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The male mite dies and the gravid female mite burrows into the epidermis lays up to 3 eggs per day for the duration of her 30-60 day lifetime 60caps diabecon mastercard blood sugar urine test. It starts on the wrist purchase generic diabecon on line blood sugar 47, finger webs and on the medial sides of fingers discount 60caps diabecon with mastercard diabetes insipidus hypothyroidism, the flexor aspect of 35 the wrist, the elbows and the anterior axillary folds, the genitalia and inner thighs and the gluteal folds More disseminated presentation in infants and toddlers. Scabies in infants and young children 9 Distribution and morphology:- generalized 9 the face the scalp, palms an soles are affected 9 Papules, vesicle and pustules 9 Secondary eczematization and impetiginazation are common Crusted (Norwegian) scabies In 1848, Danielssen and Boeck described a highly contagious variant of scabies occurring in immunocompromised patients, elderly or mentally incompetent patients. Thousands to million mites are found instead of the normal 8-11 mites in the normal host. In Norwegian scabies, pruritus may not be there (in about 50% of the cases do not itch) It is psoriasiform and generalized with nail changes and scalp involvement Skin becomes thickened and involves all part of skin including face, palms and sales. Diagnosis of scabies o Itching, worse at night o Presence of similar condition in the family or intimate contacts o Characteristic distribution of lesions o Demonstration of the mite, eggs or feces o Therapeutic test Management o Treat with a scabicide agent o All family members and close contacts should receive treatment at the same time o Provide antihistamines to alleviate pruritus. Complications of scabies Bacterial super infection Eczematization Nodule formation Urticaria Treatment of complications: - Use antibiotic and anti histamine. Causes of therapeutic failure Improper counseling Poor compliance of patient 37 Inadequate application Improper application Not treating family members who have close contacts 3. Eczemas Eczemas are groups inflammatory skin conditions manifesting either as acute eczematous lesions, which are characterized by active papules; erythema, excoriations and oozing (weeping), sub acute eczemas, also have excoriation, erythema with papules and scales or as a chronic eczematous lesion, characterized by thickening of the skin, and accentuation of the creases (lichenification) and hyperpigmentations 3. Atopic dermatitis the term atopy is a Greek word meaning "out of place” or strange. The hereditary tendency to develop allergies to food and inhalant substances as manifested by eczema, asthma and hay (allergic conjunctivitis and allergic rhinitis) fever is called atopy. It is the interaction of genetics and environmental factors that results atopic eczema. More than ¼ of the offsprings of atopic mother develop atopic dermatitis in the first 3 months of life. If one parent is atopic, more than 50% of the children would develop allergic symptoms by the age of two years and if both parents are affected, the chance of the child to have allergic symptoms would be about 79%. Diagnostic Criteria for Atopic Dermatitis the diagnosis of atopic eczema is made by constellation of criteria. Evidence of pruritus Three minor features are: Xerosis/ ichthiosis / hyperlinearity of palms and soles Perifollicular accentuation Post auricular fissure Chronic scalp scaling the hall mark of atopic eczema is pruritus and dryness of the skin. Long standing pruritus results in lichenified dry skin which would call for further scratching and in this way the itch -scratch cycle establishes which assumes a vicious form. The flexures like the popilitial fossa, wrist, and anticubital fossa are affected. The pattern of distribution in atopic eczemas depends on the age and activity of the disease. Based on that atopic eczemas are classified in to: infantile eczema (from 2 39 months up to 2 years), childhood atopic eczema (from 2 years to 10 years) and atopic eczema of adolescents and adults. Infantile Atopic eczema Atopic dermatitis usually starts in the first year of life. During this phase, there is facial erythema, vesicles, oozing and crusting located mainly on the face, scalp, forehead and extensor surface of the extremities. Psychological effects often are very prominent Adolescent and adult atopic dermatitis: Flexural predilection of lesions persists. Localized, eczematous or lichenified plaques often predominates the clinical picture. Resolved cases show dryness and irritability of the skin with a tendency to itch with sweating and other triggers. Topical Steroids High potency steroids are used for a short period to rapidly reduce inflammation. Maintenance therapy, if needed is best done with mild steroids like hydrocortisone. On face and intertriginous areas, mild steroids should be used; mid-potency formulations are used for trunk and limbs.
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Inspect the anticoagulant donor bag for leaks buy discount diabecon 60 caps online diabetes diet meal plan for losing weight, and make sure that the anticoagulant solution is clear generic diabecon 60 caps visa diabetes type 2 levels. Position the bag below the level of the donor- arm balance system discount diabecon 60 caps online diabetes type 1 worldwide statistics, making sure that the counterbalance is level and adjusted for the amount of blood to be drawn. Reapply the tourniquet or blood- pressure cuff (inflated to 40-60 mm Hg) and have the donor open and close the hand until the selected vein is again prominent. Apply the hemostat clamp to the tubing atleast 5 cm above the needle, uncover the sterile needle, and perform 94 the venipuncture immediately. Carefully tape the tubing to hold the needle in place and cover the venipuncture site with a sterile gauze pad. Have the donor squeeze a rubber ball or other soft object every 10 to 12 seconds during collection. Time limits for collecting a unit are not fixed, so long as the blood flow is continuous However, it usually takes 8- 10 minutes. A unit containing 450-495 mL should weigh 425-520 g plus the weight of the container with its anticoagulant. Remove the tourniquet & hold a sterile gauze lightly over the venipuncture site and remove the needle from the donor’s arm. Have the donor raise the arm (elbow straight) and hold the gauze firmly over the phlebotomy site with the opposite hand. Strip the donor tubing from the end of the tube towards the bag as completely as possible in order to mix well with the anti coagulant. Seal the tubing attached to bag into segments suitable for subsequent tests with either a 95 heat sealer or metal clips. However, if the blood is to be used as a source of components, up to 8 hours may elapse before storage. Whole blood or red cell collected and stored in heparin solution must be used within 48 hours of phlebotomy. Avariety of blood components can be harvested from a single unit of whole blood (Fig –8. Each component can be 99 collected, processed and stored under conditions, which maximize its storage capacity. By using a single unit one can treat anemia with the packed cells, 100 platelate deficiency with platelate preparations, clotting factor and other plasma deficiencies with plasma preparation. At the first sign of reaction, the phlebotomist should stop the phlebotomy, give initial first aid procedures and call the blood bank physician. Name the common blood components that can be prepared from a unit of donated blood. Hemolytic reactions may be defined as the occurrence of abnormal destruction of red cells of either the donor or recipient following the transfusion of incompatible blood. Nonhemolytic reactions on the other hand are not usually associated with erythrocyte hemolysis, constitute conditions such as shortened post transfusion survival of erythrocytes, febrile reactions, allergic response, and disease transmission. Transfusion reactions can be further classified in to acute (immediate) or delayed in their manifestations. Factors such as antibody concentration, class or subclass, ability to fix complement, temperature of activitiy and concentration of red cell antigen infused also influence whether a transfusion reaction will be acute or delayed. Acute hemolytic reactions, which are the most serious and potentially lethal, occur during or immediately after blood has been transfused. Delayed hemolytic reactions, as the name implies the transfusion reaction is delayed due to weak antibody in the recipient 7 to 10 days of post transfusion. In most cases of delayed hemolytic reactions, the patient has been primarily immunized by previous transfusion or 104 pregnancy. The antibody is too weak to be detected in routine cross-match, but becomes detectable 3 to 7 days after transfusion, eg. Whenever adverse reaction experienced by a patient in association with a transfusion it should be regarded as a suspected transfusion reaction, and the following lab. List laboratory investigations to be carried out when incompatible transfused reactions are suspected? Important factors in a routine quality assurance program include evaluation of reagents, equipment, and personnel qualification. Each reagent on each day of 107 use must be inspected visually for color, cloudiness and other characteristics, and the manufactures procedure should strictly be followed to confirm its reactivity. Quality control of equipment: Instruments and equipments in blood bank laboratory such as centrifuge and water bath must be properly maintained and monitored to ensure they are working accurately.
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