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.

Boil Definition Cause Symptoms Types Treatment Complication And Prevention

Definition:

Boil is a skin abscess that forms at a hair follicle infected with pus-forming bacteria. Boils are sometimes called furuncles. A carbuncle is formed when several furuncles merge to form a single deep abscess with several heads or drainage points. This is an abscess in the skin usually caused by the bacterium Staphylococcus aureus.

Cause Of Boil:

• Ingrown hair 
• Any break in the skin, such as a cut or scrape, can develop into an abscess should it become infected with bacteria. 
• Diabetes
• Problems with the immune system
• Poor nutrition
• Poor hygiene
• Exposure to harsh chemicals that irritate the skin

Symptoms of Boils:

• The skin around the boil becomes infected. It turns red, painful, warm, and swollen.
• More boils may appear around the original one.
• A fever may develop.
• Lymph nodes may become swollen.
• Fatigue
• Fluid leakage from the boil, which may crust over
• Itching feeling
• White or yellow centers in the boil
• Allergies or immune system disorders, including HIV infection 
• Alcoholism or drug abuse

Types Of Boil:

• Furuncle or carbuncle
• Cystic acne
• Hidradenitis suppurativa
• Pilonidal cyst
• Bartholin's gland

Treatment:

• Apply warm compresses and soak the boil in warm water. This will decrease the pain and help draw the pus to the surface. Once the boil comes to a head, it will burst with repeated soakings. This usually occurs within 10 days of its appearance.A warm compress can make  by soaking a wash cloth in warm water and squeezing out the excess moisture.
• When the boil starts draining, wash it with an antibacterial soap or solution until all the pus is gone. Apply a medicated ointment and a bandage. Continue to wash the infected area two to three times a day and to use warm compresses until the wound heals.
• Do not pop the boil with a needle. This could make the infection worse.
• In serious cases of infection, antibiotics may be used. However, the majority of boils heal on their own without medical treatment.

Complication Of Boil:

• Abscess formation
• Encephalitis
• Endocarditis 
• Meningitis 
• Osteomyelitis
• Permanent scarring
• Sepsis
• Spread of infection

PreventionOf Boil:

Prevention is better than cure.

• Keep the body clean. Wash very well with antiseptic soap so that skin surface remains germ free. It is always recommended to go for a shower rather than a tub bath. In shower get running water, which is not the case for as bath taken in a tub.
•  To use own belongings like towels, cosmetics and such. Sharing of such products with somebody else may result the incidence of the infection. So, as a precautionary step should use own equipments and never should use others as will get infected with the germ in case the other person is affected with boils.
• Another very important method for prevention of boils is to maintain a proper diet. It would be always beneficial for take up food products that are of less oil and non greasy. Fatty foods like junk foods should always be avoided and proper nutritious food like leafy green vegetables, fresh fruit juices and whole some cereals should be included in balanced diet schedule.
• The boils are very contagious. so while treating them  must always touch them with washed hands. Some people have the tendency of sneezing the boils nodules. This act would rather aggravate the infection and cause tremendous pain. Usage of unclean hands to deal with the boils is strictly to be avoided, especially for a boil developed on the skin surface of face.
• While selecting the agents for washing and cleaning purposes to use antiseptic soaps rather than using beauty soaps,can also use a good shower gel as this would help to keep the skin clean, fresh as well as germ free and ultimately would promote boils prevention.