A Simple Guide to Laceration

A Simple Guide to Laceration
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What is a laceration?
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A laceration is an injury to the skin and its underlying soft tissue when you are cut or hit by something.
A laceration is usually called a cut when the injury is caused by a sharp object breaking the skin. It may a clean cut without bleeding or if it damages the blood vessels in the skin, it can cause visible bleeding.
Lacerations can occur at any part of the body.
Healing time for a laceration depends on where it is on your body.
A laceration usually take longer to heal if it is over a joint such as the knee or elbow.

What are the signs and symptoms of a laceration?
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1.Lacerations may appear in all shapes and sizes.

2.It may look like a cut, tear, or gash.

3.The wound may hurt, bleed, bruise, or swell.

4.Lacerations may bleed a lot in areas of the skin which has a lot of blood vessels such as the scalp.

5.The wound may have edges that are close together, or gaping apart.

6.Sometimes there may be numbness around the wound due to a cut of the nerve endings.

7.Similarly there may be decreased movement in an area below the wound due to loss of nerve endings or tear of muscle fibres.

What are the complications arising from a laceration?
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Even with proper treatment, a laceration can become infected:

1.Increased warmth to the area.

2.Redness or swelling to the area which becomes worse.

3.Pain in the area that increases over time.

4. pus or bad-smelling discharge from the wound.
Pus is milky and may be white, yellow, green, or brown.
It is the result of the white blood cells fighting the bacteria or virus.

Other complications may be:

1.the presence of foreign bodies

2.Injury to the bone( fracture)

3.Injury to the nerve

4.Injury to the blood vessels

5.Injury to muscles

What investigations may be necessary in Laceration?
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If there is suspected foreign objects in your laceration, an x-ray may be required.

Foreign objects include things like metal, gravel, and glass.

If you have many wounds from a car accident, tests may include an ultrasound, a MRI, or a CT scan.

What is the treatment for a laceration?
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The doctor will want to
1.control the bleeding if your wound is bleeding a lot.

2.clean the wound with disinfectant.
This will remove dirt and other small objects and reduce the chance of infection.

3.look in the wound for foreign objects like dust, metal or glass splinters.

4.explore (probe) or close the wound under local anesthesia.
An anesthetic is a medicine which numbs the area so that there is no pain during the probe or surgery.

Closing the wound:
The laceration may need stitches, staples, other treatments to close the wound:
1.if it is deep or bleeds a lot.
2.if your wound is gaping open or
3.if the wound is in an area that moves a lot, such as the hands, feet, and joints.

Stitches also keep the wound from getting infected.
Stitches may decrease the amount of scarring.

If the wound is too old, it can not be stitched.
Some lacerations may heal better without stitches.

Special care:
Some lacerations need special care.
Laceration caused by bites from fish or marine life may need special medicines like antibiotics and antitoxins.
Antibiotics are not needed for most wounds.
Antibiotics are given if your wound has a high risk of infection.

If the laceration injure a bone, nerves, or blood vessels, there may be need for microsurgery to join the torn nerve or blood vessel.
A broken bone may also need to be treated conservatively or with surgery.

Tetanus injection:
Tetanus infection, or "lockjaw," can happen after any deep break in your skin. Tetanus can kill you. It is important for adults to get a tetanus shot at least every 10 years.
After an injury, a tetanus injection may be given if:
1. it has been longer than five years since your last one.
2.any wound that may have dirt or saliva in it.
3.Deep wounds also have a high risk for tetanus infection.

If necessary, tetanus injection should be given as soon as possible (within 72 hours of the injury).

What are the risks in the care of laceration?
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A sharp object which passed through your clothing before cutting your skin may have caused small threads or bits of clothing to be pushed under your skin.
The risk of getting an infection is higher if there are foreign bodies in the wound.
Sometime even with the best care, there may still problems such as infection with your wound.
People who have diabetes have a higher chance of getting a serious infection in a wound.

A Simple Guide to Asthma

A Simple Guide to Asthma
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What is asthma?
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Asthma is a common long-lasting (chronic) inflammatory disease of the lungs and airways (bronchi) that affects 5 % adults and 20% children and causes narrowing of the airtubes.

What happens during an asthma attack?
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When your airtubes are exposed to trigger factors, inflammation of the airway results.
The breathing tubes become narrowed and clogged up with mucus making breathing difficult. Inflammation may continue even though there is minimal or no symptom of asthma.

What are the symptoms of Asthma?
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Asthma is characterised by attacks of

1. breathlessness,

2.tight chest,

3.wheezing sounds and

4.coughing

These symptoms are caused by the airways becoming narrowed and inflamed.
Some people may have these symptoms all of the time.

Others may be normal between attacks.

Who is at risk of developing asthma?
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Anybody can get it at any age but it tends to run in families.
They also have an inherited tendency to develop other allergic conditions such as eczema and allergic rhinitis.
Most children, particularly those with mild asthma will be attack free by adolescence.
A small number continue to have symptoms as adults.
Yet others have their asthma symptoms reappearing only when they reach adulthood.

What causes asthma attacks?
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Asthma results from sensitive airways that react to certain trigger factors.
These triggers may be different for different people.
Avoidance of trigger factors is important.

Some common triggers are:
1.Allergens such as house-dust mites, cockroaches, animal danders, pollen, indoor moulds and foods particularly those containing sulphite.
2.Infections such as the common cold and sinus infection

3.Weather changes due to change in temperature or humidity
4.Air pollution e.g. from tobacco smoke and haze
5.Strong odours or sprays e.g. paints, varnishes, cleaning solvent fumes, perfumes, cooking fumes
6.cold air,
7.vigorous exercise
8.stress.

Attacks may be more frequent or severe in people who have a chest infection.

Avoidance of trigger factors
1.Animal dander (fur, skin of cats or dogs) Give away pet if possible. If not, prevent pet from entering the bedroom. Bathe pet weekly.
2.House-dust mites Use protective air-tight mattress covers and pillow cases. Wash bedsheets and pillow cases weekly in hot water
3.Cockroaches Do not leave garbage uncovered. Use poison baits. Use pesticide spray only when the asthmatic is out of the house.
4.Indoor moulds Reduce dampness in the house.
5.Outdoor pollens Close doors and windows and stay indoors when pollen count is highest in the afternoon.
6.Tobacco smoke and haze Avoid tobacco smoke and haze as far as possible.
7.Medication Aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers should be avoided.
8.Food Certain foods containing sulphites should be avoided such as shellfish and preserved foods.

What to do during an asthma attack?
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1.Stay calm. Family members or caregivers should be calm, positive and encouraging.
2.Use 2 puffs of your reliever inhaler immediately as previously instructed by your doctor.
If asthma symptoms are not relieved or wheezing returns within 4 hours, give another 2 puffs of the reliever.

3. take your asthma medications with warm water.

4. consult your family doctor if there is no improvement.
If necessary, go to the nearest hospital for help.

How serious is Asthma?
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Asthma is not generally considered by doctors to be a serious illness in most people who have it, mainly due to the mildness of symptoms and the range of very effective medicines that control these symptoms and stop asthma worsening.
Asthma does, however, have an effect on quality of life because attacks can be unpleasant and distressing and can restrict activity. Whilst most sufferers learn to live with and manage their condition, for some it can be disabling.
In exceptional cases, asthma can be life-threatening, particularly if it is not treated adequately or promptly. For some of these, an attack is so severe that it results in death.

How long does Asthma last?
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Asthma attacks come and go, with wide variation in the symptoms at different times.
Many people with asthma have problems only occasionally but others struggle with it every day. Modern medicines control and relieve symptoms and so attacks may only last a few hours or minutes, but without treatment this may go on for several days.
Some children grow out of asthma and some people are only affected at different times of the year.
However, the period of time during which people may have asthma attacks can last for many years or throughout life.

How is Asthma treated?
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There is no cure for asthma, but there are different types of medicines that will help to keep it under control and relieve symptoms.
1.Most sufferers must be given a type of medicine called a preventer, which is usually an anti-inflammatory steroid (of the glucocorticosteroid type) that treats the underlying causes of the asthma. These are usually given from an inhaler.
Even if symptoms are not present, sufferers should keep taking the preventer medicines, as this will greatly decrease the risk of suffering asthma attacks. This will help many asthmatics to live a normal active life.
Steroids can also be taken as tablets but have many side effects.
2.Another sort of medicine is called a reliever that is used during an asthma attack and may be contained in an inhaler. This contains a bronchodilator medicine that opens up the bronchial tubes of the lungs and works in a few minutes. It can also be taken as tablets. Side effects may be rapid heart beats and tremors of hands.

Can asthma be cured?
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No, there is currently no known cure for asthma.

The good news is that modern medicine is extremely effective in controlling symptoms.

You can lead a relatively normal life if you seek to understand how to control your asthma and prevent attacks from occurring.

Asthma attacks may be prevented at a reasonable cost.
It usually requires long term treatment with 'preventer medication'.

What you can do to control asthma?
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ASTHMA MANAGEMENT PLAN
Asthma is a chronic disease requiring continuous management and appropriate treatment.
If you follow your prescribed asthma management plan, you can expect to live an active, normal lifestyle.

Successful treatment of asthma is a partnership between you and your doctor.

You and your doctor should work out an asthma management plan.
This should include:
1.understanding what asthma is all about
2. having clear goals of management
3. knowing the severity of your asthma;
patients with mild asthma can do with just reliever medications to stop the attacks.
On the other hand, patients with severe asthma or those with frequent attacks should go on regular medications to prevent attacks
4.being able to recognise symptoms suggesting worsening of asthma
5.knowing your medicines (preventers and relievers) and how to use them correctly
6.using the right inhaler technique and practicing it until you get it right
7..recognising and avoiding trigger factors
8.knowing what to do during an asthma attack
9..arranging regular follow-up visits with your doctor

A Simple Guide to Eczema

A Simple Guide to Eczema
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What is Eczema?
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Eczema is a general term meaning inflammation of the skin with signs of redness, itch and swelling.
One of the most common forms of eczema is atopic eczema which affects 10-20% of the world population. It occurs at some point during childhood.
Fortunately, many children with eczema find that the disease clears and often disappears with age.

What causes Eczema?
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There is no known cause for the disease.
It often affects people with a family history of allergies.
Many people who have eczema also suffer from allergic rhinitis and asthma, or have family members who do.
Those who are genetically predisposed may deverlop eczema when exposed to environmental and food triggers:
milk,egg white,nuts, shellfish
dust, chemicals,detergents,flowers,pollens,dyes in clothes,cosmetics

Who gets eczema?
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Eczema occurs in both children and adults, but usually appears during infancy.

Is Eczema contagious?
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Eczema is not contagious and, like many diseases, currently cannot be cured.
For most patients the condition may be managed well with treatment and avoidance of triggers.

How common is eczema?
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The condition is quite common.
About10-20% of all infants have eczema.
In nearly half of these children, the disease will improve greatly by the time they are between five and 15 years of age.
Others will have some form of the disease throughout their lives.

Where does Eczema appear?
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Eczema can occur on just about any part of the body.
In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.
In children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles.
In some people, eczema may form bubbles which breaks and ooze.
In others, the condition may appear more scaly, dry, and red.
Chronic scratching causes the skin to take on a leathery texture because the skin thickens (lichenification).

What are the symptoms and signs of eczema?
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Typically there are dry, red, extremely itchy patches on the skin.
Eczema is sometimes referred to as "the itch that rashes," since the itch, when scratched, results in the appearance of the rash.

What makes patients with eczema itch?
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The triggers that causes a flare up of the eczema causes irritation to the skin.
When the skin becomes irritated, histamines are released into the skin causing the redness and itchiness.
For some, rough or coarse materials coming into contact with the skin causes itchiness. For others, feeling too hot and sweating will cause an outbreak.
Other people find that certain soaps, detergents, disinfectants, contact with juices from fresh fruits and meats, dust mites, and animal furs may trigger itching.
Upper respiratory infections (caused by viruses) may also be triggers.
Stress can also sometimes aggravate an existing flare-up,a condition called neurodematitis.

How can eczema be prevented?
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Eczema outbreaks can usually be prevented with some simple precautions:
1.Moisturize frequently
2.Avoid sudden changes in temperature or humidity
3.Avoid sweating or overheating
4.Avoid scratchy materials (e.g., wool or other irritants)
5.Avoid harsh soaps, detergents, and solvents
6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal furs)
7.Be aware of any foods that may trigger an attack and avoid those foods
8.Reduce stress

How can eczema be treated?
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The most important part of an eczema treatment routine is to avoid scratching because that will irritate the skin even more.

The most common treatment is the application of lotions or creams to keep the skin as moist as possible. These treatments are generally most effective when applied directly after bathing so that the moisture from the bath is remains in the skin.

Cold compresses applied directly to itchy skin can also help relieve itching.

Another effective treatment is the application of corticosteroid creams and ointments to reduce inflammation.To prevent side effects such as skin thinning, your doctor may limit the length of treatment time and locations where you can apply treatment.

For severe eczema, your doctor may prescribe oral corticosteroids, but be aware that side effects including new flare-ups can develop when treatment is discontinued (this treatment is not recommended for long-term use).

Skin affected by eczema may frequently become infected. A course of topical or oral antibiotics may be prescribed to kill the bacteria causing the infection.

For severe itching, sedative and non-sedative antihistamines are sometimes used to reduce the itch.
For day time activities as well as driving, non sedative antihistamine should be used.
Because drowsiness is a common side effect, sedative antihistamines are often used in the evening to help a person restless from eczema get to sleep.

Tar treatments and phototherapy are also used and can have positive effects. Phototherapy requires special equipment (lights).

Finally, in cases where eczema is resistant to therapy, your physician may prescribe the drug cyclosporine A, which modifies immune response.
This is used only in extreme cases because of its association with serious side effects.

What can be done for children with eczema?
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Children are special because it is difficult for them to resist scratching their eczema.
For mild to moderate cases, the application of moisturizer on a regular basis can be very helpful. And, in most cases, the eczema will disappear as the child ages.
In the meantime, avoid as many eczema triggers as possible.
Keep your child’s skin moist. After bathing, apply moisturizer to retain the moisture in the skin.
Avoid sudden temperature changes.
Keep your child’s bedroom and play areas free of dust mites.
Use mild soaps – both on your child’s skin and on your child’s clothing.
Dress your child in breathable, preferably cotton, clothing.