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Croup

Croup is very common in young children. It is usually associated with a cold (and is therefore more common in winter), and for the most part is not a serious condition. However, the obstruction to the breathing tube is occasionally severe enough to cause breathing difficulties, and the child needs urgent medical attention and sometimes observation and treatment in hospital.

Cause

The stridor or croup that is heard when the child breathes in is caused by swelling of the breathing tube just below the vocal cords. This is caused by one of the viruses that are responsible for the common cold.

Clinical features

The child usually has symptoms of a cold before the onset of croup, including a runny nose, sore throat, fever, and irritability. He then develops a harsh, barking cough, sometimes a hoarse voice, and then noisy breathing. The noise is heard when he breathes in (in contrast to asthma, in which the wheeze occurs as the child breathes out).

The stridor and the cough are usually worse at night and when the child is distressed. In the majority of children, the symptoms improve over a few days and then disappear. In a small number of children the croup is more severe and the child has difficulty with breathing. Sometimes there will be drawing in of the child’s breastbone and the muscles between the ribs, as well as flaring of the nostrils. He may appear restless and have trouble feeding and drinking, and will not want to lie down. Severe croup requires emergency medical attention.

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To prevent problems resulting from Rheus incompatibility, Rheus negative mothers are given a substance called anti-D immediately after delivery. This destroys any Rhesus positive cells from the foetus which are present in the mother’s bloodstream, preventing the mother from mounting an immune response. Because antibodies do not develop a subsequent pregnancy is problem free.

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ANSWER: Nobody ever comes together if by that you mean simultaneous pelvic muscle contraction. If it does happen, it is rare and an accident, mere chance and luck. The effort to accomplish this mutual reflex would be like trying to sneeze together. You might be able to do it, but you would wait a long time, and even if you did it, you would wonder why. Trying to have pelvic contractions together only gets in the way of enjoying psychasms together, which is much more satisfying because they are much longer and easier to share. Remember that orgasmic contractions last less than fifteen seconds. It makes little sense to spend most of the sexual encounter to synchronize your fifteen seconds. A super marital sex rule is that where you are going together is much more important than trying to end together. It’s too bad the-word “climax” was ever used. A better word might be to ‘ ‘preamble” together, to start instead of end. You might try using a less motion-oriented vocabulary of “come,” “get,” and “do” in favor of the more experiential terms of “share,” “feel,” and “be.”

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These patients become attached to, and dependent on, their doctors. They may improve a little to encourage him, then relapse or develop new symptoms if he appears less interested or too casual.

Hysteria may occur with, and complicate, real physical or other emotional illnesses. This may be seen with accident cases which are subject to compensation, either from injury at work or on the road.

Some cases of shell shock in wartime were due to hysteria. The soldier may develop marked tremors or withdraw into a passive state, take to bed and require to be fed and washed, and may even lose control of the bladder and bowels.

Improvement occurs when he is removed from the active theatre of war and the symptoms recur if he is to be posted back to active duty.

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This haemoglobin, which is a complex chemical, contains iron as an essential part of its make-up.

The red blood cells are made in the bone marrow. There are about five million red blood cells to every cubic millimetre of blood and the average man has about 11 pints of blood in his system.

The red cells have a life of about 120 days and when they are aged, they are broken down by the liver and the spleen. The iron in the haemoglobin is then transferred to the body’s store and can be used again.

A shortage of the element iron will lead to problems with the red blood cells — they will contain less haemoglobin and they will be less in number.

This is the condition known as iron deficiency anaemia.

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Vomiting may also indicate serious disorders which are not associated with digestion. Following a blow to the head, vomiting may indicate swelling of the brain or bleeding within the skull. Heart attacks may present with chest pains and vomiting.

In children vomiting is also a symptom of fevers, middle ear infections, tonsillitis and meningitis. It is quite normal for young babies to vomit small quantities of milk after feeding and is of no concern unless the child appears ill or does not gain weight.

During early pregnancy vomiting is a common symptom of morning sickness. Both ginger and raspberry leaf are recommended by herbalists to relieve the nausea and vomiting associated with pregnancy.

Bulimia is an eating disorder in which the sufferer overeats, then induces vomiting to rid the body of the food which has been consumed. When bulimia is chronic this practice can result in ulceration of the oesophagus, damage to the teeth caused by stomach acids and dietary deficiencies.

Inducing vomiting is sometimes a first aid teatment for poisoning. Vomiting should not be induced in the case of corrosive, petroleum based or unknown substances which have been swallowed. When a medicinal or general substance such as detergent, mushrooms or medicine have been swallowed vomiting should be induced by giving Syrup of Ipecac to drink, following the instructions on the bottle. Salty or soapy water should not be given to induce vomiting.

Vomiting of blood requires immediate medical advice. Tiny flecks of blood in the vomitus following extensive vomiting may come from small tears in the lining of the digestive system and are not in themselves cause for alarm.

Prolonged vomiting may result in dehydration. This requires treatment by a practitioner.

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Even so, this is no laughing matter, particularly now that we understand how placebos work. University of California researchers report in Lancet that placebo pain relief can be wiped out by injecting naloxone, a drug that is normally used as an antidote for narcotic overdosage.

This strongly suggests that the brain of a placebo-re-sponder makes its own narcotic-like substance, and it is this that relieves pain when a placebo is given. Testing this theory further, the researchers took people whose pain normally responded to placebo and pretreated them with naloxone. No pain relief could then be obtained with placebo.

After repeated use over long periods, placebos become less effective and patients with persisting pain need ever larger numbers of sugar pills each succeeding day. This growing “tolerance” is seen also with narcotics.

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Home care:

-    You can distinguish the eggs (or nits) of head lice from dandruff because dandruff can easily be brushed away but the nits cling to the hair shafts.

-    Your doctor will prescribe a shampoo to kill the lice and the nits. Apply the shampoo exactly according to the instructions, taking care not to get it in the child’s eyes or mouth.

-    If necessary, apply a vinegar rinse to loosen the nits, then fine-comb the child’s hair until all the nits are removed.

-    Clean combs and brushes with the shampoo, launder pillowcases, and have caps or hats washed or dry-cleaned.

-    Check other family members for the lice.

Precautions:

-    If one member of the family has head lice, it is often necessary to treat the rest of the family too (except infants and pregnant women).

-    The ingredient gamma benzene hexachloride prescribed in shampoo form for head lice is poisonous if swallowed or absorbed through the skin. It can also harm the eyes. Use it exactly as directed; do not repeat the application more than twice, at the stated intervals; and do not leave the shampoo within reach of the child.

-    Consult your doctor if head lice are accompanied by infected sores on the scalp or enlarged lymph nodes at the base of the skull.

Head lice are tiny parasites (smaller than fleas) less than 3 millimeters long. They are grayish-white, almost transparent, six-legged creatures that live exclusively on humans, never on pets. The lice pass easily from one human to another. Head lice live on or close to the scalp, where they bite and suck blood. Their visible eggs (or nits), which stick to the hairs, are milk-white and about the size of a flake of dandruff. During the past few years, infestation with head lice has become common among school-age children.

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