A Simple Guide to Urinary Stones
----------------------------------
What are Urinary Stones?
----------------------------
Urinary Stones are small, solid stones which occur when salts or minerals in the urine become solid crystals inside the kidney.
How are Urinary Stones formed?
----------------------------------------
Urinary Stones are formed usually because of the accumulation of salts and minerals especially calcium in the urine.
Usually the stones may be so small that they pass out through the urine without the knowledge of the patient.
Some however become bigger due to accumulation of the salts and minerals and the concentration of the urine.
The bigger stones may remain in the tubes of the kidney and are called renal stones.
Some smaller stones may move out of the kidney and passes through the ureters which are the the tubes bringing urine from the kidney to your bladder.
These are called ureteric stones.
If a ureteric stone gets stuck in the ureter, this can cause blockage of the urine and severe pain.(ureteric colic)
What are the types of Urinary Stones?
------------------------------------------
Different kinds of Urinary stones form from different salts in the urine.
1.Calcium stones forms about 80% of the urinary stones.
50% are made up of calcium oxalate and the rest are calcium phosphate.
They are spiky or large and smooth
2.Uric acid stones are caused by accumulation of excess amounts of uric acid which can be due to eating a lot of meat.
They are smooth, brown and soft
3.Struvite stones (infection stones) are produced when there is too much ammonia in the urine occuring especially in urinary tract infection.
The bacteria that cause these urinary infections can generate ammonia.
They are usually large and have a horn-like shape
This kind of kidney stone is most often found in women.
4.Cystine stones occurs when there is high levels of cystine in the urine. A hereditary disorder called cystinuria is the source of high cystine in the urine.
They are yellow and crystalline
Who is at risk of Urinary stones formation?
--------------------------------------------
Risk factors include:
1.Men get urinary stone more commonly than women
2.a previous history of kidney stone - 50% will develop another one within five years.
3.a family history of kidney stones
4.Age between 20 and 40
5.Not drinking enough water
6.eating a diet high in protein
7.taking certain medicines such as diuretics (water tablets), antacids and thyroid medications
8.having only one kidney, or an abnormally shaped kidney
What causes Urinary Stones?
---------------------------
Urinary Stones are caused by 4 main factors:
1.Insuffient water in the urine leading to concentration and stagnation of urine flow:
a.insufficient intake of water
b.intake of alcohol causing concentration of the blood volume
2.Excess Urinary Constituents:
a. Calcium:
High calcium intake (includes calcium tablets and high calcium milk)
Primary Hyperparathyroidism leading to high blood calcium
high Vitamin D intake cause high adsorption of calcium
medical conditions such as cancer, some kidney diseases, or sarcoidosis are more likely to develop calcium stones.
b. Oxalates:
high oxalate intake (cabbage,spinach,tomatoes, chocolates) in diet leads to high concentration of oxalates in urine
c. Uric Acid:
Gout or High Uric Acid can form crystals which may lead to stones
Treatments such as chemotherapy can also increase the risk of getting uric acid stones.
d: Cystine:
Hereditary cystinuria leads to high cystine in the urine and formation of cystine stones
About one in a hundred urinary stones is due to this illness.
Cystine stones tend to appear earlier in life between the ages of 10 and 30 years.
3. Infection of urine:
clumps of bacteria can form the nucleus of the stone.
Bacteria also produce ammonia which can promote formation of stones
4. Congenital deformity of the kidney and urinary tract:
these block the passage of concentrated urine and causes formation of stones.
What are the symptoms of Urinary Stones?
------------------------------------------
Many Urinary stones do not cause any symptoms.
Once an urinary stone enters the ureter and blocks the passage of urine flow, it may cause the following symptoms:
1.severe pain or aching in the back on one or both sides
2.sudden spasms of excruciating pain which usually starts in the upper back below the ribs, radiates around the flanks of the abdomen, down to the pubes, groin and genitalia.
3.Urine is bloody, cloudy or smelly
4.frequent urge to urinate, or a burning sensation during urination
5.fever and chills
6.nausea and vomiting
Urinary stones can be passed out of the body within 48 hours.
Sometimes attacks of pain from urinary stones may last for over 30 days.
How are Urinary Stones diagnosed?
---------------------------------
1.History of ureteric colic symptoms and physical examination showing tenderness of abdomen and flanks
Other tests may be done to confirm the diagnosis and to reveal the size, location and type of stone:
2.blood tests - to identify excess amounts of certain chemicals (calcium, uric acid, oxalates, cystines) related to the formation of stones
3.urine analysis - to look for signs of infection and presence of crystals
4.X-ray of abdomen - stones that contain calcium (80%) usually appears white on X-rays
5.Intravenous urogram (IVU) - an injection of a special dye that shows up the whole urinary system on X-ray images, revealing stones that can't usually be seen
6.ultrasound scan - can detect stones in kidneys and solid internal organs
7.non-contrast helical computerised tomography - X-ray images taken at different angles - can diagnose kidney stones, and is probable the most accurate diagnostic test
How are Urinary Stones treated?
---------------------------------
Treatment depends on the
1.type and
2.cause of the stone.
Most stones can be treated without surgery:
1.Drinking lots of water (two and a half to three litres per day)
2.staying physically active are often enough to move stones smaller than about 5mm out of the urinary tract.
3.paracetamol or codeine may be given to reduce the pain.
4.Infections can be treated with antibiotics.
Stones that are stuck can be removed in several ways:
1.Extracorporeal shock wave lithotripsy (ESWL)
Location of the urinary stone is dtermined using X-ray imaging or ultrasound scanning.
The patient lies in a side position while a machine called a lithotriptor sends targeted shock waves to break up the kidney stone.
There may be some pain as the stone breaks up, so the procedure is usually performed under local anaesthesia.
2.Ureteroscopic stone removal
A narrow, flexible instrument called a cystoscope can be passed up through the urethra and bladder and up the ureter where the stone is stuck. The stone is captured and removed.It can also be broken up with a laser beam or shock waves generated by a device attached at the end of the cytoscope. This procedure is usually done under general anaesthesia.
3.Percutaneous nephrolithotomy (PCNL)
Large stones can be surgically removed from the kidney.
The surgeon makes a small opening at the back and uses a telescopic instrument called a nephroscope to pull the stone out or break it up with shock waves or a laser.
This procedure is performed under general anesthesia.
How to prevent Urinary Stones?
---------------------------------
1.drink more fluid at least three litres every 24 hours.
2.reducing the amount of calcium in the diet to a normal level(not excessively high)
3.For calcium oxalate stones, reduce intake of high levels of oxalate - chocolate, tea, cooked spinach and asparagus.
4.For uric acid stones, less meat, fish, poultry, organs, peanuts and soya beans should be taken. Daily intake of allopurinol medicine can help reduce the level of uric acid in the urine.
5.For cystine stones, medicines can be given to reduce formation of the stones.
6.For struvite or "infection" stones,long term antibiotics may prevent chronic urinary infection.
Added 4th October 2008
-------------------------------------
Urinary stone:
--------------------
Melamine a chemical used for hardening plastic has found illegally in milk products in China in September 2008.
This causes urinary stones in babies.
Tuesday, March 25, 2008
Friday, March 21, 2008
A Simple Guide to Gallstones
A Simple Guide to Gallstones
------------------------------
What are gallstones?
----------------------
Gallstones are stones which are found in the gallbladder which is a sac storing bile from the liver.
They are made from cholesterol and other substances in the bile.
What causes gallstones?
-------------------------
Gallstones are formed when cholesterol and other substances like calcium found in bile combine to form stones.
They are more common in
1.overweight people
2.Females more than males
What are the symptoms?
------------------------------
Most people with gallstones do not have symptoms.
Symptomsoccur when a gallstone causes blockage in the bile duct causing obstruction to flow of bile from the liver to the intestine.
The symptoms may be:
1.mild pain in the upper right part of the abdomen and also just below the sternum just like gastritis.
2.Pain in the right upper back or shoulder blade area.
3.Pain is worse when you eat.
4.fever and chills
5.Yellowness of the eyes or skin
6.Dark coloured urine
7.Chest pain occurs when the pain radiates to the chest
How are gallstones diagnosed?
--------------------------------
1.Pain in the right side of the abdomen
2. Murphy's sign positive.
A thumb pressing against the right of the epigastrium causes more pain when the patients breathes in deeply
3.An ultrasound of the right side of the abdomen is the best way to find gallstones.
Most gallstones can be detected from the ultrasound.
4.gallbladder scan. A dye is injected into a vein in your arm.
X-rays are taken as the dye moves through your liver, bile duct, gallbladder.
What are the complications of gallstones?
-------------------------------------------------
A gallsone which is stuck in the bile duct(a tube which leads the bile from the liver to the gallbladder and small intestine) can give rise to:
1.Gallbladder inflmmation or infection(Cholecystitis)
2.Swelling and inflammation of the Pancreas(pancreatitis)
3.Hepatitis due to reflux of the bile back to the liver
4.Peritonitis(inflammation of the inner lining of the abdomen) if the bile duct or gallbladder perfoates or burst.
This is an emergency.
What is the treatment of gallstones?
----------------------------------------
1.If there is no symptoms, treatment is not needed.
2.If there is mild pain, some pain and antispasmodic medicines are given.
Patient is kept for observation.
If the pain goes away, the gallsone may have become unstuck in the bile duct and pass out into the intestine.
3.If there is severe pain or recurrence of another attack of pain, it is advisable to have the gallbladder removed.
a.Normal surgery to remove the gallbladder and the gallstones involve 4 holes in the abdomen and the use of a laparoscopic to cut away the gallbladder followed by stitching.
The surgery is usually very safe and the patient may not need to be hospitalised.
b.In an emergency, such as perforated gallbladder, immediate surgery may be required to remove the gallbladder and cleared the inner abdomen of leaked bile.
What is the prognosis of gallstones?
----------------------------------------------
Most people with gallstones do not have symptoms.
Sometimes gallstones may be detected while having tests for other health problems.
Sometimes an ultrasound done on an woman during pregnancy may show gallstones.
The prognosis for patients after surgery is usually good.
The bile will go straight to the intestine from the liver.
Digestion of oily food may not as good as before and is usually not noticeable.
------------------------------
What are gallstones?
----------------------
Gallstones are stones which are found in the gallbladder which is a sac storing bile from the liver.
They are made from cholesterol and other substances in the bile.
What causes gallstones?
-------------------------
Gallstones are formed when cholesterol and other substances like calcium found in bile combine to form stones.
They are more common in
1.overweight people
2.Females more than males
What are the symptoms?
------------------------------
Most people with gallstones do not have symptoms.
Symptomsoccur when a gallstone causes blockage in the bile duct causing obstruction to flow of bile from the liver to the intestine.
The symptoms may be:
1.mild pain in the upper right part of the abdomen and also just below the sternum just like gastritis.
2.Pain in the right upper back or shoulder blade area.
3.Pain is worse when you eat.
4.fever and chills
5.Yellowness of the eyes or skin
6.Dark coloured urine
7.Chest pain occurs when the pain radiates to the chest
How are gallstones diagnosed?
--------------------------------
1.Pain in the right side of the abdomen
2. Murphy's sign positive.
A thumb pressing against the right of the epigastrium causes more pain when the patients breathes in deeply
3.An ultrasound of the right side of the abdomen is the best way to find gallstones.
Most gallstones can be detected from the ultrasound.
4.gallbladder scan. A dye is injected into a vein in your arm.
X-rays are taken as the dye moves through your liver, bile duct, gallbladder.
What are the complications of gallstones?
-------------------------------------------------
A gallsone which is stuck in the bile duct(a tube which leads the bile from the liver to the gallbladder and small intestine) can give rise to:
1.Gallbladder inflmmation or infection(Cholecystitis)
2.Swelling and inflammation of the Pancreas(pancreatitis)
3.Hepatitis due to reflux of the bile back to the liver
4.Peritonitis(inflammation of the inner lining of the abdomen) if the bile duct or gallbladder perfoates or burst.
This is an emergency.
What is the treatment of gallstones?
----------------------------------------
1.If there is no symptoms, treatment is not needed.
2.If there is mild pain, some pain and antispasmodic medicines are given.
Patient is kept for observation.
If the pain goes away, the gallsone may have become unstuck in the bile duct and pass out into the intestine.
3.If there is severe pain or recurrence of another attack of pain, it is advisable to have the gallbladder removed.
a.Normal surgery to remove the gallbladder and the gallstones involve 4 holes in the abdomen and the use of a laparoscopic to cut away the gallbladder followed by stitching.
The surgery is usually very safe and the patient may not need to be hospitalised.
b.In an emergency, such as perforated gallbladder, immediate surgery may be required to remove the gallbladder and cleared the inner abdomen of leaked bile.
What is the prognosis of gallstones?
----------------------------------------------
Most people with gallstones do not have symptoms.
Sometimes gallstones may be detected while having tests for other health problems.
Sometimes an ultrasound done on an woman during pregnancy may show gallstones.
The prognosis for patients after surgery is usually good.
The bile will go straight to the intestine from the liver.
Digestion of oily food may not as good as before and is usually not noticeable.
Friday, March 14, 2008
A Simple Guide to Vulvitis
A Simple Guide to Vulvitis
------------------------------
What is Vulvitis?
----------------------
Vulvitis is an acute inflammation of the vulva in females.
What are the causes of Vulvitis?
---------------------------------------
Vulvitis is usually caused by the following:
Infections:
1.sexually transmitted disease like gonorrhea,trichomonas and chlamydia.
2.Fungal infection such as candidiasis
3.Herpes simplex in recurrent cases
4.Pediculosis pubis or lice
5.pinworm infection in children
6.Urinary infection such as cystitis
Allergies:
1.Clothings
2.perfumes
3.powders
4.drugs
Chemical irritants:
1.vaginal douche
2.detergents used to wash underwear
Mechanical irritants:
1.ill fitting underwear
2.inadequate sexual lubrication
Postmenopausal:
Atrophic vulvovaginitis after menopausal with dryness and inflammation of the vulval and vaginal lining
Generalised disorders:
Dermatological disorders such as lichen simplex
What are the symptoms and signs of Vulvitis?
------------------------------------------------
Persons who has Acute Vulvitis has the following
Symptoms:
1.vulval irritation and itch
2.discharge from vagina
3.painful or frequency of urination
4.excoriation of the inner lining of vulva
Signs:
1.discharge can be seen in female vagina
2.redness and inflammation of the vulva
How do you diagnose Vulvitis?
--------------------------------
Diagnosis can usually be made by :
1.History of vulval itch associated frequency of urination, painful urination or discharge from vagina
2.Vulva shows inflammation, excoriation of lining,
3.Vulval and vaginal swab to culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.
4. biopsy of the suspicious vulval lesions to exclude other causes of vulval problem such as tumor
What is the treatment of Vulvitis?
-------------------------------------
1.Approprate Antibiotics, antifungal for infections especially after urine bacterial culture
2.Antihistamine medicine for itch
3.Topical oestrogen cream for postmenopausal atrophic vulvovaginitis
4.Proper hygience after urination, sexual intercourse and bathing
5.Avoid strong soaps
6.Use of lubricants during sexual intercourse
7.Weight reduction if obese
8.Treat underlying condition such as diabetes,allergic dermatitis,other skin
conditions.
What is the prognosis of Vulvitis?
----------------------------------------
Prognosis is usually good with medication.
Sexual partner may need to be treated.
Recurrence is quite common.
------------------------------
What is Vulvitis?
----------------------
Vulvitis is an acute inflammation of the vulva in females.
What are the causes of Vulvitis?
---------------------------------------
Vulvitis is usually caused by the following:
Infections:
1.sexually transmitted disease like gonorrhea,trichomonas and chlamydia.
2.Fungal infection such as candidiasis
3.Herpes simplex in recurrent cases
4.Pediculosis pubis or lice
5.pinworm infection in children
6.Urinary infection such as cystitis
Allergies:
1.Clothings
2.perfumes
3.powders
4.drugs
Chemical irritants:
1.vaginal douche
2.detergents used to wash underwear
Mechanical irritants:
1.ill fitting underwear
2.inadequate sexual lubrication
Postmenopausal:
Atrophic vulvovaginitis after menopausal with dryness and inflammation of the vulval and vaginal lining
Generalised disorders:
Dermatological disorders such as lichen simplex
What are the symptoms and signs of Vulvitis?
------------------------------------------------
Persons who has Acute Vulvitis has the following
Symptoms:
1.vulval irritation and itch
2.discharge from vagina
3.painful or frequency of urination
4.excoriation of the inner lining of vulva
Signs:
1.discharge can be seen in female vagina
2.redness and inflammation of the vulva
How do you diagnose Vulvitis?
--------------------------------
Diagnosis can usually be made by :
1.History of vulval itch associated frequency of urination, painful urination or discharge from vagina
2.Vulva shows inflammation, excoriation of lining,
3.Vulval and vaginal swab to culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.
4. biopsy of the suspicious vulval lesions to exclude other causes of vulval problem such as tumor
What is the treatment of Vulvitis?
-------------------------------------
1.Approprate Antibiotics, antifungal for infections especially after urine bacterial culture
2.Antihistamine medicine for itch
3.Topical oestrogen cream for postmenopausal atrophic vulvovaginitis
4.Proper hygience after urination, sexual intercourse and bathing
5.Avoid strong soaps
6.Use of lubricants during sexual intercourse
7.Weight reduction if obese
8.Treat underlying condition such as diabetes,allergic dermatitis,other skin
conditions.
What is the prognosis of Vulvitis?
----------------------------------------
Prognosis is usually good with medication.
Sexual partner may need to be treated.
Recurrence is quite common.
Monday, March 10, 2008
A Simple Guide to Urethritis
A Simple Guide to Urethritis
------------------------------
What is Urethritis?
----------------------
Urethritis is an acute infection of the urethra(the tube which allows passage of urine from the bladder to the outside).
What are the causes of Urethritis?
---------------------------------------
Urethritis is usually caused by the following:
1.sexually transmitted disease like gonorrhea and chlamydia.
2.Urinary infection such as cystitis
3.In males associated with prostatitis
4.Urinary stone stuck in the urethra may cause urethitis
6.urinary catheterisation
7.Injury to the urethra
8.Important component of Reiter's Syndrome
What are the symptoms and signs of Urethritis?
------------------------------------------------
Persons who has Acute Urethritis has the following
Symptoms:
------------------
1.painful urination
2.purulent discharge from penis in males or vagina in females
3.frequency of urination
4.cloudy and unpleasant smelling urine, sometimes blood in the urine
5.fever and chills
6.Polyathritis and conjunctivitis in Reiter's Syndrome
Signs:
------
1. pussy discharge can be seen in male's urethra or in female vagina
2.redness and inflammation of the opening of the urethra
How do you diagnose Urethritis?
--------------------------------
Diagnosis can usually be made by :
1.History of sexual activity followed by frequency of urination, painful urination or pussy discharge from urethra or vagina
2.Urine test shows the presence of pus cells, leucocyte, red blood cells and micro-organisms
3.Urine culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.
4. cystoscopy may be necessary to exclude urinary stones,tumours of the bladder in the case of blood in the urine
What is the complications of Urethritis?
-------------------------------------
Upward infections from the urethra can lead to infections of the bladder and kidneys.
What is the treatment of Urethritis?
-------------------------------------
Analgesic medicine for pain
Approprate Antibiotics for infections especially after urine bacterial culture
Lots of fluids
What is the prognosis of Urethritis?
----------------------------------------
Prognosis is usually good with medication.
Sexual partner may need to be treated.
Recurrence is quite common.
------------------------------
What is Urethritis?
----------------------
Urethritis is an acute infection of the urethra(the tube which allows passage of urine from the bladder to the outside).
What are the causes of Urethritis?
---------------------------------------
Urethritis is usually caused by the following:
1.sexually transmitted disease like gonorrhea and chlamydia.
2.Urinary infection such as cystitis
3.In males associated with prostatitis
4.Urinary stone stuck in the urethra may cause urethitis
6.urinary catheterisation
7.Injury to the urethra
8.Important component of Reiter's Syndrome
What are the symptoms and signs of Urethritis?
------------------------------------------------
Persons who has Acute Urethritis has the following
Symptoms:
------------------
1.painful urination
2.purulent discharge from penis in males or vagina in females
3.frequency of urination
4.cloudy and unpleasant smelling urine, sometimes blood in the urine
5.fever and chills
6.Polyathritis and conjunctivitis in Reiter's Syndrome
Signs:
------
1. pussy discharge can be seen in male's urethra or in female vagina
2.redness and inflammation of the opening of the urethra
How do you diagnose Urethritis?
--------------------------------
Diagnosis can usually be made by :
1.History of sexual activity followed by frequency of urination, painful urination or pussy discharge from urethra or vagina
2.Urine test shows the presence of pus cells, leucocyte, red blood cells and micro-organisms
3.Urine culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.
4. cystoscopy may be necessary to exclude urinary stones,tumours of the bladder in the case of blood in the urine
What is the complications of Urethritis?
-------------------------------------
Upward infections from the urethra can lead to infections of the bladder and kidneys.
What is the treatment of Urethritis?
-------------------------------------
Analgesic medicine for pain
Approprate Antibiotics for infections especially after urine bacterial culture
Lots of fluids
What is the prognosis of Urethritis?
----------------------------------------
Prognosis is usually good with medication.
Sexual partner may need to be treated.
Recurrence is quite common.
Saturday, March 8, 2008
A Simple Guide to Prostatitis
A Simple Guide to Prostatitis
------------------------------
What is Prostatitis?
----------------------
Prostatitis is an acute or chronic infection of the prostate gland.
What are the causes of Prostatitis?
------------------------------
Prostatitis is usually caused by the following:
1.enteric Gram negative organism from intestinal or bladder infection
2.tuberculosis occasionally
What are the symptoms and signs of Prostatitis?
---------------------------------------------------
Persons who has Acute Prostatitis has the following:
Symptoms:
1.frequency of urination and nocturia
2.urgency of urination
3.hematuria(blood in urine)
4.low back pain
5.perineal pain
6.slow initiation of urine
Signs:
Tenderness on palpation of the prostate per rectum
How do you diagnose Prostatitis?
--------------------------------
Diagnosis can usually be made by :
1.History of frequency of urination, urgent urination
2.Tenderness on palpation of the prostate per rectum
3. Culture of the expressed prostatic fluid by prostatic massage
4.Urine and prostatic fluid culture will determine the micro-organism involved and the antibiotic most appropriate for it.
What is the complications of Prostatitis?
-------------------------------------
Infections from the prostate can lead to infections of the bladder and up to the kidney.
What is the treatment of Prostatitis?
-------------------------------------
Analgesic medicine
Antibiotics for infections especially after urine and prostatic fluid bacterial culture
Lots of fluids
What is the prognosis of Prostatitis?
----------------------------------------
Prognosis is usually good with medication.
Recurrence is quite common.
------------------------------
What is Prostatitis?
----------------------
Prostatitis is an acute or chronic infection of the prostate gland.
What are the causes of Prostatitis?
------------------------------
Prostatitis is usually caused by the following:
1.enteric Gram negative organism from intestinal or bladder infection
2.tuberculosis occasionally
What are the symptoms and signs of Prostatitis?
---------------------------------------------------
Persons who has Acute Prostatitis has the following:
Symptoms:
1.frequency of urination and nocturia
2.urgency of urination
3.hematuria(blood in urine)
4.low back pain
5.perineal pain
6.slow initiation of urine
Signs:
Tenderness on palpation of the prostate per rectum
How do you diagnose Prostatitis?
--------------------------------
Diagnosis can usually be made by :
1.History of frequency of urination, urgent urination
2.Tenderness on palpation of the prostate per rectum
3. Culture of the expressed prostatic fluid by prostatic massage
4.Urine and prostatic fluid culture will determine the micro-organism involved and the antibiotic most appropriate for it.
What is the complications of Prostatitis?
-------------------------------------
Infections from the prostate can lead to infections of the bladder and up to the kidney.
What is the treatment of Prostatitis?
-------------------------------------
Analgesic medicine
Antibiotics for infections especially after urine and prostatic fluid bacterial culture
Lots of fluids
What is the prognosis of Prostatitis?
----------------------------------------
Prognosis is usually good with medication.
Recurrence is quite common.
Monday, March 3, 2008
A Simple Guide to PECOMA Cancer
A Simple Guide to PECOMA Cancer
-----------------------------------------
What are PECOMA Cancer?
-------------------------------------
Perivascular epithelioid cell tumor (PEComa) is a neoplasm composed chiefly of HMB-45-positive(a marker which is relatively specific for melanoma) epithelioid cells with clear to granular cytoplasm and a perivascular distribution.
Such tumors have been reported in different organs
Although rare, only 20 + cases worldwide, PEC tumors (PEComas) should be regarded as a tumor of uncertain malignant potential.
Who is at risk of getting PECOMA Cancers?
------------------------------------------------------------
The median patient age was 46 years (range, 15-97 years).
There is a marked female predominance (22 females, 4 males).
Sites of involvement included
1.the omentum or mesentery (6 cases),
2.uterus (4 cases),
3.pelvic soft tissues (3 cases),
4.abdominal wall (2 cases),
5.uterine cervix (2 cases),
6.vagina,(1 case).
7.retroperitoneum,(1 case).
8.thigh,(1 case).
9.falciform ligament,(1 case).
10.scalp,(1 case).
11.broad ligament,(1 case).
12.forearm, (1 case).
13.shoulder,(1 case).
14.neck (1 case).
The tumors ranged from 1.6 to 29 cm in size (median, 7.8 cm).
Tumors were
1.epithelioid (N = 9),
2.spindled (N = 7), or
3.mixed (N = 10).
What are the Symptoms of Pecoma Cancer?
---------------------------------------------------------
Among the common warning signs are:
1.weight loss,
2.pain in the bones
3.swelling of lymph nodes
4.Persistent fever
5.loss of appetite
6.generalised weakness and pallour
What are the Causes of Pecoma Cancer?
----------------------------------------------------------
Unknown.
Certain genetic abnormalities may be present.
They are more common in women.
How do you diagnose Pecoma Cancer?
-------------------------------------------------
1.HMB-45-positive(a marker which is relatively specific for melanoma)is present in all cases
2.Perivascular epithelioid cell present on biopsy
What is the Treatment of Pecoma Cancer?
-----------------------------------------------------
The onset of PEComa Cancer has been known to be very rapid.
Because of its vascular origin, it can spread very fast.
Surgery will be useful if detected at the early stage.
Chemotherapy and radiation therapy are the main treatment for Pecoma cancer.
Besides these treatments, stem cells infusion also give patients and their families another source for a cure.
What are the Prognosis for Pecoma Cancer?
-----------------------------------------------------------------------
Generally poor because onset is fast and spread diffuse.
-----------------------------------------
What are PECOMA Cancer?
-------------------------------------
Perivascular epithelioid cell tumor (PEComa) is a neoplasm composed chiefly of HMB-45-positive(a marker which is relatively specific for melanoma) epithelioid cells with clear to granular cytoplasm and a perivascular distribution.
Such tumors have been reported in different organs
Although rare, only 20 + cases worldwide, PEC tumors (PEComas) should be regarded as a tumor of uncertain malignant potential.
Who is at risk of getting PECOMA Cancers?
------------------------------------------------------------
The median patient age was 46 years (range, 15-97 years).
There is a marked female predominance (22 females, 4 males).
Sites of involvement included
1.the omentum or mesentery (6 cases),
2.uterus (4 cases),
3.pelvic soft tissues (3 cases),
4.abdominal wall (2 cases),
5.uterine cervix (2 cases),
6.vagina,(1 case).
7.retroperitoneum,(1 case).
8.thigh,(1 case).
9.falciform ligament,(1 case).
10.scalp,(1 case).
11.broad ligament,(1 case).
12.forearm, (1 case).
13.shoulder,(1 case).
14.neck (1 case).
The tumors ranged from 1.6 to 29 cm in size (median, 7.8 cm).
Tumors were
1.epithelioid (N = 9),
2.spindled (N = 7), or
3.mixed (N = 10).
What are the Symptoms of Pecoma Cancer?
---------------------------------------------------------
Among the common warning signs are:
1.weight loss,
2.pain in the bones
3.swelling of lymph nodes
4.Persistent fever
5.loss of appetite
6.generalised weakness and pallour
What are the Causes of Pecoma Cancer?
----------------------------------------------------------
Unknown.
Certain genetic abnormalities may be present.
They are more common in women.
How do you diagnose Pecoma Cancer?
-------------------------------------------------
1.HMB-45-positive(a marker which is relatively specific for melanoma)is present in all cases
2.Perivascular epithelioid cell present on biopsy
What is the Treatment of Pecoma Cancer?
-----------------------------------------------------
The onset of PEComa Cancer has been known to be very rapid.
Because of its vascular origin, it can spread very fast.
Surgery will be useful if detected at the early stage.
Chemotherapy and radiation therapy are the main treatment for Pecoma cancer.
Besides these treatments, stem cells infusion also give patients and their families another source for a cure.
What are the Prognosis for Pecoma Cancer?
-----------------------------------------------------------------------
Generally poor because onset is fast and spread diffuse.
Sunday, March 2, 2008
A Simple Guide to Chikungunya Fever
A Simple Guide to Chikungunya Fever
--------------------------------------
What is Chikungunya Fever?
-------------------------------
Chikungunya fever is an acute illness caused by the chikungunya virus transmitted to humans by the bite of an infected Aedes mosquito.
How is the Chikungunya Fever transmitted?
-----------------------------------------
Chikungunya virus is transmitted to humans by the bite of infected Aedes mosquito.
Monkeys and other wild animals may be possible source of the virus.
Infected mosquitoes will spread the virus to other humans when they bite their skin.
The condition was first detected in Eastern Africa in the 1950 and recently has also outbreaks in India, Africa, Indonesia and Malaysia.
What are the Symptoms of chikungunya fever?
-----------------------------------------------
The incubation period in mosquito is 3-5 days and 1-12 days in humans.
Symptoms usually last 3-10 days.
Symptoms may be the same as denque fever:
1.fever of sudden onset
2.severe and prolonged joint pains with or without swelling
3.muscle pain
4.headache
5.chills
6.rash -no petechiae, more of a maculopaular rash
7.fatigue
8.nausea
9.vomiting.
The most severe symptom is the severe and prolonged joint pains which can even last up to 1 month.
Unlike dengue fever,there has been no documented cases of hemorrhagic (bleeding) or shock syndrome reported in chikungunya infection.
The chikungunya virus also does not affect the nervous system.
How do you diagnose chikungunya fever?
---------------------------------------
Diagnosis is made on the basis of :
1.high fever
2.severe and prolonged joint pain
3.blood tests for chikungunya fever
What is the treatment for chikungunya fever?
-------------------------------------------------
There is at present no specific medication or vaccine to treat chikungunya fever.
TREATMENT IS THEREFORE SYMPTOMATIC:
1.rest,
2.plenty of fluids and
3.pain medication such as paracetamol may relieve symptoms of joint pain, body aches and fever.
Aspirin and NSAIDs should be avoided if possible.
What is the prognosis of chikungunya fever?
--------------------------------------------
The illness is usually self-limiting.
Most symptoms lasts for 3-10 days and the joint pain may last for weeks to months.
Rarely does it cause death(through high fever and dehydration).
How can you prevent being infected with the chikungunya virus?
---------------------------------------------------------------------
The best way to prevent chikungunya infection is to avoid bites from the Aedes Mosquito.
Preventive measures are the same as dengue fever such as getting rid of mosquito breeding places.
--------------------------------------
What is Chikungunya Fever?
-------------------------------
Chikungunya fever is an acute illness caused by the chikungunya virus transmitted to humans by the bite of an infected Aedes mosquito.
How is the Chikungunya Fever transmitted?
-----------------------------------------
Chikungunya virus is transmitted to humans by the bite of infected Aedes mosquito.
Monkeys and other wild animals may be possible source of the virus.
Infected mosquitoes will spread the virus to other humans when they bite their skin.
The condition was first detected in Eastern Africa in the 1950 and recently has also outbreaks in India, Africa, Indonesia and Malaysia.
What are the Symptoms of chikungunya fever?
-----------------------------------------------
The incubation period in mosquito is 3-5 days and 1-12 days in humans.
Symptoms usually last 3-10 days.
Symptoms may be the same as denque fever:
1.fever of sudden onset
2.severe and prolonged joint pains with or without swelling
3.muscle pain
4.headache
5.chills
6.rash -no petechiae, more of a maculopaular rash
7.fatigue
8.nausea
9.vomiting.
The most severe symptom is the severe and prolonged joint pains which can even last up to 1 month.
Unlike dengue fever,there has been no documented cases of hemorrhagic (bleeding) or shock syndrome reported in chikungunya infection.
The chikungunya virus also does not affect the nervous system.
How do you diagnose chikungunya fever?
---------------------------------------
Diagnosis is made on the basis of :
1.high fever
2.severe and prolonged joint pain
3.blood tests for chikungunya fever
What is the treatment for chikungunya fever?
-------------------------------------------------
There is at present no specific medication or vaccine to treat chikungunya fever.
TREATMENT IS THEREFORE SYMPTOMATIC:
1.rest,
2.plenty of fluids and
3.pain medication such as paracetamol may relieve symptoms of joint pain, body aches and fever.
Aspirin and NSAIDs should be avoided if possible.
What is the prognosis of chikungunya fever?
--------------------------------------------
The illness is usually self-limiting.
Most symptoms lasts for 3-10 days and the joint pain may last for weeks to months.
Rarely does it cause death(through high fever and dehydration).
How can you prevent being infected with the chikungunya virus?
---------------------------------------------------------------------
The best way to prevent chikungunya infection is to avoid bites from the Aedes Mosquito.
Preventive measures are the same as dengue fever such as getting rid of mosquito breeding places.
Saturday, March 1, 2008
A Simple Guide to Dengue Fever
A Simple Guide to Dengue Fever
--------------------------------
What is dengue fever?
------------------------
Dengue fever is a acute viral infection caused by the dengue virus which is transmitted by the bite of an infected female Aedes msoquito.
What are the Types of Dengue Fever?
----------------------------------------------------
The dengue virus has 4 strains called serotypes 1, 2, 3 and 4.
An infection with one serotype does not protect you from the other serotypes.
A second dengue infection, especially with serotype 2, can cause an even worse infection such as Dengue Haemorrhagic Fever and Dengue Shock Syndrome which can be fatal.
What are the Symptoms of Dengue Fever?
----------------------------------------
The incubation period in mosquito is 8-12 days and 3-14 days in humans.
Symptoms usually last 3-14 days.
1.High, acute, prolonged fever (usually lasts for 5 to 7 days)
2.Severe headache
3.Pain behind the eyes
4.Muscle and joint pains
5.Rashes
6.Nausea , vomiting
7.Abdominal discomfort
8.Loss of appetite
9.Fatigue
10.Diarrhoea
A rash usually appears 3-4 days after the fever.
There are 3 types of dengue rash.
1.Petechial Rash:
----------------
This is the most common with the petechial rash appearing as red dots under the skin.
The rashes are usually found on the limbs and lower abdomen and is due to the bleeding under the skin.
2.Diffuse erythematous rash with areas of normal skin:
----------------------------------------------------
The whole skin becomes reddish with scattered, small areas of normal skin .
3.Maculopapular rash:
--------------------
The last type of rash appears as red flat or raised leisons(Maculopaular).
The rash can be itchy .
What are the Complications of Dengue Fever?
------------------------------------------
The complications of Dengue Fever are:
1.Dengue Hemorrhagic Fever
---------------------------------------------
a. Fever
b.bleeding likely to occur from the nose, mouth, and gums.
Bruises and ecchymosis may appear as a sign of bleeding under the skin.
There are small red spots on the skin.
c.the urine may contain blood.
d.vomiting of blood and malena(black stools) indicate bleeding in the stomach.
e.low plalelet count of <100,000
f.Hypoalbuminaemia
g.pleural effusion
h.neurological disturbances(seizures,cranial nerve signs and coma) may indicate bleeding in the brain
2. Dengue Shock Syndrome
-----------------------------
Without prompt treatment for the bleeding, the person can go into
a.shock
b.hypotension
c.narrowed pulse pressure(< 2omm Hg)
d.impaired organ perfusion which result in organ failure and death.
Dengue Haemorrhagic Fever and Dengue Shock Syndrome is fatal in about 5 percent of the cases, mostly among children and young adults.
How do you diagnose Dengue Fever?
---------------------------------
1.History of acute fever and bleeding signs
2.A low platelet count (<100,000)is suggestive of dengue fever.
3.Specific blood test(IgG and IgM antibody) for dengue virus can also be conducted. IgM antibodies occur on the 5th day of illness and last for 2 months.
What is the treatment of dengue fever?
-----------------------------------------
There is no specific anti-viral drug to treat the disease or a vaccine to prevent a person from being infected with the dengue virus.
Treatment is mainly supportive.
1. Rest
2.drinking lots of water to prevent dehydration will help.
3.Paracetamol for fever, severe headaches and body aches( Avoid aspirin and NSAIDs due to the risk of bleeding) to reduce the discomfort.
4. Intravenous fluids for hypotension and dehydration.
5.Daily blood tests (platelets and hematocrit)may be necessary to monitor the risk of bleeding
6. Platelets transfusion when the the platelet count is less than 20,000.
The illness can last up to 10 days, but complete recovery can take as long as a month.
How is dengue fever spread?
-----------------------------
Dengue Fever is spread only through the bite of the infected Aedes mosquitoes.
The transmission cycle for dengue starts when:
1.Infected Aedes mosquito bites a healthy person.
2.4-7 days later,the infected person develops fever
3..When fever starts, the person is infectious for about 5 days.
4.If an Aedes mosquito bites the person during this time when he is infectious, it will be infected by the the dengue virus.
5.The virus will multiply in the second mosquito for 5-7 days.
6.The mosquito then becomes infective.
7.The cycle starts again when it bites another person.
How can you prevent being infected with the dengue virus?
----------------------------------------------------------
To prevent dengue fever, you must prevent the breeding of its carrier, the Aedes mosquitoes.
This will be explained another time
--------------------------------
What is dengue fever?
------------------------
Dengue fever is a acute viral infection caused by the dengue virus which is transmitted by the bite of an infected female Aedes msoquito.
What are the Types of Dengue Fever?
----------------------------------------------------
The dengue virus has 4 strains called serotypes 1, 2, 3 and 4.
An infection with one serotype does not protect you from the other serotypes.
A second dengue infection, especially with serotype 2, can cause an even worse infection such as Dengue Haemorrhagic Fever and Dengue Shock Syndrome which can be fatal.
What are the Symptoms of Dengue Fever?
----------------------------------------
The incubation period in mosquito is 8-12 days and 3-14 days in humans.
Symptoms usually last 3-14 days.
1.High, acute, prolonged fever (usually lasts for 5 to 7 days)
2.Severe headache
3.Pain behind the eyes
4.Muscle and joint pains
5.Rashes
6.Nausea , vomiting
7.Abdominal discomfort
8.Loss of appetite
9.Fatigue
10.Diarrhoea
A rash usually appears 3-4 days after the fever.
There are 3 types of dengue rash.
1.Petechial Rash:
----------------
This is the most common with the petechial rash appearing as red dots under the skin.
The rashes are usually found on the limbs and lower abdomen and is due to the bleeding under the skin.
2.Diffuse erythematous rash with areas of normal skin:
----------------------------------------------------
The whole skin becomes reddish with scattered, small areas of normal skin .
3.Maculopapular rash:
--------------------
The last type of rash appears as red flat or raised leisons(Maculopaular).
The rash can be itchy .
What are the Complications of Dengue Fever?
------------------------------------------
The complications of Dengue Fever are:
1.Dengue Hemorrhagic Fever
---------------------------------------------
a. Fever
b.bleeding likely to occur from the nose, mouth, and gums.
Bruises and ecchymosis may appear as a sign of bleeding under the skin.
There are small red spots on the skin.
c.the urine may contain blood.
d.vomiting of blood and malena(black stools) indicate bleeding in the stomach.
e.low plalelet count of <100,000
f.Hypoalbuminaemia
g.pleural effusion
h.neurological disturbances(seizures,cranial nerve signs and coma) may indicate bleeding in the brain
2. Dengue Shock Syndrome
-----------------------------
Without prompt treatment for the bleeding, the person can go into
a.shock
b.hypotension
c.narrowed pulse pressure(< 2omm Hg)
d.impaired organ perfusion which result in organ failure and death.
Dengue Haemorrhagic Fever and Dengue Shock Syndrome is fatal in about 5 percent of the cases, mostly among children and young adults.
How do you diagnose Dengue Fever?
---------------------------------
1.History of acute fever and bleeding signs
2.A low platelet count (<100,000)is suggestive of dengue fever.
3.Specific blood test(IgG and IgM antibody) for dengue virus can also be conducted. IgM antibodies occur on the 5th day of illness and last for 2 months.
What is the treatment of dengue fever?
-----------------------------------------
There is no specific anti-viral drug to treat the disease or a vaccine to prevent a person from being infected with the dengue virus.
Treatment is mainly supportive.
1. Rest
2.drinking lots of water to prevent dehydration will help.
3.Paracetamol for fever, severe headaches and body aches( Avoid aspirin and NSAIDs due to the risk of bleeding) to reduce the discomfort.
4. Intravenous fluids for hypotension and dehydration.
5.Daily blood tests (platelets and hematocrit)may be necessary to monitor the risk of bleeding
6. Platelets transfusion when the the platelet count is less than 20,000.
The illness can last up to 10 days, but complete recovery can take as long as a month.
How is dengue fever spread?
-----------------------------
Dengue Fever is spread only through the bite of the infected Aedes mosquitoes.
The transmission cycle for dengue starts when:
1.Infected Aedes mosquito bites a healthy person.
2.4-7 days later,the infected person develops fever
3..When fever starts, the person is infectious for about 5 days.
4.If an Aedes mosquito bites the person during this time when he is infectious, it will be infected by the the dengue virus.
5.The virus will multiply in the second mosquito for 5-7 days.
6.The mosquito then becomes infective.
7.The cycle starts again when it bites another person.
How can you prevent being infected with the dengue virus?
----------------------------------------------------------
To prevent dengue fever, you must prevent the breeding of its carrier, the Aedes mosquitoes.
This will be explained another time
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