Ear Infection : Infection can affect the ear canal (otitis externa), the eardrum, or the middle ear (otitis media). Most ear injuries are caused by pressure changes during direct injury (such as a blow to the ear) or sport scuba diving, but, a persistently painful ear may signal an infection that requires treatment. Because an ear scope (otoscope) may not be available to examine the canal and inner ear in remote locations, starting therapy may be appropriate until a doctor can be reached.
SYMPTOMS
• Symptoms of ear infection include:
o ear pain,
o fullness in the ear,
o hearing loss,
o ringing in the ear,
o discharge from the ear,
o nausea,
o vomiting , and
o vertigo.
• Symptoms may follow a respiratory infection such as the common cold.
• Discharge from the ear canal is often caused by the infection known as swimmer's ear (otitis externa). A painful ear with decreased hearing is often the result of otitis media, an middle ear infection.
TREATMENT
• Rest: avoid further scuba dives, coughing, sneezing, bending, and attempts to equalize the ears.
• Pain may be relieved with 1 to 2 acetaminophen (Tylenol) every four hours and/or 1 to 2 ibuprofen (Advil, Motrin) every 6 to 8 hours.
• Pseudoephedrine (the active ingredient in over-the-counter medications such as Sudafed) 30 mg tablets, one every six hours for 2 to 3 days, may ease ear pressure. (People with a history of high blood pressure should avoid this product.)
• For infections of the ear canal (otitis externa): neomycin (Ak-Spore HC, Cortisporin, Neotricin HC, Ocutricin-HC), polymyxin B, and hydrocortisone (Cortisporin, Otocort, Poly Otic), two drops in the ear canal four times per day for five days, may also be used.
• If pain occurs, discontinue treatment and seek medical attention.
• Oral antibiotics are usually recommended for discharge from the ear, nose, or mouth. If infection develops, continue antibiotics for at least five days after all signs of infection have cleared. Tell your doctor of any drug allergy prior to starting any antibiotic. The doctor will recommend the right antibiotic.
Hepatic Encephalopathy : Hepatic encephalopathy is a worsening of brain function that occurs when the liver is no longer able to remove toxic substances in the blood.
CAUSES
Hepatic encephalopathy is caused by disorders that affect the liver. These include disorders that reduce liver function (such as cirrhosis or hepatitis) and conditions in which blood circulation does not enter the liver.
An important job of the liver is to change toxic substances that are either made by the body or taken into the body (such as medicines) and make them harmless. However, when the liver is damaged, these "poisons" may build up in the bloodstream.
Ammonia, which is produced by the body when proteins are digested, is one of the harmful substances that is normally made harmless by the liver. Many other substances may also build up in the body if the liver is not working well. They can cause damage to the nervous system.
Hepatic encephalopathy may occur suddenly in people who previously had no liver problems when damage occurs to the liver. More often, the condition is seen in people with chronic liver disease.
TREATMENT
Lactulose may be given to prevent intestinal bacteria from creating ammonia, and as a laxative to remove blood from the intestines. Neomycin may also be used to reduce ammonia production by intestinal bacteria. Rifaximin, a new antibiotic, is also effective in hepatic encephalopathy.