Riboflavin

Riboflavin, also called vitamin B2 or vitamin G, a substance essential for the breakdown and utilization of carbohydrates, fats, and proteins in the body, and in the production of energy. Riboflavin plays a vital role in the health of the skin and is needed for production of certain hormones by the adrenal glands, the pair of hormone-secreting organs that sit on top of each kidney. Because it is a water-soluble vitamin—that is, it is not stored in the body, but is excreted in sweat or urine—riboflavin needs to be constantly replaced in the body.

Rich sources of riboflavin include milk, cheese and yogurt, lean meat, liver, green leafy vegetables, eggs, and enriched breads and cereals. Because cheese and milk are such good dietary sources of the vitamin, lactose-intolerant people, including many of the elderly, are vulnerable to deficiency problems. Individuals who exercise often, especially women, are also at risk for riboflavin deficiency. A lack of riboflavin in the diet may result in inflammation, scaling, and blistering of the skin—symptoms characteristic of such conditions as dermatitis and eczema. Other problems can include general fatigue, burning eyes, cracks and sores in mouth and on the lips, and digestive problems.

Tracheotomy

Tracheotomy, surgical operation in which an incision, or opening, is cut through the front of the neck and into the trachea, or windpipe. The oldest mention of the operation in medical literature is found in the writings of the Greek physician Galen (2nd century ad).

A tracheotomy creates an alternate passage to the lungs for air that cannot flow from the nose and mouth through the trachea because of an obstruction. Obstructions may occur when a foreign body lodges in the larynx, or voice box, above the trachea; as a result of swelling or spasm of the larynx or vocal cords; or from infection and swelling of the epiglottis, the thin flap of cartilage covering that keeps food and liquid out of the trachea.

The purpose of a tracheostomy is to keep the airway from closing prematurely and to enable the physician to take further measures, if necessary, to ensure that the patient has a patent airway. When a tracheotomy is performed on a patient suffering from severe bronchial or lung congestion, a catheter, or small-diameter, flexible tube, is inserted through the stationary tube and used with a suction device to clean out the bronchial tubes and lungs while the patient is encouraged to cough vigorously.

Syringe

Syringe, device used to eject or collect fluids. A syringe consists of a hollow barrel made of glass, plastic, or metal with a close-fitting plunger or a rubber bulb on one end. The other end of the barrel has a nozzle which may be designed to accept a needle or other attachment. The barrel fills by suction when the plunger is pulled out, or when the bulb is compressed and subsequently allowed to inflate. Pushing in the plunger or squeezing the bulb forces the fluid out through the needle or nozzle.

Syringes come in many sizes and serve many purposes. The small syringe used in medicine to give hypodermic injections (forceful introduction of medication or fluid beneath the skin) has a plunger and a fine hollow needle. Its barrel is calibrated, featuring a set of equally spaced marks that measure the volume of its contents. The larger medical syringes used to cleanse wounds or body cavities, or to extract unwanted fluids from the body, have wider, flexible nozzles on one end and rubber bulbs on the other end.

Sharing unsterilized syringes can cause serious health problems. Human immunodeficiency virus (HIV), which may lead to acquired immunodeficiency syndrome (AIDS), has been spread by infected substance abusers who share the same syringe to inject intravenous drugs. The viruses that cause hepatitis A and hepatitis B, both of which inflame the liver, are also commonly transmitted through the use of shared needles and syringes.

Phobia

Phobia, intense and persistent fear of a specific object, situation, or activity. Because of this intense and persistent fear, the phobic person often leads a constricted life. The anxiety is typically out of proportion to the real situation, and the victim is fully aware that the fear is irrational.

Behavioral techniques have proved successful in treating phobias, especially simple and social phobias. One technique, systematic desensitization, involves gradually confronting the phobic person with situations or objects that are increasingly close to the feared ones. Exposure therapy, another behavioral method, has recently been shown more effective. In this technique, phobics are repeatedly exposed to the feared situation or object so that they can see that no harm befalls them; the fear gradually fades. Antianxiety drugs have also been used as palliatives. Antidepressant drugs have also proved successful in treating some phobias.

Phenytoin

Phenytoin or Dilantin, drug used to treat the seizures, or violent muscle contractions, caused by epilepsy. The drug can also control seizures associated with surgery of the brain or spinal cord. Phenytoin influences the movement of sodium along nerve fibers, preventing or minimizing the abnormal electrical impulses that cause seizures.

Phenytoin is available by prescription in tablet, capsule, and liquid form. Taken orally, except for one liquid form made for injection, the drug is usually prescribed in 100-mg doses taken once a day. The maximum recommended daily dosage is 600 mg. To avoid stomach irritation, oral phenytoin should be taken with food. The drug’s effectiveness is usually apparent after two to three weeks of treatment.

Patients with impaired liver function, diabetes, or heart disease should use this drug with caution. Although long-term use of phenytoin is common, it may be associated with the development of cancers in the lymphatic system or the bone marrow (leukemia). Pregnant women or those nursing an infant should not take this drug. Children who take it should be monitored with particular care.

Possible side effects include decreased coordination, mental confusion, or slurred speech. Other observed side effects include nausea, headache, fever, dizziness, twitching, involuntary eye movement, joint pain, insomnia, impotence, bedwetting, abnormal hair growth, skin rash, or change in urine color. An overdose of phenytoin can be fatal. Abruptly stopping treatment can cause uninterrupted seizures that may also be fatal.

Phenytoin may interact adversely with a variety of medications. These include, but are not limited to, aspirin, certain tranquilizers, steroids, blood thinners, ulcer medications, oral contraceptives, estrogens, and antacids. Also included are the drugs felbamate, furosemide, methylphenidate, phenobarbital, carbamazepine, diazepam, doxycycline, sodium valproate, theophylline, and valproic acid. Users of phenytoin should not drink alcoholic beverages.

Brand Name:Dilantin

Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID), bacterial infection of the upper female genital tract, including the uterus, fallopian tubes, and ovaries. PID can be caused by several different aerobic (oxygen-requiring) and anaerobic (non-oxygen-requiring) bacteria. The two most important such bacteria are Neisseria gonorrhoeae, the bacterium that causes gonorrhea, and Chlamydia trachomatis, the bacterium that causes chlamydia. These bacteria are usually transmitted through sexual intercourse with an infected partner.

The usual symptoms of acute PID are fever, chills, lower abdominal and pelvic pain, and vaginal discharge or bleeding. These symptoms often begin a few days after the start of a menstrual period, particularly when Neisseria gonorrhoeae is the cause of infection. Infections due to Chlamydia trachomatis usually progress more slowly than those caused by Neisseria gonorrhoeae. On physical examination by a doctor, the uterus, ovaries, and fallopian tubes of the infected person are usually tender. In severe cases, an abscess may be present in the pelvis. Complications from PID occur in one out of four infected women and include tuboovarian abscess, Fitz-Hugh-Curtis syndrome (inflammation surrounding the liver), chronic pelvic pain, and occasionally death. In addition, PID is the single most important risk factor for ectopic pregnancy.and one of the most common causes of female infertility.

Antibiotic therapy is the usual treatment for PID. Most women take oral antibiotics such as intramuscular ceftriaxone, and oral doxycycline and metronidazole for a period of 10 to 14 days, after which they are cured. Women who are severely ill are usually treated with intravenous antibiotic therapy in the hospital. A woman's sexual partner should also be treated with antibiotics.

Paralysis

Paralysis, loss of voluntary movement in a part of the human body, caused by disease or injury anywhere along the motor-nerve path from the brain to the muscle fiber. Paralysis may result from injury, poisoning, infection, hemorrhage, occluded blood vessels, or tumors. Occasionally paralysis is due to congenital deficiency in motor-nerve development. Permanent paralysis results from extensive damage to nerve cells or to a nerve trunk; severely damaged nerve cells cannot regenerate. Transient or incomplete paralysis, called paresis, is often caused by infections, trauma, or poisons that temporarily suppress motor activity but do not extensively damage nerve cells.

Because most of the motor nerves from either half of the brain supply the opposite side of the body, lesions in one part of the brain usually produce paralyses in the opposite half of the body. Paralysis of one limb is known as monoplegia; paralysis of two limbs on the same side of the body as hemiplegia; paralysis of both lower limbs as paraplegia or diplegia; and paralysis of all four limbs as quadriplegia or tetraplegia. Paralysis originating in the brain may sometimes be flaccid, that is, the affected muscles may be loose, weak, flabby, and without normal reflexes. More frequently it is spastic, that is, the affected muscles are rigid and the reflexes accentuated. Paralysis originating in a motor nerve of the spinal cord is always spastic; paralysis originating in peripheral nerves or thin ganglion cells is always flaccid.

Among well-known paralytic conditions are poliomyelitis (previously known as infantile paralysis), cerebral palsy, and multiple sclerosis. Bell's palsy is a common facial paralysis, generally temporary and produced by such conditions as neuritis or infection. Locomotor ataxia is a paralytic condition caused by infestation of the spinal cord and brain with microorganisms that cause syphilis. Alcoholic paralysis is caused by degeneration of nerve cells, in the spinal cord or, less often, in the brain, which have been deprived of essential nutrients.

Temporary paralyses are treated by removing the underlying cause. Permanent paralyses may be ameliorated by appropriate physical therapy and rehabilitation procedures.