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.

Name of Cardiac Medications

Inj.  Heparin 

 Name of Cardiac Medications

Anticoagulants:(Also known as Blood Thinners)

• Dalteparin 
• Danaparoid 
• Enoxaparin
• Heparin
• Tinzaparin
•  Warfarin

Antiplatelet Agents:

• Aspirin
• Ticlopidine
• Clopidogrel
• Dipyridamole
• Angiotensin

Enzyme (ACE) Inhibitors:

Tab.Captopril  

• Benazepril
• Captopril 
• Enalapril
• Fosinopril
• Lisinopril
• Moexipril
• Perindopril 
• Quinapril 
• Ramipril 
• Trandolapril 

Blockers or Inhibitors:

• Candesartan
• Eprosartan
• Irbesartan 
• Losartan
• Telmisartan
• Valsartan 

Beta Blockers:

Tab.Metoprolol

• Acebutolol
• Atenolol 
• Betaxolol 
• Bisoprolol
• Bisoprolol 
• Carteolol 
• Metoprolol
• Nadolol
• Propranolol 
• Sotalol
• Timolol 

Calcium Channel Blockers:

• Amlodipine 
• Bepridil 
• Diltiazem
• Felodipine
• Nifedipine 
• Nimodipine
• Nisoldipine
• Verapamil 

Diuretics:

Tab.Hydrochlorothiazide

• Amiloride
• Bumetanide
• Chlorothiazide
• Chlorthalidone 
• Furosemide
• Hydrochlorothiazide
• Indapamide 
• Spironolactone 

Vasodilators:

• Isosorbide dinitrate
• Nesiritide
• Hydralazine
• Nitrates 
• Minoxidil

Digitalis Preparations:(Also known as Digoxin and Digitoxin

• Lanoxin

Statins:

Common types of cholesterol-lowering drugs include statins, resins and nicotinic acid (niacin), gemfibrozil and clofibrate.

Definition And Nursing Management Of Post Operative Care

Definition:

Post operative care is the management of a patient after surgery. This includes care given during the immediate post operative period in post anesthesia care unit (PACU), as well as during the days following surgery.

The goal of post operative care is to prevent complications such as infection, to promote healing of the surgical incision, and to return the patient to a state of health.

Nursing Management:

After the surgical procedure, and anesthesia reversal and extubation the patient is transferred to the PACU. The length of time the patient spends there depends on the length of surgery; the type of surgery; the status of regional anesthesia (for example, spinal anesthesia); and the patient's level of consciousness. Nursing management is most important for post operative patient.

• Keep the patient in comfort and safety position.
• Monitor vital signs including Blood pressure, Respiration, Pulse rate , and Temperature, 15mins for first hour, 30 mins for next 2hours, Then if stable 4 hourly during 24hrs and maintain record chart.
• Assess resp rate, oxygen saturation and administer supplemental oxygen as prescribed.
• Assess the surgical site and wound drainage systems.
• Assess level of consciousness, orientation and ability to move extremities. 
• Assess Intravenous sites for patency and infusions for correct rate and solution. 
• Maintain fluid input and output and fluid balance chart.
• Chaked Urinary catheter – position, patency, hourly urine output/volume, colour and concentration.
• Assess pain level, pain characteristics (locationand quality) and timing, type and route of administration of last pain medications.
• Administer analgesics as prescribed and assess their effectiveness in relieving pain
• The patient should be turned every two hours, and should at least be sitting on the edge of the bed by eight hours after surgery.
• Patients should be kept NPO (nothing by mouth) as ordered by the surgeon, at least until their cough and gag reflexeshave returned.
•  Body temperature must be monitored, since patients are often hypothermic after surgery and may need a warming blanket or warmed IV fluids.
• Patients often have a dry mouth following surgery, which can be relieved with oral sponges dipped in ice water or by applying lemon ginger in mouth swabs.
•  The patient should be encouraged to splint chest and abdominal incisions with a pillow to decrease the pain caused by coughing and moving.  
• Provide information to patient and family.

Intensive Care Units Definition And Nursing Management

Intensive Care Units Definition:

Intensive care units (ICU) are places in the hospital where the most seriously ill patients are cared for by specially trained staff. The staff consists of doctors, nurses, respiratory therapists, nutritionists, physical therapists, pharmacists. They work closely together as a team to provide the best possible humane care. Two things that make care in the ICU different than in a regular hospital care area are the nursing support and the special type of equipment in use. The level of nursing care in the ICU is higher than care in other parts of the hospital. ICU nurses are specially trained to care for the most ill patients.  The second thing that distinguishes an ICU is the use of advanced technology. The ICU team uses a number of specialized machines and devices, called monitors, to frequently check the heartbeat, blood pressure and breathing. There are machines that help patients breathe called mechanical ventilators. While it can be overwhelming to see so many machines, wires and tubes, like intra-aortic balloon pumps , extracorporeal membrane oxygenation circuits , each does its job to help the patient. To the casual observer, the ICU would seem a good place for patients to stay all the time they are in hospital because of the high level of care. 

 Nursing Management Of ICU( Intensive care units ):

• Taking regular blood tests.
• Changing the patient’s treatment in line with test results.
• Giving  the drugs and fluids the patient that the doctors have prescribed.
• Recording a patient’s blood pressure, heart rate and oxygen levels.
• Clearing fluid and mucus from the patient’s chest using a suction tube.
• Turning the patient in his or her bed every few hours to prevent sores on the skin.
• Cleaning the patient’s teeth and moistening the mouth with a wet sponge.
•  Daily spongeing  the patient in bed.
• Changing the bed sheets.
• Changing a patient’s surgical stockings, which help circulation when he or she is inactive (lying still) for a long time.
• Putting drops in the patient’s eyes to make it easier to blink.

Latest Laparoscopic Instrument Name And Image

TROCAR AND CANNULA

LAPAROSCOPIC  CAMERA

STRAIGHT SCISSOR 10mm*330:

GRASPER:

MONOPOLAR SCISSOR:

RIGHT ANGLE FORCEP:

SUCTION TUBE:

DISPOSABLE BIPOLAR FORCEP:

BIPOLAR ELECTRO FORCEP:

NEEDLE HOLDER:

DISPOSABLE BIPOLAR DISSECTING FORCEP:

HEMOSTATE CLAMP:

Scabies Definition Symptoms Treatment And Prevention

Definition:

Scabies is a contagious skin infection that occurs among humans and other animals. It has been classified by the WHO as a water-related disease. It is caused by a tiny and usually not directly visible parasite, the mite Sarcoptes scabiei, which burrows under the host's skin, causing intense allergic itching. The infection in animals is called sarcoptic mange.

The disease may be transmitted from objects but is most often transmitted by direct skin-to-skin contact, with a higher risk with prolonged contact  It can also be spread through contact with other objects, such as clothing, bedding, furniture, or surfaces with which a person infected with scabies might have come in contact.  As with lice, scabies can be transmitted through sexual intercourse.Typically appear in-on the elbows,round the nipples,near the genitals,in-between the fingers and toes,the axillae ,ankles,groin etc.

Symptoms:

• Mite tunnels 

 These may be seen on the skin as fine, dark, or silvery lines about 2-10 mm long. They most commonly occur in the loose skin between the fingers ,the inner surface of the wrists, and the hands. 

• Itching.

 This is often severe and tends to be in one place at first  and then spreads to other areas. The itch is generally worse at night and after a hot bath.

• Rash 

 The rash usually appears soon after the itch starts. It is typically a blotchy, lumpy red rash that can appear anywhere on the body. The rash is often most obvious on the inside of the thighs, parts of the abdomen and buttocks, armpits, and around the nipples in women. The appearance of the rash is often typical. However, some people develop unusual rashes which may be confused with other skin conditions.

• Scratching

 Scratching due to intense itching can cause minor skin damage. In some cases the damaged skin becomes infected by bacteria - a secondary skin infection. If skin becomes infected with bacteria it becomes red, inflamed, hot, and tender.

• Aggravation of pre-existing skin conditions

 Scabies can worsen the symptoms of other skin conditions, particularly itchy skin problems such as eczema, or problems such as psoriasis. Scabies can be more difficult to diagnose in these situations.

Treatment:

• Permethrin

Permethrin is the most effective treatment for scabies.  It is applied from the neck down usually before bed time and left on for about eight to fourteen hours, then showered off in the morning. One application is normally sufficient for mild infections. For moderate to severe cases, another dose is applied seven to fourteen days later.Permethrin causes slight irritation of the skin, but the sensation is tolerable.

• Ivermectin

Ivermectin is an oral medication. It is effective in eradicating scabies. Ivermectin  is a single dose. It is the treatment of choice for crusted scabies and is often used in combination with a topical agent.It has not been tested on infants and is not recommended for children under six years of age.

• Others

Other treatments include lindane, benzyl benzoate, crotamiton, malathion, and sulfur preparations.

 Prevention

• The first thing is Hygiene. Ensure that one follows the practices of good hygiene. One should always wash the body properly and bathe daily. Use of clean towels and napkins and washing hands with hand wash or soap is recommended.
• Do not wear clothes that have been worn by other people. Do not share your clothes with other people.
• Ensure that you avoid physical contact with people who have been diagnosed with scabies. 

Sterilization Of laparoscopy Instruments

How laparoscopy Instruments sterilized:

After finished the procedure the instrument should clean properly.A method of cleaning that is ultrasonic cleaning . This method is the most efficient and effective. In fact, ultrasonic cleaning is 16 times more efficient than hand-cleaning. The instruments are placed in the ultrasonic unit for 10-15 minutes and use a neutral pH solution. Attention should be given to the following points during ultrasonic cleaning:

• Before placing into the ultrasonic unit, the instruments are cleaned of all visible debris.
• It’s preferable not to mix instruments made of dissimilar metals (such as aluminum and stainless) in the same cycle.
• As with all types of cleaning, all instruments should be opened so ratchets and box locks are fully exposed to the cleaning process.
• Upon completion of the cycle, the instruments are removed immediately and rinsed.

After cleaning The instruments should be dried and rinsing cycle before they are packed for sterilization. 

ETO

This is ideally achieved by using an air gun that blows all the water droplets off the surfaces of instruments. . Then the instruments packaged and submitted to sterilization by ethylene oxide .Using ethylene oxide (EO) would work for all disposable instruments, insulated hand instruments and tubings employed for gas, suction and irrigation. Endoscopic instruments may be sterilized with either cold or warm EO gas, with respect to the manufacturer’s instructions. With cold gas, the temperatures are set at 85 0C and also the instruments are subjected for 4 hours and 30 minutes. Aeration must then follow for 12 hours. Warm gas sterilization happens at 145 0C for 2 hour 30 minutes, followed by 8 hours aeration. The benefits of EO are the items aren't damaged, it's non-corrosive to optics also it permeates porous material. Its main disadvantages are its cost, toxicity, the requirement for aeration and being a longer process. 

The laparoscopy  instrument may be sterilized by 2% glutaraldehyde, 6% stabilized hydrogen peroxide and per acetic acid (acetic acid/hydrogen peroxide). Fibreoptic light cords and telescopes have to be soaked in 2% glutaraldehyde not less than Ten minutes. Soaking should not exceed Twenty minutes. The endocamera could also disinfected by 10 minutes submersion in 2% glutaraldehyde. Care must be come to leave the plug end of the cord away from solution. Alternately, sterile drape over the camera and cord may be used. Soakage of other metallic instruments, including trocars, and hand instruments, has become recommended for An hour, to avoid infection with atypical mycobacterial infection. Formaldehyde, glutaraldehyde from phenolic derivatives, iodophors, hypochlorites, phenolics and quartery ammonium compounds are unpopular and it has been condemned. Formaldehyde is potentially cancer causing and very irritating to the skin, eyes, nose, and respiratory tract. Furthermore, its efficacy is found wanting, and for that reason, routine utilization of formaldehyde for sterilizing instruments and other items isn't recommended. 

 STERRAD 

 One of the newer sterilizer system - STERRAD (Johnson & Johnson) - uses hydrogen peroxide vapor and low-temperature gas plasma to sterilize most devices quickly with no toxic residues. Usually, the process takes about 75 minutes for wrapped and dry instruments and devices. Within the chamber, a deep vacuum is drawn. Fifty-nine percent aqueous peroxide is vaporized into the chamber. The product will be enveloped within the peroxide vapor. Following a diffusion of the gaseous peroxide with the load, chamber pressure is reduced, permitting the generation of low-temperature gas plasma. Rf (RF) energy is put on the chamber via an RF amplifier, inducing the plasma state. Reactive species are generated in the peroxide on this state, reacting with materials and every other. When the high-energy species have reacted, they recombine to form water vapor, oxygen, along with other non-toxic by products. Upon completion of sterilization, instruments are dry for immediate use or sterile storage. Thus, recontamination risk is minimized, and given that they remain sterile until their next use, money and time is saved by avoiding reprocessing instruments when the case in canceled or delayed. This system occupies minimal space and requires no venting or water hookup. The only utility requirement is electrical hookup.