A Simple Guide to Liver Cancer

A Simple Guide to Liver Cancer
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What is Liver Cancer?
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Liver Cancer develops when the liver cells undergo abnormal changes to form cancer cells.
Most Primary cancer of the liver begins as mutated hepatocytes(liver cells).
Secondary cancer of the liver is due to spread from the stomach, colon, breast, lungs, ovaries etc

What is the incidence of Liver Cancer?
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Liver cancer is one of the most common cancer.
It occurs in men more than women.
It is more common in the 40s and 50s age groups.

What are the Risk Factors of Liver Cancer?
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The main risk factor for liver cancer is
1.Hepatitis B infection.

Other important risk factors include
2.Hepatitis C infection

3.alcoholic liver disease (disease of the liver caused by heavy alcohol consumption).

4.family history of liver cancer

5.Chemicals exposures such as nitrites,solvents, hydrocarbons,viny chloride

6.poisons (e.g. aflatoxin present in some spoilt or mouldy peanuts).

7.inherited liver diseases (alpha-1 anti-trypsin deficiency)

8.Drug abuse eg heroin


What are the Signs and Symptoms of Liver Cancer?
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During the early stages, most people with liver cancer do not show any signs or symptoms.
Signs and symptoms, when they do appear, include:

1.loss of appetite and weight

2.discomfort or swelling in the upper part of the abdomen on the right side

3.weakness and fatigue

4.nausea and vomiting

5.jaundice - yellowness of the skin and eyes

6.dark color urine

7.Persistent or swinging fever

How is the Diagnosis of Liver Cancer confirmed?
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1. full medical history especially history of Hepatitis B and alcohol

2. full examination especially of the liver

3.an ultrasound scan of the liver and gallbladder, if possible the whole abdomen.
4.CT scan or MRI of the liver and surrounding tissues


5.blood tests (a protein present in blood called the alpha- fetoprotein or AFP may be found to be raised in liver cancer)

6.needle liver biopsy into the liver swelling as detected by ultrasound or MRI (to confirm the liver cancer).

With the diagnosis confirmed, the doctor will proceed with further tests to find out how advanced the liver cancer is. This will help the doctor to plan the treatment.

What is the Treatment of Liver Cancer?
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As in all cancers, treatment includes surgery, radiation therapy, chemotherapy.

In Liver cancer percutaneous ethanol (alcohol) injection is injected directly into the tumour, by means of a small needle, to kill the cancerous cells.

Liver transplant can also be carried out in selected cases where the size of the cancer is not too massive but surgery is not feasible due to the patient's limited liver reserve(provided a suitable liver donor can be found).

Treatment depends on the the stage of the cancer as well as health of the affected person.

The goal of treatment is complete cure.

However, where this is not possible, treatment is aimed at
preventing the tumour from spreading or growing.
Helping to eliminate uncomfortable symptoms is also an important aspect of liver cancer treatment.

How to Protect yourself from Liver Cancer?
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Prevention from getting liver cancer is by taking steps to reduce your risk factors.

1. Reduce your risk of Hepatitis B by getting vaccinated. The Hepatitis B vaccine is safe and effective.
Both Hepatitis B and C are spread through infected blood or sexual fluids as well as intravenous drug abuse. It is therefore important to avoid activities that put you at risk:

2.Avoid multiple sex partners and having sex with commercial sex workers, strangers or anyone with multiple sex partners.

3.Do not abuse drugs or share injection needles.

4.Never share personal items like razors, toothbrushes or other items that may cause breaks in the skin.

5.Visit only reliable operators for ear/body piercing, tattooing or acupuncture.

6.It is also important that you limit your consumption of alcohol as excessive drinking can give rise to liver disease and increase your risk of liver cancer.

The liver is one of the largest and most important organs in your body. It performs many essential functions including:
making and storing of essential nutrients
making important hormones and enzymes
breaking down harmful substances.

Do not abuse Your LIVER by excessive drinking or taking drugs!

A Simple Guide to Gastritis

A Simple Guide to Gastritis
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What is Gastritis?
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Gastritis is a disease which is caused by inflammation of the stomach lining.
It may presents as gastritis ,peptic gastric ulcer or if it extends to the duodenum(first part of small intestine) duodenal ulcers.

What are the causes of Gastritis?
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Two main causes are

1.helicobacter pylori infection - this bacteria damages the protective lining of the stomach making the underlying stomach tissue more vulnerable to the acidic gastric juice.

2.excessive production of acidic gastric juice
Excessive production of acidic gastric juice burns into the protective lining of the stomach and cause inflammation of the underlying stomach tissue.
The causes of excessive production of acidic gastric juice are:
1. Most common is stress and anxiety which automatically increase the production of the acid as a result of sympathetic nervous reaction
2.hereditary- some gastric patient has family history of gastric problem. Blood group O tends to have more gastritis while Blood group A has a tendency towards stomach cancer.
3.irregular meals tend to cause more acidic gastric juice to form at regular meal time.
4.alcohol and smoking has been associated with increased acid formation
5.Drugs: prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
6. diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.

What are the Symptoms of Gastritis?
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The most common symptoms are
1.upper abdominal upset or pain.
Other symptoms are
2.belching, abdominal bloating,
3.nausea, and vomiting
4.indigestion or of burning in the upper abdomen or in the chest(heart burn).
5.Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.

How do you diagnose Gastritis?
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Gastritis is diagnosed through one or more medical tests:
Medical history - past and family history of gastritis
Physical examination- epigastric bloating or tenderness
Upper gastrointestinal endoscopy.
The doctor eases an gastroscope, a thin tube containing a tiny camera, through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests(biopsy).
The biopsy will detect how bad is the inflammation or whether there are underlying cancer cells. In additional if any polyps (benign swelling of the lining of the stomach) are detected, they are removed at the same time and sent for biopsy.
Blood test. The doctor may check your blood for any evidence of H.pylori infection and your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Urea breath test can also determine whether you have H.pylori infection
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.

What is the Treatment of Gastritis?
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The main treatment is usually
1.reduce stress
2.reorganisation of work in such a way as to be able to handle the pressure of work better as well as to have regular meals
3.Control of diet - avoid hard foods such as peanuts , tough meat, spicy food, cold food, black coffee, strong tea,citrus fruits and their juices,carbonated beverages, deep fried or oily food.
4. Take more frequent and smaller meals.
5. Avoid alcohol and smoking
6. Avoid drugs such as aspirin, painkillers,steroids which may irritate your stomach and cause increase in acid production
Medical treatment:
Treatment usually involves taking drugs
1.Antacids:to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.)
2.H2 Antagonist: to reduce to production of acidic gastric juice.(cimetidine, ranididine,omeprazole, Nexium etc)
3. Antispasmodics: anticholinergic drugs like buscopan, librax reduce the spasm in the stomach and duodenum
4. Antiflatulents - to reduce gas in the abdomen
5.If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection.

Once the underlying problem disappears, the gastritis usually does too.
Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
What are the Complications of untreated Gastritis?
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Any untreated gastritis can cause complications such as:
1. peptic ulcers
2. bleeding ulcers
3.perforated stomach and peritonitis

Gastritis or ulcer is not healed overnight. The chances of satisfactory gastric recovery are excellent. However recurrences are always possible so do not stop your medications, good food habits and healthy lifestyle too soon.

A Simple Guide to Cerebral Palsy

A Simple Guide to Cerebral Palsy
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What is Cerebral Palsy?
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Cerebral palsy refers to a group of disorders characterised by loss of motor functions or any other nerve functions that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don't worsen over time.
Even though cerebral palsy affects muscle movement, it isn't caused by problems in the muscles or nerves. These disorders are caused by brain damage that occurs during foetal development or near the time of birth.

What are the causes of Cerebral Palsy?
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The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later.
Cerebral Palsy is mainly caused by brain damage that occurs during foetal development.
A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life:
1. brain infections such as bacterial meningitis or viral encephalitis
2. head injury from a motor vehicle accident, a fall, or child abuse.

It is not an inherited disease.

What are the Symptoms of Cerebral Palsy?
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The early signs of cerebral palsy usually appear before a child reaches 3 years of age. Babies with Cerebral Palsy are usually slow to reach developmental milestones.
Abilities like learning to roll over, sit, crawl, smile or walk are not well developed.

The motor abilities will often seem unusual and strange.
The most common are:
1.lack of muscle coordination when performing voluntary movements (ataxia);
2.stiff or tight muscles and exaggerated reflexes (spasticity);
3.walking with one foot or leg dragging;
4.walking on the toes,
5.crouched gait, or a "scissored" gait:
6.muscle tone that is either too stiff or too floppy.

The symptoms of Cerebral Palsy vary from just mild clumsiness to extensive uncontrolled muscle spasticity.
Many with cerebral palsy have other disabilities :
1.seizures,
2.an inability to see, hear, speak or learn as others do,
3.psychological or behavioural problems.

Not everyone with Cerebral Palsy is retarded. Some are of average intelligence.
While some people with Cerebral Palsy have learning disabilities many others do not.

What are the Types of Cerebral Palsy?
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There are four types of Cerebral Palsy:
1.Spastic Cerebral Palsy, the most common type, is a disorder in which certain muscles are stiff and weak.
2.Athetoid (dyskinetic, hypotonic, dystonia) Cerebral Palsy where involuntary movements are present.
3.Ataxic Cerebral Palsy occurs when the Cerebellum has been damaged, thus causing lack of coordination and jerky movements. This form of Cerebral Palsy have staggered or fragmented movements often involving tremors or exaggerated posturing (athetosis) and bizarre twisting motions.
4.Mixed Cerebral Palsy is when two or more types of cerebral palsy are present in the same person.

What is the Treatment of Cerebral Palsy?
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Cerebral Palsy is a lifelong condition that cannot be cured.
The treatment is aimed at maintaining or improving the quality of life, providing the sufferer with tools to enjoy a near-normal life.

There are basically three types of treatment for Cerebral Palsy:
1.Surgery can be used to correct muscle contractures - removal of tight contractures that inhibits proper movement of the limbs.
2.Drugs such as clonazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic medications can help to control abnormal movements.
Alcohol or botulinum toxin type A (Botox) injections into muscle may be used to reduce spasticity for a short time so health care providers can work to lengthen a muscle.
3.Adjunctive therapies include
a.Physiotherapy, the most common treatment for cerebral palsy, consists of special exercises designed to increase and improve the range of movement and strength of the muscle groups, is aimed at strengthening and stretching muscles and preventing spasticity as well as increasing muscle control.
b.Occupational therapy is designed to help the child develop the fine motor skills needed to function day-to-day at home and school.
c.Speech therapy will also help the child develop communication skills.

What is the prognosis of Cerebral Palsy?
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Cerebral palsy doesn't always cause profound disabilities.
A child with severe cerebral palsy might be unable to walk and need extensive, lifelong care.
Another with mild cerebral palsy might be only slightly awkward and require no special assistance.

Supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.

A Simple Guide To Gout

What is Gout?
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Gout is a disease caused by the excessive uric acid in the blood.

Who get Gout?
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Gout is often hereditary so even young adults are affected.
It occurs more commonly in men than in women.

How does it cause problems?
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The uric acid in the blood is usually discharged from the body dissolved in the urine and the intestinal tract and sometimes as perspiration through the skin.

1. Gouty Arthritis
high concentration of uric acid in the blood caused the formation of needle shaped urate crystals which are deposited in and around joints thus causing pain and swelling.

2.Kidney stones
Deposits can also form in the kidney and urinary tract as urate crystals or stones.

3.Skin urate trophi
Some urate crystals are also deposited in the skin, mostly commonly at the earlobe and joints.

What are the symptoms of Gouty Arthritis?
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The symptoms of gouty arthritis are usually of sudden onset.
They are:
1.pain
2.swelling
3.pain
4.joint feels hot

Where does gouty arthritis attack?
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These are the most common joints affected by Gout:

1. Big toe 76%
2. Ankle 50%
3. Knee 32%
4. Fingers 25%
5.Elbow 10%
6. Other Joints 2%

How do I prevent Gout?
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1.Drinks lots of fluids(at least 8 glasses of water a day).
This will help to excrete the uric acid through the urine and dilute the uric acid
concentration in the blood.

2.Avoid food which can produce high levels of uric acid. These are high protein foods such as:

Animal organs -liver,kidneys, intestines,brain
Seafood - especially prawns, crabmeat, lobsters, cockleshells, fish roes
Bean products- beancurds, soya beans,bean sprouts, peanuts
Alcohol - cause dehydration in the blood raising the concentration of uric acid.

3.Avoid fasting and starvation - again this raises the concentration of uric acid in the blood.
Obesity should be slowly reduced. The over-weight body affects the joints.

4.Avoid certain drugs like diuretic which reduces the volume of water in the blood and
raises the concentration of uric acid.

5.Take medications like allopurinol which help to reduce the production of uric acid.

How to treat an acute attack of Gouty arthritis?
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1.Take medicine like probenecid or cochicine which helps to flush the uric acid out through the urinary tract.

2.Drinks lots of water (eg. 3 glasses of water) immediately during an acute attack.

3.Rest the joint. If the the big toe is affected, raise it above the heart level to help the blood flow.

What are the Complications of Gout?
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1.Kidney stones may develop in the kidneys or urinary tract causing pain and damage to the kidneys.
2.Recurrent attacks of gout may erode the surfaces of the joint resulting in permanent damage.