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Sinusitis:  Inflammation of the sinus. 
” I have sinus” is an expression many people use to indicate they have
an infection of the sinuses.  The sinuses are located close to the
nasal cavities, and in one case near the ear.  Infection may easily
travel into these sinuses from the mouth, the nose and the throat along
the mucous membrane lining, and the resulting inflammation is called sinusitis.

The sinuses are opening in the bones around the nose.  There are
four paranasal sinuses, only two , the frontal and maxillary sinuses, can
be assessed. ( In children under age 8, the frontal sinuses are usually
too small to examine.)  The other two, the ethmoidal and sphenoidal
sinuses, are inaccessible for general examination.

Normally, air passes in and out of the sinuses and mucus and fluid drain
from the sinuses into the nose.  Sinusitis usually follows when one
gets a cold and or other respiratory infection, or disease and disorder
such as Cystic Fibrosis.

Sinusitis occurs when there is a undrained collection of pus in one
or more of the sinuses.  Swelling occurs and prevents fluids from
draining out of the sinus.  Fluids trapped in the sinus may then become
infected with bacteria, viruses or fungi.

Disorders such as a deviated septum, obstruction of the nose, allergic
rhinitis are susceptible to sinusitis.  Dental infection such as a
tooth abscess may spread into the sinus and become infected.

Pressure and inflammation results in mild to severe pain.

Long – standing, or chronic, sinus infection may cause changes in the
epithelial cells, resulting in tumor formation.  Some of these growths
have a grape – like appearance and cause obstruction of the air pathway. 
These tumors are called polyps.

Symptoms:

Facial pain – pressure around the eyes, cheeks and or forehead

Facial swelling – common around the eyes

Headache – especially around the eyes and front of head

Nasal drainage

May have pain in the roof of the mouth or teeth

May have fever

May experience chills

Possible sore throat

Possible nosebleed

Bad breath and or foul smell in the nose

Treatment:

Antibiotic therapy

Nasal decongesting

Your doctor may prescribed a mild analgesic for moderate to extreme
pain

If it is due to a deviated septum, repair may be needed which may require
surgery

 * Call your doctor if treatment does not help within 48 hours
after antibiotic therapy

 * Take all of the prescribed antibiotic, stoppage of antibiotic
therapy may result in reinfection and or other complications.

 * Call your doctor promptly if you experience an adverse reaction
to any medication.

Sickle cell anemia:  A congenital hemolytic anemia that occurs primarily but not exclusively in black people,
sickle cell anemia results from a defective hemoglobin molecule ( hemoglobin
S ) that causes RBC’s ( red blood count ) to roughen and become sickle
shape. These cells impair circulation, resulting in chronic ill health,
periodic crises, long term complications, and premature death.

This inherited disease involves an abnormality of hemoglobin, the component
of red blood cells that carries oxygen.  The normal hemoglobin molecule
is of the A type.  In sickle cell disease much of the hemoglobin is
of the type called S type, giving it it’s shape.  Unlike normal, flexible
red cells, the sickled cells are stiff; groups of them may become entangled
in such a way as to obstruct smaller blood vessels.  When obstruction
occurs there is severe joint swelling and pain, more common in the fingers,
and toes, a development often referred to as sickle cell crisis. 
There may also be paralysis and convulsions resulting from cerebral thrombosis.

Symptoms: 

Joint swelling

Pain

Jaundice

Pallor

Chest pains

Aching bones

Ischemic leg ulcer ( especially around the ankles )

Increase susceptibility to infection

Paralysis

Convulsions

Tachycardia ( rapid heart rate )

Cardiomegaly ( enlarge heart )

Systolic and diastolic murmurs

Chronic fatigue

Unexplained dyspnea ( difficulty breathin/labored )

Hepatomegaly ( enlarge liver )

Splenomegaly ( enlarge spleen )

Patient with painful vaso – occlusive crisis may manifest severe abdominal,
thoracic, muscular, or bone pain; possible increased jaundice and dark
urine; low grade fever; and, in long term disease, spleen shrinkage.

Treatment:

Therapy for this anemia is primarily symptomatic and can usually be
done at home.  Hemoglobin level should be check frequently, if hemoglobin
drops suddenly or if the patient condition deteriorates rapidly, he must
be hospitalized for possible transfusion of packed RBCs.  In a sequestration
crisis, treatment may include sedation and administration of analgesics,
blood transfusion, oxygen administration, and administration of large amounts
of oral or I.V. fluids

 * Watch for signs of sickle cell crises:  includes; pale
lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness,
with difficulty awakening; irritability; severe pain temperature over 104
degree C or fever of 100 degree that persist for 2 days.

** CALL YOUR DOCTOR PROMPTLY if you experience the above symptoms.

Shingles  also known as Herpes zoster: 
this disorder is an acute unilateral and segmental inflammation of the
dorsal root ganglia caused by infection with the herpes virus varicella
zoster or V -Z, the same virus causes by chicken pox.  Herpes Zoster
produces localized vesicular (relating to small, saclike bodies) skin lesions
confined to a dermatome (the area of skin supplied with afferent nerve
fibers by a single posterior spinal root), and severe neuralgic pain in
peripheral areas innervated ( supply of nerve stimulation sent to a part)
by the nerves arising in the inflamed ganglia ( a group of nerve cell bodies,
located outside the central nervous system).

Cause:  Shingles is caused by reactivation of the herpes virus
V -Z that has lain dormant in the cerebral ganglia (extramedullary ganglia
of the cranial nerves) or the ganglia of posterior nerve roots since a
previous episode of chicken pox.

Symptoms:

Fever

Malaise

Within 2 to 4 days : deep pain, pruritus (itching), and paresthesia
(an abnormal sensation, such as, burning and prickling) or hyperesthesia
(Abnormal increased sensitivity of the skin or organ), more common in the
trunk and occasionally on the arms and legs.

Pain may be continuous or intermittent

Small red  nodular skin lesions then usually erupt on the painful
areas and commonly spread unilaterally around the  thorax or vertically
over the arms or legs.

They quickly become vesicles filled with clear fluid or pus.

After 10 days after they appear, the vesicles usually dry up and form
scabs,

Treatment:

To relieve the itching and neuralgic pain – your doctor may prescribe
calamine lotion or another topical antipruritic 

Aspirin, possibly with codeine or another analgesic

Your doctor may prescribe an application of collodion or tincture of
benzoin to unbroken lesions.

If lesion ruptures an becomes infected an antibiotic may be prescribe

Trigeminal zoster with corneal involvement calls for  instillation
of idoxuridine ointment or another antiviral medication. 

Your doctor may prescribe a combination of treatment for patient with
intractable pain of  postherpetic neuralgia such as ; corticosteroids
to reduce inflammation, of a sedatives or tranquilizers, or an antidepressants
with phenothiazines.

Studies shows that * Zovirax (acyclovir) seems to stop progression
of the skin rash and prevent visceral complications.  * Vidarabine
reportedly speeds healing of lesions, decreases pain and prevents the disease
from spreading and developing complications

 * Call your doctor PROMPTLY if you develop signs of dissemination
(generalized lesions) and CNS infection (headache, fever, stiff neck and
or weakness. 

 * Avoid close contact with individuals who haven’t had chicken
pos until the eruption has resolved. 

Scoliosis:  a lateral curvature of the vertebral
column., scoliosis may occur in the thoracic, lumbar, or thoracolumbar
spinal segment.  The curve may be convex to the right ( more common
in lumbar curves ) or to the left ( more common lumbar curves)  Rotation
of the vertebral column around its axis occurs and may cause rib cage deformity.
There are two different types of scoliosis; functional  (postural
) ,and   structural .  They are both associated with kyphosis
( humpback ) and
lordosis

( swayback ). Scoliosis usually affects adolescent girls. Most school
now check adolescents for scoliosis, check with your school district if
your interested.

Functional Scoliosis:  it is a results from  poor
posture or a discrepancy in leg lengths. 

Structural Scoliosis:  it involves deformity of the vertebral
bodies.  It may be congenital ( present at and existing from
the time of birth ) such as wedge vertebrae, fused ribs or vertebrae, or
hemivertebrae.  Paralytic ( affected with paralysis ) such
as polio, cerebral palsy, or muscular dystrophy, or idiopathic (
occurring without known cause ), the most common form, may be transmitted
as an autosomal dominant ( a non  – sex- determining chromosome )
or multifactorial trait, it appears in a previously straight spine during
the growing years.

Symptoms:

Curving of the spine ( usually in the thoracic segment ), with convexity
to the right  (having a rounded, somewhat elevated surface ), and
compensatory curves ( S curves ) in the cervical segment above and the
lumbar segment below, both with convexity to the left.

Backache

Fatigue

Dyspnea ( difficulty breathing )

Unequal shoulder heights, elbow levels, and heights of the iliac crests.

Your doctor may want to take an X-ray of your spine

Treatment:

The most effective treatment should begin very early, when spinal deformity
is still subtle.

Your doctor will  determine what course of therapy and or treatment
depending on the severity of the deformity.

A brace may have to worn (Milwaukee brace )

Surgery may be needed

Close observation and exercise

A mild curve ( less than 25 degrees ) can be monitored by X -Rays and
an examination by your doctor every 3 months. Along with exercise program
to strengthen the turso muscles and help prevent curve progression. 
A heel lift may help.

A curve of 25 degrees to 40 degrees requires spinal exercises and a
brace.  Your doctor may prescribe you to undergo transcutaneous electrical
nerve stimulation ( TENS ).  A brace helps to halt progression in
most patients but does not reverse established curvature.

A curve of 40 degrees or more requires surgery ( spinal fusion ), since
a lateral curve progresses at the rate of 1 degree a year even after skeletal
maturity. 

 * Early detection is the Key.  See your doctor if you suspect
and or have any of the symptoms above.

 * If the patient have a brace, keep in mind:  Do not insert
anything or let anything get under the cast and to immediately report cracks
in the cast, and if there is pain, swelling, skin breakdown, and 
numbness see your doctor Promptly.

Cast Syndrome:  a serious complication, this syndrome
may follow spinal surgery and application of a body cast. 

The patient may experience nausea, abdominal pressure, and vague abdominal
pain. Experts believe  the reason for cast syndrome is probably due
to hypertension of the spine. Hypertension of the spine accentuates lumbar
lordosis, with compression of the third portion of the duodenum between
the superior mesenteric artery anteriorly, and the aorta and vertebral
column posteriorly.  High intestinal obstruction produces nausea,
vomiting, and ischemic infraction of the mesentery.

Untreated cast syndrome may be fatal. * Call your doctor immediately,
this syndrome may develop as late as several weeks or months after application
of the cast.

Sciatic:  pertaining to the ischium

Sciatica is a form of neuritis ( inflammation of a nerve ) characterized
by severe pain along the sciatic nerve and its branches.  The pain
radiates into one or both buttocks and descends to the back of the leg
or legs, it results from the compression of the sciatic nerve at the base
of the spine.  There are many causes of this disorder, but probably
the most common are rupture of a disk between the lower lumbar vertebrae
and arthritis of the lower part of the spinal column. It can be cause by
poor posture and or muscle strain.

Symptoms:

Pain radiating into one or both buttocks, down the back of the thigh
and down the leg and even foot.

Pain may be a burning feeling

Pain can be dull or sharp

Numbness and weakness

May be aggravated by lilting and or strenuous activity

Usually affects one side of the body. 

An intermittent or continuous, shooting and or burning pain.

Your doctor may do a CT scan, MRI and or X-ray

Treatment:

Physical therapy may be recommended

Your doctor may prescribe anti-inflammatory medication called NSAID’s,
such as Naprosyn. or  Motrin,  There are many others!

Your doctor may prescribe muscle relaxants, and or narcotics

Your doctor may prescribe corticosteroids medication.

To help ease the pain, try sleeping with a pillow under or between your
knees. Avoid sleeping on your stomach, sleep on your back and or side with
your knees bent. A firm mattress is recommended.

If pain persists for more than 72 hours with no relief, accompanied
by leg and or foot weakness, * Call your doctor promptly.

Schizophrenia:  Severe emotional disorder,
usually of psychotic proportions, characterized by withdrawal from reality,
delusion, hallucinations, ambivalence, inappropriate affect, and withdrawn,
bizarre or regressive behavior.

Schizophrenic disorders:  This group of disorders
is marked by withdrawal into self and failure to distinguish between reality
and fantasy.  Studies shows an estimated 2 million Americans may suffer
from this disease.  There is four types of schizophrenia, the different
types share these essential features:  presence of psychotic features
during the acute phase: deterioration from a previous level of functioning,
the onset before age 45, and the presence of symptoms for at least 6 months
with deterioration in occupational functioning, social relations, or self
care. The four type of schizophrenia are:  catatonic, paranoid,
disorganized, and residual.

Schizophrenic disorders produce varying degrees of impairment; 1) the
prodromal phase:  is insidious, occurring about 1 year before
the patient’s first hospitalization.  During this period, the patient
may display signs of a loss of will, inappropriate affect, and impaired
job performance.  2) the active phase:  patient
show signs of psychotic symptoms such as hallucinations and delusions.
This phase marks full development of the disorder.  3) the residual
phase:  resembles the prodromal phase, but more severe. Some
people who suffers from schizophrenic disorder experience repeated, acute
exacerbation of the active phase. Some as many as one third of schizophrenic
patients have just one psychotic episode and no more. Prognosis worsens
with each acute episode.  Some schizophrenic patients have no disability
between periods of exacerbation.

The cause of schizophrenia ar unknown.  There are various theories,
both biological and psychological have been proposed. Expects point to
genetic pre-disposition, hyperdopaminergic conditions, and disturbed family
and interpersonal patterns, But experts has different opinion on this matter.
A recent report that a gene for schizophrenia exists on chromosome 5 hasn’t
yet been confirmed.

Symptoms:

Catatonic schizophrenia: 

Inability to take care of personal needs

Diminished sensitivity to painful stimuli

Negative attitude

Rigidity

May experience rapid swings between excitement and stupor

May experience extreme psychomotor agitation 

Excessive, senseless, and or incoherent shouting or talking.

Often there is an increased potential for destructive, violent behavior.

Paranoid schizophrenia: 

Feeling of persecutory (  of, related to, or being/feeling of persecution: 
paranoid)

Having a grandiose delusional thought content and auditory hallucinations.

May act on delusional thoughts,  inability to function

May exhibit an artificial or elevated mannerism towards others

Unfocused anxiety, anger, argumentativeness, and violence.

Disorganized schizophrenia:

Incoherence

Regressive, silly, flat, incongruous ( not suitable, inappropriate,
not corresponding or conforming ), chaotic speech

Fragmented hallucinations and delusions that are not systematized into
a coherent theme.

May exhibit unpredictable laughter and or grimaces

may have hypochondriacal complaints

Extreme social withdrawal

Regressive behavior

Residual schizophrenia:

Has a previous history of at least one episode of schizophrenia with
prominent psychotic symptoms and continues to suffer from two or more characteristic
symptoms such as:  inappropriate affect, social withdrawal, eccentric
behavior, illogical thinking.

Residual schizophrenia, the patient does not exhibit prominent psychotic
symptoms.

Treatment:

Goal: to control this illness and to equipped the patient with skills
they need to live and an environment that offers opportunity for meaningful
interpersonal relationships.

Patient needs to be under the care of one who is a professional who
specialize in this disorder.

Neuroleptic medication. Drug treatment should be continuous because
schizophrenic patients may relapse when medication is discontinued. * With
all medication, use as prescribe by your doctor.  Call your doctor
if you experience adverse reaction to medication.  * Make sure you
let your doctor know if you start or stop any medication.

Doctors disagree about the effectiveness of psychotherapy in schizophrenics. 
Electroconvulsive therapy ( ECT ) is sometimes used to treat acute schizophrenia
and may be helpful when neuroleptic therapy cannot be used.

Scarlet fever once had been a dangerous illness, but with early care
it is easily treatable.

Scarlet fever needs to be treated with antibiotic and can not be left
to run its course, it is characterize by sore throat, high fever 
spots on the tongue ( looks like strawberry tongue ), bright red rash. 
If left untreated it can lead to arthritis, jaundice, kidney problems rheumatic
fever and can lead to death.  Incubation period is 2 to 5 days, and
anywhere from 24 to 48 hours later, a rash ( scarlet rash ) appears, the
rash can feel like sandpaper.

Scarlet fever is caused by a bacteria known as streptococcal, it is
contagious and spread by contact with an infected person or from inhalation
of the bacteria

Symptoms:

Sore Throat

High fever 

Rash – usually starts at the neck and chest than spreading through
out the whole body

Headache

Dizziness

Nausea and or vomiting

Abdominal pain

Tongue becomes red and swollen ( looks like strawberry tongue )

 * Your doctor may want to take a culture of your throat for the
presence of streptococcal bacteria, he/she will examine your throat. 
Your doctor may order blood work to be done. 

Treatment:

Antibiotic therapy

Drink plenty of fluids

Acetaminophen ( tylenol product ) * do not take aspirin unless specified
by your doctor, due to the fact that  it can be associated with Reye’s
syndrome ( a sometimes fatal brain disease – cause – unknown )

Cool baths helps to reduce fever.

Your doctor may prescribe an antihistamine/anitpuritis medication to
relieve the itching

Scabies: A contagious skin disease due to the
itch mite,
Sarcoptes scabiei; the female mite bores into
the stratum corium (the dermis; or the layer of the skin deep to the epidermis
), forming burrows (cuniculi ), followed by intense itching and eczema
caused by scratching. Close environments such as childcare centers, prisons,
and nursing homes, the parasite needs a human host to survive, it has been
on the rise in the US and more preschool children under the age of 5 are
infected, probably due to the rise in child care providers. Transmission
almost always occurs through direct person to person contact. Scabies mites
survives only 2 to 3 days without a human host.

Symptoms:

Itching, becoming intense at night.

Red lesion ( burrow ) red patches usually appear between fingers, on
flexor surfaces of the wrists, on elbows, in axillary folds, at the waistline,
nipples in females, on genitalia in males, and possibly on the head and
neck in infants.

Scabs

 * Visual examination of the contents of the scabietic burrow may
reveal the itch mite.  A drop of mineral oil placed over the burrow,
followed by superficial scraping and examination of expressed material
under a low power microscope, may reveal ova or mite feces.  If scabies
is strongly suspected but diagnostic tests offer no positive identification
of the mite, your doctor may order skin clearing with a therapeutic trial
of a pediculicide to confirm the diagnosis.

 * If you experience intense itching  and above symptoms,
see your doctor promptly for treatment, because it is highly contagious
and getting rid of the mite may not be as easy.

Treatment:

Application of a pediculicide ( lindane cream ) for approx. 3 consecutive
days or as prescribe by your doctor.

Your doctor may prescribe an antipruritic emollient or topical steroid
to relieve persistent itching.

Good hygiene is essential. 

All person who the patient have had contact with should get treated
or see their doctor.

 * Lindane cream should not be applied to affects areas if 
the skin is raw or inflamed

 * Call your doctor if you have skin irritation or hypersensitivity
reaction to prescribed treatment

 * Washing hands thoroughly , and good hygiene is essential.