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In the series I Made a Big Mistake, PopSci explores mishaps and misunderstandings, in all their shame and glory.

Sooner or later, everybody makes the painful mistake of getting a sunburn. Maybe you thought your dark skin wasn’t sensitive to UV rays, or you forgot to put on sunscreen altogether. It’s OK, these things happen.

Whatever the reason, you need to treat a sunburn quickly, especially if you’re outside—it can go from mildly annoying to painfully severe if you don’t pay attention.

How to treat a sunburn

A sunburn kills your skin cells, so there’s technically no way to heal the damage. All you can do is treat it by preventing further harm and managing symptoms while your skin is busy churning out new, healthy cells.

1. Get out of the sun

If you’re still exposed to the sun, you need to reduce further damage. This means seeking shade, covering your skin with tightly woven clothing, or better yet, going inside. 

2. Soothe the area with cool water and moisturizer

Just like a burn from a hot beverage or plate, one from the sun’s rays traps warmth in the skin. That means a key part of effective sunburn treatment is releasing that heat. Meghan Feely, a board-certified dermatologist in New York, recommends gently applying a cool compress for 15-minute intervals throughout the rest of that day or taking a cool shower or bath. What is cool to you will depend on the burn and how sensitive you are, so make sure to test the water by allowing some of the injured skin to briefly come into contact with it.

If you want to try, she suggests adding 2 ounces of baking soda to a cool bath.

After showering or bathing, it’s important not to pat your skin completely dry, says Feely. A sunburn can dehydrate your outer layer, and leaving some water in place allows your epidermis to reabsorb some of the H2O it lost as a result of that burning heat.

While your skin is still damp, apply a moisturizer to further trap that water so your cells can reabsorb it. There are countless products on the market, and some even claim to specifically care for burned skin. Feely says that any moisturizers that contain vitamins C and E will work best. These have antioxidants that help the skin heal, minimizing the amount of flaking that will ensue.

Moisturizers containing aloe vera—or even just a gel form of the plant’s juice—are often touted as the very best thing for a sunburn. Feely says aloe is commonly used to heal and hydrate skin and decrease inflammation, and it contains certain skin-healing proteins that can help prevent infection.

Some moisturizers contain occlusives like petroleum jelly (petrolatum) or ceramides, but their use is a heated subject among skin experts. Chapas recommends these ingredients, as their sole purpose is to trap moisture and keep it close to the skin. On the other hand, Feely says petroleum-based options will trap heat along with moisture, making it far more difficult to release. Holman, meanwhile, recommends these products only in the late stages of a sunburn, when the skin has already started to peel. 

Patch testing is probably the best way to know if you can benefit from a moisturizer with occlusives. Apply the product to a quarter-sized area of burned skin and wait for 10 to 20 minutes. If you get a heightened burning sensation on that spot, wash the product off carefully and use a moisturizer with a lighter gel or water-based formulation.

Finally, for extra soothing power, place your moisturizer in the fridge between uses—not the freezer. And stay away from ice packs, as the extreme change in temperature can result in even more pain. 

3. Fight the pain with over-the-counter medicine

A sunburn on a sensitive patch of skin or an area that’s constantly stretching, like the back of your knees, usually results in a lot of pain. Like, a lot. If the cool showers and moisturizer are not helping as much as you’d like, it’s time to get reinforcements. 

The AAD recommends starting with simple over-the-counter medications, like ibuprofen or acetaminophen. Take as instructed on the packaging to reduce swelling, redness, and inflammation. You can also try topical creams that contain hydrocortisone, but Feely recommends staying away from any products with benzocaine or active ingredients ending in -caine. These ingredients, which are commonly used to reduce pain and discomfort from bug bites, can be highly irritative.   

4. Drink lots of water

As a response to sunburn, your body will draw fluid to the surface of your skin and away from the rest of your organs, which the AAD says can eventually result in dehydration. Drinking water or replenishing fluids with sports drinks can help prevent that.

5. Leave your blisters alone

If you happen to have a second-degree sunburn, you’re going to get blisters, which you should treat in a similar way as the blisters you get when wearing the wrong shoes: leaving them alone.  

In short, blisters protect damaged skin from infection. When you pop them, you risk bacteria and other pathogens getting on or in the injury. All you can do is keep the blistered area clean with mild soap (fragrance-free and ideally with moisturizing properties) and water in case one of your blisters ruptures. If that happens, you can clean the area with soap and water, apply an antibiotic ointment, and cover the wound with a non-adhesive bandage. 

Even if you should leave your blisters alone in the great majority of cases, Chapas says you may carefully drain a particularly bothersome one:

Thoroughly clean the area and wash your hands with soap and water. If you can don surgical gloves, do so. 

Slowly puncture the blister cap with a sterilized needle (thoroughly clean it with an alcohol pad). Do this slowly—you want to go deep enough so the liquid can get out, but not so deep that you poke the delicate new tissue underneath. 

Gently press the blister to drain the fluid. It is crucial to keep the cap in place, as it’ll protect the injured area from infection. 

Apply antibiotic ointment twice a day.

Cover the site with a bandage. 

Only drain blisters sparingly, as you don’t want to elevate your risk of infection. If your blisters are particularly big or are in sensitive areas, like on your face, go to a doctor. 

6. Let peeling happen naturally 

A week or so after your sunburn, your skin will start peeling. This means your body has created new tissue and is getting rid of dead cells. This process can be a bit gruesome to the eyes, and it can come with some itching and discomfort. 

And while (for some at least) nothing is more satisfying than gently lifting away a ginormous layer of skin without breaking it, that satisfaction doesn’t outweigh the detriment to the healing process. Do not pull on your peeling skin, as you may damage healthy tissue. 

You can fight discomfort by wearing loose-fitting clothing in the days following a sunburn. This will prevent the fabric from rubbing and irritating the already-sensitive area. Holman says that at this stage you can also make a paste using baking soda and water, which you can apply to the burn. This technique will help alleviate symptoms and act as a mild exfoliant, she explains. 

To reduce the itching, the Mayo Clinic recommends taking oral allergy medication, which you can get over the counter at your local pharmacy or grocery store. Just follow the instructions on the package to find some blissful relief. 

Protect yourself to prevent future sunburns  

Sun damage is cumulative, which means that every time you get a sunburn, you’re at a higher risk of developing skin cancers like melanoma. This is why it’s extremely important to shield your skin from UV radiation whenever you can. Preventing a sunburn is always better than nursing your skin back to health.

Practicing general sun safety in your day-to-day life can help enormously. Even if you stay indoors, wear sunscreen every day with at least 30 SPF protection on any exposed areas. Make sure to use the correct amount and reapply as instructed on the package. Reapplication is especially important if you’re going in the water, where your coverage can wash away.  

If you plan to stay out in the sun for an extended period of time, Feely recommends that you bolster your sunscreen with good clothing choices. For example, synthetic fabrics like polyester and nylon provide far more UV protection than cotton. 

“Linen absorbs ultraviolet light, whereas synthetic fabrics such as rayon reflect it,” she says. 

Covering yourself up with UPF clothing, a hat, and sunglasses with a high UV rating will also help protect your body’s outermost layer. Don’t forget to check your skin for signs of sunburn once in a while, too.

What is a sunburn?

All this protection matters because sunburn happens when the sun’s ultraviolet radiation damages the DNA inside skin cells. As a result, those cells die in a process known as apoptosis. This excessive damage and death prompts the immune system to release a flood of inflammatory proteins and blood to the area. This flush causes the outer skin to become hot, irritated, and red.

In first-degree sunburns, the outermost layer of the skin, the epidermis, is damaged. These are your run-of-the-mill sunburns, where you’ll experience redness, inflammation, and pain. If you see blisters, you’re dealing with a second-degree sunburn. This is where UV radiation has penetrated the epidermis and killed cells all the way down to the dermis, the second layer of skin. Blisters form when these two layers of tissue separate, and inflammatory fluid rushes to the area to prevent further damage.

[Related: 5 skin cancer-care tools you should look out for]

The length of time it takes for your skin to rebound from a sunburn varies. “Depending on the severity, the redness can persist anywhere from a few days to weeks,” says Feely. 

Even after the sunburn goes away, you might see lasting effects on your skin, such as fine lines, wrinkles, or solar lentigines, colloquially known as sunspots. All these markings more commonly develop after repeated exposure to the sun. If you notice these changes, applying a topical retinoid (a class of chemical compounds derived from vitamin A) like Retin-A could help, Feely says. This type of ointment remodels the skin’s collagen and blocks the production of the skin pigment melanin, which helps make sunspots fade.

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Hats Off To The Brands That Actually Listened In 2023

Robert Triggs / Android Authority

One of the most frustrating things in the reviews business is repeating the same complaints year after year. We certainly don’t like reprising the same lines, but it’s extra disappointing when lingering issues prevent us from offering an otherwise solid recommendation to otherwise great phones.

With that in mind, we’re taking the time to tip our hat to brands that have taken feedback onboard and improved their products for the better in 2023.

Upping the long-term update game

Ryan Haines / Android Authority

We’ve spent the past couple of years screaming at every brand, big and small, to catch up with consumer purchasing habits and update their phones for longer. Finally, that message is getting through.

Samsung kickstarted the move with an industry-leading upgrade pledge (four OS and five years’ security) in early 2023. That even bests Google, which offers just three years of OS upgrades for its Pixel phones, along with five years of security patches. But Samsung really put the industry to shame when it brought the same policy to its new mid-range Galaxy A phones.

Read more: Update policies from every major Android brand

A refined Google Pixel

Ryan Haines / Android Authority

After the success of the Pixel 6, the best Google can do for the Pixel line is stay consistent. That’s what we thought before the launch of the Pixel 7 series, and Google was certainly on the same wavelength, for once.

Refined rather than innovative has served the Pixel 7 and 7 Pro very well. The originally sluggish fingerprint scanner is vastly improved, Google has fixed the worst of the Pixel 6’s connectivity issues, and has even found the time to improve the handset’s already great camera setup.

A pause for refinement is just what the Pixel series needed.

With the issues ironed out, the Pixel 7 has gone on to pick up Android Authority’s 2023 Editor’s Choice and Reader’s Choice awards. With a solid foundation now under its belt, perhaps the series can flex a few more meaningful upgrades with 2023’s Pixel 8. Just don’t throw all the good work out the window, OK Google?

Related: I want truly innovative flagship phones in 2023

Addressing the Galaxy Z Flip 4 battery woes

Robert Triggs / Android Authority

Even the best hardware is no good if it can’t last all day. While we want to see all-day battery life by default, the ability to quickly top the phone up with powerful charging is a sought-after backup. Thankfully, Samsung heard us and addressed both these issues with the Galaxy Z Flip 4.

The battery inside the Galaxy Z Flip 4 is a fair bit larger than the Galaxy Z Flip 3 — 3,700mAh vs 3,300mAh, respectively. Samsung also boosted the phone’s charging power from a measly 15W up to a more reasonable 25W. Providing you use a USB PD PPS charger, which does complicate things a little.

At 75 minutes to full, the Galaxy Z Flip 4 won’t win an award for the fastest charging phone, but it’s something. Thanks for listening, Samsung. But we’d still like more than four to five hours of screen-on time next year.

Compact phones we want to buy

Robert Triggs / Android Authority

Sony’s Xperia 5 series has always distilled most but not all of the powerhouse Xperia 1 range down to a more compact form and mainstream price point. A job that was especially important for 2023’s Xperia 5 IV, given the bigger flagship’s $1600 retail price.

Sony did just that, for the most part, finally introducing wireless charging to the smaller model, after years of asking. The 5 IV offers identical content creator apps as its bigger sibling, and even fixed the brand’s portrait selfie mode before the 1 IV. Along with the same 4K 120fps HDR video recording, an IP65/67 rating, and Wi-Fi 6E hardware features found in the Xperia 1 IV, this is one of, if not the only, powerhouse compact flagships on the market.

Spore: A Jailbreak Tweak That Works Overtime To Secure Apps With Passcodes & Authentication

Privacy is a valuable thing, and while iPhones can be secured with a passcode or biometric authentication such as Face ID or Touch ID, many still feel like Apple could do more to improve user privacy — especially for when someone manages to get ahold of your passcode or you hand your unlocked device to another person for one reason or another.

iOS developers Devvix and nicho1asdev wanted to do something about this, and after happening upon a snazzy new concept by @Devy_Design, work ensued and a new jailbreak tweak dubbed Spore was later conceived and is now available to the general public.

To explain Spore in its simplest terms, the tweak lets you hide and protect app(s) so that when someone else has control over you device, that person won’t be able to find or use said apps. Not only are those apps hidden from the Home Screen and from Folders, but they’re also hidden from places like Spotlight search, Siri Suggestions, the App Store, and more. The tweak can even intelligently hide notifications from those apps, preventing the user from seeing them.

Once hidden, those apps are relocated to what’s called the Hidden Space, which can be accessed whenever you need it with a simple pinch gesture on your Home Screen. After you’re in the Hidden Space, you can either tap on the “+” button to add more apps or you can tap on the “x” button to exit it. Please note that you will be prompted to enter a passcode when accessing the Hidden Space, and you can either choose to use your device’s native passcode or a completely custom one that you can set in the tweak’s settings. Alternatively, you can use biometric authentication if your device supports it.

Once installed, Spore adds a dedicated preference pane to the Settings app where users can configure a few different options to their liking:

Things you can do here include:

Toggle Spore on or off on demand

Choose between a light, dark, or adaptive appearance setting

Toggle biometric authentication on or off

Toggle custom passcode on or off

Configure a custom passcode if you’ve chosen to use this instead of your device’s passcode

Respring your device to save all changes you’ve made

A few different things to note here are that Spore is fully compatible with jailbroken iOS 13 and 14 devices. iOS 12 support is expected at a future date, along with detailed usage information and support for Activator gestures to summon the Hidden Space. We especially like that the developers have taken into account all the different places where apps can be accessed, and in addition to that, the tweak supports both dark and light mode — whichever you might prefer.

The developers did request that I take note of a currently known bug where some apps may still appear in the App Store and in Spotlight on some versions of iOS, but they’ve assured me that this will be fixed in a future release.

I’ve long vouched for increasing personal security with app-protection tweaks, since A11 devices (like the iPhone X I use) can be more susceptible to foul play on iOS & iPadOS 14 when jailbroken with checkra1n because they can’t have a passcode or use biometric authentication. Spore offers yet another take on the personal security aspect, and for slightly less money than BioProtect XS at $1.99 instead of $2.99, however each tweak has its own unique feature set and uses.

If you’re interested in giving the new Spore tweak a try, then you may purchase it for $1.99 from the Geometric Store repository via your favorite package manager app. If you’re not already using the Geometric Store repository, then you can add it to your package manager of choice by using the following URL:

Posting A Copyright Notice On Social Media Doesn’t Actually Accomplish Anything

If you’ve logged into Instagram since last week, you may have seen people posting a long, typo-laden screed about a new rule going into effect that gives the company the ability to sell, use, or share your photos unless you repost a specific message denying it. I have even seen a few famous photographers doing it.

The statement sounds official, but it’s actually just the latest iteration of an internet chain letter that won’t do anything to protect your privacy or intellectual property from the social media networks or the wilds of the internet in general.

Various versions of the message exist, but they culminate with a declaration of “Instagram does not have my permission to share photos or messages.” Unfortunately, you can type this all you want—or run and shout it out loud at a semi-crowded Dave & Busters—and it still doesn’t change the fact that you have, in fact, given Instagram and other social media services the right to share your images and more.

Dig into the Instagram terms of service and you’ll find a section about permissions you give the company. These legal terms used to be even more complicated, but they got slightly simpler thanks to the European GDPR regulations, which require companies to clarify the actual cost of signing up for their services.

Under the Permissions topic, you’ll find the following phrase: ”We do not claim ownership of your content, but you grant us a license to use it.” Simply put, this means that Instagram doesn’t require you to turn over the intellectual property of your photos and videos to them completely—you still own that media and can sell it or sign it over to someone else if you want.

The terms go on to explain the license you’re granting the company. Here’s the more complicated section. “…You hereby grant to us a non-exclusive, royalty-free, transferable, sub-licensable, worldwide license to host, use, distribute, modify, run, copy, publicly perform or display, translate, and create derivative works of your content (consistent with your privacy and application settings).”

If you’ve spent any amount of time examining the terms of service for social media networks or even photo contests held online, these phrases probably sound familiar. You’ll find very similar terms on Facebook and Twitter as well.

Back in 2012, two of those terms showed up in the Instagram agreement after Facebook purchased it: “transferable,” and “sub-licensable.” It caused an outcry. The concern was that this gave the company the ability to basically sell user photos as if they were stock images, which wasn’t technically the case and it certainly hasn’t panned out that way.

Interestingly, however, Instagram and Facebook does have a little leeway when it comes to using your name or likeness as they relate to sponsored content. For example, you may have seen sponsored Facebook posts above which you’ll find a list of other friends that have liked that content or the brand sponsoring it. In that case, Facebook and Instagram have the right to display your name and even your profile picture next to the sponsored content you liked. It’s complicated, but the system has been in place for years without much backlash.

As for Instagram sharing your private messages, the company specifically says it can share your content, “consistent with your privacy and application settings,” which means it will keep private stuff private, at least to the best of its ability. That’s not to say that someone couldn’t get access to it, however, through a hack or a data breach. If that’s something you’re very worried about, you could consider a service like WhatsApp, which is also owned by Facebook, but encrypts your messages so they’re mostly useless to a hacker.

If you’re really concerned about protecting your photo and video copyright, there is an official process through which you can submit your works on chúng tôi It’s a somewhat tedious process, but it will give you stronger legal ground on which to stand if someone infringes your photos or videos.

If you’re still not comfortable with the terms, you can terminate Instagram’s licenses to your images by deleting the content—though that’s not the case with every social media network. So, if you’re really concerned about companies using your images, you may have to suck it up and actually read those terms you typically skip during sign-up.

Galactorrhea Causes Symptoms Diagnosis And Treatment

Galactorrhea can be a symptom of some abnormality with the body or hormone imbalance, also, it can be because of prolactin. Condition milk leakage is very common and it can be seen in around 20 percent of the population with minor symptoms. The condition is more common in women than in men as they are the ones responsible for breastfeeding.

To understand galactorrhea it is important to know how milk production takes place in the human body. Milk production begins in the women’s breast when they are pregnant, the hormone signals the mammary glands for the production of milk for the child.

There are a lot of vital organs and hormones involved in the release of milk. Some of them are:

Alveoli. This sac produces and stores milk.

Milk ducts. This carries the milk from the alveoli to the nipples.

Areola. This is the area surrounding the nipple and is dark in color. This produces a sensation and indicates the hormones to release the milk.

Nipple. They contain very tiny pores that help the milk to come out of the breast.

Galactorrhea: Causes

Galactorrhea happens when the pituitary gland produces too much Prolactin. This hormone is responsible for the production of milk, the excess milk that produces needs to release otherwise, it will cause further pain and infection. The leakage is caused due to this release. This can happen in any gender. Also, this condition is common in infants.

The following are the important causes of developing Galactorrhea:

Medicines. Galactorrhea may happen due to the use of certain medications like birth control pills, blood pressure control, antidepressants, and diabetes.

Gender. Cases of galactorrhea are more in women than in men.

Infants. Infants also suffer from this problem and it generally goes away in a matter of time.

Thyroid. Thyroid too causes milk release problems.

Anxiety and stress, personality disorders, and other issues can cause hormonal changes in the body and can cause irregular lactation.

Breast stimulation and excessive use of the breast in sexual intercourse may arouse hormonal simulation that can cause lactation.

Breast cancer. Cancer and tumors are one of the most important reasons for lactorrhea. Tumors can affect the hormones of the breast and discharge of milk is common.

Injury. Injury to the chest due to an accident or any damage to the chest region may also cause lactation.

Some people also take herbal supplements to increase the size of the breasts like fenugreek, fennel seeds, etc. overdose of these supplements can cause milk leakage.

Kidney disease is also associated with galactorrhea.

Galactorrhea: Symptoms

A symptom of galactorrhea is the release of white milk-like discharge from either or both of the breasts. This can happen to either sex male or female and can happen to infants too.

Infection in the vagina is also a symptom

Some of the symptoms may cause headaches

Dryness in the vagina

Nausea and weakness

Menstrual periods get also affected by this condition

Blurry vision

Less sexual drive

Pain in the breasts

New hair growing in the chest area

Galactorrhea: Risk Factors

Several factors play an important role in the development of Galactorrhea which includes:

Sex. Galactorrhea cases are more in women than in men.

Age. Leakage of milk is a known condition for infants and people who are at adolescent age and had recent pregnancies.

Diseases. Patients suffering from other hormonal diseases like thyroid are at greater risk for this problem.

Personality disorder. Personality disorders like anxiety and stress, bipolar, and borderline can cause hormonal changes in the body and can cause irregular lactation.

Sexual intercourse. During sexual intercourse, breast stimulation plays an important role and some people overdo this and may suffer breast-related issues.

Cancer and tumors. People suffering from cancer and tumor are also at risk for galactorrhea.

Medicines. Some of the medicines which are used to treat other underlying diseases can cause galactorrhea.

Accidents. A person who has suffered Injuries to the chest can develop a leakage problem.

Supplements. Uses of supplements to correct or increase the size of the breasts like fenugreek, fennel seeds, etc. increases the risk for lactation.

Galactorrhea: Diagnosis

The diagnosis of Galactorrhea is mainly done based on observation and some of the tests may be required for confirmation and to rule out underlying causes:-

Physical examination. The doctor will physically examine your breasts and look for signs of abnormality in the nipples and other areas of sensation. He will also ask about the recent injury and will look for signs of any infection.

X-rays. X-rays may be used to check for another injury to the chest.

MRI. Magnetic Resonance Imaging is a useful modern technique used for imaging tumors and other issues related to the abnormality of the pituitary glands that secrete the hormone responsible for lactation.

Ultrasound. These scans are also useful along with all the above tests to confirm lumps in the breasts or nipples.

Blood test. This test provides the result of an infection in the blood and also confirms thyroid and other diseases.

Pregnancy test. Pregnancy can also be a reason for abnormal lactation.

Galactorrhea: Treatment

Medicines. Galactorrhea can happen due to some medication and the same needs to be stopped immediately in consultation with the doctor.

Thyroid treatment. Get your thyroid levels checked and start taking prescribed medication for it.

Try to avoid over-sensation in your breast area that triggers the hormone for lactation.

Breast cancer & tumor treatment. If the tumor or cancer is diagnosed the removal of the same may be suggested by your doctor.

Galactorrhea: Prevention

Some of the measures that can help to prevent Galactorrhea include:

Do not touch your breast unnecessarily.

Keep your breast free of any infection.

Wear a loose cloth to avoid nipples getting in contact with it.

Check for any irregular levels of thyroid or infection.

Do a pregnancy test.

Look for any lumps in the breast.

Look for any signs of changes in the nipple and nipple region.

Try to identify the milk or puss that comes from the nipple.

Do not try to drain the excess milk and consult your doctor.

Do not use any supplement for the enlargement of your breast.

Do not go for any surgery to perfect your shape.

Breastfeed your baby. Breastfeeding is very important to keep your breast away from infection and cancer.

Conclusion

Delirium Causes Symptoms Diagnosis And Treatment

Delirium is an acute organic mental disorder that is characterized by impairment of consciousness, disorientation, and disturbance in perception which occurs rapidly within hours to days. Delirium causes disturbances in mental abilities that result in confused thinking and reduced awareness of the environment.

Delirium affects the cognition of the individual. Cognition includes several specific functions, such as the acquisition and use of language, the ability to be oriented in time and space, and the ability to learn and solve problems. It includes judgment, reasoning, attention, comprehension, concept formation, planning, and the use of symbols, such as numbers and letters used in mathematics and writing.

Delirium is of three types −

Hypoactive delirium is characterized by inactivity or reduced motor activity, sluggishness, and abnormal drowsiness.

Hyperactive delirium is characterized by restlessness, agitation, rapid mood changes, or hallucinations.

Mixed delirium includes both hyperactive and hypoactive symptoms. The person may quickly switch back from hyperactive to hypoactive states.

Various causes such as vascular conditions, infections, certain medicines, trauma, and electrolyte imbalance are known to result in delirium

The diagnosis of delirium and its underlying causes is based on the history, presentation, nervous system evaluations, CSF analysis, EEG, imaging tests, blood tests like CBC with ESR, blood grouping, urine examination, and serum electrolytes.

Delirium: Causes

Various factors play an important role in the development of Delirium. The following are the important causes of developing delirium −

Vascular causes such as hypertensive encephalopathy and intracranial hemorrhage.

Various Infections such as Encephalitis, and meningitis

Neoplastic diseases such as space-occupying lesions

Fever and acute infection, particularly in children

Exposure to various toxins

Malnutrition or dehydration in children

Certain medications can trigger delirium, including painkillers, benzodiazepines, opioids, anticholinergics, anti-allergics, and anti-convulsant medicines

People with Sleep deprivation for a long duration or severe emotional distress

Following major Surgeries or other medical procedures that include anesthesia

Following traumatic injuries in patients having subdural and epidural hematoma, contusion, laceration, and heatstroke.

Vitamin deficiency such as thiamine

Endocrine and metabolic causes include diabetic coma and shock, uremia, myxedema, hyperthyroidism, and hepatic failure

Heavy metals such as lead, manganese, mercury, carbon monoxide, and toxins

Decrease in the oxygen supply to the brain in conditions like anemia, pulmonary or cardiac failure

Delirium: Symptoms

Symptoms of delirium usually begin over a few hours or a few days and often fluctuate throughout the day, and there may be periods of no symptoms. Symptoms tend to be worse during the night when it’s dark and things look less familiar. Patients with delirium mainly present with the following symptoms that include −

The patient has difficulty staying focused on a topic or switching topics and gets stuck on an idea rather than responding to questions or conversation

The patient is easily distracted by unimportant things and is being withdrawn, with little or no activity or little response to the environment

Poor thinking skills

The patient has poor memory, particularly of recent events

Disorientation to time place and person

Difficulty speaking or recalling words

Rambling or talking nonsense things

Face difficulty in understanding what others are talking

Difficulty reading or writing

Behavior changes such as Hallucinations, restlessness, agitation, calling out, making other sounds, being quiet and withdrawn, slowed movement or lethargy, disturbed sleep habits, reversal of night-day sleep-wake cycle

Emotional disturbances such as the individual being either anxious, scared, or depressed., Irritable or very excited sometimes. The mood shifts are rapid and unpredictable

Disturbance of the sleep-wake cycle, the patients find difficulty in falling asleep, total sleep loss, daytime drowsiness, and disturbing dreams or nightmares.

Delirium: Risk Factors

Several factors play an important role in the development of delirium which includes −

Older age group people are at more risk

Patients with a history of brain disorders such as dementia, stroke, or Parkinson’s disease

History of previous delirium episodes

Certain Infection

Certain Medications like pain killers, anti-psychotics and anticonvulsants

Individuals with visual or hearing impairment

Patients with multiple medical problems

Bone fracture

Delirium: Diagnosis

The diagnosis of delirium is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

History of symptoms, head injury, and meningitis should be asked for

Mental status assessment and neurological exams should be done. That includes checking vision, balance, coordination, and reflexes which help to determine if a stroke or another neurological disease is causing the delirium.

Tests for memory such as immediate, recent, and remote should be checked

Serum electrolyte to check for metabolic imbalance

Electroencephalography to check the electrical activity in the brain

Blood tests such as complete blood count, ESR, blood grouping

CSF analysis to look for meningitis

Urine examination

Brain biopsy may be required in required some patients

Delirium: Treatment Conservative Treatment

Conservative treatment includes −

The mainstay of the treatment for delirium includes treating the underlying medical condition which is causing the delirium. This may involve antibiotics for an infection, discontinuing a medication causing delirium, or treating metabolic or electrolyte imbalances.

Symptomatic treatment should be done. Treating the symptoms such as agitation, hallucinations, or other behavioral symptoms with antipsychotic medicines is required. Sedatives such as benzodiazepines may be used to calm the patient.

Supportive care is important for these patients. These patients require close monitoring and supportive care to prevent complications and ensure their safety.

Patients with delirium require close monitoring and follow-up care to ensure that their symptoms are improving and that they are not experiencing any complications.

Surgical Treatment

Surgical treatment may be required in some cases to treat the underlying cause which is causing delirium.

Delirium: Prevention

Some of the measures taken can help to prevent delirium to a certain extent include −

Underlying medical conditions should be treated adequately

Avoid the medicines that may cause delirium

A good amount of sleep

A healthy balanced diet containing balanced vitamins and micronutrients

Adequate hydration with plenty of water

Providing appropriate sensory stimulation such as natural light, music, and engaging activities may help prevent delirium.

Family care and support

Early recognition and management of delirium are important to prevent complications.

The patient should be under close monitoring to prevent the patient from self-harm

Regular follow-ups can help to identify the recurrence rate

Conclusion

Delirium is a condition in which the consciousness, orientation, and perception of an individual are altered. The patient is confused, his/her thinking capacity is affected and talks about unrelated things, faces difficulty in remembering things, and is disoriented to time, place, and person. Various causes can result in developing delirium such as vascular conditions, infections, certain medicines, trauma, and electrolyte imbalance. The patient may be agitated or depressed.

The condition is diagnosed based on the symptoms, clinical examination of the nervous system, memory tests, and by observing the patient’s behavior. Investigations like imaging tests, CSF analysis, blood tests, and urine examinations are required to look for the underlying causes. Treatment mainly involves treating the underlying cause, treating the symptoms accordingly, and supportive care. The condition can be prevented by avoiding the triggering factors and medicines, adequate sleep and hydration, adequate treatment of their health problems, and by regular health check-ups.

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