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18.03.2014, admin
Diabetes can put you at risk for suffering from many skin conditions, some wanting medications while others not engaging in any specific treatment measures. Skin complications can range from the mild ones as itching to the more serious and troubling ones like vitiligo and Necrobiosis Lipoidica Diabeticorum (NLD). The first thing you need to do is to consult your doctor when you note any abnormality or change in skin. Diabetics can also have an allergic reaction to several things including medications, insulin and anti-hyperglycemic medications.
Digital sclerosis affects mostly the type 1 diabetes which is not controlled appropriately. Brining blood glucose levels back to a normal level is the main treatment measure to be adopted. Blood sugar control apparently does not play a role here, both before and after diagnosis of the condition. Prompt diagnosis can ensure timely treatment of a skin condition, before it can actually become a problem. It is important for diabetics to keep their skin clean and dry.  Even minor injuries and abrasions should be attended cautiously and monitored for infection or any other sign of deterioration. Phage therapy is the application of bacteriophages to therapeutic effect in the body to control pathogenic bacteria. Otitis externa, inflammation of the external ear canal, with or without middle ear involvement, is very common in dogs and quite common in cats.  Ear disease is seen in both first opinion and referral practice and, due to its frequently recurrent nature, constitutes a frustrating problem for owners and veterinarians alike.
Once an otic infection has been diagnosed, medical options include topical and systemic therapy, co-adjuvated by ear cleaning, when appropriate. Ear cleaning is an important part of any treatment regimen as it can remove debris and pus and permit complete diagnostic evaluation of the ear canal and tympanic membrane. In the majority of cases of infectious otitis externa, topical therapy alone is sufficient. Antimicrobial agents rarely can reach, systemically, therapeutic concentrations in the skin of the ear canal and topical therapy, chosen empirically based on otic cytology and otoscopic examination, represents an appropriate choice.  Antibiotic sensitivity data reflects the serum level needed systemically, and it is less useful with topical drugs where concentrations 100 to 1000 times superior to the MIC (Minimum Inhibitory Concentration) may be reached.
Topical agents, available as veterinary formulations, include marbofloxacin and orbifloxacin. Silver Sulfadiazine (SSD) – this has broad-spectrum antibacterial activity (most notably against P. Tromethamine–ethylenediamine-tetraacetate (TrisEDTA) –this is commonly used as either a pre-soak or a carrier vehicle in the treatment of gram negative infections. According to manufacturer’s data, hydrocortisone aceponate (Cortavance, Virbac) has a potency similar to dexamethasone and betamethasone. The reader should remember that all the UK licensed polypharmaceutical topical ear medications are not licensed to be used in the absence of tympanic membrane, and owners should be made aware of the risks of using these medications when the tympanic membrane cannot be assessed.
Considering that the middle ear (tympanic bulla) contains a highly vascular mucous membrane lining, drugs may diffuse from the vascular compartment to the bulla space better than in the external ear canals. The administration of systemic antimicotic agents is needed in cases of otitis media caused by Malassezia spp.
Ear wicks are made of polyvinyl alcohol (PVA) and are characterised by a hard compact structure. Examples of molecules that cause ototoxicity after topical administration are aminoglycosides antibiotics, furosemide, cisplatin, vinblastin, vincristin. In pathologic condition, even the use of simple saline solution during ear flushing may cause, although infrequently, complications. Finally, it is paramount to highlight that the majority of the studies on ototoxicity have been performed on laboratory animals or have been extrapolated by human studies.
This disease is of two types – viral meningitis, characterized by fever and illness and bacterial meningitis, causing brain damage and resulting in death.
Whenever, there is any bacterial or viral infection in the body, it is important to make use of antibiotics available. It is usually injected into the body that spreads all along the body, to kill and destroy infection causing bacteria. If a person is affected by meningitis, he or she will have trouble in breathing that reduces the supply of oxygen to the body. Meningitis has the characteristics of affecting the brain, therefore it is important to reduce air or pressure near the brain.
There will be a huge loss of water and chemical components in the body during meningitis, which has to be normalized for curing it. Before, reaching the hospital for treatments, it is important for patients to take rest in properly ventilated area.
When it comes to avoiding skin complications and unfavorable outcomes of diabetes, the most crucial thing is blood sugar control. Sty (infection of the eyelids), boil (infections of the hair follicles), carbuncles and nail infections are some of the infections diabetics are likely to experience.
Fungal infections, as those mentioned here, are generally caused by a yeast-like fungus (Candida albicans). Atherosclerosis affects vessels that cause cardiovascular disease; vessels supplying blood to the skin can also be affected.
They are similar to burn blister and usually found on fingers, toes, hands, feet and forearms. Symptoms of this skin condition appear as thick, waxy (but tight) skin on hands, fingers and toes.

Medications may be used; it is difficult to arrive at a conclusive treatment measure fro NLD due to lack of knowledge about what causes this condition. Many diabetic skin problems can be prevented through tight blood sugar control and routine examinations of the skin. Despite continual effort to combat infection using antibiotics, little effort has been allotted to finding alternative treatments. The use of phages has many potential applications for treating bacterial infections, especially infections that do not respond to conventional antibiotic treatment. Many different factors can cause or exacerbate otitis and recognition and correction of these is the key to successful management. 2008) the antimicrobial efficacy of different ear cleaners against Staphylococcus intermedius, Pseudomonas aeruginosa and Malassezia pachydermatis was evaluated. It should always be performed under general anaesthesia with an endotracheal tube placed and cuffed, to avoid the fluids running from the ear to the respiratory tract through the Eustachian tube. It should be performed under general anaesthesia and under direct visualisation after lavage of the external ear, when the canal is dry. Topical therapy usually is characterised by high efficacy and, with regards to the antimicrobial agents, by no systemic side effects in the presence of an intact tympanic membrane. EDTA promotes increased permeability to extracellular solutes and increased sensitisation to antibiotics, whereas Tris serves as a buffer. 2010) reported the results of a veterinary clinical trial of a bacteriophage treatment of infection. Dose and frequency of administration should be reduction until discontinuation when the medication is no longer needed. Usually ototoxicity can be divided: cochlear damage with consequent deafness or vestibular damage with consequent vestibular syndrome. Aminoglycosides can cause cochlear damage, with the exclusion of gentamicin that in a study(Strain et al. For this reason it is always important to inform owners about potential risks of ear flushing and topical therapy. Despite these studies representing guidelines for the clinician, further studies on other species are needed. Evaluation of an ear cleanser for the treatment of infectious otitis externa in dogs.Vet Ther. Diagnosis and treatment of otitis media in dogs and cats.Vet Clin North Am Small AnimPract. Comparison of pulse administration versus once daily administration of itraconazole for the treatment of Malasseziapachydermatis dermatitis and otitis in dogs. This infection leads to the irritation and swelling near the brain and spinal cord covering regions, which puts the life of a person at risk.
While the former occurs commonly among individuals, the latter occurs occasionally, but has to be treated at the earliest to avoid serious health affects. It is necessary to keep a check on the antibiotic dosage levels, which helps in overcoming drug resistance situation. It is important for individuals to breathe properly without any troubles, which helps in reducing meningitis infection to an extent. In oxygen therapy, physicians make use of nose piece, windpipe, hood and face mask like structures providing needed air for patients to breath. Patients are advised to take large amount of fluids and waters frequently, which helps in preventing the risks of dehydration and vomiting.
It not only helps in preventing a complication (including skin complication) but also treating the same in case of its occurrence. This fungus is usually found in warm and moist skin areas like fingers and toes, corners of the mouth and vagina.
Antihistamines and decongestants are generally used to hinder the effect of chemicals involved in an allergic reaction. Necrobiosis Lipoidica Diabeticorum has association with diabetes mellitus, predominantly in the insulin dependants.
Your legs are mostly affected if you have poor blood flow. Skin lotions can relieve itching to certain extent. High blood glucose can reduce your strength to fight invasions, including those on the skin. Attune with your doctor for becoming more aware of diabetic consequences and have regular checkups to get timely treatment. Although the use of phages to control bacteria has been proposed decades ago, phage therapy use for human medicine has not yet been approved in most of the world and continues to undergo extensive research.
Based on history and clinical presentation, management of ear diseases include medical and surgical options.
The preferred method used by the author is using a 6 French urinary catheter cut obliquely to a 60° and attached to a 2ml syringe containing sterile saline solution. The results show that administration of this topical bacteriophage mixture leads to lysis of P. They can be systemically absorbed, with the adrenal glands function suppressed for up to 2 weeks or more after administration of some glucocorticoids for more than one week. The choice should be based on culture and susceptibility testing and, results pending, empirical treatment, based on examination of cytological specimen from the bulla content,  should be started.
The expansion produces a structure that adapts to the contours of the ear canal, slowly releasing the medicaments.  In this author’s experience, ear wicks can be a useful alternative to daily topical therapy in those patients that do not tolerate administration of topical medications.

Comparison of microbial isolates and susceptibility patterns from the external ear canal of dogs with otitis externa.
This threat is seen among people of all ages, but the risks of disease are high among adults, because of their damaged and improper immune system. It is necessary for patients to make use of treatment for meningitis available, by taking proper medical advice from specialist medical doctors. It is important to note that treatments for meningitis depend on the type of disease, age and other related factors.
This therapy helps an individual in getting back to normal, which helps him in fighting against meningitis.
There are also chances of fever and seizures that is suffered by the patients, which has to be treated with necessary medicines available for curing it. Blood tests and pressure has to be checked, which helps in tracking sugar and sodium levels in the body.
Following these measures efficiently, can help in reducing the health impact caused by meningitis. However, these have side effects and should be implemented with precaution.  Immunotherapy is another alternative treatment option. Viable treatments include: herbal and plant extracts, folk remedies, exploiting the placebo effect, and already existing over the counter products. This review examines various research literatures involving the use of phages in human medicine. The aim of these notes is to describe the medical interventions available for otitis externa and media, discussing the principles of ear cleaning, ear flushing, and use of topical and systemic medications, mentioning the issues related to ototoxicity. Manual cleansing can be done at home by the owners; however it is important to instruct them on how to perform the cleaning and how often to use the different preparations.
Ear flushing is best to be performed by using a video-otoscope or, if not available, with a urinary catheter or a feeding tube connected to a syringe and fluids (sterile saline), preferably through a three-way tap. The catheter is advanced through the ventral and posterior quadrant of the membrane with subsequent aspiration of the fluids. It is paramount that the ear canals and (in the presence of otitis media) the tympanic bullae are aseptically cleaned prior to the placement, as if the canal is not adequately flushed, the wick can act as a lid trapping infections. The ototoxic agent can reach the inner ear via haematogenous route or directly through openings in the tympanic membrane.
With regards to chlorhexidine, recent studies have demonstrated that if used at a 0.2% or inferior concentration, it doesn’t carry a risk of ototoxicity. Agents with recognised ototoxic potential are polimixin B in the guinea pig and ticarcillin in the chinchilla.
People having viral type will get fully recovered within 10-15 days and it is necessary to confirm that they are positive for meningitis infection.
Acetaminophen is used for treating fever and Dilantin is used to provide relief from seizures, which has to be consumed according to physicians’ advice. A bacterial infection can be successfully treated with antibiotics implemented as cream or pill, as directed by your doctor. There are other ways to treat an allergic reaction depending on the severity and symptoms of the condition. This extended commentary attempts to collect the various research done in the area of alternative treatments and condense these studies into a quick reference. Included background information features some of the basic information already known about the bacteriophages and their potential applications. Although these are normally not recommended to be used more than every 48h, in one study(Cole et al. Before ear flushing is performed, some cases may require the use of an ear cleansing solution to emulsify and remove debris.
It is available as a cream and, although not readily miscible in water, a homogeneous emulsion can be achieved with gentle mixing. Additionally, in dogs with large ear canals, they often do not expand sufficiently to fill the ear canal in its entire diameter. But on the other side, bacterial meningitis is serious that requires serious medication treatment under physician’s observation.
The examples provided are only a glimpse of what is possible, but are backed by thorough research- many by the rigors of clinical trials. The studya€™s results reveal the findings on the efficacy of phage therapy as well as the present concerns about its safety and conclusions about its potential future in western medicine.
If the ear drum cannot be visualised, care should be taken as ear cleaners are not licensed for applications in the middle ear and are all potentially ototoxic. You should always consult your doctor when suffering from an allergic symptom as individual needs differ.
Manual cleansing doesn’t remove tightly adherent debris or material present in the deep portion of the ear canal and therefore is best used as routine cleansing at home once ear flushing has been performed.

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