Health Topic

[Madame Tussaud]

Why is Hand Washing so important

Kids may not always listen when you tell them to wash their hands before eating , but it’s a message worth repeating . Hand washing is by far the best way to prevent germs from spreading and to keep your kids from getting sick

The First Line of Defense against Germs
Germs –such as bacteria & viruses – can be transmitted several different ways , especially by touching dirty hands or changing dirty diapers . Other ways germs spread include :



·Through contaminated water & food

·Through droplets released during a cough or a sneeze

·Through contaminated surfaces

·Through a sick person’s body fluids

If kids pick up germs from one of these sources , they can unknowingly become infected simply by touching their eyes , nose , or mouth . Moreover , once they’re infected , it’s usually just a matter of time before the whole family comes down with the same illness .

Good hand washing is your first line of defense against the spread of many illness – and not just the common cold . More serious illnesses such as meningitis , bronchiolitis , influenza , hepatitis A , and most types of infectious diarrhea can be stopped with the simple act of washing your hands .

How to Wash Your Hands Correctly

Here are some simple steps for scrubbing those germs away . Demonstrate this routine to your child – or better yet , wash your hands together with your child several times a day so he or she learns how important this good habit is

• Wash your hands in warm water . Make sure the water isn’t too hot for little hands .
• Use soap and lather up for about 10 to 15 seconds ( anti-bacterial soap isn’t necessary – any soap will do ) . Make sure you get in between the fingers and under the nails where uninvited germs like to hang out . And don’t forget the wrists !
• Rinse and dry well with a clean towel .

To minimize the germs passed around your family , make frequent hand washing a rule for everyone , especially :

 

• • Before eating and cooking
  • After using the bathroom
  • After cleaning around the house
  • After touching animals , including family pets
  • After visiting or taking care of sick friends or relatives
  • After blowing one’s nose , coughing or sneezing
  • After being outside ( playing , gardening , walking , etc .

Don’t underestimate the power of hand washing ! The few second you spend at the sink with your child could save you trips to the doctor’s office .

[A r c h i]

Fast Workouts That Really Work


I love my long training runs, but most days carving out more than an hour to work out just isn't in the cards. And when my schedule is really crammed, shoehorning a sweat session seems next to impossible.
Luckily, the fantastic fitness team at SELF let me in on a little secret: You can get an hour's worth of fitness and calorie burning in 20 short minutes. Yes, I was skeptical at first, but this fat-blasting routine is as ultraeffective as it is speedy, and the secret lies in high-intensity spurts of energy. Here's how to do it:


Pick any cardio you like (running, swimming, the elliptical trainer). Warm up for 2 minutes at a moderate pace, then sprint for 30 seconds at the highest intensity you can muster. Slow down and do 90 seconds at a catch-your-breath recovery pace. Repeat eight times. You'll torch more calories in less time, while you burn fat faster. Follow this cardio session with a few of the following fast firmers for a total-body workout in less than 30 minutes.

Tighten your tummy: Do two sets of 10 to 12 crunches on a stability ball. Research from the University of Auckland, Tamaki Campus, in New Zealand, revealed that using the ball makes crunches 20 percent more effective compared to hitting the floor.
Firm up legs: Stand on left foot, hands on hips, and bring right knee to hip level in front. Trace a horizontal figure eight in front of you with knee. Then bend left knee and hop to right, landing on right foot. Repeat figure eight with left knee, then hop back to left to complete one rep. Do 10 reps, then hop back and forth 10 times to complete one set.


Boost your bottom: Stand with feet hip-width apart, hands on waist. Shift weight to left foot and lift heel of right foot so you're resting on toes. Bend left knee and sink hips back, keeping weight off right foot (toes stay on ground). Rise up. Do 12 reps on left leg, then switch legs and repeat.



Bare amazing arms: Holding a dumbbell in each hand, stand with feet hip-width apart. Raise arms, palms down, out and slightly forward to shoulder height. Slowly lower them behind you so weights almost touch. Do 12 reps.


Slim all over: Stand with feet hip-width apart. Keeping legs as straight as possible, bend forward and walk hands out until they're under shoulders. Do two push-ups, then walk hands back and stand. Repeat twice, doing four push-ups, then six.

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I don't have to tell you that stress is omnipresent these days. Rising prices, stock market drops, jobs lost. It's virtually impossible to find someone who's not impacted by the current economic trouble, and the effects go way beyond your 401(k). Stress, as research has shown (and my own life has proven) is not good for anyone's health. I'm a big believer in mind over "What's the matter?" and I know it's possible to go from grumpy to grinning just by flexing some mental muscle. Next time you have a "bad" day, try to outwit the stress hormones coursing through your veins with these simple tips:

Got a case of the grouchies? Try to conjure some positive vibes, as hard as it may seem. Answer the phone cheerfully. Say "Good morning" even if it feels like a grim day. Or greet the receptionist kindly when you get to work. Soon you'll be sunny side up. Why? If you fake happy, you'll make yourself happy.



Feeling impatient? Rather than fuming over the fact that you've been parked on the runway for 45 minutes (or in line at the store or waiting at the doctor's office), focus on five positive things around you -- the friend or relative you're about to see, the sun and gorgeous clouds on the horizon, the great book you're looking forward to reading, etc. Distract yourself and you'll be better able to savor the present rather than rushing through it.



Are you a worrier? We all catastrophize sometimes. It's human nature. But too much negative thinking can be unhealthy and create stress where none exists. Consider what's behind your fretting. Your fear (that your headache is a brain tumor) could be masking a solvable problem (you should take better care of your health). Realizing that anxieties are manageable makes it easier to release them.



Having a blue period? Research shows that two of the best ways to soup up your spirits are exercise and music. Take a few minutes to pump up the jams and dance around in your office, in the shower, whenever the mood strikes. You'll instantly segue into high-energy mode.

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Beauty Tricks to Get Out the Door Faster


Does your morning beauty routine make you late, shorten your snooze session or abbreviate your workout? (Or, like me, does it suffer because you don't want to be late, sleep less or cut into your exercise time?) You've got company. A Self.com poll found that 23 percent of readers wished they could condense their A.M. prep-athon, and I agree. I'd rather spend time jogging with my dog, Jenny, having breakfast with my family or, a total indulgence, reading the newspaper cover to cover. Streamline your get-ready grind with these look-great-fast tricks.

Strengthen hair as you get strong: Before working out, wet hair and comb conditioner through strands, then put it in a ponytail or cover with a bandana. Body heat from exercise will help hair absorb product. Rinse it out post-workout.


Conceal imperfections flawlessly: To decake your concealer (and get a more flawless finish), mix a drop of moisturizer with concealer before applying. Then pat (don't rub) the combination into skin or dab it on with a brush.


For a natural, outdoorsy glow (even when you're stuck inside), combine a drop of cheek stain with a dime-sized amount of facial serum. Apply evenly on face and you'll look radiantly healthy.


Get thick, clump-free lashes: Apply one coat mascara to the underside of upper lashes, then brush a coat on the top side. The extra brush rids any goops and glops so you're good to go!


Go light on lips: Rather than saturating your whole mouth with lipstick, swipe color over your top lip only, then press lips together to blend evenly. By cutting the dose in half, you'll prevent color from migrating beyond the lip border. It also makes a brighter, night-out hue more daytime appropriate.


Shift your ponytail: Love to wear your hair up? Relocate the position of the elastic often, even if only by a half inch. This will prevent breakage, which leads to flatness and flyaways in the area where your holder always sits.

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Give in to Cravings Without Guilt


Even if you eat healthy all the time, you're bound to experience the occasional hankering for something that's not exactly waistline-friendly. The fact is, you can and should indulge every so often. I know when I ignore my need for chocolate, I end up settling on a second-rate substitute--and then the chocolate wins me over later anyway, sometimes in quantities I'm not exactly proud of.
The good news is you can treat yourself to smarter, more sensible options that taste equally delicious. Next time you have a yen for something yummy, try these healthy swaps to keep you satisfied morning, noon or night.

YOU CRAVE: A chocolate cream-filled doughnut (307 calories, 20.8 grams fat)
TRY INSTEAD: A plain glazed doughnut (239 calories, 11.5 g fat) or a raised sugar doughnut (205 calories, 11 g fat)
You'll save 60 to 100 calories and nearly 10 g fat but still get a sweet treat to go with your morning joe. (Also, try cutting it in half or quarters and slowly eat it in bits to see if you even want the whole thing!)

YOU CRAVE: Bacon and eggs (461 calories, 35.4 g fat)
TRY INSTEAD: Two slices of bacon with two small whole-grain pancakes and 2 tablespoons syrup (364 calories, 12.4 g fat)
This sensible substitute allows you to eat breakfast like a champ without chomping a third of your fat for the day. Or be even more virtuous and opt for an egg-white omelet instead of the pancakes.

YOU CRAVE: Potato chips (155 calories, 10.6 g fat per ounce, about 15 chips)
TRY INSTEAD: Lighter baked chips (84 calories, 3.2 g fat)
The same crunch as you munch with about half the calories and a third of the fat.

YOU CRAVE: French fries (537 calories, 28 g fat per 6-oz order)
TRY INSTEAD: Baked frozen fries (260 calories, 7 g fat per 6 oz)
Skip the drive-thru and hightail it to your freezer--you'll save calories, fat and cash. Try sweet potato varieties for a dose of skin-smoothing and vision-helping vitamin A. If you're out and ordering a burger, ask for salad instead of fries on the side, and try to retrain your brain to not need a side of fries with that burger meal.

YOU CRAVE: Chocolate milk shake (544 calories, 12.3 g fat per 16 oz)
TRY INSTEAD: Chocolate smoothie (372 calories, 5.4 g fat)
Whip up this calcium rich alternative at home: Blend 2 cups lowfat milk, 1 frozen banana, 1 tbsp chocolate syrup and 1/4 teaspoon vanilla extract in a blender. Delicious! You can also try simply having a cup of skim milk with 1 tbsp of chocolate syrup for 141 calories and just over 1/2 gram of fat!

[دل تنگم]

Overview

Coughing is the body's way of removing foreign material or mucus from the lungs and upper airway passages or of reacting to an irritated airway. Coughs have distinctive traits you can learn to recognize. A cough is only a symptom, not a disease, and often the importance of your cough can be determined only when other symptoms are evaluated

Definedas sound that occurs on sudden release of air under high pressure,which is generated by forceful contraction of expiratory musclesagainst a closed glottis. Clinical dilemma is to determine whethercoughing is associated with mild illness or more serious problem

Principal Causes of Cough

1. Infection/inflammation
   1. Upperrespiratory tract infection - URI (commoncold) is acute viral infection. Common pathogens include rhinoviruses,parainfluenza viruses, respiratory syncytial virus (RSV), and coronaviruses.Other viruses that occasionally cause common cold are adenoviruses,enteroviruses, influenza viruses, and reoviruses. Usual clinical findings are watery,mucoid, or purulent discharge; dry, hacking cough; and inflamednasal mucosa. *Diagnosis is clinical.
   2. Sinusitis - Usually presents with history of purulent nasal discharge and persistent cough of >10 days' duration. Less common presentationis combination of fever, headache, and facial pain or sinus tenderness. Usually clinical diagnosis. CT should be performed when orbitalabscess or intracranial complication is suspected.
   3. Laryngitis - Most frequentcause is viral URI. Hoarseness and dry, hacking cough,which may last up to 1 wk, are usual clinical findings. Usually clinical diagnosis.
   4. Croup - Characterizedby a barking cough and stridor ± fever
   5. Tracheitis - Often crouplikeillness with cough and stridor precedes sudden onset of respiratory distressand high fever.Clinical picture suggests bacterialtracheitis.
   6. Bronchitis - Inflammatoryprocess affecting trachea and bronchi. Most episodes are causedby viruses (e.g., RSV, parainfluenza viruses, influenza viruses,rhinoviruses, and adenoviruses). Hacking cough appears several daysafter onset of typical URI. Rhonchi may be heard, but crackles areinfrequent. Presence of wheezing usually indicates presence of reactiveairways disease. Usually clinical diagnosis
   7. Pertussis - B. pertussisinfection begins with nasal discharge, which is followed by paroxysmal coughthat often has staccato quality. *Whoop may follow paroxysm. Fever may or may not occur. There is usually leukocytosis withpredominance of lymphocytes. Apnea is serious complication, especiallyin young infants. Duration of illness may be as longas 6–10 wks. Chest radiograph may be normal or showperihilar infiltrates. Positive direct immunofluorescent assayof nasopharyngeal secretions suggests diagnosis, but false-positiveand false-negative results occur. Positive nasopharyngeal culture confirmsdiagnosis
   8. Bronchiolitis - Usuallycaused by RSV and occasionally by parainfluenza viruses, influenzaviruses, and adenoviruses. Occurs during winter months, oftenin epidemics. Rhinorrhea usually precedes cough,which may be persistent and harsh. Expiratory wheezing is prominentfinding.
   9. Pneumonia - Definedas inflammation of lung parenchyma that may be caused by infection. Frequently presents with fever, cough,and respiratory distress. Crackles and wheezes may be heard on exam.Decreased breath sounds and dullness to percussion indicate areaof lung consolidation. Presence of pneumonia usually can beconfirmed by chest radiography, although early in illness radiographcan appear normal. Specific cause requires further investigation
      1. Viral - Accountsfor most cases of pneumonia in infancy and childhood. Most common viruses causing pneumoniainclude RSV, parainfluenza viruses, adenoviruses, and influenzaviruses. Less common causes are rhinoviruses and coronaviruses. Cytomegalovirus and herpes simplexvirus may cause pneumonia in newborn or in immunocompromised individuals. May also be caused by measles, varicella,and Hantavirus infection. Chest radiograph frequently shows involvementof both lungs, with peribronchial thickening, perihilar linear densities,and patchy infiltrates. Segmental or lobar consolidation, hilaradenopathy, and pleural effusions are unusual. Nasal wash cultures or polymerase chainreaction (PCR) of nasal secretions may sometimes diagnose specificviral infection. RSV antigen may be detected by enzymeimmunoassay or immunofluorescent techniques
      2. Bacterial - Pathogenscausing bacterial pneumonia vary with age of child. Most common causes of bacterial pneumoniain neonates are group B Streptococcus and gram-negative entericbacteria (E. coli, K. pneumoniae, P. aeruginosa). In infancy, childhood, and adolescence,S. pneumoniae is most common, whereas S. aureus and group A Streptococcusare much less common. H. influenzae type b has become unusualcause of pneumonia, since advent of H. influenzae vaccine. M. tuberculosis can cause infectionat any age. Clinical findings with bacterial pneumoniausually include fever, cough that may be productive of sputum inolder child, and some degree of respiratory distress. Leukocytosis with predominance of polymorphonuclearleukocytes is common finding. Pleural effusions and pneumatocelesare more frequent with bacterial pneumonia than with viral pneumonia. Chest radiograph usually shows segmentalor lobar infiltrate. Diagnosis of bacterial pneumonia canbe confirmed by positive blood, pleural fluid, or lung biopsy cultures.McCarthy et al. (1999) demonstrated that PCR may be used to diagnosepneumonia caused by S. pneumoniae using sample of pleural fluid. Pharyngeal or sputum culture that haslarge numbers of single organism is suggestive but not diagnostic. Counterimmune electrophoresis and latexagglutination tests have successfully detected bacterial antigensof S. pneumoniae, group B Streptococcus, and H. influenzae typeb in urine, so these tests may be diagnostic
         1. 1. Tuberculosis - Usual modeof transmission of M. tuberculosis infection is by inhalation. Positive skin test with PPD may beobserved 2–12 wks after exposure. Children with disease usually haveprimary pulmonary TB with cough and fever. In most cases of TB infection, individualis asymptomatic, primary complex of infection is not seen on chestradiograph, and disease does not progress. In TB disease, individual has clinicalor radiographic findings and disease may be pulmonary or nonpulmonary. Chest radiograph shows involvementof segment or lobe, usually with enlarged regional lymph nodes.With progression, cavitary lesions or miliary disease can occur. Acid-fast bacilli smears and culturesshould be performed in anyone with suspected TB. In young child,especially if cough is nonproductive, best culture material is fromearly morning gastric aspirate. Otherwise, isolation of tuberclebacilli by culture of sputum, urine, pleural fluid, cerebrospinalfluid, other body fluids, or biopsy material confirms diagnosis. Negative PPD never excludes infectionor disease with TB. Anergy may be due to young age, viral infections,immunosuppression, and severe disseminated TB
            2. Chlamydia - Pneumoniadue to C. trachomatis usually occurs in infants 1–3 mosof age. Clinical findings include conjunctivitisor history of conjunctivitis, staccato cough, tachypnea, crackles,and mild peripheral eosinophilia. Fever is variable finding. Chest radiograph usually shows hyperinflationand bilateral interstitial infiltrates.Positive nasopharyngeal or eye cultureconfirms diagnosis
            3. Legionella - Legionnaire'sdisease is transmitted by inhalation of aerosolized water contaminated withLegionella species. Most common cause of Legionella infectionin U.S. is L. pneumophila serogroup 1. Frequent findings include fever, nonproductivecough, headache, and myalgia. Chest radiograph usually shows infiltrate.Pulmonary nodules ± cavitation also may occur. Diagnosis can be confirmed in a numberof ways: positiveculture of sputum or lung tissue detection of organisms on smears ofrespiratory tract secretions by direct immunofluorescent assay usingmonoclonal or polyclonal antibodies DNA probes serologic testing using indirect immunofluorescenceantibody assayIncrease in antibody titer to ≥1:128is also considered diagnostic
            4. Nocardia - Nocardiaspecies are funguslike bacteria that live in soil. Lung is probable portal of entry aswell as most frequent site of infection. Most common agent in U.S. is N. asteroides. Clinical findings include fever, cough,chest pain, night sweats, malaise, and weight loss. Chest radiography shows scattered infiltrates. Stained smears of sputum, spinal fluid,or pus may reveal gram-positive rods that are variably acid fast.Positive culture confirms diagnosis
      3. Mycoplasma - Endemicin eastern and midwestern U.S., especially in Mississippi and OhioRiver valleys. Infection occurs by inhalation of H.capsulatum spores, which are present in soil or dust in barnyardsor other areas that contain bird and bat droppings. >95% of infectionsare asymptomatic. Common presentation is acute influenza-like illness withpulmonary infiltrates and hilar adenopathy. Disseminated diseasewith fever, cough, pulmonary infiltrates, hepatosplenomegaly, andpancytopenia occurs most frequently in immunocompromised hosts. Culture of sputum, blood, or bone marrowconfirms diagnosis, as does demonstration of intracellular yeastsin smears of bone marrow or biopsy material from infected tissues.Detection of H. capsulatum antigenin urine or serum also can be used to diagnose disseminated disease.Single titer of ≥1:32 or 4-fold increase in yeast phase titersis presumptive evidence of active infection. H bands found in immunodiffusionantibody assay also suggest active infection
      4. Fungal
         1. Histoplasmosis - Endemicin eastern and midwestern U.S., especially in Mississippi and OhioRiver valleys. Infection occurs by inhalation of H.capsulatum spores, which are present in soil or dust in barnyardsor other areas that contain bird and bat droppings. >95% of infectionsare asymptomatic. Common presentation is acute influenza-like illness withpulmonary infiltrates and hilar adenopathy. Disseminated diseasewith fever, cough, pulmonary infiltrates, hepatosplenomegaly, andpancytopenia occurs most frequently in immunocompromised hosts. Culture of sputum, blood, or bone marrowconfirms diagnosis, as does demonstration of intracellular yeastsin smears of bone marrow or biopsy material from infected tissues.Detection of H. capsulatum antigenin urine or serum also can be used to diagnose disseminated disease.Single titer of ≥1:32 or 4-fold increase in yeast phase titersis presumptive evidence of active infection. H bands found in immunodiffusionantibody assay also suggest active infection
         2. Coccidioidomycosis - Endemicin southwestern U.S. Transmission occurs by inhalation of dust-borne sporesof C. immitis. Primary infection is often asymptomatic,whereas symptomatic infection usually presents with fever and cough. Chest radiograph may show hilar adenopathyand calcification of healing primary lesion. Granulomatous lesionscan occur in lungs, lymph nodes, bones, joints, skin, and meninges.Typical clinical and radiologic findingsand positive skin test or ≥1:32 complement fixation antibodytiter are diagnostic. Spherules seen in tracheal aspirates, sputum,urine, or spinal fluid; biopsies of skin lesions or organs; or positivecultures from any of these sources are also diagnostic
         3. Aspergillosis - Aspergillusspecies grow in soil and in decaying vegetation. Transmission isby inhalation of airborne spores. Different clinical presentations mayoccur: Allergicbronchopulmonary aspergillosis with low-grade fever, productivecough, episodic wheezing, transient pulmonary infiltrates, and eosinophilia Aspergillomas that do not invade lungtissue Invasive pulmonary disease with feverand productive cough Disseminated disease with involvementof skin (cutaneous papules and abscesses), heart (endocarditis),bone (osteomyelitis), sinuses (sinusitis), or brain (abscess). Chest radiograph may show patchy ornodular infiltrates or consolidation ± cavitation. Branching and septate hyphae in sputumsuggest diagnosis. Positive sputum or lung biopsy cultureconfirms diagnosis
         4. Blastomycosis - Infectionwith B. dermatitidis is endemic in southeastern U.S. and in midwestern statesbordering the Great Lakes. Pulmonary, cutaneous, and disseminatedforms of disease can occur, but pulmonary disease is most commonin children. Clinical findings of pulmonary diseaseinclude cough, fever, malaise, chest pain, weight loss, and hemoptysis. Chest radiograph may show infiltrates,cavities, or nodular densities. Primary cutaneous blastomycosis maypresent with ≥1 subcutaneous nodules that eventually ulcerate. Disseminated disease produces granulomatouslesions, which may involve liver, spleen, bone, skin, and brain. Thick-walled single budding yeast formsmay be seen with 10% KOH preparations from sputum, spinalfluid, urine, or skin lesions. Positive immunodiffusion test on serathat shows precipitin bands (A and B) is evidence for active infection;however, bronchoalveolar lavage or lung biopsy may be necessaryto establish diagnosis in children with pneumonia.Serologic assays are not reliable fordiagnosis
      5. Protozoa -P. cariniiinfection occurs almost exclusively in immunocompromised childrenand is common in those affected with HIV. Clinical findings include nonproductivecough and fever. Chest radiograph shows bilateral interstitialor air-space disease. Diagnosis is confirmed by demonstrationof organism in lower respiratory tract secretions or lung tissue. Induction of sputum in older childrenand adolescents, bronchoscopy with bronchoalveolar lavage, or lungbiopsy can be performed. Methenamine silver nitrate and toluidineblue O are most useful stains to identify thick-walled cysts
      6. Chemical pneumonia - Gasoline,kerosene, and charcoal lighter fluid are hydrocarbons with low surfacetension and viscosity. Because of these properties, aspiration intotracheobronchial tree can easily occur after ingestion.Acute onset of cough and respiratorydistress and history of ingestion are diagnostic. Within severalhours of ingestion, chest radiograph may show evidence of pneumonia,with infiltrates commonly in right middle and lower lobes
      7. Aspiration pneumonia - Interferencewith normal swallowing predisposes to aspiration of oral and gastricsecretions as well as food. Children with gastroesophageal reflux,tracheoesophageal fistula, or neurologic disorders with swallowingdysfunction are more prone to develop aspiration pneumonia.Onset of respiratory distress afterchoking, gagging, coughing, or vomiting episodes should lead oneto suspect aspiration pneumonia
   10. Cystic fibrosis - Common causeof chronic lung disease in children but also affects other organsystems with epithelial surfaces, especially intestine, pancreas,liver, and sweat glands. Mutations in CFTR gene located on chromosome7 result in abnormal ion transport across epithelial surfaces. Genetictransmission is autosomal recessive. Age of onset and clinical presentationvary widely. Earliest clinical manifestation is meconium ileus innewborn. Most common manifestation of respiratory disease is coughthat may be dry or productive. Other clinical findings include wheezing;nasal polyps; frequent large, foul-smelling stools; digital clubbing;recurrent rectal prolapse; and poor growth. Chest radiograph usually shows hyperinflation,irregular aeration with areas of patchy atelectasis, and accentuatedperibronchial markings. Bacterial organisms that commonly colonizerespiratory tract in this disease are S. aureus, H. influenzae,and gram-negative enteric bacteria, including P. aeruginosa. Sweat chloride level >60 mEq/Lis diagnostic. DNA mutation analysis is definitive
   11. Bronchiectasis - Infectionor chronic inflammation of airways can cause bronchiectasis. May be focal (foreign body, local infection)or generalized (cystic fibrosis, chronic aspiration). Chronic productive cough with cracklesand rhonchi on lung exam are usual findings. Chest radiography may show persistentatelectasis or infiltrates that fail to resolve. Diagnosis may be confirmed by chestCT, which shows dilated bronchi that do not taper peripherally
   12. Lung abscess - May occur ± pneumonia. Most common organisms found in lungabscesses are Staphylococcus species and group A Streptococcus.Anaerobes also may play role in individuals with aspiration pneumonia. Persistent fever and cough are usualclinical features. Abscess (density with air-fluid level)may be seen on chest radiography, with confirmation by chest CT.Needle aspirate may reveal specificpathogen
2. Allergic disorders -
   1. Allergicrhinitis - Althoughusual clinical findings with allergic rhinitis are persistent orrecurrent rhinorrhea, sneezing, and itchy tearing eyes, nonproductivecough also occurs
   2. Asthma - Definedas inflammatory disorder of smaller airways, which is characterizedby recurrent wheezing that is reversible with bronchodilator therapyor spontaneously. Another common manifestation is recurrent cough, ± wheezing,especially after exercise or at night
3. Mechanical or chemical irritation -
   1. Environmentalirritants - Smoke, chemicalfumes, particulate matter from fire, and other environmental pollutantsand toxins may stimulate cough production. History of exposure is diagnostic
   2. Foreign body aspiration -Aspirationof foreign body into bronchus commonly produces choking or gagging followedby persistent coughing or wheezing. Some common foreign bodies are food(nuts, seeds, meat), pins, tacks, and plastic tops. Chest radiography may show segmentalor lobar collapse or unilateral hyperinflation. Chest radiographstaken in inspiration/expiration or in right and left lateraldecubitus positions as well as fluoroscopy may demonstrate unilateralair trapping and movement of mediastinum away from affected side duringexpiration. In some cases, bronchoscopy is necessary to confirmdiagnosis
4. Bronchopulmonary dysplasia- Aform ofchronic lung disease that often follows neonatal respiratory distresssyndrome treated with endotracheal intubation, mechanical ventilation,and high concentrations of inspired oxygen. During course of disease, respiratorydistress waxes and wanes with intermittent cough. Crackles and rhonchi may be heard onlung exam. Hypoxemia and hypercapnia occur, andapnea may develop. Chest radiograph shows combinationof hyperinflation, prominent perihilar markings, and streaky densitiesthat may persist for many months
5. Congenital anomalies- Congenitalanomalies that may produce cough include laryngomalacia, tracheomalacia,tracheoesophageal fistula, pulmonary sequestration, bronchogeniccyst, cystic adenomatoid malformation, and vascular rings and slings.
6. Cardiac failure - Pulmonaryvenous congestion occurring as manifestation of cardiac failuremay cause airway edema leading to cough. Other findings includerespiratory distress, tachycardia, hepatomegaly, and cardiomegaly
7. Gastroesophageal reflux- Aspirationof stomach contents into lung may produce airway obstruction andpneumonia with coughing and wheezing. Another proposed mechanismfor cough and respiratory distress is the stimulation of esophagealvagal afferents by gastric contents to produce laryngospasm andbronchospasm.
8. Swallowing dysfunction - Disordersthat cause difficulty in swallowing may produce gagging, choking,and recurrent coughing
9. Immotile cilia syndrome - Autosomal-recessivedisorder characterized by defects in ultrastructure of cilia that impairciliary motion and clearance of mucus from respiratory tract. 1 form of this syndrome has been mappedto chromosome 9p21-p13, whereas another has been mapped to chromosome5p. Structural defects include absenceof dynein arms and radial spokes. Onset is in infancy or early childhoodwith chronic cough that is usually productive of sputum. Other manifestationsinclude chronic rhinitis, sinusitis, otitis media, bronchitis, andpneumonia. Chest radiograph may show hyperinflation,bronchial wall thickening, segmental atelectasis or consolidation,situs inversus, and bronchiectasis. Electron microscopy of cilia obtainedby nasal or bronchial biopsy brushing techniques demonstrates structuraldefects
10. Neoplasm - Chroniccough may occur with airway tumors (hemangioma, papilloma), mediastinal masses,and lung tumors, including metastatic lesions
11. Reflex cough - In somechildren, foreign body or cerumen in ear canal causes transientreflex cough. Persistent cough also has been attributedto hair lodged against tympanic membrane. Otoscopic exam is diagnostic
12. Psychogenic, including habitual cough -Occasionallychild has persistent or recurrent cough with no evidence of underlying respiratorytract disease. Usually occurs in school-aged child after URI, andcough lasts for weeks. Cough is usually loud, harsh, and foghorn-like,disappearing during sleep and often decreasing when alone or onweekends. Otherwise, child is well and physicalexam and chest radiograph are normal. Often secondary gain can be identified. Some of these children may have emotional problems that requirefurther evaluation

Diagnostic Approach

In manycases history and physical exam are diagnostic. Age of child, duration of cough, qualityand characteristic features of cough, and associated findings narrowdiagnostic possibilities

Age of Child and Duration of Cough

In infantsand preschool children, most common causes of acute cough are viralURI, pneumonia (viral, bacterial, aspiration), laryngotracheobronchitis (croup), bronchiolitis, and foreign body aspiration.
In school-aged children and adolescents,most common causes of acute cough are viral URI, bronchitis, andpneumonia (viral, bacterial, M. pneumoniae).
Chronic cough lasts >3–4wks, although many coughs induced by acute viral URIs may persistfor a number of weeks after onset of infection.
Most common causes of persistent coughin early infancy are pertussis, pneumonia (infection, aspiration),and cystic fibrosis.
In later infancy and early childhood,recurrent viral URIs and asthma are most common causes of recurrentcough.
Most common causes of recurrent orchronic cough in adolescents are asthma, smoking, cystic fibrosis,and psychologic problems.

Periodicity and Quality of Cough

Asthma,pneumonia, cystic fibrosis, bronchiectasis, TB, and focal lesionscausing local irritation or infection cause persistent coughs.
Recurrent viral URIs and asthma causeepisodic coughing.
Paroxysmal cough suggests pertussisbut can also occur with Chlamydia and Mycoplasma infection.
Dry, barking or brassy cough with voicechanges signifies laryngotracheal pathology.
Loud, honking cough in older childthat disappears with sleep suggests habit or psychogenic cough.
Neuromuscular disorders produce a weakand feeble cough.
Loose rattling cough means that excesssecretions or exudate exist in airways. Moist cough with sputumproduction is hallmark of suppurative lung disease

Timing of Cough

If coughdisappears while asleep, it usually has psychologic basis.
Recurrent episodes of nocturnal coughor after exertion suggest cough-variant asthma.
Productive cough with morning awakeningis common with bronchitis secondary to smoking or cystic fibrosis.

Nature of Sputum Production

Few infants or young children expectorate.Cough productive of purulent sputum is usually associated with bacterialpneumonia, cystic fibrosis, bronchiectasis, or lung abscess. Occasionally,the sputum is blood streaked

Associated Findings

Presenceof fever suggests infectious process such as viral URI, pneumonia,croup, pertussis or TB.
Hemoptysis suggests bronchitis, foreignbody, bronchiectasis, cystic fibrosis, TB, pulmonary hemosiderosis,or lung abscess.
Cough associated with stridor indicatesairway obstruction

Evaluation

Etiologyof cough can usually be determined or at least suspected from historyand physical exam.
Chest radiography shows pattern andextent of disease and is confirmatory in many instances.
With suspected bacterial pneumonia,CBC and differential, blood culture, and sputum culture (older child)should be performed.
If TB is suspected, intermediate-strengthPPD should be placed.
Thoracentesis should be performed ifthere is significant pleural effusion because Gram and acid-faststains, cultures (viral, bacterial, fungal), PCR, and cytology mayprovide specific diagnosis.
With segmental or lobar collapse unresponsiveto therapy, bronchoscopy should be performed to define obstructivelesion and to obtain cultures.
Another useful test is sweat test inchildren with recurrent or chronic cough
With suspected pulmonary infectionin immunocompromised host, nasal wash cultures for viruses, andsputum and blood cultures for bacteria and fungi, should be performed. Empiric therapy may be started for gram-positive and gram-negativebacteria and for P. carinii infection, but bronchoscopy with bronchoalveolarlavage should be considered at early stage. If this is nondiagnostic,lung biopsy is next step.

Home Treatment

Coughing is your body's way of removing foreign substances and mucus from your lungs and upper airway passages. Productive coughs are often useful, and you should not try to eliminate them. Sometimes, though, coughs are severe enough to impair breathing or prevent rest. Home treatment can help you feel more comfortable when you have a cough.

Home treatment for adults

• Prevent dehydration. Fluids may help thin secretions and soothe an irritated throat. Dry, hacking coughs respond to honey in hot water, tea, or lemon juice. Do not give honey to children younger than 1 year of age.
• Elevate your head with extra pillows at night to ease a dry cough.
• Try a cough drop to soothe an irritated throat. Expensive medicine-flavored cough drops are no better than inexpensive candy-flavored drops or hard candy. Most cough drops have no effect on the cough-producing mechanism.
• Quit smoking and do not use other forms of tobacco, especially while you have a cough
• Avoid exposure to inhaled irritants, such as smoke, dust, or other pollutants, or wear a face mask that is appropriate for the exposure. Many kinds of face masks are available. Check with your doctor or pharmacist to determine which type of face mask will provide you with the most benefit.
• If you suspect problems with stomach acid may be contributing to your cough, see the topic.

Cough preparations may help your cough. Avoid cold remedies that combine medicines to treat many symptoms. It is generally better to treat each symptom separately. There are two kinds of cough medicines: expectorants and suppressants.

• Expectorants help thin the mucus and make it easier to cough mucus up when you have a productive cough.
  
  • Use an expectorant if you have a cough that produces thick mucus and you are having difficulty coughing the mucus up. Don't depend entirely on an expectorant to thin the mucus; drink plenty of water also.
  • Look for expectorants containing guaifenesin, such as Robitussin, Mucinex, and Vicks 44E.
• Suppressants control or suppress the cough reflex and work best for a dry, hacking cough that keeps you awake.
  
  • Use cough suppressants wisely. Don't suppress a productive cough too much, unless it is keeping you from getting enough rest. Coughing is useful because it brings up mucus from the lungs and helps prevent bacterial infections. People with asthma and other lung diseases need to cough.
  • If you have a dry, hacking cough, ask your doctor about an effective cough suppressant medicine.
  • Look for suppressant medicines containing dextromethorphan, such as Robitussin-DM or Vicks Dry Hacking Cough. Studies show that over-the-counter cough medicines do not work very well. And some of these medicines can cause problems if you use too much of them. It is important to use medicines correctly and to keep them out of the reach of children to prevent accidental use.

Cough preparation precautions

• Cough preparations can cause problems for people with other health problems, such as asthma, heart failure, high blood pressure, glaucoma, or an enlarged prostate. Cough preparations may also interact with other medicines, such as sedatives and certain antidepressants. Read the package carefully or ask your pharmacist or doctor to help you choose one.
• Use cough preparations with caution if you are older than 60 or if you have chronic respiratory problems.
• Read the label so you know what you are taking. Some cough preparations contain a large percentage of alcohol; others contain codeine. There are many choices. Ask your pharmacist to advise you.
• Do not take someone else's prescription cough medicine.

Home treatment for children

It is important to follow the directions on cough medicines for children how much medicine to take and how often to take it may be very different than for adults.

If your child has a barking cough during the night, you can help him or her breathe better by following the home treatment for a barking cough.

• Hold your child in a calming manner.
• Keep your child quiet, if possible. Crying can make breathing more difficult. Try rocking or distracting your child with a book or game.
• Use a cool air humidifier to add moisture to the air. Do not use a hot vaporizer. Use only water in the humidifier. Hold your child in your lap, and let the cool vapor blow directly into your child's face.
• If there is no improvement after several minutes, take the child into the bathroom and turn on the shower to create steam. Close the door and stay in the room while your child breathes in the moist air for several minutes. Make sure your child is not burned by the hot water or steam. Do not leave your child alone in the bathroom.
• If there is still no improvement, bundle your child up and go outside in the cool night air.

Do not give cough and cold medicines to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
Do not give your child leftover antibiotics or antibiotics or other medicines prescribed for someone else

Prevention

There is no sure way to prevent a cough. To help reduce your risk:

• Wash your hands frequently during the cold and flu season. This helps prevent the spread of a virus that may cause a cold or influenza.
• Avoid people who have a cold or influenza if possible.
• Don't smoke or use other forms of tobacco. A dry, hacking "smoker's cough" means your lungs are constantly irritated
• Avoid exposure to secondhand smoke, both at home and in the workplace.
• Increase your fluid intake. This helps keep the mucus thin and helps you cough it up. It also helps prevent dehydration.
• Get a flu shot (influenza vaccine) each autumn if you are older than 50 or have a health risk that increases your risk for a serious problem
• Get a pneumonia shot (pneumococcal vaccine) if you are older than 65 or if you have chronic lung disease, such as asthma or chronic obstructive pulmonary disease (COPD), or a health risk that increases the seriousness of your symptoms
• Make sure your immunizations are current, such as pertussis to reduce your risk of getting whooping cough
• If your child stays in a day care center, ask the day care providers to wash their hands often to prevent the spread of infection.

Prevention tips for children

• If your child goes to a day care center, ask the staff to wash their hands often to prevent the spread of infection.
• Make sure that your child gets all of his or her vaccinations, especially for diphtheria, tetanus, and pertussis (DTaP) and for Haemophilus influenzae type b (Hib)..
• If one of your children is sick, separate him or her from other children in the home, if possible. Put the child in a room alone to sleep

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call or emergency services immediately.
Chest discomfort or pain that is crushing or squeezing or feels like a heavy weight on the chest


Chest discomfort or pain that occurs with:

• Sweating
• Shortness of breath
• Nausea or vomiting
• Pain that spreads from the chest to the back, neck, jaw, upper abdomen, or one or both shoulders or arms. See an illustration of chest pain.
• Dizziness or lightheadedness
• A fast, slow, or irregular heartbeat

Moderate to severe difficulty breathing:

• In a child
• In an adult and older child

Choking. If choking is present, go to the topic Choking Rescue Procedure. Do not perform the Heimlich maneuver if the person is still coughing or able to speak.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment

:You can help your doctor diagnose and treat your condition by being prepared to answer the following questions

• How long have you had the cough?
• How often do you cough?
• Does the cough have a pattern, such as worsening at night or becoming more frequent in the morning?
• What situations increase your coughing?
• Are you exposed to any irritants, such as smoke, dust, or chemicals, in your home or workplace?
• Is the cough productive (brings up sputum) or unproductive (dry and hacking)? Be prepared to describe the color (bloody, rusty, white, yellow, or green), amount, and consistency of any sputum.
• Do you have other symptoms that may be related to your cough, such as nasal drainage, fever, shortness of breath, wheezing, or other suspected cold symptoms?
• What home treatment have you tried? Did it help?
• What prescription and nonprescription medicines or other treatments have you tried? Did they help?
• What prescription and nonprescription medicines do you take regularly?
• Have you ever been diagnosed with allergies or asthma? Does anyone else in your family have allergies or asthma?
• Have you traveled recently?
• Do you have any health risks?

References

1. Bachur R. Cough. In: Fleisher GR, LudwigS, eds. Textbook of pediatric emergency medicine, 4th ed. Philadelphia:Lippincott Williams & Wilkins, 2000:183–186.
2. Chernick V, Boat TF, eds. Kendig's disordersof the respiratory tract in children, 6th ed. Philadelphia: WB Saunders,1998.
3. del Rosario JF, Orenstein SR. Evaluation and managementof gastroesophageal reflux and pulmonary disease. Curr Opin Pediatr1996;8:209–215.
4. Eigen H. The clinical evaluation of chronic cough.Pediatr Clin North Am 1982;29:67–78.
5. Long SS, et al., eds. Principles and practice of pediatricinfectious diseases. New York: Churchill Livingstone, 1997.
6. McCarthy VP, et al. Necrotizing pneumococcal pneumoniain childhood. Pediatr Pulmonol 1999;28:217–221.
7. Morgan WJ, Taussig LM. The child with persistent cough.Pediatr Rev 1987;8:249–253.
8. Online Mendelian Inheritance in Man (OMIM). McKusick-NathansInstitute for Genetic Medicine, Johns Hopkins University (Baltimore,MD) and National Center for Biotechnology Information, NationalLibrary of Medicine (Bethesda, MD), 2001. World Wide Web URL:

   برای مشاهده محتوا ، لطفا وارد شوید یا ثبت نام کنید

   .
9. Parks DP, et al. Chronic cough in childhood: approachto diagnosis and treatment. J Pediatr 1989;115:856–862.
10. Pickering LK, ed. 2000 Red book: report of the Committeeon Infectious Diseases, 25th ed. Elk Grove Village, IL: AmericanAcademy of Pediatrics, 2000.
11. Rudolph AM, ed. Rudolph's pediatrics, 20thed. Stamford, CT: Appleton & Lange, 1996

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[obituary]

Glaucoma medication may be safe, effective route to long, full lashes

WASHINGTON - A panel of government experts said Friday a glaucoma drug from Allergan appears to be a safe and effective way to make eyelashes longer and fuller.

Allergan, which makes Botox anti-wrinkle injections, has asked the Food and Drug Administration to approve its Lumigan formula to enhance eyelashes.

The agency's panel of outside eye and skin specialists voted unanimously that the drug's benefits outweighed its risks. However, the same panel voted 5-3 with one abstention that Allergan should be required to conduct follow-up studies to address questions about the drug's use among certain patient groups.

"I'm worried about off-label, nonsupervised use of this medication, and I'm concerned teenagers might use it three or four times a day instead of once," said Dr. Marijean Miller, an ophthalmologist with the Children's National Medical Center in Washington.

Other experts noted that only one African-American patient was included in company trials and said Allergan should be required to show the drug's effectiveness in that population.

The FDA is not required to follow the panel's advice, though it normally does. The agency is expected to make a decision on the drug in mid-2009.

The drug is already marketed to treat eye conditions stemming from glaucoma. In studies for that treatment, researchers first noticed the drug seemed to stimulate eyelash growth.

Could ‘Latisse’ post $500 million a year in sales?

Irvine, Calif.-based Allergan plans to market the drug under the brand name Latisse, if it is approved as a cosmetic treatment.

A study conducted by Allergan showed once-daily application with the formula significantly increased prominence of lashes after four months. The study also met its secondary goals of increasing eyelash length, thickness and darkness.

Allergan has estimated that Latisse could garner more than $500 million in sales annually, however, analysts are more conservative about the product's short-term potential. Cowen & Co. analyst Ken Cacciatore projected in a research note that Latisse would reach $15 million in sales for 2009 and $30 million in 2010.

Shares of Allergan rose $1.36, or 3.7 percent, to $37.78.l

[obituary]

Makeup is to facial skin what colors are to canvas. If applied correctly it not only enhances the looks but also brings out a near perfect persona from the simplest of faces. Makeup hides blemishes and imperfections. Yet at the same time it is important to note makeup is not the alternative to good skin. Good skin should be the primary goal. And to maintain it applying makeup in right contours should be the secondary goal.

A clean, well moisturized skin is the prelude to makeup. Make up starts from application of foundation. Right foundation makes the skin look natural and flawless. Wrong foundation gives the appearance of superficial artificiality. Most women across the globe have yellow based skin. It includes Asian, Latin and African women. So to have that perfectly natural, flawless look they need to wear foundations with a yellow base. Most of the foundations available in market have pink or orange tints. Sacha cosmetics, that was official makeup for Miss Universe and Miss USA beauty pageants, is the first cosmetic company to manufacture yellow tint foundation and it is a good product to start with. To get the correct foundation tone, it must be first tested on jaw line or forehead.

It is imperative to moisten a gauze pad or wash cloth in astringent and gently pat it on already made up face so as to get a dewy finish. The astringent removes the matte look. Excess foundation must be wiped clean with a tissue. Foundation can be set immediately by applying translucent powder. Try to avoid cream foundation in summers as they have high content of oil and may slip in extreme heat. Sometimes tinted moisturizers can be used in place of foundation. Many people are not clear when is the time to replace your existing foundation with a new one. The answer is when your foundation begins to curdle then it must be replaced with a new one. Loose power is ideal for setting make up and compact powder for touching up during day and night. Face powder must be matched with the skin tone. It must be evenly applied on sidelines, jaws and sides of nose to get the perfect finish. Excess powder must be dabbed with help of a tissue paper. For best results try the face power by Maybelline and L'Oreal. A face powder with SPF 15 is the best bet to ensure all day protection from sunlight during day.

Right concealer can hide all types of blemishes like under eye circles and acne. Liquid concealer is ideal for dry skin and larger areas like under eye circles while solid concealer can hide small spots. While buying a concealer, choose the one that matches your skin tone or is a shade lighter. It must be applied over foundation and as sparingly as possible. While concealing dark circles, yellow eye shadow can be mixed. This will color correct the dark circle and give a natural skin tone. A little concealer must be applied under the eyes to avoid dark looking eyes.

Blush is used to give the appearance of a flush and healthy looking skin. The color of the blush can be matched with the natural color of lips. Cream based blushers are in vogue for oily to combination skin while creams based are ideal for dry skin. While applying blush, a full size brush, like MAC's blush brush No.116 can be used. While applying blush always smile as this helps you in figuring the apple of the cheeks. Blush should be applied only on apple of cheeks. Excess blush can be wiped off with translucent powder. Best brands in blushes are Max Factor, Nars and Revlon.

Eyes are the main attraction points and eye make up can make the difference between naturally done or artificially done face. In eye makeup, less is more. If you are in hurry, then apply base color that matches your skin tone and top it with mascara. Apply eyeliner as close as possible. For a dramatic look thicker and darker is the bets bet. For eyebrow use a color that matches with the color of brow. Avoid the drama, just color the brow instead and fill in the gaps after combing the brow. If your brow are too then bleaching them up could open up the face. The best brands for eye make up are Urban Decay, LORAC and Sue Devitt.

Lip colors are used to enhance the lips and give the appearance of fuller lips. If you are lucky to have fuller lips than light and frothy colors will work the best. Before application of lip color, lips must be moistened. It is important to that lipstick can act as a blusher but blusher cannot act as a lipstick .To avoid lipstick on your teeths always put index finger in your mouth after application. This will wipe excess lipstick. To get the appearance of plump lips just apply lip linear outside your lips. Many a times lip liner can be applied after the use of lipstick. When wearing a red lipstick use a brown pigment to line and fill lips first as this will make the lipstick last longer. Apply lip gloss over lipstick or alone. Women with fuller lips need not use lip gloss. The best lip color brands are by Revlon, Body Shop, Cover Girl and L'Oreal.

Real beauty is skin deep and this must be always remembered. Make up is no magic band that can transform plain looking Jane into Cinderella. It is only a tool to enhance the natural looks. Healthy looking skin is transformed by makeup but make up is not a substitute for healthy skin. Similarly it must also be noted that makeup products are composed of chemicals. Too much exposure to make up is also not good for the health of skin. Before sleeping, all traces of makeup must be wiped clean to allow skin to breathe naturally. So be ready to say hello to beautiful you. l

[Madame Tussaud]

SEVEN WAYS TO MAKE YOUR SKIN GLOW
Nothing says youthfulness and good health like glowing , fresh skin . Some people are born with it , some can thank their family genes , but for the rest of us beautiful skin takes some work . What you may not realize is that it is easier than you think to have skin hat glows . These seven tips will help you get the skin that you have always wanted


Eat Healthy
If you want beautiful skin , it is important to maintain a healthy diet . You need plenty of fresh fruits and vegetables , lean meats and dairy in order to have a healthy body and healthy skin . you want to steer clear of processed foods and canned foods because these have a great deal of sodium and ingredients that can cause your skin to become dry , oily or just malnourished . Do your skin and body a favor and only
eat fresh foods . Broccoli is a great food to eat if you have acne and fish is great for
your skin in general . If you are eating the good foods , your skin will show it


Drink Plenty of Water

It is important to drink lots of water to keep your skin supple and moist . If you do not drink enough water , your body will begin taking water from various minor organs in order to feed the major organs . One of the minor organs that is affected is the skin . When the water is drawn from the skin to take care of major organs , you may notice that your skin is very dry and even flaky or it is extremely oily . Drinking

lots of water.though , combats that and keeps your body balanced .


Cleansing Matters
Cleansing should be a vital part of your daily routine . You should remove your makeup each night and thoroughly cleanse your face each morning . The products that you use are also important . Whether you opt for a brand name , drugstore brand or a natural brand of skincare , you should cleanse your face daily and do it the right way : Using lukewarm water ( not hot , not cold ) , splash some on your face . Put some cleanser on your fingertips and work it in to a lather . Using a circular motion , rub the cleanser on your face , jaw line and neck . You don’t want to scrub , be gentle . Rinse your skin by splashing lukewarm water on your face and
neck until the cleanser is gone . Pat your skin dry with a clean towel


Exfoliate
Exfoliation is a great way to get a quick glow . the trick is to get an exfoliation that is gentle but effective . You do not want a very coarse grit because you do not want to overwork your skin . Use a fine grit and make sure that it is gentle . You can use it each morning prior to applying your makeup for a glow that will last all day . To apply , splash your face with lukewarm water . Apply the exfoliation with the pads of your fingers in a circular motion . Avoid your eye area and do not scrub hand
Rinse well and pad dry with a clean towel


Sleep
A good night’s sleep is one of the best beauty tools you can have . While many people believe that sleep deprivation causes dark circles under your eyes , this is not true . When you miss too mach sleep , fluid can collect under your eyes , making them puffy . If you are prone to dark circles , which are a concentration of blood vessels just under the skin , then the puffiness will make the dark circles more prominent . This can add years to your look . Moreover , your body repair itself while you sleep so if you do not get enough sleep , it cannot repair itself adequately .

Your Make-up Means a Lot

Your makeup can mean the difference between great , glowing skin and acne or dry flaky skin . The mineral makeup that is gaining popularity lately is actually a makeup that is good for your skin . Some versions have certain minerals , though , that certain skin types react to so you may need to try a couple of different formulations
until you find the one that is best for you

Relax
Stress can wreak havoc on your skin so it is important that you take time to relax . Meditate ; take a warm bath ( not hot ! Intense heat can harm your skin ) or just talk with a friend . Classes such as yoga are great stress relievers . If you take the time to
relax and relieve your stress , your skin will thank you

If you fallow these seven simple steps , you will soon have softer , younger looking skin

[A r c h i]

The 6 Biggest Skin-Care Mistakes


If there's one thing I stress to my patients, it's that great skin doesn't require spending a fortune on some "miracle cream" made from rare seaweed from the Arctic Circle! It's all about simple good habits. But let's approach those habits from the opposite direction: What are the most damaging bad habits that I see time and time again?

1. Using a cleanser with harsh detergents: Many people assume that the suds of their vigorously foaming cleanser are a good sign -- surely they'll leave skin extra clean. Unfortunately, copious suds are generally a sign that your cleanser contains a harsh detergent, like lauryl sulfate, that strips skin of vital lipids. (And don't get me started on bar soap -- that is always a no-no.) Instead, look for cleansers that contain fatty acids and will actually fortify your skin, like Dove's ProAge products, or even simple cold cream. If you have particularly dry skin, I recommend cleansing oils, which remove dirt and makeup without disturbing your skin's natural protective barrier.

2. Not using a retinoid: Retinol, a form of vitamin A, is the only topical ingredient proven not only to prevent lines and wrinkles but to minimize the ones you already have. Past the age of 30, I recommend seeing a dermatologist for a higher-concentration prescription retinoid (like Retin-A, Differin, or Tazorac, for example), but there are also many great over-the-counter creams that contain lower concentrations of retinol. I

3. Spending too much on skin care: Splurging on the beautiful packaging and luxurious scents of pricey boutique skin care lines can feel wonderfully pampering -- provided you know that it's absolutely not necessary for great skin. In fact, many of my favorite products are made by drugstore brands, because those companies have the large budgets for top-notch research and development. If you have to choose, put your money toward that prescription retinoid, and buy the rest of your regimen at the drugstore.

4. Getting facials: Yes, that's right -- you can strike facials from your skin-care budget and actually be doing your skin a favor! Studies show that as many as 80% of people break out after a facial. Aestheticians often don't know which products are right for the skin of each client, and may use ingredients that can worsen acne, or essential oils that tend to irritate sensitive skin. Even if you don't break out, there are really no long-term benefits to facials.

5. Washing your face at the wrong time: Always wash your face after you rinse out your hair products and conditioner in the shower, never before. Many conditioners contain pore-clogging isopropyl myristate and other hair products often contain coconut oil -- both are common acne-causing ingredients that you don't want to leave on your skin.

6. Not using sunscreen every day: Not just for your trip to the beach. Not just during the long summer days. Every day. Yes, it's important to be even more vigilant if you plan to spend lots of time in direct sunlight. But incidental sun exposure typically accounts for more of our lifetime exposure to ultraviolet rays than those days at the beach. Walking to and from your car, dashing out of the office for a sandwich, or sitting outside for a few minutes adds up -- make sure you're covered with at least SPF 15, every day.