Headache after waking up - Best Yahoo answer

Why do i have a headache when i wake up when i go to bed late?

i can go to bed from 3 am- to 6 am- and when i get up it can be like 3 pm and it feels like a hangover or something i got a bashing headache im just wondering why does this happen?




Best Answer - Chosen by Asker


If you sleep late, your brain cells and scalp muscles do not get enough rest.

Your body rhythm is affected by the late sleep.

Your scalp muscles can contract to cause headache.

A hangover effect may occur.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Throbbing headache with pain in left nostril - Best Yahoo Answer

I have a throbbing headache with a painful cracking sensation in my left nostril?

I have had the headache for two days but the cracking in my nostril only started this morning.

I can hear as well as feel the cracking sensation and it is really painful.

Has anyone got any ideas?




Best Answer - Chosen by Asker


Any infection of the parts of the head such as tooth infection, nose infection or throat infection can cause headache.

A throbbing headache is more typical of migraine which is vascular in origin.

Any nose infection can affect the ear as well.

Sinusitis is possible.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions-Sinusitis,headache

Nausea after a Meal - Best Yahoo Answer

Anyone know what I might have?

I get nausea after I eat a meal.?

Most of the time after I eat a meal I get nausea.

I don't know why.

Does anyone know what it could be or is it nothing.




Best Answer - Chosen by Asker
Nausea may be symptom of gastric problem, gastroesophageal reflux, liver or gallbladder problem or problem of imbalance in the organ of balance in the ear, sometimes due to pregnancy, hangover effect, stress, brain tumor,etc.

It is advisable to see a doctor to determine the cause of the nausea using blood tests, ultrasound ,even a brain scan.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions- vertigo, gastritis,

Hyperextended Knees? -Best Yahoo Answer

Hyperextension Knees?

I'm a 16 year old girl, and i have hyperextension knees since young.

However, I wasnt aware that of the term till yesterday, as in,
I wasnt aware that there was a medical term for my condition.

It doesnt hurt, though it aches once in a while. I'm starting a new sport - hockey now and I am wondering if it is alright to play hockey with hyperextension knees?

Also, as my condition wasnt caused by any injury but was born with it, what should I do to correct it?



Best Answer - Chosen by Voters
Hyper extension knees are related to inherited loose ligaments.

There are people with this condition with hyperextended wrists, flat feet etc.

When the ligaments are overstretched you may have some pain.

People with mild form of this illness can participate in all sports.

In more severe cases wearing a knee guard may help to prevent over extension of the knee.

In more severe cases where dislocation of the kneecap occurs, then an operation may be required to tighten the ligaments.



Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Screw in Person's Spine - Best Yahoo Answer

If a screw went into a persons spine, is there a way it can come back out, and how?

Additional Details
It is what happened to my mom, however, the doctor told her to stay stone still, which only broke the screw and it went deeper, and now she cant feel her lower body.

This is what happened to my mom and caused her to be paralyzed, however the case isnt that bad, so thats why, and the screw brack into the spine accidently by a doctor.





Best Answer - Chosen by Asker


If a screw went into a person spine by accident, you should see a doctor to see if if can be removed.

Any iron screw lodged in the spine can become rusty and should be removed immediately.

If the screw is long and go further inwards, it may injure the spinal cord or nerve.

This may cause paralysis.

The best way is to see an orthopaedic surgeon to have it removed.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Prolonged period - Best Yahoo Answer

Long period concern, help?
Right, I started my period last Thursday and so this Thursday - still on - makes it 8 days.

I'm usually 7 days the longest and 5 days the shortest.

I started the birth control pill - my first time ever - on Friday, second day of my period.

My period seemed off on Saturday, then appeared on Sunday stayed till Tuesday, disappeared on Wednesday and then appeared again today.

It's driving me mad. I've even gone to bed with nothing on bottom fine thinking its over - but no.

Is this anything to do with the pill? Or am I just lasting a bit longer than usual?

I've gone on a diet also since Saturday - I'm considering stopping it for now because prolonged period and less calories don't seem like a good combo at the moment.

Please help.





Best Answer - Chosen by Asker


In most women, the first time they use the contraceptive pill, there may be abnormality in the menstrual cycle with spotting or excess bleeding because of the sudden change of female hormones in the body.

Sometimes the dosage of the contraceptive pill may not be suitable for the person.

If you are uncomfortable with the contraceptive pill, it is best to stop it.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions


Asker's Rating:
4 out of 5
Asker's Comment:
Thanks. It stopped finally and I checked with my GP just in case. Every things okay thankfully.

What to do for swollen eyelid? Best Yahoo Answer

Swollen eyelid !!?
today at soccer training i got hit with a ball in the eye and now my eyelid is swollen what do i do??

when will it go away??





Best Answer - Chosen by Voters


when your eye is hit by a ball, the eyelids and the tissues around the eye are injured resulting damage to walls of the cells releasing the fluid from the cells.
This will cause swelling in the tissues surrounding the eye.

If a blood vessel is damaged blood may exude from the blood vessel causing a blood clot and swelling.

You can put a cold compress on the eye which should shrink the blood vessel and reduce the swelling.

In most cases swelling of the tissues of the eye will subside within 5 days.

Blood clots may take longer to subside.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Washing Hair after removing staples in my scalp -Best Yahoo Answer

1.
Got staples in my scalp Sun Afternoon.

How soon can I wash my hair?




Best Answer - Chosen by Voters


After removing the staples, you should wash your hair and scalp. Clean the scalp, wash with mild soap or shampoo, dry thoroughly and apply some antiseptic or antibiotic cream.

If the staples are rusty , you should have an tetanus toxoid shot.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Side/Back Pain - Best Yahoo Answer

Side/back pain?
I have been having an achy pain on my left side/back & it's not all over,
it's just in a strip starting under my ribs extending down to my hip.

Also, both hips have been achy on outside of my pelvic area, although it's not in the joint.

Does anyone have any idea what could be wrong?




Best Answer - Chosen by Voters


You probably have an overstretched back muscle which can extend obliquely down to the top of the pelvic bone.

Aches on both hips may due to the muscular pain.

If you have a severe pain starting from the upper back (lower ribs) which goes down to your pelvis and have urinary difficulty, it may be caused by a stone blocking the tube leading from the kidney to the bladder.

Sometimes if there are blisters appearing on the back down the side, it could be shingles.

In your case, most likely it is muscular pain.


Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

Best Yahoo Answer to medical question about Sinusitis:

Answer to medical question about Sinusitis:
-------------------------------------------


I have a sinus infection and not I'm coughing up GREEN?
I've had a sinus infection for a week, been on meds for 2 days, now I'm coughing up green stuff. My chest hurts, and my throat is swollen. What can I do to feel better?



Best Answer - Chosen by Voters

If you have a confirmed sinus infection, the green stuff that you are coughing up is probably from the sinuses.

Any infection of the nose or sinuses can cause your throat to feel swollen and your chest to feel congested and painful.

You can try steam inhalation to loosen the green mucous stuck in your sinuses or see your doctor for a sinus washout.

Sometimes antibiotics are needed for a bacterial infection of the sinuses. With treatment you should feel within a few days.

Source(s):
http://kennethkee.blogspot.com
A Simple Guide to Medical Conditions

A Simple Guide to Vitiligo

A Simple Guide to Vitiligo
-----------------------------------

What is Vitiligo?
---------------------------

Vitiligo is a skin disorder which presents as white spots or patches on the skin.
It is not contagious.


What are the causes of Vitiligo?
----------------------------------------

The cause of Vitiligo is not known.
However many people with Vitiligo may have associated auto immune disease including thyroid disease and pernicous
anemia.
Autoimmune conditions are conditions where the body's own cells attack its cells (in this case the skin cells)
There is a progressive loss of the pigment melanin which gives us our skin color.
The loss of pigment occurs when the pigment cells (melanocytes) are destroyed and melanin cannot be produced.

What are Signs and symptoms of Vitiligo?
---------------------------------------------

white spots or patches on the skin

Common sites affected by Vitilgo are:

1.Bony surfaces - back of hands and fingers,elbows and knees

2.Body orifices - around the eyes, mouth and nose

3.Body folds - armpits and groins

Vitiligo may also occurs over an area of injury such as a cut or burn.

The hair in the vitilgo patch may be white in color.


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

1.typical white patches or spots

2.skin biopsy for microscopic examination.


What is the treatment of Vitiligo?
------------------------------------

There are different treatments for Vitiligo:

1.Corticosteroid creams
---------------------------
Corticosteroid creams are effective against small patches or spot of vitilgo but there may be side effects such as skin thinning.

2.Topical Immunodulators
----------------------------------------
Tacrolimus or pimecrolimus are topical immunodulators which work by:

1.modulating the immune attack against the melanocytes on the skin and
2.stimulating the functions of the melanocytes

3. UltraViolet Light Treatments
a.Psoralen photochemotherapy(PUVA)
PUVA is a combination treatment involving
1.the use of the drug Psoralen(P)
2.and then exposing the skin to UltraViolet A light(UVA)
hence the term PUVA.
Psoralen makes the skin temporarily sensitive to UVA which is part of natural sunlight.
Psoralen can be applied to the skin as a solution or ingested orally with subsequent exposure to ultraviolet light A.
Patient treated with PUVA may need to undergo treatment for 1 year for satisfactory results.
Use of PUVA may result in sunburn and blister fromation.

b.Narrowband UVB
Narrowband UltraViolet light B treatment does not require Psoralen tablets before treatment.
In fact this treatment is safer and as effective if not better than PUVA. Again treatment may require 1 year before satisfactory results.

c.Focused Multiple Wavelength UltraViolet Therapy(Multiclear)
This is a form of targeted light therapy as only the vitiligo areas are treated.
It is useful for small localised lesions.

d.Excimer Laser
This laser emits a certain UVB wavelength but is more costly than Multiclear Light therapy.

4.Surgery
Surgical transplants are meant for patients with stable vitligo that fail to respond to topical or phototherapy.
Stable vitiligo means no new lesions or progressive lesions for 12 to 24 months.
Surgery involve tissue and cellular grafting.

5.Camuoflage Cosmetics.
Cover up camouflage provides good color and camouflage of vitiligo lesions.
They are particularly useful for white patches on the face ansd back of the hands.

6.Sunscreens
Areas of vitiligo exposed to the sun are very prone to sunburn as they lack protective pigments.
Patients should always use broad spectrum sunsceens to protected the affected vitiligo areas.



What is the prognosis of Vitiligo ?
------------------------------------------

Generally fair.
Treatment takes time and patience.


What are the Preventive measures taken for Vitiligo ?
--------------------------------------------------------

1.Sunscreens

2.Proper skin care

A Simple Guide to Salivary Gland Cancer

A Simple Guide to Salivary Gland Cancer
----------------------------------------

What is Salivary Gland Cancer?
------------------------------

Salivary Gland Cancer is a malignant disease of the Salivary glands.

Cancers affecting the salivary glands are rare.

They can occur at any age, but are more common in people over 50.

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

The cause of the cancer is unknown.

Malignant tumours of the salivary glands are rare but there are benign or non-malignant tumours of the salivary glands which are more common.

Cancer of the salivary glands cannot be transmitted to another person through the saliva.

There is no inherited gene and the cancer do not run in families.

What are the symptoms and signs of Salivary Gland Cancer?
----------------------------------------------------------

Symptoms - non-specific and silent.

In the early stage there is no symptoms.

By the the time the symptoms appeared, the cancer may be in the advanced stage.

1.swelling on one side of the face either in front of the ear or under the jaw.

2.numbness and drooping of one side of the face (facial palsy).

3.weight loss

Signs:

palpable mass under the jaw

How do you diagnose Salivary Gland Cancer?
----------------------------------------------

1. full medical history and physical examination

2. blood tests for general screeing including tumor markers

Definite diagnosis requre the following tests:

3.X-rays to show the size and position of the cancer and possible spread.

4.CAT (computerised tomography) scan of the skull and neck to detect the enlarged salivary tumors

5.MRI (magnetic resonance imaging) scan of the skull and neck to detect the enlarged salivary tumors

6.Biopsy of the affected salivary gland for examination under a microscope through a needle or surgical removal.

Salivary Gland Biopsy
-----------------------------
Biopsy of Salivary tumor may be done to determine stage of Salivary cancer:

Stage 1 :
1.Size is < 2cm

2.no spread

Stage 2
1. Size is between 2 and 4cm

2.No spread.

Stage 3
1.Size > 4cm in size

2.There may be spread into nearby soft tissue.

Stage 4a
1.Size can be any size > 4cm

2.spread to the skin, jaw-bone, ear-canal or facial nerves.

Stage 4b
1.Size can be any size > 4cm

2.spread to other nearby bones, the base of the skull or the carotid artery.

Lymph nodes spread
-------------------
Stage 0
1. None of the lymph nodes are affected.

Stage1.
1.spread to one lymph node on the same side of the neck as the tumour.

2.Size of affected node <3cm

Stage 2a
1.spread to one lymph node on the same side of the neck as the tumour.

2.Size of the node is between 3-6cm

Stage 2b
1.spread to >one lymph node on the same side of the neck as the tumour.

2.Size < 6cm in size.

Stage 2c
1.spread to one or more lymph nodes on both sides of the neck.

2.Size < 6cm in size.

Stage3
1.Size of lymph nodes > 6cm in size.

Metastases Stages
---------------------
Stage 0
No spread to other parts of the body.

Stage 1
spread to other parts of the body, such as the lungs.

What is the treatment of Salivary Gland Cancer?
------------------------------------------------

Treatment of Salivary cancer can be
1.surgery
2.chemotherapy
3.radiotherapy

The type of treatment given depend on
1.the position of the cancer,
2.the exact type of cancer,
3.the general health of the patient.

Surgery
Surgery is done to remove the salivary gland tumor.

If necessary, surgery is also done to remove any affected lymph nodes in the neck.

Radiotherapy
Radiotherapy can be used to treat salivary gland cancers.

Radiotherapy can be used in conjunction with surgery especially where there is spread to lymph nodes and other parts of the body.

Chemotherapy
Chemotherapy involve the use of anti-cancer drugs to destroy the cancer cells.

It is however not very effective in treating salivary gland cancers and is used only more for the cancer which has spread to the lungs, bones and other parts of the body.

What is the Prognosis of Salivary Gland cancer?
-------------------------------------------------

The prognosis of Salivary cancer is usually fair

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Survival rates are best in the slow growing tumors.

How to prevent Salivary Gland cancer?
------------------------------------

There is no way to prevent salivary gland cancer but proper mouth hygience may hlp to prevent infections and chemicals in the mouth from causing mutations in the salivary gland cells.

Smoking should be avoided if possible.

A Simple Guide to Atopic Dermatitis

A Simple Guide to Atopic Dermatitis
----------------------------------------

What is Atopic Dermatitis?
-------------------------------------

Atopic Dermatitis is a common skin condition which presents as a chronic, relapsing, and very itchy rash at some point during childhood.

Atopic Dermatitis clears and often disappears with age.

What causes Atopic Dermatitis?
-------------------------------------

The causes of Atopic Dermatitis is unknown.
However some possible causes are:
1.Genetic

Genes play a part in Atopic Dermatitis as the condition runs in families

2.External causes

a.abnormal response of the body’s immune system play a part in the development of Atopic Dermatitis.

b.damage to the skin barrier may lead to dryness and inflammation of the skin

c.irritating substances overacts, causing itching and scratching.

Atopic Dermatitis is not contagious .

Who is at risk of Atopic Dermatitis?
------------------------------------------

Atopic Dermatitis occurs in both children and adults, but usually appears during infancy.

1.Those who are genetically predisposed

2.Those exposed to environmental triggers

a.rough or coarse materials coming into contact with the skin causes itchiness.

b.feeling too hot and/or sweating will cause an outbreak.

c.certain soaps, detergents, disinfectants,

d.contact with juices from fresh fruits and meats,

e.food allergens in childhood such as cow's milk, hen's egg,peanuts, nuts, shellfish

f.dust mites,

g.animal saliva and faeces may trigger itching.

h.Upper respiratory infections (caused by viruses) may also be triggers.

i.Stress can also sometimes aggravate an existing flare-up.

Many people who have Atopic Dermatitis also suffer from Atopic rhinitis and asthma, or have family members who do.

Atopic Dermatitis affects both sexes equally.

Where does Atopic Dermatitis appear?
------------------------------------------

Atopic Dermatitis can occur on just about any part of the body

In infants, Atopic Dermatitis typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

In children and adults, Atopic Dermatitis typically occurs on the face, neck, and the insides of the elbows, knees, and ankles.

In some people, Atopic Dermatitis may "bubble up" and ooze.

In others, the condition may appear more scaly, dry, and red.

Chronic scratching usually make the skin worse taking on a leathery texture because the skin thickens (lichenification).

What are the symptoms and signs of Atopic Dermatitis?
-----------------------------------------------------------

Typical features of Atopic Dermatitis are:

1.dry,

2.red,

3.extremely itchy patches on the skin.

4.Oozing of the rash

5.Thickening of the skin

How is Atopic Dermatitis diagnosed?
-------------------------------------------

1.History and appearance of the rash

2.Screening test for food allergy

3.Blood test for specific antibodies to food substances

How can Atopic Dermatitis be treated?
------------------------------------------

Treatment of an Atopic Dermatitis treatment routine is:

1. prevent scratching.

2. application of lotions or creams to keep the skin as moist as possible after bathing (within three minutes is a common recommendation) so that the moisture from the bath is "locked in."

3.Cold compresses applied directly to itchy skin can also help relieve itching.

4.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.

Hydrocortisone cream and ointment are preferred to prevent side effects such as skin thinning.

5.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).

6.topical or oral antibiotics may be needed for the skin infection which may affect the dry inflamed skin.

7.sedative antihistamines are sometimes used to reduce the itch

8.Tar treatments can have positive effects; however, tar can be messy.

9.Phototherapy requires special equipment (lights).

10.cyclosporine A, which modifies immune response; however, this is used only in extreme cases because of its association with serious side effects.

How can Atopic Dermatitis be prevented?
---------------------------------------------

Atopic Dermatitis outbreaks can usually be avoided with some simple precautions.

The following suggestions may help to reduce the severity and frequency of flare-ups:

Moisturize frequently

Avoid sudden changes in temperature or humidity

Avoid sweating or overheating

Dress the child in breathable cotton clothes

Reduce stress

Avoid scratchy materials (e.g., wool or other irritants)

Avoid harsh soaps, detergents, and solvents

Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)

Be aware of any foods that may cause an outbreak and avoid those foods

A Simple Guide to Heat Stroke

A Simple Guide to Heat Stroke
----------------------------------------------

What is Heat Stroke?
------------------------------------

Heat Stroke is a disturbance of the heat regulating mechanism of the body which can result in hyperpyrexia (high body temperature), syncope (fainting), convulsions (fits), coma and sometimes death


Who is at risk of Heat Stroke?
----------------------------------------------

1.people staying in hot dry climates (eg. desert)

2.People training under hot temperature (eg. soldiers)

3.During heat waves.


What are the causes of Heat Stroke?
--------------------------------------------------

Most forms of Heat Stroke are due to

genetic conditions:
------------------------

1.Icthyosis

Acquired Heat Stroke
----------------------

1.Body's inability to dissipate body heat

2.Strenuous exercise without sufficient hydration

3.Prolonged exposure to high temperatures especially sunshine especially in desert and heat waves

4.Dehydration and inability to sweat.

5.Medications:
anticholinergics
antidepressants
MAO inhibitors


What are Signs and symptoms of Heat Stroke?
---------------------------------------------

Onset is usually sudden.

Symptoms:

1.feeling of weakness

2.dizziness and nausea

3.headache

4.chest discomfort

5.flushing of face and body

Signs:

1.Fever

2.Flushed skin

3.Muscle twitching

4.cramps

5.tachycardia, raised blood pressure

6.Dilated pupils

7.reduced reflexes

8.Seizures and coma

9.Hyperventilation

10.Cardiac failure


How is the diagnosis of Heat Stroke made?
--------------------------------------------------------

1.History of exposure to high temperature

2.Body temperature

3.Blood electrolytes and acid base


What are the complications of Heat Stroke?
-----------------------------------------------

1.Brain damage

2.Heart damage

3.Kidney damage


What is the treatment of Heat Stroke?
------------------------------------

Heat Stroke is a life threatening emergency.

1.Reduce temperature with ice packs or ice baths

2.Alcohol sponging if ice not available

3.Cooler packs if available

4.Intravenous fluids to correct dehydration and electrolytes

5.Oral fluids and isotonic drinks.

6.Anticonvulsant to prevent seizure or fits

7.Remove drugs which can cause dehydration such as anticholinergics and antidepressants.


What is the prognosis of Heat Stroke ?
------------------------------------------

Prognosis is poor if treatment is delayed.

Treat the condition urgently as it is a life threatening emergency.

What are the Preventive measures taken for Heat Stroke ?
--------------------------------------------------------

Prevention is by

1.frequent drinking of water and

2.avoiding extreme hot temperature.

A Simple Guide to Kidney Cancer

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

What is Kidney Cancer?
------------------------------

Kidney Cancer is a malignant disease of the kidney.

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

1.Hereditary- hereditary kidney cancer is related to the Von Lindau syndrome.

2.Smoking. cigarettes smoke chemicals has been known to damage the Kidney cells

3.Uncontrolled hypertension-damage to kidney cells may contribute to Kidney cancer

4.Obesity has been found to have some causal effect

5.Age - more common in in 50-70 age group

6.Long term dialysis for kidney failure.

What are the symptoms and signs of Kidney Cancer?
-------------------------------------------------------

Symptoms - non-specific and silent.

In the early stage there is no symptoms.

By the the time the symptoms appeared, the cancer is usually in the advanced stage.

1.painless hematuria or blood in urine

2.pain in the renal flanks

3.Fever

4.weight loss

Signs:

1.tenderness in renal area of backs

2.palpable mass in the side of abdomen

How do you diagnose Kidney Cancer?
----------------------------------------------

Diagnosis can usually be made by :

History
-----------

1.hematuria

2.Renal flank pain

3.Weight loss

Liver function tests
---------------------

may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels) in the absence of liver disease.

Ultrasound or abdominal CT
------------------------------

may be used to identify tumors.

Kidney Biopsy
---------------
biopsy of kidney may be done to determine types of Kidney cancer:

Clear Cell Type: 75%
Papillary type: 20%
Chromophole type: 4%
Others: 1%

What is the treatment of Kidney Cancer?
------------------------------------------------

Treatment of Kidney cancer can be
surgery
chemotherapy
radiotherapy
immunotherapy
biological targeted therapy
depending on the stage of the cancer.

Surgery
--------------

If the cancer is localized within the kidney , then it is surgically resectable and curable.

No treatment after surgery has been proven to prevent recurrence.

Depending on the size of the cancer, the recurrence rate varies from
10% in Stage I
60% in Stage III

Once recurrence occur then the cancer is considered as a Stage IV cancer and therefore incurable.

The aim of treatment then is palliative with emphasis to improve overall survival rates and quality of life.

Immunotherapy
-----------------

High dose immunotherapy such as interleukin may be able to cure less than 5% of the kidney cancer patients.

It is however toxic and potentially life threatening and is used for patients not suitable for surgery.

Low dose immunotherapy such as interferon is better in that it can relieve symptoms and improve quality of life for an average of 3-6 month in 15% of cases treated.

Despite its low dose the side effects can also affects the treatment of the patients such as fever, chills and loss of appetite.

Biological targeted therapy
-------------------------------------

These drugs target the growth of the cancer cells by suppressing the cellular pathways which stimulates the growth of the abnormal tumor blood vessels and the tumor cells .

These treatments have been proven to better in terms of better response and length of the disease control compared to interferon and interleukin.

There has also being an improved overall survival rate with a reduced risk of death by 28%.

Side effects are hypertension, ischemia of heart, fatigue, loss of appetite, diarrhea and loss of weight.

The approved drugs are sorafenib, sumitinib and tensirolimus.

Chemotherapy and radiotherapy
-----------------------------

Chemotherapy and radiotherapy have been found to be ineffective for renal cancer treatment.

What is the Prognosis of Kidney cancer?
-------------------------------------------------

The prognosis of Kidney cancer is poor

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Median survival from diagnosis is around 1 year

3.5-year survival is lower than 5%.

4.Kidney cancer has one of the highest mortality of all the cancers.

How to prevent Kidney cancer?
------------------------------------

Avoid smoking

Reduce weight in obese patients

Control high blood pressure to prevent damage to the kidney

Avoid taking toxic substances which may damage or injure the cells of the kidney.

A Simple Guide to Pleural effusion

A Simple Guide to Pleural effusion
-------------------------------------

What is Pleural effusion?
----------------------------

Pleural effusion is excess fluid collection in the pleural space between the parietal and visceral layers of the pleural cavity.

Excessive fluid can limit the expansion of the lungs and cause breathing difficulty.

What the types of Pleural effusions and their causes?
------------------------------------------------------------------

There are 4 types of pleural effusion which can occur in the pleural space:

1.Serous fluid (hydrothorax)

This is essentially passive collection of extracellular fluid with a specific gravity of <1.015 and protein < 2-3g/dl.

It is translucent in color.

It occur as part of :
a.generalized edema

b.left heart failure

c.liver cirrhosis giving rise to hydrothorax

2.Pus (pyothorax or empyema)

This consists of inflammatory or neoplastic fluid with high protein content.

It is usually yellow or orange in color.

There may be cells or pus or bacteria.

Causes include:
a.bacterial and viral infections such as pneumonia

b.tuberculosis

c.intra-abdominal abscess

d.autoimmune diseases like SLE, rheumatoid arthritis

e.neoplasm(cancer of the lung)

3.Blood (hemothorax)

The exudate is typically blood stained.

Causes are:
a.pulmonary embolism and infarction

b.neoplasm especially with secondaries to lungs

4.Chyle (chylothorax)

Here the exudate arise from the leakage of thoracic duct.

It is milky in appearance.

Causes are:
a.Trauma including chest and heart surgery

b.filariasis in the tropics

What are the symptoms and signs of Pleural effusion?
-----------------------------------------------------------

Symptoms:
-----------

1.Breathless

2.Side Chest pain

3.dry cough

Signs:
----------

1.Dullness to percussion

2.Faint or absent breath sounds

3.Decreased movement of the chest

4.Decreased vocal resonance

5.Fremitus

6.pleural friction rub

How do you made a Diagnosis of Pleural effusion?
----------------------------------------------------

Pleural effusion is usually diagnosed on:
1.medical history and physical exam,

2.chest x-ray.
Chest films with the patient lying on their side are more accurate and can show fluid level as low as 50 ml of fluid.

Upright chest films can show fluid level of at least 300ml of pleural effusion

In large effusion there may be tracheal deviation away from the effusion.

3.CT scan of chest showing left sided pleural effusion.

Effusion fluid often settles at the lowest space due to gravity;

4.Pleural tap or thoracentesis.

A needle is inserted through the back of the chest wall in sixth, seventh or eight intercostal space in midaxillary line, into the pleural space.
The fluid may then be evaluated for the following:

Chemical composition including
protein,
lactate dehydrogenase (LDH),
albumin,
amylase,
pH and
glucose

Gram stain and culture to identify possible bacterial infections

Cell count and differential white cell count

Cytology to identify cancer cells

Cytology to identify some infective organisms

Other tests :
lipids,
fungal culture,
viral culture,
specific immunoglobulins

5.Thoracoscopy
If cytology does not show cancer but cancer is still suspected, then a thoracoscopy, or needle biopsy of the pleura may be done to exclude cancer.

What is the Treatment of Pleural Effusion?
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1.Pleural Aspiration is done for relief of chest discomfortand breathlessness.

The Chest Drainage Device is usually connected to an underwater seal below the level of the chest.

Air or pleural fluid is allowed to escape from the pleural space but nothing is allowed to return to the pleural cavity.

Larger effusions may need insertion of an intercostal drain .

2.Treatment depends on the underlying cause of the pleural effusion.

a.Therapeutic aspiration may be sufficient in some cases of trauma and leakage.

b.Installation of antibiotics( eg.bleomycin, tetracycline/doxycycline) in pleural cavity

c.Installation of chemotherapy drugs for cancer into the pleural cavity.

d.treatment of filariasis cases with anti-parasitic drugs

e.surgical pleurodesis- here the parietal and visceral pleural surfaces are made to adhere to each other to prevent accumulation of fluid.

What is the Prognosis of Pleural Effusion?
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Recovery of patient from the pleural effusion after appropriate treatment of the underlying disease is the rule.

Recurrence from returning cancer or infections may be common.