Nosebleeds

What is a nosebleed?

A nosebleed - more formally called epistaxis - can occur without any obvious cause. The blood usually comes out through just one nostril, although it may affect both.

Nosebleed symptoms

Fairly obviously, loss of blood from the nose is the major symptom. Some children can sense a bleed starting before it's obvious. The child may also be aware of blood entering the throat from the back of the nose especially if they hold their head back or lie down (this can cause a bad taste).

Causes and risk factors

Many nosebleeds are idiopathic - that is there is no obvious cause, or the cause is unknown. But in children frequent colds and the drying effect of central heating can cause irritation of the delicate mucous membrane that lines the nose. This becomes inflamed, crusted or cracked, and is much more likely to bleed.
Bumps to the nose, especially once it's inflamed, and vigorous nose blowing can trigger a bleed. The common childhood pass time of picking your nose can cause it to bleed. Some children just have a tendency to nosebleeds, for no obvious reason.
Rare causes include cancers and illnesses that prevent the blood from clotting properly.
Nosebleeds are described as either anterior or posterior depending on which part of the nose the bleeding comes from. Children almost always have anterior nosebleeds, from a vein (unlike older adults where it's more likely to be posterior and come from an artery).

Nosebleeds - treatment and recovery

Most nosebleeds in children can be easily treated. Keep the child as calm as possible. Tell them to tip their head forward and breathe through their mouth while you pinch the soft parts of the nose together between your thumb and index finger, just below the bony part of the nose.
Then press the pinched nose firmly towards the face. Keep this position for five full minutes (ideally ten) making sure the child's head is held up well above the level of the heart.
If bleeding persists, apply a cold pack against the face whilst still pinching the nose and get medical advice. If nosebleeds are frequent, treatment such as cautery to seal the blood vessels may be needed.
READMORE:http://www.bbc.co.uk/health/physical_health

Ears popping when flying

Why do the ears make a popping sensation?

The ear consists of three chambers:

• The outer ear canal which leads up to the ear drum.
• The middle ear chamber behind the drum which is filled with air.
• The very specialised inner ear.

The air in the middle ear is constantly being absorbed by the membranes that line the cavity, so the internal pressure can easily drop, putting tension on the tissues there. Fortunately, air is frequently resupplied to the middle ear during the process of swallowing.
Usually when you swallow, a small bubble of air passes from your throat or back of your nose, through a narrow tube known as the Eustachian tube which is usually closed, into your middle ear. As it does this, it makes a tiny click or popping sound.
This action keeps the air pressure on both sides of the eardrum about equal. If the air pressure isn't equal, for example if the Eustachian tube isn’t working efficiently or if pressures suddenly change, the ear feels blocked or uncomfortable.

What happens in an airplane?

The pocket of air in the middle ear is particularly vulnerable to the changes in air pressure as you go up in a plane.
The higher the plane, the lower the air pressure around you, although inside the cabin you're protected, to some extent, from these pressure changes. Pressure in the middle ear remains higher until the Eustachian tube opens up to allow the pressure to equalise. Until this happens the relatively lower pressure outside the middle ear pulls the ear drum and tissues of the middle ear outwards, making them feel very uncomfortable.
The eardrum is stretched and can't vibrate properly, so sounds become muffled. When the Eustachian tube opens, air travels out from the middle ear, making a popping noise as pressure equalises.
During the descent in a plane, the opposite happens as pressure builds up outside the ear, pushing the eardrum inwards.
Abnormal pressure can develop in the middle ear, pulling in or stretching the ear drum, when the Eustachian tube is blocked for other reasons - as the result of a bad cold, for example, or a nasal allergy - or because it's narrow as a result of childhood ear infections.

Treatment and recovery

The following can help to relieve the problem:

• Swallowing activates the muscle that opens the Eustachian tube, and you swallow more often when chewing gum or sucking sweets so try this just before and during descent.
• Yawning is an even stronger activator of the muscles.
• Avoid sleeping during descent, because you may not be swallowing often enough to keep up with the pressure changes.

The most forceful way to unblock your ears is to pinch your nostrils, take in a mouthful of air and use your cheek and throat muscles to force the air into the back of your nose, as if you were trying to blow your thumb and fingers off your nostrils. You may have to repeat this several times before your ears pop.
Decongestants shrink internal membranes and make your ears pop more easily. Ask your pharmacist for advice. However, you should avoid making a habit of using nasal sprays, because after a few days they may cause more congestion than they relieve
READMORE: http://www.bbc.co.uk/health/physical_health

Ear health

Waxy ears

One of the most common complaints seen by GPs is a blocked ear, usually caused by wax that has been pushed into the ear by a cotton bud.
As well as the blocked sensation, waxy ears can reduce hearing, cause a ringing sound (tinnitus) and, occasionally, pain.
There's no need to clean your ears with a cotton bud. The ear has its own internal cleaning mechanism. Fats and oils in the ear canal trap any particles and transport them out of the ear as wax. This falls out of the ear without us noticing.
When we try to clean the ear, this wax gets pushed back and compacted. There's also no need to dry ears with a towel, cotton buds or tissue paper. Let them dry naturally or gently use a hair-drier on low heat.
Olive oil can help to soften the wax and enable it to come out. Apply two drops in each ear twice a day. Wax-softening drops can also be bought from a pharmacist.
Sometimes, the wax needs to be syringed out by a GP or practice nurse.

Itchy ears

These can be irritating, and when ears are affected with eczema or psoriasis they can cause constant discomfort. But scratching or poking damages the ear's sensitive lining, allowing infection in, called otitis externa.
This can also happen when ears gets waterlogged through swimming. The ear canal swells, becoming narrow and painful. Hearing becomes a problem and discharge often appears.
Treatment requires antibiotic drops and strong painkillers. In severe cases, the ear needs to be cleaned by an ear specialist.

Piercing

Anything that damages the skin can allow infection in. This is often the case with ear piercing, especially when the skin isn't cared for properly during or after the piercing. Follow care advice carefully.
Many people are allergic to certain inexpensive metals, such as nickel, which can make the outside of the ear swell and feel uncomfortable.

Sunburn

The tops of the ears are exposed to the sun and sensitive to its harmful UV rays. Skin cancer affects ears, too.
Make sure you apply suncream and wear a hat that keeps your ears in the shade.
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Hepatitis C

What is hepatitis C?

Hepatitis C is an infection with the hepatitis C virus. Although there is no vaccine to protect against infection, there is effective treatment available.
Estimates suggest over 250,000 people in the UK have been infected with hepatitis C, but eight out of 10 don’t know they have it because they have no symptoms. About 75% of these people go on to develop a chronic hepatitis.
Because it can take years, even decades, for symptoms to appear, many people (possibly 100,000 or more) remain unaware they have a problem. By the time they become ill and seek help, considerable damage has been done to the liver. This might have been prevented if the person had been diagnosed earlier.
Elsewhere in the world, hepatitis C is even more common – the World Health Organization estimates that three per cent of the world’s population (about 170 million people) have chronic hepatitis C and up to four million people are newly infected each year.

Hepatitis C symptoms

In most cases, the initial infection doesn't cause any symptoms. When it does, they tend to be vague and non-specific.
Possible symptoms of hepatitis C infection include:

• Fatigue
• Weight loss
• Loss of appetite
• Joint pains
• Nausea
• Flu-like symptoms (fever, headaches, sweats)
• Anxiety
• Difficulty concentrating
• Alcohol intolerance and pain in the liver area

The most common symptom experienced is fatigue, which may be mild but is sometimes extreme. Many people initially diagnosed with chronic fatigue syndrome are later found to have hepatitis C.
Unlike hepatitis A and B, hepatitis C doesn't usually cause people to develop jaundice.
About 20-30 per cent of people clear the virus from their bodies - but in about 75 per cent of cases, the infection lasts for more than six months (chronic hepatitis C). In these cases, the immune system has been unable to clear the virus and will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all.
About one in five people with chronic hepatitis C develops cirrhosis of the liver within 20 years (some experts believe that, with time, everyone with chronic hepatitis C would develop cirrhosis but this could take many decades).

Hepatitis C causes

Hepatitis C virus is usually transmitted through blood-to-blood contact. One common route is through sharing needles when injecting recreational drugs - nearly 40 per cent of intravenous drug users have the infection and around 35 per cent of people with the virus will have contracted it this way.
Similarly, having a tattoo or body piercing with equipment that has not been properly sterilised can lead to infection.
Before 1991, blood transfusions were a common route of infection. However, since then all blood used in the UK has been screened for the virus and is only used if not present.
Hepatitis C can be sexually transmitted, but this is thought to be uncommon. It can be passed on through sharing toothbrushes and razors. It is not passed on by everyday contact such as kissing, hugging, and holding hands - you can't catch hepatitis C from toilet seats either.
If someone needs a blood transfusion or medical treatment while staying in a country where blood screening for hepatitis C is not routine, or where medical equipment is reused but not adequately sterilised, the virus may be transmitted.
Most people diagnosed with hepatitis C can identify at least one possible factor which may have put them at risk but for some, the likely origin of the infection isn't clear. Because it can remain hidden and symptomless for so many years, it may be very difficult to think back through the decades to how it might have begun.

Preventing hepatitis C

There are a number of ways to reduce the risk of the infection being transmitted. Those most at risk of contracting the infection are injecting drug users, who should never share needles or other equipment.
Practising safe sex by using condoms is also important.
People with hepatitis C infection aren't allowed to register as an organ or blood donor.

Hepatitis C test

If you think you could have been in contact with the hepatitis C virus at any point in the past, you can have a test to find out if you've been infected. You should ask you GP. Local drug agencies and sexual health clinics (sometimes called genito-urinary medicine or GUM clinics) may also offer testing.

Hepatitis C treatments

People with chronic hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy.
Whether treatment is needed, and if so which type, depends on a number of factors. These include blood tests to identify which strain of hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.
Hepatitis C can be treated with pegylated interferon alpha and ribavirin. These drugs help the body's immune system to overcome the virus, and are often used together as dual or combination therapy which has been shown to be effective in 55 per cent of cases. Some strains or genotypes of the hepatitis C virus are more likely to respond than others. Even if the virus isn't completely cleared, the treatments can reduce inflammation and scarring of the liver. They may, however, cause side effects that some people find difficult to tolerate.
A number of new drugs, known as direct acting antivirals or DAAs, are being developed which work in a different way, by targetting the virus itself. Two of the drugs, which are types of a group known as protease inhibitors that block vital enzymes that the hepatitis C virus needs to reproduce, are now approved for use in Hepatitis C. They may help to clear the virus from the body when used in combination with the standard treatments, pegylated interferon alpha and ribavirin.
Many people also find that complementary and lifestyle approaches help. There is little evidence these can reduce levels of the virus, but they may help to deal with symptoms and improve quality of life.
READMORE:http://www.bbc.co.uk/health/physical_health