Q& A

Woman's Era - - Short Story -

AM A 40 YEARS OLD WORK­ING WOMAN. SINCE LAST ONE MONTH, I am suf­fer­ing from swelling on one side of neck and swelling cor­re­sponds to the shape of a gland and it has raised the lobe of ear. I have con­sulted a doc­tor. He told me that you are suf­fer­ing from acute paroti­tis. For this he has given me some med­i­ca­tion and told that if it can not be cured with med­i­ca­tion then some sur­gi­cal pro­ce­dure is to be done to drain the pus. What is your opin­ion.

Acute paroti­tis may be due to a virus, a non spe­cific bac­te­rial in­fec­tion or more rarely acti­no­my­co­sis or tu­ber­cu­lo­sis. Mumps is the usual virus in­fec­tion but other viruses such as cox­sackie A virus may pro­duce a sim­i­lar ill­ness. A tu­ber­cu­lous in­fec­tion of a sali­vary gland is usu­ally as a re­sult of spread from a tu­ber­cu­lous lymph node. Acute paroti­tis is more com­mon in im­muno­com­pro mised pa­tients. Clin­i­cal fea­tures are brawny swelling of the side of the face. In case of a virus paroti­tis or early sup­pu­ra­tive paroti­tis the swelling cor­re­sponds to the shape of the gland and raises the lobe of the ear. As sup­pu­ra­tive paroti­tis pro­gresses wide­spread cel­luli­tis is seen and the over­ly­ing skin be­comes dusky red. Pus can be ex­pressed from the parotid duct and a swab should be taken for cul­ture, iden­ti­fi­ca­tion of the or­gan­ism and an­tibi­otic sen­si­tiv­ity tests. The body tem­per­a­ture is usu­ally raised. Treat­ment con­sists, ev­ery­thing should be done to im­prove the gen­eral state of the pa­tient and an­tibi­otics are ad­min­is­tered. Metic­u­lous oral hy­giene should be prac­tised with tooth­brush and paste where teeth are present and with sodium bi­car­bon­ate mouth­washes for the eden­tu­lous pa­tient. Den­tures should be left out ex­cept at meal times. The gland can be mas­saged gently at reg­u­lar in­ter­vals to ex­press pus.

If pus ceases to drain through the duct and im­prove­ment in the gen­eral and lo­cal con­di­tion is not seen within 48 hours of the start of treat­ment, drainage of the gland should be con­sid­ered. Drainage is es­sen­tial if the dusky red­ness be­comes lo­calised to the lower pole be­cause an ab­scess here might drain spon­ta­neously into the ex­ter­nal au­di­tory mea­tus.

AM 45 YRS OLD WORK­ING WOMAN AND MY JOB IS FIELD WORK re­lated. Since last one year I am suf­fer­ing from burn­ing in the eyes es­pe­cially in the evening, red­ness in the eyes, feel­ing of dry­ness on lid mar­gins, mild dis­charge and off and on wa­ter­ing from eyes. I con­sulted an eye spe­cial­ist for this prob­lem, he told me that you are suf­fer­ing from chronic catarrhal con­junc­tivi­tis. I want to know the symp­toms and causes of the disease and how can I pre­vent my eyes from this prob­lem.

Chronic catarrhal con­junc­tivi­tis also known as sim­ple

Ichronic con­junc­tivi­tis. Pre­dis­pos­ing fac­tors are chronic ex­po­sure to dust, smoke and chem­i­cal ir­ri­tants. Lo­cal cause of ir­ri­ta­tion are trichi­a­sis and con­cre­tion strain due to re­frac­tive er­rors and con­ver­gence in­suf­fi­ciency. Abuse of al­co­hol, in­som­nia and meta­bolic dis­or­ders. Sta­phy­lo­coc­cus au­reus is the com­mon­est cause of chronic bac­te­rial con­junc­tivi­tis. Symp­toms of the disease are burn­ing and grit­ti­ness in the eyes es­pe­cially in the evening, mild chronic red­ness in the eyes, feel­ing of heat and dry­ness on the lid mar­gins, dif­fi­culty in keep­ing the eyes open, mild mu­coid dis­charge, off and on lacrima­tion, feel­ing of sleepi­ness and tired­ness in the eyes, sur­face of con­junc­tiva looks sticky and lid mar­gins may be con­justed. Treat­ment con­sists of, pre­dis­pos­ing fac­tors when as­so­ci­ated should be treated and elimi - nated. Top­i­cal broad spec­trum an­tibi­otic eye drops should be in­stilled 3 to 4 times a day for about 2 weeks to elim­i­nate the mild chronic in­fec­tion. As­trin­gent drops such as zinc boric acid drops pro­vide symp­to­matic re­lief. In se­vere and re­cal­ci­trant cases the palpe­bral con­junc­tiva may be painted with 1 per­cent sil­ver ni­trate so­lu­tion. Vac­cine ther­apy, as the prob­lem is off re­cur­rent chronic staphy­lo­coc­cal in­fec­tion, there­fore, a vac­cine pre­pared against the causative sta­phy­lo­coc­cus may be tried, but any treat­ment should be taken with con­sul­ta­tion of a doc­tor.

Y MOTHER IS ABOUT 70 YEARS OLD, TWO MONTHS BE­FORE she de­vel­oped hema­turia ( bleed­ing dur­ing mic­turi­tion and some­times blood clot may be present in urine and con­tin­ued fever. We have con­sulted a doc­tor, af­ter ex­am­i­na­tion and in­ves­ti­ga­tion, he di­ag­nosed as a case of re­nal car­ci­noma (Cancer of Kid­ney). I want your opin­ion.

Re­nal Car­ci­noma is the most com­mon tu­mour of the Kid­ney. It was for­merly called a hy­per­nephroma on the mis­taken view that it arose from adrenal rest tis­sue within the Kid­ney. Hema­turia is the most fre­quent pre­sent­ing fea­ture and blood clots may give rise to re­nal colic. Some­times the tu­mour causes vague ab­dom­i­nal pain and it may also be re­spon­si­ble for long con­tin­ued fever. Oc­ca­sion­ally pa­tients present first with symp­toms aris­ing from metas­tases in the lungs, liver or bones. On rare oc­ca­sions poly­cythemia (blood be­come con­cen­trated and thick) oc­curs and this is be­lieved to be due to ex­ces­sive pro­duc­tion of ery­thro­poi­etin. The tu­mour may be pal­pa­ble and is de­fined by ra­di­o­log­i­cal in­ves­ti­ga­tions and ul­tra­sonog­ra­phy. Early sur­gi­cal treat­ment af­fords the only prospect of cure. – Dr San­jay Teo­tia.

Newspapers in English

Newspapers from India

© PressReader. All rights reserved.