Health related information and news from around the world.

Signs and symptoms

A sprain causes pain which is sometimes severe, swelling, tenderness, decreased movement of the joint and internal bleeding. A mild or moderate sprain generally can be suspected if a joint is tender after it has been twisted or overextended.

Because dislocations produce a visible malformation, they are seldom missed. Furthermore, the inability to use the joint is an obvious sign of a dislocation. Fractures of the bones of the joint cannot be ruled out without X rays.

Home care

A dislocation should not be treated at home. Minor sprains, particularly of the fingers, toes, and ankles, may be treated safely at home by immobilizing the hand or foot involved and then resting it. The sprained part should be kept elevated. Cold compresses applied for one to four hours after injury help minimize swelling. Aspirin or paracetamol will temporarily relieve the pain. If a sprain does not improve rapidly a bone may be fractured; the child should be seen by a doctor.

Precautions

• Do not attempt to correct a dislocation, even of the fingers. Dislocations are often accompanied by a fracture.

• What appears to be a sprained wrist in a child may actually be a fracture of the forearm bones near the joint; what appears to be a sprained thumb may actually be a fractured navicular bone in the hand.

• A severe sprain may take as long as a fracture to heal and if not treated properly can result in a permanently weak joint.

• A sprain is not healed if it is still swollen or if it is painful to move.

• Elastic bandages do not adequately support or protect a sprained ankle.

Medical treatment

Your doctor will carefully examine the injured joint and will take X rays if a dislocation or a fracture is suspected. A minor sprain may be X-rayed, or the joint immobilized and its rate of healing observed. If the rate of healing is not rapid enough, an X ray will be ordered.

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What is it?

Itchy, irritating, dry skin from any cause. The skin becomes prematurely wrinkled and often drives the person (especially a child) mad with itching.

What causes it?

• Extremes of temperature from freezing winds to direct sun.

• Ageing itself makes skin drier.

• Central heating without humidifiers.

• The use of detergents as bath foams (especially children’s ‘fun’ bath products). This removes the natural oils from the skin.

• The misuse of cosmetics which block the oil glands that normally lubricate the skin.

Prevention

• Drink more water.

• Stay out of harsh sunlight unless you wear an effective sunscreen.

• Never use detergents in the bath and use soaps sparingly.

• Wear gloves if you use detergents for washing up dishes.

• Try to get a humidifier installed in your place of work or any other air-conditioned building where you spend a lot of time.

• Use only small amounts of skin lotions-the skin can absorb only so much, after which you block the natural ducts that bring oils to the surface. The best moisturizer for the skin is water-not oils. Use oils and creams, therefore, on slightly moistened skin. Many good moisturizer creams are mostly water for this reason.

• One skin expert uses a mixture of five vitamin A capsules to a 4 ounce jar of hand or body lotion to alleviate dry skin, with some success.

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Growing old is a growing business with an ever increasing proportion of the population being over 65. People over 65 are at much greater risk than other age groups of having a fatal accident. The problem gets worse as the person becomes older, and women are more likely to be hurt than men.

Suffocating and choking

These accidents are chiefly associated with food. The problems may be exacerbated by arthritic hands which have difficulty cutting up food, ill-fitting dentures, or a total lack of teeth with which to chew the food. There is little that can be done positively to prevent such hazards.

Falls

Falls are the most common type of accident amongst elderly people. More than half of them occur when the elderly person is moving about on the same level but a substantial proportion also take place on the stairs.

Environmental hazards such as poor lighting and worn carpets play a part in this type of accident but physical factors are a more potent factor. These could include physical impairment, drugs or alcohol, inactivity and the reduced ability to retain one’s balance.

Cuts

This type of accident is rarely fatal, with only about twenty-five deaths a year across all age groups. Although the younger groups suffer most there is still a substantial number of accidents in the older range too. There can be medical consequences too as wounds may heal more slowly in the elderly.

Among the younger retired group lawn-mowers and garden tools are major offenders. Handling difficulties among the older group may lead to hitherto unlikely accidents with kitchen knives and can openers.

Fire

Fire and flames are the second major hazard for the older age groups. Nearly 10 per cent of cases are fatal in the 65-74 age group, and 13 per cent in the over 75 age group. Nonfatal accidents are likely to be serious. Many accidents occur because of physical problems in elderly people. Dizziness, blackouts, strokes and heart conditions are often involved in a fall on to a radiant or open fire.

Blows

Once again there are few fatal cases of a person being struck by another person or an object but there are a significant number of such incidents causing injury to elderly people. The younger age group of elderly people is typically hurt trying to retrieve an object from the top of a wardrobe or cupboard while the older age group bumps into furniture while moving about.

The general lowering of shelves and improvement of low-level storage is a task for pre-retirement days with a view to making life easier later.

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If you think you have testicular torsion, you should see your doctor or urologist immediately. He will first try to manually untwist the spermatic cord. It’s likely, however, that even when he succeeds, he will also want to perform minor surgery by placing a few judiciously placed stitches that will prevent the cord from twisting again, which is a likely possibility. The surgical procedure to repair the torsion and prevent future episodes will require several days in the hospital and about a week of recuperation.

If the pain is caused by an infection in your testicle caused by bacteria in your urinary tract, the doctor will need to find out what particular bacterium is causing the infection. He will do a prostate exam through the rectum or massage the penis to extract a sample of discharge (if it exists) to send to the lab for a culture. An antibiotic will then be prescribed depending on the organism isolated. If the infection is caused by a sexually transmitted disease, your doctor will prescribe the antibiotic Floxin 300, which you will take twice a day for 10 days; your sexual partner or partners will also need to be treated.

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Sometimes diarrhea can be the body’s way of ridding itself of a harmful substance, such as the bacteria that cause food poisoning or contaminate water. However, when you have diarrhea that lasts for more than a few days, it’s usually due to another reason.

Whenever a patient complains to me about chronic diarrhea, the first thing I look for is a change in his diet. Juice diets or diets that are high in fruit can cause chronic diarrhea when you first start the new regimen. A new medication, especially blood pressure medication, can also cause chronic diarrhea. Obviously, the continuing use of laxatives, stool softeners, and antacids can cause chronic diarrhea, as can new vitamin regimens, especially when they contain yeast.

If “you have lost weight during your bout with diarrhea, it’s probably because your intestines are not absorbing most of the food you eat; the most common cause of this malabsorption is lactose intolerance. Lactose is found in dairy products such as milk, ice cream, yogurt, and cheese.

A more serious kind of malabsorption is caused by an intolerance to gluten, which is found in all bread products and cereals made with wheat. If you have a gluten intolerance, you probably have a long history of diarrhea and weight loss, in addition to hair loss, mild anemia, and abnormalities in any liver function tests you take.

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Description and Possible Medical Problems

You’d think that if you had a tendency to become short of breath with slight exertion, sitting or lying down would allow you to catch your breath. Not so for some people; lying down can actually make breathing harder.

If you find yourself to be short of breath when lying down or sitting and you also often have the seemingly unrelated symptom of swollen ankles, you should see your doctor. This is important, especially if you have diabetes or a previous history of heart disease of any kind.

If your shortness of breath is accompanied by wheezing, coughing, and an inability to talk, you will need to seek immediate medical attention.

In the elderly population, shortness of breath that occurs while lying down is usually caused by heart failure. Other times, however, the cause can be as simple as a heavy intake of salt. When I was a young doctor, we saw a group of nursing home residents come to the emergency room with heart failure. They had recently eaten a meal of hot dogs, corned beef, and pastrami, provided as a generous gift by the local deli. These people, who usually ate low-salt diets, could not handle the sudden overload of sodium, and as a result several ended up in the emergency room.

Treatment

If you are short of breath whenever you lie down and your doctor suspects heart failure, he will perform a total medical evaluation, which will include an electrocardiogram and an echocardiogram, among other tests. The ensuing treatment will depend on the degree of the heart failure.

The condition might actually require only a simple change in diet— limiting salt intake. Fat consumption should be reduced, and, if you’re overweight, you’ll probably need to lose some weight.

If your condition requires it, your doctor may prescribe a diuretic such as hydrochlorothiazide to reduce your blood pressure and take some of the strain off your heart. The ACE inhibitors digoxin and Lasix may also be used on an individual basis.

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The hot new product in skin care the past couple of years has been Retin-A, popularly called the “antiwrinkle cream.” Retin-A is the brand name for tretinoin, a derivative of vitamin A, and it’s been around for 20 years for the treatment of acne. Retin-A has been shown to reduce fine wrinkles and improve skin texture by smoothing out rough patches of skin, but this prescription drug has still not been approved by the FDA for the specific purpose of reversing the effects of photoaging.

It’s not known exactly how Retin-A works, but it does stimulate new collagen growth in the dermis of the skin and help restore the epidermis to its natural, undamaged state. As with any medication, some individuals are sensitive to Retin-A and many people experience dryness, peeling, redness, and swelling when they use it. People who are prescribed this preparation by their physicians are also advised to use sunscreen regularly, as Retin-A increases sensitivity to the sun.

Although Retin-A may help make your skin look and feel younger, you shouldn’t relax when it comes to monitoring any changes in your skin that could point to melanoma and other skin cancers.

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Usually, the best way to treat hoarseness is to rest your voice, learn to talk at a normal volume, and let the taspiness run its course. Drinking warm beverages, such as hot tea with honey, is also quite soothing. And if you smoke, stop. If the hoarseness is accompanied by a cold or flu, you should treat your other symptoms as well as limit your conversation.

If you become hoarse only after certain instances—like after a late night out—and your voice returns to normal after a few days, you have nothing to worry about. However, if you have chronic laryngitis or your hoarseness lasts more than a week, or if your voice changes, you should see your doctor immediately to rule out the possibility of polyps or a more serious problem. He or she may refer you to an ear, nose, and throat specialist, who will use a laryngoscope to check your vocal cords for polyps or other growths. A laryngoscope is a thin, small, flexible tube that your doctor will insert through your nostril so that she can look down into your throat. The procedure lasts only a few minutes and requires a local anesthetic.

Tips and Precautions

Many people gargle with salt water or an antiseptic mouthwash when they become hoarse. Although you’re probably just doing what your mother told you to do when you were a kid, you may actually be doing more harm than good. First, you should keep the use of your vocal cords—including both speaking and gargling—to a minimum in order to give the larynx a chance to rest and heal. Second, salt water and antiseptic may irritate the infection of a cold more, delaying a return to your normal voice.

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Description and Possible Medical Problems

Most of us accept the fact that, in one way or another, the aging process is going to affect the hair on our heads, whether it becomes thinner or grayer or we begin to lose some of it and it doesn’t grow back. For some people, the process began in their 20s; others still have a full head of hair into their 60s, though the color is probably gray or white to some degreee.

The fact is that 50% of men and women will see some significant changes in their hair by the time they turn 50.

Treatment

The effect that aging has on our hair is biologically not reversible, though by using hair color, a body wave or permanent, or even a new hairstyle, these effects can be minimized.

You can either color or perm your hair yourself or go to a professional salon. One caveat about doing it yourself: when coloring or perming hair, many people have a tendency to leave the preparation on too long. This can lead to dryness, breakage, and loss of even more hair. Many of the chemicals that are used in hair color or permanent solution can cause the scalp to become irritated. This may also be more of a problem in elderly men and women, since their scalps produce less of the protective oils than younger people’s do. Besides the professional attention you get, it’s a good idea to go to a salon because the coloring and perming preparations used in salons tend to be gentler on the hair and scalp than over-the-counter preparations are. To play it safe, you may want to have a professional stylist care for your hair.

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There is a new medication used to treat migraines called Imitrex, or Sumatriptan. It comes in a kit that provides the patient with everything she needs to adminster the medication through self-injection. The medication is injected at the first signs of a migraine, when nausea and spots before the eyes begin to appear and the head begins to hurt. If the symptoms have not begun to subside after an hour, another injection can be given; this is usually effective. However, people with heart disease shouldn’t use Imitrex, since the medication can cause spasm in the coronary arteries.

Ergotamine is another medication that should be taken at the beginning of a migraine, except it is taken orally or sublingually and can be repeated at 30-minute intervals, or as often as necessary until the symptoms subside. If you want to take ergotamine, your doctor will want to monitor your health, since the medication can be habit forming and a rare disorder called ergotism can develop. Since ergotamine helps decrease the pain of a migraine through a process known as vasoconstriction, in which the blood vessels become narrow and the pain is reduced, some of the side effects of the medication include rapid heart rate, muscular aches and pains, coldness in the hands and feet, depression, and seizures, which explains why ergotamine is not a medication to be taken lightly.

A migraine headache doesn’t necessarily have to immobilize a person. The most important part of treatment is to recognize the onset of a migraine and treat it with medication immediately, as well as to eliminate foods that tend to trigger a migraine.

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