Medsblog. About Health & Medicine

Cause

These infections of the cuticle or nailbed are due to infection with bacteria or a fungus, which enter the skin through a crack in the cuticle of the nail. This is more likely to occur if your child bites or chews his fingernails.

Clinical features

The finger is swollen and red, and sometimes pus oozes from the nailbed or cuticle. The lymph glands in the armpit may also be swollen in reaction to the infection.

Treatment

If the infection is only mild, and no pus is present, soak the finger in an antiseptic solution and then apply iodine. If there is pus in the sore, your child will probably need antibiotics. If the infection is fungal, then your doctor will prescribe an antifungal cream which should be used for 2-3 weeks.

When to see your doctor

See your doctor if your child has any of the symptoms described above or you are worried.

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All children at some time have illnesses that require medical attention. Most will be relatively minor, such as the coughs and colds that are a normal part of growing up. Sometimes an illness may be more serious, so that prompt and expert medical attention becomes a matter of life and death. Access to good medical care for your child is very important, and parents need to choose a doctor carefully.

In some communities there is only one doctor, so there may be no choice. Most parents will have a choice of health care providers for themselves and their children. Some families will have gone to the same doctor or clinic for many years, and it seems natural that the children should also attend that doctor. While there are obvious advantages in the one doctor or clinic seeing all members of the family, many parents choose a different doctor for their children, for reasons outlined below.

If your family moves into a new community, you can obtain a list of local doctors from the Australian Medical Association or sometimes from the local hospital, or else ask friends, neighbours or the local maternal and child health or community nurses. Parents should not hesitate to ‘interview’ doctors to see whether they seem appropriate to provide medical care for their child. If you don’t have a good instinctive feeling about the doctor after talking to him, it may be wise to seek somebody else.

Here is a checklist of some of the things that you may want to consider in choosing a doctor for your child. The list is not intended to be complete and is not in order of importance. You may wish to add points you think are important.

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DIMINISHED AFTERGLOW: I don’t glow after sex, I just sort of smolder. I think it’s the origin of the word “burnout.” I feel spent.

HUSBAND

Absence of afterglow was reported in 907 of the husbands. They could not understand the idea of feeling invigorated after sex, instead feeling that sex had exhausted their energy supply, at least temporarily.

I feel a sense of relief, or completion, but I sure wouldn’t say a “glow.” It’s like a job well done. It’s getting off.

WIFE

Five hundred fifty-one women reported the lack of or diminished afterglow. More often than the men, they knew about afterglow, might have felt it following some of their sexual experiences, including masturbation, but reported a connection between partner and the afterglow phenomenon. It is difficult to glow alone after being sexual with someone.

DIMINISHED CONTEMPLATION: I just tune out after it’s over. I don’t feel like moving, thinking, talking, or doing anything but sleeping. I drift away.

HUSBAND

Four hundred fifty-three men reported the absence of or no understanding of reflection or contemplation following the sexual experience. The “energy release” model of early sexual research probably conditions many men to feel that an athletic event has ended when sex is over. It was new for most of the men to ask themselves about satisfaction, to reflect on the sexual experience rather than to forget it.

I’ve learned to tune out after sex. I used to laugh sometimes, cry other times, or sometimes get real philosophical. It was like I was on a drug after sex, like it was with some good pot. Now I don’t have the time or the interest. I just turn over and go to sleep.

WIFE

One hundred twenty women reported this problem, and the majority of the wives in the sample reported that the reflective phase of the sexual system diminished with length of marriage. Our culture’s linear view of time, the start/stop orientation we bring to sex, does not help us reflect. We tend to be prospective in our sexuality; foreplay is much more popular than after- or replay. Hot-running life-styles allow little time for looking back or prolonging experiences through reflection. We barely have time to enjoy the moment once, and seldom twice or thrice.

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We have never really talked. When I ask her for more attention, more feeling, she takes it as a criticism orputdown. We just can’t talk it over, work it out. She has no idea how I really feel inside.

Husband

Do you feel clearly understood in your marriage, sometimes even well beyond what you say or do? Do you feel “well sensed ” and listened to beyond words (attention)? Or do you seem to have to expend a great deal of energy just to get your feelings stated, and even then feel misunderstood (disattention)? This atten-tion/disattention issue is another example where it seems that attention must be much “better” than disattention. The purpose of taking this test is to learn a new view of the marital system that allows for constructive disattention, some relief from the vigilant state required for constant attention. It’s the strong relationship that can tolerate misreadings and occasional low empathy because it is counterbalanced with corrective reading and sensing of one another’s feelings. If you score this test by placing each item on a circle instead of a line, you see how systems theory works. Too much attention, for example, throws the circle off balance; it turns awkwardly and may steer off course. The same is true for too much disattention.

One of the husbands managed to learn this new scoring system by equating it to breathing. You need to inhale good fresh air, but you have to make time to exhale also. This “flowing” concept is at the heart of a systems view of intimacy.

Attention in this case does not just refer to talking and listening. Psychotherapy, marital therapy, and so-called sexual therapy focuses primarily on words, on talking, thinking, listening, and physically touching and being touched. Super marital sex adds “supersensory” communication. I am not referring to “extrasensory” perception, because sensing is not an “extra.” We all have

it, but we must learn to develop it. Supersensory marital communication can be practiced, enhanced, and strengthened. We can go beyond talk-and-touch therapy, and work toward our own forms of “marital telepathy.”

Physicists know that communication takes place on levels beyond the see and touch world. Physicist Fritjof Capra writes, “Throughout history, it has been recognized that the human mind is capable of two kinds of knowledge … the rational and the intuitive.” This part of the marital sexual system test refers to the intuitive dimension of marital interaction, a dimension too long ignored by professional therapists and health-care workers. All healing depends as much or more on intuitive communication and awareness than it does on the rules of rational, verbal communication.

Our example couple scored high toward the disattention end of the axis. Not only was the husband unaware of his wife’s pain, but she, too, failed to sense his difficulties. The husband stated, “I leave the table because I just don’t know what to do. If I try to help, I think she thinks I don’t think she is doing a good job, sort of letting us all down.” The wife responded, “He just does not give a damn. He’s just lazy and self-involved. He never gives one thought to how I might feel.”

When I presented a part of this report at a recent professional meeting for therapists, one of my colleagues stood up and said, “I tell my couples that the only way anyone is ever going to know how you feel is if you tell them. You must share your feelings and listen for the feelings of your spouse. Now you come along and tell us that there is some sort of ’supersensory communication’ in marriage. There just is no such thing. We have to talk, listen, and do. This is a ridiculous idea . . . sensing. That’s when couples get in trouble, trying to sense instead of trying to communicate.”

I responded by saying, “You are making an important point, but if you will let me continue, I think I can document my ideas with case examples.”

The therapist answered, “Never mind. I can just tell what you are going to be saying, and I don’t want to hear it.”

The audience laughed at the obvious contradiction, referring to his “sense” of what I was going to do as a means of denying that sensing goes on all the time.

Again, some “rest” from constant attention is necessary in any system. Watching and listening or being watched and listened to all of the time can be as disruptive to the marital system as no attention at all.

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The nails are often affected, usually with evidence of psoriasis elsewhere but, occasionally, they alone are involved. In this case, the diagnosis may be missed and the problem thought to be due to fungal infection or some other cause.

The nail may show small pin-head size pits or the nail may separate from the underlying nail bed or it may be thickened and discolored.

Unfortunately, treatment produces little benefit. Psoriasis on the skin responds well, in most cases, to local applications but the nail seem particulary resistant.

Patients undergoing treatment with methotrexate often show an improvement in their nails.

It is worth repeating that most cases of psoriasis are mild and can be controlled by simple means. Self-medication should be avoided, as it may irritate the skin.

Sometimes a previously satisfactory treatment loses its effect. When this happens the sufferer will need to change to something else. Later, the original treatment may again be effective.

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The most common symptoms are abdominal pain and diarrhoea and the diagnosis may be missed and thought to be either an episode of mild appendicitis or the irritable-bowel syndrome.

Sometime ulcerative colitis may be suspected, if Crohn’s disease affects the large bowel. At times there is a fever and weight loss.

When the rectum and anus are affected there may be localised pain, bleeding and sometimes a fistula or track leading from the bowel and opening out on to the skin around the anus.

Involvement of large areas of the small bowel may lead to poor absorption of food, anaemia, vitamin deficiencies and malnutrition.

Treatment is not altogether satisfactory, as this is often so in diseases where the exact cause is not always known. Cortisone or its derivatives are often used as in any chronic inflammatory disorder.

One of the antibacterial sulpha drugs can be of value in acute flare-ups, but is of little use in long term maintenance.

It may be necessary to operate and remove the affected segment of the bowel when medical treatment fails.

Most patients can be kept in reasonable health and can live full and active lives.

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Almost one in three babies have episodes in which they cry vigorously, sometimes for several hours, draw up their legs and go red in the face.

It is usually assumed they have abdominal pain. This “three-month colic” usually starts in the first six weeks of life, nearly half having stopped by three months and 90 per cent by six months.

The cause is unknown, but is often said to be due to intolerance to cows’ milk. However, breast-fed babies seem as prone to get it as those artificially fed.

Cows’ milk proteins are thought to enter the mother’s breast milk and taking the mother off cows’ milk may be of benefit.

Many of these babies seem to settle with a mixture containing antispasmodic drugs with a sedative.

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Emergency symptoms

Apply emergency treatment immediately.

Emergency treatment

1.    Give essential life-saving first aid: take steps to stop bleeding and make sure the child’s airway is open.

2.     Get professional help immediately. Call police or paramedic squad.

3.     Keep the child lying flat with the head lower than the body (unless there is a head injury).

4.     If there is a head injury, have the child lie flat without elevating the feet.

5.     Keep the child warm.

6.     Do not offer food or water.

Symptoms: weakness; feeling faint; rapid, weak pulse; paleness; cold, clammy skin; cold sweat; chills; dry mouth; nausea; rapid, shallow breathing; restlessness; confusion.

Precaution

Shock can be fatal if the victim does not get immediate professional emergency care.

Shock is the term used to describe a sudden drop in blood pressure or a collapse of the circulatory system, which seriously reduces the blood supply to all parts of the body. Shock is an extremely dangerous condition; if it is not treated quickly it is usually fatal.

Generally, shock occurs when a great deal of blood or body fluid has been lost. It can also occur when blood vessels dilate (expand) and cause blood to pool or collect in one part of the body instead of circulating normally. The danger of shock exists in virtually every case of serious accident, injury, burn, or poisoning. Shock can also follow any of the following: severe infections; wounds or broken bones; hemorrhage (severe and uncontrolled bleeding); insect stings (in people who are allergic to the insect’s venom); excessive vomiting or diarrhea; heart attacks; or reaction to certain drugs.

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•    The way that your labour is handled greatly depends on the obstetrician at your local hospital. There is no evidence that hospital is a safer place to have a baby (unless you are at high risk for some reason)-a home birth can be just as safe or even safer. Make a birth plan and discuss it with your obstetrician early on in pregnancy. If you want to avoid having an episiotomy, an epidural, and so on, say so and put it all in writing to the hospital. Surgical and other interventions can save babies’ lives but can produce problems too. The best way of ensuring that you have as trouble-free a birth as possible is to go to ante-natal classes to learn about birth and to prepare you for what is to come.

During the labour keep upright and walking around as long as possible and then give birth standing, squatting, kneeling or indeed in any position that keeps your body upright. This provably helps improve the blood supply to the baby, and makes labour shorter and less painful. Most women who give birth in this position are very loath or even refuse to deliver on their backs in subsequent labours. Because labour is quicker the baby is less likely to suffer from a shortage of oxygen. All of these factors contribute to a greater chance of having a normal, healthy baby.

Asphyxia (a shortage of oxygen) is the commonest cause of preventable death or handicap occurring at the time of delivery, but much of the danger can be avoided by giving birth in an upright position and by having trained staff with oxygen available in case a baby is born with asphyxia. Permanent brain damage can occur after a remarkably short period of time with an insufficient supply of oxygen to the brain.

•    After low birth weight, congenital malformations are the next most common cause of infant death. In the UK 18 per cent of first-week deaths and 20 per cent of perinatal deaths are caused by congenital malformations. Some of these can be prevented by taking proper care before conception and during pregnancy.

•    Treating neonatal jaundice is a way of preventing cerebral palsy (a diffuse group of neurological conditions that produce a ’spastic’). There are six spastic babies born every day in the UK-over 2,000 a year. In some cases the recognition of a failing placenta, followed by appropriate action, is another way of preventing this heartrending handicap: babies who are suffering from poor placental blood supply can be delivered with the minimum of trauma and have their asphyxia (if any) treated so as to be born healthy and normal. The prevention of premature babies and their care in intensive nursing facilities can dramatically reduce the numbers of spastic babies born from this cause.

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Reproductive and sexual behaviour

These both influence the incidence of certain cancers, and change with westernization. Early first childbirth and having large numbers of children both reduce the incidence of breast cancer. In the West we delay the birth of the first child and women have few children. Both of these things have produced substantially higher levels of breast cancer in the West. Cancer of the ovary is also seen more in populations with reduced fertility. Cancer of the cervix, in contrast, increases in incidence with greater fertility. This relationship may be related to the proven link between early promiscuous sexual activity and cervical cancer. No one knows why this should be but the current theories are that smegma (the white matter that can collect under an uncircumcised man’s foreskin) or even semen itself might be carcinogenic. A more recent suggestion is that cancer of the cervix is caused by a venereally transmitted virus such as herpes. Genital hygiene and the use of a condom (sheath) reduce these risks.

Occupational exposure to chemicals

This is an unfortunate side-effect of moving off the land and into factories. It has led to increasing numbers, of men especially, being exposed to carcinogenic chemicals, for much of their working lives in certain industries. It has definitely caused an increase in tumours of the bladder and the skin. A particular type of lung tumour is seen commonly in those who work with asbestos dust. No one knows how great a problem industrial exposure to carcinogens is and today many known hazards have been reduced or totally removed, but westernized peoples are still exposed to food additives, washing-up liquid residues, air pollutants, water pollution from industry and agriculture and frank chemical hazards at work in varying amounts. The harm done by some of these agents is well known and provable, yet we continue to bombard ourselves, often quite unnecessarily, with chemicals of a dubious nature.

Improved hygiene

Better sanitary conditions are a reason for falling levels of certain sorts of cancer as populations become westernized. Cancer of the liver is the best example here. There is increasing evidence that hepatitis  is an important factor in the production of liver cancer and this infection falls with improved personal and community hygiene. Greater personal hygiene in the West has also led to a reduced number of cancers of the penis.

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