A Simple Guide to Scabies

A Simple Guide to Scabies
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What is Scabies?
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Scabies is a contagious skin disease caused by the mite Sarcoptes scabiei characterised by intraepidermal burrows, itchiness and secondary skin infections.

The female mite burrows into the skin and deposits her eggs and faeces. The eggs hatch in 3-4 days into larvae which then becomes nymphs, moulting to adults mites in 14 days.The skin becomes extremely itchy and red lesions appear in the skin.

Retirement and nursing homes are ideal breeding grounds for the parasite, which needs a human host to survive. Some child care centres may also be the place for spread of the skin parasite.

What are the Symptoms of Scabies?
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1.itching which is worse at night

2.characteristic burrow lines on the skin with papule at one end.

3.rashes and abrasions on the skin due to scratching and secondary infections.

Rashes typically are present on legs and arms, sometimes on the body , seldom on the face. Rarely it may be present on the scalp. Mode of transmision is by direct contact with a person with scabies.

How to confrim the diagnosis of Scabies?
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Skin scrapings can be examined microscopically for the scabies parasite.

What is the Treatment of Scabies?
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Scabicides (chemicals to treat scabies) actually contain mild insecticide :

Benzyl benzoate lotion

Malathion lotion

Gamma benzene hexachloride cream

Permethrin cream

Bathing is followed by application of the scabicide to the whole body from the neck to soles, left for 24 hours.

For some children under 2 years, the elderly in rest homes and others with reduced resistance, the scalp and face also needs to be treated.
A single overnight application of the scabicide(8 hours) is washed off the following morning .A second application four to seven days later is often recommended.

Treatment of contacts may be required if there is obvious signs of scabies.

While the scabies mite cannot live off the human skin for longer than 24 hours, each treatment with scabicide should be accompanied by washing, in hot water, of bedsheets, pillow cases and any clothes worn over the previous week.

Most people improve within a few days of treatment but it may take 4-6 weeks for the itch and rash of scabies to go away completely.

A Simple guide to Hemorrhoids

A Simple guide to Hemorrhoids
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What are hemorrhoids?
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Hemorrhoids or piles are distended veins inside the anus which are swollen and inflamed. Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external).

What is the cause of hemorrhoids?
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Hemorrhoids usually result from straining to pass the stool out of anus. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea.

What are the symptoms of hemorrhoids?
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The most common symptom of internal hemorrhoids is bleeding from the anus.Bright red blood may be seen covering the stool, on toilet paper, or dripping from the anus into the toilet bowl.
There may be pain too especially if the stool is hard. This could be due to the hard stools pressing on the swollen piles or due to a tear in the inner lining of the anus.

A painful swelling or a hard lump around the anus may occur when a blood clot forms. This condition is known as a thrombosed hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching.

How common are hemorrhoids?
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Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50.
Hemorrhoids are also common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. For most women, however, hemorrhoids caused by pregnancy are temporary.

When are hemorrhoids diagnosed?
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A thorough examination and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with a proctoscope, useful for more completely examining the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and the entire colon with colonoscopy.
Colonoscopy is a diagnostic procedure that also involve the use of lighted, flexible tube inserted through the rectum.

What is the treatment?
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a.Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include:

1.tub baths several times a day in plain, warm water for about 10 minutes
2.application of a hemorroidal cream or suppository to the affected area.
3. medicines such as daflon to shrink the swollen blood vessel.

b. Surgical treatment:A number of methods may be used to remove or reduce the size of internal hemorrhoids.
These techniques include
1.Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
2.Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
3.Laser coagulation. A special device is used to burn hemorrhoidal tissue.
4.Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.
5.A new method is the Longo technique. It involve using a circular stapling device which removes a ring of tissue in the lower anus pulling the enlarged piles up within the anus. The staples also interrupt the blood supply to the piles

How do you prevent hemorrhoids?
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The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs.

Drink lots of water at least eight glasses a day.

Eating the right amount of fiber result in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Good sources of fiber are fruits, vegetables, bran bread, and whole grains.

Avoid food which cause local irritation of anus (spicy food,alcohol) or bowel excitation (coffee,tea)

Exercise, including walking, swimming, help reduce constipation and straining by producing stools that are softer and easier to pass.
Avoid certain sports such as cycling and horse -riding because of the pressure exerted on the anal region.

Avoid sitting in hot places for too long.

Use the toilet at a fixed time eg. after drinking a big glass of water, when you wake up.