Monthly Archives: June 2011

All About A Proctologist

Proctologist is a physician who deals with the digestive tract, specially the final part of the digestive tract- the anus, colon and the rectum.

Proctologist help in the diagnosis of the patient’s problem, they help in determining the course of action, prescribe proper medicine and sometimes may take part in the treatment procedure as well. A proctologist basically works with the laboratory tests and help in the diagnosis of the condition affecting the patient.

A proctologist is also referred to as a colorectal surgeon. The word proctology is derived from a Greek word. Proktos means behind or rear quarters and logy meaning study. He sees a variety of conditions in his or her normal practice. He generally works very closely with an urologist and a gynecologist/obstetrician.

The condition a proctologist treats are varied which are as follows:

-severe constipation

-fecal inconsistency

-cancer of the colon

-rectal cancer

-conditions like fissures, fistulas and hemorrhoids

-birth defects like imperforated anus

-any kind of swelling or infection in the anus and rectum

-in rectal prolapse condition where there is the protrusion of the walls of the rectum into the anus.

-treatment of colic disorders like in conditions like crohn’s disease

-repositioning of the rectal area

A proctologist is consulted when a surgery is needed or when a complex proctological condition exists.

He provides a specialized surgery which is non-invasive and high quality care is provided to the patient.

 

 

Proctologist duties:

-the most important part of a proctologist’s duties is the correct diagnosis of the condition

-he looks for signs of pain, swelling, abnormal growth, constipation or any kind of discomfort in the anus, rectum and the colon area

-to decide the line of treatment he is expected to perform routine tests such as colonoscopies and biopsies

-an important part of a proctologist’s working is to treat his patients holistically

-he might advice and suggests certain dietary and lifestyle changes

-he decides the medicine and the correct surgery needed to handle a particular case successfully

-colectomies, polypectomies and stricture plasties are the common surgeries performed by a proctologist. Colectomy is a procedure in which the colon is removed or repositioned. Polypectomies are done to remove the polyps and stricture plasties are done to remove the scar tissue from the bowels

proctologists generally work in a clinic, hospital or they may have a private practice

-patients who generally come to a proctologist are referred by a general care physician

To become a proctologist one must become a medical doctor. He should then gain access to a proctologist training program. He should complete the course and become a licensed practisioner. All proctologists are surgeons. The first step in becoming a proctologist is completing medical school. They must be fully certified surgeons. Proctology specialty program is available at many medical schools. A typical course of proctology is of five years. It is a combination of surgical and diagnostic courses. Studying for this course involves lot of time, effort and focus. All proctologists get affiliated to at least one major hospital in order to meet their patients need.

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Progesterone Cream: What You Should Know

Progesterone cream is used in women to ease menopausal symptoms. One of the hormones found in a women’s body is progesterone. It is a steroid hormone made up of corpus luteum of the ovary at ovulation. This hormone is also secreted by the adrenal glands in smaller amounts. The precursor of this hormone is known as the pregnenolene.

This progesterone hormone is needed in women, in hormone replacement therapy for menopausal women for many reasons. The most important role of this hormone is to oppose the effects of estrogen hormone. In the absence of the progesterone hormone there is a higher risk of developing reproductive cancer and breast cancer in women.

The hallmark symptoms of estrogen dominance can be easily recognized by menopausal women and in women suffering from the pre-menstrual syndrome.

The main symptoms are as following:

-mood swings

-feeling of bloating

-irritability

-headaches

-tender breasts

-weight gain

-depression

-uterine fibroids

-fatigue

Estrogen hormone dominance can also cause cancer of the breast, ovary and uterus

Every woman in about 15 years, have anovulatory cycles. Due to this enough estrogen is produced in the body to start menstruation. In this stage no progesterone is produced and there is a stage of estrogen dominance that exists in women. By using the progesterone cream during the anovulatory months can help to prevent symptoms of the pre-menstrual syndrome.

Before using the progesterone cream, one should familiarize themselves about perimenopause. It is important to choose the right progesterone cream as this cream is available at local health stores or online. A doctor should be consulted before using this cream as he will guide you in picking up the right progesterone cream and also will instruct you on its correct usage. Before buying this cream one should make sure that the cream contains only natural ingredients and no synthetic ingredients are used in it. Also one should be aware of how many milligrams of progesterone are contained per ounce of cream. Some creams contain helpful ingredients like the wild yam and ginseng. After the right cream is chosen only 1/16 of teaspoon should be applied twice a day. The cream should be used for a month and the dose should be modified accordingly under the doctor’s advice.

The usual dose recommended for premenopausal women is 15-24mg/day for 14 days before the expected menses. For postmenopausal women the usual dose that works is 15mg/day for 25 days of the month.

As progesterone is fat soluble it is easily absorbed from the skin. Progesterone is absorbed into the capillary blood by the subcutaneous fat. The best absorption skin sites are: face, neck, inner arms, breasts, palms of the hands and the chest.

The side effects seen by the progesterone cream application are usually temporary. They are as follows:

-increased mood swings

-increased hot flashes

-increased headache

-increased menstrual cramping

-weight gain specially in the hip and the belly area

-decreased sex drive

-increased hair thinning

Normally the progesterone hormone causes increased sleepiness. This effect is mainly seen when progesterone pills are taken orally as it gets metabolized in the liver. However when the progesterone cream is applied it gets absorbed directly into the skin, bypasses the liver and gets absorbed into the capillary blood and hence does not cause sleepiness.

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Valley Fever Symptoms And Treatment

Valley fever is also known as Sao Joaquin Valley fever, California fever, Desert Rheumatism or Coccidiodomycosis. It is caused due to a fungal infection, with the spores of a fungus called Coccidiodes immitis. This infection is most commonly seen in central and south America and in the desert regions of southwestern United States. It is transmitted by inhalation of the fungal spores into the lungs. The infection starts in the lungs. The risk of acquiring this infection is more in cases where the host is immunocompromised or suffering from AIDS, diabetes, those under immunosuppressant drugs.

Incidence: Filipinos, blacks and Hispanics have an increased risk of developing a disseminated disease as compared to whites. Hispanics with a blood group A or B Type have a higher risk of developing a disseminated disease. A lower income group or lower socio economic group is predisposed to severe lung infections and disseminated infection with Coccidiodomycosis. The incidence of Valley Fever is equal in males and in females. All age groups can be affected. The mortality rates in a case of disseminated disease are higher in infants and children.

There are three known forms of Coccidiodomycosis infection. They may be divided into acute, chronic and disseminated infection. In case of an acute pulmonary infection, the duration between inhalation of the fungus and onset of symptoms may be 7 to 21 days. The infection is usually mild and may produce few or no symptoms at all. A chronic infection develops even after 20 years or more after the primary infection. Disseminated Coccidiodomycosis means an infection which has spread from the lungs. It involves the heart, brain, meninges, skin and bones.

Symptoms: In most cases patients may not develop any symptoms. Some may develop cold, cough, flu like symptoms and pneumonia. Other symptoms may be headache, fever, cough, joint pains and stiffness, muscles pains, loss of weight, wheezing, night sweats, neck stiffness, chest pain, erythema nodosum on the lower extremities, joint swelling and effusion, ankle and swelling of the feet and enlarged lymph nodes.

Diagnostic Tests for Valley fever: It can be demonstrated by microscopic detection of the diagnostic cells in the body fluids such as saliva, sweat, blood, sputum and biopsy of the tissues. PCR can be used to detect the DNA of the organism. The fungal antigen or antibody may be detected in the patient’s serum. Chest radiograph, sputum smear and culture, lymph node biopsy and bronchoscopy with lavage are the other tests that might be done.

Treatment: An acute infection is usually a self-limiting process. The patient may benefit from bed rest and conservative treatment of the flu like symptoms. An acute infection does not require treatment with antifungal medications. Disseminated infections must be treated immediately as they are severe and have a high rate of developing complications like meningitis. The fatality rates associated with a disseminated infection are very high. Severe infections of Valley fever may be treated with antifungal medications like ketoconazole, fluconazole, itraconazole and other similar medications.

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Vaginismus Treatment And Symptoms

Vaginismus refers to involuntary tightness of the vagina during attempted sexual intercourse, insertion of tampons into the vagina and per vaginal gynaecological examinations. It is the main cause of unconsummated relationships. The tightness of the vaginal walls is caused due to involuntary contraction of the pelvic floor muscles especially the pubococcygeus also known as the PC muscle. This reflex contraction of the muscles is an involuntary reaction that is the woman does not voluntarily or consciously control the spasm. This spasm of the muscle makes any kind of vaginal penetration especially sexual intercourse extremely painful or even impossible. It can be divided into two types primary and secondary.

Primary vaginismus: A woman is said to be suffering from primary vaginismus when she has never been able to undergo any form of vaginal penetration without pain. In such a case a woman is unable to have a sexual intercourse or even insert tampons or undergo a gynaecological examination. Any attempt to penetrate the vagina is accompanied by severe burning, pain and discomfort. A few causes which may contribute to development of primary vaginismus are urinary tract infections, vaginal yeast infections, vaginal vestibular syndrome, past history of sexual or physical abuse in the woman, witnessing any violent act related to sexuality, anxiety and fear of rupture of the hymen, stress, generalized anxiety disorder or in some cases idiopathic.

Secondary vaginismus: It is a condition in which a woman has previously attempted pain free intercourse but experience vaginismus later in life. It affects women, having temporary problems like urinary or yeast infections, birth trauma experienced after the birth of a child, menopause or surgery. Once the patient experiences pain, it is seen that the response becomes a conditioned one resulting in a progressive and continued worsening of vaginal pain and tightness on attempted intercourse. If left untreated the intensity and duration of involuntary contraction of the PC muscle worsens. As the severity worsens women may suffer from severe pain and discomfort during vaginal penetration or even tampon insertion.

Treatment: There are a variety of causes that contribute to development of vaginismus. However an individualized approach must be used in each and every case. The treatment can be divided into physical and psychological. Physical treatment involves usage of probes of different sizes. Vaginal probes are introduced into the woman’s vagina under the guidance of a doctor or a nurse. The probes are introduced usually with her own hand so that she can physically control the rate of insertion and eventually overcome her fear of penetration. Most cases of primary vaginismus are due to some traumatic experience in the past, notions of sex being wrong or morally incorrect especially seen among those having a strict religious upbringing, fear and anxiety of painful intercourse or a history of sexual abuse or traumatic physical abuse in childhood. Hence in such patients it is important to address these psychological aspects of the problem. Emotional issues and psychological problems are more important to be addressed in primary vaginismus, while those suffering from secondary vaginismus may rely on a physical than psychological treatment.

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What Causes Fishy Vaginal Odor

fishy-vaginal-odorA normal healthy vagina always emanates a peculiar odor at all times. It is normal to have a certain vaginal odor. However whether it is a natural odor or foul is left up to the woman to judge. Foul odor may pose a serious problem during sexual activity between partners, in terms of the woman or man being uncomfortable.

Every woman has a certain vaginal smell peculiar to herself. There may be a change noticed over time in the odor emanated from the vagina. The change in odor may vary depending on the part of the menstrual cycle the woman is in. Most commonly any change in the odor is associated with vaginal infections. However not every slight change in the odor is not necessarily associated with vaginal infection. On the contrary, one should look for other symptoms of vaginal infection than a mere change in odor.

In some cases there may be a stark change in the vaginal odor. It may become very strong and unpleasant. A strong fishy vaginal odor may be an indication of a serious infection. Some women develop social problems and avoid company and people, as they fear the odor being noticed by others. Thus it may lead to a lot of stress, emotional and social problem.

The normal flora of the vagina consists of a large number of microaerophilic bacteria. Lactobacilli are the main ones which protect the vagina from other infections. They give the vagina an acidic environment. Any change in the pH of the vagina disrupts the vaginal flora and makes the vagina prone to a variety of infections. Also washing the area too often and with potent antimicrobial soaps or lotions, alter the pH of the vagina and decrease the local immunity of the vaginal mucosa. Most women believe that vaginal odor may be due to poor genital hygiene and indulge in obsessive cleanliness of the genital area. This may have adverse effects and if done in excess may itself be a cause for developing various infections.

Some other causes for vaginal odor may be wearing tight undergarments, wearing synthetic undergarments, excessive washing, certain chemicals like antibacterial soaps, scented body washes. All these make the vagina prone to bacterial or yeast infections. Foreign body insertion into the vagina also causes vaginal infection and odor.

Prevention: Wear cotton panties. Tight clothing should be avoided as far as possible. Avoid Douching. Wear clean tampons and change them regularly. Any form of vaginal infection which may present as excessively foul vaginal odor, foul discharge from the vagina, must be brought to the notice of a doctor and must be treated immediately. Following intercourse it is important that a woman must go to urinate. Urination following intercourse helps to eradicate any bacteria lingering outside or inside the vaginal canal up to the urethral orifice. Urination forces out bacteria along with the urine voided. Prompt treatment and prevention of all bacterial and yeast infections itself helps prevent vaginal odor to a great extent.

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Prader Willi Symptoms and Treatment

Prader-Willi syndrome (PWS) is a rare congenital disorder that involves heart and orthopedic problems, coupled with decreased mental capacity and sex glands that produce little or no hormones. It was first identified by Andrea Prader and Heinrich Willi of Switzerland in 1956 and hence the name. The probability of occurrence of the syndrome is as low as 1 in every 10,000 live births. A sister syndrome, called the Angelman syndrome has also been identified complimentary to the Prader Willi syndrome.

Causes of Prader Willi Syndrome

Prader-Willi syndrome is caused by missing genetic material on part of the paternal chromosome during inheritance.

Symptoms of Prader Willi Syndrome

The severity and types of symptoms may differ from one patient to another depending upon the age of onset. Some common symptoms of the Prader Willi Syndrome age wise are:

In utero:

Below are the symptoms identified in case of a fetus suffering from the Prader Willi syndrome during the gestation period

  • Less fetal movement
  • Abnormal fetal position
  • Frequent polyhydramnios (high ratio of amniotic fluid)

At birth:

The following symptoms are common in newly born children at birth:

Infancy:

In case of infants, the symptoms below have been identified:

Childhood:

Young children have reported the following symptoms while suffering from the Prader Willi Syndrome:

Adolescence:

The following few symptoms have been identified among adolescent patients:

  • Delayed puberty
  • Short body stature
  • Morbid obesity
  • Excessive flexibility

Adulthood:

During adulthood, the following symptoms may be experienced:

  • Infertility
  • Hypogonadism
  • Lowly distributed pubic hair
  • Morbid obesity
  • Hypotonia
  • Learning disabilities/borderline intellectual functioning (cases of average intelligence are found sparingly)
  • Affinity towards diabetes mellitus
  • Excessive flexibility

General physical appearance (in case of adults only)

Certain common physical symptoms experienced by adult patients suffering from the Prader Willi syndrome are:

  • Nasal bridge is prominent
  • Small limbs with tapering fingers
  • Soft skin
  • Excessive fat, located around the central portion of the body
  • High but narrow forehead
  • Almond-shaped eyes with thin eyelids
  • Light skin and scanty hair
  • Sexual under-development
  • Frequent skin picking
  • Striae
  • Delayed motor development

Treatment

As a measure to control the obesity, calorie intake is limited to the minimum coupled with exercises. Growth hormone is often administered to improve physical strength and agility. In case of under developed reproductive organs, testosterone is administered. Any fall in the levels of sex hormones is often treated using the hormone replacement therapy.

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Pregnanacy Symptoms Week By Week

Pregnancy symptoms in week 1, 2, 3, 4:

Not many symptoms are seen in the first four weeks of pregnancy as fertilization has just started. Early symptoms of pregnancy may include elevated body temperature, tender breasts, nausea and vomiting, constipation, fatigue and exhaustion.

A woman may experience mood swings due to hormonal alteration.

Pregnancy symptoms in week 5, 6, 7, 8:

-morning sickness may be strongly felt. A sense of nausea or vomiting may develop in the morning.

-around the 5th week the woman urinates frequently and may seem to be unaccountably tired.

-amenorrhoea (absence of menstruation) develops.

-tender breasts with darker areola are seen.

-fatigue is commonly seen starting from the 5th week of pregnancy due to an unexplained reason.

-around the 7th week changes in the face are visible.

-hormonal changes can be seen in the facial area. Some women appear fairer while some experience hyper pigmentation due to which their skin tone appears to be darker than usual. Sudden outbreak of pimples is seen in some women. This happens mainly due to the increase of progesterone level in the body.

-women experience sudden unusual food cravings.

-some women experience a heartburn or ingestion.

Pregnancy symptoms seen in week 9, 10, 11, 1 2:

-by this time the woman must have missed her second period.

-some of the early pregnancy symptoms might have eased as the body gets adjusted to the hormonal changes.

-the veins especially in the legs, appear larger. This happens as there is increased volume of blood in the body.

-the uterus is seen to be risen slightly above the pelvic bone.

-the black line called the linea nigra is seen extending from the diaphragm to the pubis area, which gradually disappears after giving birth.

-fatigue is also seen throughout the pregnancy

-by the 12th week, the symptoms of morning sickness seem to have reduced in most women.

Pregnancy symptoms seen in the 13th week to the 27th week:

This period is also known as the second trimester of pregnancy.

-increased breast size is seen mainly due to the hormonal changes occurring in the body. The initial tenderness may disappear although the nipple area may still be tender.

-weight gain is seen in most women during this time.

-changes in skin tone may be seen

-abdomen gets bigger. Stretch marks may be visible.

-nose bleeds or nasal congestion may be seen during this time of pregnancy. Minor bleeding in the gum area may be present.

-bladder and kidney infections are common. This occurs due to the changes in the urine which occur as a result of hormonal changes in the body.

-whitish, thin vaginal discharge is common. If this discharge is foul in smell or accompanied with irritation then a doctor should be consulted.

Pregnancy symptoms from week 28 onwards:

This is the third trimester of pregnancy.

-pain in the back and the hip area is generally present due to the extra weight of the baby.

-leg cramps which occur due to the pressure exerted by the uterus on the veins in the legs.

-increased vaginal discharge

-frequent urination due to the pressure that is exerted by the uterus on the bladder area

-shortness of breath is experienced

-feet and the ankles swell up. This mainly occurs due to the pressure exerted on the veins of the legs.

-little colostrum leaks out as the due date approaches. This happens due to the increase in the breast tissues.

-weak and intermittent contractions are felt in the lower abdomen and the groin area.

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Types Of Vaginal Infections: Yeast And Bacterial Vaginal Infections

The vagina can be infected with various types of bacteria, yeast or protozoa. Most women develop some kind of vaginal infection once during their entire life time. The vagina contains normal vaginal flora. The lactobacillus is the most numerous organisms to be found in a normal vagina. These organisms help maintain an acidic pH and prevent growth and development of other pathogenic bacteria or organisms. Any factor that changes the vaginal pH or the content of the lactobacillus makes the vagina prone to variety of infections. Even in normal cases the vagina gives out a peculiar odor and discharge. An infection must be suspected when the discharge becomes unusually profuse, smells foul or changes texture. The discharge will also be accompanied with pruritic or severe itching. Hence the woman may complain of itching, burning, swelling and redness around the vagina.

Specific vaginal infections:

Trichomoniasis: This is the most common vaginal infection. It is commonly seen in women during the childbearing period. It is transmitted through sexual intercourse in most cases; however it may be transmitted through infected towels or clothes. Trichomonas is a protozoon. Most women may be asymptomatic. Others develop an infection 7 to 28 days following infection with the organism. Symptoms produced are vaginal discharge which is thin, creamy, slightly green in colour, frothy and is associated with intense pruritic. On examination the vagina appears red, inflamed, angry looking. The cervix and vagina appear red as a strawberry hence is called ‘strawberry cervix’ or ‘strawberry vagina’. The patient may also complain of increased frequency of passing urine or dysuria. This vaginal infection is diagnosed by a wet film preparation of the vaginal discharge and examination under a microscope. Gram staining and culture of the discharge too may help in isolating the organism. Treatment includes administration of Metronidazole 200 mg orally three times a day for 7 days. It must be given to both the partners. The partners must be advised to avoid sexual intercourse or use a barrier contraceptive until the treatment is over.

Candidiasis: Is caused due to infection with a gram positive fungus called Candida albicans. It is a common infection in women who are pregnant or suffering from diabetes. The patient may complain thick curdy vaginal discharge, accompanied by intense pruritic. There may be soreness of the vagina, burning sensation, dysuria and dyspareunia. Treatment includes administration of antifungal medications orally and as a vaginal pessary.

Chlamydia: Is common among young and sexually active women. Chlamydia trachomatis is a gram negative bacterium. Increased use of oral contraceptive pills has increased the chances of women suffering from this infection. PCR and ELISA tests are both extremely useful for detection of the antigen. Patient presents with vaginal discharge, itching and dysuria.

Bacterial vaginosis: This vaginal infection is caused by Gardnerella Vaginalis. The patient complains of white milky vaginal discharge. It is characterized by the presence of Clue cells on a smear. This infection responds very well to a 7 day course of Metronidazole.

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Uterine Fibroids Symptoms And Treatment

Uterine fibroids are the most common pelvic tumour. It is a benign growth that develops from muscles forming the wall of the uterus. They are usually round or semi – round in shape. It usually affects women above the age of 30 years, rarely seen in women below 20 years of age and usually shrinks in size after menopause. The cause of development of these tumours is still unknown; however the hormone estrogen seems to promote the growth and development of these tumours. Hence once the hormone levels decline post menopause, the fibroids too gradually shrink and reduce in size. Based on their location in the uterus there are divided into myometrial, subserosal, submucosal and pedunculated. Myometrial fibroids arise from the myometrium which is the muscular wall of the uterus, subserosal arise from just below the covering of the uterus, submucosal arise from just below the uterine lining and pedunculated are those which bear a stalk and hence project from the uterus outside or within the uterine cavity.

Symptoms of Uterine fibroids: Heavy menstrual flow also called menorrhagia, may or may not be associated with the passage of blood clots. Menstrual flow is prolonged in most patients. Patients may complain of irregular bleeding or bleeding in between periods. Severe pain in the lower abdomen or back during menses also known as dysmenorrhoea is another common symptom. Most patients complain of a sensation of abdominal fullness and distension. Some patients may complain of pain during intercourse, increased frequency of micturition and a sensation of fullness or pressure in the lower abdomen.

Signs on examination: On examination, on per abdominal examination one would be able a mass in the lower abdomen, especially if the mass is big enough. When aided with per vaginal examination, the physician is able to find out the approximate size and position of the fibroid. However the differential diagnosis for a mass felt in the pelvis may be ovarian tumours, pregnancy, pyosalpinx or hydrosalpinx, endometriosis and uterine adenomyosis. Many diagnostic tests can be done, but a transvaginal ultrasound or pelvic ultrasound is most important to diagnose Uterine Fibroids. An MRI or CT scan of the pelvis will help to confirm the diagnosis. In a few cases however, a laparoscopy or endometrial biopsy may be required to rule out the differential diagnosis.

Complications of fibroids: Menorrhagia can lead to anaemia, torsion of a pedunculated fibroid, recurrent urinary tract infection if a fibroid hampers complete voiding of urine due to pressure on the urinary bladder, cancerous or malignant changes in the fibroid and infertility. In case a woman having a fibroid is pregnant she may suffer from recurrent miscarriages, red degeneration of the fibroid and heavy bleeding post partum.

 

Treatment: The treatment of Uterine fibroids varies vastly depending on the needs of the woman. It depends on the severity and intensity of symptoms such as menorrhagia, dysmenorrhoea, infertility, and age of the woman, the size of the fibroids and the rate of growth of the tumour and whether or not the woman desires to conceive and bear children in the future. Myomectomy means removal of the growth, keeping the uterus intact. Hysterectomy is done once the woman does not desire to have any more children. Symptomatic treatment would include administration of iron supplements, non steroidal anti-inflammatory drugs, oral contraceptive pills and insertion of intrauterine devices.

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Tick Bites On Humans: Symptoms And Treatment

Ticks are arthropod parasites which carry disease causing bacteria in their saliva that they transmit to humans through a bite. However, tick bites can also be innocuous. Ticks are mainly found in grasslands and woods. On the human body they mainly attack areas such as armpits, hair and the groin region.

 

Symptoms

For the most part there are no discernable symptoms of a tick bite. Most individuals may not even realize that they have in fact been bitten as the bite does not evoke any kind of pain. Later on however, the person may notice the area to take on a red appearance. It may also itch uncontrollably and the person may experience a burning sensation. Some specific types of ticks may cause a throbbing pain in the infected area.

If the victim is unfortunately allergic to tick saliva discharge he may experience symptoms of breathlessness, the area around the bite may swell up or become numb, he may also notice a rash and in extreme cases paralysis might occur.

Uncommon immediate symptoms that warrant prompt medical attention include fever, nausea, tremors, weakness, chest pain and difficulty in breathing.

 

Some of the diseases that one can be inflicted with through a tick bite include:

  • Lyme’s Disease: In the initial stage of this illness, the patient has a symptomatic rash along with fever, uneasiness, a feeling of tiredness and often a severe headache.
  • Ehrlichiosis: The vector of this ailment is the brown dog tick. The patient is likely to develop a high fever, experience acute muscle pain along with discomfort. He will however not suffer from a rash.
  • Rocky Mountain spotted fever: With similar symptoms as Ehrlichiosis, this type of fever causes the victim to get a rash. However, the rash only manifests itself after 5 to 10 days of the tick bite. It must be noted that this illness the responsible for the highest number of deaths caused by a disease spread by ticks.

What is essential to note is that the signs of these diseases show up days or even weeks after the bite.

Treatment

Proper removal of the tick is important to decrease the chances of infection. One should ideally use a pair of tweezers and ensure that the tick in its entirety is removed. The tick bite should then be cleaned and an antiseptic cream may be applied. It is essential that you keep checking the area for any rash or other symptoms, in which case you should seek medical help. After removing the tick its correct disposal (flushing it down a drain) is important. If you have contracted a tick-transmitted disease then the treatment will depend on the disease and its severity. Oral antibiotics are mostly recommended. However, in severe cases the doctor may suggest hospitalization. Whichever line of treatment has been opted for, it depends completely on the disease, and hence diagnosis is the most crucial aspect which must be dealt with carefully.

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Removing Tonsil Stones: The Symptoms And Treatment

When it comes to one’s health, the only stones most people know about are kidney stones. But there are other stones that can be as painful. When bacteria or debris such as mucous and dead cells calcify at the back of one’s mouth on the tonsils, one is said to have tonsil stones, which are also called tonsilloliths.

 

Tonsils are designed to protect us from infections. Unfortunately, they can sometimes cause problems while trapping bacteria and other foreign materials that enter our system. The latter may end up getting trapped in pockets of fibrous tissue around the tonsils. These pockets of tissue develop over the years especially when one has experienced several infections of the tonsils. The trapped debris in combination with the salts from your saliva leads to calcification, and you end up with tonsil stones.

 

Symptoms of tonsil stones

It can be quite difficult to determine whether you have tonsil stones or not because they are usually not clearly visible to the human eye. You may even require a CT scan or x-ray to know for certain. When they are large though, they look like white or yellow stones and cause multiple symptoms. Bad breath is a key indicator, especially when it is present in conjunction with a tonsil infection. Sulfur compounds that emit a foul odor cause bad breath. A sore threat is another symptom of tonsilloliths. They can often make it quite difficult for you to swallow your food, and if they are big enough, it can be painful to even swallow liquids. And lastly, while swollen tonsils can sometimes be a symptom of another infection like tonsillitis, they usually accompany tonsilloliths.

 

Treatment of tonsil stones

There are a variety of ways to treat tonsilloliths and the appropriate method is selected depending on their size and the level of discomfort caused. If they are of miniscule size and cause no pain, they are usually left untreated. In most cases, people can treat them at home on their own. One of the ways to do this is by using cotton swabs and the like to dislodge the stones. As with any other infection involving your throat, gargling your mouth and throat with salt water that’s warm can be very soothing. It also serves as an effective disinfectant. Antibiotics can be prescribed to help bear with tonsilloliths, although they cannot dislodge the stones. When the tonsilloliths are quite large and cause considerable discomfort, a surgical procedure may be required to remove them. It is a fairly simple procedure though and a local anesthetic is used.

 

Prevention of tonsil stones

Some people unfortunately endure frequent cases of tonsilloliths due to tonsillitis. Tonsillectomy is a surgical procedure employed to remove one’s tonsils in the case of chronic tonsillitis. Undergoing this surgery would also eliminate future occurrences of tonsilloliths. It is a major procedure that requires general anesthesia. The patient usually takes a few days to recover, and may experience a sore throat and discomfort while swallowing until then.

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Rectocele Repair | Rectocele Symptoms And Treatment

It is often said that a woman is responsible for keeping the balance of nature. A woman is responsible for enabling peace and harmony in this world. She has the gift of bringing a human life into this world and she nurtures the child to be a man one day. The process of childbirth is quite complicated and hazardous in nature. Sometimes, it can cause a number of problems that may even occur after a few months. Rectocele is one of the most common forms of diseases found in women after the childbirth. It is also visible in women who have undergone the procedure of hysterectomy.

Rectocele appears when there is a tear in the tissues laying between the rectum and the vagina. This usually happens when an anomaly occurs during the childbirth process or the hysterectomy procedure. Although, it is not considered to be a fatal disease, the pain produced from it can be quite tremendous and agonizing.

Symptoms of Rectocele

The rectal and the vaginal region of women often experiences pain and discomfort that can sometimes last for hours. Women may experience extreme discomfort and pain when the pressure appears around the region. They may also find it difficult to pass stools which can be quite painful as well. There is a constant feeling of constipation even after the stools have been passed. Sexual intercourse during rectocele can cause throbbing pain which may also lead to excessive internal bleeding. The degree of pain can vary according to the severity of the disease.

Treatment for Rectocele

In the recent years, the technology in medicine has helped eradicate rectocele on a permanent basis. However, the treatment entirely depends upon its severity. If the disease has been present in the system for a long period of time, the treatment may take as long. Surgery is highly advisable in this situation as it eradicates the problem completely. Nevertheless, in milder cases, numerous pelvic exercises are recommended. These exercises relax the tissues in the rectal and vaginal region that provide maximum comfort. It is also very important to adapt a healthy diet that is rich in fiber. Constant intake of liquids is also highly recommended in order to get rid of the disease as soon as possible. The treatment for mild rectocele in women usually lasts a couple of months and the chances of acquiring the disease again are as close to nil.

There are a number of precautions you can take in order to suppress the disease and avoid it from spreading further. If you are a smoker, you need to stop it immediately as it is considered to be the main instigator of rectocele. You also need to maintain a healthy diet that helps in the proper functioning of the bowels. Avoid red meat and other foods that are high in fat and carbohydrates. Mild exercises on a daily basis will allow you to feel much better with time.

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Sickle Cell Trait Symptoms And Treatment

A person diagnosed with sickle cell trait is called a carrier and is said to have inherited an abnormal hemoglobin gene. This is not considered as a disease and does not pose any health problems for the carrier directly. However, if both parents of a child are carriers, then they could pass on sickle cell disease to their child, which is a lifelong condition.

 

While being diagnosed with sickle cell trait does not have any immediate consequences on your health, it is important to find out if you are a carrier as it makes you aware of the risks that your children face. If both parents are carriers, their child has a 25% chance of inheriting sickle cell disease. This happens when the child inherits an abnormal hemoglobin gene from each of the parents. There is a 50% chance that the child may not inherit the disease but may become a carrier like his or her parents. This is due to the child only inheriting one abnormal gene from one of the parents, and a normal gene from the other. It isn’t all bad news though, as there is also a 25% chance that the child will inherit normal hemoglobin genes, and therefore, will neither have the disease nor be a carrier of it.

 

Symptoms of sickle cell trait

It is extremely rare for carriers to show any symptoms. As mentioned earlier, being a carrier means that you also have the normal hemoglobin gene and therefore your body will have enough normal red blood cells for the circulation of oxygen. But certain complications may arise if the person endures severe physical conditions such as extremely high altitude, issues during a general anesthetic procedure or severe dehydration. Such scenarios make it possible for sickle cells to form. This can be quite harmful as it leads to plugging of blood vessels and it hinders the oxygen delivery from the lungs to the various organs throughout the body. This in turn may lead to unbearable pain being experienced in the muscles, bones or the spleen. Intensive exercise routines can also cause the above symptoms as such exercise can lead to dehydration. If a person is diagnosed with anemia, i.e. a very low number of healthy red blood cells, a doctor will usually request specific blood tests, including one to detect the presence of sickle cell trait.

 

Treatment of sickle cell trait

As this is not considered a disease and has no direct impact on a person’s health under normal conditions, there is no treatment as such. The risks that you may face due to extreme physical conditions, either brought about by the environment or by intense exercise, are preventable. You need to avoid as much as possible extreme heat and high altitude locations. Make sure that your personal trainer is aware of your health condition, so that you move on to more intensive exercise routines gradually. As long as you keep yourself hydrated by drinking a lot of water, you will be able to live a relatively healthy life.

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All About Sclerotherapy Cost And Side Effects

Sclerotherapy is a method of treatment of which involves injection of a medicine (sclerosing solution) into the blood vessels in order to shrink the vessel. It is used to treat vascular and lymphatic malformations. In adults it has been used most popularly to treat haemorrhoids and varicose veins. The veins are injected with a sclerosing solution, this causes sclerosis and shrinkage of the vein. Over a period of weeks or months the vein dissolves and is naturally absorbed by the body. It is usually preferred over laser treatment to eliminate telangiectasiae and small varicose veins in the lower extremities. Telangiectasis is a condition where there is dilatation of the small vessels near the surface of the skin or mucous membrane. It consists of tiny blood vessels, all joining together and forming a conglomeration of blood vessels resembling the shape of a spider. With the help of sclerotherapy, there is destruction of the telangiectasiae and there are less chances of recurrence with this therapy.

In the case of varicose veins of the lower legs, multiple injections of the sclerosant solution is injected into the surface veins. Following this the patient is advised to compress the legs with crepe bandage or elastic stockings for a period of around two weeks. This applies a firm pressure over the sclerosed veins and in a period of weeks the veins shrink and disappear.

It can be performed as an Outpatient procedure and does not require anaesthesia. Once the treatment area is cleansed, the surgeon injects the solution directly into the blood vessels with the help of fine needles. This procedure may be done with or without ultrasound guidance. Depending on the size and location of the veins, the number of sessions of sclerosant injections would differ.

Sclerotherapy has been seen to highly successful in most patients. Almost 50 to 80 percent of the injected veins may be sclerosed in each session. Only a few of the patients about 10 percent do not respond to the procedure. In such cases different methods may be tried out including laser therapy. Bigger veins may take longer to respond, period varying from 3 to 6 months, whereas the smaller ones respond in about 3 to 4 weeks. The procedure takes about 30 to 45 minutes.

Complications: The side effects following the procedure may include:

The larger veins which are injected may not shrink and dissolve for a period of many months. Until then the veins may appear as hard and lumpy swellings under the skin.

Following injection the surrounding skin may appear red and inflamed and may take a few days to return back to their normal colour and texture.

Some patients may develop an allergic reaction to the sclerosant solution. They may develop itching, redness and swelling.

The skin over the treated area with sclerotherapy may get discoloured in most cases. Brown lines or spots may form over the area. In some cases this discolouration may be permanent, in others it may disappear in a period of 3 to 6 months. The discolouration is believed to be due to the iron deposition in the skin. The iron being derived from the blood that oozes during the injecting procedure.

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Normal PSA Levels And What They Mean

When we are young, we never have to worry about our health. The days are spent in having fun and being reckless. However, things we do today have a tendency to react at a later stage. As a result, we are always told to be careful now so that we can live without worries in the future. It is often speculated that when a person crosses the threshold of 30, the body stops developing and rather starts deteriorating. It is very important to take enough care of health once you pass the age of 30. Prostate cancer is one of the most commonly found and feared diseases in men. It is usually seen after the age of 50 and can be quite fatal in nature. The rise in PSA levels is often considered to be one of the major causes of prostate cancer. It is highly recommended to check the PSA levels from time to time in order to be aware of the malignancy.

Causes of High PSA Levels

The high rise in PSA levels is caused by a number of factors. Basically, any kind of irritation in the prostate gland is known to cause a sharp rise in the PSA levels. The Benign Prostatic Hyperplasia is a serious medical condition found in men that enlarges the prostate quite abnormally. It is quite commonly seen in men over the age of 60. This enlargement causes a rise in levels. Secondly, recent ejaculation also causes a mild increase in the PSA levels. In this regard, doctors advise patients not to indulge in any kind of sexual activity. Doctors also have a reason to believe that excessive bicycle riding causes this particular ailment.

 

Treatment for High PSA Levels

PSA levels in the body are obtained by a blood test. The amount in the blood should be less than 4 ng/mL. If it is higher than that, then there is a possibility of prostate cancer. It is also very important to know that the levels fluctuate on a daily basis. If it is less today, it can be more tomorrow. In order to keep the levels normal, there are a couple of steps you can take. A healthy diet is considered to be one of the key requirements in order to control the PSA levels. High intake of fresh fruits and vegetables are highly recommended along with the regular intake of milk. Some doctors also recommended a glass of red wine once a week as it contains anti-oxidants that help remove the harmful toxins from your body.

Men over the age of 50 are highly advised to undergo blood tests either monthly or bi-monthly. This helps in monitoring the presence of prostate cancer or other forms of prostate related diseases. All things considered, it is advisable to lead a simple lifestyle and a healthy diet in order to avoid high PSA levels and hence live a worry-free life.

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What Is Prothrombin Time?

Prothrombin time is a type of an investigatory test which helps us to know how much time blood takes to clot. This test is usually done to check for bleeding problems. It is also a test to check the efficacy of a medicine in case of bleeding problems.

A prothrombin time test is sometimes referred to as the INR test which stands for the international normalized ratio.

Clotting factors are needed for the blood to clot by a process of coagulation. There are about twelve clotting factors present in the body. Prothrombin which is also the second factor is synthesized by the liver. Vitamin k is an important factor as it helps in the synthesis of prothrombin. Prothrombin time test helps to determine the presence of the five clotting factors in the blood. Hence this test is important especially while detecting any kind of bleeding disorder.

An abnormal prothrombin time is caused by any kind of liver disease or injury or in cases where treatment with heparin which is an anticoagulant is advocated.

Prothrombin time test is done in the following cases:

-To check for any kind of abnormal bleeding.

-To detect any kind of unexplained bruising.

-To check the efficacy of blood thinners like warfarin. When this drug is being tested, a prothrombin time test is done. This is basically useful in knowing the correct amount of dosage of the drug needed.

-To check for vitamin k level in the body. Vitamin k is essential for the synthesis of various clotting factors.

-To determine low levels of clotting factors in the body as in cases of hemophilia (bleeding disorder)

-Also done as a part of the liver function test.

Procedure of the prothrombin time test:

A band is tied around the upper arm which sort of stops the blood flow. By doing so the veins under the band become prominent and blood can easily be drawn into a needle. A tube is then connected to the needle into which the blood is drawn. The band is removed after the blood is drawn and pressure is applied on the area where the needle was inserted after which a bandage is put on that particular area.

In normal conditions the values are as follows:

Prothrombin time (PT): 11-13 seconds

International standardized ratio (INR): 0.8-1.1

If any abnormal prothrombin time is detected it means the following:

-If the prothrombin time is more than normal, it can mean the lack of one of the clotting factors. The various clotting factors are the factor I, factor II, factor V, factor VII and factor X

-it could also show the presence of any kind of liver disease such as cirrhosis of the liver, any kind of injury or the absence of vitamin k.

-a serious life threatening condition known as the disseminated intravascular coagulation exist when there is a longer than normal prothrombin time. In this condition all the clotting factors of the body are used up very quickly. Due to which the blood is unable to clot and the normal clotting process is affected. Hence the bleeding cannot stop.

-an increase in the prothrombin time is also seen when blood thinners like heparin and warfarin are used.

This test can be affected when a person takes any kind of medicine which may alter the test results or in cases of severe diarrhea and vomiting. Drinking lot of alcohol or taking laxatives may also alter the test results.

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Prolapsed Uterus Symptoms And A Look At Surgery

Prolapsed uterus refers to the sliding or the falling of the uterus from its normal position in the pelvic cavity into the vaginal canal.

The uterus in normal conditions is held in its position by the pelvic muscles, ligaments and other tissues. The falling of the uterus in the vaginal canal takes place when these muscles and other supporting tissues weaken. This is generally seen in women who have had one or more vaginal births.

Causative factors:

Prolapsed uterus can happen as a normal ageing process or after menopause due to lack of estrogen hormone.

– Conditions like obesity or chronic cough also increase the chances of developing a prolapsed uterus as these conditions increase the pressure on the pelvic floor.

-This can also occur due to a tumor of the pelvis.

Condition like chronic constipation causes a constant pressure on the uterus which will worsen the condition.

Symptoms:

-frequent urination

-lower back pain

-pain during intercourse

-repeated bladder infections

-pulling sensation in the pelvis

-sudden urge to empty the bladder

-protruding uterus from the cervix of the vagina

-increased vaginal discharge

-vaginal bleeding

These symptoms worsen on sitting for a long time or standing.

Diagnosis:

A pelvic examination is performed. Prolapsed uterus can either be mild or moderate. It is considered mild when the uterus drops in the lower part of the vagina and is moderate when it drops out of the vaginal opening. A pelvic examination also shows that the cystocele and the retrocele which are the front n the back wall of the vagina respectively, are entering the vaginal area. Even the bladder is seen to be positioned lower than normal.

Treatment:

Prolapsed uterus can be treated either by surgery or vaginal pessary. Treatment for the prolapsed uterus is generally not necessary unless the symptoms get bothersome for the patient.

Surgery is done in severe cases. The type of surgery depends on the following things like:

-desire for future pregnancy

-degree of prolapse

-general health condition of the women

-other medical conditions

Surgical procedures like vaginal hysterectomy or sacrospinous fixation can be done without the removal of the uterus.

Vaginal pessary is a form of permanent or a temporary treatment. In this procedure a donut shaped rubber or a plastic device is inserted into the vagina to hold the uterus correctly in place. These are fitted individually for each woman. They are taught how to insert, clean and wear this device. There might be some amount of pain and discomfort to the vaginal mucosa which may cause damage in certain cases also an abnormal smelling discharge from the vagina is sometimes seen, which might need cleaning from a doctor or the nurse.

Vaginal pessary has shown excellent results in most women. For women who have had a surgery also show good results but may require some treatment in the future.

Certain lifestyle changes are recommended in women with prolapsed uterus like:

-weight loss in obese women

-coughing can worsen the symptoms so preventive measures should be taken for chronic cough.

-activities like lifting or straining should be avoided as they worsen the symptoms.

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Pompe Disease Symptoms and Treatment

Pompe disease (also called as Glycogen Storage Disease II or Acid Maltase Deficiency or Alpha Glucosidase Deficiency) is a rare neuromuscular disorder estimated to happen to 1 in every 40,000 births. It is a genetic disorder and often fatal, disabling the heart and the muscles.

Causes of Pompe Disease

The Pompe disease is genetically inherited and caused by mutations in a gene that that produces an enzyme called alpha glucosidase (GAA).  Under normal conditions, the human body utilizes this GAA to disintegrate glycogen (a stored form of sugar in the lysosome of each cell) into usable energy. But under conditions of Pompe disease, the body is unable to break down the stored glycogen into usable energy as a result of which the unused glycogen accumulates in the lysosomes of the cells located throughout the body causing serious harm to the functioning of the heart and the skeletal muscles.

Forms of Pompe Disease

The Pompe disease is classified into various forms depending upon the age of onset. There are four primary forms of the disease:

  • The classic infantile Pompe disease: This particular form is the consequence of a complete or almost complete deficiency of GAA, causing symptoms to show up as early as the first few months of birth.
  • The non-classic infantile Pompe disease
  • The juvenile Pompe disease: This form is the result of a partial deficiency of GAA, triggering an onset that can be as early the first decade of childhood.
  • The adult Pompe disease

Symptoms of Pompe Disease

Up to 70 different mutations in the GAA gene that are the causal agents of the Pompe disease have been identified by researchers till date. These mutations may vary in terms of age of onset and the severity.

Symptoms of the classical form of Pompe disease that begin within the first few months of child birth include but may not be limited to:

  • severe loss of muscle tone
  • slow and progressive muscle weakness
  • enlargement and thickening of the heart, and,
  • feeding and respiratory problems

Symptoms of the non-classic infantile form are similar to the classic form, except for the enlargement of the heart.

In contrast, symptoms of the juvenile form mostly begin after age of two and are characterized by a loss of muscle tone.

Symptoms of the adult form comprise slow, progressive muscle weakness and respiratory difficulties.

Treatment of Pompe Disease

A patient experiencing the fatal Pompe disease is best treated by a team of medical practitioners comprising of a cardiologist, neurologist, and a respiratory therapist. Common treatments employed for treating the disease include the enzyme replacement therapy to reduce the size of the heart, improve functioning of the muscles, tone them and strengthen them, and to reduce deposition of glycogen in the cells of the body. The drug alglucosidase alfa (FDA approved) is most commonly used for the treatment of infants and children suffering from the Pompe disease.

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Polycystic Kidney Disease: Symptoms and treatment

Polycystic Kidney Disease is the genetic disorder of the kidneys. It is seen in humans and also some other animals. It is characteristically seen in both the kidneys. It is characterized by presence of cysts filled with fluid which results in enlargement of the kidney. It can also damage the other organs like the liver, pancreas, sometimes in brain and heart also. It is considered as the one of the life threatening disorders among all the genetic disorders.

Classification:

Polycystic Kidney Disease is of two types:

  • Autosomal Dominant
  • Autosomal Recessive

Autosomal Dominant:

It is the most common inherited disorder caused in kidneys. The symptoms of Autosomal Dominant Polycystic Kidney Disease are developed between ages of 30 to 40 but are sometimes also seen in childhood. It comprises about 90% of all the Polycystic Kidney Disease. It is characterized by progressive cyst development and increase in size of both the kidneys. Kidneys are seen with multiple numbers of cysts. The genes responsible for this Autosomal Dominant Polycystic Kidney Disease are PKD-1, PKD-2 and PKD-3. PKD-1 gene is responsible for encoding proteins responsible for regulation of cell cycle and intracellular calcium transport in epithelial cells. PKD-2 gene is responsible for encoding proteins which act as voltage linked calcium channels. PKD-3 is left unproven as of now. Mutations in these three genes are responsible for the development of this disease. The cyst development begins from the nephrons which accumulates fluid, enlarges, gets separated from the nephron and compresses the adjoining renal parenchyma as well as depress the renal function. In fully developed autosomal dominant disorder, the cyst filled kidney weighs 20-30 pounds and cause hypertension.

Autosomal Recessive:

The incidence is 1 in 20 thousand live births. It is diagnosed in first few weeks after birth and the hypoplasia caused by Autosomal recessive Polycystic Kidney Disease in 30% cases results in death of the neonate. In this disease the kidneys retain the shape but they are larger than the normal anatomical structure with dilated collecting ducts.

Symptoms:

There is abdominal discomfort, urinary tract infections specifically in the kidney cysts. The patient also presents wit loss of blood in urine called hematuria. It also affects the liver and pancreas causing liver and pancreatic cysts. It can lead to development of abnormal heart valves, High blood pressure and Kidney stones. It can severely cause aneurysms in the blood vessels in the brain and also small pouches may bulge out through colon called diverticulosis. In autosomal recessive Polycystic Kidney disease it causes frequent urination, affects the liver and the spleen causing decrease in the blood cell count, high blood pressure, varicose veins and hemorrhoids in children. The urinary tract infection is followed by fever, chills and pain. Approximately 50% people develop end stage disease as the consequence of Polycystic Kidney Disease.

Diagnosis:

Polycystic Kidney disease is diagnosed with renal ultrasonography with positive family history. Two or more cysts in both are mandatory for the procedure of diagnosis. Before the age of 30 years computerized tomography and Magnetic resonance imaging is performed.

Treatment:

Pain in the area of kidneys may be caused due to cyst infection, bleeding into cysts, kidney stone, and stretching of the tissue around the kidney. Physician has to assign first the cause of the pain among the conditions stated above and then prescribe the medication. Over-the-counter pain killers are prescribed like aspirin or acetaminophen. Surgery to shrink the cysts can relieve pain but is not helpful in long term as it may develop into further complications. Urinary tract infections are treated by antibiotics like cotrimoxazole and quinolone. High blood pressure is treated with antihypertensive medications and changing the lifestyle. If Polycystic Kidney Disease progresses further to develop end stage kidney disease, dialysis and implantation are a must for the survival of the patient. Sometimes in recessive disorder growth hormones are used and if it affects the liver, liver transplantation has to be done.

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Policosanol Side Effects And Benefits

Policosanol (also known as Octacosanol, 1-Octacosanol, N-Octacosanol, Octacosyl Alcohol) is the generic term used for a natural extract of waxes which is medicinal in nature. It is used as a dietary, nutritional supplement (due to its high potency of sugar) for the purpose of lowering down LDL cholesterol (low density lipoprotein cholesterol) and raising HDL cholesterol (high density lipoprotein cholestrol), and also for the prevention of atherosclerosis with rare or shot term side effects. Thus, Policosanol forms a great alternative to statin drugs that are known to produce side effects such as liver dysfunction and the atrophy of muscles.

Policosanol functions by modulating HMG-CoA reductase and bile acid absorption inhibition in the organ called as the liver in the human body. A typical dosage of Policosanol prescribed ranges from 5 mg to 10 mg of the extract, consumed twice a day. It may be used alone or in combination with other libido inhibiting extracts in the form of cocktails or otherwise. The extract is particularly produced and marketed by Cuba. Although the extract is available in other countries also, it is found to be low on quality parameters due to the source of wax shifted from Cuban sugar cane to yams, wheat germ, bees wax and other compounds.

Physical properties

Policosanol is a composition of fatty alcohols (octacosanol and triacontanol, contributing to almost 60 percent of the composition and being the most prevalent; behenyl alcohol, lignoceryl alcohol, ceryl alcohol, 1-heptacosanol, 1-nonacosanol, 1-dotriacontanol, and geddyl alcohol are also found in smaller amounts) derived from the waxes of Cuban sugar cane, yams, wheat germ and bees’ wax.

Uses of Policosanol

Policosanol, in its purest form (when extracted from original Cuban sugar canes) is used to treat a number of medical conditions such as intermittent claudication (characterized by cramping of muscles on exercise; the cramps often cease upon rest) or hypercholesterolemia, amyotrophic lateral sclerosis (ALS), hyper lipidemia and atherosclerosis. It also helps build up strength, stamina, reflex actions whilst helping prevent formation of lesions in arterial walls, heart diseases, infections, inflammatory skin diseases and the Parkinson’s disease by acting as an effective anti-coagulant.

Side Effects of Policosanol

Although side effects may vary from one person to another, some common side effects include indigestion, skin rashes, headache, insomnia and weight loss.

Policosanol is also known to increase the effects and the side effects of medications that interfere with blood clotting or anti-platelet drugs (such as aspirin, warfarin, heparin, clopidogrel, ticlopidine, and pentoxifylline) or supplements (such as garlic, ginkgo and vitamin E) or Levodopa (a medication used for treating Parkinson’s disease).

Precautions

Policosanol should not be given to children, pregnant or nursing women. Also, one must consult a physician before starting any such supplementation.

Contradictions

Researchers and published literatures have often depicted conflicting conclusions regarding the efficacy of Policosanol in lowering LDL levels and increasing HDL levels in the body. Despite several funded researches being carried out by the Cuban government to prove the efficacy of Policosanol, the extract and its functioning is still an issue of debate.

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Podagra Symptoms and Treatment

Podagra or gout (also called as the “disease of the rich” or the “king’s disease) is a disease that occurs due to the elevated levels of uric acid in the blood marked by recurrent attacks of chronic arthritis characterized by red, tender, swollen joints. The most commonly affected is the metatarsal-phalangeal joint at the base of the big toe. Apart from the toe joint, knees, heels, fingers and wrists are other commonly affected areas among patients. The disease may also occur in the form of tophi (hard, painless deposits of uric acid crystals), kidney stones, or urate nephropathy.

Causes of Podagra

Podagra is the disorder of purine metabolism and as mentioned above, it occurs due to increased levels of uric acid (hyperuricemia) in the blood which later crystallize (in the form of monosodium urate) and settle down in the various precipitating joints, tendons and tissues of the body causing redness and swelling. Hyperuricemia can occur due to a number of reasons including genetic predisposition, over production of uric acid, under excretion of uricase (which breaks down uric acid prevalent in most of the cases), or due to an unsuitable diet.

Lifestyle: Consumption of fructose-sweetened drinks, alcohol, meat and seafood; surgery and physical trauma trigger conditions of hyperuricemia. On the contrary, consumption of purine-rich vegetables, protein, dairy products, vitamin C and coffee are said to decrease any such risk.

Genetics: One cause of hyepruricemia can be the genes, contributing to about 60% of variability in the level of uric acid.

Medical conditions: Certain pre-medical conditions also trigger Podagra. Some Podagra complimenting diseases include metabolic syndrome (a combination of abdominal obesity, insulin resistance, hypertension and abnormal lipid levels), lead poisoning, polycythemia, hemolytic anemia, renal failure, psoriasis, solid organ transplants and the Lesch-Nyhan syndrome.

Medications: Diuretics have often been associated with Podagra including other medications such as niacin and aspirin (acetylsalicylic acid), cyclosporine and hydrochlorothiazide as well as certain immuno-suppressive drugs such as ciclosporin and tacrolimus.

Symptoms of Podagra

While the symptoms may vary across patients depending upon the seriousness of the disease, the level of hyperuricemia and other causal factors, some common symptoms experienced by patients worldwide include:

Joint pain: Patients experience pain in the Podagra affected joints ranging from 2-4 hours, especially during night hours (as the temperature of the body drops down allowing the crystallized uric acid to harden further). Pain can be generally reduced by application of ice on the joint several times a day. It also eases redness and swelling.

Inflammation or swelling over the joint: Inflammation also accompanies during acute cases of Podagra giving rise to pain in the joints.

Redness: A chronic attack of Podagra is often accompanied by redness in the affected joint.

Inability to move

Fluid discharge from the Podagra affected site/ joint

Treatment

Some common treatments practiced for the treatment of Podagra include application of ice (for 20 to 30 minutes several times a day) and consumption of non-steroidal anti-inflammatory drugs (NSAIDs) like colchicine and steroids, allopurinol, probenecid and febuxostat and pegloticase.

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Pinched Nerve in Neck: Symptoms and Treatment

Pain in the neck is caused due to many conditions. The cause for it most of the times is the Pinched Nerve in Neck. Peripheral nerves are the nerves which leave the brain and go to the extremities through spine. These nerves are protected by insulation and have the capacity to transmit as well as receive the electrical signals from brain or spinal cord. But if the insulation damages due to lack of nutrition or injury the electrical signals are interrupted or may not be transmitted at all. As the brain leaves the spine it can be compressed by bone spurs, herniated disc and can lead to condition called the Pinched Nerve in Neck. The symptoms are mostly observed at peripheral limbs because the impulses are not properly transmitted through the nerve. It can also be caused due to calcification of spine narrowing the space through which the nerve passes. It can also be caused by injury, infection or arthritis.

Symptoms:

  • Pain in neck is the obvious and the first sign of the Pinched Nerve in Neck. Generally patient ignores it as he feels it’s a general muscle pain.
  • The pain is usually presented at other sites called referred pain. It may cause numbness, tingling or burning sensation at arms, shoulders, fingers.
  • There may be spasm of the muscles with pain at the adjoining areas.
  • The pain is often radiated to upper arm region, shoulders which may confuse the patient to locate the pain.
  • It can result into headache at the occipital or the temporal region. As there is pain in occipital region, pain may be experienced at the areas behind the eyes.
  • The diagnosis is made easier if there’s pain in fingers, as the nerve which is getting pinched can be pin pointed.
  • There is muscle weakness.
  • Coughing and sneezing can exacerbate or worsen the symptom of the Pinched Nerve in Neck.
  • If this persists without recovery it may worsen the peripheral neuropathy.

These are generally diagnosed symptoms of this disease.

Investigation:

It can be diagnosed by the doctor by physically examining the neck of the patient. X- Rays, Computerized tomography and the magnetic resonance imaging is used generally to diagnose. Sometimes Pinched Nerve in Neck is misdiagnosed as there are mostly peripheral symptoms and no neck pain experienced. It is mostly recovered without any surgery but the patient should not ignore the symptoms and should get it diagnosed as early as possible to avoid further complications.

Treatment:

For patients of the Pinched Nerve in Neck, exercise is a good remedy. Aquatic and land based exercise are done with the focus on neck, shoulders and arms since they help in maintaining the motion in different sections of the cervical spine. Yoga, an Indian therapy is also seen as an approach for the treatment.

Conventional treatment involves relief of pain by giving medications like pain killers and invasion treatment like the fusion surgery. These treatments provide comfort to the patient but do not cure the underlying cause of the pain. Surgery also is not a guaranteed treatment. The alternative treatments are: Acupuncture, Acupressure, Chiropractic treatment which involves manipulations of vertebrae to put them back on their original sites, Heat and cold treatment which reduces the inflammation and helps to improve circulation. These are the treatment used for this disease.

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All About The Pessary Device

A pessary is a medical device, often made of plastic, latex or silicone available in various shapes and sizes to suit the needs of the patient. It is inserted into the rectum or the vagina and held in place by the pelvic floor musculature. It’s used for the non-surgical management of a variety of gynecological disorders.

A pessary can be planted temporarily or permanently, a procedure ideally performed by a physician, midwife, or an advanced practice nurse.

Classification of pessaries

Pessaries can be broadly classified into the following few categories:

Therapeutic pessaries: A therapeutic pessary resembles the outer ring of the diaphragm and is used to treat prolapse of the uterus, a retroverted uterus, stress urinary incontinence, cystocele and rectocele. They support the uterus, vagina, bladder, or the rectum as the case may be. In the past, therapeutic pessaries have also been utilized to perform abortions.

Pharmaceutical pessaries: A pharmaceutical pessary functions as an effective tool for delivering pharmaceutical substance for easy absorption through the vaginal or rectal surface.

Occlusive pessaries: Occlusive pessaries are used as contraceptives, often coupled with a spermicide.

Types of pessaries

The type of pessary that is suitable for each patient primarily depends upon the condition being treated.

Some common types of pessaries used in medication are:

Ring pessary: It is used to treat conditions of a mild uterine prolapse. The ring pessary is available in the form of incontinence rings (used to treat stress urinary incontinence) and ring with support (helps in treating mild cystocele).

Incontinence dish: An incontinence dish is used for the treatment of stress urinary incontinence and mild uterine prolapsed. It is also available with support (for treating mild cystocele).

Donut pessary: It is 2 and a half to 3 inches in size and functions to treat a moderate uterine prolapse or a mild cystocele.

Gellhorn: The gellhorn is about 4 inches in size and used to treat a moderate uterine prolapse or a mild cystocele.

Inflatable pessary: It is available in medium as well as large sizes for the treatment of a moderate uterine proplapse.

Cube pessary: It is available in variations of 2 to 4 inches used to treat severe cases of uterine prolapsed, mild conditions of cystocele and rectocele and other types of vaginal vault prolapse.

Gehrung: It is available in sizes ranging from 3 inches to 5 inches used to treat moderate conditions of cystocele, rectocele and uterine prolapsed. It is also available as a knob.

Hodge: It is available in sizes ranging from 2 to 4 inches with support variations to choose from. It is used to treat mild conditions of cystocele.

Contraindications
While pessaries prove to be beneficial in the non-surgical treatment of gynecological disorders, patients fitted with pessaries are at the risk of Active infections of the pelvis or vagina (such as vaginitis or pelvic inflammatory disease) due to the use of the device.

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Common Perimenopause Symptoms

Perimenopause is the term that refers to the menopause transition years, characterized by increased FSH (Follicle Stimulating Hormone) levels in the female body. Signs and effects of a perimenopausal transition can show up as early as 35 years of age, lasting up to 10 years or more till the occurrence of the final period.

Causes of Perimenopause

Menopause marks the permanent stoppage of the primary function of the female ovaries, i.e. the production and maturation of ova and the release of hormones (estrogen and progesterone) that cause the creation of the uterine lining and the subsequent shedding of the uterine lining. Menopause mostly occurs in women during their late 40s or early 50s, and signals the end of their fertile phase. This transition from the fertile to the non-fertile phase often occurs over a period of years, as a natural result of ageing. At other times, functional disorders like endometriosis, polycystic ovary syndrome, cancer of the reproductive organs, etc. can also cause the onset of the symptoms of menopause or even speed up the menopausal process.

Symptoms of Perimenopause

During the perimenopausal transition period, women undergo noticeable and clinically observable physical changes resulting from hormonal fluctuations. However, the intensity, duration and frequency of these symptoms may vary from one woman to another – while for some, most of the perimenopause symptoms only last for a few months, for others, no symptoms occur at all.

Some common effects encountered by women during the perimenopausal transition period include:

  • Hot Flashes/ Flushes: A “hot flash” can be described as a sudden temporary increase in body temperature. Hot flashes are often considered to be harmless by physicians and can be treated by the hormone replacement therapy (HRT) or SSRI medications, or by using over the counter plant estrogens and herbal remedies.
  • Mood Fluctuations: A women undergoing perimenopausal transition often experiences unexplained feelings of anger, anxiety, depression, irritability and stress.
  • Changes in the Menstrual Cycle: Experiencing irregular periods, etc.
  • Headaches: Headaches stretching over long hours are common among women at the advent of a menopause.
  • Heart palpitation: Heart palpitation may be defined as a feeling of the heart skipping a beat or a sudden change in the rate of heat beat.
  • Tender breasts
  • Reduced sex drive
  • Insomnia: Insomnia is marked by regular sleep disturbances or extreme lack of sleep.
  • Fatigue: A feeling of tiredness and weakness prevails.
  • Memory disorders: Some common memory disorders associated with perimenopausal transition period include loss of concentration, forgetfulness, etc.
  • Empty Nest Syndrome: Menopause, along with the physical changes, brings along a sense of loss – related to the end of fertility, the death of parents, the sudden independence of children and the end of youth.

Treatment of Perimenopause

Prescription of melatonin supplementation to a woman undergoing perimenopausal symptoms can produce a major improvement in thyroid function and gonadotropin levels. It may also help in restoring menstruation and fertility and preventing the depression associated with the menopause in some cases.

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Patellar Tendonitis Symptoms and Treatment

Patellar tendonitis, also called as the jumper’s knee or Sinding Larsen Johansson disease, is a disorder of the inferior patellar region and is a common cause of pain among athletes.

The patellar tendon connects the knee cap to the shin bone and is composed of strong, string-like bands, surrounded by a lining of vascular tissue serving as a source of nutrition to the tendon.

Patellar tendonitis begins as an inflammation in this patellar tendon in the region of attachment to the patella (knee cap) and may later result into tearing or degeneration of the tendon also.

Causes of Patellar Tendonitis

Patellar Tendonitis is mostly caused due to repetitive overburdening of the extensor mechanism of the knee. The disease is a common among participants of various sports including baseball, cricket, golf, football, rugby, volleyball, tennis, basket ball, lacrosse, badminton, diving, skateboarding, snowboarding, gymnastics and kick boxing.

Symptoms of Patellar Tendonitis

The symptoms of patellar tendonitis may vary from one patient to another, depending upon the location and the cause. Yet, some common symptoms of patellar tendonitis are:

  • Pain directly over the patellar tendon
  • Pain during jumping or kneeling activities
  • Swelling around the patellar tendon

X-ray tests or an MRI are usually prescribed to look for areas of degenerative tendon.

Treatment for Patellar Tendonitis

Early stages of patellar tendonitis are usually treated conservatively using the RICE (Rest, Ice, Compression and Elevation) methodology, a treatment method for soft tissue injury. It generally shortens the recovery time and also helps in minimizing pain and discomfort.

Rest: Rest is an integral part of any kind of cellular repair process.

Ice: Ice is considered great as an agent to reduce inflammation, often prescribed for application every 20 minutes, for a 24 to 48 hour period.

Compression: Usage of a light, elastic bandage would result in an increase blood flow, relieving the patient off swelling.

Elevation: Elevation aids in increasing venous return of blood to the central circulation system.

The RICE methodology is often prescribed along with other components:

  • “HI-RICE” – Hydration, Ibuprofen, Rest, Ice, Compression and Elevation
  • “PRICE” – Protection, Rest, Ice, Compression and Elevation
  • “PRICE” – Pulse (Radial or Distal), Rest, Ice, Compression, and Elevation
  • “PRICES” – Protection, Rest, Ice, Compression, Elevation and Support
  • “PRINCE” – Protection, Rest, Ice, NSAIDs, Compression, and Elevation
  • “RICER” – Rest, Ice, Compression, Elevation, Referral
  • “DRICE” – Diagnosis, Rest, Ice, Compression, Elevation

Certain exercises and stretches to strengthen the muscles and tendons may also be recommended as a part of a conservative treatment. Non-steroidal anti-inflammatory medications (NSAIDs) such as Ibuprofen, Motrin, Naprosyn, Celebrex, and many others are also prescribed.

However, if these fail, autologous blood injections, injections of platelet rich plasma and high volume saline injections are prescribed.

Uncommonly, the needling therapy, also called as the prolotherapy may be required to remove myxoid degeneration in the tendon, which is mostly reserved for patients with debilitating pain for 6–12 months despite conservative measures.

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