Dialysis Introduction Type And Principle Of Peritoneal Dialysis

Introduction:

Dialysis is the artificial process of getting rid of waste (diffusion) and unwanted water (ultrafiltration) from the blood. This process is naturally done by kidneys. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly - they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function . Dialysis may be used for people who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function (stage 5 chronic kidney disease). Dialysis  need  when people develop end stage kidney failure --usually by the time people lose about 85 to 90 percent of kidney function.

Types Of Dialysis:

There are two main types of dialysis.

1. Hemodialysis:

The blood circulates outside the body of the patient , it goes through a machine that has special filters. The blood comes out of the patient through a catheter (a flexible tube) that is inserted into the vein. The filters do what the kidney's do; they filter out the waste products from the blood. The filtered blood then returns to the patient via another catheter.

Patients need to be prepared for hemodialysis: A blood vessel, usually in the arm, needs to be enlarged. . The enlarged vein makes the insertion of the catheters possible. US researchers have developed a new way of growing blood vessels using patients' own skin cells to seed the growth of tissue and have tested it in dialysis patients with end stage kidney disease.

Hemodialysis usually lasts about 3 to 4 hours each week. The duration of each session depends on how well the patient's kidneys work, and how much fluid weight the patient has gained between treatments. Hemodialysis is either done in a special dialysis center in a hospital.

2. Peritoneal Dialysis :

A sterile (dialysate) solution rich in minerals and glucose is run through a tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal membrane acts as a semi-permeable membrane.

The abdomen is the area between the chest and hips , it contains the stomach, small intestine, large intestine, liver, gall bladder, pancreas and spleen. Peritoneal dialysis uses the natural filtering ability of the peritoneum ,the internal lining of the abdomen. In other words, peritoneal dialysis uses the lining of the abdomen as a filter of waste products from the blood.

The dialysate is left there for some time so that it can absorb waste products. Then it is drained out through a tube and discarded. This exchange, or cycle, is generally repeated several times during the day - with an automated system it is often done overnight. The elimination of unwanted water (ultrafiltration) occurs through osmosis - as the dialysis solution has a high concentration of glucose, it results in osmotic pressure which causes the fluid to move from the blood into the dialysate. Consequently, a larger quantity of fluid is drained than introduced.

Although peritoneal dialysis is not as efficient as hemodialysis, it is carried out for longer periods. The net effect in terms of total waste product and salt and water removal is about the same as hemodialysis.

Peritoneal dialysis is done at home by the patient; by a willing and motivated patient. It gives the patient a greater amount of freedom and independence because he/she does not have to come in to the clinic at multiple times each week. It can also be done while traveling with a minimum of specialized equipment. Peritoneal dialysis is said to 'save lives and save money'.

Before having peritoneal dialysis, the patient needs to have a small surgical procedure to insert a catheter into the abdomen. This is kept closed off, except when fluid is being introduced or taken out of the abdomen.

There are two principal types of peritoneal dialysis:

1. Continuous ambulatory peritoneal dialysis (CAPD) :

This requires no machinery and can be done by the patient or a caregiver. The dialysate is left in the abdomen for up to eight hours. It is then replaced with a fresh solution straight away. This happens every day, about four to five times per day.

2. Continuous cyclic peritoneal dialysis (CCPD) :

A machine does the dialysis fluid exchanges. It is generally done during the night while the patient sleeps. This needs to be done every night. Each session lasts from ten to twelve hours. After spending the night attached to the machine, the majority of people keep fluid inside their abdomen during the day. Some patients may require another exchange during the day. A study found that a significant number of patients prefer "dialysis while patient sleep" treatment.

Latest Procedure Of Laparoscopic cholecystectomy

Procedure:

• To begin the operation, the patient is placed in the supine position on the operating table and anesthetized.

• Disinfect the skin of patient using antiseptic lotion like savlon,betadin,spirit.

• Maintain the sterile technique during procedure.

•  A scalpel is used to make a small incision at the umbilicus

•  Using either a Veress needle or Hasson technique the abdominal cavity is entered.

• The surgeon inflates the abdominal cavity with carbon dioxide to create a working space.

• The camera is placed through the umbilical port and the abdominal cavity is inspected.

• Additional ports are opened inferior to the ribs at the epigastric, midclavicular, and anterior axillary positions.

• The gallbladder fundus is identified, grasped, and retracted superiorly. 

• With a second grasper, the gallbladder infundibulum is retracted laterally to expose and open Calot's Triangle (the area bound by the cystic artery, cystic duct, and common hepatic duct). 

• The triangle is gently dissected to clear the peritoneal covering and obtain a view of the underlying structures.

• The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut.

• Then the gallbladder is dissected away from the liver bed and removed through one of the ports

Recently, this procedure is performed through a single incision in the patient's umbilicus. This advanced technique is called Laparoendoscopic Single Site Surgery or "LESS".

AIDS Definition Defference between HIV and AIDS Symptoms Transmitted And Prevention

Definition of AIDS:

Acquired immune deficiency syndrome, or AIDS, is a condition that describes an advanced state of HIV infection. With AIDS, the virus has progressed, causing significant loss of white blood cells (CD4 cells) or infections that result from immune system damage. 

Difference between HIV and AIDS:

• HIV is the virus which attacks the T-cells in the immune system.But AIDS is the syndrome which appears in advanced stages of HIV infection. 

• HIV is a virus. But AIDS is a medical condition. 

• HIV testing can identify infection in the early stages. This allows the patient to use prophylactic (preventive) drugs which will slow the rate at which the virus replicates, delaying the onset of AIDS. But AIDS patients still have the HIV virus and are still infectious. Someone with AIDS can pass HIV to someone else. 

Symptoms:

Symptoms of early HIV infection may include: 

• Fever 
• Chills 
• Joint pain 
• Muscle ache 
• Sore throat 
• Sweats (particularly at night) 
• Enlarged glands 
• A red rash 
• Tiredness 
• Weakness 
• Weight loss 

Signs and symptoms of late-stage HIV infection may include:

• Blurred vision 
• Diarrhea, which is usually persistent or chronic 
• Dry cough 
• Fever of above 37C (100F) lasting for weeks 
• Night sweats 
• Permanent tiredness 
• Shortness of breath 
• Swollen glands lasting for weeks 
• Weight loss 
• White spots on the tongue or mouth 

Transmitted:

HIV can be transmitted through:

• Sexual transmission: It can happen when there is contact with infected sexual secretions (rectal, genital or oral mucous membranes). This can happen while having unprotected sex, including vaginal, oral and anal sex or sharing sex toys with someone infected with HIV. 

• Perinatal transmission: The mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding. 

• Blood transmission: The risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries, thanks to meticulous screening and precautions. Among drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.

The virus CANNOT be transmitted from:

• Shaking hands 
• Hugging 
• Casual kissing 
• Sneezing 
• Touching unbroken skin 
• Using the same toilet 
• Sharing towels 
• Sharing cutlery 
• Mouth-to-mouth resuscitation 

Prevention: 

• Protected sex: Having sex without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV. 

• Drug abuse nd neeadle sharing: Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C.

• Body fluid exposure: Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood. At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. 

• Pregnancy: Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the baby´s health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected. A study by scientists from Columbia University, New York, found that breastfeeding for 6+ months with antiretroviral therapy could help reduce mother-to-child HIV transmission as well as improve chances of infant's survival. 

• Education. Health education is an important factor in reducing risky behavior. 

List Of Latest HIV Medicines

List of HIV medicine:

• Nucleoside analog reverse transcriptase inhibitors- These drugs can block HIV's ability to copy a cell's DNA. Without complete DNA, HIV can't make new virus copies. These HIV medicines include the following:

1. Zidovudine, also known as AZT (brand name: Retrovir)
2. Didanosine, also known as ddI (brand name: Videx)
3. Zalcitabine, also known as ddC (brand name: Hivid)
4. Lamivudine, also known as 3TC (brand name: Epivir)
5. Stavudine, also known as d4T (brand name: Zerit)
6. Abacavir, also known as ABC (brand name: Ziagen

• Non-nucleoside reverse transcriptase inhibitor- Also doing same function as above but better way and faster. These HIV medicines include the following.

1. Delavirdine (brand name: Rescriptor)
2. Nevirapine (brand name: Viramune)
3. Efavirenz, also known as EFV

• Protease inhibitors- Will prevent infected cells from releasing HIV Medicine into the body. Type of medicinesare following-

1. Saquinavir (brand name: Invirase)
2. Indinavir (brand name: Crixivan)
3. Nelfinavir (brand name: Viracept)
4. Ritonavir (brand name: Norvir)
5. Amprenavir (brand name: Agenerase)

Fusion inhibitors- Prevent HIV from entering in to CD4 cells- Examples-

Enfuvirtide (brand name: Fuzeon)

NOTE:Please to be used after Doctor advice.

Gastroenteritis Definition Cause Symptoms Treatment Prevention And Vaccination

Definition:
Gastroenteritis is a medical condition characterized by inflammation of the gastrointestinal tract that involves both the stomach and the small intestine.

Causes:

Gastroenteritis has many causes. Viruses and bacteria are the most common.Gastroenteritis caused by viruses may last 1-2 days. On the other hand, bacterial cases can last a week or more.

Bacteria: These are the most common bacterial causes:

• Escherichia coli - Traveler’s diarrhea, food poisoning, dysentery, colitis, or uremic syndrome.
• Salmonella - Typhoid fever; handling poultry or reptiles such as turtles that carry the germs.
• Campylobacter - Undercooked meat, unpasteurized milk.
• Shigella - Dysentery

Viruses: Viral outbreaks (30-40% of cases in children) can spread rapidly through close contact among children in day care and schools. Poor handwashing habits can spread viruses. Common viral causes include the following:

• Adenoviruses
• Rotaviruses
• Caliciviruses
• Astroviruses
• Norovirus 

Parasites and protozoans: These tiny organisms are less frequently responsible for intestinal irritation.May pick up one of these by drinking contaminated water. Swimming pools are common places to come in contact with these parasites. Common parasites include these:

• Giardia - The most frequent cause of waterborne diarrhea causing giardiasis.
• Cryptosporidium - Affects mostly people with weakened immune systems, causes watery diarrhea

Other common causes: Chemical toxins most often found in seafood, food allergies, heavy metals, antibiotics, and other medications also may be responsible for bouts of gastroenteritis that are not infectious to others.

Medications:

• Aspirin
• Nonsteroidal anti-inflammatory medicines (such as Motrin or Advil)
• Antibiotics
• Caffeine
• Steroids - Excessive use or a sudden change in frequency or dosage
• Laxatives

Symptoms:

• Abdominal gas, bloating or belching
• Abdominal pain or cramps
• Blood-streaked stools
• Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
• Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach
• Vomiting including multiple episodes
• Watery diarrhea including multiple episodes
• Weakness

Treatment:

Treatment generally involves a multifaceted plan that addresses the cause; minimizes the discomfort of nausea, vomiting, and diarrhea; and decreases the risk of dehydration.

• Not eating solid foods to rest the stomach and intestines until symptoms have passed.

• Drinking plenty of fluids (water or rehydrating fluid, such as Pedialyte) to ensure adequate hydration.

• In some cases, medications are used to treat gastroenteritis. Antibiotics may be prescribed when gastroenteritis is caused by a bacterial infection, such as in bacterial food poisoning due to Shigella,Salmonella, or Campylobacter infection.

Treatment of severe gastroenteritis that does not resolve or leads to dehydration may require hospitalization and rehydration with intravenous fluids.

Prevention:

• A supply of easily accessible uncontaminated water and good sanitation practices are important for reducing rates of infection and clinically significant gastroenteritis.

• Personal measures (such as hand washing) have been found to decrease incidence and prevalence rates of gastroenteritis in both the developing and developed world by as much as 30%. Alcohol-based gels may also be effective.

• Breastfeeding is important, especially in places with poor hygiene, as is improvement of hygiene generally.

• Breast milk reduces both the frequency of infections and their duration.

• Avoiding contaminated food or drink should also be effective.

Vaccination:

Due to both its effectiveness and safety, in 2009 the World Health Organization recommended that the rotavirus vaccine be offered to all children globally Two commercial rotavirus vaccines exist and several more are in development. In Africa and Asia these vaccines reduced severe disease among infants and countries that have put in place national immunization programs have seen a decline in the rates and severity of disease.This vaccine may also prevent illness in non-vaccinated children by reducing the number of circulating infections.Since 2000, the implementation of a rotavirus vaccination program in the United States has substantially decreased the number of cases of diarrhea by as much as 80 percent. The first dose of vaccine should be given to infants between 6 and 15 weeks of age.The oral cholera vaccine has been found to be 50–60% effective over 2 years.

Balance Diet For Tuberculosis Patient Some tips for a balanced diet

Balance Diet For Tuberculosis Patient 

Tuberculosis is a disease caused by an infection of a bacterium known as Mycobacterium tuberculosis. The  only  way to cure tuberculosis is through a rigorous course of antibiotics prescribed by  doctor. The average duration of treatment is around six months to a year. A healthy balanced diet can help prevent of  malnutrition .

Some tips for a balanced diet 

• Consume an adequate amount of fruit and vegetables but stay within the correct calorie level for a healthy weight. On a 2000-calorie diet, eat 2 cups of fruit and 2 and a half cups of vegetables per day. Eat more or less according to calorie needs.

• Eat a variety of fruit and vegetables each day. Choose from all five vegetable sub-groups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.

• Consume 3 or more ounce-equivalents of whole-grain foods each day, with the rest of the recommended grains coming from enriched or whole-grain products. At least half  grains should come from whole grains. Eating at least 3 ounce-equivalents of whole grains per day can reduce the risk of heart disease, may help with weight maintenance, and will lower health risk for other chronic diseases.

• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. Adults and children can consume milk and milk products without worrying that these foods lead to weight gain. There are many fat-free and low-fat choices without added sugars that are available and consistent with an overall healthy dietary plan. If a person has difficulty drinking milk, ...choose alternatives within the milk food group, such as yogurt or lactose-free milk, or consume the enzyme lactase prior to the consumption of milk products. For people who must avoid all milk products (e.g. individuals with lactose intolerance, vegans), non-dairy calcium-containing alternatives may be chosen to help meet calcium needs.

• Eat a variety of protein rich foods, with more fish, beans, peas, nuts and seeds.

• Eat less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day.

• Choose low-sodium foods, and do not add salt when cooking. Also, eat potassium-rich foods, such as fruits and vegetables.

Checking Of Vital Sing Definition Purpose And Procedure

Definition:

Vital signs are the measurement of body temperature, pulse rate, respiration rate, and blood pressure. Vital signs are indicators of one's overall health. They offer clues to diseases and help evaluate progress toward recovery. Vital signs should be taken at rest. Any abnormal findings should be repeated in order to verify the findings.All of these vital signs can be observed, measured, and monitored. This will enable the assessment of the level at which an individual is functioning. Normal ranges of measurements of vital signs change with age and medical condition.

Purpose:

• The purpose of recording vital signs is to establish a baseline on admission to a hospital, clinic, professional office, or other encounter with a health care provider.  The health care professional has the responsibility of interpreting data and identifying any abnormalities from a person's normal state, and of establishing if current treatment or medications are having the desired effect.
• Abnormalities of the heart are diagnosed by analyzing the heartbeat (or pulse) and blood pressure. The rate, rhythm and regularity of the beat are assessed, as well as the strength and tension of the beat, against the arterial wall.
• The vital signs are recorded and compared with normal ranges for a person's age and medical condition. Based on these results, a decision is made regarding further actions to be taken.
• All persons should be made comfortable and reassured that recording vital signs is normal part of health checks, and that it is necessary to ensure that the state of their health is being monitored correctly. 

Procedure Of Vital Checking :

• Body temperature

Body temperature is taken with a thermometer.In general, the normal oral temperature is 98.6 degrees Fahrenheit (or 37 degrees Centigrade).The most common places to measure temperature include: 

• The mouth (oral temperature)
• Under the arm (axillary temperature)
• The anus (rectal temperature)

To record the temperature using  mercury thermometer, one should shake down the thermometer by holding it firmly at the clear end and flicking it quickly a few times, with the silver end pointing downward.   who is taking the temperature should confirm that the alcohol or mercury is below a normal body temperature.

To record an axillary temperature, the silver tip of the thermometer should be placed under the right armpit. The arm clamps the thermometer into place, against the chest. The thermometer should stay in place for three to four minutes. After the appropriate time has elapsed, the thermometer should be removed and held at eye level. During this waiting period, the body temperature will be measured The mercury will have risen to a mark that indicates the temperature of a person.

To record an oral temperature, the axillary procedure should be followed, except that the silver tip of the thermometer should be placed beneath the tongue for three to four minutes, then read as described previously.

In both cases, the thermometer should be wiped clean with an antiseptic and stored in an appropriate container to prevent breakage.

To record a rectal temperature, a rectal thermometer should be shaken down, as described previously. A small amount of water-based lubricant should be placed on the colored tip of the thermometer. Infants must be placed on their stomachs and held securely in place. The tip of the thermometer is inserted into the rectum no more than 0.5 in (1.3 cm) and held there for two to three minutes. The thermometer is removed, read as before, and wiped with an antibacterial wipe. It is then stored in an appropriate container to prevent breakage, because ingestion of mercury can be fatal.

• Pulse rate and rhythm

Checking  pulse rate is counting the number of times your beats in a minute. Pulse checks can be taken at the wrist (radial pulse) or at the neck (carotid pulse). Do not use your thumb; instead use your index and middle fingers. A resting adult heart rate should be between 60 and 90 beats a minute, average is 72 beat a minute.  Athletes may have lower rates. Children, depending on their age, will have higher pulse rates. 

• Respiratory rate

Checking  respiratory rate is counting the number of times take a breath in a minute. The best time to check the respiratory rate is at rest. To do this, count the number of times the chest rises for one full minute while breathing normally. The normal adult rate is 16 to 20 breaths per minute. Children breathe faster.

• Blood pressure

 The average blood pressure is 120 millimeters of mercury (systolic-the upper number), over 80 millimeters of mercury (diastolic-the lower number). A resting blood pressure of over 90 diastolic is considered mildly elevated; over 100 may require treatment.

If the blood pressure is monitored manually, a cuff is placed level with the heart and wrapped firmly but not tightly around the arm one inch above the elbow over the brachial artery. Wrinkles in the cuff should be smoothed out. Positioning a stethoscope over the brachial artery in front of the elbow with one hand and listening through the earpieces, the cuff is inflated well above normal levels (to about 200 mmHg), or until no sound is heard. Alternatively, the cuff should be inflated 10 mm Hg above the last sound heard. The valve in the pump is slowly opened. Air is allowed to escape no faster than 5 mmHg per second to deflate the pressure in the cuff to the point where a clicking sound is heard over the brachial artery. The reading of the gauge at this point is recorded as the systolic pressure.

The sounds continue as the pressure in the cuff is released and the flow of blood through the artery is no longer blocked. At this point, the noises are no longer heard. The reading of the gauge at this point is noted as the diastolic pressure. "Lub-dub" is the sound produced by the normal heart as it beats. Every time this sound is detected, it means that the heart is contracting once. The noises are created when the heart valves click to close. When one hears "lub," the atrioventricular valves are closing. The "dub" sound is produced by the pulmonic and aortic valves.

Seizure Disorder Definition Type Cause treatment And Prevention

Seizure Disorder 

Definition
A seizure is a sudden disruption of the brain's normal electrical activity accompanied by altered consciousness and/or other neurological and behavioral manifestations. Epilepsy is a condition characterized by recurrent seizures that may include repetitive muscle jerking called convulsions.

Type Of Seizure Disorder

There are two basic types of seizures:

• Epileptic: These seizures have no apparent cause  and occur repeatedly. These seizures are called a “seizure disorder” or “epilepsy.”
• Nonepileptic: These seizures are triggered (provoked) by a disorder or another condition that irritates the brain. In children, a fever can trigger a nonepileptic seizure.

Causes

The origin of 50-70% of all cases of epilepsy is unknown.

• Head trauma resulting from a car accident, gunshot wound, or other injury.
• Alcoholism
• Brain abscess or inflammation of membranes covering the brain or spinal cord
• Phenylketonuria (PKU, a disease that is present at birth, often is characterized by seizures, and can result in mental retardation) and other inherited disorders
• Infectious diseases like measles, mumps, and diphtheria
• Lead poisoning, mercury poisoning, carbon monoxide poisoning, or ingestion of some other poisonous substance
• Suddenly discontinuing anti-seizure medication
• Hypoxic or metabolic encephalopathy (brain disease resulting from lack of oxygen or malfunctioning of other physical or chemical processes)
• Acute head injury
• Blood infection caused by inflammation of the brain or the membranes that cover it

Symptoms:

• Chew or smack the lips involuntarily
• Move the hands, arms, and legs in strange, purposeless ways
• Utter meaningless sounds
• Have severe muscle spasms and jerking throughout the body
• Fall down
• Forcefully turn their head to one side
• Clench their teeth
• Bite their tongue (often occurs)
• Drool or froth at the mouth
• Lose bladder control

Treatment:
 Long-term anticonvulsant drug therapy is the most common form of epilepsy treatment.
Medication
A combination of drugs may be needed to control some symptoms, but most patients who have epilepsy take one of the following medications:

• Dilantin (phenytoin)
• Tegretol (carbamazepine)
• Barbita (phenobarbital)
• Mysoline (primidone)
• Depakene (valproic acid, sodium valproate)
• Klonopin (clonazepam)
• Zarontin (ethosuximide).

First aid for seizures:

• A person having a grand mal seizure should be helped to lie down.
• Tight clothing should be loosened. 
• A soft, flat object like a towel or the palm of a hand should be placed under the person's head.
• Forcing a hard object into the mouth of someone having a grand mal seizure could cause injuries or breathing problems. 
• If the person's mouth is open, placing a folded cloth or other soft object between his teeth will protect his tongue. 
• Turning his head to the side will help him breathe. 
• After a grand mal seizure has ended, the person who had the seizure should be told what has happened and reminded of where he is.

Prevention:

All Natural Supplementary 

• Eating properly.
• Getting enough sleep.
• Controlling stress and fevers can help prevent seizures. 
• A person who has epilepsy should be careful not to hyperventilate. 
• A person who experiences an aura should find a safe place to lie down and stay there until the seizure passes. 
• Anticonvulsant medications should not be stopped suddenly and, if other medications are prescribed or discontinued, the doctor treating the seizures should be notified.
• In some conditions, such as severe head injury, brain surgery, or subarachnoid hemorrhage, anticonvulsant medications may be given to the patient to prevent seizures.

Name Of Oral Drugs For Neuropathic Pain

 Name Of  Oral  Drugs For Neuropathic Pain 

Neurontin Oral

• Effexor XR Oral
• Tramadol Oral
• Neurontin Oral
• OxyContin Oral
• Pristiq Oral
• Gabapentin Oral
• Lamictal Oral
• amitriptyline Oral
• Ultram Oral
• Morphine Oral
• Nortriptyline Oral
• Venlafaxine Oral
• Kadian Oral
• lamotrigine Oral
• Roxicodone Oral
• Avinza Oral
• Ultram ER Oral
• Pamelor Oral
• Imipramine HCl Oral
• Tofranil Oral
• Lamictal ODT Oral
• Ryzolt Oral

Gabapentin Oral

• Lamictal XR Oral 
• Desipramine Oral
• Lamictal Starter (Blue) Kit Oral
• Norpramin Oral
• Desvenlafaxine Oral
• Gralise Oral
• ConZip ER Oral
• Fanatrex Oral
• Oxecta Oral

NOTE:Please to be used after Doctor advice.

Hair Care Tips

Washing And Drying

• Hair should be washed around 2 – 3 times a week.

• Shampoo is applied to the scalp and allowed to run down the hair.

• Conditioner is applied from the ends up, avoiding the scalp.

• During shampooing, massage your scalp gently, rather than rubbing vigorously

• To avoid irritating the scalp, or damaging hair roots, which may attribute to hair loss.

• Avoid using water that is too hot.

• Remember: hair is most fragile when wet. Avoid too much manipulation until it has dried partially at least.

• Use a hair dryer as soon as you’re out of the shower.

• It is best to pat the hair dry. Avoid excessive rubbing with the towel.

• When possible, opt for air drying rather than heat drying.

• When heat drying, start out with a lower heat setting and then go higher gradually.

• When hair is wet, water is actually inside the hair. If heated too quickly, water starts boiling inside the hair, leading to bubble formation and hair rupture.

• Do not sleep with your hair wet ..

• Applying direct heat to the scalp can cause burns, damage hair roots, or in the least irritate the scalp enough to cause itching and flaking. 

• Try to start about an inch away from the roots.

Brushing

• Never brush too harshly or pull on the hair when tied or in a roller to prevent damaging the follicle which may lead to hair loss.

• Contrary to a popular myth, boar bristle brushes are not better for hair.

• It is best to stick to the more readily available plastic brushes.

• Teasing or backcombing should be kept to a minimum as it damages the hair.

• Do not allow the comb to hit or scratch the scalp. 

• Avoid scratching, which can damage the hair.

Cutting

• To keep hair looking healthy, it should be trimmed often: about half an inch every 2 months.

• Very short hair should be trimmed more frequently to keep the short style looking tidy (every 1 – 2 months).

• To grow hair out, trimming still has to be done, but trims should be kept further apart (every 2 -3 months).

Coloring

• The more permanent the hair dye is, the more damaging it is to the hair.

• As a general rule, going darker is less damaging than going lighter.

• Hair that is dyed or bleached is fragile, dull, dry, and more easily affected by humidity.

• Always condition hair to give it back some of its luster and strength and to avoid breakage.

Hair Care Tips, Prevention Of Hair Loss

Prevention Of Hair Loss 

• Getting proper nutrition is essential for healthy hair.

• Water, protien, biotin (part of the vitamin B complex), vitamins A, B6, B12, C, copper, iron, omega 3 fatty acids, zinc, calcium, folic acid, and magnesium all play a part in maintaining a healthy scalp, skin, and hair.

• Using  fingertips to massage  scalp will increase circulation in scalp which is important for hair growth.

• Gentle combing or brushing of hair will help break up hardened oils that clog pores. It is recommended that  comb or brush 100-200 strokes in the morning and at night.

• Avoid excessive wind, sun, and heat (such as from hair dryers, hot showers, and curling irons) on  hair.

• Tight fitting caps and hats will cause poor circulation in scalp and will also cause build-up of sweat and grime.

• Try to reducing stress by taking some time out daily just to relax, excessive stress is believed to induce hair loss.

• Limit coloring it to once every 2 months hair coloring damages hair and the less frequently color it the better.

• Avoid putting too much physical stress on  hair, brush/comb hair gently, don't pull  hair when  brush and avoid braids and ponytails if possible, they place constant stress on hair.

• Get enough sleep.

• Use a conditioner and trim any split ends.

Latest Skin Care Tips

Beautiful Skin

• To make or keep skin beautiful, it's best to work from the inside.
• Eating the right kind of food can do more good than any medicine.
• Go a long way in helping body's own healing forces.
• Eat a balanced diet that includes raw foods, plenty of yellow and orange vegetables (they contain beta carotene - a precursor to vitamin A).
• Foods high in sulfur such as garlic, onions, asparagus and eggs.
• Include fruits, seeds, grains and nuts.
• Many find Stevens Skin Softener Cream very helpful for these situations.

Dry Skin

• Blend together one ounce safflower oil, one ounce avocado oil and two ounces of sesame oil.
• Apply this to dry skin areas.
• An excellent facial mask can be made with stewed and mashed apricots.
• Apply to  freshly cleaned face and leave for 20 minutes or longer. 
• Rinse away with warm water, and blot dry.
• One application will help sallow, dead skin tones, but applying this 3 or 4 times a week will do wonders.

Itchy Skin

Softener Cream 

• A compress made with skim milk or powdered milk or soak the affected area in a colloidal bath made with oatmeal, corn starch or baking soda.
• Homemade Skin Lotion
• Mix one teaspoonful of honey, one teaspoon of lemon juice and a half cup of water.
• Massage into  skin after bathing.
• Many find Stevens Skin Softener Cream very helpful for these situations.

Mayonnaise for dry Facial

For a tendency towards dry facial skin, a gentle daily massage with mayonnaise will do wonders.

Can use lemon juice, egg and safflower or other such oil to make your own dry skin lotion.

Oily Skin

• Here is a cleansing stimulating facial treatment that is very helpful for those with oily skin. 
• Mash together the pulp of one garden ripe tomato and enough fuller's earth (should find it at most pharmacies) to make a smooth paste.
• Rub it into skin and leave it on until it dries completely (note: do not apply to eye area). 
• Rinse with warm water, then splash  face with cold water. Blot dry.

Rashes

Whether it's diaper rash, chicken pox, measles, insect bites or hives, corn starch can provide relief. 

For measles and chicken pox, bathe in a tub of water to which a large handful of cornstarch has been added. For the other rashes rub the cornstarch on as a powder.

Softening Of Skin

Avocado oil used regularly is an excellent skin softener. It is in rich in vitamins and minerals, especially the skin vitamins A, C and E.

Teenagers

Many teenagers have to deal with embarrassing skin problems. taking supplements of zinc and Vitamin A will go a long way in helping them relieve these problems.Many find Stevens Skin Softener Cream very helpful for these situations.

Ulcers

Leg ulcers are more likely to develop in persons with poor circulation, thrombophlebitis and/or varicose veins. To speed healing, apply vitamin E oil to the sore and bandage it lightly with a sterile gauze pad. Change the bandage daily until the sore is healed.

Vitamins and Skin

Vitamins are essential to the health of skin, especially vitamins A, B, C and E. Vitamin E is especially helpful to improve your complexion when applied externally.

Winter Care

• The air inside your house can get very dry in the winter.
• This will play a major part in aggravating  dry skin condition. 
• To add humidity the dry air in house, put a little extra water in the kettle when boiling water. Leave the kettle on the burner as it cools. It will continue to steam for 10 to 15 minutes, making  life a whole lot more comfortable.

Asthma Definition Causes Symptoms Diagnosis And Medication Of Asthama

Definition:

Asthma is a disease affecting the airways that carry air to and from lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.The inside walls of an asthmatic's airways are swollen or inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases susceptibility to an allergic reaction.As inflammation causes the airways to become narrower, less air can pass through them, both to and from the lungs.  Asthma is Incurable disease.

Causes Asthma:

The exact cause of asthma isn't known. Researchers think some genetic and environmental factors interact to cause asthma. These factors include:

• An inherited tendency to develop allergies, called atopy.
• Parents who have asthma.
• Certain respiratory infections during childhood.
• Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing. 

Symptoms:

• Coughin
• Wheezing (a hissing sound while breathing)
• Chest tightness
• Breathing problems( Shortness of breath.) 

 Causes of Asthma Symptoms To Occur:

Many things can trigger or worsen asthma symptoms.  Triggers can include:

• Allergens from dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers
• Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products, and sprays (such as hairspray).
• Medicines such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
• Sulfites in foods and drinks
• Viral upper respiratory infections, such as colds
• Physical activity, including exercise

Diagnosis:

• Allergy testing to find out which allergens affect .
• A test to measure how sensitive airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures  lung function during physical activity or after  receive increasing doses of cold air or a special chemical to breathe in.
• A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object in airways.

Medication Of Asthama:

Medications used to treat asthma are divided into two general classes: quick-relief medications used to treat acute symptoms; and long-term control medications used to prevent further exacerbation.

• Short acting beta2-adrenoceptor agonists (SABA), such as salbutamol are the first line treatment for asthma symptoms.
• Anticholinergic medications, such as ipratropium bromide, provide additional benefit when used in combination with SABA in those with moderate or severe symptoms.Anticholinergic bronchodilators can also be used if a person cannot tolerate a SABA
• Older, less selective adrenergic agonists, such as inhaled epinephrine, have similar efficacy to SABAs.
• Glucocorticoids are generally considered the most effective treatment available for long term control.Inhaled forms are usually used except in the case of severe persistent disease, in which oral steroids may be needed.It is usually recommended that inhaled formulations be used once or twice daily, depending on the severity of symptoms.
• Long acting beta-adrenoceptor agonists (LABA) have at least a 12-hour effect. The FDA has issued a public health advisory recommending that these drugs should not be used without an accompanying steroid due to an increased risk of severe symptoms, including severe exacerbation of asthma in both children and adults.
• Leukotriene antagonists (such as zafirlukast) are an alternative to inhaled glucocorticoids, but are usually not preferred. They may also be used in addition to inhaled glucocorticoids but in this role are second line to LABA.
• Mast cell stabilizers (such as cromolyn sodium) are another non-preferred alternative to glucocorticoids.
• Medications are typically provided as metered-dose inhalers (MDIs) in combination with an asthma spacer or as a dry powder inhaler. The spacer is a plastic cylinder that mixes the medication with air, making it easier to receive a full dose of the drug. A nebulizer may also be used. Nebulizers and spacers are equally effective in those with mild to moderate symptoms however insufficient evidence is available to determine whether or not a difference exists in those severe symptomatology.

When asthma is unresponsive to usual medications, other options are available for both emergency management and prevention of flareups. For emergency management other options include:

• Oxygen is used to alleviate hypoxia if saturations fall below 92%.
• Magnesium sulfate intravenous treatment has been shown to provide a bronchodilating effect when used in addition to other treatment in severe acute asthma attacks.
• Heliox, a mixture of helium and oxygen, may also be considered in severe unresponsive cases.
• Intravenous salbutamol is not supported by available evidence and is thus used only in extreme cases.
• Methylxanthines (such as theophylline) were once widely used, but do not add significantly to the effects of inhaled beta-agonists.
• The dissociative anesthetic ketamine is theoretically useful if intubation and mechanical ventilation is needed in people who are approaching respiratory arrest.

Name Of Antibiotic For Acute Upper Respiratory Infection (URI)

Drugs List:

Cap. Penicillin

• Penicillin

Penicillin is a antibiotic. It is used to treat certain kinds of bacterial infections. It will not work for colds, flu,  and other viral infections.

• Erythromycin

Erythromycins, also called macrolides, are a group of antibiotics , medicines that kill bacteria or prevent their growth.

• Amoxicillin

Treatment of acute otitis media (AOM). AAP, AAFP, CDC, and others recommend amoxicillin as drug of first choice for initial treatment of AOM, unless patient has severe illness (moderate to severe otalgia or fever ≥39°C) or the infection is suspected of being caused by β-lactamase-producing Haemophilus influenzae or Moraxella catarrhalis , in which case the fixed combination of amoxicillin and clavulanate is recommended for initial treatment. Those who fail to respond to amoxicillin should be retreated with amoxicillin and clavulanate. 

• Tetracycline

Antibacterial  antibiotic derived from Streptomyces aureofaciens or produced semisynthetically from oxytetracycline.

Tab. Cefuroxime

•  Doxycycline

Antibacterial; antibiotic derived from Streptomyces aureofaciens or produced semisynthetically from oxytetracycline.

• Cefuroxime

Treatment of AOM caused by Streptococcus pneumoniae , Haemophilus influenzae (including β-lactamase-producing strains), Moraxella catarrhalis (including β-lactamase-producing strains), or S. pyogenes .

• Cephalexin

Treatment of AOM caused by susceptible S. pneumoniae , Haemophilus influenzae , M. catarrhalis , or staphylococci or streptococci.

Tab. Minocycline

• Minocycline

Antibacterial; semisynthetic tetracycline antibiotic

• Cefpodoxime
• Sulfamethoxazole-trimethoprim.
• Demeclocycline
• Clarithromycin

Medication For Respiratory Disease

Name Of Respiratory Disease And Drugs:

• Accolate:Treatment for asthma(Tab. zafirlukast, 10 mg and 20 mg )
• Azmacort (triamcinolone acetonide) Inhalation Aerosol :Treatment for asthma.
• Adcirca (tadalafil);For the treatment of pulmonary arterial hypertension
• Aldurazyme (laronidase):For the treatment of Mucopolysaccharidosis.
• Allegra (fexofenadine hydrochloride):Treatment for seasonal allergy symptoms.
• Allegra-D:Treatment for nasal congestion due to seasonal allergy.
• Alvesco (ciclesonide):For the maintenance treatment of asthma as prophylactic therapy in adults and adolescents.
• Arcapta (indacaterol maleate inhalation powder):For the treatment of airflow obstruction resulting from chronic obstructive pulmonary disease.
• Astelin nasal spray:Treatment for seasonal allergic rhinitis.
• Atrovent (ipratropium bromide):Treatment for runny nose due to allergies and the common cold.
• Augmentin (amoxicillin/clavulanate):Treatment for infections involving drug-resistant bacteria.
• Avelox I.V. (moxifloxacin hydrochloride):Injectable antibacterial agent for adults with susceptible strains of bacterial infections.
• Biaxin XL (clarithromycin extended-release tablets):For Acute Bacterial Exacerbation of Chronic Bronchitis (AECB) and Acute Maxillary Sinusitis.
• Brovana (arformoterol tartrate):For the treatment of Chronic Obstructive Pulmonary Disease.
• Cafcit Injection:For the short term treatment of apnea of prematurity in infants between 28 and <33 weeks gestational age.
• Cayston (aztreonam for inhalation solution):For the treatment of cystic fibrosis patients with Pseudomonas aeruginosa.
• Cedax (ceftibuten):Treatment for chronic bronchitis, acute bacterial otitis media, pharyngitis/tonsillitis
• Cefazolin and Dextrose :Treatment for Respiratory tract infections
• Ceftin (cefuroxime axetil):Treatment of secondary bacterial infections of acute bronchitis
• Cipro (ciprofloxacin HCl):Treatment for acute sinusitis
• Clarinex:treatment of allergic rhinitis and chronic ideopathic urticaria.
• Claritin RediTabs (10 mg loratadine rapidly-disintegrating tablet):Treatment for seasonal allergy symptoms.
• Claritin Syrup (loratadine):Treatment for children with seasonal allergies
• Daliresp (roflumilast):For the treatment of chronic obstructive pulmonary disease.
• DuoNeb (albuterol sulfate and ipratropium bromide):For the treatment of bronchospasm associated with COPD.
• Infasurf:For the prevention and treatment of Respiratory Distress Syndrome (RDS) in premature infants.
• Iressa (gefitinib):For the second-line treatment of non-small-cell lung cancer.
• Ketek (telithromycin):For the treatment of infections caused by bronchitis, bacterial sinusitis and Community-acquired pneumonia.
• Letairis (ambrisentan):For the treatment of pulmonary arterial hypertension.
• Priftin:Treatment for pulmonary tuberculosis.
• Sclerosol Intrapleural Aerosol:Treatment for malignant pleural effusions.
• Singulair:Treatment for asthma.
• Spiriva HandiHaler (tiotropium bromide):For the treatment of bronchospasm associated with chronic obstructive pulmonary disease.
• Synagis:Treatment for the prevention of serious lower respiratory tract disease in infants.
• Teflaro (ceftaroline fosamil):For the treatment of bacterial skin infections and bacterial pneumonia.
• Xalkori (crizotinib):For the treatment of ALK+ non-small cell lung cancer.

NOTE:Please to be used after Doctor advice.