A Simple Guide to Coughing

A Simple Guide to Coughing
------------------------------

What is Coughing?
----------------------

Coughing is the reflex mechanism in which the body tries to get rid of excessive mucus and phlegm accumulated in the lining membranes of the respiratory tract.

The secretions from the lining of the respiratory tract trap and then flush out the viruses, bacteria and other particles like smoke, haze particles.

It prevents serious infections from entering the lungs and bronchial tubes.

What are the common causes of cough?
---------------------------------------

Coughing is usually caused by the following:

Infections:
1.bacterial or viral infection of the nose and throat such as the common cold or influenza.(yellow or green phlegm)

2.anaerobic infections of the mouth,

3.Infection of the tonsils, nose and sinuses(postnasal drip)

4.Bacterial infection of the bronchial tubes and lungs(bronchiectasis, bronchitis, pneumonia, sinusitis, or tracheitis).
This often comes with rusty or green mucus.

Dry mouth:
1.Insufficient drinking of water

2.medications especially ACE inhibitors(eg. enapril) can cause dry persistent coughs

Allergies:
1.Certain plants, pollens, chemicals, cosmetics can cause allergic reactions in the throat and bronchial causing cough. (white clear phlegm)

2.Asthma - narrowing of the bronchial tubes due to allergic and other causes usually results in white sticky clear productive phlegm

Smoking:
Cigarettes smokes contains 40 over chemicals which irritates the cells in the lining of the bronchial tubes causing a chronic cough

Stress:
Stress can cause cough due to dryness of mouth during stress or anxiety, causing the saliva to dry up and producing dry unproductive cough.
The cough in stress usually disappears during sleep.

Gastric problems or indigetions
1. Indigestion of food in the stomach can cause the undigested food in the stomach to produce gas in the stomach which goes upwards to the throat drying saliva which then become irritating phlegm in the throat.

2.gastroesophageal reflux of food can also cause the acid and undigested food to travel to the mouth and produce mucus secretions.

Systemic diseases:
1.Congestive heart failure

2.Lower respiratory tract infections

3.Chronic Obstructive Lung Disease

4.Carcinoma lung.

What investigations are needed for cough?
------------------------------------------

1.chest X-ray

2.sputum culture

3.pulmonary function tests

What is the treatment of Coughing?
-------------------------------------

Medications
1.Approprate Antibiotics, antifungal for infections of throat and bonchial tubes

2.Antihistamines for allregic cough

3.Bronchodilators for asthma and Chronic Obstructive Lung Disease

4.cough mixtures - expectorants helps to expel out the phlegm
- suppresant suppress the cough -especially for dry cough and at night to stop the cough

5.Antacids and antiflatulent agents to get rid of gas in stomach and prevent reflux

6.Diuretics for treatment of congestive heart failure especially in the elderly

Healthy Lifestyle:
1.drinking several glasses of water a day prevents dryness of mouth

2.Avoid cold, acidic, spicy and oily food which irritates the throat

3.Proper oral hygience after eating: brushing of teeth and flossing.

4.Gargle mouth after every meal.

4.Avoid smoking

6.Avoid frequent usage of the voice and throat - do not talk too much

6.Treat underlying condition such as asthma, diabetes, liver, kidney and other conditions.

A Simple Guide to Erectile Dysfunction

A Simple Guide to Erectile Dysfunction
-------------------------------------------

What is erectile dysfunction (ED)?
----------------------------------------

Erectile dysfunction is defined by the WHO as "the consistent or recurrent inability of a man to attain and/or maintain a penile erection of the penis sufficient for sexual performance"

The WHO sponsered Consultation recommend" a minimum of three months of erectile difficulty qualified foe a diagnosis of Erectile Dysfunction."

What is the incidence of ED?
-----------------------------------

The incidence of ED is unknown:
ED is currently underdiagnosed and undertreated.
More than 50% of all men 40-70 years old are likely to experience it.

What are the Causes of ED?
----------------------------

Erectile dysfunction can be due to:
1.Medical causes
2.Lifestyle causes
3.Psychosocial causes
4.or a combination of these.

Medical causes:
------------------

1.vascular disease-is the most common cause of ED.
atherosclerosis(hardening of the arteries)

high blood pressure

high cholesterol

heart disease

stroke

All these conditions affects the blood flowing and out of the penis.

2.diabetes-
can cause nerve damage and damage to the blood vessel to the penis resulting in two thirds patients developing ED

3.nerve disease-
such as spinal cord disease, nerve degeneration from diabetes and alcohol can reduce the sensitivity of the nerves to the penis

4.hormonal problems-
low levels of testosterone(male hormone) can cause ED

5.Surgery-
any surgery of rectum,colon or prostate cancer and radiation therapy in the genital area may damage nerves and blood vessels to the penis.

6.Trauma-
spinal cord injury and pelvic fractures damages the nerves and blood vessels to the penis.

7.Side effects of medications (e.g. certain high blood pressure medications, antidepressants,tranquillisers) may reduce the blood flow to the penis

8. Urinary infections and a disease called Peyronie's Disease(causing scar tissue in the penis) can cause ED.

Lifestyle causes:
----------------------

1.alcohol -
heavy drinking reduces the ability to have a strong erection. long term excessive drinking damage nerves and blood vessels to the penis.

2.Smoking-
The incidence of ED in smokers are hiher than in non smoker because the toxic chemicals in the cigarettes can damage nerves and blood vessels to the penis.

3.Substance abuse such as heroin etc can cause damage to the nerves and blood vessels to the penis.

4. Sedentary lifestyle-
Lack of exercise may lead to ED due to poor blood circulation

Psychosocial Causes:
-----------------------

1. Performance anxiety -nervousness and worry about poor sexual performance
2. Stress due to any cause

3. Depresssion

4. Relationship Problems- marital problems and tensions may affect sexual relationship

5. fatigue.

How is the diagnosis of ED made?
---------------------------------

1.medical hisory especially about diabetes, hypertension, medications, alcohol adrug abuse,smoking.

2.medical examination including genitals and prostate

3. Blood tests of testosterone, cholesterol, sugar and PSA( in males above 50)

What is the treatment of ED?
------------------------------

Successful treatment of erectile dysfunction includes:

1. Lifestyle modifications:
exercising

dieting

quitting smoking

reducing alcohol/drug abuse

counselling to manage anxiety/stress/marital problems

2.treatment of underlying medical conditions such as diabetes

3.change of medications

4.medication for treatment of ED.

There are now oral medications available to treat erectile dysfunction.
They belong to a group of drugs known as phosphodiesterase inhibitors
e.g. Viagra, Cialis, Levitra.

There is no instant erections when the medicine is taken but with physical and psychological stimulation erections do occur.
Most of the men who has taken the drugs have had improvements in their erectile functions regardless of the cause of the ED.

Certain patients with heart problems or a history of stroke are advised against taking medications belonging to this group.

6.Other treatments for erectile dysfunction

a.Penile Injection therapy- medication which increases the blood flow in the penis is injected into the penis to cause erection before sexual activity

b.Intrautrethral therapy -pellets of medications which increases blood flow is inserted into the urethra which is the tube from the bladder to the outside.

c.Vacuum therapy :
This procedure holds the blood in the penis using a ring at the base of the penis

d:surgery for blocked blood vessels

e.penile implants -these are inserted into the penis and inflated when there is a desire for sexual intercourse.
This surgery is offered when all other options failed.

How to cope with ED?
-----------------------

Erectile dysfunction can cause a lot of stress on one’s marital relationship.

Communication and honesty with the spouse is important in ED.so that she understands the problem and that she is not the cause of the problem.

In recent years, more men are becoming aware of the treatment of erectile dysfunction and are seeking help.