Nose Problems

Nose Problems

• It filters the air you breathe, removing dust, germs and irritants. 
• It warms and moistens the air to keep your lungs and tubes that lead to them from drying out. 
• Your nose also contains the nerve cells that help your sense of smell. 
• When there is a problem with your nose, your whole body can suffer. 
• For example, the stuffy nose of the common cold can make it hard for you to breathe, sleep or get comfortable.

Many problems besides the common cold can affect the nose. They include

• Deviated septum - a shifting of the wall that divides the nasal cavity into halves
• Nasal polyps - soft growths that develop on the lining of your nose or sinuses
• Nosebleeds
• Rhinitis - inflammation of the nose and sinuses sometimes caused by allergies. The main symptom is a runny nose

 

Anosmia-- Loss of smell

Deviated Nasal Septum-- The nasal septum is the part of the nose that separates the two airways and the nostrils. A deviated septum is when there is a shift from the midline or center position. The septal deviation may be severe enough to obstruct the passage of air through the nostrils. This obstruction may predispose the patient to sinusitis, infection and epistaxis (nose bleeds).

Epistaxis (nosebleeds)-- The cause may be a trauma to the nose, but many times the nose bleeds because of nasal congestion due to a nasal allergy,sinus infection, or a cold that irritates and weakens the delicate nasal lining.

Nasal Airway Obstruction-- Blockage/obstruction of the flow of air through the nasal passages most commonly caused by nasal fracture, allergies, deviated nasal septum, nasal deformity and enlarged adenoid tissue.

Nasal Polyps-- A protruding growth from the mucous membrane most commonly caused by chronic infection and allergies.

Rhinitis-- An inflammation of the mucous membrane of the nose. Commonly caused by allergies . Symptoms may include sudden attacks of sneezing, swelling of the nasal mucosa, watery discharge from the nose, itching, watering of the eyes.

Sinusitis-- Sinusitis is an infection of the sinuses near the nose. These infections usually occur after a cold or after an allergic inflammation. There are other possible conditions that can lead to sinusitis. 

These may include:

• abnormalities in the structure of the nose
• enlarged adenoids
• infections from a tooth
• trauma to the nose
  foreign objects that are stuck in the nose

Symptoms may include:

• runny nose or cold symptoms that last longer than seven to 10 days
• complaints of drip in the throat from the nose
• headaches
• facial discomfort
• bad breath
• cough
• fever

Nosebleeds First Aid 

• Nosebleeds can happen after nasal injuries, overzealous picking or blowing, or simply because you tend to get them. They're pretty common, and rarely life-threatening. Here's how to stay calm and stop the bleeding.
• Hold a tissue or soft cloth to your nose. This can be done with one hand, so you can use the other to continue holding a tissue or cloth beneath your nostrils. Minimizing the mess will lessen your irritation with the nosebleed when it's over.
• Lean forward and pinch your nostrils shut for 5-10 minutes. Doing this should help the blood clot and stop running, the same way it does when you hold a bandage to a wound on your skin.
• Pinch both nostrils completely shut. While you do this, you can breathe through your mouth.
• Lean forward as much as you can. This keeps the blood in your nose, instead of allowing it to run down your throat.
• Wait 10 minutes. It seems like an incredibly long wait, but it's worth it if it stops the bleeding. Try to stay calm and think happy thoughts, so that your blood pressure and heart rate stay low.
• Apply a cold compress over the bridge of your nose. The cold will cause blood vessels to constrict, slowing the bleeding. Try one of these methods:
• Wet a washcloth with cold water. It's not as cold as it could be, but it's more comfortable than ice on your skin and it should still help.
• Make a quick ice pack. Put ice inside a resealable plastic bag, and hold it on top of your nose. Crushed ice is ideal, but cubed works, too.
• Keep frozen sponges handy. If you tend to get nosebleeds often, this trick can save you a lot of time. Get a new kitchen sponge, add a bit of water to it, and put it into a resealable plastic bag. Put the bag in the freezer, and pull out a sponge whenever you have a nosebleed — it'll be easier than hassling with ice cubes while you're bleeding.

• Bleeding started after a head injury.
• Your nose was hit, and you suspect it's broken.
• Combat dryness.
• Many people suffer nosebleeds during periods of the year when the air is dryer, or if they live in a desert climate. Here's what you can do to mitigate the risks:
• Run a humidifier. Humidifiers are available cheaply, and they're easy to manage. Run one while you sleep and turn it off while you're gone during the day.
• Use a nasal saline spray. Saline spray doesn't have anything in it but — you guessed it — salt, so its primary purpose is simply to wet your nasal passages. Use it a few times a day.
• Keep your cool. Heat can sometimes lead to nosebleeds, so take steps to keep your body and your environment a little cooler.
• Run fans or air conditioning inside your house.
• Wear breathable cotton clothing.
• Stay hydrated and drink cool water.
• Run cool water over your wrists.
• Avoid picking your nose too often, especially if you've had a recent nosebleed. 

Home Treatment for Nosebleeds

• A small amount of bleeding from a nosebleed requires little intervention. A common scenario is when a person with a cold or a sinus infection blows his or her nose vigorously and notices some blood in the tissue. Avoiding any more vigorous nose blowing, sneezing, or nose picking is usually enough to keep the bleeding from getting worse.
• To stop a nosebleed:
• Remain calm.
• Sit up straight.
• Lean your head forward. Tilting your head back will only cause you to swallow the blood.
• Pinch the nostrils together with your thumb and index finger for 10 minutes. Have someone time you to make sure you do not release the nostrils any earlier.
• Spit out any blood in your mouth. Swallowing it may make you vomit.
• After the bleeding has stopped:
• Try to prevent any irritation to the nose, such as sneezing or nose blowing, for 24 hours.

• Ice packs do not help.
• Exposure to dry air, such as in a heated home in the winter, can contribute to the problem. Adding moisture to the air with a humidifier or vaporizer will help keep the nose from drying out and triggering more bleeding. Another option is to place a pan filled with water near a heat source, such as a radiator, which allows the water to evaporate and adds moisture to the air.

Psoriasis and its Types

Psoriasis and its Types

What is psoriasis?

 

• Psoriasis is a noncontagious skin condition that produces red, dry plaques of thickened skin.
• The dry flakes and skin scales are thought to result from the rapid proliferation of skin cells that is triggered by abnormal lymphocytes from the blood .
• Psoriasis commonly affects the skin of the elbows, knees, and scalp.
• Some people have such mild psoriasis that they may not even suspect that they have a medical skin condition.
• Others have very severe psoriasis where virtually their entire body is fully covered with thick, red, scaly skin.
• Psoriasis is considered a non-curable, long-term (chronic) skin condition.
• It has a variable course, periodically improving and worsening. It is not unusual for psoriasis to spontaneously clear for years and stay in remission. Many people note a worsening of their symptoms in the colder winter months.

Types of Psoriasis

 

Plaque Psoriasis

• Plaque psoriasis is the most common type of psoriasis. About eight in 10 people with psoriasis have this type. 
• It is also sometimes known as psoriasis vulgaris.
• Plaque psoriasis causes raised, inflamed, red skin covered by silvery white scales. These may also itch or burn.

 Plaque psoriasis can appear anywhere on your body but often appears in these areas:
·         Elbows
·         Knees
·         Scalp
·         Lower back
Rather than coming and going, plaque psoriasis may last for years.

Guttate Psoriasis

Guttate psoriasis often starts suddenly in childhood or young adulthood. It occurs is less than 2% of cases. This type causes small, pink-red spots on the skin. Usually less thick than plaque lesions, they often appear in these areas:

·         Trunk
·         Upper arms
·         Thighs
·         Scalp
These things may trigger guttate psoriasis:
·         An upper respiratory infection such as strep throat or tonsillitis
·         Stress
·         Skin injury

·         Certain drugs such as beta-blockers

This type of psoriasis may go away within a few weeks, even without treatment. However, some cases are more stubborn and require treatment.

Inverse Psoriasis

Inverse psoriasis appears as bright-red, smooth, shiny lesions. These don't have scales. Inverse psoriasis usually appears in these areas:
·         In the armpits
·         In the groin
·         Under the breasts
·         In skin folds around the genitals or buttocks
Because of its location, inverse psoriasis may worsen from sweating and rubbing. For this reason, it can be hard on overweight people or those with deep skin folds. An overgrowth of yeast may trigger this type of psoriasis.

Pustular Psoriasis

Pustular psoriasis is uncommon and mostly appears in adults. Pustular psoriasis causes pus-filled bumps (pustules) surrounded by red skin. These may look infectious, but they are not. Reddening can appear first, followed by scaling and the formation of the pus-filled bumps.

This type of psoriasis may show up in one area of the body such as the hands and feet. Or it may cover most of the body (generalized). Pustular psoriasis can be very serious, so immediate medical attention is needed. Generalized pustular psoriasis can cause:

·         Fever
·         Chills
·         Nausea
·         Fast heart rate
·         Muscle weakness
These things may trigger pustular psoriasis:
·         Topical or systemic medications, especially steroids
·         Sudden withdrawal of systemic medications or strong topical steroids
·         Overexposure to ultraviolet (UV) light
·         Pregnancy
·         Infection
·         Stress
·         Exposure to certain chemicals

Erythrodermic Psoriasis

This type of psoriasis is the least common, but it’s very serious. Eyrthrodermic psoriasis affects most of the body and causes widespread, fiery skin redness that may appear burned. In addition, you may have:

·         Severe itching, burning, or peeling
·         An increase in heart rate
·         Changing body temperature
If you have these symptoms, see the doctor right away. You may need to be hospitalized. This type of psoriasis can cause severe illness from protein and fluid loss. You may also develop an infection, pneumonia, or congestive heart failure.
These things may trigger erythrodermic psoriasis:
·         Sudden withdrawal from a systemic psoriasis treatment
·         An allergic drug reaction
·         Severe sunburn
·         Infection
·         Medications such as lithium, anti-malarial drugs, cortisone, or strong coal tar products
Erythrodermic psoriasis may also occur if you have a long period where it is hard to control your psoriasis.

Nail Psoriasis

Up to half those with psoriasis have nail changes. This is even more common in those who have a type of psoriasis that affects the joints (psoriatic arthritis).

These are common symptoms of nail psoriasis:

·         Shallow or deep holes
·         Changes in nail shape
·         Thickening
·         Separation of the nail from the bed
·         Unusual color
With nail psoriasis, you are more likely to also have a fungal infection.

Nails are a more difficult area to treat because the medication doesn't easily penetrate the nail bed. It helps to keep nails trimmed as short as possible.

Psoriatic Arthritis

This is a condition where you have both psoriasis and arthritis (joint inflammation). In 70% of cases, people have psoriasis for about 10 years before developing psoriatic arthritis. About 90% of people with psoriatic arthritis will also have nail changes related to psoriasis.

The most common joint symptoms of psoriatic arthritis are:
·         Painful and stiff joints that are worse in the morning and after rest
·         Sausage like swelling of the fingers and toes
·         Warm joints that may be discolored
 

HAND/WRIST PAINFUL CONDITIONS

HAND/WRIST PAINFUL CONDITIONS

1. Overuse problems.

a. Carpal tunnel syndrome

- Caused by pressure on the nerve in the wrist.

- Symptoms are numbness, tingling, weakness or pain.

b. Tendon pain

- A series of small tears in the tissue in or around the tendon.

- Symptoms are pain, tenderness, decreased strength and movement.

c. DeQuervain’s disease

- Occurs when the tendons and the tendon covering on the thumb side of the wrist swell and become inflamed.

d. Repetitive motion syndrome.

- Occurs when pain, swelling or tenderness occur from repeating the same motion over and over.

e. Writer’s cramps

- Occurs with repeated hand or finger motion, like writing or typing.

f. Trigger finger or trigger thumb

- Is a tendon problem.

2. Bone, muscle or joint problems.

- Dupuytren’s disease.

- Abnormal thickening of tissue beneath the skin in the palms of the hands or soles of feet.

- The thickened skin or fascia may limit movement or cause the fingers to bend so the are unable to be straightened.

- Trigger finger or thumb.

- Occurs when the flexor tendon and its sheath in a finger or thumb become thickened or swell.

- Ganglion cysts - Small sacs filled with fluid that appear as bumps on the hands and wrists.

- Also can appear on feet, ankles, knees or shoudlers.

3. Problems from medical conditions.

- Tingling or pain in the fingers or hand, may be sign of heart attack, especially in the left hand.

- Diabetes may affect feeling or touch to be decreased. Decreased feeling in the hands may be due to decreased blood flow to the hands or damage to the nerves of the hands.

- Pregnancy may cause redness, itching, swelling, numbness or tingling. This will often go away after delivery.

- Osteoarthritis is a progressive breakdown of the tissue that protects and cushions joints. It may cause stiffness and pain with movement.

- Rheumatoid arthritis may cause stiffness and pain with movement. Deformity of the fingers may occur over time.

- Lupus is a long-standing autoimmune disease, where the immune system attacks normal body tissues as though they are foreign substances. It may cause joint pain.

- Gout is an inflammatory joint disease that causes acute pain and swelling. Develops when uric acid crystals form in and around joints.

- Raynaud’s phenomenon is a condition in which some areas of the body have an extreme response to cold temperature or emotional stress. During an episode of Raynaud’s, the blood vessels will tighten, severely limiting the flow of blood to the skin, causing numbness, tingling, swelling, pain and pale color.

- Infection can cause pain, redness and swelling with red streaking, heat, fever or drainage of pus. Infection can cause tenderness to touch or pain with movement at the site of the infection.

4. Finger, Hand and Wrist injuries

- Commonly occur during sports or recreational activities, work-related tasks, accidental falls, fistfights, or using machinery.

- Injuries in children most often occur during play or sports or from accidental falls.

- Adults are at higher risk for injuries and fractures due to loss of muscle mass, bone strength, balance and vision problems.

- A. Sudden Acute Injury

- - Bruises.

- - Ligament injuries.

- - Tendon injury.

- - Sprain/strains

- - Fractures.

- - Dislocations.

- - Crushing injuries.

- B. Overuse Injuries

- - Carpal tunnel syndrome

- - Tendon pain

- - DeQuervain’s disease

- Treatment may include first aid measures, medications, taping, bracing, splinting, casting, physical medicine modalities and surgery in some instances

Pain Types and Classifications

Pain Types and Classifications

Even though the experience of pain varies from one person to the next, it is possible to categorize the different types of pain.

Abdominal Pain

Whether it is a mild stomach ache, sharp pain, or stomach cramps, abdominal pain has numerous causes.

Hip Pain: Causes and Treatment

Despite its durability, the hip joint isn't indestructible. With age and use, the cartilage can wear down or become damaged.

Chronic Knee and Joint Pain

Arthritis that affects your “shock absorbers” is the cause of pain and disability in knee and hip joints that can lead to surgery.

Back Pain

The causes of back pain can be complex -- accidents, muscle strains, sports injuries. Stiffness, pain, lower back pain, and pain radiating down the leg are symptoms of back pain.

Chronic Neck and Shoulder Pain

Overexertion, pinched nerves -- all sorts of joint and muscle problems can cause neck and shoulder pain.

Whiplash

A car accident or any abrupt jerking motion to the head and neck -- and suddenly you have serious neck, shoulder, back pain. Standard X-rays of the neck may not show any injuries.

Chronic Muscle Pain

Use your muscles incorrectly, too much, too little -- and you’ve got muscle pain.

Muscle Pain

Overuse injuries -- muscle sprains, strains, and pains -- result from all sorts of assaults, small to severe. Read more about the causes of muscle pain and treatment of muscle pain.

Trigeminal Neuralgia

It’s considered one of the most painful conditions in medicine. The face pain it causes can be treated. Learn more about what causes trigeminal neuralgia and treatments for face pain caused by it. 

Shingles Pain (Postherpetic Neuralgia)

A complication of shingles is the painful after-effects known as postherpetic neuralgia.  This condition occurs only in some people and after the rash of shingles has disappeared.

Sciatica Pain

When your rear or leg muscles worsen when sitting for a long period of time, climbing stairs, walking, or running -- it might be sciatica.

Arachnoiditis: Spinal Pain

Inflamed tissue, which surrounds the spinal cord -- caused by injury, infection, or other assaults -- can cause great disability and pain

Joint Pain

See the causes of joint pain and how to treat it with both home remedies and prescribed medication.

Complex Regional Pain Syndrome

It’s a baffling, intensely painful disorder that can develop from a seemingly minor injury, yet is believed to result from high levels of nerve impulses being sent to the affected disorder.

Central Pain Syndrome

A stroke, multiple sclerosis, or spinal cord injuries can result in chronic pain and burning syndromes from damage to brain regions.

Phantom Limb Pain

Phantom pain refers to the sensation of pain felt by patients who have had a limb amputated. Treatments are usually disappointing and do not provide relief.

Diabetes-Related Nerve Pain (Neuropathy)

If you have diabetes, nerve damage can be a serious complication. This nerve complication can cause severe burning pain especially at night.

Depression, Anxiety, and Pain

Depression, anxiety, and other emotional problems can cause pain -- or make existing pain worse.

Alzheimer's disease

Alzheimer's disease

Definition:

·         Alzheimer's disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception.

·         The likelihood of having Alzheimer's disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85.

·         The main risk factor for Alzheimer's disease is increased age. There are also genetic risk factors and others.

·         There are 10 classic warning signs of Alzheimer's disease: memory loss, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor or decreased judgment, problems with abstract thinking, misplacing things, changes in mood or behavior, changes in personality, and loss of initiative.

·         The cause(s) of Alzheimer's disease is (are) not known. Although, accumulation of the protein amyloid in the brain is suspected to play a role.

·         Alzheimer's disease is diagnosed when: 1) a person has sufficient cognitive decline to meet criteria for dementia; 2) the clinical course is consistent with that of Alzheimer's disease; 3) no other brain diseases or other processes are better explanations for the dementia. Many other causes of dementia are screened for prior to diagnosing Alzheimer's disease.

What is dementia?

Dementia is a syndrome characterized by:

1.     impairment in memory,

2.     impairment in another area of thinking such as the ability to organize thoughts and reason, the ability to use language, or the ability to see accurately the visual world (not because of eye disease), and

3.     these impairments are severe enough to cause a decline in the patient's usual level of functioning.

Asthma

Asthma

Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

Common asthma triggers include

  Animals (pet hair or dander)

·         Dust
·         Changes in weather (most often cold weather)
·         Chemicals in the air or in food
·         Exercise
·         Mold
·         Pollen
·         Respiratory infections, such as the common cold
·         Strong emotions (stress)
·         Tobacco smoke

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.

Many people with asthma have a personal or family history of allergies, such as hay fever or eczema. Others have no history of allergies.

 

Symptoms

Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.

Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.

Symptoms include:

·         Cough with or without sputum (phlegm) production

·         Pulling in of the skin between the ribs when breathing

·         Shortness of breath that gets worse with exercise or activity

·         Wheezing, which:

o    Comes in episodes with symptom-free periods in between

o    May be worse at night or in early morning

o    May go away on its own

o    Gets better when using drugs that open the airways (bronchodilators)

o    Gets worse when breathing in cold air

o    Gets worse with exercise

o    Gets worse with heartburn (reflux)

o    Usually begins suddenly

Treatment

The goals of treatment are:

·         Control airway swelling
·         Stay away from substances that trigger your symptoms 
You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.
There are two basic kinds of medication for treating asthma:
·         Control drugs to prevent attacks
·         Quick-relief (rescue) drugs for use during attacks
Each type is described in more detail below.
Long-term control drugs for asthma are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel okay.
·         Inhaled steroids prevent symptoms by preventing airway swelling. These work very well and are almost always the first choice.
·         Long-acting beta-agonist inhalers also help prevent asthma symptoms. These drugs should be used together with an inhaled steroid drug. It may be easier to use an inhaler that contains both drugs.
Other control drugs that may be used are:
·         Leukotriene inhibitors (such as Singulair and Accolate)
·         Omalizumab (Xolair)
·         Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
Quick-relief (rescue) drugs work fast to control asthma symptoms:
·         You take them when you are coughing, wheezing, having trouble breathing, or having an asthma attack. They are also called "rescue" drugs.
·         They also can be used just before exercising to help prevent asthma symptoms that are caused by exercise.

Quick-relief drugs include:

·         Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, and Xopenex
·         Your doctor might prescribe oral steroids (corticosteroids) when you have an asthma attack that is not going away. 

ASTHMA CARE AT HOME

·         Know the asthma symptoms to watch out for
·         Know how to take your peak flow reading and what it means
·         Know which triggers make your asthma worse and what to do when this happens.
Asthma action plans are written documents for anyone with asthma. An asthma action plan should include:
·         A plan for taking asthma medications when your condition is stable
·         A list of asthma triggers and how to avoid them
·         How to recognize when your asthma is getting worse, and when to call your doctor or nurse
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
·         It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken.
·         Peak flow values of 50% - 80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.