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Superficial and deep local infections, systemic infections, allergic reactions, photodermatitis, granulomatous reactions and lichenoid reactions may occur. Skin diseases localised on the tattooed area, such as eczema, psoriasis, lichen planus, and morphea can be occasionally seen. When used as a camouflage technique, colour mismatch and patient dissatisfaction are common complications. On the other hand, regrets after a tattoo are also seen and requests for tattoo removal are rising. Laser tattoo removal using Q- switched lasers are the safest; however, complications can occur. Acute complications include pain, blistering, crusting and pinpoint hemorrhage. Among the delayed complications pigmentary changes, hypopigmentation and hyperpigmentation, paradoxical darkening of cosmetic tattoos and allergic reactions can be seen. Another common complication is the presence of residual pigmentation or ghost images. Scarring and textural changes are potential irreversible complications. 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Medical therapeutic tattooing has been used as a camouflage technique in vitiligo, for breast areola reconstruction after cancer surgery, as camouflage for permanent hair loss after craniofacial surgery, and scars following plastic and reconstructive surgery. There are currently few requirements or regulations and no legislation for the safety of tattoos. Sterility of the pigments and equipment is an uncertainty as many are being performed on the roadside and in makeshift salons. Consequently, the number of reported adverse reactions after tattooing has increased. These are often seen by physicians, but are generally unknown to the public.[2] The most common skin reactions to tattooing reported in the literature include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localised on tattooed area, such as eczema, psoriasis, lichen planus and morphea[3,4,5,6,7] [Table 1]. In addition there has been an exponential increase in patients seeking removal of tattoos for various psychosocial reasons, especially when names are tattoed and patients have a change of heart or a change of faith in case of religious symbols. Many occupations such as the armed forces prohibit the presence of tattoos and youngsters seek tattoo removal. It has been rightly sung by Jimmy Buffett, an American singer that a tattoo is a permanent reminder of a temporary feeling. Many people who get a tattoo will eventually want to get rid of it. Tattoo removal can also be a tedious prolonged procedure, particularly professional tattoos, hence there is an urgent need to caution youngsters before they get themselves a tattoo. COMPLICATIONS OF MEDICAL TATTOOSTattoos by physicians are used in certain medical conditions for camouflage, like resistant vitiligo,[8] breast areola reconstruction following surgery, scar camouflage following burns or surgery and hair camouflage for permanent hair loss following radiation or craniofacial surgery. In these settings infections are less common as compared to decorative tattoos as they are carried out in sterile environments, but general complications of tattoos can still occur. The commonest complications are changes in colour, leading to colour mismatch. In vitiligo it is essential to get a good cosmetic skin- coloured tattoo matching with the surrounding normal skin. This requires a great degree of skill and often a colour mismatch leads to worsening appearance of the patch and a dissatisfied patient [Figure 1]. ![]() ![]() This is more common on the lips, exposed skin and the acral areas. The colour can fade if the pigment is placed superficially or it can appear bluish due to the Tyndall effect if it is placed too deep [Figure 2]. Tattooing should be avoided when the skin is tanned, as when the tan fades, the tattoo will appear darker than the surrounding skin. Management for a mismatched tattoo in vitiligo is skin grafting if the tattoo fades, though it is difficult to cover the tattoo adequately if it is deep in the dermis. Small patches can be excised, followed by suturing. Colour mismatch of a skin- coloured tattoo on the exposed area used as a camouflage technique for vitiligo. Fading of the tattoo and bluish discolouration due to Tyndall effect on a patch of vitiligo. COMPLICATIONS OF DECORATIVE TATTOOSThese occur mainly due to the unsterile pigments that are implanted and unsterile conditions in which they are carried out. Different reactions have different times of onset as few of them appear immediately after the procedure and some may take days to weeks to years to appear [Table 1]. INFECTIONSTattooing involves physical injury to the skin that may promote the transdermal transmission of viral and bacterial infections, depending on the conditions of hygiene during tattooing. There are three potential origins of infections after tattooing. Firstly, use of contaminated tattoo ink. Secondly, inadequate disinfection of the skin area to be tattooed because of which resident skin bacteria can enter the skin during the tattooing process. Thirdly, during the healing process of the injured tissue after tattooing, patients often develop pruritus and burning.[9] This increases the risk of superinfection of the tattooed skin area due to scratching and therefore inoculating microorganisms.[1. Viral diseases. Transmission of hepatitis B and C virus,[1. HIV),[1. 3] human papillomavirus (HPV),[1. HSV)[1. 0] infection has been described. In a meta- analysis it was reported that there is an increased risk of infectious complications like hepatitis C when tattooing was not done in professional parlors.[1. There was no definite evidence when it was performed in professional parlours. Bacterial infections[1. Bacterial infections related to tattooing comprise infection by Streptococcus pyogenes leading to impetigo, erysipelas and even septicaemia, Staphylococcus aureus causing the rare toxic shock syndrome, skin and soft tissue infections caused by community- acquired methicillin- resistant S. CA- MRSA), treponema pallidum causing syphilis, infections with atypical mycobacteria[1. Mycobacterium leprae which causes leprosy. A study of 3. 1 female patients with leprosy lesions starting over tattoo marks was reported from a leprosy endemic area from India.[1. In most cases, improper use of hygiene regimens, particularly contaminated needles are causal, but sometimes, contaminated pigments are implicated. Fungal infections. A case of zygomycosis was observed after tattooing.[1. Severe systemic mycoses can be transmitted rarely by tattooing. A case of Candida endophthalmitis in a 4. Allergic and foreign body reactions. Classic pigments and their degradation products used in tattooing, such as dichromate (green), cobalt (blue), cadmium (yellow) and mercury salt (red)- based pigments are responsible for these kind of reactions with permanent tattoos. In addition, contamination of pigments with nickel sulphate can cause marked allergic reactions.[1. Liver Disease in Dogs | Treatment and Prognosis. Goals of Treating Liver Disease. The liver is unique in that it has a large reserve capacity and more regenerative capability than almost any other organ. As a result, canine liver disease typically can be treated, or at least managed, if a diagnosis is made early. Treatment depends upon the underlying cause of the condition. The goals of treating liver disease are to eliminate harmful toxins (or minimize their detrimental effects on the liver), promote healing and regeneration of liver tissue, prevent or control complications of liver dysfunction, treat the underlying cause when possible and keep the dog as comfortable and stable as possible until sufficient liver function can be restored. Treatment options include prescription and over- the- counter medications, dietary supplements, lifestyle changes, supportive care, surgical procedures and a number of other possible therapies that the attending veterinarian will discuss with her patient’s owner. Treatment Options. Treatment protocols for dogs with liver disease vary based upon the cause of the condition. Acquired liver diseases in dogs are extremely diverse, especially chronic disorders which are collectively referred to as “chronic hepatitis.” Chronic hepatitis in dogs refers to a range of disorders that have similar historical features and clinical signs. Hepatitis can be familial (especially in Bedlington Terriers, Doberman Pinschers, West Highland White Terriers, Skye Terriers and Dalmatians), but it also can be caused by infection, ingestion of certain drugs or toxins or by unknown factors. Treatment options for dogs with liver disease may include some or all of the following approaches and often will be long- term. Dietary Modification. Dietary adjustments are normally recommended to ensure that a dog with liver disease receives the caloric and nutrient intake necessary to support liver regeneration and to manage the effects of hepatic encephalopathy. So- called “liver diets” are commercially available but can also be homemade. They are designed to contain extremely digestible, high- quality but restricted levels of bioavailable protein, to reduce the metabolic demands on the liver. Protein restriction is important to reduce the levels of circulating ammonia, which comes from bacterial breakdown of protein in the gut. Non- meat protein sources, such as dairy products and eggs, generally are preferred in diets for dogs with liver disease. The attending veterinarian can recommend an appropriate diet, which might include carefully regulated portions of certain carbohydrates, vitamins, proteins, minerals and fats. Dietary sodium (salt) should be restricted in dogs that are retaining excess fluid in their abdomens due to liver disease. In addition to dietary changes, the veterinarian may suggest vitamin or other oral supplements that can promote liver regeneration and improve liver functioning, such as Vitamin E, Vitamin C, Vitamin K, zinc, S- adenosylmethionine (“SAM- e”), milk thistle (silybin) and/or Ursodiol. Treatment of Copper- Related Hepatitis. For liver disorders associated with abnormal accumulation of copper, the amount of ingested copper must be minimized. There are several commercially available prescription diets, and/or diets that can be made at home, that contain restricted copper levels. The attending veterinarian may recommend supplementation with zinc or copper chelating agents, which help remove these elements from the bloodstream. Medication. Drug therapy is warranted for many dogs with liver disease. Glucocorticoids (“steroids”) have been used to prolong survival times in dogs with liver disease due to their anti- inflammatory and immunosuppressive properties, although their use and appropriate dosage protocols are somewhat controversial. Azathioprine has been used to manage some of the adverse effects of steroid medications. However, azathioprine can contribute to bone marrow damage. Antibiotics are sometimes prescribed to combat bacterial infections, especially when hepatic abscesses are present. Other medications have been used to combat liver fibrosis, including colchicine. Studies of this anti- fibrotic agent in people with fibrotic liver disease show remarkable improvement in symptoms and survival rates. Some dogs have benefitted from its use as well, although reported side effects include diarrhea, vomiting and abdominal discomfort. Other medications are available to relieve vomiting (emesis), gastrointestinal bleeding and gastric ulcers, if present. These currently include ranitidine, famotidine and omeprazole, sometimes in combination with sucralfate. Lactulose is commonly prescribed in cases of hepatic encephalopathy to increase the dog’s gastrointestinal tolerance of proteins. Lactulose is broken down by bacteria in the colon and traps ammonia molecules there, making them non- absorbable and therefore excreted in the dog’s feces. Lactulose also changes bacterial metabolism so that less ammonia is generated in the first place. If the dog has seizures associated with its liver disease, barbiturates such as phenobarbital may be recommended, although generally barbiturates are avoided in cases of liver disease. Other medications will no doubt be developed over time to help treat the causes and consequences of liver disease. Drugs that require metabolism by the liver to become effective (or to be eliminated by the body) are normally avoided, and drugs are prescribed conservatively and in moderate doses in dogs with liver disorders. Protocols for medical management of canine liver disease are rapidly changing based on the results of scientific studies and drug trials. Supportive Care. Sometimes, liver disorders are treated only with supportive care, although normally supportive care accompanies other treatment methods. Intravenous or subcutaneous fluids may be given to resolve dehydration and restore proper electrolyte balance. Antacids or other medications for taxing symptoms like vomiting and diarrhea can be given. Of course, a safe, calm, quiet, temperature- regulated environment, a healthy diet and free access to fresh water are all essential. Blood Transfusion. Blood transfusions may be appropriate in dogs that have severe bleeding disorders associated with clotting and coagulation abnormalities caused by liver disease. Fresh whole blood, fresh packed red blood cells or fresh frozen plasma typically are used, because stored blood products contain high ammonia concentrations which are undesirable in most cases of liver disease. High ammonia concentrations contribute to the behavioral and neurological signs associated with hepatic encephalopathy. Surgery. When a dog has an identifiable liver or gall bladder mass, the treatment of choice usually is surgical removal. Internal hemmorhage is the most common complication of these surgeries, and fresh blood products should be available in case transfusion is necessary before, during or after surgery. Dogs with liver disease are anesthetic risks, because most anesthetic agents are processed by the liver. Chemotherapy and radiation therapy can be used for some forms of liver cancer. Unfortunately, treatment options are very limited for those cancers affecting more than one lobe of the liver, and for those that are metastatic. Newer Treatment Options in Development. New treatment options are being explored for companion animals with liver disease - especially for those with cancer (neoplasia). These include intra- arterial chemotherapy, trans- arterial chemoembolization, percutaneous ethanol injections, microwave coagulation and various immunotherapeutic strategies. While these potential therapies are beyond the scope of this article, owners of dogs with liver disease may want to discuss them with their veterinarian to determine the most current status of their development, availability and cost. Prognosis. The liver is a remarkably complex organ that can malfunction and yet recover in multiple ways. Specific treatment protocols and an accurate prognosis depend almost entirely upon the cause and extent of liver dysfunction. Only a veterinarian can assess which treatment methods are best in any given case of canine liver disease and provide an accurate prognosis for the patient in question. GameStop’s stores will be open on Thanksgiving Day this year, the company told staff during a series of conference calls this morning, according to two people who. File Not Found. We're sorry, the page you are looking for could not be found. The page may no longer exist or have moved to a new location. The new flick Pokémon: I Choose You! ditches Brock and Misty, but there’s something that might be even more surprising. (Warning: this article has spoilers!).Or, you may have followed an outdated link or mistyped the address in your browser. If you feel that the page you are looking for should be available, please let us know. Otherwise, you may browse the links below. Watch Movies Online Free in HD at Watch. Watch32 - Watch Movies on Watch32.com - Watch32 is the Biggest Library of free Full Movies. 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