OSTEOARTHRITIS

                    OSTEOARTHRITIS(OA) is a condition where there is an imbalance between degradative and reparative process of the whole joint  and its component parts particularly in the synovium.
                 osteoarthritis is also known as osteoarthrosis or degenerative joint disease.it leads to gradual loss of cartilage in the joints leading to the formation of bony spurs.OA primarily involves dependent joints like knee and hip.About 4 lakhs of knee replacement surgeries are going on every year because of OA of knee.



causes:

             primary reason for OA is aging.other causes like obesity,trauma,hereditary causes may also come under.Gout,DIabetes are the other risk factors.long running is also another risk factor to be noted.



SYMPTOMS:

                Pain and Joint swelling are the main symptoms in osteoarthritis.History of limited walking distance due to pain..pain that interrupts sleep in the night are the main symptoms.PHYSICAL EXAM SHOWS JOINTLINE TEMDERNESS TO PALPATION.




DIAGNOSIS:
              
                        Standing and flexed knee radiographs shows narrowing of joint space.other radiological findings include osteophytes,cysts and subchondral sclerosis.



TREATMENT:


                       1. weight reduction and avoiding exercises that cause pressure on joint.
                       2. rest,exercise,physical and occupational therapy
                       3. NSAIDs like ibuprofen and acetaminophen to reduce pain.
                       4.Corticosteroids for moderate joint narrowing.
                       5.surgical options:indications depends on patient age,weight,activity and status of                              compartments.total joint replacement,unicompatmental replacement and osteotomy are
                          the other surgical procedures used.   




            


 

SCABIES

      Scabies is a skin disease which is contagious,caused by a small mite names SCORBUTIC SCABIEI.


CAUSES:
   It is very easy to get infected by a mite.Personal hygiene and cleanliness play an important role.


SYMPTOMS:
   Intense discomfort and itching are the main symptoms.
   It typically involves genital area in boys.It can spread to every part in the body except face.
   Palms & soles are also mainly involved.

DIAGNOSIS:
      Diagnosis can be easily made by looking at the lesions and the areas involved.

TREATMENT:
     Prevention is better than cure.Maintaining personal hygiene ,cleanliness and preventing the spread by not
using clothes of other persons and regular and proper washing of clothes.


    1.Home treatment :As said above regular washing of clothes,maintaining personal hygiene
    2.symptomatic treatment:Using tab.cetrizine or any anti histaminic drug to relieve the discomfort.
    3.25% benzoyl benzoate lotion or 5% permethrin lotion can be used.1/2 of this dose for children.
       should be applied from below the face and kept for 72 hours continously without washing.
       It would be better if everyone in the house takes this treatment.

COUGH

 COUGH is a sudden,protective and repetitively occuriong reflex movement that helps in clearing the airway from various irritants.

                                           

CLASSIFICATION:
           cough is classified into either acute(<3 weeks),subacute(3 to 8 weeks),chronic(>8 weeks) or acute cough i.e, lasting
<3 weeks or persistent cough lasting > 3 weeks.

cough may vary from simple cough to coughing up sputum or blood and sometimes may be associated with other symptoms like sore throat,
wheezing and difficulty in breathing.


CAUSES FOR ACUTE COUGH:
           In most of the healthy adults the cause of acute cough syndrome is mostly viral upper respiratory tract infection like
common cold and other bacterial infections of the nose,
2.Psychogenic,
3.Acute pulmonary oedema i.e, associated with pink,frothy oedema.
4.Pulmonary embolus,
5.Use of ACE inhibitors(used to treat hypertension) and other beta blockers


CAUSES FOR CHRONIC COUGH:
           1.Bronchitis(infection of the air passages leading to lungs),
           2.Asthma
           3.Croup(barking cough more commom in children between 6 months and 3 years)
           4.GERD(Heartburn)
           5.chronic lung disease(Bronchitis or Emphysema)
           6.lung tumour
           7.pulmonary tuberculosis
           8.Whooping cough(Pertussis)


DIAGNOSIS:
     
              *Age
              *Cough
              *Dyspnoea(Atrest or with exertion)
              *Constitutional symptoms
              *Tobacco use history
              *Vital signs(heart rate,respiratory rate,body temperature)
              *chest examination
              *chest radiograph

       These are the essential requirements to make a diagnosis of cause of cough.


TREATMENT:
           1. Treatment depends upon the cause of cough.Natural remedies like some fruits(oranges),hot water bath may treat the acute cough by thinning the mucus in the throat.
 

           2.Drink plenty of fluids

           3. HOME CARE:
          Cough due to common cold and postnasal drip can be treated by some cough syrups like                     Phensedyl(pseudoephedrine,promethazine).
     Should not be used in children below 6 years.
 
          4.Consult your doctor if the cough persists and it is associated with constitutional symptoms.


PREVENTION:


       1.Quit smoking and stay away from second hand smoke and air pollution.
       2.If you have seasonal allergies or any allergies,take preventive measures like staying indoors,using medication etc.

DROWSINESS

   DROWSINESS is nothing but feeling abnormally sleepy during the day.it has got many reasons.main reasons behind drowsiness include somnolence,abnormal thyrotoxic profile,sleep apnoea,depression,stress,grief and some psychological disorders.Medications like tranquilizers,sleeping pills and first genearation antihistamines may also cause drowsiness.

COMMON COLD

rhinitis:inflammation in the nose..sneezing,snuffy and running nose,watery eyes,postnasal drip.
              diagnosis :cap. amoxycillin 250 mg tid for 5 days...tab cetrizine or tab.pseudoephedrine is the commom treatment                                      used now a days

ABDOMINAL PAIN(CHILD)

Cholecystitis:(unlikely in children) Gallstones, Fever, right upper abdomi-
                       nal pain, sometimes pain in right shoulder, nausea,vomiting, chills, sometimes jaundice,dark
                        urine



Pancreatitis:(unlikely in children) Inflammation of the pancreas,the organ that produces insulin,glucose regulating hormone,associated with gall stones. Pain in the upper abdomen,sometimes in  the back,nausea, vomiting sometimes weakness and rapid heart rate
                                             

Ulcerative colitis: Inflammation of the rectum and colon. Low-grade fever (less than
 101 degrees F), some pain  in lower abdomen, blood may appear in stools,sometimes weight loss



Crohn’s disease:(unlikely in children) Inflammation of the entire gastrointestinal tract. Low-grade fever
                               less than 101 F,pain in the lower right part of the abdomen that is often relieved by
                               defecation of stools that are soft and not well formed

Sickle-cell disease: Painful “crises” caused by misshapen red blood cells,an inherited disease foubd most often in african americans. Severe pain in abdomen and joints,sweating,sometimes fever
 

Worms: Infection by Ascaris,hookworm, Taenia,Strongyloides species. Worms and eggs in stool,
, mild pain, weight loss and diarrhoea


Lead poisoning :Caused by exposure to lead, most often in lead paint in older houses.Diffuse abdominal pain,in the long term lead to mental retardation


Bowel obstruction:A blockage in theintestine. Nausea, vomiting, sometimes constipation
                               distended belly, extreme discomfort

Intussusception: common between ages of 5 months and 2 years.“Telescoping” of tubes of intestine into
                            one another. Slight fever, acute sudden pain,vomiting,often decreased bowel movements.

Ulcer: Severe irritation of the stomach or intestinal lining.Burning upper abdominal
                 pain that is worse when lying down,sometimes relieved by antacids,made worse by  aspirin or
                 ibuprofen

Henoch schonlein purpura:inflammation of the blood vessels that often follow respiratory     
                                       infections.joint pain,vomiting,distended belly,bruising occurs later
Kidney disease: Congenital kidney problems... Severity of pain varies, but
                            generally over the flank
Hepatitis: Infection or inflammation of the liver caused by viruses.Weakness, fatigue, right
                   upper abdominal pain,jaundice (skin taking on a yellowish appearance)