Tuesday, August 2, 2016

Open fracture and gustillo classification

Fracture: Fracture may be defined as a breach in the natural structure of a bone or a cartilage. Fracture is grossly classified into two major catagories, named open fracture and closed fracture. 
An Open Fracture 

Classification of Open Fracture 

Open fracture is one where the fracture fragments come in contact with the external environment. And close fracture is one where the fracture fragments do not come in contact with the external environment. A close fracture is better than an open fracture. An open fracture is dangerous because the chance off infection is more here. And this infection can result in ostiomyelitis or delayed unnion or malunion or non union.
All the open fractures are not equally dangerous. To know, how much dangerous an open fracture is, you have to know the gustillo open fracture classification properly. 
Gustillo open fracture classification is made on the basis of wound size, degree of communication, vascular injury, soft tissue injury and neuro vascular status. 
Type-I Open fracture: This is an open fracture where the wound size is less than 1cm. loss of blood is not so much. No crashing injury is present. 
Type-II Open fracture: This type of open fracture is worse than Type-I. Here the wound size is more than 1cm but less than 10cm. Soft tissue injury and bleeding is moderate.
Type-III Open fracture : Here the wound size is more than 10cm. Communication of the fracture fragment with the environment is more than the previous fracture. This Type-III fracture has some sub division.
Type-IIIa: Here adequate soft tissue is present to cover the fracture fragments. 
Type-IIIb: Here adequate soft tissue is not present to cover the fracture fragments. 
Type-IIIc: Here the vascular supply is compromised.  
Nevertheless the above discussion, one must keep in mind that any open fracture with vascular injury will treated as a Type-III open fracture. 

Saturday, July 30, 2016

Painful Blister on lips or herpes labialis.

Infection with type one herpes simplex virus can cause painful blister over you lips. This disease is called herpes labialis. Herpes simplex virus is a very common one. They are of two types. One is type-I another is type-II. Genital herpes usually caused by type-II. Type-I virus usually attack over the west region. But exception may occur.
Painful blister over lips is usually for type-I herpes simplex virus. But keep in mind that this is the commonest but not the only reason.
Patient with herpes labialis develop vescicular rashes over lips and surrounding areas. The rashes first appears in the muco cutanious junction of the lips. Patient usually have low grade fever. Sometimes oral ulceration can be seen ass well. If you dought about SLE, you must take proper history along with serum ANA and serum anti DSDNA test.
Confirmatory Diagnosis :
To confirm herpes labialis proper history and clinical examination is enough. For confirmation PCR and immunoflurocence microscopic study can be done.
Treatment of herpes labialis :
Treatment of herpes labialis is usually easy and the prognosis is very good unless the case is too much complicated. Oral acyclovir can be used for this disease. Proper nutrition must be endured for rapid recovery.
Blisters in HSV-I

Vaginal candidiasis. Cause, treatment and its prevention

Vaginal candidiasis is nothing but a simple fungal infection of vagina. Though I am calling this disease a simple one, sometime  this can be a very annoying one. Vaginal candidiasis is caused by the overgrowth of the candida albicans in the vagina. candida albicans is a normal flora (Normal inhabitants) of human vagina.
Vaginal Candidiasis 

Sigh symptoms of Vaginal candidiasis :

The most common symptoms of vaginal candidiasis are itching of the vulva.