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Febrile seizure

Febrile seizures are high fever related fits or convulsions that affect young children. It occurs in association with elevated temperature and is a very common childhood seizure disorder. It happen any time between three months or five years of age when t he fever gets higher. It tend to occur in families. In a child with this disorder,the risk of febrile seizure is 10% for the siblings and almost 50% for the sibling if a  parent has febrile seizure as well. Though the mode of inheritance is not clear and know, there are clear evidences for the  existence its genetic basis. Such children have a slightly higher risk of epilepsy compared with the general population.

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They are often harmless and typically don’t indicate a serious health problem.

TYPES OF FEBRILE SEIZURES

  • Simple seizure:  These seizures lasts from a few seconds to 15 minutes. They do not recur within a 24-hour period and are not specific to one part of the body.
  • Complex seizures: These types lasts longer than 15 minutes and occurs more than once within 24 hours or is confined to one side of your child’s body.

CAUSES

Though a higher than normal body temperature causes febrile seizures,  a low-grade fever can  also trigger a febrile seizure.

  • Infection: The fevers that trigger febrile seizures are usually caused by a viral infection, and rarely by a bacterial infection. Influenza and the virus that causes roseola, which  are accompanied by high fevers are frequently associated with febrile seizures.
  • Post-immunization seizures:  Febrile seizures may increase after some childhood immunizations. These include the diphtheria, tetanus and pertussis or measles-mumps-rubella vaccinations. A child can develop a low-grade fever after a vaccination. Not th vaccine but the fever causes the seizure.

the risk of recurrence is higher if  the first seizure resulted from a low fever,the period between the start of the fever and the seizure was short, a family history of febrile seizures and the child was younger than 18 months at the time of the first febrile seizure.

DIAGNOSIS AND  TREATMENT

Identifying the cause of the fever is the first step of treating the seizure.

Mostly the  febrile seizures stop on their own within a few minutes. Once your child has a febrile seizure, stay calm and follow these steps:

  • Place your child on his side on a  flat surface where he won’t fall.
  • Time how long the convulsion lasts, if possible.
  • Remove hard or sharp objects near your child.
  • Loosen his clothing.
  • Don’t restrain your child or interfere with your child’s movements.
  • Don’t put anything in your child’s mouth.
  • Do not put a child who is having a convulsion in the bath to lower their temperature.
  • If the convulsion lasts more than five minutes call an ambulance.

Retinoblastoma

Retinoblastoma is cancer of the eye which begins in the retina. Retina is a layer of nerve cells
that lines the back of the eye. It happens when the cells form a tumor when nerve cells in the retina
change and grows in size and number. Cells usually spread in and around the eye. They can
also spread to the brain and spine. Retinoblastoma usually occur in young children below the
age of five though it appear in adults as well. Children with an inherited gene from their parents
tend to get retinoblastoma at an earlier age, and in both eyes.The early symptoms of
retinoblastoma is a cloudy white pupil(leukocoria). In bright light, the pupil can look silvery or
yellow.
Other symptoms are :IMG-20190326-WA0012
● Poor and blurred vision
● The coloured part of the eye (Iris) appear cloudy
● Crossed eyes (Eyes that appear to be looking in different directions)
● Eye redness
● Eye swelling

There are two types of retinoblastoma.

● Heritable retinoblastoma
This is the most common type of retinoblastoma. It occurs when a child inherits a
mutation (change in a gene) from a parent. Such babies will be born with retinoblastoma.

● Sporadic retinoblastoma
Occurs when a gene mutation happens in early childhood, usually after 1 year of age. It
affects just one eye.

TREATMENT

Treatment involves chemoreduction and focal treatments without the use of external beam
radiotherapy. This allows preservation of the eye in some cases, often with visual function.

Nomophobia

IMG-20190326-WA0008Have you ever been without your mobile phone for a few hours? What goes through  your mind when your phone is not within your reach? Irritated?,tensed? or restlessness?.If yes, then probably you are undergoing a state called nomophobia. Nomophobia or “nomobile-phone phobia” is the irrational fear of being without your mobile phone. This happens when your are not able to use your phone for some reason, such as the absence of a signal or running out of minutes , battery power or credit. Today it’s increasing among high school and college students. A person with this syndrome may be tensed, stressed ,or anxious when he cannot use his mobile phone . It can also be an addiction when such people cannot go to sleep with or next to their smart phone or never switch off their phone or cannot take a break from it.  However, there is debate among the medical community on its classification; is it a phobia, anxiety disorder, lifestyle disorder, or addiction?. But it is commonly perceived as a phobia. Nomophobia preoccupies an individual with his phone and turn to it if they are depressed, anxious, and lonely. It not only affects the mind, but also relationships, where a person is physically present but psychologically absent. It can affect job performance, academic performance, impairs concentration and mental health in a long run. The various symptoms of this condition include,

  •  Elevated heart rate, sweaty palms, shallow breathing.
  • Keep checking the phone every now and then for battery life and/or messages.
  • Plug and connect regularly.
  • Use of phone even at inappropriate places .
  • Health and mental well being suffers in the absence of mobile phone.

The treatment of nomophobia often does not require medical interventions.  The best remedies for this phobia includes  taking control over phone ,interpersonal counseling, cognitive behavioral therapy, addiction therapy, gradual exposure therapy and systematic desensitization. Exposure therapy is, first exposing the individual to their phobia in therapy (ie, not taking the phone in the room with them) and gradually moving to real-life scenarios (ie, moving the phone to another room for gradually increasing amounts of time). For worst cases of this phobia, anxiety medication may be required.

 

Breast Milk

Breast milk is the primary nutrition source  for the newborn. According to WHO, newborn babies should be fed exclusively with breast milk for the first six months. It is the complete nutrition source till six months of age. The rich composition of the breast milk protects the baby against infections, diseases and illness. Bless fully, the benefits of which continue even long after breast feeding has ended.

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STAGES OF BREAST MILK

Breast milk is typically studied under three stages. The colostrum, transitional milk and mature milk.

Colostrum is the thick yellow sticky breast milk produced during the end of pregnancy and during the first few days after delivery. It is high in protein, low in fat and has abundant amount of immunoglobulin(IgA) and white blood cells to fight infections. It also act as a natural laxative by helping to prevent jaundice and clearing meconium from the baby’s body.

Transitional breast milk comes in as a combination of colostrum and mature milk three to five days after birth of the baby.

Mature human milk contain fat (3%-5%), protien (0.8%-0.9%), carbohydrates (6.9%-7.2%),  calculated as lactose. The energy content of breast milk is 60-70kcal//100ml. The protein content is more than the carbohydrate content in the colostrum than the matuem milk. There is no consistent compositional difference between milks from the two breasts unless one is infected.

COMPOSITION OF BREAST MILK

The nutrient rich complex composition of breast milk include water, protien, carbohydrates, fats, immunoglobulins, vitamins, minerals, enzymes and hormones. The composition may varies among mothers and within the same mother throughout a day. This variation over time helps to meet the needs of a growing child.

The principal protein of human milk is casein. It is homologous to bovine beta- casein, alpha lactalbumin, lactoferrin, immunoglobulin IgA, lysozyme and serum albumin.

The principal sugar of human milk is lactose. Apart from lactose 30 or more other oligosaccharides are also present. These amount is the aggregate to as much as 1g/100ml in mature milk and 2.5g/100ml in colostrum. Some of them has the ability to promote growth of certain strains of lactobacilli.

The principal fat elements in human milk are palmitic acid and oleic acid.

The principal mineral constituents are sodium, pottasium, calcium, magnesium, phosphorus, and chlorine. The iron, copper and zinc contents of human milk varies considerably.

BENEFITS OF BREAST MILK

  • Water: Water which makes up 90% of the breast milk keeps the baby hydrated and help to regulate body temperature , lubricate and protect internal organs.
  • Carbohydrates: Apart from being the energy provider , it is also linked to greater brain development.
  • Lipids: lipids or fats play a major role in the baby’s weight gain as he grows.
  • Protein:  It helps to build, strengthen and repair the body. Protein lactoferrin in the milk is associated with the iron transport in the body.
  • Immunoglobulins/ antibodies: They are baby’s first vaccine. It helps fight off germs, bacteria, fungi, viruses, parasites and diseases.  IgA ,the main immunoglobulin  prevents germs from entering the nanbab body and blood.
  • Vitamins protects the baby from scurvy, rickets,and other deficiency diseases.
  • Minerals helps to build strong bones, produce red blood cells and helps in the proper functioning of muscles and nerves.

Acid reflux

Acidity or acid reflux is the back flow of stomach acid to the chest cavity. It is a very common medical condition among people. It is often caused by one or multiple factors. The gastric acid which aids digestion in stomach rises up to the chest cavity or food pipe. This happens when  the lower oesophageal spincher (LES) that regulates the flow of food from oesophagus to stomach doesn’t close or opens too long.

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CAUSES

  • Hiatal hernia: This is a stomach abnormality that occurs when gastric acid builds up or fills the oesophagus as the lower part of the stomach and lower oesophagus moves above the diaphragm.
  • Excess production of acid in the stomach.
  • Excess consumption of spicy and oily foods.
  • Irregular eating patterns and habits.
  • Side effects of medices.
  • Consumption of alcohol.
  • Being pregnant.
  • Snacking just before bed time.
  • Lying on the back or bending over at waist just after a heavy meal.

SYMPTOMS

Acid reflux is generally characterised by a  burning sensation in the stomach throat and heart. The person with acidity may face difficulty in swallowing, indigestion, constipation, restlessness and prolonged sour taste in mouth. Nausea and bad breath are other common symptoms of acidity.

DIAGNOSIS

Acidity is usually self diagnosable with its symptoms. If it doesn’t help, a doctor may ask you to undergo,

a) an X-ray of stomach and oesophagus.

b)an endoscopy of gastrointestinal tract

TREATMENT

  • Antacids: It helps neutralise the stomach acidity
  • H2  receptor blockers/ histamine blocking agents like nizatidine, famotidine, cimetidine.
  • Home remedies include consuming mint leaves, ginger, clove cardomom, banana , cucumber etc.
  • Drinking a glass of milk every day helps reduce acidity.
  • Follow regular eating patterns.

Choking

Choking is a medical emergency where in a foreign body obstructs the air passage to lungs. It is often life threatening caused due to inhalation or ingestion of food or another object .This obstruction can be partial or complete.Partial obstruction allows some air passage to lungs and compete obstruction prevents air passage to lung. It prevents normal breathing and thus body is deprived of oxygen delivery leading to asphyxia. It can be fatal.

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SYMPTOMS

  • Difficulty in breathing ,gasping and wheezing
  • Difficulty to speak.
  • Clutching, and grabbing of throat or mouth.
  • Person’s face turns blue and may become unconscious.

CAUSES

It occurs when a foreign body blocks the air passage to lungs. The object may block either the upper or lower air passages. The most common causes of choking are food and toys. Nuts, seeds, peanut butter are the causes of choking in children.Toy and toy parts also have high potential to completely block the airway in children.

TREATMENT

  • Alternate back blows and abdominal trust.

a)Five back blows: Stand behind the person choking /kneel down behind a hoking child.Bend the person so that his upper body is parallel to the ground and blow between the shoulder blades using the heel of your hand. Repeat it five times.

b)Wrap the person in your arms at his waist. Position one fist above the person’s navel and hold the fist in the other hand and deliver a hard and quick upward thrust to the abdomen.continue doing this five times.

In case of infants less than one year.

  1. Hold the infant face down in a seated position.
  2. Support his head and neck with your hand so that the head is lower than the trunk.
  3. Blow the infant gently between the shoulder bones using the heels of your arm five times.
  4. If the infant is still not breathing,turn him face up n your fore arm resting on your thigh with the head lower than the trunk.
  5. Give five chest compressions at the center of breast bone using two fingers.Press down to a depth of 1.5 inches and let the chest rise again between each compressions.

 

Alopecia Areata

 

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Alopecia areata is a medical condition in which hair falls out in round patches..It is an autoimmune disease which is affected by one’s genetic makeup along with factors such as stress and extremes of dieting. The fall out of hair can be from the scalp or elsewhere on the body. Though the hair re grows, it may fall out again and often the hair loss lasts for years. It can occur in all age groups and otherwise healthy people.

SYMPTOMS

  • Hair fall out in patches: Patches of hair are usually noticed on one’s pillow or in shower. Hair fall out may occur on scalp, eyebrows, eyelashes and beards.
  • In severe cases some patients go bald
  • Nail problems: Nails show pinpoint pitting, white spots and loss their shine often splits.
  • Exclamation mark hair: Hair may grow narrow at the end and as round patch at the bald end.

CAUSES

It is an autoimmune disease where the body attacks its own hair follicles. It is not contagious. Alopecia areata patients may have a family history of this disease and are at a higher risk for thyroid disease, vitiligo, asthma , eczema and hay fever.

DIAGNOSIS

  • Skin biopsy: A small piece of skin is removed and studied under a microscope by a dermatologist.
  • Blood tests: To look for any chances of other autoimmune diseases.

TREATMENT

Currently there is no approved treatment and complete cure so far. Some immunosuppressants and hair regrow medicines are often prescribed by dermatologists to help hair regrow.

Immunosuppressants like corticosteroids and hair regrow medicines such as minoxidil, anthralin and diphencyprone are some other medicines that triggers allergic reactions that help hair regrowth.

Light therapy or photo chemotherapy is a radiation treatment which uses both oral medication called psoralens and UV light.Essential oils like tea rose, rosemary ,lavender, peppermint and oils like coconut, olive,castor and jojoba help reduce symptoms.

The effectiveness of treatment may vary among patients. However hair regrowth may only be temporary. Hair may regrow and fallout again.

Varicose vein

Varicose veins are swollen, twisted veins that can be visible just under the surface of the skin. Although it usually occurs in the legs, they also can form in other parts of the body also.Varicose vein is quite a common condition.29.varicosevein

Veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.

Causes

Weak or damaged valves in the veins can cause varicose veins. After your arteries and capillaries deliver oxygen-rich blood to your body, your veins return the blood to your heart. The veins in your legs must work against gravity to do this.One-way valves inside the veins open to let blood flow through, and then they shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell.
Weak vein walls may cause weak valves.If these walls become weak, they lose their normal elasticity. They become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it causes the flaps of the valves to separate.When the valve flaps separate, blood can flow backward through the valves. The backflow of blood fills the veins and stretches the walls even more. As a result, the veins get bigger, swell, and often twist as they try to squeeze into their normal space. These are varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.

Associated vein problems

Telangiectasias
Telangiectasias are small clusters of blood vessels usually found on the upper body, including the face.These blood vessels appear red. They may form during pregnancy, and often they develop in people who have certain genetic disorders, viral infections, or other conditions, such as liver disease.Telangiectasias can be a sign of a more serious condition.

Spider Veins
Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body.Spider veins often appear on the legs and face. They’re red or blue and usually look like a spider web or tree branch. These veins usually aren’t a medical concern.

Varicoceles
Varicoceles are varicose veins in the scrotum and may be linked to male infertility.

Other types of varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on the face and neck. Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus.

Diagnosis

Duplex Ultrasound
Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create a picture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through the veins. Duplex ultrasound combined with traditional together gives a picture of the blood flow in your arteries and veins.

Angiogram
Although it is not very common, an angiogram givest a more detailed look at the blood flow through your veins.An angiogram helps to confirm whether you have varicose veins or another condition.

Treatment

Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.For more severe symptoms like pain, blood clots, or skin disorders ,one or more medical procedures may be needed.

Medical procedures

Sclerotherapy
Sclerotherapy uses a liquid chemical which is injected into the vein to cause irritation and scarring inside the vein. It causes the vein to close off, and it fades away.This procedure often is used to treat smaller varicose veins and spider veins.

Microsclerotherapy
Microsclerotherapy  is used to treat spider veins and other very small varicose veins.A small amount of liquid chemical is injected into a vein which scars the inner lining of the vein, causing it to close off.

Laser Surgery
The laser light makes the vein fade away.Laser surgery mostly is used to treat smaller varicose veins. The main advantage is that no cutting or injection of chemicals is involved.

Endovenous Ablation Therapy
Endovenous ablation therapy uses lasers or radiowaves to create heat to close off a varicose vein.A device at the tip of the catheter inserted to the vein heats up the inside of the vein and closes it off.

Endoscopic Vein Surgery
For endoscopic vein surgery, a small cut is made in your skin near a varicose vein. A tiny camera is used at the end of a thin tube to move through the vein and a surgical device at the end of the camera is used to close the vein.Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers.

Ambulatory Phlebectomy

For ambulatory phlebectomy,  doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.

Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.

 

Bronchiectasis

Bronchiectasis is serious!Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD) .It is a lung condition in which the airways to the lungs are damaged making it abnormally wide,scarred and thickened.This extra space allows bacteria and mucus to build up causing recurrent infections and  leading to the blockages of airways.5.feb7BronchiectasisBronchiectasis in Detail

When we breathe, air is carried into lungs through our airways, also called bronchi. The bronchi divide into thousands of smaller airways called bronchioles which contain tiny glands that produce mucus.Mucus is a slimy substance that helps to keep airways moist and traps the dust and germs that are inhaled.The mucus is moved away by tiny hairs, called cilia, which line the airways.
In bronchiectasis, airways are scarred and inflamed with thick mucus, also called phlegm or sputum,airways slowly lose their ability to clear out mucus. When mucus can’t be cleared, it builds up and creates an environment in which more bacteria are breathed in.Bacteria grows in the excess mucus, leading to repeated, serious lung infections.Each infection causes more damage to your airways ,the breathing tubes become baggy and holes form in the lungs.. Over time, the airways lose their ability to move air in and out preventing enough oxygen from reaching your vital organs.This can ultimately lead to the loss of lung function over time, as well as serious health problems such as respiratory failure,heart failure and atelectasis.

Causes

Bronchiectasis can be congenital resulting from an abnormal lung development before birth. Bronchiectasis usually begins with some type of  lung damage which might have been caused by a common childhood infection such as whooping cough or measles, or from a lung-related medical condition such as  cystic fibrosis or primary ciliary dyskinesia.There are two main categories of this condition. One is related to having  cystic fibrosis and is known as CF bronchiectasis. CF is a hereditary condition that causes an abnormal production of mucus.The other category is non-CF bronchiectasis, which isn’t related to CF.

Bronchiectasis can develop in the following conditions:

  • Humoral immunodeficiency (low levels of infection-fighting proteins in the blood)
  • Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
  • Rheumatologic diseases (rheumatoid arthritis and Sjögren’s disease)
  • Alpha1-antitrypsin deficiency (genetic cause of COPD in some people)
  • Chronic obstructive pulmonary disease or COPD
  • HIV infection
  • Allergic bronchopulmonary aspergillosis (a type of allergic lung inflammation)
  • pneumonia
  • Whooping cough or measles
  • Tuberculosis
  • Fungal infection

Symptoms

The most common signs and symptoms of bronchiectasis are:

  • A daily cough that occurs over months or years
  • Daily production of large amounts of sputum (spit). Sputum, which you cough up and spit out, may contain mucus (a slimy substance), trapped particles, and pus.
  • Shortness of breath and wheezing (a whistling sound when you breathe)
  • Chest pain
  • Clubbing (the tissue beneath the nail thickens and the fingertips become rounded and bulbous)
  • Fatigue which is profound

Diagnosis

If your doctor listens to your lungs with a stethoscope, he or she may hear abnormal lung sounds.

Some tests that aid in the diagnosis include:

  • Chest x-ray: A chest x-ray may show some signs of the disease, but other tests (such as a CT) are usually needed to confirm or refute the diagnosis.
  • Chest CT scan: The diagnosis is usually made based on the appearance of a CT scan.
  • Pulmonary function tests can help with the diagnosis as well as the severity.
  • A bronchoscopy may be done to rule out a foreign body or lung cancer.

Treatment

The goals of treatment are to:

  • Treat any underlying conditions and lung infections.
  • Remove mucus (a slimy substance) from your lungs. Maintaining good hydration helps with mucus removal.
  • Prevent complications.

Early diagnosis and treatment of the underlying cause of bronchiectasis may help prevent further lung damage. In addition, any disease associated with the bronchiectasis, such as cystic fibrosis or immunodeficiency, also should be treated.
Medicines
Your doctor may prescribe antibiotics, bronchodilators, expectorants, or mucus-thinning medicines to treat bronchiectasis.
Antibiotics
Antibiotics are the main treatment for the repeated lung infections that bronchiectasis causes. Oral antibiotics often are used to treat these infections.For hard-to-treat infections, your doctor may prescribe intravenous (IV) antibiotics. These medicines are given through an IV line inserted into your arm. Your doctor may help you arrange for a home care provider to give you IV antibiotics at home.Expectorants and Mucus-Thinning MedicinesYour doctor may prescribe expectorants and mucus thinners to help you cough up mucus.
Expectorants help loosen the mucus in your lungs. They often are combined with decongestants, which may provide extra relief. Mucus thinners, such as acetylcysteine, loosen the mucus to make it easier to cough up.
Hydration
Drinking plenty of fluid, especially water, helps prevent airway mucus from becoming thick and sticky. Good hydration helps keep airway mucus moist and slippery, which makes it easier to cough up.
Chest Physical Therapy
CPT also is called physiotherapy (FIZ-e-o-THER-ah-pe) or chest clapping or percussion. This technique is generally performed by a respiratory therapist but can be done by a trained member of the family. It involves the therapist pounding your chest and back over and over with his or her hands or a device. Doing this helps loosen the mucus from your lungs so you can cough it up.You can sit with your head tilted down or lie on your stomach with your head down while you do CPT. Gravity and force help drain the mucus from your lungs.
Some people find CPT hard or uncomfortable to do. Several devices can help with CPT, such as:

  • An electric chest clapper, known as a mechanical percussor.
  • An inflatable therapy vest that uses high-frequency air waves to force mucus toward your upper airways so you can cough it up.
  • A small handheld device that you breathe out through. It causes vibrations that dislodge the mucus.
  • A mask that creates vibrations to help break loose mucus from your airway walls.

Some of these methods and devices are popular with patients and doctors, but little information is available on how well they actually work. Choice usually is based on convenience and cost.
Several breathing techniques also are used to help move mucus to the upper airway so it can be coughed up. These techniques include forced expiration technique (FET) and active cycle breathing (ACB).FET involves forcing out a couple of breaths and then doing relaxed breathing. ACB is FET that involves deep breathing exercises.
Other Treatments
Depending on your condition, your doctor also may recommend bronchodilators, inhaled corticosteroids, oxygen therapy, or surgery.
Bronchodilators
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are inhaled medicines. You will use an inhaler or a nebulizer to breathe in a fine mist of medicine.Inhaled bronchodilators work quickly because the medicine goes straight to your lungs. Your doctor may recommend that you use a bronchodilator right before you do CPT.
Inhaled Corticosteroids
If you also have wheezing or asthma with your bronchiectasis, your doctor may prescribe inhaled corticosteroids (used to treat inflammation in the airways).
Oxygen Therapy
Oxygen therapy can help raise low blood oxygen levels. For this treatment, you’ll receive oxygen through nasal prongs or a mask. Oxygen therapy can be done at home, in a hospital, or in another health facility.
Surgery
Your doctor may recommend surgery if no other treatments have helped and only one part of your airway is affected. If you have major bleeding in your airway, your doctor may recommend surgery to remove part of your airway or a procedure to control the bleeding.In very rare instances of severe bronchiectasis, your doctor may recommend that you receive a lung transplant replacing your diseased lungs with a healthy set of lungs.

To prevent bronchiectasis, it’s important to prevent the lung infections and lung damage that can cause it.Childhood vaccines for measles and whooping cough prevent infections related to these illnesses. These vaccines also reduce complications from these infections, such as bronchiectasis.Avoiding toxic fumes, gases, smoke, and other harmful substances also can help protect your lungs.Proper treatment of lung infections in children also may help preserve lung function and prevent lung damage that can lead to bronchiectasis.Stay alert to keep children (and adults) from inhaling small objects (such as pieces of toys and food that might stick in a small airway). If you think you, your child, or someone else has inhaled a small object, seek prompt medical care.In some cases, treating the underlying cause of bronchiectasis can slow or prevent its progression.

 

Uterine didelphys

We have two kidneys,one brain,one heart. Aren’t the numbers right?Now,can you guess how many uterus a woman can have?Most of you would say ‘one’.But there can be ‘two’ too!In this post,we are discussing one of the  congenital uterus anomaly-uterine didelphys. There are two uterus ,two cervices involved and in many cases two vaginas too.

Formation and malformation

As aforementioned,uterine didelphys is an anomaly and so a result of malformation.4.feb6uterinedidelphys

Now let’s look at the formation of uterus,females fetus ofcourse. The development of the normal female reproductive tract is a complex process. It starts in the womb.The mesonephros , principal excretory organ during early embryonic life (4—8 weeks), appears in humans during the 4th week of gestation and degenerates after 8th week. Draining function of this transient kidney is handled by mesonephric ducts(Wolffian ducts).The ‘indifferent’ or ‘bipotential’ gonad (meaning it appears same for both sexes at this stage) differentiates to the ovary.Two paramesonephric ducts called Müllerian ducts form from coelomic epithelium extending from the vaginal plate to lie beside the developing ovary. The wall between these paired tubes breaks down in its lower aspect (fuse from the vaginal plate end), forming the primordial body of the uterus .And the unfused lateral portion of the paramesonephric ducts form the uterine tubes.
Thus,the mesonephros, Wolffian and Müllerian ducts differentiate in an orchestrated manner to form the uterus, vagina and lower urinary tract. Any disordered differentiation can result in congenital abnormalities affecting the female reproductive tracts, renal tract and lower intestines.When the Müllerian ducts do not fuse completely resulting in complete duplication of uterine horns as well as duplication of the cervix, with no communication between them,it is called uterine didelphys or double uterus.

Other anomalies due to the incomplete fusion are

  • Uterus bicornis
  • Uterus bicornis unicollis rudimentary horn
  • Uterus Arcuatus
  • Atresia of cervix
  • Atresia of vagina

Symptoms and complications

In most women,the condition is asymptomatic.In others,it remains undetected untill menarche,the time when menstrual cycles start in a girl.They can discover this condition as putting a tampon into one of the vaginas does not cause bleeding to stop completely.Since women with uterine didelphys also has vaginal septum or partition in varying degrees,some may present with following symptoms.
Dyspareunia or painful intercourse
Dysmenorrhea or painful periods.This is accompanied by heavy monthly menstrual periods .
In extremely rare cases, genital neoplasms(tumor of the genital system) and renal anomalies are reported.

The condition is in most cases diagnosed when women undergo frequent miscarriages.It usually do not hinder woman becoming pregnant.One of the uteri is usually bigger and better than the other, which is also composed of stronger tissues and muscles, which can support implantation which occurs once she conceives. That is why, women with double uterus can carry their babies only in the stronger one.
The pregnancy in these women is classified as high risk .The pregnancy complications associated are reccurent miscarriages,late miscarriage,pre term delivery and still births.Term deliveries of untreated didelphys uterus is approximately 45%.
Despite these complications, there are many women that did not exhibit any gestational challenges.Some percentage of women can go on to have full term and healthy babies.The delivery would normally require a C section.Also a very few cases are known where these women delivered vaginally.
For those of women who do not face pregnancy problems,contraception may pose an issue.Often the two uteri are of unequal size, so fitting an intrauterine device to each may not be possible.They will need to use contraceptive pills which can work like for any other normal woman.

Diagnosis

  • Hysterosalpingography for Double Uterus Diagnosis: This method of examination make use of a dark colored dye which is filled into the uterus which is followed by taking X rays of the reproductive organs. As the uterus is filled with colored dye, a clear image of the shape of uterus can be observed in the images taken by the X-rays.However, these methods rely on the clinician’s subjective interpretation rather than strict diagnostic criteria
  • Ultrasound Test is Conducted to Diagnose Double Uterus: The use of 3D ultrasound is becoming more commonly used for diagnosis as it is not only noninvasive, but it also overcomes the limitation of 2D ultrasound by providing a coronal view that enables examination of both the endometrial cavity and uterine fundus, thus giving all the information needed for morphological classification.Modern ultrasounds make use of advanced transducers that are capable of producing a 3-D image of the tissue. It is more effective than traditional ultrasound.
  • Sonohysterogram: This is a special type of ultrasound for diagnosing double uterus in which the uterus is filled with a fluid before carrying out ultrasound scan. Usually a tube is first inserted into the uterus through which the fluid is filled into the uterus. It gives a better view of the vagina to the doctor and helps him in proper diagnoses of condition.
  • Magnetic Resonance Imaging (MRI): It is an advanced method of imaging which is more effective than ultrasound for double uterus. It consists of tunnel shaped MRI machine that is open at both the ends. The person to be examined is made to lie on a table that is moved into this tunnel. This tunnel shaped machine produces a combination of radio waves and magnetic waves to produce a 3 dimensional image of the complete body.

Treatment

It is the degree of the müllerian malformation that bears the most important consequences on reproductive outcome rather than the type of malformation encountered.Generally, women with this condition should make sure to work closely with a doctor during pregnancy to watch for signs of pre term or other risks to the baby. These women will likely need an obstetrician who specializes in high-risk pregnancies.
Before conceiving, a woman with a double uterus should discuss her plans to become pregnant with her physician. Doctors may perform surgery to unify the uterus or to remove an underdeveloped uterus if a woman is having health problems.
Surgery is rarely performed for the condition, though. It’s usually reserved for women who’ve had repeated pregnancy problems. A physician may also help such women take additional steps to lower their risk of complications during pregnancy, labor, and delivery.

 

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