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Cough (Reading and Sharing)

A cough is the natural reflex response of the body to clear the airways, to the stimuli that may irritate the respiratory system, which consists mainly the nasopharynx, larynx, trachea, and large bronchi. It is acute when it is less than 3 weeks, and chronic if beyond 8 weeks.  Cough can also be generated by issues in the upper and lower airways, psychological issues, cardiovascular system pathophysiologic disturbances, and the side effects of certain medications like the ACE inhibitors. Cough is the fifth most common symptom that prompts the patients to see their health care provider in the primary care setting (Rhoads & Jensen, 2015). Mainly, the pathogenic triad of cough, that is responsible for 92% to 100% of cough, is due to upper airway cough syndrome which is commonly known as post nasal drip syndrome; asthma, and gastroesophageal reflux disease (GERD). The other associated signs and symptoms of cough are: fatigue, rhinitis, epistaxis, tickle in the throat, pharyngitis, night sweats, dyspnea, fever, sputum production, hoarseness and post nasal drip.  As cough interferes with the activities of daily living and sleeping, there is a decrease in quality of life (QOL).  Therefore, patients seek treatment in the health care settings (Cash & Glass, 2017).

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Differential Diagnosis: Interstitial Cystitis, Urethritis, and Pelvic Inflammatory Disease

  • Interstitial cystitis (painful bladder syndrome), due to pain associated with bladder filling as well as urinary urgency and frequency. Urethritis due to typical symptoms of urinary tract infection (UTI) such as frequency and dysuria. Pelvic inflammatory disease (PID) due to abdominal or suprapubic pain.

On physical examination of a patient with a urinary tract infection, you may notice fevers, pelvic pain or tenderness on palpation, costovertebral angle tenderness (CVA) if pyelonephritis is considered, pain on urination, burning on urination, back pain or hematuria.  Patients may also present with shaking and chills, nausea, and vomiting (Ferri, 2018).

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Bursitis is an inflammation a small fluid-filled sac called bursa that lubricates to reduce friction between a bone and muscle, skin or tendon. The most common places bursitis occurs is the olecranon and prepatellar bursae, but can also occur at the superficial infrapatellar and subcutaneous calcaneal bursea (Khodee, 2017). There various type of bursitis all of which depend on the affected bursa location.  The commonly affected areas of the condition include the elbow, shoulder, hip, knees, and calf. The primary cause of this condition is sports injuries and repetitive movements although other factors such as bad posture, some types of arthritis, diabetes and certain medications effects may also cause bursitis (Sayegh & Strauch, 2014).

The exact prevalence and incidence of bursitis are not known. However, according to the report given by national health interview survey on disability, the incidence of bursitis is approximated to be 560 cases per every 100,000 admissions (Rhyou et al., 2016). The prevalence rate is estimated to be 32 cases in every 1000 people (Rhyou et al., 2016).  Bursitis is a very common condition that even affects healthy individuals. It can occur at any age and affects both genders although the attack rate depends on the type of bursitis. For example, the incidence of trochanteric bursitis is higher in middle-aged groups as compared to elderly adults while prepatellar and septic bursitis commonly affects males than females.

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Pectus Carinatum (seek nonoperative treatment )

Pectus Carinatum:

Recently, a friend asked me what the best supplement is for a 12-year-old boy with pectus carinatum. I searched my memory, and I could not think of anything/ knowledge related to this disease. Therefore, my advice to her was a very common and not so responsive answer, “I would encourage parents to consult with his or her doctor for the best advice”.

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COPD -Reading and Sharing

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease or COPD is a condition of the lungs that is progressive. Airflow is limited and it is not completely reversible. It is an obstruction of pulmonary airflow. The bronchial wall becomes inflamed and there is increased mucus secretion along with decreased lung elasticity (Grossman & Porth, 2014). It is a disease that approximately 5% of the adults in the U.S. have. It is also a leading cause of death. COPD has become a global problem and is climbing on the list as a leading cause of death worldwide.

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