condition,

Insect Bites

Insect bites (and stings) are very common occurrences. Swelling and redness around the site of the bite (or sting) are the most common symptoms. Depending on the person or insect, other symptoms like itching, stinging or pain may occur as well. Some persons may be allergic to the sting or bite of an insect which can result in mild to life-threatening reactions.

Bites and stings contain proteins along with other substances which the body may identify as harmful; this is the reason for allergic reactions. Fire ants, hornets, wasps, yellow jackets, ticks and bees are some of the most common insects that can cause severe allergic reactions. In fact, deaths occurring from bee stings are 3 to 4 times higher than fatalities from snake bites.

Many insect bites can cause diseases. It is important to note that most bites are harmless hence diseases caused by insect bites do not result from the actual bites but from other organisms transferred when bitten. Micro-organisms like protozoans, bacteria and viruses (referred to as pathogen) are spread by insects (referred to as vectors).

The main vectors and diseases are

Mosquitoes: malaria, dengue fever, West Nile virus, Japanese b encephalitis, yellow fever and filariasis
Ticks: lyme disease, tick borne encephalitis and typhus fever
Lice: Typhus Fever
Flies: Blackflies- filariasis, sandflies-leishmaniasis, Tsetse flies- sleeping sickness
Assassin Bugs: Chagas disease
Fleas: Plague or Black Death

Avoiding Insect Bites

The easiest way to deal with insect bites is to prevent them. The above diseases may be worldwide or occur in specific regions on the globe. For this reason, research the areas to which you are travelling to know what you will be exposed to. Prohibit skin contact by wearing suitably thick clothing that covers the entire body since short or thin clothing can facilitate bites. In the absence of proper clothing, insect repellants must be used on skin. Insecticides (spray or heated tablets) and pyrethroid coils can be used inside rooms while mosquito nests treated with insecticide can be used outdoors or for unscreened rooms.

Treatment for Insect Bites

Where bites occur, for allergic reactions or serious symptoms (including high fevers, dizziness and nausea) see a doctor. Most bites however, can be treated at home. More times than not, a simple local application is all that is needed since the insect remains on the skin’s surface. These are ointments, creams and antiseptics that can be used at the site of the bite. Antiseptics are important especially for bites that cover extensive areas and may already be resulting in swelling, redness or any kind of irritation.

Ticks on the other hand tend to burrow beneath the skin so removing the insect carefully to avoid further infection is needed. Using turps or kerosene to kill the tick is recommended then, using a fine tipped splinter forcep (instrument that looks like a tweezer but narrows to toothpick looking tips), firmly grip the neck of the tick and pull the head from under the skin (avoid leaving the head below the skins surface or squishing the tick on the site of the bite since both can lead to further infection). The necessary topical treatments can be used or in serious cases consult a doctor.

How to Make a Wreath

Through the centuries, wreaths have been regarded as symbols of protection, love, friendship and welcome. Most are composed of a central core, although you can twist and weave stipple stems of foliage such as clematis or hops into wreaths that are decorative in their own right, or construct a simple wreath base from supple grass or other stems and then decorate it with flowers.
With the revival of interest in decorative rings, it is now possible to buy a wide variety of wreath bases from florists and department stores. Dried-stem rings, vine wreath forms and twisted willow rings can all be adorned with posies of fresh flowers and foliage, or with dried plant material for long-term display. Pre-formed rings of absorbent stem-holding foam encased in a plastic base provide fresh flowers with a moisture source and can be used throughout the year for wall hangings or table decorations. They are, however, unattractive to look at, so you must plan your decoration to include an all-concealing cover – a handful of ivy leaves or other foliage would be ideal.

HOW TO MAKE A FRESH FLOWER WREATH

  1. Gather up your materials: a pre-formed foam ring of 25 cm/10 in diameter, a selection of flowers such as sweet peas, roses, spray carnations, Peruvian lilies, and gypsophila, evergreen foliage such as ivy, and florist’s scissors. Arrange a ring of ivy leaves around the inside and outside of the ring form to frame the flowers. Cut each sweet-pea flower on a short stem and arrange at intervals around the ring.
  2. Complete the ring of sweet peas and arrange more ivy leaves between the flowers, to give the design a natural and ‘countrified’ look.
  3. Cut individual roses, Peruvian lilies and spray carnations and arrange them between the sweet peas. Insert short sprays of gypsophila around the ring.
  4. Use the floral circlet to decorate a tabletop, a low shelf or a buffet table, where it would make an unusual centrepiece.

HOW TO MAKE A POTPOURRI WREATH

  1. Gather up the materials you will need: a dried-stem ring of 20 cm/8 in diameter, about 115 g/402 potpourri, a hot-glue gun, dried flowers such as rosebuds and sea lavender, a roll of florist’s silver wire, half a stub wire (floral pin), satin ribbon and a pair of scissors.
  2. Spurt the glue on to the ring a little at a time, and press the potpourri on to it. Take care not to burn your fingers when using hot glue. Allow to cool for a few seconds before pressing on the petals.
  3. Work all around the ring, gluing and pressing on the petals until you have covered the form on top, both inside and outside. If there are any gaps, spurt on a little more glue and add more petals. Glue some of the most colourful petals on top to give the ring a bright appearance.
  4. Arrange the dried flowers to make a small posy. Cut short the stems and bind them with silver wire. Bend the stub wire in half to make a U-shape, loop it over the stems and press the ends of the wire into the ring to secure the posy.
  5. Tie the ribbon around the ring form, bringing the ends over the top, where they will cover the posy stems and binding wire. Tie the ribbon into a bow and then trim off the ends neatly.

IDEAS FOR FOAM RINGS

Outline a foam ring with periwinkle leaves, fill it with some short-stemmed daffodils, tulips and pansies, and then embellish it with a cluster of lighted tapers for an Easter table decoration. Cover a small ring with lady’s mantle and cornflowers, and then stud it with strawberries pierced with cocktail sticks (toothpicks) for a midsummer party piece. Or, define a large ring with ivy leaves, fill in with sweet peas, Peruvian lilies and roses, and cover it with delicate gypsophila.

Sydenham’s Chorea

This condition is now fortunately quite rare, a contradistinction to its relative frequency a quarter of a century ago, when it was a common childhood ailment. It may result from rheumatism and rheumatic fever (now also uncommon), and is most common in the age group between ten to fifteen years. Girls are more likely to be affected than boys.

Children who suffered from “growing pains” in fact have been rheumatic, and have developed chorea. A sore throat may give rise to rheumatism. Often there is no obvious sign of rheumatic fever. Emotional disturbances either at home or at school may lead to the sudden onset of symptoms. It may occur during the first and third months of a pregnancy most likely the first; usually on careful checking, there may have been a rheumatism history in evidence, even though vague.

Sydenham’s Chorea Symptoms

The child tends to become inattentive and clumsy, often dropping objects she is handling. This may be in association with an emotional upset. Involuntary, irregular movements set in, often repetitive in nature, but not in time, starting and ending abruptly. Often the child makes voluntary movements to try to cover up the purposeless ones. Frequently several muscle groups are involved. Twitching of the lips and muscle groups about the eyes takes place. Often there is muscle weakness and loss of precision in voluntary actions.

Psychological disturbances are common, and there is frequent emotional instability. Depression, laughing and weeping without any obvious reason as well as becoming capricious, irritable and obstinate, are all part of the normal picture. Sensations, attention and memory are usually not impaired. As the condition improves, these features usually subside, and with a permanent recovery, do not tend to recur. About one third have more than one attack, and this is more likely with girls. Disorders of the heart system are most likely to be present.

Sydenham’s Chorea Treatment

This must be under the supervision of the doctor. In the early stage, hospital care may be necessary. A few days of complete rest in bed is customary, and ordinary rest periods should be prolonged. The salicylate family of medication is used (such as aspirin), together with sedatives and tranquillizers, such as diazepam and related benzodiazepines. Treatment may be in conjunction with that for rheumatic fever, if this is present at the same time.

Skilled nursing is essential especially with a young child. The sides of the cot should be padded to avoid injury occurring to the child from striking this with her limbs or body. Sometimes the limbs are best padded also.

The outcome is usually satisfactory. Cases treated in hospital average ten weeks. Some cases appear cured in a few weeks, while others may take as long as six months, a year or even more.

Seborrhoeic Dermatitis

What is Seborrhoeic Dermatitis?

Seborrhoeic Dermatitis is a very common skin complaint characterised by the formation of greasy whitish-yellow scales that come away in profusion when the scalp is combed or brushed. These may settle on the clothing giving a mini confetti like appearance. The complaint varies from mild to very severe. It’s generally worse in winter weather, particularly if hats are worn. Dandruff commonly causes itchiness of the scalp.

Seborrhoeic Dermatitis Causes

The underlying cause of dandruff is a condition called seborrhoeic dermatitis, but the reason for it is unknown. Certain areas of the skin have an abundance of sebaceous glands, tiny factories that produce sebum, the waterproofing material covering the skin. The glands gain access to the outside by microscopic canals. If excessive amounts of sebum are produced, above-average layers are laid down on the skin. When this dries out, it tends to flake away in the form of dandruff.

The scalp, eyebrows and mid-portion of the face, nasal folds, the area behind the ears, the breastbone region, the area between the shoulder blades, the armpits, and the parts between the legs (called the ano-genital region) arc most commonly affected.

More advanced cases of the disorder show a reddening of the skin, an excess-ive oiliness. It appears more common in overweight people and those with diabetes. In the overweight, it is common for the area between the fatty folds to be affected, and these crack and become infected with other germs.

Seborrhoeic Dermatitis Treatment

Nothing is curative, but careful regular attention will produce excellent results in most cases.

Regularly cleanse all affected parts. Shampoo the scalp and affected parts with any of the many commercial preparations available for dandruff: Many lines are excellent. Selenium sulphide suspension shampoo and zinc pyrithione 2 per cent preparations are also very effective. Instructions usually accompany the commercial package.

Simple general measures are often helpful. These include eating a sensible balanced diet, avoiding excess sweets and carbohydrates or spicy food, hot drinks and alcoholic beverages. Get adequate rest at night (every night). Follow sensible working hours and avoid foolish excesses. Adequate recreation helps, and the basics of simple hygiene are important. Infections, emotional stresses and upsets, constipation, and dietetic indiscretions should be attended to. Regular scalp massage may help.

If these simple measures do not assist, seek professional help from the family physician. Other treatment could include:

Creams containing corticosteroids (equal to 0.5 to 1.0 per cent hydrocortisone). These often reduce the inflammation and excessive discharges.

Creams containing sulphur (3-5 per cent) and salicylic acid (2-3 per cent) are popular and often satisfactory. They are used as a cream the night before shampooing.

If sores develop, indicating infection from other germs, these must be treated independently.

In overweight people where the condition arises between folds of fat rubbing together, the physician may check for diabetes (a simple blood test will show if this is present). Castellani’s paint (a bright magenta-coloured preparation applied will often cure the irritating,: cracks and fissures that develop in these areas. Pre-cleansing the area with soap and water is essential (but all traces soap must be removed afterwards).

Pneumonia

What is Pneumonia?

Pneumonia means an acute infection takes place in the substance of the lung. Yes, severe symptoms can occur. Even though antibiotics have revolutionized the outlook in most cases, it is still a disease that needs prompt and efficient treatment.

Pneumonia symptoms

These include a fairly sudden rising fever and possibly chills and shivering. Breathing becomes rapid, the heart races, and there may be a cough and sometimes vomiting and diarrhea. There may be neck stiffness, and sometimes convulsions occur. There may be chest pains with breathing, indicating that the pleura, the lining of the lungs are also involved. Sometimes there are abdominal pains as well. As the illness advances, the child is pale and may be bluish, prostrate and restless. A wheezy noise may be present with breathing, and the patient is obviously very ill. Breathing may be difficult, and on breathing out there may be a grunting sound, with cheeks flushed, nostrils dilated in the battle to get enough air. The infection is often caused by a virus, but there are usually many other bacteria that climb aboard and manage to play a part also.

Pneumonia Treatment

Medical treatment as a matter of urgency is the obvious answer. Most mothers can obviously see if their child is ill and becoming worse. The sooner the child with serious symptoms is admitted to hospital, the better. Any form of breathing difficulty needs expert attention and nursing. X-rays will show the extent of the infection, and other tests will indicate the most appropriate form of therapy.

In today’s world, it is highly likely that antibiotics will be given very early on and the full course of the disease aborted before it is fully established. Times and treatments change. This is right. Unless treatment is given, disaster is still a likely outcome. The young children are especially at risk, as they are with nearly any infection. There is still a significant mortality rate, especially with babies in the six to eight week age group.

The advent of the antibiotics saw a major change in treatment and, fortunately, a major improvement in the once depressingly high mortality figures. Nevertheless, one should never overlook the risk factors with any disorder involving the breathing system.

Secondary Dysmenorrhoea

Secondary Dysmenorrhoea is a period-associated pain hardly ever occurs before the age of 30. More often it is seen in women past 35 years. As the name implies, the pain is -often secondary to some other precipitating cause. Sometimes the pain is associated with actual diseases of the pelvis.

The most notorious is a condition called endometriosis. This means that small pieces of tissue, much the same as that forming the lining of the womb have started to grow on other pelvic organs – perhaps the outside of the uterus, or the ovaries or tubes.

Often severe pelvic pain sets in two to three days before a period starts. It will persist right throughout the menstrual flow and stops only when the period itself finishes.

Sometimes there are other infections M the pelvic organs, which may be short- , term or long-term. A similar picture results. These symptoms invariably require proper medical investigation. Medication 46 is usually required, and the results of this are often very valuable. But the correct therapy can be given only after the physician. or more likely the gynaecologist, has made a full and thorough pelvic examination and has pinpointed the diagnosis. The actual treatment will depend on the diagnosis made.

Another type of secondary dysmenorrhoea is commonly called the “pelvic congestion syndrome.” This is more common in women who have a heavy menstrual flow. The pain similarly comes on a few days before the actual flow (usually two to three days). Generally, as soon as the period commences and the blood can escape. The discomfort tends to wane. Sometimes the pain may persist until the end of the menstrual flow.

Often there is a tremendous psychological overlay to this type of problem. It is more common in women who are normally tense, anxious or uptight.

Sometimes it is related to general ill health, vague aches and pains, backaches and pelvic disorders in general. Wry frequently it is associated with the next condition to be discussed, premenstrual syndrome. Often the personality types are identical. The treatment is the same as it is for premenstrual syndrome.

Free Standing Shelving

Free standing shelf units have several advantages over wall-mounted or built in ones. They can easily be moved if the room layout is changed. They can be moved away from the wall to allow painting or papering. They can even be taken along when moving house. However, they have drawbacks too. Some manufactured shelving and display units are rather flimsy, and may twist out of square or sag if they are heavily loaded. In general, better results are found in building units that use strong materials such as natural wood and plywood. The other problem is getting them to stand upright against the wall; skirting’s (baseboards) prevent standard units from being pushed back flush with the wall surface, and carpet gripper strips make them lean forward slightly. The answer is to design the side supports on the cantilever principle with just one point of contact with the floor, as far as possible from the wall, so that the unit presses more firmly against the wall as the load on the shelves is increased.

Since a shelf unit is basically a box with internal dividers, it can be constructed in several different ways, using simple butt joints or more complicated housings. Perhaps the best compromise is to use gilled butt joints reinforced with hardwood dowels, which give the joints the extra rigidity they need in a unit of this sort.

Start by deciding on the dimensions of the unit, then select materials to suit the likely load the shelves will have to support. Mark up and cut matching groups of components to length in batches to ensure that they are all precisely the same size. Pre-drill all the dowel holes, using a drill stand and depth stop for holes in the board laces and a dowelling jig for those in the board ends. Insert the dowels and make up the joints. A thin plywood or hardboard backing panel can be pinned (racked) on to give the unit extra rigidity.

CONSTRUCTING A FREE-STANDING SHELF

  1. Clamp groups of identical components together. Mark them to length and cut them in one operation to ensure that they are all the same length.
  2. Mark the positions of the shelf dowel holes on the unit sides, ensuring that they match. Drill them all to the required depth, using a drill stand if possible.
  3. Use the dowelling jig to drill the dowel holes in the shelf ends. This ensures that the holes are correctly positioned and centered, and are drilled straight.
  4. Glue the dowels and rap them into the holes in the shell ends. Ensure that they all project by the same amount, and cut down any that are overlong.
  5. Assemble the unit by gluing one end of each of the three shelves and joining them to a side panels. Then glue the other ends and add the second side panel.
  6. Cut a hardboard or plywood backing panel. Check that it is perfectly square, then pin (tack) it to the bark of the unit