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.