
cheettal

shareerathinte tissukkullil kettippadukkunna pazhuppinte oru shekharamaanu kurukkal. chuvapp, vedana, choodu, veekkam ennivayaanu kurukkukalude adayaalangalum lakshanangalum. amarthumbol veekkam draavakam niranjathaayi anubhavappedaam. chuvapp niram palappozhum veekkathinappurathekku vyaapikkunnu. kaarbankkilukalum kurukkalum palappozhum romakoopangal ulppedunna, kaarbankilukal valuthayirikkunna, kurukkukalude tharangalaanu.
avaa saadhaaranayaayi oru bacteria anubadha moolamaanu undaakunnath. palappozhum palatharam bakteeriyakal orotta anubaadhayil ulppedunnu. lokathinte pala pradeshangalilum kaanapedunna ettavum saadhaaranamaaya bacteria "methisilin-resistant staphylococcus ooriyas" aanu. apoorvvamaayi, paraannabhojikalkku kurukkal undakkaan kazhiyum; ithu vikaswara rajyangalil kooduthalaanu. charmmatthile kurukkal saadhaaranayaayi athu engane kaanapedunnu ennathine adisthaanamaakkiyaanu roganirnayam nadathunnathu, athu murichu thurakkunnathiloode sthireekarikkunnu. roganirnayam vyakthamallaatha kesukalil ultraasoundu imaging upayogapradamaayekkaam. gudadwaarathinu chuttumulla kurukkalil, aazhathilulla anubaadhaykkaayi computer tomography (sidi) pradhaanamaayirikkaam.
mikka charmmatthino mriduvaaya tissue kurukkalkko ulla saadhaarana chikitsa athu murichu thurannuviduka ennathaanu. antibioticukal upayogikkunnathil ninnu chila gunangalundennu thonnunnu. oru cheria alavilulla thelivukal drainageinu sesham kuzhiyil avasheshikkunna kuzhikal pothiyaathirikkunnathine pinthunaykkunnu. eee arra thurannitt pookunnathinupakaram athu vattikkazhinjayudane adaykkunnathu kurukkal thirichuvaraanulla saadhyatha vardhippikkaathe rogashanti vegathilaakkum. soochi upayogichu pazhuppu valichedukkunnathu palappozhum mathiyaakilla.
charmmatthile kurukkal saadhaaranamaanu, sameepa varshangalil ithu kooduthal saadhaaranamaayitheernniriknu. apakadasaadhyatha gadakangalil intravinus mayakkumarunnu upayogam ulppedunnu, upayokthaakkalil 65 sathamaanam vare uyarnna nirakkukalil ithu report cheyyappedunnu. 2005ll amerikkayil 3.2 dasalaksham aalukal oru kurukkine thudarnnu emarjansi departmentilekku pooyi. 2008ll austreliyayil 13,000 perr eee avasthayumaayi ashupathriyil praveshippikkappettu.
adayaalangalum lakshanangalum.
eathu tharatthilulla tissuevilum, ennaal palappozhum charmmatthinte uparithalathil (avaa pollalukal allengil aazhathilulla charmmatthile kurukkal ennariyappedunna upariplavamaaya pustyoolukal aakam), shwaasakoshathilum thalachorilum pallukalilum vrukkakalilum tonsilukalilum kurukkal sambhavikkam. pradhana sankeernathakalil aduthullatho vidooramo aaya tissukalilekku kurukkal vyaapikkunnathum vipulamaaya praadeshika tissue maranavum (gangreen) ulppedaam.
chuvapp, choodu, veekkam, vedana, pravartthanam nashtappedal ennivayaanu charmmatthile kurukkukalude pradhana lakshanangalum adayaalangalum. uyarnna thapanilayum (panii) thanuppum undakam. upariplavamaanengil, spandikkumbol kurukkal ettakkurachilukalkku kaaranamakaam; eee tharamgam polulla chalanam kurukkinullile pazhuppinte chalanamaanu.
oru aantharika kurukkine thirichariyaan kooduthal budhimuttaanu, ennaal rogalakshanangalil badhita pradeshathe vedana, uyarnna thaapanila, pothuve asukham enniva ulppedunnu.
aantharika kurukkal apoorvvamaayi maathrame sukhappedukayulloo, athinaal atharam oru kuruk samshayikkappettal udanadi vaidyasahaayam nalkunnu. oru kuruk athu evideyaanu sthithicheyyunnathu ennathine aashrayich maarakamaayekkaam.
kaaranagal.
kurukkal roopappedaanulla apakada gadakangalil intravinus mayakkumarunnu upayogam ulppedunnu. disk herniation allengil mattu nattellu asaadhaaranathakalude munkaala charitramaanu mattoru apakadasaadhyatha ghadakam, ithu theliyikkappettillettil.
bacteria anubadha, paraannabhojikal allengil videsha padaarthangal moolamaanu kurukkal undaakunnath.
bacteria anubaadhayaan ettavum saadhaarana kaaranam, prathyekichu staphylococcus ooriyas. kooduthal aakramanathmakamaaya "methisilin-resistant staphylococcus ooriyas" (emm. aarr. ezz. eiii) anubaadhayude uravidamaayirikkaam, ennirunnaalum ithu valare apoorvamaanu. nattellu subdural kurukkalil, methisilin sensitiivu "staphylococcus ooriyas" aanu ettavum saadhaaranamaaya jeevikal.
apoorvvamaayi paraannabhojikalkku kurukkalkk kaaranamakum, ithu vikaswara rajyangalil kooduthalaanu. ithu cheiyunnathinu ariyappedunna prathyeka paraannabhojikalil draconculiasis, mayasis enniva ulppedunnu.
periyanal cheerppu.
oru cheettine neekkam cheiyunnathinaayi guda fisttulayude sasthrakriya fisttulaye chikilsikkukayum athinte aavarthana saadhyathayum aavarthichulla shasthrakriyayude aavasyakathayum kuraykkukayum cheiyunnu. malavisarjjanathinulla eee shasthrakriyayude anantharafalamaanu malavisarjanam ennathinu thelivukalonnumilla.
udaaharanathinu, koshajwalana malavisarjanam (krons rogam polullava) allengil prameham ullavaril periyanal kurukkal kaanaan kazhiyum. palappozhum alsar, kadinamaaya malam allengil aparyapthamaaya lubrication ulla nuzhanjukayatta vasthukkal enniva moolamundaakunna aantharika murivaayi kurukkal aarambikkum. malaashayathil malam saadhaarana undaakunnathinte falamaayi eee murivu saadhaaranayaayi rogabadhithamaakukayum pinneedu oru kurukkayi vikasikkukayum cheiyunnu. ithu palappozhum gudathinu sameepamulla tissue pindamayi svayam avatharippikkunnu, ithu kaalakramena valuthum kooduthal vedanaajanakavumaayi valarunnu. mattu kurukkaleppole, periyanal kurukkalkkum murivu, debridement allengil lansing polulla pettennulla vaidyachikitsa aavashyamaayi vannekkaam.
insitional phoosphoorus.
oru "insitional focus" ennathu oru shasthrakriyayude pinbhaagathulla oru sankeernathayaayi vikasikkunnu. athu murivukalude arikukalil chuvappum choodum avatharippikkunnu, athil ninnu shudhamaaya drainage undu. roganirnayam anishchithathvathilaanenkil, roganirnayam sthireekarikkukayum gram steyin, bacteria kalchar enniva prayojanappeduthukayum cheiyunna pazhuppu aaspireshanodoppam oru soochi upayogichu murivu aspirated cheyyanam.
pathophysiology.
shareerathinte mattu bhaagangalilekku pakarchavyaadhikal padaraathirikkaan tissue nadathunna prathirodha prathikaranamaanu kurukkal.
cytokainukal purathuvidumbol, jeevikal allengil videsha vasthukkal praadeshika koshangale nasippikkunnu. cytokainukal oru koshajwalana prathikaranatthinu kaaranamaakunnu, ithu aaa pradeshathekku dhaaraalam velutha rakthaanukkale aakarshikkukayum praadeshika rakthayottam vardhippikkukayum cheiyunnu.
pazhuppu ayal gadanakale baadikkunnathil ninnu thadayunnathinulla shramathil aduthulla aarogyamulla koshangal roopeekarikkunna oru kurukkuthand mathil allengil capsule aanu kurukkinte anthima ghadana. ennirunnaalum, atharam encapsulation rogaprathirodha koshangale pazhuppile bakteeriyakale akramikkunnathil ninno kaaranamaaya jeeviyilo videsha vasthuvilo athunnathil ninno thadayunnu.
roganirnayam.
oru tissuevillo avayavathilo allengil oru parimithamaaya sthalatho kuzhichidunna, piogenic membron varachirikkunna pazhuppinte (puralant inflammatory tissue) praadeshika shekharamaanu kurukkal. ultraasoundu imaging roganirnayathinu sahayikkum.
vargeekaranam.
kurukkale "charmmatthile kurukkal" allengil "aantharika kurukkal" ennu tharamthirikkaam. charmmatthile kurukkal saadhaaranamaanu; aantharika kurukkal nirnnayikkaan budhimuttullathum kooduthal gurutharavumaan. charmmatthile kurukkale charmmatthile kurukkal allengil subcutaneous kurukkal ennum vilikkunnu.
IV mayakkumarunnu upayogam.
intravinus mayakkumarunnu upayogathinte charitramullavarkku, soochi shakalangalonnum illennu parisodhikkaan chikilsaykku munbu oru ex-reey shupaarsha cheiyunnu. eee janasamkhyayil oru panii undengil, pakarchavyaadhiyaaya endocarditis pariganikkanam.
vyathyasam.
puthuthayi roopappetta shareeraghadana arayil ninnu vyathyasthamayi, munpu nilanilkkunna pazhuppinte shekharanamaaya empimakalil ninnu kurukkal verthirikkanam.
samanamaaya lakshanangalkk kaaranamakunna mattu avasthakalil iva ulppedunnu cellulitis, oru sebatius sistt, necrotising faasiyaittis. cellulitisinu saadhaaranayaayi oru erithamaattas prathikaranamundu, pakshe ithu cheenja azhukkuchaalukalonnum nalkunnilla.
chikitsa.
sankeernamallaatha charmmatthino mriduvaaya tissue cheenjukalkko ulla saadhaarana chikitsa thurakkunnathum vattikkunnathum aanu. mikka kesukalilum antibioticukal upayogikkunnathil ninnu oru prayojanavum undakunnathaayi thonnunnilla. oru cheria alavilulla thelivukalkku cheepp pooshunnathiloode oru prayojanavum kandethiyilla.
murivum drainage.
videsha vasthukkal oru kaaranamaano ennu thirichariyaan cheepp parisodhikkanam, avaa neekkam cheyyendathundu. videsha vasthukkal kaaranamallengil, kurukkine murikkukayum vattikkukayum cheiyunnathu saadhaarana chikilsayaanu.
sasthrakriya uyarnna apakadasaadhyathayundaakkunna nirnaayaka pradeshangalil, ithu vaikukayo avasana maarggamaayi upayogikkukayo cheyyaam. shwaasakoshathile kurukkukalude azhukkuchaalukal, badhita vyakthiye shwasananaalathiloode ulladakkam puranthallaan prapthamaakkunna vidhathil sthaapichukondu nadatthaam. choodulla compressukalum avayavathinte uyaravum charmmatthile kurukkalkk gunam cheyyum.
antibioticukal.
sankeernamallaatha charmmatthile kurukkukalulla mikka aalukalum antibioticukal upayogikkaruthu. gurutharamaaya kurukkal, anubaadhayude pala sthalangal, druthagathiyilulla roga purogathi, cellulitisinte saannidhyam, shareerathiludaneelam bacteria rogathe soochippikkunna lakshanagal allengil rogaprathirodha sheshi vardhippikkunna aarogyasthithi ennivayulla vyakthikalil saadhaarana murivinum drainagein purame antibioticukal shupaarsha cheiyunnu. valare cheruppamo valare praayamaayavaro aaya aalukalkkum antibioticukal aavashyamaayi vannekkaam. murivum azhukkum kondu maathram kurukkal sukhappedunnillenkil, allengil mukham, kaikal, jananendriyangal enniva polulla azhukaan prayaasamulla sthalathaanu kurukkal undengil, antibioticukal soochippikkaam.
antibiotic chikitsa aavasyamulla cheeppukalude kesukalil, "staphylococcus ooriyas" bacteria oru saadhaarana kaaranamaan, koodaathe fluecloxacillin allengil dicloxacillin polulla aanti-staphylococcus antibiotic upayogikkunnu. community nediya methisilin-resistant "staphylococcus ooriyas" (emm. aarr. ezz. eiii) pariharikkan oru kuruk vattunnath paryapthamallennum atharam sandarbhangalil parambaraagatha antibioticukal phalapradamallennum community oof amerikkayude pakarchavyaadhikal sosaitti upadeshikkunnu. community nediya emrsaikkethire phalapradamaaya badal antibioticukalil palappozhum clindamycin, doxycycline, minocycline, trimethoprim-sulfamethoxazole enniva ulppedunnu. saadhaarana chikilsaykku purame antibiotic chikitsa nalkunnathiloode emm. aarr. ezz. eiii. yill ninnulla saadhaarana kurukkalkk oru prayojanavum labhikkillenn american koleju oof emarjansi physicians upadeshikkunnu. eee avastha oru kurukkinekkaal cellulitis aanennu karuthappedunnundengil, dicloxacillin allengil sephalexin polulla parambaraagatha aanti-staphylococcus ejantumaarodu ippozhum sensitiivu aaya strep inam oru kaaranamaayi kanakkaakkanam. pensilin sahikkaan kazhiyunna aalukalude kaaryathilaayirikkum ithu. antibioticukalkku palappozhum kurukkilekku praveshikkaan kazhiyaathathum kuranja piechu thalatthil avayude falapraapthiyillaathathum kaaranam kurukkine shasthrakriyayiloode neekkam cheyyaathe maathram antibiotic therapy apoorvvamaayi maathrame phalapradamaakoo.
murivinum drainagein sesham saadhaarana thudar paricharanam nalkaan kazhiyumenkil murivu samskarikkenda aavasyamilla. murivu samskaaram nadathunnathu anaavasyamaanu, kaaranam ithu chikitsa nayikkaan upayogikkaavunna vivarangal apoorvvamaayi maathrame nalkunnulloo.
packing.
vadakke amerikkayil, drainageinu sesham, oru kurukkuthiri saadhaaranayaayi paaykk cheyyappedunnu, palappozhum prathyeka iodophome-treat cheytha thuni upayogichu. avasheshikkunna eathenkilum eksudettu agiranam cheiyunnathinum nirveeryamaakkunnathinum athupole thanne draining prolsaahippikkunnathum akaala adachupoottal thadayunnathinum ithu cheiyunnu. deerghaneram vattunnath rogashanti prolsaahippikkumennu karuthappedunnu. hridayathinte pumping pravarthanatthinu rogaprathirodha, punarujjeevana koshangale parikkukalude arikilekku ethikkaan kazhiyumenkilum, oru kuruk nirvachanam anusarichu rakthakkuzhalukalillaatha oru shoonyathayaanu. shareerathil ninnu gunakaramaya gadakangaleyum koshangaleyum thudarchayaayi sukhappeduthenda shoonyathayilekku aakarshikkunna oru wicking pravartthanam packing nalkumennu karuthappedunnu. sravam pinneedu thwakk baandejukal agiranam cheyyukayum eee baandejukal pathivayi maattunnathiloode wicking prolsaahippikkukayum cheiyunnu. ennirunnaalum, emarjansi medisin saahithyathil ninnulla thelivukal report cheiyunnathu, packing murivukal, prathyekichu cheria murivukal, vyakthikk vedanayundaakkukayum aavarthana nirakk kuraykkukayo vegathil rogashanti varuthukayo doctorude sandarshanangal kuraykkukayo cheiyunnilla ennaanu.
lupe drainage.
aduthide, niravadhi vadakke american aashupathrikal saadhaarana drainage, murivu packing ennivaykku pakaram kuranja aakramanathmaka lupe drainage thiranjedutthu. 143 pediatric phalangalekkurichulla oru padanatthil, lupe groupil 1.4% parajaya nirakk report cheyyappettu, athesamayam packing groupile (p <. 030) 10.5%, oru prathyeka patanam lupe groupil 5.5% parajaya nirakk report cheythu.
praadhamika adachil.
oru kuruk vattiyathinushesham udan adaykkunnathu aavarthana saadhyatha vardhippikkaathe rogashanti vegathilakkunnathaayi thonnunnu. anorectal kurukkalkk ithu baadhakamallaayirikkaam, kaaranam avaa vegathil sukhappedumenkilum, thurannuvechathinekkaal uyarnna aavarthana nirakk undakam.
pravachanam.
chikilsayillaathe polum, charmmatthile kurukkal apoorvvamaayi maranathinu kaaranamaakunnu, kaaranam avaa swaabhaavikamaayi charmmatthiloode pottitherikkum. mattu tharatthilulla kurukkal kooduthal apakadakaramaanu. chikilsichillenkil masthishkathile kurukkal maarakamaayekkaam. chikilsikkumbol, marananirakk <aii. dii. 1> aayi kurayunnu, ennaal kurukkal pottukayaanengil ithu kooduthalaanu.
epidemiology.
charmmatthile kurukkal saadhaaranamaanu, sameepa varshangalil ithu kooduthal saadhaaranamaayitheernniriknu. apakadasaadhyatha gadakangalil intravinus mayakkumarunnu upayogam ulppedunnu, upayokthaakkalil 65 sathamaanam vare uyarnna nirakkukalil ithu report cheyyappedunnu. 2005ll amerikkayil 3.2 dasalaksham aalukal oru kurukkine thudarnnu emarjansi departmentilekku pooyi. 2008ll austreliyayil 13,000 perr eee rogathe thudarnnu ashupathriyil praveshippikkappettu.
samoohavum samskaaravum.
laattin medical soothravaakyam "yubi pazhuppu, aibi ekluva" "pazhuppu ullidathu, avide athu ozhippikkuka" ennu prakadippikkunnu, ithu paashchaathya vaidyashaasthra samskaarathile classical upadesamaanu.
soochi kaimatta paripaadikal palappozhum dosham kuraykkunna pothujanaarogya thanthratthinte bhaagamaayi kuthivayppu marunnu upayogikkunnavarkk kurukkal chikilsikkunnathinulla referralukal nalkukayo nalkukayo cheiyunnu.
padavyuthpathishaasthram.
mrugangalude tissue bhagangal thammil chernnirikkunna marddita dravyathinu idam nalkunnathinaayi avayil ninnu parasparam oru "absusses" (pogukayo pogukayo cheyyuka) ullathinaal oru kurukkine "absus" ennu vilikkunnu.
carbankle enna vaakk laattin bhashayil ninnaan uthbhavichathenn vishwasikkappedunnu yadhaarthathil oru cheria kalkari aaya carbonculus; "kaarban-", "carbo": curry allengil ember ennathinte cheria roopamaanu, mathramalla oru carbankle kallum, "chuvapp allengil thee niramulla vilayeriya kallukal", saadhaaranayaayi gaarnettukal.
mattu tharangal.
thaazhepparayunna tharatthilulla kurukkal medical nighanduvil pattikappeduthiyittundu

