Category Archives: Health

Dislocation of Bones

What is Dislocation of Bones?

A fracture means a bone is broken. In accidents, several may be affected. As bleeding, injury to surrounding structures, pain, shock or infection may all occur, emergency treatment is advisable. The key to success is to get the patient to emergency professional help as quickly as possible. Make the casualty comfortable and attend to any emergency symptoms that are amenable to first aid help.

The break in the bone is usually complete, but in children in whom growing bones are soft, it may be bent, cracked and incompletely broken (called a “greenstick” fracture).

The fracture may be closed or open (simple or compound), depending on whether it communicates with the air outside. Open fractures are more serious, for this allows contamination to enter the wound and probably the bone. Some fractures are “complicated,” which means surrounding structures, such as internal organs, blood vessels or nerves are also injured. These too are more serious, for they can lead to important complications. Fractures may be produced by direct force (such as receiving a direct blow by a car). They may be indirect, such as falling on the outstretched arm, which causes fracture of the shoulder bones. for instance. Occasionally sudden muscle contraction may cause a fracture.

Bones are well endowed with blood vessels, and any fracture, especially of major bones, is invariably accompanied by a heavy blood loss and consequent shock. (For example, a fractured femur, the large bone in the upper part of the lower limb, may hemorrhage a liter or more of blood if broken.) Pain invariably occurs. The first aider will endeavor to prevent further damage and minimize risks from blood loss, reduce pain, and if possible reduce the chances of infection.

The basic essential of immobilizing (stopping further movement) the injured part is to disturb the patient as little as possible, inflict minimum pain and avoid complications. Injured parts should be supported in a natural a position as possible.

Dislocation of Bones Symptoms

  1. The fracture site is painful, swollen and bruised.
  2. There is loss of function of the part, particularly noticeable in limbs.
  3. The part may be obviously deformed.
  4. There may be abnormal mobility of the part.
  5. Shock, to some extent, is usually present. In injuries to larger bones, this may be severe.

What to Do in the Case of Fractures

  1. Aim at bringing relief to the major injuries as quickly as possible, without making the condition worse, and then getting the casualty to expert medical attention (preferably the emergency ward of a large hospital) as soon as possible. Often assistance is necessary.
  2. Keep calm. Don’t panic. Often the sight is distracting, and may nauseate you. Keep a cool head and act deliberately, but calmly and methodically. Rushing breeds confusion.
  3. Immobilize the fracture (i.e. prevent further movement).
  4. Control bleeding if present.
  5. Handle gently, for it is easy to convert a simple fracture into a more complicated one.
  6. Reassure the patient with words of comfort and confidence.

Dislocation of Bones Treatment

Often the use of broad bandages can help this. If not possible, narrow ones may be used. Triangular and crepe bandages are often useful in an emergency. Every effort should be made not to disturb or hurt the patient. Avoid jerking movements, particularly when bandaging or securing them.

Sometimes splints are necessary to prevent movement of the injured parts during transport. Anything that is wide, long and firm may be suitable. They should be well-padded, and securely applied, so as to immobilize the joints above and below the break.

Adequate padding will improve the efficacy of the splints, and this helps to bring relief to the patient. These can be improvised from any sort of material in an emergency.

Rather than run risks of bringing further damage to the patient (such as in suspected spinal fractures, where care in handling may be vital), it is advisable to make the patient as comfortable as possible, and call the ambulance. Ambulance officers are specially trained to handle potentially serious fractures, and know the special movements necessary. Also, some are equipped with special stretchers that can pick up the patient from the ground, thus ensuring minimum movement and risks.

Most people will not be conversant with the various first aid bandaging techniques that have been worked out for the different kinds of fractures. For practical purposes, general principles may be adhered to, and the patient transferred to expert help as a matter of urgency. Some general principles will be outlined that may be of assistance. This is not the time to teach bandaging.

However, anyone interested in learning full techniques is advised to take a St John First Aid instruction course, which gives excellent instruction in these useful techniques.

Crippling Diseases

Despite the advances in the medical sciences, there are still many crippling diseases that affect people. These can be inherited, occur after birth due to mutations or anomalies within the body, contracted through activities in our daily lives or as a result of medical treatments gone wrong. They can also be physical or mental. Although many are rare, it affect persons or ages in rare circumstances or may be gender specific if not more prevalent in one than the other, in general they are impartial. Some like heart and lung diseases, many forms of cancer (some of which are untreatable), spinal abnormalities, liver, kidney and degenerative brain diseases can be fatal.

A crippling disease is not necessarily one that directly affects the physical legs but any disease with the ability to drastically affect one’s life. Conditions can range from those that render the legs or lower parts of the body useless, to those that affect the spine (causing severe pain, curvatures, shrinking/degeneration or sometimes even death) or those that make walking too painful.

Causes of Crippling Diseases

Diseases of the body that do not directly affect the legs or lower extremities but cause so much pain that they render sufferers immobile or limit their day to day activities are also very common; autoimmune diseases in whatever form are good examples. Many bone diseases characterized by the depletion or wearing done of ligaments or cartilages; like arthritis, affect both adults and children and where as some are mild, some lead to deformities of the body part affected bringing life to a grinding halt.

Mental diseases like depression, bipolar disorders, genetic disorders (like autism), Alzheimer’s and many others can disrupt daily life if left untreated. Unfortunately, many persons pay more attention to physical diseases than they do mental disorders especially when some; like depression, occur in children and teens which can make the daily symptoms harder to cope with. All mental disorders and conditions that seem common like depression or migraines should be taken seriously since they can be life-threatening. A migraine attack while driving or carrying out any other such activity can have devastating results.

Disorders that affect the mood or emotions can not only make persons unsuited for interaction with others but lead to violent behaviors including homicides and/or suicides. A child suffering from a mental disorder can develop a learning disability directly linked to the disorder or as a result of it being ignore or untreated. Antisocial behavior at home and school can arise from feeling ‘misunderstood’.

Dealing with Crippling Diseases

When dealing with anyone diagnosed with a crippling disease; whether physical or mental, it is best to understand the underlying cause, the symptoms, the effect these symptoms will have on the patient’s daily life, how it affects you and where you fit in. Taking into consideration the nature of the disease and how you are expected to contribute to the patient’s treatment can greatly improve your ability to ease some of the burden being felt.

Multiple crippling diseases that do not developed during pregnancy can develop without signs while many will show symptoms that can be linked to common conditions. Any symptom being experienced that persists or worsens especially if being treated at home for the maximum recommend time should be brought to a doctor’s attention. Unusual behavior especially in children, teens and the elderly should never be ignored. Also, the body uses pain, nausea and infections (all from no apparent source) as warnings so heed them, if you think something is wrong then see a doctor.

Gall Bladder Stones

What is a Gall Bladder Stone?

Bladder stones nearly always occur in males, and usually as a complication of some other disease, commonly a persisting infection. There may be residual urine, which means the bladder does not empty completely on voiding, and this gives germs the opportunity to set up a long-standing infection.

The gall bladder is a small pear-shaped container that nestles into the liver. Each day the liver produces about one liter of bile. This is piped into the gall bladder where it is stored until needed. It is highly concentrated, being 10 times more powerful than ordinary bile, for water and certain chemicals are absorbed during the storage. Under the influence of stimulation, usually the presence of fat in the intestine, the gall bladder contracts, and bile is expelled into the intestine to assist digestion.

Those who have undergone a gallbladder X-ray will remember having first to take some tablets. These are absorbed from the intestine, processed by the liver and then go to the gall bladder where they enable an X-ray picture to show the outline clearly. Then a fatty meal is usually eaten, producing the rapid contraction of the gall bladder. Stones and the presence of disease or obstruction (commonly by gallstones) can often be detected in this manner. In general, ultrasound is used for diagnosis.

Gall Bladder Stones Symptoms

Usually the symptoms of infection are present. There may be the desire to pass urine often. Blood and pus may be present, and the urine may be unpleasant in odor. Sometimes there may be a sudden interruption of the urinary flow when micturating (passing urine). There may be sudden pain when voiding, as the stones roll down the neck of the bladder. Occasionally the stones may become very large, and there may be several present.

Gall Bladder Stones Treatment

Often the stones will show up on X-ray examination. A cystoscopic examination may take place. An instrument is passed up the urethra (the canal leading from the exterior to the bladder interior), and this enables the internal contents of the bladder to be seen under direct viewing. Small stones may be removed in this manner. Larger stones will require surgery. If there are any predisposing causes apparent, these may also be remedied.

Alzheimer Symptoms

The symptoms of cerebral arteriosclerosis, as they advance, are referred to as “senile dementia” by doctors. It is not a very attractive term, and other more euphonious ones are often used. Nobody likes to think of a parent as being “demented.” In recent years, another term has come into popular use. It is called Alzheimer’s disease. Some doctors describe it as the same as senile dementia, with similar causes. Others claim it is a separate, unrelated disease, even though symptoms are often similar or identical.

It is not new, having first been described by Dr Alois Alzheimer, a neurologist born in Poland in 1864. He was the first to accurately describe the disorder.

Like dementia, it afflicts ageing persons, often in their 60s. In fact, figures indicate that with the advancing age of the population in general, vast numbers of patients with this diagnosis will keep occurring well into the foreseeable future.

These often come on suddenly, in persons who may have been very mentally alert. It seems to afflict anybody. Gradual or fairly sudden memory loss, inability to recall events, even recent ones, unable to utter certain words and phrases, seeing things, but unable to describe them, becoming annoyed easily and irritable, bad-tempered and even violent, are common symptoms.

There is often rapid deterioration, lack of care for oneself and personal appearance, forgetting most things in life, and withdrawing into oneself, are common. This usually requires total nursing care in bed or hospital.

The cause of the disease is unknown. It may be related to reduced cerebral circulation. Aluminum poisoning of the cerebral cells has been cited often. Others claim an infection, for at autopsy certain particles have been discovered in the brain cells of these patients. It is claimed it may be genetically predetermined, and seeking a certain chromosome in developing babies could foretell if the disease will occur – all a bit late for the patient and immediate offspring.

One day we will probably have the complete picture as to the cause, and likewise the cure. At present neither is known. It is a progressive, downhill disorder that usually ends up in a nursing home for incurables. Total attention to the patient’s needs, nutrition and encouragement are essential.

Alzheimer support units abound, and relatives are recommended to contact the nearest one for support, advice and general cooperation, with a difficult disease and usually a difficult patient.

Liver Disease

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.

Friedreich’s Ataxia

Friedreich’s ataxia is an inherited disease, with the patient usually affected in childhood. The disease generally sets in between the child’s sixth and tenth years. Onset is gradual, with foot deformity and ataxia (an inability to appreciate the normal sensation of space). Awkwardness of walking is the typical symptom, with a tendency to stumble and fall easily. This may even date from infancy. The walk becomes clumsy and irregular, short steps are taken and the trunk tends to sway unsteadily from side to side. When walking each foot is raised in a poorly coordinated manner. Gradually this tendency spreads to the upper limbs.

As the condition advances, irregular movements of the head and neck follow, with the upper part of the body moving with jerky, nodding motions. Irregular eye movements occur, also difficulties in speech and word correlation. There may be wasting of the muscles of the hands and feet however, sensation appreciation is often little affected.

The course is a slow and irregular one, but the average duration of the disease is more than 30 years. Concurrent infections do not help, and may finally cause the patient’s death, rather than the disease itself.

There is no known treatment of any benefit. Training of the limbs by physiotherapy may assist, and orthopedic shoes can assist the deformities of the feet.

Purpura

What is Purpura?

Purpura means there is a tendency for the skin to bruise. It’s more likely in children under the age of six years, and often there may have been a tendency to bruise easily with simple knocks. A large number of purpuras exist, and they have a strange variety of names. Basically, the cause is a fault with the clotting mechanism of the blood. This usually involves tiny particles called platelets, which are part of the solid phase of the blood. There may be too few, or the place where they are produced, in the bone marrow, may be diseased.

Sometimes the condition follows a few weeks after a simple infection, often a viral one, or germs collecting in the urinary tract or teeth. There may be bleeding into the skin causing bruising. It may come from the nose, gums or urinary system these are the most common areas. Sometimes bleeding may occur into the bowel or pints or even into the nervous system, hit these are more unlikely. The child may run a fever, appear pale, but this varies. When the blood is examined, there is usually a reduced number of platelets.

Purpura Treatment

It can be a worrying time, and treatment may be needed for many months, often up to six or eight. Blood transfusions are given to restore the platelet count to normal, and these may be repeated depending on the child’s reaction.

Any infection is treated. The child is given a nutritious diet, probably with added vitamins, and the steroid drugs are sometimes used. Every effort is made to avoid injuring the body, for this will aggravate the bruising and bleeding. Certain of the newer drugs may also be used. It depends on the case, and the opinion of the doctors treating it. In continuing cases despite treatment (probably after six to twelve months of active therapy), the spleen, the large organ in the upper abdomen is sometimes surgically removed.

In most cases the results are favourable often with or without treatment, the vast majority of people recover within six months, but some may take longer and cases have continued for three years or more. Occasionally a purpura is fatal, but usually not.

Acute Pharyngitis

What is Acute Pharyngitis?

It is common for the pharynx to become inflamed and infected. Indeed, in practically any upper respiratory tract infection, some degree of sore throat will take place. It is almost impossible for the pharynx to escape, for it forms a basic part of the respiratory tract. Also, in the many invasive infections, the throat will become sore. This is true of many of the childhood fevers: measles, mumps, possibly chickenpox, infectious mononucleosis (glandular fever) and all the other simple infections that are common. Usually it is a simple process, and healing occurs with time and straightforward measures.

Acute Pharyngitis Symptoms

The throat becomes progressively more painful. The back part becomes red, and small raised areas of lymphoid tissue often become prominent. The mucus becomes thick. Talking may be difficult, and often there is some intercurrent laryngitis as well. The lymph glands in the neck may swell and become painful. The tonsils may become involved to some extent. Often pharyngitis is part of a generalised tonsillitis, and often the two conditions will be treated simultaneously.

The complications of simple pharyngitis are similar to those of tonsillitis.

Acute Pharyngitis Treatment

Treatment of pharyngitis is usually similar (often identical) to that for acute tonsillitis. Generally the condition is not so severe, and as a rule systemic side effects are less marked.

However, many respond well to antibiotics from the doctor. Incidentally, no antibiotic should be taken unless doctor prescribed for a specific illness, and then the full prescribed course should be taken. This helps to ensure that the germs are totally killed and not merely “stunned,” so giving rise to the possible development of resistant strains that in future might not respond to antibiotics at all. (This is fast becoming a major worldwide problem with indiscriminate use of antibiotics.) Do not take antibiotics prescribed for others unless given specific medical instructions.

Renal Dialysis

Two types of machines are available, and they are set with alarms that sound loudly if faults develop. Ideally, efforts are made so as to make the lifestyle as near to normal as possible. Some dialysers may be used at night when the patient is asleep; three 10-hour spells weekly being adequate. Other types are more powerful, and require shorter sessions.

The artificial kidney, as it is often called, is far less efficient than the real one, and many patients exist in a mild state of chronic renal failure. For this reason eating habits may be restricted, the diet may be low in protein, sodium and potassium, and the patient may be allowed only 600 ml of fluid daily.

Initially the patient may be treated in hospital in a dialysis unit. However, many are taught to run their own units, and can manage well at home. This, of course, throws added burdens on the marital partner, for supervision is always necessary and the whole system can alter the usual lifestyle in a home.

Various medical problems are inevitable with a system interfering so markedly with the normal operation of the body.

Access must be gained to the blood circulation. This is often at the wrist or ankle. Various devices are used. A so called arteriovenous teflon silastic shunt is popular. This basically consists of a tube connecting the artery and vein at the wrist. It is made of silastic and consists of two halves connected when not in use.

When dialysis is about to be carried out, the halves are separated and hooked to the machine. In some types, normal heart action is sufficient to pump the blood through the dialyser, but in others a blood pump is necessary. Blood comes from the artery through the dialyser where the unwanted metabolites of the body are filtered off, and then returned to the vein to re-enter the body’s circulation.

Dialysis vs Transplant

There is a continual question as to which form of treatment is best. There is no doubt that having a functioning organ, if possible is far preferable to having to rely on regular treatment with a machine. However, surgery carries with it the usual risks that go with an operation – possibly of the patient’s own life. Most patients are happy to accept the risk.

The main problem at present is not the acceptance of the concept by the patient, but the availability of suitable kidneys for transplant. At any given time there are probably 2000 to 3000 persons on the waiting list, anxious to undergo surgery, and hoping that a suitable opportunity (a suitable matching kidney) will become available. With greater public awareness and education, it is to be hoped that more supplies will become available. Many Western countries have taken the initiative in public educational programs, and have altered legislation making the total enterprise simpler, and notification easier. In the next few years one would expect to see a major step forward in this rewarding and lifesaving field.

Cogenital Heart Disorders

What is Congenital Heart Disease?

Congenital heart disease probably represents the most common disease of the heart system in infancy and early childhood. About six to eight babies for every 1,000 born may suffer from one of these disorders. It doesn’t sound very many, but when you consider that around 4,000,000 babies are born in each year within the US alone, the figure still tallies up to a fair number in gross figures. It could represent up to 24,000 to 32,000 babies affected each year.

Congenital Heart Disease Causes

There is little doubt that infections during early pregnancy, especially the first trimester (first three month period), may play a major part. In the bad old days before it was realized how powerful the virus of rubella was. Many more babies were affected. After a rubella epidemic, many babies were born with severe congenital defects, not only of the heart, but of the eyes, ear and brain. The heart is developed around eight to ten weeks after conception, and the virus readily crosses over the placenta into the developing embryo. It can markedly interfere with normal cell division, hence the problems of defects occurring from that point on.

Viruses are not the only cause. There must be many other causes. The taking of drugs during pregnancy may interfere adversely with development. X-rays have also been incriminated, for they too, may interfere with normal cellular replication. If there are defects in the parent, this, too, may increase the baby’s risk. But in the main, we do not know too much about it all. There arc undoubtedly many other causes present.

The symptoms may be many and varied. There may be a below-average weight gain. Feeding problems are common, and attacks of vomiting may take place. There may be sighing, fainting attacks and even blackouts. The baby may be pale, have difficulty in swallowing normal feeds, or may regurgitate food with the appearance of curdled milk. Normal comfortable breathing may be absent. Baby may seem more at ease while bending backwards. The -growing child is often disinclined to join in the normal playground activities with playmates, and may prefer to sit on the SI lines. There could be a bluish tinge to the s in. (This is called cyanosis.)

Congenital Heart Disease Treatment

The question that immediately looms is what should the parent do if any of these telltale symptoms put in an appearance? Many of the symptoms may be intermittent. There are usually no flags flying and red lights flashing. The mother may realize that something is wrong, although often especially with a first baby, the mother may not recognize the symptoms as being abnormal, for she may have no yardstick of comparison. This is often a major problem for young mothers regarding any childhood illness, not necessarily solely heart disorders.

The mother is best advised to take the baby or infant or child to the family doctor. Here, general checks may be initiated. If there is any question of congenital defects, then the appropriate specialty will be recommended. There are experts in this field in every capital city in Australia and New Zealand, and rural towns also have access to good medical investigation and care. Ideally, the child will ultimately wind up at a major city centre with the facilities to diagnose and correct any abnormality.

The range of heart defects is quite large. It is all very complex but today we live in a sophisticated society, and we have access to first-class medical care. A parent with problems should be steered toward the expert centers. Surgery has made remarkable advances in recent times.

In some congenital defects, the relatively simple administration of certain medications is proving beneficial. A condition called patent ductus arteriosus 4 (which means a connection between two major vessels remains open instead of shutting off at birth) is now being treated with a simple drug called indomethacin (also used for arthritics). Given early, it enables the vessels to close and stay shut.