Health | Panacea

Normal Laboratory Values: Hematology

noreply@blogger.com (Unknown) — Sat, 28 Mar 2009 04:53:00 +0000

Hematology normal values (Conventional)

Blood Volume = 8.5-9.0% of body weight in kg
Red Blood Cell (RBC) = Male: 4.6-6.2 million/cu. mm Female: 4.5-5.9 million/cu. mm
Hemoglobin (Hgb) = Male: 13-18 g/100 mL Female: 12-16 g/100 mL
Hematocrit (Hct) = Male: 45-52% Female: 37-48%
Leukocytes (WBC) = 4,300-10,800/cu. mm

Bands: 0-5%

Basophils: 0-1%

Eosinophils: 1-4%

Lymphocytes: 25-40%

*B-Lymphocytes: 10-20%
*T-Lymphocytes: 60-80%

Monocytes: 2-8%

Neutrophils: 54-75%

Platelets = 150,000-350,000/cu. mm
Erythrocyte Sedimentation Rate (ESR) = Male: 1-13 mm/hr Female: 1-20 mm/hr

Breast Care: Preventing Abnormal Growths

noreply@blogger.com (Unknown) — Tue, 10 Mar 2009 03:38:00 +0000

Recently, a high school classmate of mine was admitted to the hospital for a 2 cm tumor in her right breast. Good thing is, the biopsy went well but I warned her that this is not the right time to rejoice and taking them for granted. She might be at risk for malignancy and that means she has to submit to annual breast examination and check up. Although fibroadenomas rarely become malignant she should be careful. Women read the tips below:

Wear a good fit bra

A well-fitted bra can prevent unwanted injury of the breast from activities of daily living. Athletic women should be cautioned on choosing the right bra for their sports. Loose bras cause the pulling of the supporting ligaments of the breast which then results to long term sagging. Girls you won't like that right? Your breasts may begin to droop and fall to the bottom of the cup. The breast tissue will role off the chest wall and under the arm, thus pulling on the neck. Headaches results, since the muscles being pulled in the shoulders go all the way to the head. Reduced circulation to the head can cause headaches and backaches, as the extra weight of the bust places more pressure on the back. A tight one can impede breathing since it compresses the chest wall much.

Use hormone replacements cautiously

Long-term hormonal replacement medications are said to cause abnormal growths not only in the breast but also in other organs of the reproductive system. Usually, it increases breast cancer risk.The risk of developing one of the less common lobular or tubular breast cancers increases twice as much under hormone replacement therapy as the risk of the common type of ductal carcinoma, which constitutes 40 to 75 percent of all malignant tumors of the breast—Dr. Wilhelm Braendle, Hamburg-Eppendorf University Hospitals.

Have a monthly breast self-examination

Breast self-exam is taught among the adolescents before they reach their teenage years. Make it sure it is performed right after menses. The recommended time is just after the end of the last period when the breasts are least likely to be swollen and tender. Older, menopausal women should do BSE once a month, perhaps on the first or last day of every month. Report to family physician if anything unusual is observed.

Avoid eating 'junk' foods

Foods with preservatives like processed foods may precipitate abnormal growths in the body. Eat less fat and grilled, charred food and eat more fresh preservative-free foods. The longer the shelf life the bigger the amount of preservatives are added in the food. Be a wise shopper and diner. Go organic!

Knowing Varicella

noreply@blogger.com (Unknown) — Mon, 23 Feb 2009 14:54:00 +0000

A special someone contacted varicella for the past 2 weeks. Lucky enough for me I had my exposure when I was 8. A scar under my eyebrows is the living proof. Blisters suddenly grow after a relief from a fever. They begin to produce purulent fluid within the thin-walled blisters in 12 hours and grow at the center to the limbs of the body until they leave crater-like remnants on the skin that fades eventually. Chickenpox as what everyone calls it, is a highly infectious disease that requires not only contact but also airborne precautions to people who haven't had the disease or did not receive any varicella shot. Shots are readily available in the nearest public health centers but for third world countries early exposure of the disease is undeniably cost-effective. The growth of adult-onset chickenpox is frustrating since blisters are more distributed on the face than the extremities. A child's blister distribution is dispersed compared to an adult's and it fades as the child matures. Take note on this:

Early detection is good
Once 'chickenpox' blisters starts growing at the midline of the body consult a health provider to control the symptoms. Acyclovir, an antiviral medication is usually prescribed before blisters begin to multiply and pus.

Don't touch it!
Touching the pus-filled blisters does not only ruptures it but also promotes infection. Handwashing is essential before checking on them. Fingernails should be cut short.

Itch out!
Along with antivirals, antihistamines like Benadryl is also prescribed to get for the itch. Itch causes scratching and scratching with dirty hands and fingernails causes rupture and infection. Drowsiness is often the side effect of antihistamines. Consult a physician to determine the appropriate medication. Calamine lotion also reduces the itch. It also promotes crusting since it leaves them dry when applied on the affected areas.

Get grounded!
Stay at home & reduce the spread of infection to susceptible individuals especially pregnant women during their first 28 weeks of gestation. It causes harmful effects on the fetus. The crust usually falls off after 7 days. Although one lesion goes through this complete cycle in about seven days, new lesions crop up every day for several days. It may take a week before blisters stop appearing. Children should not be sent back to school until all lesions have crusted over.

Sunscreen helps
Sunscreen helps the darkening of the scars. Avoiding or omitting soy sauce in food also helps. Ointments or creams for the scars may be prescribed by a dermatologist.

Points on Skin Allergies

noreply@blogger.com (Unknown) — Fri, 26 Dec 2008 12:11:00 +0000

Personally, I do have an allergy with a component of a certain nasal decongestant. The symptom I usually get is a scaly appearance on the skin of my hands & feet, the palms and the soles. I'm pretty thankful that it doesn't affect my face or any part of it. The first action that most people do with their symptoms is to seek relief from it. There are a number of steps that can be and should be taken as soon as possible. One of these steps involves determining what is causing an allergic reaction.

Know Your Allergy

For example, do you develop a rash right after doing yard work? If you do, you may have seasonal allergies. Do you develop a rash after holding a cat? If you do, you may have pet allergies, and so forth.

Consult Your Doctor

You may want to consider scheduling an appointment with your doctor. Some individuals are even more surprised to learn that they may have multiple trigger factors, like certain foods or chemicals that are found in many household products, such as laundry detergents and even metal kitchen utensils like copper! One of the many reasons why you will want to consider seeing a doctor is because they can help you determine what you are allergic. Of course, you can try your own experiments at home, but you will want to proceed with caution. This is important if you think the cause of your skin rash or allergic reaction is food, as your symptoms can become much more severe. That is why you are advised against performing your own allergy tests at home, but if you do, just make sure that you aren’t alone when doing so.

Seek Appropriate Relief Per Prescription

Once you are able to determine what is causing your skin to have an allergic reaction, you can better go about seeking relief. First, over-the-counter allergy medications may be examined. There are also lotions and creams that can provide you with relief from itching and or hives. If you visit your doctor, he or she may be able to recommend specific products to you. If a doctor is inaccessible try to ask your local pharmacist for the best drug of choice.

Try Basic Home Remedies/Alternatives & Prevention

It is also important to know that you can seek relief without the use of over-the-counter products. For example, oatmeal when mixed with one cup of boiling water, let cooled, and then strained can provide relief to those who have hives. The water extracted from the oatmeal can be dabbed on the skin. You can also reduce your skin reactions by eliminating or significantly reducing your trigger factors. For example, if you are a pet owner who cannot bear to part with your pet, consider not holding them or petting them without gloves, keeping them out of your bedroom, and perhaps invest for an air purifier.

Tips for Peanut Allergies

noreply@blogger.com (Unknown) — Wed, 24 Dec 2008 00:40:00 +0000

A little overview of peanut allergy, it is one of the leading causes of food-related death due to complicated anaphylactic shock or hypersensitivity allergic reaction. It is important to do as soon as your child can understand the concept of allergies and not eating certain foods. As early as 6 months parents should introduce food one at a time to determine which of it is the infant's allergy. Bear in mind that there should be a 4-day trial period for the newly introduced food. According to experts, he best time to reinforce the teaching occurs at the preschool level. You may need to talk to your child more than once, but it is important to let them know what could happen if they carelessly share food with friends or classmates. Teen should be taught how to check the food labels.

Inform

Inform everyone around the child about the allergy like their teachers in school, seatmates, friends and friends' parents. You may be surprised to know that many food allergies, happen when parents are not around. That is why it is extremely important that all adults know about your child’s allergic reactions to peanuts. When your child leaves your home to visit friends or family, pack safe snacks for them to eat.

Ask Questions

If you and your child are known for eating out, it is important that you ask as many questions as possible. You should do so at all eating establishments, but it is particularly important to do at a bakery. Are all baked goods made in the same spot, like on the same table? Even if not, are gloves changed? What are the chances that a peanut or peanut butter can make its ways into other foods? You should know before feeding your child anything that you did not prepare yourself.

Read the Labels

Speaking of the foods that you do prepare yourself, be sure to read all food labels. When doing so, you may be surprised just how many products have warnings that claim that peanuts may be present. Even if they only “may,” be, you are still advised to proceed with caution and skip. Also, make sure that you always read labels, as food manufacturers are known for updating or changing their ingredients.

Be Alert

It is also important to know how to handle a reaction. There is a good chance that your child’s doctor will teach you the proper steps that you should take, which will likely include administering medicine to help your child breathe. It is also important to educate those around you too. Make sure that all relatives, parents of friends, and school teachers know what to do in the event of an allergic reaction to peanuts. If medication is provided by your doctor, which it should be, make sure the school has some and always carry the medication with you, like in your car or in your purse.

Assess For Allergic Reaction

Vomiting
Diarrhea
Urticaria (hives)
Angioedema (swelling of the lips, face, throat and skin)
Acute abdominal pain
Exacerbation of atopic eczema
Asthma
Anaphylactic shock

Tawa-Tawa: A Remedy for Hemorrhagic Fever

noreply@blogger.com (Unknown) — Thu, 27 Nov 2008 14:24:00 +0000

July 1996, Philippine Southfield School grounds. Time for general cleaning for the upcoming Nutrition Month culmination day. We finally cleared the drainage from mineral water bottles, planted and trimmed the durantas around our classroom and dusted the jalousies, that's the last thing I remembered before it all started. I felt weak and hot. It must be out of exhaustion. I asked permission from the prefect to go home before dismissal. I arrived home at lunch time and went flat at bed. The next day, I was fine. Then I went hot then off the next morning. My temperature was like a switch, on and off. The fourth day, I grew rashes on my arms. I was rushed to the nearest hospital and blood work was pretty bad. A platelet below normal.

Dengue Hemorrhagic Fever is viral disease in the tropics from a vector, a mosquito of either Aedes aegypti or A. albopectus. A few days after the bite, the patient develops an 'on-and-off' of fever and joint pain also known as break-bone fever. The client must be rush to the nearest hospital when the fever subsides for IV fluids. At this time, platelet count drops and bleeding is inevitable. No cure is known for its treatment is palliative in nature. Just IV fluids, pain medication and a stand-by platelet transfusion to prevent hypovolemia and the dangers of it.
Today, with the spread of helpful information about and against Dengue, people discovered a remedy and it grows all throughout the Philippines. Euphorbia pilulifera also locally known as Tawa-Tawa. This is how you prepare the concoction:

Take 25 newly uprooted Tawa-Tawa plants.
Cut off the roots
Wash and clean
Fill pot with 7 glasses of clean water then boil
Slowly boil the Tawa-Tawa for 1 (one) minute
Strain out the Tawa-Tawa leaves and stems from the concoction then let it cool
Sip 1 to 1.5 glasses of Tawa-Tawa concoction every 1 hour for 24 hours

The concoction should be given as early as possible or right after the diagnosis. According to some preliminary research conducted in Davao, Tawa-Tawa has naturall anti-viral and anti-bacterial properties that can cure even at stage 4 of the dreaded disease. For more piece of information about Tawa-Tawa click here

Healthy Fat Intake

noreply@blogger.com (Unknown) — Sat, 22 Nov 2008 14:07:00 +0000

This posting is aimed to help you to reduce not eliminate. your fat intake. The average individual eats too much fat, a factor that's linked to a variety of health problems, and cancer. Diets that are high in fat are associated with breast and colon cancer, with some studies linking high fat to prostate cancer as well. But hereditary also predisposes the likelihood of having such disease.
A majority of people can bring their fat intakes down to a healthy range by making a few adjustments in the way they shop, cook, and prepare the foods they eat. Now days, it's getting easier and easier to control the amount of fat you consume. The fat content of foods are now available through the nutrition label and through brochures distributed by food companies and even fast food restaurants.
You can use this information on nutrition to choose lower fat foods by comparing products and food brands. Once you have a rough idea of what a healthy intake of fat is, you'll know what you can and what you can't have. From day to day, the amount of fat you eat will vary. Some meals and some days will be higher in fat than others. Even high fat meals can be kept in line with healthy eating as long as you balance those days accordingly. The average fat intake over the course of weeks and months is important, not the fat intake of every meal and food you consume.
Younger adults and high active adults who have higher calorie needs can probably eat a little more fat. Older adults and those that aren't very active should aim for a lower fat intake. This way, you can control your fat intake and avoid the many problems that fat is associated with. There are a few postings in my blog that might help you with having a health meal by clicking here.

Physical Assessment: Checking for Fluid Wave

noreply@blogger.com (Unknown) — Thu, 20 Nov 2008 16:32:00 +0000

This test is done to determine ascites or an excess of fluid in the peritoneal cavity, the cavity that encloses most of the abdominal organs. It is performed by having the patient push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap. Fluid allows the tap to be felt on the other side.

Bisphenol A: An Environmental Risk Factor for Cardiovascular Disease?

noreply@blogger.com (Unknown) — Mon, 10 Nov 2008 09:28:00 +0000

In a cross-sectional analysis, high urine concentrations of a commonly used industrial chemical were associated with diabetes and coronary events.

Bisphenol A (BPA) is added to the plastic used in products such as baby bottles and to the epoxy that lines food cans. Most individuals in industrialized countries are thought to have BPA in their bodies. In humans, BPA may bind to estrogen receptors, and concern has arisen as to whether it might adversely affect health.

In this study from the U.S. National Health and Nutrition Examination Survey 2003–2004, investigators measured total concentration of BPA in urine samples collected from 1455 adult participants and determined whether urine BPA concentrations were associated with self-reported histories of physician-diagnosed arthritis, cancer, cardiovascular disease (angina, coronary heart disease, or heart attack), diabetes, liver disease, respiratory disease (asthma, bronchitis, or emphysema), stroke, or thyroid disease. The odds ratio for a diagnosis of cardiovascular disease or diabetes was 1.39 for each 1 standard-deviation increase in urine BPA concentration (P<0.001>

Comment

Despite recent assertions by the FDA of the safety of bisphenol A, criticism is mounting about its use in consumer products because of its potential neurologic and reproductive health effects. By linking BPA concentrations to increased risks for diabetes and heart disease, these new data raise questions about the current assumptions and assessments the FDA has made. These findings should stimulate additional studies into the potential health effects of BPA.

— JoAnne M. Foody, MD

Eating Healthy For A Healthy Heart

noreply@blogger.com (Unknown) — Wed, 05 Nov 2008 13:12:00 +0000

It's impossible to eat healthy our whole lives, even though we may try hard to do it. Eating healthy for your heart is something everyone should try to do, especially when it comes to restoring health and reducing heart attacks.

Your heart and food
We know these things for sure - a diet high in saturated fats will help raise your cholesterol, which is a risk factor for heart disease and worst fatal heart attacks. People that are obese are more prone to heart disease. A diet high in sodium may elevate your blood pressure, leading to constriction of the blood vessels.

To help prevent heart disease and improve your health, put the tips below to good use.

Eat plenty of fish
Herring, sardines, mackerel, tuna and salmon are all excellent sources of Omega 3 essential fatty acids. Other fish are great to, although Omega 3 may help to get your cholesterol down to a healthier level.

Choosing healthy fats and oils
Saturated fat will increase the risk of heart disease. It's found in meat, butter, and even coconut oil. You should avoid them until your cholesterol levels are down and you are at a healthy weight. Even those that love red meats can enjoy seafood and nuts for their main sources of protein. Monounsaturated fats such as olive oils will help you to protect your heart. Olive oil is an ideal choice for cooking, dressing, or even as a dipping sauce.

Plenty of Roughage
Fiber can help you control your cholesterol. You can find fiber in whole grain products to help control sugar absorption as well, which will help you keep your digestive system healthy.

Choosing the right carbohydrates
Eating for your heart involves staying away from sugary foods such as candy, cookies, cakes, and pastries. Eating a lot of sugar isn't good for your heart disease at all. Healthy carbohydrates involve whole grain breads, whole grain pasta, brown rice, and a lot of vegetables. You should make fruits and vegetables the main aspect of your diet.

Healthy cooking methods
Stir frying and sauteing with olive oil or canola oil are both great methods, as you shouldn't dip your food in batter and fry it anymore. If you cook chicken, remove the skin and bake it in the oven in foil. Instead of frying your fish you should always bake it. Steaming your vegetables can help maintain the most nutrients. You should use cream sauces or lots of butter anymore either. When you eat vegetables, try squeezing lemon juice on them or using your favorite seasonings.

As you make the proper changes to your diet, keep in mind that it takes time for them to become habits. Eating healthy is always great for your body and your lifestyle, especially when it comes to your heart and the prevention of heart disease.

Physical Assessment: Checking for Rovsing's Sign

noreply@blogger.com (Unknown) — Fri, 31 Oct 2008 02:45:00 +0000

A Rovsing's sign is elicited by palpation on the abdomen far from the appendix in the left lower quadrant (LLQ) as in most people the appendix is in the right lower quadrant. While this maneuver stretches the entire peritoneal lining, it only causes pain in any location where the peritoneum is irritating the muscle. In the case of appendicitis, the pain is felt in the right lower quadrant despite pressure being placed elsewhere. If left lower quadrant pressure by the examiner leads only to left-sided pain or pain on both the left and right sides, then there may be some other pathologic etiology. This may include causes relating to the bladder, uterus, descending (left) colon, fallopian tubes, ovaries, or other structures. The maneuver is said to named after a Danish surgeon, Niel Thorkild Rovsing Kimpel.

Cryopreserved Sperm from Men with Malignancies Can Produce Pregnancies

noreply@blogger.com (Unknown) — Mon, 27 Oct 2008 11:44:00 +0000

Preserving sperm before cancer therapy can enhance the likelihood of later fatherhood.

As survival rates after cancer rise, more emphasis has been placed on preserving fertility despite probable chemotherapy- and radiation-induced sterility in both men and women. Does cryopreservation of sperm before treatment allow men who survive cancer to father children later? To address this issue, researchers evaluated data from all 118 couples who underwent in vitro fertilization (IVF) procedures with pretreatment cryopreserved sperm during a 12-year period at a single center in New York City.

Before cancer treatment, about 43% of men had at least one abnormal parameter in their semen analyses, and about 20% had very-low total sperm counts (<5>

Comment

Data on the health of the children born to this cohort are still limited, but no evidence has accrued to date for excess genetic abnormalities. Although we must remain cautious, these findings emphasize the need to discuss future fatherhood with young men who have malignancies and to encourage cryopreservation of sperm before cancer treatments.

— Robert W. Rebar, MD

Smoking, Breaking A Fatal Habit

noreply@blogger.com (Unknown) — Sat, 25 Oct 2008 17:00:00 +0000

Working on to quit smoking is one of the hardest things that many people encounter. There are countless reasons why it is so difficult not to quit. There are two main reasons that are most often cited, the habit of smoking itself is extremely hard to break and procrastination or delaying. The task then becomes an ordeal to break the habit. After all, it took you a while to get into the habit of smoking so reason stands that it will take a while to break the habit.

If you are determined to quit smoking, you have made a good start. Quitting on your own means that you are doing even better. Strange isn't it? You would be surprised at just how many people “decide” to quit smoking by being informed by their doctor, spouse, parent, sibling or friend that they will be quitting. In order to successfully quit smoking for good you need to decide for yourself to quit. There is a popular line saying 'What the mind perceives the body achieves.' If you have actually made this decision on your own, you are doing a terrific job. If you are letting someone push you into quitting you are just setting yourself up for headaches, hassles and complications that are easily avoided.

As a smoker, you have no doubt developed a pattern to your smoking. For example, if you are a typical one pack a day smoker one of your habits is to smoke a pack a day. You need to take small steps to break these habits. Perhaps you will find best luck in simply changing your habits slowly. For example, if you typically smoke a cigarette after each meal, you might find it helpful to brush your teeth. This can have the effect of providing a fresh mouth that you do not want to dirty with cigarette taste. You might find that after each meal you need to try chewing a piece of gum, sucking on hard candy or even attempting nicotine gum. If there are any specific circumstances that always trigger a cigarette craving, you should work to avoid the situation like stress and anxiety we have measures to prevent such occurrences. Diversional activities will help you avoid the itch on grabbing a stick of cigarette. Activities that you enjoy the most that prevents you from giving in the urge to take a cigarette. If it is something that you absolutely cannot avoid, such as dinner times, you need to create an alternative habit that you replace smoking with. For example, if you always smoke as soon as you get to your car after work, you might want to consider carpooling with someone who does not smoke, taking a different route home, stopping for groceries, jamming to some music or even taking a bus. Anything you can do to shake up your normal smoking routine is good. There will of course be times that it is quite difficult to break the habits. If you find yourself in a position where you cannot avoid a typical smoking situation, you need to create a way to deal with it.

Some people use nicotine gum whenever they are faced with a smoking situation. However, nicotine gum has potential side effects that might be even worst for your health and that's addiction. Aside from that you get hiccups from such lame alternative and gum disease which will increase the potential of bad breath and falling teeth. Remember, nicotine is a powerful vasoconstrictor (ability to narrow the lumen of blood vessels). We won't add you up another problem on that. Others find that the stop smoking sticks are beneficial. These sticks can allow you to hold a pretend cigarette that just provides your hands with something to do. If you find these quite useful then you know that your problem is your hands are idle, finding something for your hands to do might help a lot.

Trying to quit is a very difficult process and it entails an amount of time before you see effects of the newly adopted routine. Many people take weeks if not months to quit smoking completely. If you find it too drastic to quit smoking slowing down might help you. Reducing or cutting off your consumption of cigarettes helps a lot in the process. Regardless of the method that you choose, it can take a minimum of 2 weeks to start adapting new habits. This means that any new behavior you adopt in your quest to stop smoking must be repeated continuously for at least two weeks before you will start to see a real difference in your lifestyle. Adherence is the key to achieve this. Giving yourself plenty of time to work on your new habits is essential and will set you on the road to success to a healthier smoke-free lifestyle.

Facts on Regional Entiritis (Crohn's Disease)

noreply@blogger.com (Unknown) — Sat, 25 Oct 2008 07:59:00 +0000

I haven't come across inflammatory bowel diseases much and only know one, ulcerative colitis which I am going to post later. It commonly occurs among adults or young adults but may appear any time in the entire lifespan. Although women are more susceptible but the older population experiences the bouts more than any other age group (Between the ages 50 to 80). The site of affection is commonly located at the distal ileum and colon. Crohn's may be subacute or chronic inflammation which extends through all layers of the intestinal wall. Remissions and exacerbations happen. The pathogenesis begins with intestinal edema and of course, thickening of the mucosa then ulcers begin to appear on the inflammed areas. Lesions are not in continuous contact with each other for they are separated with normal tissue. As the disease progresses into the peritoneum fistulas, fissures and abscesses form. Bowel wall thickens and becomes fibrotic and the intestinal lumen narrows in the advance stage. Granulomas form in almost half of the patients. Diseased bowel loops sometimes adhere to other loops surrounding them.

Clinical Manifestations:

Lower right quadrant pain
Diarrhea unrelieved by defecation
Crampy abdominal pains AFTER MEALS
Abdominal tenderness and spasm
Weight loss
Secondary anemia due to poor nutrient absorption
Nutritional deficiencies
Fever
Leukocytosis
Anoreixa

Complications:

Intestinal obstruction
Perianal disease
Fluid and electrolyte imbalances
Malnutrition secondary to malabsorption
Fistula and abscess formation
Stricture formation

Lab Findings (click here for normal lab values)

Decreased hematocrit and hemoglobin levels
Elevated white blood cell count
Elevated sedimentation rate
Low albumin and protein levels
Positive for occult blood and steatorrhea (excess fat in the feces) in fecalysis

Diagnostics (click here for diagnostic procedures)

Proctosigmoidoscopy
X-Ray barium study of upper gastrointestinal tract
Endoscopy and intestinal biopsy (Confirming diagnosis)
Barium enema
CT Scan

Impression:
Barium enema shows ulcerations (cobblestone appearance)
Classic 'string sign' on X-Ray indicating constriction of a segment of a bowel (most conclusive diagnosis)

Medical Management:

Nutritional therapy
Antidiarrheal and antiperistaltic medications are given
Sulfasalazine which is effective for mild or moderate inflammation, reduces recurrence
Corticosteroids

Surgical Management:

Total Colectomy with Ileostomy
Total Colectomy with Continent Ileostomy
Total Colectomy with Ileoanal Anastomosis

Nursing Management:
Assessment:

Health history
Dietart patterns (include intake of alcohol, nitcotine)
Assess elimination patterns and stool consistency
Nutrition status
Assess abdomen for bowel sounds and characteristics
Pain assessment

Nursing Diagnosis:

Diarrhea R/T the inflammatory process
Acute pain R/T increased peristalsis and GI inflammation
Deficient fluid volume deficit R/T anorexia. nausea and diarrhea
Imbalanced nutrition, less than body requirements
Activity intolerance R/T fatigue
Anxiety
Ineffective coping
Risk for impaired skin integrity

Nursing Intervention:

Relieve pain by administering anticholinergic medications 30 mins. before meals
Maintain fluid intake
Maintain optimal nutrion through parenteral nutrition in severe cases
Record intake and output
Weigh daily
High protein low fat and residue diet
If food is tolerated give small frequent feedings
Promote rest
Establish rapport to reduce anxiety
Provide perianal care and prevent skin breakdown for bed-ridden clients especially over bony prominences

Evaluate:

Elimination status
Pain
Fluid Balance
Nutrition status
Skin integrity
Knowledge of disease process and management
Potential complications must be reported

Image taken: healthheroes.files.wordpress.com

The Benefits of Lemon Grass

noreply@blogger.com (Unknown) — Sat, 25 Oct 2008 05:08:00 +0000

Last Sunday, I enjoyed browsing my cousin's newly installed cable TV. The first show that caught my attention was Lifestyle Network's cooking show (unfortunately I forgot the title) that featured Asian cuisine particular South East Asian cuisine. I've noticed lemon grass is always an ingredient in most of the dishes prepared so today I'm gonna talk about the benefits we get from these herb. But before anything else, lemon grass belongs in the genus Cymbopogon and is widely found in tropical countries. The one found mainly in Southeast Asia is Cymbopogon citratus which gives off a more citrus flavor to teas, soup and curries. This type of lemon grass is abundant in the Philippines and little of it was known to have medicinal properties.

Active Ingredients:

Myrcene has antibacterial and analgesic effect
Citronella or citronella oil is an all natural unadulterated insect-repellent
Geraniol and citronellol is responsible for the flavor that it gives off

Chicken Inasal

Preparation & marinating: 6 hours to overnight
Estimated cooking time: 40 minutes

Ingredients:

Preparation & marinating: 6 hours to overnight
Estimated cooking time: 40 minutes

2 Chickens (free range if available)
3/4 cup Filipino vinegar
1/4 cup Garlic finely minced
2 stalks Lemon grass
Salt
Annatto oil
Wooden skewers
Spiced vinegar
Additional Ingredients Instructions:
2 free-range chickens, approx. 3 pounds each, or if you can find smaller chickens, use 3 of them
3/4 cup Filipino vinegar, palm if you can find it, or cane; or if you must, the equivalent in kalamansi juice (available in the frozen aisle of your Asian market if you don’t have access to fresh)
1/4 cup garlic, minced very finely, or better yet, mashed into a paste with 2 teaspoons sea salt
Achuete or annatto oil, made by steeping 1/4 cup annatto seeds in 1/2 cup hot oil for half an hour (If not available, you may mix a small amount of paprika and tumeric to achieve the same color.)
Thick wooden skewers, soaked for 1 hour in water prior to cooking
Bottled spiced vinegar for serving, or make your own by mixing Filipino vinegar, lots of crushed garlic, a bit of salt, and a handful of Thai peppers or other tiny red hot peppers

Procedure:

Quarter the chickens, or if using the small ones, halve them. Marinate in the vinegar, garlic and salt, several hours or overnight, turning several times.
Preheat grill to 350 degrees. Make sure your grill is cleaned and oiled well. Cook over indirect heat for 20 minutes, basting with the achuete oil.
Turn and cook for 10-15 minutes more, or until thickest parts of chicken exude clear juices when pierced. Can also be made in a grill pan on the stove if no outside barbecue is available.
Serve immediately with the spiced vinegar. Other welcome additions to the vinegar: some soy sauce or fish sauce if you like, or even some minced ginger.

Cooking Variations:

Another technique we’ve found to work well, is to heat the oil in which the annatto is to be steeped, and to steep the garlic (and lemon grass if using) together with the seeds. This ensures a more even distribution of flavors. Just remember to discard this mixture when you’re done with the cooking, as you risk botulism from the garlic. Or, if you want to make it ahead of time, be sure to refrigerate the oil to retard any toxins from developing.

If your chicken is particularly fatty, you could render the fat slowly in a skillet, and use that instead of cooking oil to steep the annatto seeds. In which case, you’ll want to have enough not only for basting but also for serving later, as there’s nothing more appetizing than chicken inasal drizzled with this orange concoction.

Physical Assessment: Obturator Lift

noreply@blogger.com (Unknown) — Tue, 21 Oct 2008 11:47:00 +0000

Another assessment of acute appendicitis.

Diverticular Disease

noreply@blogger.com (Unknown) — Sun, 19 Oct 2008 03:31:00 +0000

Hmm I feel like talking about intestinal disorders. Actually, I'm doing this for my state board review which is due around January of next year. Wish me luck guys. A diverticulum is a sac-like outpouching of the lining of the bowel that extends through a defective muscle layer. It may occur anywhere along the GI tact. Multiple diverticular disease of the colon is called diverticulosis. Diverticulitis results when retention of food and bacteria happens causing infection and inflammation. A congenital predisposition is suspected when the disorder occurs in those younger than 40 years old. An intake of low dietary fiber predisposes the disease but the exact cause is unknown. It forms when the mucosa and submucosal layers of the colon herniate through the muscular wall due to high intraluminal pressure, low volume in the colon wall. Content accumulate in the diverticulum and eventually decompose, causing inflammation and infection. Obstruction can happen while inflammation aggravates the obstruction more. The inflammation tends to spread to the surrounding bowel wall, giving rise to irritability and spascitiy of the colon.

Complications

Bowel Perforation
Peritonitis
Blood vessel erosion
Bleeding
Abscess
Septicemia

Clinical Manifestations

May be asymptomatic
Chronic constipation
Diarrhea
Abdominal cramps left lower quadrant
Low-grade fever
Nausea & anorexia
Bloating
Abdominal distention
Weakness
Fatigue

Lab Tests and Findings (click here for normal lab values)

Complete blood cell count
Elevated leukocyte
Elevated sedimentation rate
Fecalysis

Diagnostics (click here for diagnostic procedures)

CT Scan
Abdominal X-Ray
Barium enema (contraindicated with peritoneal irritation, potential perforation)
Colonoscopy

Impression: Abscesses (CT scan), free air under the diaphragm indicates perforation (x-ray), narrowing of colon (barium enema)

Medical Management
Dietary & Medication Regimen:

Analgesics
Antispasmodics
Clear liquid diet until inflammation subsided THEN high-fiber, low fat diet to increase stool volume decrease colonic transit time and intraluminal pressure
Low-fiber diet until signs of infection decrease
Antibiotics
Bulk-forming laxative
Opioids prescribed but NO MORPHINE

Antispasmodics:

Propantheline bromide (Pro-Banthine)
Oxyphencyclimine (Daricon)

Other medications:

Metamucil
Colace
Dulcolax

Nursing Management
Assess:

Health history
Onset and duration of pain
Past and present elimination patterns (include constipations, diarrhea, tenesmus)
Fiber intake
Auscultate bowel sounds
Stool inspected for pus, mucous or blood
Monitor vital signs

Diagnosis:

Constipation R/T narrowing of the colon from thickened muscular segments and strictures
Acute pain R/T inflammation and infection

Planning & Goals:

Attainment and maintenance of normal elimination patter
Relief from pain
No complications

Nursing Interventions

Recommend a fluid intake of 2 L per day (within the limits of patient's cardiac & renal reserve)
Suggest fiber-rich soft foods that can increase the bulk of the stool to facilitate peristalsis
Exercise program to improve abdominal muscle tne
Adherence to medication regimen
Analgesics for pain
Record intensity, duration and location of pain
Assess for signs of perforation:

-Increased pain and tenderness with abdominal rigidity
-Elevated WBC count
-Elevated sedimentation rate
-Increased temp.
-Tachycardia
-Hypotension

Be ready for surgical emergency when perforation symptoms persist

Image taken: http://apps.uwhealth.org/health/adam/graphics/images/en/15810.jpg

Physical Assessment: Checking for Rebound Tenderness

noreply@blogger.com (Unknown) — Thu, 16 Oct 2008 08:00:00 +0000

Rebound tenderness indicates peritoneal irritation. It refers to pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.) It is a classical sign of peritonitis. Additional tests should be done before coming up with a specific diagnosis.

Peritonitis

noreply@blogger.com (Unknown) — Thu, 16 Oct 2008 06:52:00 +0000

I'm posting this in relation to my previous posting about appendicitis. Peritonitis is the inflammation of the peritoneum, serous membrane lining the abdominal cavity and covering the viscera. It is usually a result of bacterial infection, organisms out from certain diseases of the GI tract or, in women, from the internal reproductive organs. It can also be a result from external sources such as injury or trauma (e.g. gunshot wound, stab wound) or an inflammation that extends from an organ outside the peritoneal area, such as the kidney. Symptoms depend on the location and extent of inflammation. Diffuse pain is felt initially then becomes more constant and aggravates in movement. Abdomen is tender (rebound tenderness) and distended and muscles become rigid. Paralytic ileus may be present. Usually, nausea and vomiting occur and peristalsis is diminished. Purse rate and temperature increases.

Common bacteria:

Escherichia coli
Klebsiella
Proteus
Pseudomonas

Other common causes:

Appedicitis
Perforated ulcer
Diverticulitis
Bowel perforation

May be associated with:

Abdominal surgical procedures
Peritoneal dialysis

Complications

Sepsis
Shock due to septicemia or hypovolemia
Intestinal obstruction due to bowel adhesions
Post-OP tenderness and pain MUST be reported as well as wound dehiscence

Lab Findings (Click here for normal lab values)

Leukocyte count elevated
Potassium, Sodium and Chloride may reveal altered levels

Diagnostics (click here for diagnostic procedures)

Abdominal X-Ray
CT Scan
Impression: Abscess formation, X-Ray shows air and fluid levels as well as distended bowel loops

Nursing Management
Assess:

Vital Signs
GI Function
Fluid/Electrolyte balance
Nature of pain

Nursing Intervention (N/I):

Administer analgesics
Position client for comfort to decrease pain: Side-lying, knees flexed decreases tension of abdominal organs
Monitor intake and output
Monitor CVP
Increase fluid and food intake gradually
Prepare for emergency surgery if complication is inevitable
Observe and record character of drains
Care must be taken when moving and turning t prevent drains from being dislodged

Discharge Teaching:

Teach and demonstrate to the patient and family about the importance of incision and drain care

Image taken: www.bartleby.com

Normal Laboratory Values: Coagulation

noreply@blogger.com (Unknown) — Tue, 14 Oct 2008 16:50:00 +0000

ACT 90-130 sec
aPTT 21-35 sec
Fibrinogen 160-450 mg/dL (1.6-4.5 g/L)
INR (Target Therapeutic) 2-3
Plasminogen 62-130%
Platelets 150,000-300,000/cu. mm
PT (Prothrombin Time) 10-12 sec
PTT (Partial Prothrombin Time) 30-45 sec
Thrombin Time 11-15 sec

Learning Apendicitis

noreply@blogger.com (Unknown) — Sun, 12 Oct 2008 03:35:00 +0000

Alright, I'm fed up of listening to people when they complain of pain during an activity after a large meal and said that they got appendix. Of course, everyone has not unless they undergone any surgical removal of the appendix. The appendix is a finger-like appendage about 4 inches long that is attached to the cecum, the pouch connected to the ascending colon of the large intestine. It is located below the ileocecal valve. The appendix fills with food and regularly empties into the cecum. Since it empties inefficiently and with a small lumen, the appendix is prone to obstruction and is highly vulnerable to infection, appendicitis. Appendicits is known to strike people between ages 10 to 30 years old. The most signature symptom is pain in the abdomen. Appendicitis pain is not like the type of pain you get from gas or indigestion. Pain starts in the navel area. It then moves into the lower right-hand (Right Lower Quadrant/RLQ pain) corner of the sufferer's abdomen. Pain increases as the disease progress. The pain then settles in an area that is near the appendix. This area is called the McBurney point. An inflamed appendix lies on the psoas muscle and the patient will lie with the right hip flexed for pain relief. Checking for a positive Psoas sign will assist in the diagnsis. Other than that lab works are performed to check for infection. A person should report any pain that persists and that is accompanied by loss of appetite, nausea, vomiting, and fever to a physician. Remember, it is an emergency condition and should be managed as early as possible. Surgery is indicated if appendicitis is diagnosed. Fluid and electrolytes imbalance and dehydration should be corrected through intravenous fluids and antibiotics prior to appendectomy, surgical removal of the appendix. Analgesics can be given after the diagnosis is made. Appendectomy can be performed either spinal or general anesthetic with a low abdominal incision or by laparoscopy, Caution should be observed in the elderly population since classic signs and symptoms are altered and may vary greatly. Pain may be absent or minimal. Symptoms may be vague, suggesting bowel obstruction or the like. Thus, diagnosis and prompt treatment may be delayed, which heightens the probablity of potential complications and worse, mortality.

Complications

Perforation of the appendix

Peritonitis

Lab Findings (Click here for normal lab values)

Elevated white blood cell count

Leukocyte might exceed 10,000 cells/ cubic mm

Neutrophils exceeds 75%

Diagnostics (Click here for diagnostic procedures)

Abdominal X-Ray

Ultrasound studies

CT Scan

Impression: RLQ density or localized distension of the bowel

Nursing Management
Goals:

Relieving pain
Preventing fluid volume deficit
Reducing Anxiety
Eliminating infection from potential or actual disruption of GI tract
Maintaining skin integriy
Optimal Nutrition

Nursing Intervention (N/I):

Prepare client for surgery

NO ENEMA it can lead to perforation

Post-OP patient in Semi-Fowler's position, reduces pain and tension on the incision and abdominal organs

Opioid analgesic is prescribed to relieve pain

When tolerated, oral fluids are given

Food given as desired and tolerated on the day of surgery

Check temperature and should be maintained within normal limits

Patient is discharged on the day of surgery if client illicits normal temperature, no undue discomfort, and appendectomy was uncomplicated

Discharge Teaching:

Instruct to make an appointment with the surgeon to remove sutures between 5th and 7th days after surgery

Incision care and dressing changes

Activities can resume within 2 to 4 weeks

Cat Vs. Cat Owner

noreply@blogger.com (Unknown) — Thu, 09 Oct 2008 05:27:00 +0000

Definitely, this is not a brawl between domestic felines and the typical homo sapiens but it is about man's struggle of getting allergies from pets especially those cute cuddly fur balls. This posting will give an idea to cat owners how to combat attacks and getting relief from these symptoms.

Assess Yourself

Nasal congestion? Or...
Postnasal drip when you are around your cat or cats?
Skin rash after close contact?
A change of respiratory pattern?

If so, you might have a cat allergy. I recommend you to have an appointment with your physician to determine whether you really got a pet allergy or not. Aside from that, they may prescribe the best medication to combat such attacks.

Prevention is absolutely better than cure

The best way is to remove your cat or cats from your home. Unfortunately, this isn’t so easy for many cat lovers to do. If you cannot find a good home for your them, like with a trusted friend or family member, you need not to worry. There are still a number of steps that you can take to seek relief.

Avoid cuddling with your cats is a great way to reduce your symptoms. Close contact with a cat is one of the many ways that skin rashes, like those that resemble an eczema outbreak develop. It might be devastating for you to be isolated from them but this is the best way to prevent contacting allergic reactions from especially if your symptoms are severe.

Keep the fur balls off your furniture. This includes your beds, reclining chairs, or couches. This is particularly important if you are known to lie down or nap on your living room furniture. Covers are a nice alternative. Should you choose to use cloth covers, which are more attractive, be sure to wash them every few days or whenever you notice a large accumulation of cat hair.

Another tip involves keep your cat or cats out of your bedroom. As it was previously stated, keep them off your bed. This can help you sleep better at night. But, just keeping them out of your room in general is the best approach.

Vacuum as often as possible. Vacuuming can help to pick up some of the pet hair and pet dander that may be in the carpet, bed and cushion. Vacuum cleaners that use HEPA (High Efficiency Particulate Air) filters are highly recommended. You may want to give these types of vacuum cleaners a close look.

An air purifier can also be used and should be used if you are allergic to your cat. All air purifiers remove potentially harmful particles from the air especially allergens. This includes pet dander. If you have a cat allergy, the removal of dander from the air can be a great source of relief. You can research and find air purifiers that are marketed towards those who suffer form allergies online. As with vacuum cleaners, air purifiers that use HEPA technology, often produce the best results.

For the latest cat info just visit The Catzine by clicking the image above.

Normal Laboratory Values: Cardiac Enzyme Markers

noreply@blogger.com (Unknown) — Mon, 06 Oct 2008 15:49:00 +0000

Cardiac Marker Levels with Onset, Peak and Duration

Troponin-I 0.0-0.1 ng/mL Onset: 3-6 hrs Peak: 12-24 hrs Duration: 4-6 days
Troponin-T <0.18>
CPK <150>
CPK-MB 0-5 ng/mL Onset: 4-6 hrs Peak: 14-20 hrs Duration: 2-3 days
SGOT 1-36 U/L Onset: 12-18 hrs Peak: 12-48 hrs Duration: 3-4 days
LDH 70-180 Onset: 3-6 days Peak: 3-6 days Duration: 7-10 days
Myoglobin Male: 10-95 ng/mL Female: 10-65 ng/mL Onset: 2-4 hrs Peak: 6-10 hrs Duration: 24-36 hrs

Physical Assessment: Checking for Psoas Sign

noreply@blogger.com (Unknown) — Sun, 05 Oct 2008 03:04:00 +0000

It is an indicator of irritation to the ilio-psoas group of hip flexors in the abdomen. An inflamed appendix lies on the psoas muscle and the patient will lie with the right hip flexed for pain relief. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis of appendicitis. The most widely used is the Alvarado Score.

Normal Laboratory Values: General Blood Chemistry

noreply@blogger.com (Unknown) — Sat, 04 Oct 2008 02:09:00 +0000

Albumin 3.5-5.0 g/100 mL
Aldolase 1.8-8.2 U/L
Alkaline phosphatase 13-39 U/L, infants and adolescents up to 104 U/L
Ammonia 12-55 µmol/L
Amylase 4-25 units/mL
Anion gap 8-16 mEq/L
AST, SGT Males: 8-46 U/L Females: 7-34 U/L
Bilirubin (Total) up to 1.0 mg/100 mL
Bilirubin (Direct) up to 0.4 mg/100 mL
BUN 8-25mg/100 mL Male: 0-14 pg/mL Female: 0-28 pg/mL
Calcitonin Male: 0-14 pg/mL Female: 0-28 pg/mL
Calcium (Ca+) 8.5-10.5 mg/100 mL
Carbon dioxide 24-30 mEq/L
Chloride (Cl-) 100-106 mEq/L
Cholesterol <200>
Cortisol A.M. 5-25 µg/100 mL P.M. <10>
Creatine Male: 0.2-0.5 mg/dL Female: 0.3-0.9 mg/dL
Creatine Kinase (CK) Male: 17-148 U/L Female: 10-79 U/L
Creatinine 0.5-1.5 mg/100 mL
Ferritin 10-410 ng/dL
Folate 2.0-9.0 ng/mL
Glucose 70-110 mg/100 mL
Ionized calcium 4.25-5.25 mg/dL
Iron (Fe) 50-150 µg/100 mL
Iron-bonding capacity (IBC) 250-410 µg/100 mL
Lactic acid 0.6-1.8 mEq/L
Lactic dehydrogenase (LDH) 45-90 U/L
Lipase 2 units/mL or less
Magnesium (Mg++) 1.5-2.0 mEq/L
Osmolality 280-296 msm/kg water
Phosphorous 3.0-4.5 mg/100 mL
Potassium (K+) 3.5-5.0 mEq/L
Prealbumin 18-32 mg/dL
Protein, total 6.0-8.4 g/100 mL
PSA 0.0-4.0 ng/mL
Pyruvate 0-0.11 mEq/L
Sodium (Na+) 135-145 mEq/L
T3 75-195 ng/100 mL
T4 (free) Male: 0.75-2.0 ng/dL Female: 0.75-2.0 ng/dL
T4 (total) 4-12 µg/100 mL
Thyroglobulin 3-42 µ/mL
Triglycerides 40-150 mg/100 mL
TSH 0.5-5.0 µU/mL
Urea Nitrogen 8-25 mg/100 mL
Uric Acid 3.0-7.0 mg/100 mL