Colic

Colic occurs when a baby cry very loudly in uncontrolled manner without unknown cause. It affects boy and girl equally. This usually occurs late in the afternoon and evening, where the baby’s face may become red associated with passing winds and constipation. Research shows that baby with colic still will gain weight despite crying loudly. Therefore, if your baby doesn’t, then referral should be sought.

Colic is confirmed when a baby cries for at least 3 hours a day, at least 3 days per week for at least 3 weeks. During this period, the babies may lift their heads and clench their fists.

Treatments

There are not many options available for the treatment of colic. Normally colic will improve by itself without any intervention but if you find it’s very disturbing, then you can see your GP for any advices.

Dimethicone is an emollient used to treat colic by moisturizing the skin.

Traditional therapy such as Dicycloverine has been used to comfort stomach but there is evidence suggests that it will cause difficulty in breathing.

Cystitis

Cystitis is characterized by strong smelling and cloudy urine that indicate signs of bacterial infection. This is caused by inflammation of lining of bladder that is due to infection, irritation or damage. Cystitis is more common in women than men as women have a shorter urethra and is more susceptible to infection. Most of the cases will healed or resolved within 3 days even without treatment. There is no need for panic if women are having cystitis as this is very normal.

According to estimation, most women will have at least once infection of cystitis in their lives. However, if you have more than 3 attacks in one subsequent year, you should seek your general practitioner (GP).

Women who takes cytotoxic drugs e.g. Cyclophosphamide and methenamine hippurate (hexamine) are thought to have higher risk of developing cystitis due to the reason that they are likely to be more sexually active.

Referral
Children present with cystitis need to be referred to the doctor for investigation due to the possibility of urinary tract infection that may damage the kidney or bladder.
Any man who presents with cystitis should be referred immediately because this may indicate more serious conditions such as kidney or bladder stones.

Pregnant women who present with cystitis need to be referred to doctor as well because this can leads to kidney infection.

Haematuria (presence of blood in the urine) is also a sign for referral. This is due to the inflammation in the lining of the bladder that causes bleeding to occur. It can be taken care of with antibiotic treatment and will resolve quickly. However, if there is no pain felt during haematuria, it is important to see your doctor as there is a possibility of a tumor to develop in the bladder or kidney.
Women with recurrent cystitis should also see their doctor.

If anyone experiencing excessive thirst, sudden weight loss and higher tendency to pass urine, he or she should be referred immediately as well as this may be caused by other serious illness such as diabetic.

Why women more susceptible to cystitis compare to men?
The urethra of women are much shorter than men, therefore are more susceptible to infection. Bacteria can pass up along the urethra easily and multiply when they entered within the bladder. Besides, the prostatic fluid in males is believed to have antibacterial properties, giving them additional defence against bacterial infection.

Women who have painful intercourse despite using oestrogen cream should be referred. The oestrogen cream is used to give more lubricant in order to minimize irritation an cystitis attack.

What are the symptoms of cystitis?
• Itching or pricking sensation in the urethra
• Frequent desire to pass urine
• Passing urine with only small amount or few painful drops
• Dysuria
• Vaginal discharge would indicate local fungal or bacterial infection (need to be refer too)

Practical points
Avoid sexual intercourse (honeymoon cystitis) as this may precipitate an attack due to resulting infection as bacteria may be pushed further inside urethra. If you have sexual intercourse, it is best to go to pass urine immediately after that to flushed out possible bacteria present in the urethra.

Lack of hygiene is one of the factors affecting the severity of cystitis. During toiletries, it is recommended to wipe from front to back to minimize or avoid any bacteria from entering into vagina and urethra.

Take large fluids intake per day as this will increase the tendency to pass urine more frequently and as a result help the flushed out any bacterial reside within the bladder.

It is advised to wait for approximately 20s after passing urine to completely empty the bladder.
Avoid any alcoholic and coffee drinks. These will cause irritation to the bladder in some people.

Treatments
Cystitis should resolve itself within 3 days. If the symptoms have not improve after 3 days, referral to doctor is required.

Paracetamol and ibuprofen can be of help in treatment of cystitis.

Potassium and sodium citrate work by alkalinizing the urine. The urine become acidic due to bacterial infection and is thought to be responsible for dysuria. However, potassium and sodium citrate do not have antibacterial effect, therefore if the symptoms have not improve after 3 days, referral to doctor is required. Patients with hypertension are not recommended to take potassium and sodium citrate. They should not be taken by anyone taking potassium sparing diuretics, aldosterone antagonists or ACE inhibitors. It is important to advise the patient that the potassium citrate mixture tastes unpleasant and should be diluted with cold water.

Cranberry juice at 300ml per day is believed to have an antibacteriostatic effect.

Cold sore

Cold Sore Symptoms

I don’t really have much experience and knowledge about cold sore as I never had it before because it is occur more in women than men. According to Alison Blenkinsopp, the Symptoms in the Pharmacy, cold sore is caused by herpes simplex virus (HSV). There are two types of HSV; HSV1 which affecting mouth area and HSV2 affecting genital area.

Aciclovir is used to treat cold sore and should be initiated early in the course of infection and the cold sore is believe to resolve within 1-2 weeks. Cold sore is a bit irritating and tingling.

However, don’t mistaken cold sore with cancerous lesion as they may look similar in appearance. I distinguish them by how long the symptom lasted. This is because cancerous lesion last longer than cold sore. Another way to differentiate them is by how painful is the symptom. If you feel very painful, then it probably is the cold sore as cancerous lesion is painless.

Since I don’t have much experience in this, I can’t mention sufficient information about cold sore. Anyway, cold sores normally occur on the lips or face. But please be alerted that if the lesions occur inside your mouth or affect your eyes, please go see doctor immediately.

When you have cold sore, I would advise you not to go out during windy time or when the sunlight is very strong. This is because the wind and the sunlight can cause your cold sore even worse. For women, menstruation is also one of the precipitating factors. Also, if you are very stress while having cold sore, this may make the symptom even worse.

Cold Sore Treatment

Aciclovir cream 5% is an antiviral that is used to decrease the pain felt and also to make healing faster. It should be used before lesions appear and best started as soon as possible when symptoms are felt like tingling or itching. Aciclovir is applied 5 times a day for up to 5 days. If you still experiencing cold sore after this period, you need to go to see doctor. However, do keep in mind that Aciclovir may cause stinging sensation and the affected skin may become dry and flaky.

Antiseptics are also used in treatment of cold sore. It is used to prevent secondary bacterial infection, and not to reduce the time of healing. E.g. Povidone-iodine 10% in an alcoholic solution has an antiviral action and the cold sore will be dried by the alcoholic base. Other than Povidone-iodine 10%, benzalkonium chloride or cetrimide can also be used in this treatment and care should be exercise not to contact with the eyes. Please be aware that if you are pregnant, you mustn’t use Povidone-iodine. This includes anyone with history of iodine sensitivity.

Cold Sore Management

The HSV1 is contagious and can easily transmit to others by direct contact. Therefore, it is important to wash your hands after applying the treatment to the cold sore. You are not advised to share cup, towels, toothbrushes or face flannels until the cold sore has healed completely. If you are having cold sore, try not to have oral sex with someone as there is a risk of genital herpes type-2 to develop and vice versa.

The use of sunscreen cream can be useful if you are having a high exposure to the sunlight especially during summer season or on holiday to countries with hot climate.

Stress in life should be solved by discussing with your doctor or someone who may be of help.

For more information about cold sore, visit the cold-sore-skin-treatment.com.