Ingrown toenails are a common condition in which the corner or side of a toenail grows into the soft flesh. The result is pain, redness, swelling and, sometimes, an infection. Ingrown toenails usually affect your big toe.
Often you can take care of ingrown toenails on your own. If the pain is severe or spreading, your doctor can take steps to relieve your discomfort and help you avoid complications of ingrown toenails.
If you have diabetes or another condition that causes poor blood flow to your feet, you're at greater risk of complications of ingrown toenails.
Ingrown toenail symptoms include:
See your doctor if you:
Common ingrown toenail causes include:
Left untreated or undetected, an ingrown toenail can infect the underlying bone and lead to a serious bone infection.
Complications can be especially severe if you have diabetes, which can cause poor blood flow and damage nerves in your feet. So a minor foot injury — a cut, scrape, corn, callus or ingrown toenail — may not heal properly and become infected. A difficult-to-heal open sore (foot ulcer) may require surgery to prevent the decay and death of tissue (gangrene). Gangrene results from an interruption in blood flow to an area of your body.
Your family doctor or a foot doctor (podiatrist) can diagnose an ingrown toenail. Because appointments can be brief and you may have a lot of ground to cover, it can help to be well-prepared. Here are some tips to help you get ready.
What you can do
Prepare a list of questions to ask your doctor during your appointment. Put the most important questions first, in case time runs out. Some basic questions include:
What to expect from your doctor
Your doctor is likely to ask you questions such as:
If home remedies haven't helped your ingrown toenail, your doctor may recommend:
Your doctor may also recommend using topical or oral antibiotics, especially if the toe is infected or at risk of becoming infected.
You can treat most ingrown toenails at home. Here's how:
To help prevent an ingrown toenail:
Ingrown toenail. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00154. Accessed Nov. 12, 2013.
Foot care. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html. Accessed Nov. 12, 2013.
Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed Nov. 12, 2013.
Eekhof AH, et al. Interventions for ingrowing toenails. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001541.pub3/abstract. Accessed Nov. 12, 2013.
Canale ST, et al. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa.: Mosby Elsevier; 2013. http://www.clinicalkey.com. Accessed Nov. 13, 2013.
Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=740. Accessed Nov. 14, 2013.
Living with Diabetes: Foot complications. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/foot-complications. Accessed Nov. 14, 2013.
Goldstein BG, et al. Paronychia and ingrown toenails. http://www.uptodate.com/home. Accessed Nov. 14, 2013.
Apr. 03, 2014
Urinary Tract Infections are one of the most common infections, especially in women.
About 40% of women develop a urinary tract infection (UTI) at some point in their life. This condition is uncommon in boys and young men. Serious consequences can occur if a urinary tract infection affects the kidneys. Infections of the urinary tract are usually treated with antibiotics.
A Urinary tract infection (UTI) is an infection that affects any part of the urinary tract. The urinary system consists of the kidneys, ureters, bladder, and urethra. A Bladder infection, or cystitis, is the most common type of UTI. If the infection affects the kidney, it is called pyelonephritis which is a much more serious infection.
Women are especially prone to urinary tract infection. This is due to the shortness of the female urethra. In addition, women are at particular risk of recurrent UTIs after menopause because of decreased levels of oestrogen, which reduces the number of lactobacilli. Lactobacilli are 'friendly' bacteria that inhabit the vagina of fertile women and prevent other bacteria from invading the urethra. Also, after menopause, the mucous lining of the urinary tract 'thins out' and its ability to resist bacteria invasion is reduced. In Singapore, about 4% of young adult females are affected. The incidence rises with age to 7% at 50 years.
During the first six months of life, UTIs are more common in boys. This is because more males are born with structural abnormalities of the urinary tract. In older children and adults, UTIs are more common in females.
Urine is normally sterile. An infection occurs when micro-organisms (usually bacteria from the gut) attach itself to the urethra and begin to multiply. The infection may remain in the lower urinary tract (urethra and bladder) or it may move higher up to the kidneys as well. There are also micro-organisms causing this condition that are transmitted sexually.
Causes & risk factors
Cystitis is caused by bacteria which enter the urethra and bladder and cause inflammation. Over 90% of cases of cystitis are caused by E. coli, a bacterium normally found in the intestine.
Other risk factors for cystitis include:
If cystitis is not successfully treated, the infection may go up causing kidney damage. Bacteria may also enter into the bloodstream and this can cause a serious blood infection called septicaemia.
Screening & diagnosis
If a person has symptoms of UTI, the doctor usually requests for a urine sample analysis. The urine is examined for the presence of nitrites and white blood cells. However, a urine culture to identify the bacteria is needed to confirm the diagnosis. This also allows the doctor to identify the micro-organism involved.
Urinary tract infections in certain groups like young children and adult men warrant further work up and may require special methods of investigation.
Antibiotics may be used to control the infection. The drug of choice and length of treatment depends on the patient's history and the urine test that identify the offending bacteria. It is imperative that the patient finishes the entire course of prescribed antibiotics. For infection that spread to the kidneys , stronger antibiotics given intravenously may be indicated.
Surgery is generally not indicated in the presence of a urinary tract infection. Preventive measures may reduce symptoms and prevent recurrence of infection.
Follow-up measures may include urine cultures to ensure that bacteria are no longer present in the bladder. Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra.
Text adapted from Singapore Health Promotion Board
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