Clinical explanation of Bronchiectasis

Permanent dilatation and distortion of the bronchi is called bronchiectasis. What is it’s effect to human health?

Etiology and Pathogenesis:

Most of the cases of bronchiectasis result from acquired causes.

• Obstruction to the bronchus due to any cause leads to distal collapse of the pulmonary segment. The pull on the bronchi by the collapsed alveoli leads to dilatation of the bronchi. In the initial stages this is reversible and the bronchi regain their normal size when the lung expands. If the obstruction persists, accumulation of mucus occurs distally, infection supervenes and the bronchial wall is destroyed permanently.

This results in permanent dilatation. The infective organisms are streptococci, pneumococci, Klebsiella, and anaerobes.

• Bronchiectasis may follow several viral infections without passing through the obstructive phase.

• Congenital defects in the bronchial wall lead to bronchiectasis. The classical example is Kartagener’s syndrome, which is characterized by dextrocardia, sinusitis, and defects of ciliary function in the bronchi and non-motile sperms.

• Middle lobe bronchiectasis is a sequel to pulmonary tuberculosis. This is caused by obstruction to the middle lobe bronchus by tuberculous glands. This is called “middle lobe syndrome” or “Block’s syndrome”.

Clinical features:

The clinical picture is very chronic, extending over several years.

The common site of lesion is the left lower lobe. Though children may be affected, usually symptoms manifest in early adulthood or middle age. Males are affected more than females. Digital clubbing is a prominent sign, sometimes being associated with hypertrophic pulmonary osteoarthropathy.

Postural cough with the production of large quantities of purulent and foul smelling sputum is the presenting complaint in most cases. On keeping for sometime, the sputum settles into 3 layers as described under lung abscess. Hemoptysis may occur frequently. This may be mild or severe. Recurrent infections such as pneumonia may develop. Repeated affection of the same lobe or segment should suggest the possibility of underlying bronchiectasis. Bronchiectasis sicca is the condition in which bronchiectasis presents with mild or severe hemoptysis without purulent sputum.

Physical examination may reveal impairment of the percussion note and diminution of respiratory sounds over the presence of coarse, persistent leathery rales. At times bronchiectasis may present with one of its complications. These include massive hemoptysis, recurrent pneumonia, emphysema, septicemia brain abscess, and cor pulmonale. Anemia develops in long standing cases due to chronic sepsis and recurrent hemoptysis. In untreated cases secondary amyloidosis may develop.

Diagnosis:

Bronchiectasis should be diagnosed by the long history, presence of clubbing, postural cough, coarse leathery rales over the affected part and reasonably normal general health. Once established, bronchiectasis is not curable by medical treatment.

Differential diagnosis

Bronchiectasis should be distinguished from chronic bronchitis and emphysema, lung abscess, tuberculosis, congenital cystic disease of the lung and malignancy. Lung abscess generally develops acutely. The right lower lobe is affected more often and the signs are localized. Tuberculosis is more common in the upper lobes and clubbing is not prominent in uncomplicated cases. Features like digital clubbing and copious sputum are seen in tuberculous bronchiectasis. Cystic disease is not uncommon. All age groups are affected. A long history or recurrent respiratory disease is present in the majority of cases. Clubbing is not prominent. The cysts may be localized or generalized. Clinical distinction from bronchiectasis is difficult. The presence of cysts in other organs like the kidneys, liver, etc, suggests the probability of congenital cystic disease of the lung. X-ray reveals the presence of soap bubble-like or ring shadows.

Diagnosis is confirmed by bronchography. This procedure is absolutely essential for determining the extent and type of bronchiectasis. Plain X-ray of the chest is not a reliable investigation to assess the site and extent of bronchiectasis.

Management

General measures include high protein diet, treatment of intercurrent infections, and removal of focal sepsis from the upper respiratory tract. Principles of specific therapy include postural drainage, administration of antibodies, respiratory exercises and in selected cases surgical excision. Postural drainage helps in clearing the bronchi and brings about relief. The patient should be instructed to practice postural drainage regularly. This gives relief of cough and also the foul smell. The fetid odor of the breath can be controlled by administering steam inhalations containing tincture benzoin or eucalyptus oil. The choice of antibiotic is determined by microbiological studies. Intermittent antibiotic therapy is required to clear infection and prevent exacerbation. The site of lesion may have to be excised if medical treatment fails.

Indications for surgery:

The following are the indications for surgery.

• The disease is localized to one lung or one segment and is not amenable to medical therapy.
• Socio-economic factors such as non-compliance by the patient
• Uncontrollable hemoptysis in which the site of origin of blood may be detected by emergency bronchoscopy and surgical resection has to be planned;
• To reduce the area of infection-even in bilateral disease sometimes surgical resection may have to be done on the more affected side, with a view to reducing the surface area of infection; and
• To remove an obstructive lesion which tends to perpetuate the condition, eg, bronchial growth or bronchostenosis?

I am Funom Theophilus Makama. I advertise through writing. As a platinum expert Author, I write lots of articles and hence promote interested websites, companies, groups, organizations, and communities through publishing and distributing my articles

Modern Bathroom Renovation Ideas

If you are getting a bathroom renovation then this is one of the very best ways to transform your home and make it look like a show home or a home of tomorrow. The bathroom is one of the rooms that is the quickest to date and which often looks the most out of place. At the same time it is one of the rooms (like the kitchen) where you spend a lot of time and where there are a lot of features that can be updated to look more modern. By smartly choosing your bathroom renovation features you can make it a feature rich experience that looks and feels modern and that at the same time is even more of a joy to use.

The first idea for modern bathroom renovations that is an absolute must is to get a walk in shower. Walk in showers are basically shower cubicles that are not elevated off the ground and that are often inside a glass enclosure.

You can use these easily by walking in and you will be surrounded by light as it comes in through the glass. This means that the first and most impressive benefit of these kinds of showers is that you won’t feel at all claustrophobic – in fact you are likely to feel very spacious and this makes it easier to relax and makes it feel more natural. At the same time you will find that walk in shower enclosures are easier in many ways to keep clean etc. This is because there is no shower screen which can leak water and because you won’t need to step in and out of them and that makes it much easier.

There are other factors that can improve your shower too. For instance, why not get extra jets that can spray you from different angles. These are normally synonymous with spa retreats, but modern innovation has meant that they’re now cheap enough that we can afford them in our own home and enjoy the feeling of powerful blasts of water coming from every angle on our back. At the same time this will often be enough to help us to clean other areas that often get forgotten so it also improves hygiene.

What’s more common these days though is to have jets in the bath and this way you have created a spa tub in your bathroom. The bubbles create a highly relaxing sound, improve your bubble bath and massage your muscles into relaxation making them perfect for relaxing in after a long day and they are of course another feature that will make your bathroom seem very modern and all-singing and dancing.

Another option is to have a glass sink. This won’t change the effectiveness of the sink, but it will make it look very modern and it can almost be like an optical illusion at times when completely clean as it looks as though there is just a semi circle of water floating in the bathroom. If you also have a glass shower enclosure then you’ll find that the two match.

Working with Employment Agencies – Picking One which Fits into your budget!

Employment agencies are the most useful choice for anyone, who wish to change or find jobs .Nowadays the look for jobs are becoming very hard even when using the normal methods. Today some people are willing pay a particular sum on the agency, provided the agency finds them a good placement. The experienced businesses most often have collaborations with various companies in numerous industries .At often times these agencies would be the just one providing opportunities that cannot be found any place else. You will find agencies which are dedicated to any type of jobs they give. Therefore people from specialized fields like medical care and executive levels can approach these agencies.

“Staffing agency’ is the one other name for the employment agencies. These agencies offers temporary staffing methods of companies which might be in need of workers. Here, the employees do not need to pay the agency any amount of cash as it is the company which contacted the agency. These organizations may help companies find people for those stages of work, from the computer professionals to day’s laborers. The period of time of the agencies work may vary from your day to your months. It is rather present with get the Companies to employ a short while worker permanently, provided their skills be satisfactory

Know of the sort of individuals who the employment office can be ready to work with, before approaching one. There are several agencies which cope with the placements of top level executives, and so they generally expect experienced those that have managerial, leadership qualities. There’s also agencies which will not consume men and women without per year or two experience with regards to providing workers to the medical and computer industries. Folks who currently have work will find it challenging help the agency’s schedule .While temporary workers have zero choice and work the given schedule, understanding that you can find probability of them being hired.

Industrial or general employment agencies can provide jobs for individuals who want jobs for any short period of time period . In terms of employment agencies the restrictions are less as well as the opportunities are lots of. Whether you have completed your school or college , these agencies will find you jobs accordingly. From time to time you will find organizations who claim to be employment agencies and they cheat the innocent with hopes of providing them with good job opportunities. Become acquainted with your neighborhood agencies and don’t let yourself to use any organization that needs contact through 1-900 numbers. The legal employment offices have zero problem should the contract is fully being read before you sign them.

Car rental companies do provide dinner for toddlers, but will you look for it?

Of course, those of us with a good credit score can rent an RV and cook whenever we need food for the toddlers. That way, we can always take the emerging food preferences into account without undue waste and expense. It’s the same if we decide to go the route of camping. We can either pick the sites with cooking facilities or carry our own gas rings. Remember starting real fires in the middle of our current hot summer is not likely to endear us to Park Rangers and others trying to prevent wildfires from starting. So this gives you a shopping list of possible makes and models to shop for at the car rental agencies if you propose carrying outdoor cooking equipment.

Otherwise you load the people into the vehicle and set off into the wild blue yonder, full of the joys of the road and hope in your hearts. Those of you with toddlers will know they are just learning about the world and beginning to take some control over how they relate to it. One of the first symptoms of toddler control comes in emerging taste preferences. This is not to say any child should have a say over what gets put on the plate, but practical reality may call for some negotiation over how much is eaten. Most children go through phases of being picky. Many never seem to emerge from this phase. If you’re lucky, the child will only eat something available at every diner or restaurant. This may be macaroni cheese which has the benefit of being relatively cheap and nutritious, or it may be junk food which will encourage faster growth around the waist. Either way, you need food storage in the vehicle you rented so that, if there’s a mutiny and all outside food is refused, you can fall back on snacks when the real hunger kicks in.

Hopefully, the car rental companies offered guidance on the diners and restaurants offering child-friendly portions at reasonable price. If not, spend time on the internet searching out the likely places to eat. Never assume all diners will cater for your toddlers.

Comparing Online Travel Services To Your Local Travel Agent

Sites such as Expedia, Orbitz, and Travelocity claim to offer the best price – sometimes even guaranteed. They may even claim to offer the best rates on a luxury world cruise, a trip that travel wholesalers publicly prefer to be sold by agents. The emergence of online travel sites have put many agencies out of business, and claim to have conquered the consumer base by offering quality product at a lower cost. When you call your local travel agency and ask for a price quote on an air and hotel luxury travel vacation package, most consumers will check against one of the more popular travel websites to see what prices better. True, two thirds of the time, you will find that the Internet will beat the travel agent price by about $150. The travel website will assure you that it is the same package. The resorts and hotels are aware that you are going to be in the most unfavorable rooms, in fact, that is why they sold them to the Internet travel site at a discounted rate in the first place.

Travel service sites proudly proclaim that they are able to further save customers money by selling large volumes of travel and collecting a smaller fee. Orbitz and Travelocity do have a large volume of travel reservations made, but what little they make in commission they make back in changed or canceled reservations. Most travel agencies offer a travel insurance that covers you and your travel companions if you should have to cancel for a medical or personal emergency.

American Express Travel offers a cancel for any reason insurance that even covers your airline tickets. These Internet booking engines are now beginning to offer “insurance,” but it rarely covers cancellations in full. Your local travel agent is there to offer the customer care you need back at home while you’re traveling abroad. When it comes to planning luxury travel vacation, you are truly better off using a travel agent. If you don’t like your room, your travel agent can have it fixed in a matter of moments. Travel agents are not focused on quantity, but quality. So travel safe, not sorry, and call a travel agent to hear more benefits that each agency offers their clients

Comparing Online Travel Services To Your Local Travel Agent

Sites such as Expedia, Orbitz, and Travelocity claim to offer the best price – sometimes even guaranteed. They may even claim to offer the best rates on a luxury world cruise, a trip that travel wholesalers publicly prefer to be sold by agents. The emergence of online travel sites have put many agencies out of business, and claim to have conquered the consumer base by offering quality product at a lower cost. When you call your local travel agency and ask for a price quote on an air and hotel luxury travel vacation package, most consumers will check against one of the more popular travel websites to see what prices better. True, two thirds of the time, you will find that the Internet will beat the travel agent price by about $150. The travel website will assure you that it is the same package. The resorts and hotels are aware that you are going to be in the most unfavorable rooms, in fact, that is why they sold them to the Internet travel site at a discounted rate in the first place.

Travel service sites proudly proclaim that they are able to further save customers money by selling large volumes of travel and collecting a smaller fee. Orbitz and Travelocity do have a large volume of travel reservations made, but what little they make in commission they make back in changed or canceled reservations. Most travel agencies offer a travel insurance that covers you and your travel companions if you should have to cancel for a medical or personal emergency.

American Express Travel offers a cancel for any reason insurance that even covers your airline tickets. These Internet booking engines are now beginning to offer “insurance,” but it rarely covers cancellations in full. Your local travel agent is there to offer the customer care you need back at home while you’re traveling abroad. When it comes to planning luxury travel vacation, you are truly better off using a travel agent. If you don’t like your room, your travel agent can have it fixed in a matter of moments. Travel agents are not focused on quantity, but quality. So travel safe, not sorry, and call a travel agent to hear more benefits that each agency offers their clients

Longstay Travel Insurance: Extend Your Travel Stay

Whenever we decide to travel abroad, we always get the think of taking travel insurance. If you are an occasional traveler you’ll probably buy your insurance from the travel agent. But if you travel more than twice a year, it is much more cost effective to have one insurance lasting all year round, than buying one every time you travel. If you are travelling for a long time then its better to take longstay travel insurance.

Before buying any longstay travel insurance, it is better to go through the whole policy. Health concerns which are rather severe as well as problems brought about by alcohol and drug uses are oftentimes excluded from the full coverage a client is entitled to. War and terrorism clauses can be excluded in most policies to protect both the company and the traveler with the latter being influenced not to plan a trip to such hazardous nations. Travel insurance is an agreement or a contract which can offer a traveler with an adequate amount of assistance that can be beneficial when traveling so it would be smart to compare a list of policies beforehand.

There are different forms of insurance which is hard to classified but considering the durations, travel insurance is further divided in three types:

* Single trip,
* Multi-trip and
* Annual / Long stay

“Long stay” insurance is the most important and attractive part of the travel insurance because for the large number of travelers who planned their vacations for more numbers of days / many months. It not helps you only in travelling plans but also a safeguard for cancellation charges, luggage and personal belongings, financial investments, your health and well being and most important to give you sense of peace. Companies are offering much best coverage to the customers who are buying long stay like international travel insurance, top up insurance etc. The main benefit of this insurance is the customization of coverage. A customer of long stay travel insurance can optimize their coverage as per their need; he should take help with their insurance adviser. Go for most appropriate coverage often their charges may be more than the standard one. The customers must be clear about their need and the ignorance.

Affordable Child Health Insurance in San Antonio Texas

Finding affordable health insurance is no easy task unless you are employed by a business that offers a health benefits package. Unfortunately, not everyone works, or works for an employer who offers a group health insurance plan to his or her employees. If you or your spouse doesn’t have affordable health insurance in San Antonio, Texas, how is your child supposed to obtain affordable child health insurance? Imagine trying to find affordable child health insurance for your child if you’re having difficulty finding affordable health insurance for yourself.

If you live in San Antonio, Texas, or anywhere in Texas for that matter, and have a child or children who are without adequate health insurance, you may want to look into Medicaid for Texas Children.

Medicaid for Texas Children is both a state and federal assistance program that provides children with excellent comprehensive health insurance at affordable prices or at no cost at all. To be eligible for Medicaid for Texas Children, a child must be a resident of the United States and of Texas, under the age of 19. The family of the child applying for Medicaid for Texas Children must meet the Medicaid of Texas Children income requirements.

If a child belongs to a family that receives Temporary Assistance for Needy Families, also referred to as TANF, the child will instantly qualify for Medicaid for Texas Children. Otherwise, the child’s eligibility is determined by the Texas Health and Human Services Commission, also referred to as HHSC. If a child is found to be eligible for Medicaid for Texas Children, his or her family’s financial status may be evaluated every half year or so to make sure the child is still eligible.

For more information about the Medicaid for Texas Children program, visit the Texas Department of Insurance Web site, or give them a call. You can also visit the Web site of the Texas Health and Human Services System.

Planning Healthy Family Recipes

You might think that healthy family recipes are going to be hard to make and expensive. With the current economic climate meaning that many families are increasingly feeling the pinch you will learn how you can feed your family with healthy food, without breaking the bank.

The following are some of the things you should look out for when planning healthy recipes to feed your family.

Healthy Family Recipes – Make From Scratch

If you are planning your healthy family recipes on a budget, it can sometimes be difficult to afford the fresh ingredients needed to make everything from scratch. It can also be a time consuming process, which is why many people resort to ready-made meals and processed foods.

However, buying tinned and frozen products can often be a false economy. Inspecting the labels of processed foods will often reveal that they are full of low-quality ingredients, additives and preservatives, which mean that they are far from a healthy option. Shop around for the best deals on fruit and veg, and you will often find that you can produce your own, healthy family recipes which are a lot more nutritious, and you exactly what the ingredients are.

Healthy Family Recipes – Plan In Advance

Planning is the key to successfully producing healthy family recipes as it will allow you to make the most of your ingredients and stretch them that bit further. For example, if you make spaghetti bolognaise and have some left over sauce, why not freeze it and then use it to make a lasagne later in the week? It may seem like an old-fashioned concept but investing in some freezer-proof storage boxes can help you to save leftovers and dramatically cut your food bills.

Healthy Family Recipes – Visit Your Local Shops

It’s easy to get stuck in a routine of going to the supermarket, but you may be surprised at the quality and affordability of produce from your local greengrocers or butchers. With local stores you are not paying for packaging and can be less tempted by the array of processed goods you will find in your supermarket. Also, you can feel good about helping local producers rather than lining the pockets of the supermarket giants.

Healthy Family Recipes – Grow Your Own Produce!

Even if you’re not in the slightest bit green-fingered you might be surprised to learn how easy it is to grow your own vegetables. By growing your own, you can reduce your shopping bills, and ensure that your family is eating totally organic produce. It’s a win-win situation!

Whether you want to eat healthily for financial reasons, to lose weight or you want your children to have the best start in life and not eat lots of processed food, you’ll find that many healthy family recipes are easy to make and aren’t expensive. Why not start today?

The Automotive Industry Marketing Plan

The auto industry is one of the largest industries in the world. It includes dealers, service shops for repair and body work, parts suppliers, insurance companies and even towing companies just to name a few. All areas of the auto industry share a common interest and that is cars. The interest in the auto industry has done nothing but increase over the years and all areas of the industry are learning to implement new marketing techniques in order to gain their customers attention.

Promotional products have been proven to be very effective marketing tools for businesses within the auto industry. Repair tools, key chains, safety tools, road side kits and many other promotional products that boast the company’s name or logo can not only be useful to the consumer but can be very effective in gaining more business for the company.

Tow companies often use roadside kits as a promotional part of their marketing campaign and it works. Think about the times of accidents, emergencies or break downs and that feeling of desperation while wondering who you should call. When you reach for the bag in your trunk that supplies your road side safety and emergency supplies and the logo of a towing company is clearly printed with a number for assistance, who else would you call? Many companies offer elaborate kits while others offer simple ones, the effectiveness of the advertising in those situations are not easily compared so there is no real proof that creating a kit complete with jumper cables and hazard signals works any better than one with road flares and a few simple tools.

Insurance companies and parts suppliers can also benefit from this promotional method of advertising. Any event that requires assistance will cause the driver to look for items they already possess in their vehicle to rectify the situation at hand and with those items and the contact information that is the number that will 9 times out of 10 be used.

Branding is another great way to use promotional advertising within the auto industry. When people take great lengths to accessorize or customize their vehicles they often want to show off the brands that they used. By incorporating engraved key chains, branded licensed plates and other accessories that sport the company brand or logo will be a great way to grab the attention of admirers. When consumers see the vehicle looking great and your company brand is located on it you will get the majority of the credit and they of course will come to you for all of their customization needs.

Parts suppliers and service garages often use tools as part of their promotional advertising campaign. This is due to the fact that when a vehicle breaks down or is in need of service or maintenance those tools that are on standby with the company logo on it will often be the reminder for the consumer to contact that company for their parts or service needs. You can use anything from flashlights, tire gauges to multi set tool kits to offer the advertising that you need to get that customer in your door.