User-agent: Google Allow: A Simple Guide to Medical Conditions: October 2007

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Sunday, October 14, 2007

A Simple Guide to Acne

A Simple Guide to Acne
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What is Acne?
-----------------

Acne is a skin condition which is characterised by papules, pustules and inflamed sebaceous oil glands.
It typically occurs on the face, neck, upper back, chest, or shoulders where the concentration of these glands are normally located.

What is the cause of Acne?
--------------------------------

It is a disease caused by the overactivity of the skin's sebaceous glands which are located at the base of the hair follicles.
Sebaceous glands produce an oily moisturising secretion (sebum)which helps to wax the hair growing from the hair follicle.

The sebum then empties into the skin's hair follicles which cover most of the body. Normally tiny skin cells shed so that new skin can replace the ones on the surfaces. When the shedding of such cells is abnormal, the opening of the hair follicle can be blocked. The result is a accumulation of sebum in the follicle which can easily become infected.

Bacteria Infection of the accumulated sebum produce pus
and toxins which then resulted in a infected swollen gland or infected pimple.
The infected pimples if severe may result in scars.

What are the Symptoms of Acne?
---------------------------------------

The severity of symptoms depends on the individual.
Acne usually occurs during puberty when the production of male hormone in teenagers both male & female are higher.

1.Small bumps which appear under the skin and have no opening are known as whiteheads.

2.Dark spots with plugged pores in the centre are blackheads.

3.Persistent, recurrent red spots or swellings on the skin, filled with pus, are pustules.

4.Lumps under the skin which are inflamed and solid are nodules, or if fluid filled are cysts.

Often the acne become worse during stress or using oily cosmetics or hair creams.
In girls the acne may be aggravated during menses or during pregnancy

What is the Treatment of Acne?
-------------------------------------

Reassurance of worries about their looks in teenagers is very important because it reduces stress and the production of more male hormones.

Fresh air, enough rest and a healthy lifestyle will help physically and psychologically.

A small amount of sun exposure may also help acne problems because of drying effect on the oily skin.

Avoid touching the acne spots with dirty hands because of increased risk to infections.

Do not try to squeeze the pimples.

Patients with minimal symptoms:
1. simple healthy skin care can resolve the problem.
Oily skin can washed with simple soap and water.
Topical medications that help to dry up the oil and promote skin peeling can be applied on the skin. Such products may contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or tretinoin, or retinoic acid (Retin-A).

2.antibiotics (such as tetracycline or erythromycin) is prescribed if the skin lesions appear infected.
Topical antibiotics (applied to a localized area of the skin) such as clindamycin or erythromycin are also used to control infection.

3.New treatment with synthetic vitamin A analogues (isotretinoin, Accutane) have been shown to be beneficial in the treatment of severe acne.
This medication is not to be taken by pregnant women and sexually active adolescent females because of the danger of deformity to the foetus.

4. Sometime oestrogen therapy (Diane 35) on a short term may benefit girls with very severe acne and whose menses are not regular.

It is important to remember that every person who has gone through puberty has some form of acne and usually do not have any complications or bad scarring with the condition.

Prognosis is very good for 99% of cases.

Saturday, October 13, 2007

A Simple Guide to Laceration

A Simple Guide to Laceration
-----------------------------------

What is a laceration?
-------------------------

A laceration is an injury to the skin and its underlying soft tissue when you are cut or hit by something.
A laceration is usually called a cut when the injury is caused by a sharp object breaking the skin. It may a clean cut without bleeding or if it damages the blood vessels in the skin, it can cause visible bleeding.
Lacerations can occur at any part of the body.
Healing time for a laceration depends on where it is on your body.
A laceration usually take longer to heal if it is over a joint such as the knee or elbow.

What are the signs and symptoms of a laceration?
----------------------------------------------------------

1.Lacerations may appear in all shapes and sizes.

2.It may look like a cut, tear, or gash.

3.The wound may hurt, bleed, bruise, or swell.

4.Lacerations may bleed a lot in areas of the skin which has a lot of blood vessels such as the scalp.

5.The wound may have edges that are close together, or gaping apart.

6.Sometimes there may be numbness around the wound due to a cut of the nerve endings.

7.Similarly there may be decreased movement in an area below the wound due to loss of nerve endings or tear of muscle fibres.

What are the complications arising from a laceration?
----------------------------------------------------------------

Even with proper treatment, a laceration can become infected:

1.Increased warmth to the area.

2.Redness or swelling to the area which becomes worse.

3.Pain in the area that increases over time.

4. pus or bad-smelling discharge from the wound.
Pus is milky and may be white, yellow, green, or brown.
It is the result of the white blood cells fighting the bacteria or virus.

Other complications may be:

1.the presence of foreign bodies

2.Injury to the bone( fracture)

3.Injury to the nerve

4.Injury to the blood vessels

5.Injury to muscles

What investigations may be necessary in Laceration?
--------------------------------------------------------------

If there is suspected foreign objects in your laceration, an x-ray may be required.

Foreign objects include things like metal, gravel, and glass.

If you have many wounds from a car accident, tests may include an ultrasound, a MRI, or a CT scan.

What is the treatment for a laceration?
----------------------------------------------

The doctor will want to
1.control the bleeding if your wound is bleeding a lot.

2.clean the wound with disinfectant.
This will remove dirt and other small objects and reduce the chance of infection.

3.look in the wound for foreign objects like dust, metal or glass splinters.

4.explore (probe) or close the wound under local anesthesia.
An anesthetic is a medicine which numbs the area so that there is no pain during the probe or surgery.

Closing the wound:
The laceration may need stitches, staples, other treatments to close the wound:
1.if it is deep or bleeds a lot.
2.if your wound is gaping open or
3.if the wound is in an area that moves a lot, such as the hands, feet, and joints.

Stitches also keep the wound from getting infected.
Stitches may decrease the amount of scarring.

If the wound is too old, it can not be stitched.
Some lacerations may heal better without stitches.

Special care:
Some lacerations need special care.
Laceration caused by bites from fish or marine life may need special medicines like antibiotics and antitoxins.
Antibiotics are not needed for most wounds.
Antibiotics are given if your wound has a high risk of infection.

If the laceration injure a bone, nerves, or blood vessels, there may be need for microsurgery to join the torn nerve or blood vessel.
A broken bone may also need to be treated conservatively or with surgery.

Tetanus injection:
Tetanus infection, or "lockjaw," can happen after any deep break in your skin. Tetanus can kill you. It is important for adults to get a tetanus shot at least every 10 years.
After an injury, a tetanus injection may be given if:
1. it has been longer than five years since your last one.
2.any wound that may have dirt or saliva in it.
3.Deep wounds also have a high risk for tetanus infection.

If necessary, tetanus injection should be given as soon as possible (within 72 hours of the injury).

What are the risks in the care of laceration?
---------------------------------------------------

A sharp object which passed through your clothing before cutting your skin may have caused small threads or bits of clothing to be pushed under your skin.
The risk of getting an infection is higher if there are foreign bodies in the wound.
Sometime even with the best care, there may still problems such as infection with your wound.
People who have diabetes have a higher chance of getting a serious infection in a wound.

Friday, October 12, 2007

A Simple Guide to a Bruise

A Simple Guide to a Bruise
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What is a bruise?
--------------------

A bruise is a bluish discolouration of the skin which occurs when tiny blood vessels are damaged or broken as the result of a heavy blow or fall.

The raised area of a bruise results from blood leaking from these injured blood vessels into the tissues.

A purplish, flat bruise that occurs when blood leaks out into the top layers of skin is referred to as an ecchymosis.

What are the causes of bruises?
-------------------------------------

Every person can get a bruise depending on the severity of the blow or injury.

However there are some people who are more prone to a bruise:
1.Age
The injury required to produce a bruise varies with age of the patient.
In the elderly person the skin together with its blood vessels has become thinner due to age, small knocks or scrapes of the skin may cause extensive bruising or ecchymosis as compared to a young person.
Bruising may even occur without prior injury in the elderly.

2. Medications:
In some cases bruising may also be affected by medications which interfere with blood clotting.
These drugs include many prescription arthritis medications called non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen as well as over-the-counter medications such as aspirin.
Warfarin is often prescribed to prevent clotting in patients who have had blood clots in their legs or heart. Warfarin can cause particularly severe bruising.
Corticosteroids medications, such as prednisone, promote bruising by increasing the fragility of the tiny blood vessels in the skin.

3.Inherited blood clotting problems
In addition, patients with inherited clotting problems (such as in hemophilia) or acquired clotting problems (such as in patients with liver diseases like cirrhosis), can develop extensive bruising or even life-threatening bleeding.

4. Blood cancer especially Leukemia patients tend to bleed more easily than normal people because of the low platelets.

How do you treat a bruise?
-------------------------------

There are a few things which can help:
1.apply a cold compress such as a cold water pack or an ice bag on the bruise.

2. Apply some cream like Silvadene (containing silver nitrate)which has the effect of coagulating the blood vessel and hence prevent more blood from leaking into the tissue.

3. Treat the cause .
In the case of leukemia blood transfusion may need to be given.

In most cases bruises disappear on their own within 1 week.

Thursday, October 11, 2007

A Simple Guide to Chronic Obstructive Lung Disease

A Simple Guide to Chronic Obstructive Lung Disease
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What is Chronic Obstructive Lung Disease?
------------------------------------------------

Chronic Obstructive Lung Disease (COLD) is a disease of the lungs characterised by the obstruction to the air flow in the airways of the lungs.

The narrowing of the airways together with distension of the air sacs beyond the terminal bronchioles with destruction of the alveolar walls over the course of many years damages the air sacs reducing the surface area left for the exchange of oxygen and carbon dioxide.

As a result the patient become increasingly short of breath.

What is the cause of Chronic Obstructive Lung Disease?
-------------------------------------------------------------

Chronic Obstructive Lung Disease is associated with
1.Chronic bronchitis .
Chronic bronchitis is an ongoing inflammation of the lining of the breathing tubes (the bronchi), which is caused by bacterial infection or cigarette smoke irritation.

As the inflammation progresses, the bronchi fill up with mucus resulting in a chronic cough, as the body attempts to rid itself of the excess mucus that is irritating the lungs. The excess mucus in the bronchi also makes the diameter of the bronchi narrower and reduces the amount of air that can pass through. There is obstruction to air flow and hence breathlessness.

Smoking is the main culprit here.

2.Chronic asthma-
the narrowing of the airtubes caused by spasm of the muscles of the lining the airtubes triggered off by the allergens can cause permanent damage to the airtubes causing obstruction to airflow and hence difficulty in breathing.

3.Emphysema -
here the narrowing of the airway extends to the smaller airways or bronchioles with damage and overdistension of the air sacs resulting in obstruction and less air getting through to the lungs.

4.Chronic infection of the lungs like pneumoconiosis and tuberculosis may cause damage to the lungs with difficulty in breathing and poor air flow.

In all cases of the above conditions air flow is impeded and there is hyper inflation of the lungs.

What are the Symptoms of Chronic Obstructive Lung Disease?
--------------------------------------------------------

Symptoms include:
1.Cough is usually the first symptom to develop.
It is usually a wet cough with phlegm(sputum).
Initially the cough is intermittent but becomes persistent as the condition progresses.

2. Excessive sputum or mucus is produced by the damaged airways.
This results in excessive production of phlegm

3.Chronic shortness of breath or shortness of breath occurs with mild exertion.
As the illness continues, breathlessness occurs even when sitting and can be very distressing to the patient.

4.There may even be breathing difficulty when lying down.

5.Wheezing may occur due to the sound of the air trying to squeeze through narrow airways.

6.Bluish coloration of the skin due to lack of oxygen

7.Dizziness can occur if the brain does not receive enough oxygen

8.Fatigue also occur when the body does not receive enough oxygen

Besides these main symptoms, other symptoms are:
1. Nasal flaring and bulging eyes

2.Vision abnormalities

3.Anxiety, stress, and tension

4.Ankle, feet, and leg swelling

5.Unintentional weight loss

6.Headache (especially in the morning)

7.Excessive daytime sleepiness

8.Insomnia

How is the diagnosis of Chronic Obstructive Lung Disease made?
----------------------------------------------------------

1. medical history of cough, excessive sputum, breathlessness and their duration.
Any history of smoking,asthma, exposure to environmental toxins.

2. Physical examination for barrel-shaped chest and flattened diaphragm.

3. Pulmonary (lung) Function Testing-
this is a very important tool used to confirm COLD.
The patient is asked to into a machine called the spirometer which measures the amount of air the patient is able to blow out from his lungs.
The readings from the spirometer will confirm the diagnosis of COLD and assess the severity.
It is also used to monitor the patient's progress.

4. Chest X-ray is useful as an aid in the diagnosis of COLD(hyperinflated lungs and depressed diaphragm is typical).
It is also useful to rule out other conditions besides COLD.
It also detects any complications of COLD.

What is the Treatment of Chronic Obstructive Lung Disease?
-------------------------------------------------------

There is no cure for COLD.

Medications and lifestyle changes may help in the relief of symptoms and preventing the progression of the disease.

Lifestyle Changes:
1.Stop Smoking is the most important step for a COLD sufferer.
While the damage to to the lungs cannot be reversed, stopping smoking will help prevent the progression of the condition.

2. Avoid air pollution and second hand smoke in the workplace and wear a mask if the air pollution index is high

3.Pulmonary Rehabilation- this involved a structured programme which includes education, exercise training,psychosocial support and instruction proper breathing techniques.
Benefits include improvement in the ability to exercise, reduced breathlessness and fatigue resulting in improvement in the quality of life.

4.Nutrition- eat a well balanced diet.
If chewing and swallowing interfere withbreathing, take small frequent meals.

5. Rest, meditation,adequate sleep are factors which will help improve your quality of life.

Medications:
1.Bronchodilators are medicines that relax the muscles aound the airways in your lungs, It opens the airways allowing air flow in and out of the lungs to improve. Bronchodilators may be taken orally or in inhalers.

2. Corticosteroids helps reduce airway inflammation and decrease the mucus production. Again these medicines can be taken orally or in inhalers.
Side effects are less with inhalers.

3. Antibiotics are taken to treat any underlying infection.

4. Vaccinations:
a.Yearly influenza vaccination is given if there is a higher risk of pneunomia if you suffer from influenza.
b.Pneumoccal vaccination for protection against pneumococcal infection.

Oxygen Therapy:Those wth severe symptoms may benefit from a regime of oxygen therapy for at least 15 hours a day.

Surgery:
Sometime removal of section of lung which has collapsed may improve symptoms. Sometimes a few may be considered for lung transplantation.

What are the Complications of Chronic Obstructive Lung Disease?
-----------------------------------------------------------

Most patients ends up with pneumonia and death because of the chronic progression of the disease.

Many if treated are able to live a long time before succumbing to pneumonia.

Other advice:

Air travel may be possible if the doctor deem that you are fit to travel.

Sometimes arrangement for oxygen and medications during the air flight may be necessary.

Wednesday, October 10, 2007

A Simple Guide to Endometriosis

A Simple Guide to Endometriosis

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What is Endometriosis ?

----------------------------

Endometriosis is a disorder of the endometrial tissues (which line a woman's uterus) in which these tissues are implanted in places outside the uterus, usually in other parts of the pelvic cavity and abdomen.

However, in women with Endometriosis, blood from the implanted endometrial tissue is trapped inside, becomes inflamed, and develops into scar tissue.

Because of this inflammation, severe pain, infertility and bowel problems occur.


What are the Causes of Endometriosis?

----------------------------------------------

The cause of endometriosis is still not known.

There are a few theories:

1.during menstruation, some of the menstrual tissue is pushed back through the fallopian tubes into the abdomen where it implants and grows.

2.it may be due to a genetic process

3.certain families are predisposed to endometriosis:

Higher socioeconomic groups

women who marry late and have no or few children

4.Stress may constrict the opening of the uterus .

Some endometrial tissues are pushed backward into the abdominal cavity instead of through the opening of the uterus


What are the Symptoms of Endometriosis?

--------------------------------------------------

Endometriosis occurs usually years after the periods begin.

Symptoms may worsen as the endometrial area increases in size.

However after menopause, the implanted tissue shrinks away and the symptoms subside.

Common symptoms include:

Severe menstrual cramps

Pelvic pain apart from menstrual periods

Diarrhoea or painful bowel movements during menses

Menstrual irreuglarities

Menorrhagia

Painful intercourse

Backache

Pain with exercise

Painful pelvic exams

Painful and frequent urination

Bloating

Constipation

Fatigue


How do you made the Diagnosis of Endometriosis ?

------------------------------------------------------------

A diagnosis can only be made via laparoscopy.

A laparoscope is a tube with a light in it which is inserted through a small incision in the navel area. The misplaced endometrial tissue can then be found and the location, extent and size of the endometriosis detected.

What is the Treatment for Endometriosis?

----------------------------------------------------------

There is no cure for endometriosis.

If the symptoms are mild, only medication for pain is required.

Treatment depends on the size, extent of the lesions, age of the patient and the desire for pregnancy.

If these women want to be pregnant, the best course of action is to have a trial period of unprotected intercourse for 6 months to 1 year.

Once pregnancy occur, the endometriosis will cleared by itself because there is no menses for nine months. Whether the endometriosis will recur after delivery depends on the patient. Most patients do not have a recurrence.

If the patient is not seeking pregnancy and where specific treatment of the endometriosis is required, hormone suppression treatment may be tried. This prevents ovulation and less endometrial tissue is formed. Because of this the endometriosis may reduced resulting in less symptoms. A course of treatment may last 6 months.

Where hormone suppression therapy do not work, some patients may require surgical treatment to remove the endometriosis tissue in the abdomen.

In severe cases, where the uterus and ovaries are affected, removal by surgery of the uterus and/or ovaries is required especially in those nearing menopause or who do not wish to be pregnant.

Tuesday, October 9, 2007

A Simple Guide to Chlamydia

A Simple Guide to Chlamydia
-----------------------------------


What is Chlamydia?
------------------------


Chlamydia is a bacterial infection which is one of the most common sexually transmitted diseases.
It used to be called Lymphogranuloma venereum because of the typically enlarged lymph nodes at the groins.
It can lead to pelvic inflammatory disease (PID), as well as sterility and pregnancy problems.

How do you get Chlamydia?
--------------------------------


Chlamydia is highly contagious.
It spreads by sexual contact with an infected partner.

It can also be transmitted from mother to child during birth.
This may lead to an infection of the eyes and lungs in the infant.

It is also be transmitted through casual sexual contact with other people.

What are the signs & symptoms of Chlamydia?
------------------------------------------------------


About 80% of women and 10% of men display no symptoms.

For the rest the symptoms often appear 7-14 days after transmission in the following ways:

For men:

1.Discharge from a papule on the penis

2.Burning pain and itching when urinating.

3.lymph nodes enlargement at inguinal regions

4. Anal infections in homosexuals

Symptoms present early a few days after exposure, go away, only to return.
Advanced Chlamydia infection may lead to inflammation of the sperm duct (epididymitis), proctitis (anal region) and sterility.

For
women:

1.Vaginal itching or discharge.

2.Abdominal pain,

3.Bleeding between menstrual periods

4.Low grade fever

5.Anal infections

The disease can also cause cervicitis, endometritis and pelvic inflammatory disease which can result in sterility.

For infants:

1.Fever

2.Pneumonia

3.Conjunctivitis

Symptoms usually show up one week to one month after exposure.

Besides the above symptoms, headache, conjunctivitis, skin rashes, nausea and vomiting can be present.

How can Chlamydia be detected?
---------------------------------------


Women may be tested through the insertion of a swab into the cervix during a pelvic exam.

Men can be examined by inserting a swab into the urethra to take a specimen.

Urine testing can also be done for both sexes.

Blood test for chlamydia can also be done.

What is the Treatment of Chlamydia?
--------------------------------------------


Early treatment is important as it can protect against problems like pelvic inflammatory disease as well as sterility and pregnancy problems.

Patients typically undergo antibiotic treatment (usually tetracycline or sulphonamides) for a week.
The medication can be taken orally.
This treatment must be followed through even when symptoms of Chlamydia disappear.

Alcohol should be avoided when taking antibiotics
, as well as milk and other dairy products.

Where Chlamydia has been transmitted through sexual contact, it is essential that both sexual partners are treated for the disease.

It is recommended that both partners abstain from sexual activity from the time of diagnosis until they have completed treatment.

Follow-up treatment is also important, as doctors need to make sure the infection has been cured.

How can I avoid contracting Chlamydia?
------------------------------------------------


The best way to prevent Chlamydia is through improved hygiene standards and lifestyle changes.

Sexually active persons should use condoms.

Abstinence is recommended for those infected and on antibiotic treatment.

One's risk for Chlamydia, or any other sexually transmitted disease, increases with the number of sexual partners.
Prevention is always better than cure!

Monday, October 8, 2007

A Simple guide to Stress

A Simple guide to Stress
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What is Stress?
-----------------

Stress is a very common condition characterised by exaggerated worry and tension.
People with stress worry excessively about money, health, family, or work, even though there are no signs of trouble.
They are unable to relax and may suffer from insomnia.

What are the common warning signs of stress?
------------------------------------------------------

The signs vary from person to person.
Some of them are:

1. Headaches
2. fast heartbeats
3. Muscle tension; muscle aches
4. muscle tremors
5. Inability to concentrate
6. Stomach ache
7. Diarrhoea
8. Chest pain
9. Breathlessness; hyperventilation
10.Dry mouth
11.Excessive sweating
12.Cold clammy hands
13.Under eating or overeating
14.Anxiety or panic
15.Irritability
16.Hyperactivity
17.Loss of sex drive
18.Fatigue
19.Sense of impending doom
20.Difficulty in falling asleep or frequent nightmares

Other signs may include chills, thirst, dizziness, nausea, fainting, twitches, vomiting, weakness, stuttering,shaky and strained voice,high-pitch laughter and higher blood pressure.

Even for children of school-going age, there are stress.
Symptoms include:

1.Fear of being away from the family
2.Refusal to go to school
3.Fear of strangers
4.Fear of falling asleep or having recurrent nightmares
5.Unnecessary worry

What can we do to lower our stress level?
------------------------------------------------

There are some ways to manage Stress:

1.Be more organised.
Plan your time well.
Do a list of all the things you need to do.
Arrange them in order of importance.
Decide how much time you need for each job.
Keep to your plan.

2.Give yourself time to adjust from one change to another.
Spread out the changes in your life.
Don't do too many things at one time.

3.Always do your work according to your own ability and interest.
Be realistic about what you can do.
Do not ask for the impossible.
Set goals which are achievable so that you don't feel frustrated or discouraged.

4.Think before making decisions.
Get all the relevant information first.
Don't decide blindly.
Consider all the pros and cons of each choice.
Get the people who will be affected by the decision involved in the process.

5.Learn to like yourself.
Don't worry about your external appearance and other faults.
Make the best of what you have.
Accept what you cannot change.

6.AlwaysThink positively.
Prevent negative feelings from building up.
Try to find the source of these feelings.
Always deal constructively with them.
Do not blow things out of proportion.

7.Do not keep all your problems and worries to yourself.
Remember you are not alone.
Share your problems with your spouse, friend or supervisor .
They may have had experience with similar situations.
They may be able to solve your problem.

8.Always build a happy family.
Be kind and loving to your family.
They will provide you with love and support in your times of need.
Always set aside some time each day to talk, play or relax together.
Your home should be a happy place to return to after a hard day's work.

9.Have good friends.
You also need good friends to talk to and laugh with.
They will visit you, go out with you and help you in times of need.
Treat others the way you would like them to treat you.
Respect their views and be patient with their faults.
Always try to give and take.

10.A healthy body is important to overcome stress.
Keep healthy by exercising regularly, eating wisely and getting enough sleep.
Do not smoke or drink to relieve your stress.
Smoking and drinking do not solve anything.
They will cause more problems for your health.

11.Spend some time on yourself.
Do something that you really enjoy like a hobby or an exercise.
Take a short break when you feel tensed or tired.
You deserve to have a little fun sometimes.

12.Try to learn some Relaxation Techniques:
Deep breathing exercise,
meditation,
massage and
muscle relaxation techniques
can be helpful in relieving stress.

What is the Treatment of Stress?
---------------------------------------

Stress can be treated with conventional medicine, psychotherapy and alternative approaches.
A combination of conventional and alternative methods has been shown to be effective.

Conventional Medicine
Psychotherapy and psychoanalysis helps to identify the buried conflicts and worries that may be causing the stress.

Behaviour modification, on the other hand, focuses on changing patterns of behaviour to help the patient avert stress or to cope better with it.

Cognitive therapy similarly concentrates on changing ways of thinking.

One of the best forms of treatment for stress is daily exercise and a healthy lifestyle.

Medication relieves symptoms of stress and is often prescribed in conjunction with other therapies.

Alternative Medicine:
--------------------------
music therapy,
yoga,
herbs and
aromatherapy
are some ways that have helped stress sufferers to relax.

"Remember that you are not alone.
There are always people who are willing to help you.
In this life you must always give and take.
Be happy! Don't worry unnnecessarily!"

Sunday, October 7, 2007

A Simple Guide to Malaria


A Simple Guide to Malaria
---------------

What is Malaria?
-----------------

Malaria is a parasitic disease transmitted to humans through the bite of infected Anopheles mosquitoes characterised by high fever at certain times of the day, chills and rigors.

What is the cause of Malaria?
-----------------------------------

The cause of Malaria is a parasite called Plasmodium of which there are 4 species:
P.vivax,
P.falciparium,
P.malariae and
P.ovale.
When the parasites (Plasmodium) enter the blood in the human body through the mosquito bite, they travel to the liver.
In the liver after 6 -14 days depending on the species, they mature and then re-enter the bloodstream and infect the red blood cells.
There they multiply inside them.
Within 48 hours of becoming infected in the case of P.vivax, falciparium,and ovale, the red blood cells rupture, releasing more parasites (merozoites) which in turn infect more red blood cells.
In the case of P.malariae, the cycle is 72 hours.
Malaria causes anaemia by the rupturing of the red blood cells.
The large amounts of free haemoglobin released into the circulation after red blood cells rupture accumulate in the liver and spleen causing enlargement.
The symptoms of Malaria occur in cycles of 48 to 72 hours, due to the massive release of merozoites into the bloodstream.

What are the Symptoms of Malaria?
------------------------------------------

1.Fever, chills and sweating -
fever is high coinciding with the release of merozoites in the blood stream.
It drops to a lower fever, then goes up again when the parasites are released into the blood stream again.

2.muscle pain & rigors -
due to the high fever and sweating

3.headache, nausea and vomiting -
due to high fever and liver infection

4.jaundice with enlarged and tender liver
due to infection of the liver

5.anaemia and bloody stools
due to the rupture of the red blood cells

6.convulsion and coma
if the brain is affected.

What are the investigations done in Malaria?
-----------------------------------------------------

Blood smear tests for the malaria parasite-
a thick blood smear done at the height of the fever is able to show up the parasite more accurately than a thin blood film done randomly.

Blood tests for anemia, liver and kidney functions.

What is the Treatment of Malaria?
----------------------------------------

Malaria is treatable and curable.

Antimalarial drugs are readily available.
Drugs used include chloroquine, quinine and primaquine.
The drug used for treatment depends on factors such as
1. age,
2. where the malaria was acquired (as the malarial parasite from certain areas may be resistant to common ant-malarial drugs),
3.drug allergies and
4.G6PD deficiency patients who can have severe reactions to quinine based drugs.

For patients who have G6PD deficiency or are allergic to quinine drugs, the use of Lariam(mefloquine), Malarone(Atovaquone) and Doxycycline have been used effectively against the Malaria parasite.

In severe cases, the person suffering from malaria may require treatment in the intensive care unit of a hospital, especially if there are complications involving the brain or kidneys.

What is the Prognosis of Malaria?
---------------------------------------

The outcome is expected to be good in most cases of malaria with treatment,
but poor in Falciparum infections with complications.

What are the Complications of Malaria?
------------------------------------------------

Complications are liver, kidney, spleen or brain damage usually as a result of bleeding and ruptured red blood cells.
1.liver failure and kidney failure
2.destruction of blood cells (haemolytic anaemia)
3.meningitis
4.rupture of the spleen and subsequent massive haemorrhage

What is the Prevention measures against Malaria?
-----------------------------------------------------------

There is no effective vaccine against malaria.
Antimalarial drugs may be given prophylactically to persons travelling to areas where the disease is widespread, or to pregnant women in areas in which the disease is endemic.

Antimalarial drugs should be prescribed for visitors to areas where malaria is prevalent at least one week before entering the area, and continue for 2 weeks after leaving the area.
The types of antimalarial medicine prescribed will depend on the drug-resistance patterns in the areas to be visited. It is very important to know the countries and areas you will be visiting to obtain appropriate preventive support for malaria.

What is the prognosis of Malaria?
---------------------------------------

Most cases of Malaria are completely cured.
In rare cases, reinfection may occur if the patient remains in the endemic area without proper prophylaxis.

How do you prevent Malaria?
-----------------------------------

Preventive measures are concentrated on getting rid of the anopheles mosquito by removing all possible breeding grounds such as places containing stagnant water.

Use of insecticides and natural biologic predators of mosquitoes will help to reduce the population of the anopheles mosquito.

Saturday, October 6, 2007

A Simple Guide to Cancer

A Simple Guide to Cancer
------------------------------

This is a summary of all the articles that I have done on the different types of Cancer.

There is a common thread which runs through all the articles such as the risk factors, causes and treatments.

What is Cancer?

-------------------

A normal cell can be compared to a "hero" because it saves the body by repairing any damage or injury to the tissues of the body.

A person's body is made up of many types of cells which normally grow, divide and die. Sometimes, the cells mutate (change to abnormal cells) and begin to grow and divide more quickly than normal cells.

Rather than dying, these abnormal cells clump together to form tumors.

If these tumors are cancerous (also called "malignant"), the cancer cells can invade and kill your body's own healthy tissues becoming a "villian" in the process.

By contrast, noncancerous tumors (also called "benign") do not spread to other parts of the body.

What are the dangers of Cancer?
--------------------------------------

Normal healthy cells grow and multiply in an orderly, controlled manner.

Cancer cells on the other hand multiply uncontrollably.

They do not function normally and instead form a growth or tumour which can enter the blood and spread to nearby tissues and organs as well as to other parts of the body.

Cancer kills by:

Destroying important organs
Disturbing normal body functions
Blocking important blood vessels or air passages.

Cancer is really a group of diseases. There are many types of cancer which can arise from the different types of cells in the body.

What are the most common cancers?
--------------------------------------------

MOST COMMON TYPES OF CANCER IN THE WORLD ARE:
Lung
Colon & rectum(large intestine)
Breast
Ovary
Stomach
Cervix(neck of the womb)
Liver
Prostate
Nasopharynx(back of the nose)
Lymphomas

What are the causes of Cancer?
-------------------------------------

1. Genetic -family history,chromosonal abnormality

2. Viruses & Bacteria -hepatitis B, Epstein Barr, HIV : Helicobacter pyrori

3. Smoking - chemicals from cigarette smoke

4. Alcohol - liver cirrhosis

5. Chemicals -pesticides, asbestos,preservatives,chemotherapy, aflatoxins

6. Radiation -from sun rays, x-rays, radiotherapy,nuclear plants

7. Obesity - fat can cause breast, ovarian cancer

8. Age - mutations increase with age

How can you prevent yourself from cancer?
---------------------------------------------------

Cancer can be prevented.

Cancer is not contagious like the flu or chickenpox.

About one-third of all cancers can be prevented from occurring:
1. A healthy lifestyle
------------------------
get some exercise, a well balanced diet and avoid stress.

2. Smoking
-------------
avoid cigarettes and cigarette smoke.

Cigarette smoke contains about 40 different cancer-causing substances.

Almost all of those who develop lung cancer are smokers.
Smoking also causes cancers of the mouth, throat, larynx , oesophagus, stomach, pancreas, kidney and bladder.

Breathing in other people's smoke can increase your risk of developing lung cancer, so ask any smokers not to smoke in your presence.

What you can do
Don't smoke.
If you do, then stop.
Ask your family and friends to support your efforts to quit.
Get rid of all your cigarettes and lighters.
Enrol in a programme that helps smokers to quit.
Spend less time with friends who smoke.
Spend more time with non-smoking friends in smoke-free places.
There are chewing gum and skin patches with nicotine to help you to stop smoking.

3.Food and chemicals
--------------------------
avoid any cancer causing chemicals such as asbestos or nitrosamines from preserved food.
The chemicals used to preserve foods like ham, bacon, luncheon meat may form cancer-causing substances when they are digested.

These substances have also been found in salted or preserved foods (such as salted fish or pickled vegetables) and may lead to cancer of the stomach and nasopharynx.
Eat them less often.

Peanuts, seeds and grains that are not stored properly often become mouldy.
Some of these moulds produce toxins(aflatoxins) that can cause liver cancer.

What you can do:
1.Have some fresh fruits and vegetables at every meal. Fruits and vegetables contain vitamins and fibre which help to reduce the risk of developing colorectal and stomach cancer.
Choose dark-green leafy vegetables and orange-yellow fruits as these contain greater amounts of vitamins and minerals.

2.Take more fibre by eating wholemeal bread or wholegrain cereals such as brown rice.

3.Eat less salted, pickled, preserved and processed foods.
Store nuts in air-tight containers to prevent them from going mouldy.

4.Obesity
-----------

People who are overweight are more likely to develop cancers of the colon, rectum, breast and prostate.

What you can do
Exercise regularly .
To maintain a healthy weight, take up a regular exercise or sport.
Aim to stay in the healthy weight range.
Exercise for at least 20 minutes three times a week.
Play a game or sport that you enjoy and can do with your friends or family.

Eat less foods high in fat or sugar.
Trim away fat from meat and skin from poultry before cooking.
Change to foods low in fat like skimmed milk, reduced fat cheese or low-fat yoghurt.
Use low-fat cooking methods like stewing, baking, steaming or boiling instead of deep frying.
Choose healthier snacks like fresh fruit or wholemeal crackers.

5.Radiation
--------------
radiation from sun, x-rays, nuclear plants can cause damage to the skin,bones and other organs of the body resulting in cancer.


What you can do
Avoid sunburn and prevent overexposure to the sun.
The ultraviolet rays from the sun damage the skin.
Sunburn may lead to skin cancer.
Avoid overexposure to the sun, especially if you are fair-skinned.
Stay in the shade whenever possible.
Wear a hat or a cap.
Use a sunscreen or sunblock with a sun protection factor of at least 15 on any exposed areas of skin.


6. Workplace chemicals
----------------------------

exposure to cancer-causing substances at work can lead to cancer of lungs, liver, kidneys, skin. Always follow the safety regulations as they are meant to protect you.

What you can do
Hide behind protective shields or stay in the "safe" area.
Remember to wear protective equipment (like gloves, masks or goggles).
Be careful when you handle the equipment or the chemicals.
Learn about safety drills and what to do in case of emergencies.

6.Alcohol
-----------
People who frequently drink large amounts of alcohol are likely to develop liver cancer.
They are also at risk of developing cancer of the mouth, throat and oesophagus .

What you can do
Limit yourself to not more than two standard drinks a day.
One standard drink is roughly equal to:
One can of beer(285 mls)
One glass of wine (120 mls)
One measure of spirits(30 mls)

Alternate your drinks with non-alcoholic ones.
Drink them slowly so they last longer.

How to screen for Cancer:
-------------------------------
Mneumonics for Warning Signs of Cancer
-------------------------------------------------

Be on the alert for: CANCERS

1.Changes in bowel or bladder

2.A lump in breast or elsewhere

3.Nagging cough, hoarseness,

4.Changes in the size, shape or colour of a mole on the skin

5.Extraordinary bleeding from the nose or any other part of the body, and blood in the stools.

6.Reccuring Indigestion

7.Sore or an ulcer anywhere on the body, including the mouth, which does not heal properly.


Look out for these early warning signs and let your doctor know.

What you can do
Inform your doctor about it right away.
He can examine you and do some tests to find out if your problem is serious.

Regular breast self examination (BSE) helps to detect breast cancer at a stage when it can still be treated and even cured.
Learn how to do BSE properly and then do it every month.
See your doctor for a breast examination once every two years.
Women over 40 should see their doctor once a year.
Mammograms are special X-rays of the breasts to look for lumps.
They are usually recommended for women over 50.

Regular Pap Smears at least once in 2 years should be done for women who are sexually active. A Pap smear is a simple, quick and painless test that detects cervical cancer at an early stage when it has a good chance of cure.

Women infected with certain sexually transmitted diseases have a higher chance of getting cervical cancer.

Speak to your doctor about your personal and family medical history of cancer.
Certain medical conditions may increase your risk of developing some cancers.
Examples are people who are carriers of the Hepatitis B virus are more likely to develop liver cancer.
Some cancers (like breast and colorectal cancers) tend to run in families.
If your parents, brothers or sisters have had cancer, discuss it with your doctor.
If you have any risks of cancer, the doctor can tell you what steps you can take to reduce your risk of developing cancer.
He may recommend some screening tests to help determine your risk for developing the same cancer.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.
Recognising the early warning signs and going for regular check-ups can save your life if cancer strikes.

What are the Treatment of Cancers ?
-------------------------------------------

Basic treatments for cancer are traditionally surgery, radiotherapy and chemotherapy.

However with the advancement of medical treatment, there are more choices of treatments.

Surgery - is still the mainstay of cancer treatment in the early stages and other stages except for leukemia, nasopharyngeal and some rare cancer.

Radiotherapy-standard, intensity modulated radiotherapy, stereotactic radiotherapy, interventional radiotherapy.

Radiotherapy is used particularly in nasopharyngeal cancer, brain cancer and in conjuction with surgery. It can be curative as well as palliative( help to relieve pain)

Chemotherapy - standard,molecular targetted therapy is fast becoming the choice for many cancers because of newer drugs with lesser effects and more effective than before.

Hormonotherapy - espcially for breast,ovary,uterine,prostate, testicular cancer

Immunotherapy - immune systems are boosted with vaccines against certain viruses such as HPV(Human Papilloma Virus)

Stem cells - can help in replacing killed cancer cells with normal cells usually used in conjunction with chemotherapy

Bone marrow transplant - similar to stem cells therapy

Organ transplant especially in liver cancer

Other ways of treatments:

Healthy life style will help to strengthen the patient during the cancer treatment

Well balanced Diet will also help to improve the healing process

Meditation and avoidance of stress reduce the reduced immunity of patients and pyschological effect of cancer treatment

Finally:

Cancer can be cured.

Many people are afraid of cancer because they think it is incurable.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.

Modern medicine has also improved the survival rates of most cancers.

Friday, October 5, 2007

A Simple Guide to Scabies


A Simple Guide to Scabies
-----------------------------

What is Scabies?
--------------------

Scabies is a contagious skin disease caused by the mite Sarcoptes scabiei characterised by intraepidermal burrows, itchiness and secondary skin infections.

The female mite burrows into the skin and deposits her eggs and faeces. The eggs hatch in 3-4 days into larvae which then becomes nymphs, moulting to adults mites in 14 days.The skin becomes extremely itchy and red lesions appear in the skin.

Retirement and nursing homes are ideal breeding grounds for the parasite, which needs a human host to survive. Some child care centres may also be the place for spread of the skin parasite.

What are the Symptoms of Scabies?
------------------------------------------

1.itching which is worse at night

2.characteristic burrow lines on the skin with papule at one end.

3.rashes and abrasions on the skin due to scratching and secondary infections.

Rashes typically are present on legs and arms, sometimes on the body , seldom on the face. Rarely it may be present on the scalp. Mode of transmision is by direct contact with a person with scabies.

How to confrim the diagnosis of Scabies?
------------------------------------------------

Skin scrapings can be examined microscopically for the scabies parasite.

What is the Treatment of Scabies?
----------------------------------------

Scabicides (chemicals to treat scabies) actually contain mild insecticide :

Benzyl benzoate lotion

Malathion lotion

Gamma benzene hexachloride cream

Permethrin cream

Bathing is followed by application of the scabicide to the whole body from the neck to soles, left for 24 hours.

For some children under 2 years, the elderly in rest homes and others with reduced resistance, the scalp and face also needs to be treated.
A single overnight application of the scabicide(8 hours) is washed off the following morning .A second application four to seven days later is often recommended.

Treatment of contacts may be required if there is obvious signs of scabies.

While the scabies mite cannot live off the human skin for longer than 24 hours, each treatment with scabicide should be accompanied by washing, in hot water, of bedsheets, pillow cases and any clothes worn over the previous week.

Most people improve within a few days of treatment but it may take 4-6 weeks for the itch and rash of scabies to go away completely.

Thursday, October 4, 2007

A Simple Guide to Backache


A Simple Guide to Backache
----------------

What is Backache?
-----------------

Backache is a symptom, not an illness.
It is one of the most common complaints.

The complaint may be:
1.Constant aching, pain or stiffness that occurs anywhere along your spine, from the base of the neck to the hips.

2.Sharp pain in the neck, upper back, or lower back, especially after lifting heavy objects or other strenuous activity.

3.Chronic ache in the middle or lower back, especially after sitting or standing for long period of time.

Who suffer from Backache?
--------------------------------

About 80 per cent of people will experience back pain at some point in their lives.
More men suffer from it than women.
Backache is most common among people in their middle age.
Backache also occurs among young people aged between 16 - 24
Backache can also be hereditary (example: ankylosing spondylosis)

What causes Backache?
----------------------------

Acute Backache
Acute backache may occur due to
1.back strain from the lifting of a heavy object,

2.from a fall,

3.violent jerk as a car suddenly stops.

4.fracture of the spine or the dislocation of a vertebral disc

Chronic Backache
Chronic backache may be caused by

1.Osteoarthritis with degeneration of the spinal column when one vertebra slips forward on the one immediately below it

2. slipped disc. The discs act as cushions between two vertebral bones but due to degeneration in old age, or in cases when the spine has been injured before, a slipped disc may occur.

3.Bad posture can also lead to chronic backache such as sitting for long hours in an incorrect position. The right position is to stand up or sit up straight instead of slouching in a couch when watching TV. If the bad posture is prolonged, backache may occur.

4.sprains in the muscles of the back and

5.gynaecological problems (such as ovarian tumours,fibroids) and pregnancy.
6. Chronic infections of spine such as Tuberculosis

7. Cancer of the organs of pelvic region such as bladder or prostate

8. Cancer of the spine from primary bone marrow or secondary spread.

How can Backache be prevented?
--------------------------------------

1.Maintain the correct posture at all times. When standing or sitting, ensure that your back is kept straight instead of a slouched position.

2.support your back and use a cushion when necessary.

3.Correct furniture can also help to prevent the occurrence of backache.
Use chairs of a proper height in relation to the table or desk.

4.Sleep on a firm mattress

5. Do not wear high heels

6. Keep your back straight when carrying heavy item.Keep the item close to the body.

7.Do not bend the back to carry heavy objects. Bend the knees and keep the back straight

8.Exercise is another good way to prevent backache by strengthening the back muscles. However, if you have had back injuries before such as a slipped disc, do be cautious when you exercise.

What to do when Backache occurs?
-----------------------------------------

1. maintain good posture and rest the back.

2.Ice packs can provide relief for backaches. Ice packs will help to reduce the swelling and inflammation.

3.Heat treatment will help improve circulation and reduce stiffness.

4.Painkiller like paracetamol may relieve pain

If pain persists, do consult a doctor.

When should you see a doctor for Backache?
---------------------------------------------------

You should see a doctor under the following conditions:
1. backache is severe and acute.

2.backache starts suddenly and is severe enough to prevent you from work.

3.backache is accompanied with associated pain in legs or weakness and tingling in the legs or back.

4. painkillers and other therapies do not help to relieve pain and your backache is getting worse.

5.pain increases when you cough or bend forward at the waist. This could be a sign of a herniated disk. Try to lie flat with a pillow under your knees.

6.pain follows an injury and is accompanied by sudden loss of bladder or bowel control. If you have difficulty moving any limb, or if you feel numbness, pain, or tingling in a limb, you may have injured your spinal cord.

7.backache is accompanied by nausea, vomiting, fever, muscle weakness, pain down an arm or leg, or bowel or bladder disturbances

8.pain is still present after two to three days of rest.

9.pain lasts longer than 72 hours.

10.pain radiates into the legs,

11.other symptoms such as unexplained weight loss occur,

12.pain is in one side of the small of your back accompanied by a sick feeling and fever. You may have a kidney infection.

13.the pain in your back extends downward along the back of the leg. You may be suffering from sciatica.

14.dull pain in one area of your spine when trying to lie down or getting out of bed, especially if you are over 50 years of age. You may be suffering from osteoarthritis.

15.pain is felt in both thighs when walking. This can be a symptom of spinal stenosis (the narrowing of the lower spinal canal).

16.persistent backache may also be an indication of an undetected cancer of the colon,ovary,bladder or prostate.

How to investigate the cause of Backache?
--------------------------------------------------

1.Full medical history especially of injuries, type of work, onset of pain,radiation to the arms or legs, changes in bowel or bladder habit, loss of weight

2. Full medical examination especially of movement of the back ,any deformity of the spine, abdominal swelling, straight leg raising test

3. X-ray of the Spine: to exclude fracture, osteoarthritis, dislocation,deformity, bone tumour,

4. X-ray of abdomen to exclude any tumours in the abdomen pressing against the spine

5.MRI of spine for slipped disc,tumours,fracture

6.Bone density test to exclude osteoporosis

7.Blood tests for calcium, protein,kidney function,cancer markers, RA factor

8. Urine and stool tests for blood,

A definite diagnosis can then be made and the cause of the pain treated.

What is the Treatment of Backache?
-------------------------------------------

Symptomatic:

Painkillers and muscle relaxants

Ice packs or heat treatment

Physiotherapy to strengthen muscles

Good posture and firm mattress

Avoid aggravating factors like high heels, overstretching muscles,excessive strenous activities

Curative:

The cause must be found and treated. Examples are fractures due to injury.

Causes like cancer and aged related illness(osteoarthritis) may not be cured but may improved with treatment.

Wednesday, October 3, 2007

A Simple Guide to Mumps

A Simple Guide to Mumps
------------------------------

What is Mumps?
--------------------

Mumps is a highly contagious viral infection that causes painful swelling in the salivary glands (the glands which produce saliva) which include the parotid, submandibular and submental glands.

How is Mumps spread?
---------------------------

The mumps (paramyxovirus) virus is spread by coughing, sneezing and through the saliva of an infected person.

It can also be spread by contact with contaminated items and surfaces.

It is contagious 1 - 2 days before the appearance of symptoms to 1 - 2 days after the symptoms disappear.

The incubation period is about 18 days.

An attack gives lifelong immunity.

Who is infected in Mumps?
-------------------------------

Although mumps may affect adults, children between the ages of 5 - 15 years are most prone.

What are the Symptoms of Mumps?
-----------------------------------------

Symptoms
1.Prodromal symptoms such as fever, headache and sore throat

2.Facial pain and swelling

3.pain or lumps in their testicles

4.Abdominal pain

Signs:
1.Swollen and tender parotid glands in front of the ear, cheek and neck.
Submandibular glands below the jaws are less affected

2.Dry mouth - less saliva ,fever

3.Males may experience pain or lumps in their testicles, and swelling in the scrotum. However this rarely causes infertility problems.

4.Pain in the abdomen may indicate pancreatitis, a rare complication

5.Meningoencephalitis (infection of the central nervous system) with fever, headache and neck rigidity. It usually does not cause permanent damage.

What is the Treatment of Mumps?
----------------------------------------

Mumps is a viral disease and cannot be cured.
It normally run its course within 1 week.
Treatment of mumps is therefore symptomatic.

1.Rest and soft diet.

2.Lots of fluids

3.Paracetamol can be given to reduce fever and relieve pain. For children, aspirin should not be given because of the risk of Reye's syndrome which can damage the brain.

4.Warm or cold compresses can be given to relieve pain and swelling in the parotid glands.

5.Cool compresses and scrotal support can be given to reduce pain and swelling in the testicles.

6.Avoid foods that stimulate the parotid glands (stimulating the glands causes pain) such as fruit juices and tart beverages.

What are the complications of Mumps?
----------------------------------------------

The mumps virus may affects many different glands including the brain.
It can affect the testes (orchitis)in boys or ovaries (oophoritis) in girls during puberty rarely causing infertility.

It can also affect the pancreas in some patients giving rise to Juvenile Diabetes or pancreatitis.

In the brain rarely encephalitis or meningitis may occur with damage to some brain cells.

What is the prognosis of Mumps?
--------------------------------------

Prognosis is good in all cases.
Very rarely do complications such orchitis or meningitis occur.

How is Mumps Prevented?
------------------------------

Mumps can be prevented by administering the Mumps, Measles, Rubella vaccine (MMR). This vaccine is given at the age of 15 months and again at 12 years old.

Tuesday, October 2, 2007

A Simple Guide to Menorrhagia


A Simple Guide to Menorrhagia
-----------------

What is Menorrhagia?
-----------------

Menorrhagia
is defined as excessively heavy or prolonged bleeding through the vagina either during menstrual period or any time between menses or after menopause in women.
It is a symptom not an illness.

What is the cause of Menorrhagia?
------------------------------

The cause of Menorrhagia is abnormal uterine bleeding.
The most common causes are

1.hormonal imbalances.
During a normal menstrual cycle, there is a balance between estrogen and progesterone, two female hormones in the body. These regulate the buildup of the endometrium which is the lining of blood and tissuein the wall of the uterus and which is shed each month during menstruation.
Menorrhagia can occur because of an imbalance between estrogen and progesterone.
As a result of this imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding.
Hormone imbalances are often present in adolescents and in women approaching menopause. This type of menorrhagia also known as Dysfunctional Uterine Bleeding is fairly common in these groups.

2.fibroids and benign tumour of the uterus
Another frequent cause of menorrhagia is uterine fibroids (benign tumours of the lining of the womb).
Together, hormone imbalances and fibroids account for about 80% of menorrhagia cases.

Other causes include

3.cancer of the uterus(endometrial cancer) or cervix

4.inflammation or infection of the vagina, cervix, or pelvic organs

5.polyps which are small growths on the cervical or uterine wall

6.thyroid diseases

7.liver, kidney diseases

8.blood bleeding diseases,

9.the use of blood-thinning drugs

10.stress affects the hormonal imbalance

11.injury or disease of the vaginal opening as a result of intercourse, infection, polyp, genital warts, ulcer, or varicose veins.

12.vaginal injury from insertion of foreign objects, from malignancy, or from infection

13.dry vaginal walls from lack of estrogen after menopause

14.abortion spontaneous or induced

15.stopping and starting birth control pills or estrogens

16.low thyroid function

17.IUD or intrauterine device use for contraception can cause occasional spotting

18.abnormal pregnancy eg.ectopic pregnancy

19.drugs such as oral contraceptives and anticoagulants

20.cervical conization or cauterization procedures

Bleeding may be more serious in women over 50 (post-menopausal) or younger than 12 (prepubertal).

The risk of cancer increases with
1.age.

2.obesity,

3.taking estrogen (without progestin),

4.young women who have not established a regular ovulation cycle,

5.approaching menopause.

What are the Signs of Menorrhagia?
-------------------------------------------

The most common sign is excessive bleeding per vagina.
Make sure that bleeding is coming from the vagina and not from the rectum or in the urine.

Some women may experience paleness and fatigue (anaemia)due to loss of blood.

Women with menses which consistently last more than seven days or whose periods are less than 21 days apart (unless that's normal for the woman) may be required to have a medical examination.

For a married woman or non-virgins,
1.a pelvic exam (examination of the internal reproductive organs),

2.a Pap smear test.

3.blood tests for hormonal changes and bleeding tendencies

4. urine and stool tests for conditions of the gastrointestinal and urinary systems.

5.investigations to determine ovulation

6.pregnancy test may be done if you are sexually active.

7.tests for any sexually transmitted diseases.

8.colposcopy- examination of the inside ot the uterus with a small amount of tissue taken from the endometrium may be taken for testing for canceror hormonal disorders.

Cancer should be ruled out in older women (aged 35-40) or in younger women with longer duration of exposure to unopposed estrogen.

For a non-married woman or virgin, the same examination may be done except care is taken to avoid damaging the hymen.

What is the Treatment of Menorrhagia?
----------------------------------------------

Any underlying medical condition (eg infection,bleeding disease)causing menorrhagia should be treated first.

If a hormone imbalance is responsible for Menorrhagia, hormonal treatment or replacement may be started.

Polyps are generally removed.

Anti-bleeding drugs such as daflon, dicyclone, etc can be given but may not necessarily work.

If the bleeding do not stop in spite all these measures, hysterectomy sometimes may be your only option.
Recently there is a procedure makes use of lasers or microwave technology to remove the lining of the womb (which is the part that bleeds) while leaving the rest of the womb intact.

Fibroids may require myomectomy or hysterectomy.

Hysterectomy and radiation are the usual treatment for endometrial cancer.

Bed rest may be recommended if bleeding is heavy.
The number of pads or tampons used should be recorded (so that the doctor can determine the amount of bleeding). Change tampons regularly, at least twice a day.

To help in relieving menstrual cramps, nonsteroidal anti-inflammatory drugs e.g. mefenemic acid and ibuprofen are prescribed.

The menstrual cycle is not the same for every woman. Menstrual flow occurs about every 28 days, lasts about 5 days, and produces an average of 30 - 40 mls (six to eight teaspoons) total blood loss. The menses may be regular, irregular, light, heavy, painful, pain-free, long, or short, and still be normal. Any variation in the menstrual cycle is medically less important than bleeding, pain, or discharge between menses.

The best prevention of Menorrhagia is having annual pelvic examinations with a cervical smear test (Pap smear).

Monday, October 1, 2007

A Simple Guide to Astigmatism


A Simple Guide to Astigmatism
--------------

What is Astigmatism?
--------------
Astigmatism is a condition in which the cornea of the eye is curved differently leading to blurred and distorted at all distances.

The eyeball is flattened usually from above downwards or sometimes sideways or along an oblique axis.

It is different from short or long sightedness.
It is therefore important to recognise Astigmatism and seek the correct treatment for it.

What causes Astigmatism?
--------------------------------

Astigmatism is generally an inherited condition where the curvature of the cornea of the eye is different from a normal person.
Because of the curvature, the eye is seeing the objects in front of it at a different angle. Light is entering the eye at a different angle which cast shadows and cause blurring of vision.
Besides inheritance it is also possible to get Astigmatism from eye surgery or sport injuries.

What are the symptoms of Astigmatism?
------------------------------------------------

1.Blurred and distorted vision of near and distant objects

2.blurring of vertical, horizontal and diagnonal lines

3.eyestrain & fatigue

4.sensitivity to light

5.Tired and dry eyes

6.Headaches

How is Astigmatism treated?
----------------------------------

Astigmatism can be diagnosed easily by your optometrist or eye specialist.

A eye examination followed by vision tests and computerised testing of the curvature of eye, short sightness, long sightness and any other abnormality of eye vision.

Prescription spectacles and contact lens can be prescribed to correct the Astigmatism.

Other methods of treatment include LASIK, wavefront eye surgery, lens implants especially in older patients

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