VIRAL SKIN INFECTIONS: COMMON WARTSCommon warts, or verruca vulgaris, are caused by human papillomavirus infection, of which there are over 60 types. The virus infects keratinocytes by direct contact. Warts often resolve spontaneously.Groups of hyperkeratotic, cylindrical projections form and often make up a distinct mosaic pattern when fused. The lesions are typically less than 1 cm in diameter and remain confined to the epidermis. Warts can be differentiated from other lesions (molluscum contagiosum, seborrheic keratosis) by the red to brown dots within them, which are actually thrombosed capillaries. Warts are diagnosed by visual inspection. A hand lens is often helpful, as is paring with a scalpel, which can reveal the black dots and mosaic pattern described above.Common warts can be treated a number of different ways, including salicylic acid, bichloroacetic acid cantharidin, podophyllin, liquid nitrogen, tretinoin cream, intralesional interferon, blunt dissection, and electrocautery. The site and size of the lesion should be considered when deciding upon therapy. For instance, treatment of plantar warts can be lengthy and painful. Warts often require several treatment sessions. Warts disrupt the normal “fingerprint lines” of the skin. Watching for the return of these lines is helpful in monitoring response to treatment.*117/348/5*
WHY YOU CAN’T STAY AWAKE: OTHER TYPES OF DOESIf you experience a period of excessive sleepiness, you may find that it, like other sleep disorders, is a response to a transient life situation, such as conflict, loss, grief, or stress. If so, your problem will usually resolve itself within a short time. The need for additional sleep may even be therapeutic to some extent, serving to gently remove you from conscious awareness of your problem and perhaps allowing you the opportunity for further restorative sleep. However, if you find that the sleepiness persists for longer than two or three weeks, or if it begins to interfere with your daytime functioning, you should seek the advice of a physician.If no evidence of sleep apnea or narcolepsy can be found, then some other cause for excessive daytime sleepiness must be identified. Although seen relatively infrequently, any of the following types of DOES may be the source of difficulty in staying awake and functioning fully during the day.*155\226\8*
HOW ASTHMA MEDICATIONS CAN BE EFFECTIVELY DELIVERED? INHALATION THERAPY: SOME GUIDELINES FOR PARENTS
no commentsHOW ASTHMA MEDICATIONS CAN BE EFFECTIVELY DELIVERED? INHALATION THERAPY: SOME GUIDELINES FOR PARENTS/ When large volume spacers are used, actuate the MDI, make the child breathe in one puff, repeat the actuation, make him or her breathe in the second puff. Continue until the appropriate number of puffs have been inhaled./ The doses of relief medication for 0-2 and 3-4 year age groups are the maximum doses. Sometimes smaller amounts will suffice./ Some children who are receiving powdered drugs for prevention, need an MDI plus large volume spacer device for relief treatment./ Relief treatment outside a hospital can be repeated 2-4 hourly, but if there is a failure to respond or deterioration in the condition, immediate medical assessment is advised./ A child usually cannot achieve the coordination necessary to use an unmodified MDI; therefore this should not be used unless there is certainty about the child’s technique./ A child taking steroids through an MDI, should also be made to use a large volume spacer to enhance deposition of the medication in the lungs.*78\260\8*