recent medical updates

2010-08-07T12:05:00.007+05:30

Cataracts - a condition so common, that by age 80, more than half of Americans will have developed or been treated for it. Because the disorder can develop over time, it is best to educate yourself about the risk factors and symptoms.

What Is a Cataract?

A cataract is a clouding of the lens of the eye that makes objects look as though you were viewing them through foggy glasses or a frost-covered window. The condition is called cataract or cataracts - either term is correct. It can occur in one or both eyes. If both eyes are affected, the cataracts may progress (become larger or more opaque) at different rates, but the condition is not contagious and does not spread from one eye to the other. Cataracts are not painful and do not irritate the eyes or cause them to produce tears.

The lens is a transparent, layered structure that lies behind the iris - the colored part of the eye. For a visual image to be processed, the lens must focus light on the retina, the back part of the eye. The clearer the lens is, the sharper your vision will be. A hazy lens will cause the brain to perceive filmy images, rather than crisp and distinct ones.

Types of Cataract

Age-related cataracts

Cataracts are categorized according to their cause, and there are several types of cataract, as we’ll explain below. But unless otherwise specified, the term usually refers to age-related cataracts. The lens is made up primarily of water and protein fibers, which are arranged in a way that optimizes visual clarity. But year by year, the lens becomes thicker and heavier, and these protein fibers begin to break down. The proteins form clumps that distort light as it penetrates the lens and reaches the retina. A cataract can form in any part of the lens, but the closer it is to the center, the more likely it is to obscure vision.

Other types of cataract

Secondary. Age-related cataracts is considered to be a primary disease because it evolves by itself, rather than as the unintended consequence of a surgical procedure, as a medication side effect, or as a result of some other condition. A secondary cataract is one that can be linked to another cause, such as those listed below:

Eye surgery, such as for glaucoma or for a previous cataract in the same eye

Use of medically approved medications, such as corticosteroids (for example, prednisone), chlorpromazine, and phenothiazine

Other conditions, such as diabetes, retinitis pigmentosa, hypoparathyroidism, atopic dermatitis, and uveitis

Congenital. A baby born with cataracts is said to have congenital cataracts, although the condition may be either inherited (genetically transmitted) or congenital (acquired in the womb by means of illness or an infection such as rubella [measles]). Cataracts that develop during early childhood is also usually called congenital cataracts.

Traumatic. A traumatic cataract is one that occurs after an injury, either right away or years after the event. Almost any kind of traumatic injury can be responsible:

Blunt trauma, like getting punched in the eye during a fist fight

Penetrating trauma, such as when a shard of glass or metal pierces the eye during an auto accident

Alkaline chemical burns

Electrical trauma, such as being shocked with a Taser (stun) gun

Radiation. The word radiation simply refers to radiant heat, such as the heat of the sun’s rays. Radiation cataracts, sometimes called toxic cataracts, is a form of the disease caused by ultraviolet radiation from sunlight or by exposure to other forms of radiation. For example, the development of cataracts among workers who cleaned up the Chernobyl nuclear reactor accident was linked to their radiation exposure at the plant. Even radiation therapy intended to shrink a cancerous tumor can cause cataracts as a side effect.

Classification of Cataract

The lens of the eye is made up of three layers the nucleus, or core, of the lens is surrounded by a cortex. This cortex, or cortical layer, is in turn enveloped by a capsule, or capsular layer. It might help to picture the lens as a candy-coated chocolate-covered almond. The almond is the nucleus, the chocolate is the cortex, and the candy shell is the capsule that surrounds the chocolate-covered almond. When a vision specialist diagnoses a cataract, he or she classifies it according to type and according to its location on the lens:

Nuclear

When the nucleus of the lens hardens or becomes opaque (clouded), it's called a nuclear cataract. This type of cataract tends to have a muddy, dark-brown or a milky, opalescent appearance and poses the greatest threat to visual acuity because it lies behind the pupil, obscuring central vision. People with this kind of cataract tend to become more nearsighted as the cataract distorts the light entering the pupil. They may actually have better vision in dim light because pupil dilation allows them to see around the dense area of the lens.

Cortical

A cataract on the cortex of the lens is called a cortical cataract. This type of cataract has a distinctive spoked or striated appearance. Nearly two-thirds of all cataracts fall into this category.

Posterior subcapsular

A lacy, dense area that forms just in front of the posterior lens capsule (that is, the back of the lens capsule) is called a posterior subcapsular cataract (PSC). PSCs often make the person sensitive to glare and make it difficult for them to focus on objects in the near distance. A PSC often combines with one of the other types of cataract as they progress to more advanced stages.

Other types
When two or more types of cataract combine in a person with advanced cataract disease, the area is referred to as a mixed cataract. When the lens becomes completely veiled, the cataract is said to be mature or ripe. A hypermature cataract may cause pain or inflammation that necessitates surgery.

Weighing Your Options

If a vision care provider discovers that you or a friend or loved one has a cataract, it’s time to take stock of your options. But take heart - remember, most cataracts progress slowly and do not cause low vision for several years after they’re detected.

The good news is treatment is available and cataract surgery is extremely effective. Luckily, many people don’t require surgery at all, but rather need to be monitored by their doctors to track the progression of this condition.

Cataract Symptoms

Cataracts: Risk Factors and Symptoms

Why do some of us develop cataracts and not others? Who is most likely to develop the condition, and how can we tell if we have it? In the following sections, we’ll outline the risk factors for cataracts and tell you what signs and symptoms to be alert for.

Who Is At Risk?

As with heart disease and most other chronic health conditions, some risk factors for cataracts—getting up in years, for instance—are beyond our control. But specific behavioral and lifestyle choices we make, such as smoking, may magnify our risk. Cataracts is a multifactorial disease—that is, several factors contribute to its development even within a single individual. Let’s take a look at some of them:

Age. As the crow’s feet and laugh lines become more deeply etched in our features, the risk for cataracts inevitably increases .

Ethnicity. Some evidence suggests that our ethnic ancestry influences the likelihood of developing cataracts. In fact, cataracts is the leading cause of treatable vision loss among African-Americans age 40 and over, and it’s the number one cause of low vision among Americans of Latino, African, and European descent.

Gender. For reasons that are unclear, women are more likely than men to develop cataracts.

Sunlight exposure. A higher level of exposure to ultraviolet radiation from the sun’s rays makes the development of cataracts more likely.

Diabetes. According to the American Diabetes Association, people with diabetes are 60% more likely than those without diabetes to develop cataracts, and the condition tends to affect them at a younger age and to progress more rapidly than in people with cataracts who do not have diabetes.

Poor nutrition. Although further study is needed, vision researchers believe that a diet high in saturated fat may be linked to the development of cataracts. They’re also investigating the possibility that low blood calcium levels may contribute to cataract development.

Smoking. In addition to the dangers that everyone already knows, smoking also puts you at a higher risk for caracts. The relationship is dose related, so heavy smokers have a higher risk than people who smoke less.

Alcohol intake. A higher incidence of cataracts has been found among people who chronically abuse alcohol.

Researchers have proposed several other factors that may increase the risk of cataracts. They include a family history of the disease, myopia (nearsightedness), obesity, use of statin (cholesterol lowering) medications, and high blood pressure.

The most important way you can protect yourself is simply by making sensible lifestyle choices—eating a low-fat diet, wearing UV-filtering sunglasses, and not smoking or quitting smoking are good ways to start. Some studies suggest that taking an antioxidant vitamin supplement might cut your risk of cataracts, too.

What Are the Symptoms?

Okay, let’s say you or someone in your care has a few of the risk factors listed above—most of us do. How do you know whether to consult a vision care provider? Following are some common signs and symptoms of cataracts:

Blurry or dim vision. Your vision may be cloudy, as though you were looking out the window on a foggy day. Sharp outlines may seem to fade into the background, and you may lose the ability to perceive fine detail.

Sensitivity to glare. Glaring light may cause frequent headaches, or you may have eye strain that prompts you to blink continually in an effort to refocus your eyes.

Muted color perception. Colors may appear dull or yellowed.

Poor night vision. Headlights and street lights may seem to be surrounded by a halo, making it dangerous to drive after dark. Inside, you may find yourself using brighter reading lamps or other task lighting, or you may require indirect lighting.

Poor central vision. When a cataract forms behind the pupil, called a nuclear cataract, it may be hard to discern objects in the center of your visual field for an explanation of how cataracts are classified). This kind of cataract is a common cause of low vision.

Double vision. You may perceive duplicate images in a single eye.

Frequent changes in your eyeglasses or contact lens prescription. Although a cataract clouds your vision little by little, your prescription will change more often than usual as the condition progresses. In particular, your ability to see objects close to you may improve suddenly, while your ability to see things far away declines. A posterior capsular cataract develops more rapidly than the other types, necessitating even more frequent prescription adjustments.

What If I Suspect Cataracts?

If you believe that you or a friend or loved one has cataracts, a thorough eye examination by a vision care specialist is in order. The provider will review your medical history and risk factors, ask about your symptoms, examine your eyes, and perform specialized tests to check for cataracts and to rule out other eye diseases. If you do have cataracts, your provider will explain the treatment options or advise taking a "wait and see" approach

Diagnosing Cataracts

Sophisticated diagnostic tests now allow vision care specialists to determine the type, location, and stage of a cataract, helping you and your provider decide in advance whether surgery is prudent and likely to be successful . In the following article, we’ll describe the tests that might be used to gather this information and prepare you for surgery.

Diagnostic Steps

An optometrist, ophthalmologist, or general practitioner can diagnose cataracts, but only an ophthalmologist - a physician who specializes in eye care - can perform cataract surgery. Your provider will want to determine whether you have a cataract or cataracts, confirm whether or how much the condition is impairing your vision, rule out other eye diseases that could account for your low vision, and check for any conditions that might make surgery risky.

Cataracts can be diagnosed from your description of signs and symptoms, a visual acuity test using an eye chart, and a physical examination of the eyes. Specialized tests can be used to evaluate particular problems. Below are descriptions of some of the diagnostic tests your provider is likely to perform.

Standard Eye Examination

Visual Acuity Testing
Most of us are familiar with the "big E" chart, so named for the large block letter at the top. This chart measures how well you see at various distances. From a specified distance, usually 20 feet, the provider will ask you to read aloud progressively smaller rows of high-contrast (black type on a white background) capital letters and numbers.

However, a person's score on the visual acuity test may not reflect functional impairments, such as glare sensitivity and reduced contrast sensitivity. Specialized tests can be performed to measure diminished function.

Ophthalmoscopy Followed by Slit-Lamp Examination
Cataracts can be seen with an ophthalmoscope, a hand-held, microscope-like viewing instrument. After using special drops to dilate your pupils, your vision care provider will examine the internal structures of the eye to assess the cataract, if one is found, and to check for other eye diseases. A slit lamp, which is a high-intensity light source combined with a low-power microscope, will then be used to examine the frontal structures of the eye.

Tonometry
A tonometer is a hand-held instrument that measures intraocular pressure (the pressure of fluids inside the eye) after anesthetic drops are instilled. This test is performed to rule out glaucoma.

Keratometry and A-Testing
To fit you with an IOL of the proper size and magnification, your vision care provider will use keratometer to measure the curvature of your cornea. Then the length (optical axis) of your eye will be measured using painless ultrasound waves to determine the ocular power of the IOL lens. This test is called an A-scan.

Specialized Tests

Contrast Testing
People who have good visual acuity but poor contrast sensitivity may fail to see low-contrast objects, such as curbs and steps, under conditions of reduced visibility, such as in the shade or twilight. They may also have trouble reading and walking at a normal speed, identifying faces from a distance, and doing tasks such as sewing and preparing food.

Contrast sensitivity testing assesses the eye’s ability to detect subtle shade variations by asking you to view letters and numbers or groups of figures, such as gray bars, that vary in contrast, luminescence, and spatial frequency.

Glare Sensitivity Testing
Glare is simply scattered light that reduces visibility. Reading lamps, illuminated computer monitors, street lights, and headlights are various sources of glare that can interfere with the ability to see targets in the visual field. These objects might range from text on a glossy magazine page or a laptop screen to a jogger on the shoulder of the road at dusk.

Cataracts disperse light that enters the lens, reducing the contrast of the retinal image. Glare sensitivity is markedly increased in those with advanced cataracts, so testing for it can help indicate the stage of the opacity. You may be asked to read a chart under simulated lighting conditions that include direct sunlight, a partly cloudy day, and fluorescent lighting. Your performance will then be compared to your score under ideal lighting conditions.

Corneal Endothelium Testing
The corneal endothelium, a layer of tissue that lines the posterior surface of the cornea, is particularly apt to be injured during surgery, so your provider must examine its condition microscopically before operating. A low cell density indicates that the cornea may not function well after cataract surgery, eventually necessitating a transplant.

Potential Acuity Testing
Potential acuity testing uses a meter to examine macular function. The purpose of the test is to estimate how well you can expect to see after surgical removal of a cataract. It is most accurate if your cataracts are not advanced.

Wavefront Mapping
Symptoms are sometimes disproportionate to the degree of cataract formation observed during the physical examination. New wavefront technology uses computer analysis of a laser beam to track the distortion of light as it passes through the eye. This technology can corroborate a person’s report of disabling symptoms, establishing that a medical need exists (for insurance reimbursement) and allowing surgery to take place earlier in the disease’s progression.

Living with Cataracts
Ultimately, only those who live with cataracts can say whether the condition is merely a nuisance or is significantly compromising their quality of life - or perhaps falls somewhere in between. Most people with cataracts, however, do not proceed immediately to the operating room. You and your provider may prefer to take a "wait and see" approach and monitor the progression of the condition.

Unless your work requires visual precision, making small adjustments may suffice early in the course of the disease. For example, you can reposition lights to reduce glare, rearrange furniture and rugs to remove hazards, update your eyeglasses prescription frequently, and read large-print publications when available.

When accommodating the condition becomes too burdensome, though, most people with cataracts can undergo safe, effective surgery to restore their sight

prevention is better then cure

2009-08-14T10:13:00.000+05:30

Some common-sense precautions can help keep you safe from this potentially deadly infection.

You Will Need

Hand washing
Knowledge of symptoms
Prompt medical attention
Isolation
A face mask
Hand washing
Knowledge of symptoms
Prompt medical attention
Isolation
A face mask

Step 1:

Understand what it is. Swine flu is a respiratory disease of pigs caused by the influenza virus. Usually the virus does not infect humans, but transmission can sometimes occur in persons with direct exposure to pigs. The current outbreak has been caused by human-to-human transmission.

Step 2:

Swine flu is spread between humans like a cold: A person can catch it by being sneezed, coughed, or breathed on by a carrier, or by touching a surface that has the virus on it and then touching their own nose, eyes, or mouth. Direct contact with infected pigs can also transmit the virus to people, and vice versa. So far, no other animals can transmit the virus to humans.

You cannot get swine flu from eating cooked pork or pork products.

Step 3:

Wash your hands with warm water and soap often, lathering up for as long as it takes you to sing “Happy Birthday” twice, or about 20 seconds. Use hand sanitizer in between, and avoid touching your eyes, nose, and mouth. Don’t shake hands with anyone.

Step 4:

If someone is showing signs of a cold or flu, keep your distance.

Step 5:

Don’t assume you’re immune to the swine flu because you got a flu shot last year. It may not prevent you from being made sick by this particular strain, though it could prevent you from catching other strains.

Unlike other flu viruses, which tend to attack weakened immune systems, swine flu flourishes in young, strong, healthy bodies.

Step 6:

Know the symptoms, which include a fever higher than 100 degrees, body aches, coughing, a sore throat, and respiratory congestion. Some people have diarrhea and vomiting, too.

Step 7:

Don’t delay in getting medical attention if you show symptoms. Swine flu can be successfully treated with the antiviral drugs Tamiflu and Relenza, which are most effective when taken within 48 hours of the onset of symptoms.

Step 8:

If you are diagnosed with any kind of flu, stay indoors and limit your interaction with loved ones for seven days after the onset of symptoms to avoid passing it to others.

Step 9:

If you are in an area where there’s been a swine flu outbreak, wear a face mask. Swine flu is spread through respiratory droplets, which are transferred by a cough, sneeze, or even an exhale.

A simple face mask filters about 62 percent of small particles; a professional-grade one keeps 98 percent out.

Step 10:

Don’t panic if you recently visited an area with an outbreak. The incubation period is three to five days, so if you’re flu-free a week after your trip, you’re probably not infected.

video preview available here

http://www.howcast.com/videos/180564-How-To-Prevent-and-Recognize-Symptoms-Of-Swine-Flu

Why is swine flu now infecting humans?

2009-08-14T10:07:00.000+05:30

Why is swine flu now infecting humans?

Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.

First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termedantigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus' antigenic makeup over time (usually years).

Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a "mixing pot" for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.

H1N1 Flu (Swine Flu)

2009-08-14T09:42:00.000+05:30

1.SWINE FLU IN GENERAL

Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human FLU and include fever, cough, sore throat, body aches, headache, chills and fatigue.

2.SWINE FLU WITH MEDICAL DETAILS

What is the swine flu?
The swine influenza A (H1N1) virus that has infected humans in the U.S. and Mexico is a novel influenza A virus that has not previously been identified in North America. This virus is resistant to the antiviral medicationsamantadine (Symmetrel) andrimantadine (Flumadine), but is sensitivE to oseltamivir (Tamiflu) andzanamivir (Relenza).

What are the symptoms of swine flu?
Swine Flu Symptoms
According to the CDC, like seasonal flu, symptoms of swine flu infections can include:
fever, which is usually high, but unlike seasonal flu, is sometimes absent
cough
runny nose or stuffy nose
sore throat
body aches
headache
chills
fatigue or tiredness, which can be extreme
diarrhea and vomiting, sometimes, but more commonly seen than with seasonal flu
Signs of a more serious swine flu infection might include pneumonia and respiratory failure.
Swine Flu Symptoms vs. a Cold or Sinus Infection
It is important to keep in mind most children with a runny nose or cough will not have swine flu and will not have to see their pediatrician for swine flu testing.
This time of year, many other childhood conditions are common, including:
spring allergies - runny nose, congestion, and cough
common cold - runny nose, cough, and low grade fever
sinus infections - lingering runny nose, cough, and fever
strep throat - sore throat, fever, and a positive strep test
Swine Flu treatment

Recommended Infection Control for a non-hospitalized patient (ER, clinic or home visit):
Separation from others in single room if available until asymptomatic. If the ill person needs to move to another part of the house, they should wear a mask. The ill person should be encouraged to wash hand frequently and follow respiratoryhygiene practices. Cups and other utensils used by the ill person should be thoroughly washed with soap and water before use by other persons.
Antiviral Treatment
Suspected Cases
Empiric antiviral treatment is recommended for any ill person suspected to have swine influenza A (H1N1) virus infection. Antiviral treatment with either zanamivir alone or with a combination of oseltamivir and either amantadine or rimantadine should be initiated as soon as possible after the onset of symptoms. Recommended duration of treatment is five days. Recommendations for use of antivirals may change as data on antiviral susceptibilities become available.Antiviral doses and schedulesrecommended for treatment of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza:
Confirmed Cases
For antiviral treatment of a confirmed case of swine influenza A (H1N1) virus infection, either oseltamivir (Tamiflu) or zanamivir(Relenza) may be administered. Recommended duration of treatment is five days. These same antivirals should be considered for treatment of cases that test positive for influenza A but test negative for seasonal influenza viruses H3 and H1 by PCR.
Pregnant Women
Oseltamivir, zanamivir, amantadine, and rimantadine are all "Pregnancy Category C" medications, indicating that no clinical studies have been conducted to assess the safety of these medications for pregnant women. Only two cases of amantadine use for severe influenza illness during the third trimester have been reported. However, both amantadine and rimantadine have been demonstrated in animal studies to be teratogenic and embryotoxic when administered at substantially high doses. Because of the unknown effects of influenza antiviral drugs on pregnant women and their fetuses, these four drugs should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus; the manufacturers' package inserts should be consulted. However, no adverse effects have been reported among women who received oseltamivir or zanamivir during pregnancy or among infants born to such women.
Antiviral Chemoprophylaxis
For antiviral chemoprophylaxis of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir are recommended. Duration of antiviral chemoprophylaxis is 7 days after the last known exposure to an ill confirmed case of swine influenza A (H1N1) virus infection. Antiviral dosing and schedules recommended for chemoprophylaxis of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza:
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir is recommended for the following individuals:
Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) of a confirmed or suspected case.

School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.

Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).

Border workers (Mexico) who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).

Health care workers or public health workers who had unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the case's infectious period.
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir can be considered for the following:
Any health care worker who is at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) who is working in an area with confirmed swine influenza A (H1N1) cases, and who is caring for patients with any acute febrile respiratory illness.

Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.

2009-04-13T21:14:00.000+05:30

Hallucination

A hallucination, in the broadest sense, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space. Some people have quick passing hallucination, particularly when falling asleep or waking up and this is considered normal. Hallucinations and delusions that persist or recur may be a sign of mental illness.

Hallucination is sometimes confused with Illusion and Delusion.

Illusion - something not real or imaginary. An example is, a shadow of a curtain taken for a person.

Delusion - is a mistaken belief that cannot be corrected by reasoning. An example is, a person may think that a dear friend is trying to kill him.

Types

Types of Normal Hallucination :

Hypnagogic hallucination - happens when a person is falling asleep. Usually last from seconds to minutes.
Hypnopompic hallucination - happen when one is waking up.

Hallucinations are categorized according to which sensory modality is involved and, in addition, are categorized as either mood-congruent or mood-incongruent. The types of hallucinations are:

Auditory: The false perception of sound, music, noises, or voices. Hearing voices when there is no auditory stimulus is the most common type of auditory hallucination in mental disorders. The voice may be heard either inside or outside one’s head and is generally considered more severe when coming from outside one’s head. The voices may be male or female, recognized as the voice of someone familiar or not recognized as familiar, and may be critical or positive. In mental disorders such as schizophrenia, however, the content of what the voices say is usually unpleasant and negative. In schizophrenia, a common symptom is to hear voices conversing and/or commenting. When someone hears voices conversing, they hear two or more voices speaking to each other (usually about the person who is hallucinating). In voices commenting, the person hears a voice making comments about his or her behavior or thoughts, typically in the third person (such as, "isn’t he silly"). Sometimes the voices consist of hearing a "running commentary" on the person’s behavior as it occurs ("she is showering"). Other times, the voices may tell the person to do something (commonly referred to as "command hallucinations").
Gustatory: A false perception of taste. Usually, the experience is unpleasant. For instance, an individual may complain of a persistent taste of metal. This type of hallucination is more commonly seen in some medical disorders (such as epilepsy) than in mental disorders.
Olfactory hallucination: A false perception of odor or smell. Typically, the experience is very unpleasant. For example, the person may smell decaying fish, dead bodies, or burning rubber. Sometimes, those experiencing olfactory hallucinations believe the odor emanates from them. Olfactory hallucinations are more typical of medical disorders than mental disorders.
Somatic/tactile hallucination: A false perception or sensation of touch or something happening in or on the body. A common tactile hallucination is feeling like something is crawling under or on the skin (also known as formication). Other examples include feeling electricity through one’s body and feeling like someone is touching one’s body but no one is there. Actual physical sensations stemming from medical disorders (perhaps not yet diagnosed) and hypochondriacal preoccupations with normal physical sensations, are not thought of as somatic hallucinations.
Visual hallucination: A false perception of sight. The content of the hallucination may be anything (such as shapes, colors, and flashes of light) but are typically people or human-like figures. For example, one may perceive a person standing before them when no one is
there. Sometimes an individual may experience the false perception of religious figure (such as the devil, or Christ). Perceptions that would be considered normal for an individual’s religion or culture are not considered hallucinations.
Mood-congruent hallucination: Any hallucination whose content is consistent with either the depressive or manic state the person may be in at the time. Depressive themes include guilt, death, disease, personal inadequacy, and deserved punishment. Manic themes include inflated self-worth, power, knowledge, skills, and identity and a special relationship with a famous person or deity. For example, a depressed person may hear voices saying that he or she is a horrible person, whereas a manic person may hear voices saying that he or she is an incredibly important person.
Mood-incongruent hallucination: Any hallucination whose content is not consistent with either the depressed or manic state the person is in at the time, or is mood-neutral. For example, a depressed person may experience hallucinations without any themes of guilt, death, disease, personal inadequacy, or deserved punishment. Similarly, a manic person may experience hallucinations without any themes of inflated self-worth, power, knowledge, skills, or identity or a special relationship to a famous person or deity.

Causes of Hallucination:

It may be induced by drugs (hallucinogenic drugs) or hypnosis
It may be due to lack of sleep
Depression
Mental Illness

Scientific explanations

Various theories have been put forward to explain the occurrence of hallucinations. When psychodynamic (Freudian) theories were popular in psychiatry, hallucinations were seen as a projection of unconscious wishes, thoughts and wants. As biological theories have become orthodox, hallucinations are more often thought of (by psychologists at least) as being caused by functional deficits in the brain. With reference to mental illness, the function (or dysfunction) of the neurotransmitter dopamine is thought to be particularly important.^[12] The Freudian interpretation may have an aspect of truth, as the biological hypothesis explains the physical interactions in the brain, while the Freudian deals with the origin of the flavor of the hallucination. Psychological research has argued that hallucinations may result from biases in what are known as metacognitiveabilities.^[13] These are abilities that allow us to monitor or draw inferences from our own internal psychological states (such as intentions,memories, beliefs and thoughts). The ability to discriminate between internal (self-generated) and external (stimuli) sources of information is considered to be an important metacognitive skill, but one which may break down to cause hallucinatory experiences. Projection of an internal state (or a person's own reaction to another's) may arise in the form of hallucinations, especially auditory hallucinations. A recent hypothesis that is gaining acceptance concerns the role of overactive top-down processing, or strong perceptual expectations, that can generate spontaneous perceptual output (that is, hallucination

Stages of a hallucination

Emergence of surprising or warded-off memory or fantasy images
Frequent reality checks
Last vestige of insight as hallucinations become "real"
Fantasy and distortion elaborated upon and confused with actual perception
Internal-external boundaries destroyed and possible panentheistic experience

When to Contact a Medical Professional

A person who begins to hallucinate and is detached from reality should get checked by a health care professional right away, because many medical conditions that can cause hallucinations may quickly become emergencies. A person who is hallucinating may become nervous, paranoid, and frightened, and should not be left alone.

Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if someone appears to be hallucinating and is unable to tell hallucinations from reality.

What to Expect at Your Office Visit

The health care provider will do a physical examination and take a medical history. Blood may be drawn for testing.

Medical history questions may include the following:

Do you hear a voice?
Do you see something?
Do you have a sensation of feeling something or being touched?
How long have you been having hallucinations?
When did the hallucinations first appear?
Do the hallucinations occur just before or after sleep?
Has there been a recent death or other emotional event?
What medications are you taking?
Do you use alcohol regularly?
Do you use illegal drugs?
Are the hallucinations related to a traumatic event?
Is there agitation?
Is there confusion?
Is there a fever?
Is there a headache?
Is there vomiting?

2009-04-10T11:55:00.000+05:30

What is a Fracture?

A bone fracture is a break in a bone. Fractures are common. Most people fracture at least one bone during their lifetime.

The severity of fractures increase with age. Children's bones are more flexible and less likely to break. Falls or other accidents that do not harm children can cause complete fractures in older adults. Older adults suffer from fractures more than children because their bones are more likely to be brittle.

How Do Fractures Happen?

Fractures can happen in a variety of ways, but there are three common causes:

Trauma accounts for most fractures. For example, a fall, a motor vehicle accident or a tackle during a football game can all result in a fracture.
Osteoporosis also can contribute to fractures. Osteoporosis is a bone disease that results in the "thinning" of the bone. The bones become fragile and easily broken.
Overuse sometimes results in stress fractures. These are common among athletes.

Symptoms
The symptoms of a bone fracture depend on the particular bone and the severity of the injury, but may include:

Pain
Swelling
Bruising
Deformity
Inability to use the limb.

Types of Bone Fractures

The Human Skeletal System

The skeletal system is made up of 206 bones and provides support, allows for movement, and protects the internal organs of the body.

What Is a Fracture?

Sometimes, too much pressure is applied to a bone that results in what is known as a fracture. Fractures are often classified as either open or closed.

What Is an Open Fracture?

An open fracture is a fracture where a piece of the broken bone pierces through the skin. This can be dangerous because the bone is exposed, increasing the risk of infection.

What Is a Closed Fracture?

A closed fracture is a fracture where the bone is broken, but does not come through the skin.

What Is a Compression Fracture?

A compression fracture is a closed fracture that occurs when two or more bones are forced against each other. It commonly occurs to bones of the spine and may be caused by falling into a standing or sitting position, or a result of advanced osteoporosis.

What Is an Avulsion Fracture?

An avulsion fracture is a closed fracture where a piece of bone is broken off by a sudden, forceful contraction of a muscle. This type of fracture is common in young athletes and can occur when muscles are not properly stretched before activity. This fracture can also be the result of an injury.

What Is an Impacted Fracture

An impacted fracture is similar to a compression fracture, yet it occurs within the same bone. It is a closed fracture that occurs when pressure is applied to both ends of the bone, causing it to split into two fragments that jam into each other. This type of fracture is common in falls and car accident

FOR MORE INFORMATION ON TYPES OF BONE FRACTURE DO WATCH THIS VIDEO

http://video.about.com/orthopedics/Fractures-2.htm

Diagnosis and treatment
Bone fractures are diagnosed with x-rays. CT and MRI scans may also be used.

Broken bones heal by themselves – the aim of medical treatment is to make sure the two pieces are lined up correctly. Subsequent x-rays are taken to monitor the bone’s healing progress.

Depending on the site of the fracture and the severity of the injury, treatment options may include:

Splints – to discourage movement of the broken limb
Braces – to support the bone
Plaster cast – to provide support and immobilise the bone
Traction – this option is less common
Surgically inserted metal rods or plates – to hold the bone pieces together
Pain relief.

The healing process
The blood clots that form on the broken ends of bone are the beginning of the healing process. Over five or so weeks, the body fuses the two bone portions together with a combination of fibrous cells and cartilage. This bridge is temporary and not as strong as real bone. It can break easily with comparatively little force.

A cast or splint may be removed after a few weeks, but the bone still needs to be handled with care for at least one more month. The temporary bone (callus) is slowly replaced with real bone over the next couple of months.

Unlike skin, broken bones heal without forming scar tissue. However immobilised muscles tend to weaken and wither. Rehabilitation, including strengthening exercises, may be needed for a short time.
Complications of bone fractures
Complications can include:

Blood loss – bones have a rich blood supply and a bad break can result in substantial blood loss.
Injuries to organs – such as the brain (in the case of skull fractures) or chest organs (if a rib breaks).
Growth problems – the fractured long bone of a young child may not grow to its intended adult length if the injury is close to a joint, since bone fuses when it heals.

First aid
Suggestions for immediate treatment of a suspected bone fracture include:

Do not move the person unless there is an immediate danger, especially in the case of a suspected fracture of the skull, spine, ribs, pelvis or upper leg.
Attend to any bleeding wounds first. Stop the bleeding by pressing firmly on the site with a clean dressing. If a bone is protruding, apply pressure around the edges of the wound.
If bleeding is controlled, keep the wound covered with a clean dressing.
Do not attempt to straighten broken bones.
For limb fractures, provide support and comfort such as a pillow under the lower leg or forearm. However do not cause further pain or unnecessary movement of the broken bone.
Apply a splint to support the limb.
Immobilise the area by applying a sling for arms. Immobilise legs by tying them together above and below the fractured area.
If possible, elevate the fractured area and apply a cold pack to reduce swelling and pain.
In an emergency dial triple zero (000) for an ambulance.
Do not eat or drink anything until seen by a doctor, in case surgery is required.

How serious is a fracture?

The seriousness depends on the age of the individual and location of the fracture. Some fractures only require temporary protection (crutches, splint). Other, more serious fractures require surgery.

Things to remember

A fracture occurs when force exerted against a bone is stronger than the bone can structurally withstand.
The most common sites for bone fractures include the wrist, ankle and hip.
Treatment options include immobilising the bone with plaster casts, or surgically inserting metal rods or plates to hold the bone pieces together.

BOOKS TO BE PREFERED FOR USMLE

2009-04-02T13:36:00.000+05:30

THE BEST USMLE BOOKS

1. First Aid - the mother of all preparations
2.kaplan notes.... (jus write extraa on the margins)
3.Anatomy : high yield for embryo, neuro , histo and gross
4.Physiology : brs physio jot extra points to kaplan (courtesy:georgia)
5.Biochemistry :Lippincott
6.Microbiology :Jawetz (for reference only ...)
7.Pathology : Brs with points on kaplan
8.Webpath for slides
9.Behav science:Brs is okk
10.Biostats :NMS
11.Q book kaplans...+/- nms series

personalise the list according to ur time n needs

This book is a must-have for second year medical students and anyone taking Step 1 of the USMLE. It's great preparation for your second year classes, and the most concise and comprehensive text of what you'll need to know for Step 1. If you understand the material in this book, you will do quite well on Step 1. The information could be a bit better organized, but otherwise this book is unreservedly recommended Order your today.
The book reviews below were taken directly from FIRST AID FOR THE USMLE STEP 1, this is the bible of board review.

COMPREHENSIVE

A- Body Systems Reviews I, II, and III

Board Simulator Series, Gruber
Four exams with approximately 160 questions each. Follow new USMLE content outline (Book I covers hamatopoietic/lymphoreticular, respiratory, and cardiovascular systems; Book II tests GI, renal, reproductive, and endocrine systems; and Book III tests nervous, skin/connective tissue, and musculoskeletal systems). Numerous vignettes reflect clinical slant of the exam. Good black-and-white photgraphs. Comprehensive systems-based approach. Most effective if all three books are used. For the motivated student. Explanations discuss important concepts.

A- Retired NBME Basic Medical Sciences Test Items

NBME
Contains "retired" questions in all seven areas of basics science. Good topics. Letter answer only with no explanations. Content is still relevant, but the format is outdated. Contains old K-type questions. No clinical vignettes. Out of print, so try to find an old copy.

A- Review for USMLE Step I Examination

NMS, Lazo
Williams & Wilkins
Very good source of practice questions and answers. Features updated clinical questions with a limited number of vignettes. Some questions are too picky or difficult. Good explanations, but occasionally offers unnecessary detail. Good buy for the number of questions.

ANATOMY

A- High-Yield Embryology

Dudek
William & Wilkins
Excellent, concise review of embryology. Thorough coverage of subject. Excellent organization with clinical correlations. Crammable list of embryologic origins of tissues. Consider BRS Embryology for more complete diagrams.

A- High-Yield Gross Anatomy

Dudek
William & Wilkins
Excellent, concise review with clinical correlations. Contains will-labeled, high-yield radiologic images. Limited but very positive student feedback.

A- High-Yield Neuroanatomy

Fix
William & Wilkins
Clean, easy-to-read outline format. Straightforward text with excellent diagrams and illustrations. Just enough detail without anything extra. Very high yield review. More comprehensive than Clinical Neuroanatomy Made Rediculously Simple. Lacks index.

B+ Ace NeuroScience

Ace, Castro
Mosby-Year Book
Outline format with some good photomicrographs. Covers neuroanatomy, neurophysiology, and neuropathology. Separate chapters on clinical correlations are very high yield. For the motivated student. Test software included with text. Mony-back guarantee if you fail.

BEHAVIOR SCIENCE

A High-Yield Behavior Science

High Yield, Fadem
Williams & Wilkins
Clear, concise, very quick review of behavior scienc. Logical presentation with charts, graphs, and tables. More compact than Fadem's other review text. Short byt adequate statistics chapter. Lacks index.

A- Behavioral Science Review

BRS, Fadem
Williams & Wilkins
Easy reading, outline format, boldfacing of key terms. Good, detailed coverage of high-yield topics. Gives more information than may be needed for the USMLE. Great tables and charts. Short but complete statistics chapter.

B+ Ace Behavioral Science

Ace, Cody
Mosby-Year Book
Concise content review with boards-style questions and explanations. Thorough, easy-to-read format with numerous tables. Icons may be more distracting than helpful. No biostatistics. Test software is included with tex. Money-back guarantee if you fail.

BIOCHEMISTRY

A Lippincotts's Illustrated Reviews: Biochemistry

Champe
Lippincott
Excellent book, but requires time commitment, so an early start is necessary. Best used while taking the course. Excellent diagrams. Emphasizes concepts. Good clinical correlations. Comprehensive review of biochemistry, including low-yield topics. Not for cramming unless you skim high-yield diagrams.

A- BRS Biochemistry

Marks
Williams & Wilkins
Easy-to-read outline with very good boldfaced chapter summaries. More concise alternative to Lippincott. Outline format is not ideal for some sections. Mixed-quality diagrams. High-yield clinical correlations are given at the end of each chapter. Questions with short answers. Some questions are too picky.

MICROBIOLOGY

A Medical Microbiology & Immunology: Examination and Board Review

Levinson
Appleton & Lange
Clear, concise writing, with excellent diagrams and tables. Excellent immunology section. Forty-two page "Summary of Medically Important Organisms" very crammable. Requires time commitment. Sometimes too detailed and dense. Best if started early with the course. Covers all topics, including low-yield ones. Good practice questions and comprehensive exam, but questions have letter answer only.

A- Clinical Microbiology Made Rediculously Simple

Gladwin
MedMaster
Very good chart-based review of microbiology. Clever and humorous mnemonics. Best of this series. Text easy to read. Excellent antibiotic review helps for pharmacology as well. "Rediculous" style does not appeal to everyone. Does not cover immunology. Excellent if you have limited time or are "burning out."

A- BRS Medical & Immunology

Johnson BRS
Williams & Wilkins
Outline-format, well-organized, organ-based approach. Good questions at the ends of chapters. Too few diagrams. Includes chapters on bacterial genetics and laboratory methods. Immunology section is concise.

PATHOLOGY

A BRS Pathology

BRS, Schneider
William & Wilkins
Excellent, concise review with appropriate emphasis. Outline-format chpaters with boldfacing of key facts. Excellent questions with explanations at the end of each chapters and a comprehensive exam at the end of the book. Well-organized tables and diagrams. Some good black-and-white photographs representative of classic pathology. Short on clinical details for vignette questions. Consistently high student recommendations. Must start early, but very worthwhile to master this book. Correlate with color photographs from an atlas.

A-Pathology: Review for New National Boards

Miller
J & S
Questions-and-answer-based review of pathology. Includes many case-based questions. Focuses on high-yield topics. Good black-and-white photographs. Some picky questions with incomplete answers. Inadequate as sole source of review. Expensive for number of questions.

A-Pathophysiology of Disease: An Introduction to Clinical Medicine

McPhee
Appleton & Lange
Interdisciplinary course text useful for understanding the pathophysiology of clinical symptoms. Excellent integration of basic sciences with mechanisms of disease. Great graphs, diagrams, and tables. Most helpful if used during coursework due to length. Few non-board-style questions. Clinical emphasis nicely complement BRS Pathology.

PHARMACOLOGY

A- Lippincott's Illustrated Reviews: Pharmacology

Harvey
Lippincott
Outline format with practice questions and many excellent and memorable illustrations and tables. Cross-referenced ro Lippincotts's Biochemistry. Good for the "big picture." Good pathophysiologic approach. Detailed, so must start early. For the motivated student. Ten illustrated case studies with questions and answers in the appendix.

A- Pharm Cards: A Review for Medical Students

Johannsen
Little, Brown Review in compact index-card format; very popular with students. High-lights important features of major drugs/drug classes. Perfect for class review; also offers a quick, focused review for the USMLE. Lacks pharmacokinetics. Good charts adn diagrams. Highly rated by students who enjoy flash-card-based review.

A- Pharmacology: Examination and Board Review

Katzung
Appleton & Lange
Text is well organized in a narrative format. Good charts and tables. Large number of relevant and challenging questions with concise explanations. Good for drug interactions and toxicities. Text is quite detailed and requires substantial time commitment. Includes some low-yield/obscure drugs. The 40-page crammable list of "top boards drugs" is especially high yield.

PHYSIOLOGY

A BRS Physiology

BRS, Costanzo
Williams & Wilkins Clear, concise review of physiology. Fast, easy reading. Comprehensive and efficient. Great charts and tables. Good practice questions with explanations with a clinically oriented final exam. Excellent review book, but many not be enough for in-depth coursework.

A Ace Physiology

Ace, Ackermann
Mosby-Year Book
Concise yet thorough content review with some boards-style questions. Outline format is easy to read. Good illustrations. Test software included with text. Money-back guarantee if you fail.

USMLE

2009-04-02T13:27:00.000+05:30

Students who are currently in medical school/college must take the United States Medical Licensing Exam, or USMLE, in order to obtain a license to practice medicine. The USMLE is divided into three parts. This site contains information and resources for each step of the USMLE exam, as follows:

Step 1
Information on Step 1 includes an overview of the content that can be expected on the exam, which consists of seven sections of 50 questions each. The student will have one hour to complete each section. Step 1 covers various topics that fall under the area of basic science. The resources for Step 1 include a database of medical mnemonics, flashcards, test prep materials, and a discussion forum.

Step 2
The content of Step 2 of the USMLE is much more clinically oriented than that of Step 1. The USMLE Step 2 information provides an overview of the exam content as well as a list of study guides that provide students with a basic description of the content of each guide. Students can use these descriptions to determine which study guides will most benefit them. Step 2 resources include links to sites that can help student doctors with the clinical knowledge they will need to successfully pass Step 2 of the USMLE.

Students will also find the list of downloadable resources very helpful. The resources cover topics that are tested on the USMLE. Students can use these resources to help prepare for the exam.

Step 3
Step 3 of the USMLE is the final part of the exam. Step 3 will test the student's ability to work in an unsupervised environment. Students must apply their knowledge of biomedical and clinical science to manage and assist patients in an ambulatory setting as well as display their ability to handle some scenarios involving inpatient encounters. Because students will become independent physicians, it is crucial to ensure that students have obtained sound knowledge and practical skills that can be applied when treating patients.

This part of the exam will have two basic dimensions: the clinical encounter and the physician task. The physician tasks that students should be knowledgeable of include evaluating the severity of problems as described by patients, managing patient therapy, and exercising clinical judgment. Exam questions regarding clinical problems will include identification and control of diseases, especially those considered mainstream or high-impact.

Students will be presented with questions in the form of vignettes. A clinical encounter will be presented and questions will take the form of multiple-choice as well as case simulation. Both types of questions will require students to make clinical judgments and decisions just as they will have to do when they become practicing physicians. Step 3 will contain little or no basic science, because the testing board assumes that basic science concepts have been adequately tested in Steps 1 and 2 of the exam. The clinical encounter will require the student to be able complete an initial workup, provide a continuing care plan, and intervene in urgent care situations.

In addition to the clinical encounter and physician task organization, the exam is further divided into two dimensions: normal conditions and disease categories. Questions that fall under the category of normal conditions will involve the basic concepts and general principles associated with normal growth and development. Questions in the disease categories dimension will involve diseases and disorders that affect individuals.

hair fall

2009-04-02T13:04:00.000+05:30

Hair Loss and Its Causes

What is the normal cycle of hair growth and loss?

As you leave your teenage years behind and enter your 20s you realize that hair loss is an affliction that affects everybody, although in varying degrees of severity.

To distinguish normal hairfall from abnormal hair loss, one must understand the hair cycle. Each strand of the scalp goes through a growing phase termed 'anagen', lasting about 1000 days, a transitional phase called 'catagen', lasting 10 days (the hair stops growing during catagen) and the final resting phase called 'telogen', which lasts 100 days -- the hair then falls out of the follicle to be replaced by a new strand of hair, which will go through the same three phases.

There are roughly 1,00,000 hairs on the average scalp and thus it is said that upto 100 hair strands dying and falling out each day is normal. Most people, however, feel that they should not be losing even a single strand, which is obviously impossible. Hair, as per its life cycle, will grow and periodically fall out -- normal hair loss should not be stressed over, as the 100 strands that fall out are replaced by new ones produced by the scalp.

What causes excessive hair loss?

Stress:A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.

Poor nutrition comes a close second, with crash dieting often to blame. Girls starving themselves to look like Kareena Kapoor often pay for it with severe hair loss after six to eight weeks.

Hormonal problems :may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.

Post-Pregnency:Many women notice hair loss about 3 months after they've had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.

Medicines:Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.

Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.

Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.

Management of hairfall :
Taking Right Care
If you want to keep hair healthy, start by feeding it from the inside out.

Balanced Diet for Healthy Hair Eating a diet that has lots of vitamins, minerals and a well-balanced one will make hair strong and shiny. Extra Care while Combing Be careful when you're combing your hair after washing it because it's extra delicate when it's wet. Avoid Chemical Damage Go easy on the styling products and straightners, which can damage hair and make it weak. Tie Them Loose When you're combing or brushing your hair, do it gently, and keep braids and ponytails loose so they don't hurt your hair by pulling it too tightly.

Can improper care of my hair cause hair loss?

Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called "perms") may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.

What is common baldness?

The term "common baldness" usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Women may develop female-pattern baldness. In this form of hair loss, the hair can become thin over the entire scalp.

Is there any treatment for hair loss?

Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.

Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.

If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement or even surgical methods

inguinal hernia

2009-03-27T15:54:00.000+05:30

Medically outpatient hernia treatment in India.
Uploaded by surgeonsindia

latest medical breakthroughs

2009-03-27T15:11:00.000+05:30

Gut Chemical - Anti Obesity

Image Source: buzzle.com

There is a discovery that will possibly pave the way for new approaches in dealing with obesity. It is in a form of a fatty substance made by the gut. What it does is it signals the brain when it is time to stop eating. The fat derived chemical is known as NAPE. And it is present in humans and animals alike. It has been observed that when the mice being tested were given a fatty set of meal, their Nape level shot up, the substance was then synthesized and injected to the animals greatly diminishing their appetites. After a five day testing and dose of Nape, the animals lost weight and their eating greatly reduced. Many see this as a viable solution to the worldwide fight against obesity. Scientists are working doubly hard to develop the new discovery.

A new treatment for brain cancer

Image Source: alternative-cancer.net

Nimotuzumab is a humanised monoclonal antibody that works by binding and disabling the epidermal growth factor receptor. It is a protein that is thought to be a pivotal driver in tumour proliferation. It can be used as monotherapy or in combination with chemotherapy and radiotherapy. This is a mode of treatment for brain cancer that can be used alongside conventional therapies. It has a very low toxicity for a better quality life.

Nimotuzumab as a form of targeted therapy that binds with high specificity is thought to minimally affect normal tissues and have fewer toxic side effects. It is in fact proven safe cancer drug to be used on children with brain tumors in a clinical trial in Germany.

Dermabrasion: Skin Technology

Image Source:bucosmeticsurgery.com

Have you ever wondered why some older people have small holes in their face? It’s because during puberty they have severe acne that left them with scars. An acne refers to lesions or pimples caused when the hair follicles (or “pores”) on the skin become plugged with oil and dead skin cells. Scars from acne can seem like double punishment, first you had to deal with the pimples, now you have marks as a reminder. Most serious scarring is caused by the more severe forms of acne, with nodules more likely to leave permanent scars than other types of acne. The best way to deal with acne is to get treatment soon after the acne appears to prevent further damage. If you have nodules, see your doctor or dermatologist for treatment.
One of the medical breakthroughs for acne scarring is the treatment to diminish or remove the marks.There are various treatments for acne scarring. If you have serious bout of scarring from previous breakout one form of treatment is laser resurfacing. The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. This can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely. Another method for treating acne scarring is dermabrasion, which uses a rotating wire brush or spinning diamond instrument to wear down the surface of the skin. As the skin heals, a new, smoother layer replaces the abraded skin. It may take a bit longer for skin to heal using dermabrasion it usually last between 10 days and 3 weeks. The newest form of treatment for acne scarring is called fractional laser therapy. This type of treatment works at a deeper level than laser resurfacing or dermabrasion, because fractional laser therapy doesn’t wound the top layer of tissue, healing time is shorter. Fractional laser therapy is quite costly, and it’s not usually covered by insurance.
A person’s acne will need to be under control before having any of these treatments. After the treatment, we don’t’ have to be reminded of how bad are face was when we look in the mirror.

Diet the Effective way to loose weight

Image source: www.lhsc.on.ca
Diet has a very important role in man’s struggle against diseases and disability.
Latest research finds that eating enough quantities of nutritious diets in along with proper exercise are the major contributing factors to one’s physical fitness and health. The research was conducted to American people. It showed that one out of every three Americans is obese. These individuals who are obese are at greater risk for additional diseases, since obesity leads to other health problems, such as diabetes. A team of researchers has examined the effect of exercise on fat accumulation in a new study involving five obese women. In one session the women overate and did not exercise; in a follow-on session they overate and did exercise. The researchers found out that the body’s fat-burning oxidation rate was reduced after one day of overeating; conversely, just one session of exercise increased the rate of fat-burning oxidation; and exercise increased the amount of fat that would eventually be stored in the muscle.

Amputees gain new hope

Losing an arm or a leg - or worse, both - in an accident or because of a sickness can be a truly devastating experience. Once the initial shock wears off though, the greatest challenge for the survivors is how they could cope with their new life. Doing simple tasks that were often neglected before could prove to be difficult at first. But over time and with practice, most amputees learn to cope with their loss.

However, scientists from the Rehabilitation Institute of Chicago and Northwestern University give new hope to amputees as a new study could one day enable them to feel with an artificial limb as though it were their own. In an experiment done with the help of two patients who lost their arms, scientists rerouted key nerves to their chests. According to the patients, they could feel their missing arms and hands when pressure, heat and cold, and electrical stimulus were applied in the nerve areas.

IMAGING TECHNIQUES TO CURE EPILEPSY

There are at least three million Americans that have epilepsy and 30 percent of this has seizures that cannot be controlled by medicine. But as of now, new imaging techniques have stridently increased the number of people who are possible candidate for epilepsy surgery. And the children have more benefits on this since their brain is still flexible. Surgery is the only way to completely cure epilepsy but this is crucial because many things can happen inside your brain during surgery that can cause further damages. And to accurately map the brain during surgeries, surgeons place dozens of tiny electrodes directly on the surface of the brain and these sensors allow a digital brain wave machine to generate a high-tech image of what is happening inside the brain.

PENUMBRA — brain vacuum cleaner

It is a disheartening fact that stroke is the third leading cause of death and the leading cause of disability in the US. But there is a new tool called Penumbra which is a device suction for blood clots from the brains of stroke patients. It gives possibility of life and cuts the risk of death and disability. A catheter is used as it goes from a small incision in the groin through blood vessels up to the brain where this is a blockage and Penumbra suctions out the clot thus, saving a stroke victim’s life. There is a new study in fact that shows it restored blood flow in 82 percent out of 125 patients.

HEART BREAKTHROUGH

It has always been believe that atherosclerosis which is the buildup of plaque in the arteries, was irreversible. But this year, heart experts has done something that was thought to be almost impossible, they were able to shrink the fatty clogs blocking the heart’s arteries of patients by around 7 percent only with the use of maximum dosage of Crestor which is a cholesterol-lowering medication. Heart medications before are only taken to slow or stop the narrowing of arteries. But this new finding raises the possibility that you can actually reverse the plaque accumulation that starts even as early as childhood.

A fitting transplant

In organ transplants, patients need to take anti-rejection drugs after the operation. Otherwise, their body’s immune system shall reject the organ because it recognizes that the transplanted organ is a foreign one. The patient has to take the medicine for an undetermined length of time and it could be for the rest of his life including its side effects.

One way of avoiding the need for anti-rejection drugs, which is currently undergoing extensive study, is to infuse the donor’s marrow to the patient such that the latter’s immune system can recognize the new organ as its own. This approach had its initial taste of success but it’s not yet perfected. Patients who have undergone this treatment need to take the anti-rejection drugs for less than a year and have not needed to take them again.

Pacifier reduces risk of SIDS

Sudden infant death syndrome (SIDS) is the sudden and unexplained death of babies aged one month to one year even if they appear to be healthy. It is also known as cot or crib death. The causes of SIDS cannot be determined with certainty although some have might have been identified as risk factors. The same thing goes for its prevention.

One way of preventing SIDS is by giving the baby a pacifier as recommended by the American Academy of Pediatrics (AAP). A study conducted in relation to the use of pacifiers showed that there is a 90% reduction of the occurrence of SIDS when babies are offered pacifiers. One reason attributed for the risk reduction is that the pacifier keeps the face of the infant away from the mattress thus suffocation is avoided.

laser eye surgery---->general information

2009-03-26T22:00:00.000+05:30

What Is Corrective Laser Eye Surgery?

In layman's term, corrective laser eye surgery is a way to fix your eyesight, without the use of glasses or contacts, and a way for you to be able to see the world as you are supposed to see it. Corrective laser eye surgery is considered as one of the newest and established technologies for eyesight correction.

Laser Eye Surgery

A minimally invasive laser treatment which reshapes the cornea and helps the eye to focus properly is the laser vision correction of the eye. This treatment is effective enough to reduce or eliminate the use of contact lens or eyeglasses

How Corrective Laser Eye Surgery Works

The basis behind corrective laser eye surgery is just as it sounds. In the surgery process, lasers are utilized to operate on the cornea and fix the parts of your eyes that don’t work, so that your eyesight becomes clearer and much improved. The whole process usually takes only a few minutes, depending on the patient’s present state of health.

Depending on how poor your eyesight is, and what type of problems you have to cause your eyesight to worsen, you are going to see varying results in how much better your eyesight will get when you are finished with the corrective laser eye surgery treatments.

The Benefits Of Corrective Laser Eye Surgery

There are a lot of apparent benefits to corrective laser eye surgery. To begin with, you will no longer require glasses or contact lens, which are something that creates a lot of hassle for many people.

If you have a new born kid, you will realize how troublesome it is to wear glasses. Your baby always likes to pull your glasses, and break it if you are not careful! It's such a hassle. Contact lens is good, but you cannot be wearing your contact lens 24 hours 7 days a week!

Needing glasses and contacts also makes things like water sports difficult because you either have to chance losing your contacts, wear prescription goggles, or simply go without being able to see very well.

It is quite easy to see that corrective laser eye surgery is going to be beneficial to you and your life in many different ways.

Risks and Complications

Just like any surgical operation, there are risks involved in corrective laser eye surgery. We're all well-acquainted with the touted benefits of corrective surgery, but what about what the ads don't necessarily tell you? What are the risks associated with laser eye surgery? Any surgical procedure carries with it a certain amount of risk, and laser eye surgery is no different.

Some of the risks of undergoing such procedures include:

Loss of vision. If things don't go as planned, some patients emerge from the procedure with vision that's worse than what they came in with.
Development of new visual problems. Some patients develop a glare, halos, starbursts and double vision as a result of laser eye surgical procedures.
Undertreatment/ Overtreatment- Reshaping the cornea is a delicate business. Sometimes the cornea is not reshaped enough—too little material is taken out; sometimes it's reshaped too much—too much material is taken out.
Dry eyes. Many patients report having dry eyes after surgery. Although eye drops (plus a little time for healing) are usually able to correct or at least help the problem, in some more serious cases, special plugs are required to prevent tears from draining away from the eyes.
Infection and other flap-healing problems. Cutting a flap into your cornea is like cutting any other part of your body. There is always the potential that it may get infected or otherwise not heal properly.
Results may diminish with Time. Although technically not a “risk” of surgery, you should know that even with the best laser eye surgery, the results don't last forever. The cornea continues to age and change shape. Keep in mind that these procedures are still so new that no long-term data exists. In how many people will Lasik corrections last twenty years or longer? We don't really know. The first FDA-approved Lasik eye surgery was in 1998.

Are You a Candidate for Laser Eye Surgery?

You may be a good candidate for laser eye surgery if you:

are at least 21 years of age for a Summit laser or 18 years of age for a VISX laser, since the eyes are still growing to this point
have healthy eyes that are free from retinal problems, corneal scars, and any eye disease (refractive errors are considered eye disorders, not diseases)
have mild to moderate myopia (nearsightedness) within the range of treatment (see your doctor to determine your range)
have a way to pay for the treatment since laser procedures are costly and probably not covered by health insurance policies
are fully informed about the risks and benefits of laser surgery compared with other available treatments.

Frequently Asked Questions About Laser Eye Surgery

Is it painful?: There is little if any discomfort during surgery because the cornea and eye are anesthetized by drops. Some patients experience a "scratchy feeling." After the anesthetic wears off, the amount of discomfort varies with each individual, but any irritation is minor and usually disappears within a few hours. You may be sensitive to light for a few days.
When will I be able to return to work?: Most people can return to work one to three days following surgery, but a rule of thumb is to wait until you feel up to it. Most return to normal activities as soon as the day after surgery.
What are the side effects and risks?: The most common side effects are a halo effect and some glare at night around lights.
How long does the treatment take?: Laser treatment itself takes only about 15 to 40 seconds, based on the degree of correction necessary. Recovery is minimal, and usually the patient is able to be driven home after about 30 minutes. Typically, you will notice improved sight in 3 to 5 days following treatment.
Is the treatment permanent?: According to the results of the U.S. clinical trials and results reported internationally, the treatment appears to be permanent. As people age, however, their eyes change and re-treatment may be necessary.
Are there any activity restrictions following surgery?: Following surgery, do not rub your eyes. Other than that, patients can do whatever they feel up to as long as they follow their doctors' instructions.
What if I move my head during surgery?: This is the number one question that patients ask when undergoing laser treatment. The surgeon is skilled in the technique of removing his foot from the pedal that controls the ultraviolet beam as soon as a patient moves his or her head. This allows him to realign the beam with the corneal "target" and proceed with the surgery.

Recent Medical Studies on Circumcision

2009-03-26T20:03:00.000+05:30

Circumcision Removes the Most Sensitive Parts of the Penis

A sensitivity study of the adult penis in circumcised and uncircumcised men shows that the uncircumcised penis is significantly more sensitive. The most sensitive location on the circumcised penis is the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision are significantly more sensitive than the most sensitive location on the circumcised penis.

In addition, the glans (head) of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The tip of the foreskin is the most sensitive region of the uncircumcised penis, and it is significantly more sensitive than the most sensitive area of the circumcised penis. Circumcision removes the most sensitive parts of the penis.

This study presents the first extensive testing of fine touch pressure thresholds of the adult penis. The monofiliment testing instruments are calibrated and have been used to test female genital sensitivity.

Circumcision Results in Significant Loss of Erogenous Tissue

A report published in the British Journal of Urology assessed the type and amount of tissue missing from the adult circumcised penis by examining adult foreskins obtained at autopsy. Investigators found that circumcision removes about one-half of the erogenous tissue on the penile shaft. The foreskin, according to the study, protects the head of the penis and is comprised of unique zones with several kinds of specialized nerves that are important to optimum sexual sensitivity.

Taylor, J. et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," BJU 77 (1996): 291–295.

Circumcision Affects Sexual Behavior

A study published in the Journal of the American Medical Association found that circumcision provided no significant prophylactic benefit and that circumcised men were more likely to engage in various sexual practices. Specifically, circumcised men were significantly more likely to masturbate and to participate in heterosexual oral sex than uncircumcised men.

Laumann, E. et al., "Circumcision in the U.S.: Prevalence, Prophylactic Effects, and Sexual Practice," JAMA 277 (1997): 1052–1057.

Researchers Demonstrate Traumatic Effects of Circumcision

A team of Canadian researchers produced new evidence that circumcision has long-lasting traumatic effects. An article published in the international medical journal The Lancet reported the effect of infant circumcision on pain response during subsequent routine vaccination. The researchers tested 87 infants at 4 months or 6 months of age. The boys who had been circumcised were more sensitive to pain than the uncircumcised boys. Differences between groups were significant regarding facial action, crying time, and assessments of pain.

The authors believe that "neonatal circumcision may induce long-lasting changes in infant pain behavior because of alterations in the infant’s central neural processing of painful stimuli." They also write that "the long-term consequences of surgery done without anaesthesia are likely to include post-traumatic stress as well as pain. It is therefore possible that the greater vaccination response in the infants circumcised without anaesthesia may represent an infant analogue of a post-traumatic stress disorder triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination."

Taddio, A. et al., "Effect of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination," The Lancet 349 (1997): 599–603.

Circumcision Study Halted Due to Trauma

Researchers found circumcision so traumatic that they ended the study early rather than subject any more infants to the operation without anesthesia. Those infants circumcised without anesthesia experienced not only severe pain, but also an increased risk of choking and difficulty breathing. The findings were published in the Journal of the American Medical Association. Up to 96% of infants in some areas of the United States receive no anesthesia during circumcision. No anesthetic currently in use for circumcisions is effective during the most painful parts of the procedure.

Lander, J. et al., "Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision," JAMA 278 (1997): 2157–2162.

Circumcised Penis Requires More Care in Young Boys

The circumcised penis requires more care than the natural penis during the first three years of life, according to a report in the British Journal of Urology. The clinical findings of an American pediatrician showed that circumcised boys were significantly more likely to have skin adhesions, trapped debris, irritated urinary opening, and inflammation of the glans (head of the penis) than were boys with a foreskin. Furthermore, because there are large variations of appearance in circumcised boys, circumcision for cosmetic reasons should be discouraged.

Van Howe, R., "Variability in Penile Appearance and Penile Findings: A Prospective Study," BJU 80 (1997): 776–782.

Poll of Circumcised Men Reveals Harm

A poll of circumcised men published in the British Journal of Urology describes adverse outcomes on men’s health and well-being. Findings showed wide-ranging physical, sexual, and psychological consequences. Some respondents reported prominent scarring and excessive skin loss. Sexual consequences included progressive loss of sensitivity and sexual dysfunction. Emotional distress followed the realization that they were missing a functioning part of their penis. Low-self esteem, resentment, avoidance of intimacy, and depression were also noted.

Hammond, T., "A Preliminary Poll of Men Circumcised in Infancy or Childhood," BJU 83 (1999): suppl. 1: 85–92

Psychological Effects of Circumcision Studied

An article titled "The Psychological Impact of Circumcision" reports that circumcision results in behavioral changes in infants and long-term unrecognized psychological effects on men. The piece reviews the medical literature on infants’ responses to circumcision and concludes, "there is strong evidence that circumcision is overwhelmingly painful and traumatic." The article notes that infants exhibit behavioral changes after circumcision, and some men have strong feelings of anger, shame, distrust, and grief about having been circumcised. In addition, circumcision has been shown to disrupt the mother-infant bond, and some mothers report significant distress after allowing their son to be circumcised. Psychological factors perpetuate circumcision. According to the author, "defending circumcision requires minimizing or dismissing the harm and producing overstated medical claims about protection from future harm. The ongoing denial requires the acceptance of false beliefs and misunderstanding of facts. These psychological factors affect professionals, members of religious groups, and parents involved in the practice."

Expressions from circumcised men are generally lacking because most circumcised men do not understand what circumcision is, emotional repression keeps feelings from awareness, or men may be aware of these feelings but afraid of disclosure.

Goldman, R., "The Psychological Impact of Circumcision," BJU 83 (1999): suppl. 1: 93–102

Serious Consequences of Circumcision Trauma in Adult Men Clinically Observed

Using four case examples that are typical among his clients, a practicing psychiatrist presents clinical findings regarding the serious and sometimes disabling long-term somatic, emotional, and psychological consequences of infant circumcision in adult men. These consequences resemble complex post-traumatic stress disorder and emerge during psychotherapy focused on the resolution of perinatal and developmental trauma. Adult symptoms associated with circumcision trauma include shyness, anger, fear, powerlessness, distrust, low self-esteem, relationship difficulties, and sexual shame. Long-term psychotherapy dealing with early trauma resolution appears to be effective in healing these consequences.

Rhinehart, J., "Neonatal Circumcision Revistited," Transactional Analysis Journal 29 (1999): 215-221

Anatomy and Function of the Foreskin Documented

A new article describes the foreskin (prepuce) as an integral, normal part of the genitals of mammals. It is specialized, protective, erogenous tissue. A description of the complex nerve structure of the penis explains why anesthetics provide incomplete pain relief during circumcision. Cutting off the foreskin removes many fine-touch receptors from the penis and results in thickening and desensitization of the glans outer layer. The complex anatomy and function of the foreskin dictate that circumcision should be avoided or deferred until the person can make an informed decision as an adult.

Cold, C. and Taylor, J., "The Prepuce," BJU 83 (1999): suppl. 1: 34–44.

Male Circumcision Affects Female Sexual Enjoyment

A survey of women who have had sexual experience with circumcised and anatomically complete partners showed that the anatomically complete penis was preferred over the circumcised penis. Without the foreskin to provide a movable sleeve of skin, intercourse with a circumcised penis resulted in female discomfort from increased friction, abrasion, and loss of natural secretions. Respondents overwhelmingly concurred that the mechanics of coitus were different for the two groups of men. Unaltered men tended to thrust more gently with shorter strokes.

O’Hara, K. and O’Hara, J., "The Effect of Male Circumcision on the Sexual Enjoyment of the Female Partner," BJU 83 (1999): suppl. 1: 79–84

Male Circumcision and Psychosexual Effects Investigated

Infant male circumcision continues despite growing questions about its medical justification. As usually performed without analgesia or anesthetic, circumcision is observably painful. It is likely that genital cutting has physical, sexual, and psychological consequences, too. Some studies link involuntary male circumcision with a range of negative emotions and even post-traumatic stress disorder (PTSD). Some circumcised men have described their current feelings in the language of violation, torture, mutilation, and sexual assault. In view of the acute as well as long-term risks from circumcision and the legal liabilities that might arise, it is timely for health professionals and scientists to re-examine the evidence on this issue and participate in the debate about the advisability of this surgical procedure on unconsenting minors.

Boyle, G., Goldman, R., Svoboda, J.S., and Fernandez, E., "Male Circumcision: Pain, Trauma, and Psychosexual Sequelae," Journal of Health Psychology 7 (2002): 329-343.

Surveys Reveal Adverse Sexual and Psychological Effects of Circumcision

A survey of the 35 female and 42 gay sexual partners of circumcised and genitally intact men, and a separate survey of 53 circumcised and genitally intact men, and a separate survey of 30 genitally intact men themselves indicated that circumcised men experienced significantly reduced sexual sensation along with associated long-lasting negative emotional consequences.

Boyle, G. and Bensley, G., "Adverse Sexual and Psychological Effects of Male Infant Circumcision,". Psychological Reports 88 (2001): 1105-1106.

Foreskin Reduces the Force Required for Penetration and Increases Comfort

Masters and Johnson observed that the foreskin unrolled with intercourse. However, they overlooked a prior observation that intromission (i.e., penetration) was thereby made easier. To evaluate this observation an artificial introitus was mounted on scales. Repeated measurements showed a 10-fold reduction of force on entry with an initially unretracted foreskin as compared to entry with a retracted foreskin. For the foreskin to reduce the force required it must cover most of the glans when the penis is erect.

Taves, D., "The Intromission Function of the Foreskin," Med Hypotheses 59 (2002): 180.

Survey of Men Circumcised as Adults Shows Mixed Results

Men circumcised as adults were surveyed to assess erectile function, penile sensitivity, sexual activity and overall satisfaction. Over 80% of these men were circumcised to treat a medical problem. The response rate was 44% among potential responders. Mean age of responders was 42 years at circumcision and 46 years at survey. Adult circumcision appears to result in worsened erectile function, decreased penile sensitivity, no change in sexual activity, and improved satisfaction. Of the men 50% reported benefits and 38% reported harm. Overall, 62% of men were satisfied with having been circumcised. Note: Results may be affected by the fact that there was no sample of normal, healthy, genitally intact men for comparison.

Fink, K., Carson, C., DeVellis, R., "Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction," J Urol 167 (2002): 2113-2116.

Survey Finds Circumcision Contributes to Vaginal Dryness

The impact of male circumcision on vaginal dryness during coitus was investigated. We conducted a survey of 35 female sexual partners aged 18 to 69 years who had experienced sexual intercourse with both circumcised and genitally intact men. Women reported they were significantly more likely to have experienced vaginal dryness during intercourse with circumcised than with genitally intact men.

Bensley, G. and Boyle, G., "Effects of Male Circumcision on Female Arousal and Orgasm," N Z Med J 116 (2003): 595-596.

Early Adverse Experiences May Lead to Abnormal Brain Development and Behavior

Self-destructive behavior in current society promotes a search for psychobiological factors underlying this epidemic. The brain of the newborn infant is particularly vulnerability to early adverse experiences, leading to abnormal development and behavior. Although several investigations have correlated newborn complications with abnormal adult behavior, our understanding of the underlying mechanisms remains rudimentary. Models of early experience, such as repetitive pain, sepsis, or maternal separation in rodents and other species have noted multiple alterations in the adult brain, correlated with specific behavioral types depending on the timing and nature of the adverse experience. The mechanisms mediating such changes in the newborn brain have remained largely unexplored. Maternal separation, sensory isolation (understimulation), and exposure to extreme or repetitive pain (overstimulation) may cause altered brain development. (Circumcision is described as an intervention with long-term neurobehavioral effects.) These changes promote two distinct behavioral types characterized by increased anxiety, altered pain sensitivity, stress disorders, hyperactivity/attention deficit disorder, leading to impaired social skills and patterns of self-destructive behavior. The clinical importance of these mechanisms lies in the prevention of early adverse experiences and effective treatment of newborn pain and stress.

2009-03-26T19:32:00.000+05:30

What is a knee sprain?

A knee sprain is a joint injury that causes a stretch or tear in one or more of the knee ligaments. A sprain can be mild, moderate, or severe depending on the amount of damage to the ligament.

Ligaments are strong bands of tissue that connect one bone to another. The knee joint is held together by the cruciate and collateral ligaments. These ligaments connect the thighbone (femur) in the upper leg to the bones in the lower leg. The anterior and posterior cruciate ligaments cross each other inside the knee joint and keep the thighbone from sliding or rotating over the tibia (one of the 2 main bones in the lower leg). The medial and lateral collateral ligaments are on either side of the knee and keep the knee from moving side to side.

Description of Knee Sprains

Most ligament injuries of the knee involve a tearing of either the medial collateral ligament (MCL) on the medial side of the knee (medial means toward the midline of the body, and lateral means away from the midline), the anterior cruciate ligament (ACL) deep inside the joint, or both ligaments. The posterior cruciate ligament (PCL) is much less likely to sustain an injury than the ACL.

Causes and Risk Factors of Knee Sprains

The most commonly sprained ligament is the medial collateral ligament (MCL). This ligament can be sprained by a blow to the outside of the knee, particularly if your foot is planted on the ground when you are hit. The blow causes the knee to move toward the inside of the body and stretches the ligament. You will feel tenderness and pain on the inside of the knee, and the knee will feel like it may buckle or give way to the inside. Anything more than minimal pain should be treated by a doctor.

A sprain on the outside of the knee, the lateral collateral ligament, is caused by a blow to the inside of the knee, which forces the knee to the outside. This is much less common than an MCL sprain because it is hard to get hit on the inside of the knee. Usually, your leg gets in the way and takes the blow.

Athletic or occupational trauma is usually the cause of an ACL injury. Sports that involve sudden acceleration and deceleration, such as basketball, soccer, field hockey, football and skiing, are frequently associated with ACL injuries. Nevertheless, ACL injuries can occur in any sport if the knee undergoes acceleration-rotation-type movement. Disability may be immediate because of pain and (frequently) swelling, which sometimes appears as soon as 1 to 4 hours after injury. However, immediate disability does not suggest the degree or severity of a particular type of injury. Patients may report that the knee "gave way" or became unstable; an audible "pop" raises the specter of an ACL tear.

A good rule of thumb for these injuries is: if you receive a blow to the knee and the pain is on the same side of the knee that was hit, it is probably just a bruise, and the pain will go away rapidly. If the pain is on the opposite side of the knee, consider this a serious injury that needs careful treatment.

Treatment of Knee Sprains

Surgery is needed for patients who fall into the high or moderate risk category based on job, recreational, and/or athletic demands. Surgery may be considered for patients who are not at high risk but who experience symptoms during everyday activities, such as walking on uneven surfaces and performing simple twisting maneuvers. Before surgery, it is necessary to establish whether there is a full range of motion in the knee; if there is significant atrophy of the quadriceps and hamstrings, an intensive retraining period should be instituted before surgery.

It is not uncommon for patients with ACL-deficient knees to have had multiple procedures to remove articular or meniscal cartilage fragments. With the loss of these secondary restraints, the knee becomes more unstable, and the patient may become a surgical candidate based on overall knee instability. Physical therapy may help enhance balance and proprioception.

Rehabilitation

If the MCL sprain is a mild one, an early rehabilitation program using a stationary bicycle and leg extension and curl exercises is all you need. Begin by riding the bicycle for 20 minutes. Keep the seat high so that the range of motion is minimal. Do not put any drag on the bike; you are simply interested in moving the knee. In the very beginning, you may not be able to pedal all the way around. Just pedal back and forth until you can come over the top.

Do the leg extension while seated at a bench or a table. Once you lift the weight, hold at full extension for three seconds, and then very slowly lower your leg. Concentrate on the slow movement down, which is the most important part of the lift. Muscle contraction against weight while the muscle is lengthened builds the most strength. Ten lifts make a set. Do five sets of this exercise and rest for 30 seconds or more, if needed, after each set.

Do the leg curl while lying on your stomach. Do 10 lifts per set for five sets. If you are using a weight machine, you should hold for three seconds with the leg bent. If you are using free weights, this is not necessary.

The purpose of these exercises is to strengthen the quadriceps muscles in the front of the thigh (leg extensions) and the hamstring muscles in the back of the thigh (leg curls). These muscles control the knee and must be restrengthened.

If you have a problem doing the leg extensions, that is, if your range of motion is too limited or you find it too painful, then do isometric quadriceps exercises first.

How long will it take to get better?

If you start participating in sports or other activities before you have completely recovered, you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Follow your health care provider's instructions and advice. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

If you've had surgery, wait to return to sports or other activities until your provider has told you that you can safely return.

Self Care

The immediate treatment for a sprained knee is the standard RICE formula. This is an acronym for Rest, Ice, Compression, and Elevation. These steps will help reduce swelling and pain, and speed the healing process. Rest the knee while it aches and ice it intermittently several times a day. Wrap it in an elastic bandage in between icings, and keep it elevated as much as possible.

Questions To Ask Your Doctor About Knee Sprains

Saying you have a "knee sprain" is not a terribly useful diagnosis for two reasons:

First: it does not tell you which ligament is injured. This is important because different ligaments are treated very differently. For example, ACL (anterior cruciate ligament) injuries often need surgical reconstruction. On the other hand MCL (medial collateral ligament) injuries seldom require surgery.
Second: it does not tell you how badly the ligament is injured. The reason this is important is that minor injuries usually require minor treatment. More severe injuries may require more substantial treatment, rehabilitation, and possibly surgery.

Despite this, patients are often told they have a knee sprain. If you are diagnosed with a knee sprain, try to get more information. Find out which ligaments are injured, and then you will be able to understand more about what possible treatments and rehabilitation are necessary.

Where is the sprain located and how severe is it?

What treatment do you recommend?

What rehabilitation program do you recommend?

Will surgery be recommended?

Can conservative treatment be tried first?

Will the knee ligaments be permanently weak or susceptible to injury?

hamstring problems,assesment and treatment

2009-03-25T21:05:00.000+05:30

What is a pulled hamstring or hamstring strain?

A hamstring strain or a pulled hamstring as it is sometimes called is a tear in one or more of the hamstrings muscles. Strictly speaking there are three hamstring muscles (Semitendinosus, Semimembranosus and Biceps femoris) which are known as the hamstring muscle group

The role of the hamstring muscles is to bend (flex) the knee and to move the thigh backwards at the hip (extend the hip). Understanding how the hamstrings work give vital clues as to their modes of injury. Mild to severe hamstring strains are extremely common in sprinters and hurdle jumpers and in all sports that involve sprinting activities, such as football and rugby.

Symptoms of a Pulled Hamstring:

A sudden sharp pain at the back of the leg during exercise-most probably during sprinting or high velocity movements.
Pain on stretching the muscle (straightening the knee whilst bending forwards).
Pain on contracting the muscle against resistance.
Swelling and bruising.
If the rupture is severe a gap in the muscle may be felt.
Click here for information on how a hamstring strain is assessed.

Severity of a Pulled Hamstring:

Strains are graded 1, 2 or 3 depending on severity. Grade 1 consists of minor tears within the muscle. A grade 2 is a partial tear in the muscle and grade 3 is a severe or complete rupture of the muscle.

Grade 1: What does it feel like?

May have tightness in the posterior thigh.
Probably able to walk normally however will be aware of some discomfort
Minimal swelling.
Lying on front and trying to bend the knee against resistance probably won't produce much pain.

Grade 2: What does it feel like?

Gait will be affected-limp may be present .
May be associated with occasional sudden twinges of pain during activity.
May notice swelling.
Pressure increases pain.
Flexing the knee against resistance causes pain.
Might be unable to fully straighten the knee.

Grade 3: What does it feel like?

Walking severely affected- may need walking aids such as crutches
Severe pain- particularly during activity such as knee flexion.
Noticeable swelling visible immediatel

Treatment of a Pulled Hamstring:

What can the athlete do?

It is vitally important that treatment for a pulled hamstring starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury. In this time the following can be carried out by the athlete themselves:

Use Cold Therapy (Rest, Ice, Compress, Elevate) technique
Use a compression bandage to minimize intra muscular bleeding.
Early mobilization of the injured lower limb is vital for the correct rehabilitation of the muscle. This includes stretching and strengthening exercises throughout the pain free range. These can aid with decreasing the swelling in the area. In addition, exercise will ensure that any new material will be laid down in correct orientation thus reducing the risk of subsequent injuries.
See a sports injury specialist.

What can a Sports Injury Specialist do?

Use sports massage techniques to speed up recovery- these are extremely important in the rehabilitation of the injury as massage breaks down the new collagen network allowing for correct fibre realignment and minimizing scar tissue. In addition massage can increase the blood flow to the injured area. Visit
out sports massage page to learn specialized massage techniques for a pulled hamstring.
Use ultrasound and electrical stimulation.
Prescribe a rehabilitation program
Advise on specific stretches
Provide mobility aids such as crutches
Provide an MRI scan to ascertain the amount of damage sustained
In severe ruptures surgery may be needed to repair the damage

How is the Hamstring Strained?

During sprinting the hamstring muscles work extremely hard to decelerate the tibia (shin bone) as it swings out. It is in this phase just before the foot strikes the ground that the hamstrings, become injured as the muscles are maximally activated and are approaching their maximum length. A pulled hamstring rarely manifests as a result of contact -if you have taken an impact to the back of the leg it should be treated as a contusion until found to be otherwise.

Preventing a Pulled Hamstring:

One of the most important methods of preventing a pulled hamstring is to warm up correctly- this has been scientifically proven to reduce the risk of hamstring strain. This should consist of some light aerobic exercise followed by stretching and sports specific drills with gradually increasing intensity.

Other factors which increase the likelihood of suffering a hamstring strain include:

Age: The older the individual the greater at risk to a pulled hamstring.
Previous Injury: Prior injuries to the hamstrings or adductor muscles can greatly increase the chance of future injury.
Flexibility: Research suggests that the greater the flexibility of the hamstrings the less prone they are to injury.
Hamstring strength: Similarly studies have shown that lack of hamstring strength is strongly linked to hamstring injury.
Lumbosacral nerve impingement: Nerve impingement in L5-S1 can lead to associated hamstring muscle weakness.
Tiredness and fitness: When a player is fatigued he/she loses coordination between certain muscle groups. The biceps femoris muscle is known to become damaged due its two portions being innervated by two separate nerves. In states of tiredness, lack of synchronization between these two nerves can lead to a mismatch in firing resulting in a pulled hamstring.

Tight hamstrings

Many people suffer with tight hamstrings. Most of the time they will not cause a problem but can be more prone to bad tears and also limit sporting activity. The hamstring muscles consist of the semitendinosus, semimembrinosus and biceps femoris.

Tight hamstrings can also be responsible for postural problems and other back problems as they will tend to pull the pelvis out of normal position.

Why do I have tight hamstrings?

Genetic reasons. You can be born with naturally short hamstrings when some people are naturally supple.In general women and children are more supple than men.
Not enough stretching. If you participate in a lot of sport and do not stretch properly then you are more likely to have your hamstrings tighten up. It is especially important to stretch properly after exercise as this is when the muscles are warm and more receptive to stretching. If you tend to make a beeline for the bar after your game of football think about spending 20 minutes stretching first.
Problems in your lower back can put pressure on your sciatic nerve which runs down the legs and cause muscles to tighten.

What can I do about it?

Learn which Sports Massage techniques can help improve muscle condition and flexibility.

Even if you are not naturally supple you can still improve your flexibility by stretching.
Types of stretching include dynamic, static, passive, PNF and CRAC. A full description of these can be seen here.
Avoid ballistic stretching which is bouncing and forcing the muscle to go further than is comfortable and will damage it.
Sports massage can help in loosening tight muscles. Have a regular sports massage on the legs.

What problems can tight hamstrings cause?

More susceptible to tearing. If you force a muscle to go further than it can normally go at speed it is likely to tear.
Tight hamstrings can cause the hips and pelvis to rotate back flattening the lower back and causing back problems.
If your muscles have tightened up then blood has been squeezed out of them therefore your muscles are working at less than 100 % of capacity and your performance will be down as a result. Regular sports massage and stretching to improve muscle condition will not only reduce the likelihood of injury but may improve performance.

Hamstring Assessment

Assessment of any injury should include questions concerning the patients general health, previous injuries and current injury. The aim of these questions is to determine which structure may be causing the pain and what treatment is appropriate.

The therapist will then perform several tests and assessments, as shown in the videos below:

Straight leg raise
The therapist raises the leg off the couch as far as is comfortable for the patient, keeping the knee straight. This stretches the hamstring muscles and may reproduce the patients pain. The therapist should also observe how far the leg can be lifted. A normal range of motion is 80-90 degrees. Movement less than this and especially less than on the other side indicates that the hamstring muscles are tight
Resisted knee flexion
The therapist provides resistance as the patient bends their knee. This causes the hamstring muscles to contract which will be painful in most hamstring strains. The strength of the movement should also be compared to the other side as weakness may also suggest a hamstring strain >
Slump test
The slump test can be used to determine if there is neural involvement. The patient bends the head down, straightens one leg and points the toes up to the ceiling. The therapist will then push the patient forwards to increase the stretch. Pain shooting down the leg or reproduction of any other symptoms are a positive result
Palpation
The therapist will feel or 'palpate' the muscles, observing areas of pain, tension or gaps within the muscle

central control of bone formation

2009-03-25T20:26:00.000+05:30

Bone mass regulation by leptin: a hypothalamic control of bone formation

Bone remodeling, the function affected in osteoporosis, the most common of bone diseases, comprises two phases: bone formation by matrix-producing osteoblasts and bone resorption by osteoclasts. The demonstration that the anorexigenic hormone leptin inhibits bone formation through a hypothalamic relay suggests that other molecules that affect energy metabolism in the hypothalamus could also modulate bone mass.

role of leptin
Bone mass is maintained constant between puberty and menopause by the balance between osteoblasts and osteoclasts activity. The existence of a hormonal control of osteoblast activity has been speculated for years by analogy to osteoclast biology. Through the search for such humoral signal(s) regulating bone formation, leptin has been identified as a powerful inhibitor of bone formation. Leptin was initially proposed to be the antiobesity hormone. [Although leptin influences both energy balance and bone mass by acting on the hypothalamus, the two processes involve different proteins and neurons.]Now it is realised that leptin is more a signal molecule that communicates nutritional status to the brain, and that it is involved in bone formation by having an antiosteogenic action.Furthermore, by means of intracerebroventricular infusion of leptin, it has been shown that the effect of this adipocyte-derived hormone on bone is mediated via a brain relay, like all its other functions. Subsequent studies have led to the identification of hypothalamic neurons involved in leptin's antiosteogenic function. In addition, it has been shown that those neurons or neuronal pathways are distinct from neurons responsible for the regulation of energy metabolism. Finally, the peripheral mediator of leptin's antiosteogenic function has been identified as being the sympathetic nervous system. Catecholamine-deficient mice have a high bone mass and sympathomimetics administered to mice decreased bone formation and bone mass. Conversely, beta-blockers increased bone formation and bone mass and blunt the bone loss induced by ovariectomy.

treatment of osteoporosis via central control
Neuromedin U (NMU) is an anorexigenic neuropeptide that acts independently of leptin through poorly defined mechanisms. Here we show that Nmu-deficient (Nmu-/-) mice have high bone mass owing to an increase in bone formation; this is more prominent in male mice than female mice. Physiological and cell-based assays indicate that NMU acts in the central nervous system, rather than directly on bone cells, to regulate bone remodeling. Notably, leptin- or sympathetic nervous system-mediated inhibition of bone formation was abolished in Nmu-/- mice, which show an altered bone expression of molecular clock genes (mediators of the inhibition of bone formation by leptin). Moreover, treatment of wild-type mice with a natural agonist for the NMU receptor decreased bone mass. Collectively, these results suggest that NMU may be the first central mediator of leptin-dependent regulation of bone mass identified to date. Given the existence of inhibitors and activators of NMU action, our results may influence the treatment of diseases involving low bone mass, such as osteoporosis.

2009-03-24T21:27:00.000+05:30

What Is Tennis Elbow?

Doctors first identified Tennis Elbow (or lateral epicondylitis) more than 100 years ago. Today nearly half of all tennis players will suffer from this disorder at some point. Interestingly though, tennis players actually account for less than 5 percent of all reported cases making the term for this condition something of a misnomer.

There are 2 additional strain related conditions which are often mistaken for Tennis Elbow. These being Golfer’s Elbow & Bursitis. Before we delve into the details of what Tennis Elbow actually is and options that are available for relieving & preventing the pain...let’s look at the distinguishing characteristics of each of these 3 ailments.

Tennis Elbow
(lateral epicondylitis)
Outside of Elbow
Cause & Symptoms

The onset of pain, on the outside (lateral) of the elbow, is usually gradual with tenderness felt on or below the joint's bony prominence. Movements such as gripping, lifting and carrying tend to be troublesome.

Golfer’s Elbow
(medial epicondylitis)
Inside of Elbow
Cause & Symptoms

The causes of golfers elbow are similar to tennis elbow but pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint's bony prominence.

Bursitis
Back of Elbow
Cause & Symptoms

Often due to excessive leaning on the joint or a direct blow or fall onto the tip of the elbow.
A lump can often be seen and the elbow is painful at the back of the joint.

Symptoms Of Tennis Elbow

Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.
Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.
Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).
Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years.

The damage that tennis elbow incurs consists of tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to hemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

Tendons, which attach muscles to bones, do not receive the same amount of oxygen and blood that muscles do, so they heal more slowly. In fact, some cases of tennis elbow can last for years, though the inflammation usually subsides in 6 to 12 weeks.

Many medical textbooks treat tennis elbow as a form of tendonitis, which is often the case, but if the muscles and bones of the elbow joint are also involved, then the condition is called epicondylitis. However, if you feel pain directly on the back of your elbow joint, rather than down the outside of your arm, you may have bursitis, which is caused when lubricating sacs in the joint become inflamed. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumor.

Relief Of Tennis Elbow

The best way to relieve tennis elbow is to stop doing anything that irritates your arm — a simple step for the weekend tennis player, but not as easy for the manual laborer, office worker, or professional athlete.

The most effective conventional and alternative treatments for tennis elbow have the same basic premise: Rest the arm until the pain disappears, then massage to relieve stress and tension in the muscles, and exercise to strengthen the area and prevent re-injury. If you must go back to whatever caused the problem in the first place, be sure to warm up your arm for at least 5 to 10 minutes with gentle stretching and movement before starting any activity. Take frequent breaks.

Conventional

Home Exercise for Tennis Elbow

medicine offers an assortment of treatments for tennis elbow, from drug injections to surgery, but the pain will never go away completely unless you stop stressing the joint. Re-injury is inevitable without adequate rest.

For most mild to moderate cases of tennis elbow, aspirin or ibuprofen will help address the inflammation and the pain while you are resting the injury, and then you can follow up with exercise and massage to speed healing.

For stubborn cases of tennis elbow your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects. Another attractive option for many sufferers, especially those who prefer to not ingest medication orally, is the application of an appropriate and effective topical anti-inflammatory such as Penetrex.

If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). One procedure is for the tendon to be cut loose from the epicondyle, the rounded bump at the end of the bone, which eliminates stress on the tendon but renders the muscle useless. Another surgical technique involves removing so-called granulated tissue in the tendon and repairing tears.Even after you feel you have overcome a case of tennis elbow, be sure to continue babying your arm. Always warm up your arm for 5 to 10 minutes before starting any activity involving your elbow. And if you develop severe pain after use anyway, pack your arm in ice for 15 to 20 minutes and call your doctor.

Treatment

Nonsurgical Treatment

In most cases, nonsurgical treatment should be tried before surgery.

Pain relief is the main goal in the first phase of treatment.

The doctor may tell you to stop any activities that cause symptoms.
You may need to apply ice to the outside part of the elbow.
You may need to take acetaminophen or an anti-inflammatory medication for pain relief.

Orthotics can help diminish symptoms of tennis elbow. The doctor may want you to use counterforce braces and wrist splints. These can reduce symptoms by resting the muscles and tendons.

Left, counterforce brace. Right, wrist brace.

Symptoms should improve significantly within four weeks to six weeks.

If symptoms do not improve, the next step is a corticosteroid injection around the outside of the elbow. This can be very helpful in reducing pain. Corticosteroids are relatively safe medications. Most of their side effects (i.e., further degeneration of the tendon and wasting of the fatty tissue below the skin) occur after multiple injections. Avoid repeated injections (more than two or three in a specific site).

Wrist stretching exercise with elbow extended.

After pain is relieved, the next phase of treatment starts. Modifying activities can help make sure that symptoms do not come back. The doctor may want you to do physical therapy. This may include stretching and range of motion exercises and gradual strengthening of the affected muscles and tendons (see figure right). Physical therapy can help complete recovery and give you back a painless and normally functioning elbow. Nonsurgical treatment is successful in approximately 85 percent to 90 percent of patients with tennis elbow.

Surgical Treatment

Surgery is considered only in patients who have incapacitating pain that does not get better after at least six months of nonsurgical treatment.

The surgical procedure involves removing diseased tendon tissue and reattaching normal tendon tissue to bone (figure below). The procedure is an outpatient surgery, not requiring an overnight stay in the hospital. It can be performed under regional or general anesthesia.

Most commonly, the surgery is performed through a small incision over the bony prominence on the outside of the elbow.
Recently, an arthroscopic surgery method has been developed.

So far, no significant benefits have been found to using the arthroscopic method over the more traditional open incision.

Prevention

To prevent tennis elbow:

Lift objects with your palm facing your body.
Try strengthening exercises with hand weights. With your elbow cocked and your palm down, repeatedly bend your wrist. Stop if you feel any pain.
Stretch relevant muscles before beginning a possibly stressful activity by grasping the top part of your fingers and gently but firmly pulling them back toward your body. Keep your arm fully extended and your palm facing outward.

Caution!

To prevent a relapse:

Discontinue or modify the action that is causing the strain on your elbow joint. If you must continue, be sure to warm up for 10 minutes or more before any activity involving your arm, and apply ice to it afterward. Take more frequent breaks.
Try strapping a band around your forearm just below your elbow. If the support seems to help you lift objects such as heavy books, then continue with it. Be aware that such bands can cut off circulation and impede healing, so they are best used once tennis elbow has disappeared.

Call Your Doctor If....

The pain persists for more than a few days; chronic inflammation of the tendons can lead to permanent disability.
The elbow joint begins to swell; tennis elbow rarely causes swelling, so you may have another condition such as arthritis, gout, infection or even a tumor.

here comes ADULT ENERGY FOR MEN

2009-03-24T20:50:00.000+05:30

Adult Energy For Men is the first natural liquid energy formula developed for middle aged and senior men. It was created by a former NIH consultant as a food supplement that naturally increases testosterone production without the negative side effects associated with artificial testosterone treatment. This breakthrough formula could change the way men avoid age related diseases and is set to launch March 24, 2009.

Details

Washington, DC (PRWEB) March 23, 2009 -- With a family history of diabetes Brian Ayers, a former National Institutes for Health consultant and author, searched for an energy supplement to make the exercise and diet that is required to overcome diabetes easier. His discovery looks to be much more than a diabetes supplement. It could change the way men look at aging.

The newly launched natural liquid supplement Adult Energy For Men (http://www.AdultEnergyForMen.com) is designed to improve the testosterone output of men by giving the body the exact nutrition it needs. For years men were prescribed artificial testosterone through injections, patches or creams. These treatments ignore the body's ability to create its own testosterone and as a result produce several side effects. When the body has the correct nutrition it will create its own testosterone at the right levels just as it did all throughout a developing male's life.

Scientist has known for some time that testosterone loss is the cause of a great number of ailments for men as they age. For men who smoke, drink, don't exercise regularly and take multiple medications the loss is more dramatic. This means dying from a low testosterone related disease is higher.

The testosterone levels in men drops by 1% per year on average. By the age of 50, most men have 30% less testosterone than they did at 20. Low testosterone levels have been linked to heart disease, memory loss, mood swings, loss of muscle mass, pot bellies, higher risk of Alzheimer's, higher risk of osteoporosis, declining sex drive and impotence.

New research shows that a high number of men with diabetes also suffer from low testosterone levels. This means Adult Energy For Men could provide a double benefit of energy and testosterone nutrition for men who suffer from diabetes or are pre-diabetic.

Mr. Ayers calls this product a game changer for middle aged and senior men. "No product is going to do away with exercise and healthy eating, but now there is an effective way to get the nutrition needed to directly stimulate testosterone without unwanted side effects."

Adult Energy For Men will be available for the first time on March 24, 2009 through http://www.AdultEnergyForMen.com.

About Adult Energy For Men
Adult Energy For Men is a unique natural liquid formula that was developed by a former NIH consultant to help men and some women who have noticed an overall decline in vitality, mental alertness, stamina, strength and energy level as they have gotten older. It helps you produce testosterone at the right levels and gently increases circulation which can help you feel younger and more vital at the right times without unwanted side effects. This helps counteract the negative effects of testosterone reduction as you age.

How Can You Safely Increase Your Energy Level
Without Negative Side Effects?

Your body naturally creates testosterone from the nutrition in the foods you eat. By getting the right nutrition you can increase the amount of testosterone your body creates.

Testosterone loss is a natural part of the aging process. Its effect on men has been scientifically linked to illnesses such as diabetes, alzheimers, heart disease, obesity, muscle loss, loss of sexual desire, memory loss and high blood pressure.

While testosterone replacement has shown limited promise to help reverse these issues, it ignores the processes of the body and how it regulates hormone levels.

Adult Energy For Men is a non-prescription liquid formula that gives your body the nutrition it needs to increase its production of testosterone naturally.

How is Adult Energy different from other medicines and supplements?

Adult Energy is NOT testosterone replacement but a natural food supplement
Adult Energy helps your body function as it normally would with the proper amount of testosterone available
Adult Energy is a liquid formula that is easily absorbed by your body for optimum effect
Adult Energy is all natural with each of its 8 herbs independently researched for effectiveness
Adult Energy is designed for men but is also effective for women

The Benefits of Adult Energy include:

Memory

Improves working memory
Improves verbal memory
Improves spatial memory

Mood

Increases energy
Enhances the feeling of well-being
Helps alleviate depression

Sexual Health

Increase in sexual desire
Increase in frequency and firmness of erections
Increase in sexual stamina

Body

Enhances strength and energy
Protects the cardiovascular system

Adult Energy & Your Body

Adult Energy has been referred to as “the key to your fountain of youth”. Testosterone affects a wide variety of health issues and can help you regain your youthful feelings. Here are other ways it affects your body…

Researchers from the University of Washington have shown that men with low testosterone levels appear to be at greater risk of developing “pot bellies”.

A decline in testosterone at any age increases a man’s risk for osteoporosis. Older men with low testosterone levels are twice as likely to fracture their hips as men of the same age with normal testosterone levels.

Older men with lower levels of testosterone could have a higher risk of developing Alzheimer’s disease. Loss of testosterone is at the root of some memory loss in men.

Testosterone may help men recover from strokes.

Testosterone can limit the storage of fat.

Research presented at a meeting of the Endocrine Society shows men with low testosterone were 33 percent more likely to die than men with normal levels, even after adjusted for smoking, alcohol, exercise, age, and body size.

Important Safety Information

Who should not use Adult Energy?

People using MAO inhibitor drugs, usually for Parkinson’s disease, should avoid using Adult Energy.
People with severely high or low blood pressure, heart arrhythmia or those recovering from a heart attack.
Those who are currently taking prescribed medication are STRONGLY encouraged to print out a listing of the ingredients in Adult Energy and consult your physician before using our product.
Women who are pregnant, may become pregnant or are lactating

People with the following conditions may wish to talk with their physicians before using Adult Energy.

People with severely high or low blood pressure or those recovering from a heart attack.

In recommended doses, Adult Energy may help men with these conditions, but there is a chance that Adult Energy will slightly enhance or decrease the effectiveness of medications used to treat these conditions.

Is Yohimbe safe?
Adult Energy does contain Yohimbe, an herb that has been known to produce unpleasant side effects when taken alone. Adult Energy is a liquid herbal extract, so Adult Energy does not contain a weighted amount of Yohimbe, but rather a concentration of Yohimbe extract. This way you extract the herbal constituents without including the bulk herb.

The Adult Energy formula is comprised of a combination of herbs that works to balance the powerful effects of the Yohimbe. In traditional cultures, herbs were used in combinations to bring out the good effects and diminish any unpleasant ones.

The Adult Energy formula comes from one of these cultures, so Adult Energy is powerful, yet non-irritating.

Is Adult Energy safe when mixed with the prescription drug or supplement I am currently taking?

There have been no tests on the effect of Adult Energy when taken with prescription medication or health supplements. Although many people use Adult Energy safely along with other products, there is no specific assurance as to the effects of such combined therapy.

For those who are currently taking prescribed medication, we STRONGLY encourage you to print out a listing of the ingredients in Adult Energy and consult your physician before using our product.

Some medications may make Adult Energy less effective, or vice versa. Since we are not medical professionals, we urge you to discuss such issues with your doctor prior to first use.

For those who are currently taking other health supplements, if you still want to use such supplements, we suggest that you start with low servings of the other supplement. Also, you should add one supplement at a time; no "GNC binges."

Who should avoid taking Adult Energy?
We here at Adult Energy monitor success rates to see which people should not take Adult Energy. Although we would love to have all men try Adult Energy, we do not want to waste the time or effort of those for whom Adult Energy may not help.

Can I take Adult Energy if I have Diabetes?
In general, Adult Energy poses no danger to Diabetics; in fact it may be helpful. We do have clients who are Diabetic and find the formula very helpful.

However, we suggest that anyone under medical supervision first consult with his or her physician before using Adult Energy. If you are currently taking prescription drugs to treat your Diabetes, Adult Energy may interfere with or enhance the effectiveness of those medications.

Adult Energy increases blood circulation to the genital region and improves blood circulation in general.

Since Diabetes impairs blood circulation, many people with Diabetes are prescribed medications that increase circulation. Taking both Adult Energy and a blood circulation medication may feel a bit uncomfortable.

This is why we suggest that you consult your physician. If you decide to use Adult Energy, we suggest starting with low doses to test your tolerance. You should also know that people with Diabetes usually need to take Adult Energy longer before seeing significant results. This is also true for heavy smokers and people with any health condition that reduces blood circulation.

What effect does Adult Energy have on women?
The effect of Adult Energy on women is an increase in sexual desire and pleasure. For some women, after a few weeks of daily use they may become much more aggressive sexually.

Women have one tenth of the testosterone in comparison to men, so a slight increase in this hormone can cause strong changes in a women sexual desire.

Because Adult Energy has a balancing effect, there is no threat of unwanted hormonal changes such as facial hair, a deeper voice, or any physical changes.

MIGRAINE

2009-03-23T20:01:00.000+05:30

Migraine
A migraine is a very painful type of headache. People who get migraines often describe the pain as pulsing or throbbing in one area of the head. During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit.
Migraine is three times more common in women than in men. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.
Many things can trigger a migraine. These include
1.Anxiety
2.Stress
3.Lack of food or sleep
4.Exposure to light
5.Hormonal changes (in women)
Doctors used to believe migraines were linked to the opening and narrowing of blood vessels in the head. Now they believe the cause is related to genes that control the activity of some brain cells. Medicines can help prevent migraine attacks or help relieve symptoms of attacks when they happen. For many people, treatments to relieve stress can also help.

What things may set off a migraine?
Certain things that can set off migraines in some people include the following:
Strong or unusual odors, bright lights or loud noises
Changes in weather or altitude
Being tired, stressed or depressed
Changes in sleeping patterns
Certain foods (see the list below), especially those that contain tyramine, sodium nitrate or phenylalanine
Missing meals or fasting
Menstrual periods, birth control pills or hormones
Intense physical activity, including sexual activity
Smoking

Foods that may trigger migraines:
Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage
Aged cheese
Alcoholic beverages, especially red wine
Aspartame
Avocados
Beans, including pole, broad, lima, Italian, navy, pinto and garbanzo
Brewer's yeast, including fresh yeast coffee cake, donuts and sourdough bread
Caffeine (in excess)
Canned soup or bouillon cubes
Chocolate, cocoa and carob
Cultured dairy products, such as buttermilk and sour cream
Figs
Lentils
Meat tenderizer
Monosodium glutamate (MSG)
Nuts and peanut butter
Onions, except small amounts for flavoring
Papaya
Passion fruit
Pea pods
Pickled, preserved or marinated foods, such as olives and pickles, and some snack foods
Raisins
Red plums
Sauerkraut
Seasoned salt
Snow peas
Soy sauce

Simple steps to head off the pain
Migraines cause pain as real as the pain of injuries — with one difference: Healthy habits and simple nonmedical remedies sometimes stop migraines before they start.By Mayo Clinic staff
Medication is a proven way to treat — and prevent — migraines. But medication is only part of the story. It's also important to take good care of yourself. The same lifestyle choices that promote good health can reduce the frequency and severity of your migraines. In fact, combining lifestyle measures with medication is often the most effective way to handle migraines.
Seek a calm environment
At the first sign of a migraine, retreat from your usual activities if possible.
Turn out the lights. Migraines often increase sensitivity to light and sound. Relax in a dark, quiet room. Sleep if you can.
Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the sensation of pain. Hot packs and heating pads can relax tense muscles. Warm showers or baths may have a similar effect.
Massage painful areas. Apply gentle pressure to your scalp or temples. Alleviate muscle tension with a shoulder or neck massage.
Drink a caffeinated beverage. In small amounts, caffeine can enhance the pain-reducing effects of acetaminophen and aspirin. Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on.
Sleep well
Migraines may keep you from falling asleep or wake you up at night. Likewise, migraines are often triggered by a poor night's sleep. Here's help encouraging sound sleep.
Establish regular sleep hours. Wake up and go to bed at the same time every day — even on weekends. If you nap during the day, keep it short. Naps longer than one hour may interfere with nighttime sleep.
Unwind at the end of the day. Anything that helps you relax can promote better sleep. Listen to soothing music, soak in a warm bath or read a favorite book. But watch what you eat and drink before bedtime. Heavy meals, caffeine, nicotine and alcohol can interfere with sleep.
Minimize distractions. Save your bedroom for sleep and intimacy. Don't watch television or take work materials to bed. Close your bedroom door. Use a fan to muffle distracting noises.
Don't try to sleep. The harder you try to sleep, the more awake you'll feel. If you can't fall asleep, read or do another quiet activity until you become drowsy.
Check your medications. Medications that contain caffeine or other stimulants — including some medications to treat migraines — may interfere with sleep.
Eat wisely
Your eating habits can influence your migraines. Consider the basics:
Be consistent. Eat at about the same time every day.
Don't skip meals. Breakfast is especially important.
Avoid foods that trigger migraines. If you suspect that a certain food — such as aged cheese, avocados or raisins — is triggering your migraines, eliminate it from your diet to see what happens.
Exercise regularly
During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help alleviate anxiety and depression — conditions that can make migraines worse. If your doctor agrees, choose any exercise you enjoy. Walking, swimming and cycling are often good choices. But it's important to start slowly. Exercising too vigorously can trigger migraines.
Manage stress
Stress and migraines often go hand in hand. You can't avoid daily stress, but you can keep it under control — which can help you prevent migraines.
Simplify your life. Rather than looking for ways to squeeze more activities or chores into the day, find a way to leave some things out.
Manage your time wisely. Update your to-do list every day — both at work and at home. Delegate what you can, and break large projects into manageable chunks.
Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy for the task at hand.
Adjust your attitude. Stay positive. If you find yourself thinking, "This can't be done," switch gears. Think instead, "This will be tough. But I can make it work."
Let go. Don't worry about things you can't control.
Relax. Deep breathing from your diaphragm can help you relax. Try to do 20 minutes of deep breathing every day. It may also help to consciously relax your muscles, one group at a time. When you're done, sit quietly for a minute or two.
Keep a migraine diary
A diary may help you determine what triggers your migraines. Note when your migraines start, what you were doing at the time, how long they last and what, if anything, provides relief. Eventually you may be able to prevent migraines by changing patterns in your daily life.
Strive for balance
Living with migraines is a daily challenge. But making healthy lifestyle choices can help. Ask your friends and loved ones for support. If you're feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain.

Can nonprescription medicines help relieve the pain?
Yes. Nonprescription medicines that can help relieve migraine pain include aspirin, acetaminophen (one brand name: Tylenol), an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine), ibuprofen (one brand name: Motrin), naproxen (brand name: Aleve), and ketoprofen (brand name: Orudis KT).

What about prescription medicines?
People who have more severe pain may need prescription medicine. A medicine called ergotamine (brand name: Ergomar) can be effective alone or combined with other medicines. Dihydroergotamine (brand names: Migranal, D.H.E. 45) is related to ergotamine and can be helpful.Other prescription medicines for migraines include sumatriptan (brand name: Imitrex), zolmitriptan (brand name: Zomig), naratriptan (brand name: Amerge) rizatriptan (brand name: Maxalt), almotriptan (brand name: Axert), eletriptan (brand name: Relpax) and frovatriptan (brand name: Frova).If the pain won't go away, stronger medicine may be needed, such as a narcotic (brand name: Stadol nasal spray) or medicines that contain a barbiturate. These medicines can be habit-forming and should be used cautiously.

Can medicine help prevent migraines?
Yes. Medicine to prevent migraines may be helpful if your headaches happen more than twice a month or if your headaches make it hard for you to work and function. Examples of medicines used to prevent migraines include propranolol (brand name: Inderal), timolol (brand name: Blocadren), divalproex (brand name: Depakote) and some antidepressants.

acne---> the most serious problem of teens

2009-03-22T23:22:00.000+05:30

Acne Overview

Acne is a red, irritating skin rash primarily affecting teenagers and young adults. It can, however, occur at all ages. Typical acne appears in the oil-producing areas of the body-namely, the face, chest, and back. Acne can also occur on the neck and upper arms.

Acne can have a short-term, potentially lasting psychological effect. Decreased self-esteem and self-confidence can lead to social withdrawal and even depression. Left untreated, severe acne can lead to disfiguring scarring, which can itself be difficult to treat.

Several myths exist about acne.
- Acne is not a result of uncleanliness or infrequent washing. In other words, acne does not result from too much dirt on the skin or in the pores. Too much scrubbing may actually make acne worse.
- Acne does not come from eating a lot of so-called bad foods such as chocolate or fried foods. No foods cause acne or make it worse.
Acne Causes
Several factors contribute to the development of acne. The primary problem is that the abnormal flaking of cells inside the hair follicle leads to the formation of a plug. The plug can enlarge and even rupture the hair follicle. A ruptured hair follicle spills its contents of oil and debris into the skin where it leads to swelling and causes redness (inflammation).
- Bacteria that normally live on the skin also play a role in acne development. The bacteria known as Propionibacterium acnes are responsible for causing acne. These bacteria produce substances that cause redness and irritation (inflammation). They also make enzymes, which dissolve the sebum (oil from oil glands in the skin) into irritating substances. These substances also make the inflammation worse.
- Certain hormones called androgens are an additional factor in causing acne. Androgens are male hormones that are present in both men and women, but are higher in men. Androgens do two things: First, they enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increased sebum leads to plug formation and serves as more "food" for the bacteria. Androgens surge at puberty, which is why teens develop armpit and pubic hair, and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the development of acne in teens.
- Estrogens, which are the female hormones, actually can help to improve acne in girls. A woman's monthly menstrual cycle is due to changes in the estrogen levels in her body. This is why acne in a female may get better and then get worse as she goes through her monthly cycle. A doctor may recommend acne treatment with birth control pills, which contain the helpful estrogens.
- We also now believe that acne can run in some families. This may be due to some genetic factor that has not yet been discovered.
Acne lesions: There are 2 major types of acne lesions: noninflammatory and inflammatory. Noninflammatory acne lesions include blackheads (open comedones) and whiteheads (closed comedones). Open and closed comedones along with papules and pustules are referred to as papulopustular acne-a form of inflammatory acne. Nodular acne is the most severe form of inflammatory acne.
- Noninflammatory acne: Open comedones result from the enlargement and dilation of a plug that forms from oil and flakes of skin inside the hair follicle.
  - The hair follicle pore remains open exposing a black plug (known as a blackhead). The dark color is not dirt inside the pore. Instead it is the oil inside the pore, which has become exposed from the outside air.
  - A closed comedo forms if the hair follicle pore remains closed. The plug in a closed comedo or whitehead is therefore not exposed to the outside air, and no black color develops. The closed comedo simply appears as a tiny, sometimes pink bump in the skin.
- Inflammatory acne: Inflammatory acne lesions consist of red blemishes, pimples also called zits (papules, pustules), and larger, deeper swollen tender lesions (nodules).
  - Papules are closed comedos, which have become red, swollen, and inflamed.
  - Pustules are closed comedos, which become inflamed and begin to rupture into the skin forming pustular heads of various sizes.
  - Nodules represent large, tender, swollen acne lesions, which have become intensely inflamed and rupture under the skin. If untreated, these can produce deep scarring.
  When to Seek Medical Care
  Acne that does not improve with over-the-counter medicines should be evaluated by a doctor.
  People with acne that is severe and tender or already scarring should also be seen by a doctor.
  Women with acne who develop facial hair or have irregular periods require evaluation by a doctor.
  Anyone with a sudden severe worsening of their acne or acne with fever and severe swelling should see a doctor immediately. These could be signs of a serious skin infection.
  
  Acne Treatment
  Self-Care at Home
  Wash once or twice daily with soap and water to remove excess oil from the skin. An acne cleanser purchased over-the-counter in any drug store can also be helpful. Avoid scrubbing too abrasively because this can actually irritate the skin and cause acne to worsen.
  Over-the-counter acne medications can be used either at bedtime or during the day. Always follow the directions on any acne product.
  Many cover-up products are available without a prescription to improve the appearance of blemishes while they have a chance to heal. Most work well and should not worsen acne.
  Some cosmetics and other skin care products, however, can cause acne to worsen. Look for make-up, cosmetics, and skin care products labeled with the wordnoncomedogenic. This means that it does not cause or worsen acne.
  
  Medical Treatment
  Many treatment options are available to treat all forms of acne. Medications are the main treatment for acne and usually work well. Several preparations are available over-the-counter, while others require a prescription from a doctor.
  Over-the-counter medications: Nonprescription or over-the-counter medications for acne are plentiful and can be effective for milder forms of acne. They come in the form of soaps, washes, and cleansers.
  
  Many contain benzoyl peroxide, which does two things. First, benzoyl peroxide kills the acne-causing bacteria, which are thought to play a role in acne. Second, benzoyl peroxide can cause drying and flaking off of skin, which can help prevent the pores from becoming plugged. Plugged pores can develop into acne blemishes.
  
  Scrubbing excessively with any over-the-counter preparation can actually cause acne to worsen by additionally irritating the hair follicles.
  
  Prescription medications: Doctors can prescribe medications when acne becomes moderate to severe or is not controlled by over-the-counter medications. Prescription drugs can be used effectively alone or in combination with other prescription and nonprescription medications.
  
  Antibiotics: Antibiotics can be effective in treating most inflammatory acne (papules and pustules). They work by killing the bacteria and also by decreasing the redness and swelling seen in the inflammatory forms of acne.
  
  Antibiotics may be applied to the skin in the form of gels and lotions, or by way of pills. We now know that using a combination of 2 medications together may be very effective in treating acne. Using a topical antibiotic with topical benzoyl peroxide, for example, may prevent bacterial resistance to the antibiotic. Giving an antibiotic by mouth is often needed for acne that is more extensive, red, and tender.
  
  Antibiotics taken by mouth can be associated with more side effects than if applied to the skin and may interact with other medicines such as birth control pills. Sensitivity to the sun can result in a "badsunburn" in some people who take the antibiotic tetracycline by mouth.
  
  Retinoids: Medicines made from vitamin A (retinoids) are useful in treating several types of acne lesions. Topical retinoids are effective in treating the noninflammatory types of acne (blackheads and whiteheads).
  
  Topical retinoids (applied directly to the skin) help to open clogged pores by creating a mild peeling effect. Drying of the skin can be a frequent side effect. Oral retinoids are reserved for treating the more extensive nodular type of acne or severe inflammatory acne, which has not responded to other treatments. Oral retinoids not only have a peeling effect but also decrease the production of oil.
  
  They can also be associated with a number of serious side effects including birth defects in babies of women who become pregnant while taking the medicine. They can also cause elevated blood fats (triglycerides) and damage to the liver. Your doctor may recommend certain blood tests to check for these problems (and to make sure you are not pregnant) if you are given oral retinoids. Depression andsuicidal thoughts have been reported while taking oral retinoids.
  
  Next Steps
  Outlook
  The prognosis for most acne is excellent. Most people experience their worst acne during the teen years and grow out of it. The goal in all acne treatment is to prevent scarring. Severe acne left untreated for a long time can result in scarring. The scars can appear as pits (usually on the face) or as big, bumpy scars (usually on the chest and back). The scarring of acne can also be treated. Your doctor can tell you about various ways available to treat acne scars.
  Pits and depressions left in the skin from acne scarring can be treated with a "skin-sanding" procedure called dermabrasion or by chemical peels.
  Bumpy scars are often treated with injections of a steroid medicine.
  Lasers can be used in treating scars but can be expensive.
  
  For More Information
  American Academy of Dermatology

common skin problems

2009-03-22T22:49:00.000+05:30

Do you have skin problems?

Is your skin itching, breaking out, covered in a rash, or playing host to strange spots? Skin inflammation, changes in texture or color, and spots may be the result of infection, a chronic skin condition, or contact with an allergen or irritant. You can learn to recognize common adult skin problems. Yet, while many are minor, they may signal something more serious, so always consult a doctor for proper diagnosis.

Shingles (herpes zoster)Shingles results in a rash that can be mildly itchy to intensely painful.

Shingles starts with burning, tingling, or very sensitive skin. A rash of raised dots develops into painful blisters that last about two weeks. Shingles often occurs on the trunk and buttocks, but can appear anywhere. Most people recover, but pain, numbness, and itching linger for many -- and may last for months, years, or the rest of their lives. Treatment with antiviral drugs, steroids, antidepressants, and topical agents can help.

Hives (urticaria)Hives vary in size and may join together to form larger areas.

Hives, a common allergic reaction that looks like welts, are often itchy, stinging, or burning. They may appear anywhere and last minutes or days. Severe hives can cause difficult breathing (get immediate medical attention if this occurs). Medications, foods, or food additives, temperature extremes, and infections like strep throat can cause hives. Removing the trigger often resolves the hives in days or weeks. Antihistamines can provide relief.

PsoriasisSymptoms of psoriasis may be mild (left), or moderate to severe (right).

A non-contagious rash of thick red plaques covered with silvery scales, psoriasis usually affects the scalp, elbows, knees, and lower back. The rash can heal and recur throughout life. The cause of psoriasis is unknown, but skin inflammation may be triggering new skin cells to develop too quickly. Treatments include steroid or retinoid creams, light therapy, and medications.

EczemaThe appearance of eczema can vary from person to person.

Eczema describes several non-contagious conditions where skin is inflamed, red, dry, and itchy. Stress, irritants (like soaps), allergens, and climate can trigger flare-ups though they are not eczema's cause, which is unknown. In adults, eczema often occurs on the elbows and hands, and in "bending" areas, such as inside the elbows. Treatments include cortisone creams, pills, shots, antibiotics, antihistamines, or phototherapy.

RosaceaMen may have more severe symptoms of rosacea; it's more common in women.

Often beginning as a tendency to flush easily, rosacea causes redness on the nose, chin, cheeks, forehead, even in the eyes. The redness may intensify over time, taking on a ruddy appearance. If left untreated, bumps and pus-filled pimples can develop, with the nose and oil glands becoming bulbous. Rosacea treatment includes medications, as well as surgery to remove blood vessels or correct nose disfigurement.

Rash from poisonous plantsA close-up view of a poison ivy rash.

Contact with sap from poison ivy, oak, and sumac causes a rash in most people. It begins with redness and swelling at the contact site, then becomes intensely itchy. Blistering appears within hours or a few days. The typical rash is arranged as a red line on an exposed area, caused by the plant dragging across the skin. The rash usually lasts up to two weeks.

Razor BumpsPeople with curly hair are most affected by razor bumps.

Razor bumps are tiny, irritated bumps that develop after shaving. The sharp edge of closely shaven hair can curl back and grow into the skin, causing irritation and pimples, and even scarring. To minimize razor bumps, take a hot shower before shaving, shave in the direction of hair growth, and don't stretch the skin while shaving. Rinse with cold water, then apply moisturizer.

Skin tagsSkin tags appear most often in women and elderly people.

A skin tag is a small flap of flesh-colored or slightly darker tissue that hangs off the skin by a connecting stalk. Usually found on the neck, chest, back, armpits, under the breasts, or in the groin area, skin tags are not dangerous and usually don't cause pain unless they become irritated by clothing or nearby skin rubbing against them. A doctor can remove a skin tag by cutting, freezing, or burning it off.

AcneAcne is not just for teens: (left) whiteheads; (right) blackhead.

At the heart of acne lies the pimple -- a plug of fat, skin, and keratin. When open, the plug is called a blackhead, closed, a whitehead. Often seen on the face, chest, and back, acne is caused by many things, including hormones. To help control it, keep oily areas clean and don't squeeze pimples (it may cause infection and scars). Only three medications are proven effective for acne treatment: benzoyl peroxide, retinoids, and antibiotics.

Athlete's footInterdigital, or toe web infection, is the most common kind of athlete's foot.

A fungal infection that can cause peeling, redness, itching, burning, and sometimes blisters and sores, athlete's foot is mildly contagious, passed by direct contact or by walking barefoot in areas such as locker rooms, or near pools. The fungi then grow in shoes, especially tight ones without air circulation. It's usually treated with topical antifungal lotions or oral medications for more severe cases.

Moles
Moles can appear anywhere on the skin, alone or in groups.

Usually brown or black, moles can be anywhere on the body, alone or in groups, and generally appear before age 20. Some moles (not all) change slowly over the years, becoming raised, developing hair, and/or changing color. While most are non-cancerous, some moles have a higher risk of becoming cancerous. Have a dermatologist evaluate moles that change, have irregular borders, unusual or uneven color, bleed, or itch.

Age or liver spots (lentigines)
Sun avoidance and the use of sunscreen are key in preventing "age" spots.

These pesky brown spots are not really caused by aging, though they do multiply as you age. They're the result of sun exposure, which is why they tend to appear on areas that get a lot of sun, such as the face, hands, and chest. Bleaching creams, acid peels, and light-based treatments may lessen their appearance. To rule out serious skin conditions such as melanoma, see a dermatologist for proper identification.

Pityriasis Rosea
Pityriasis rosea is most often seen between the ages of 10 and 35.

A harmless rash, pityriasis rosea usually begins with a single, scaly pink patch with a raised border. Days to weeks later, salmon-colored ovals appear on the arms, legs, back, chest, and abdomen, and sometimes the neck. Patches on the back may appear "Christmas tree" shaped. The rash, whose cause is unknown, usually doesn't itch, and often goes away in 6-8 weeks without treatment.

Melasma ('pregnancy mask')
'Pregnancy mask' occurs in half of all women during pregnancy.

Melasma (or chloasma) is characterized by tan or brown patches on the cheeks, nose, forehead, and chin. Although usually called the "pregnancy mask," men can also develop it. Melasma may go away after pregnancy but, if it persists, can be treated with prescription creams and over-the-counter products. Use a sunscreen at all times if you have melasma, as sunlight worsens the condition.

Digestive Disease Myths - Common Misconceptions

2009-03-22T19:46:00.000+05:30

digestive disease m

yths

Researchers have o

nly r

ecently begun to underst

and the many, often complex, diseases that affect the digestive system.

Accordingly, people ar

e gradually replacing folklore, ol

d wives' tales,

and rumors about the

causes and treatments of digestive diseases with accurat

e, up-to-date

information. But misunderstandings still exist,

and, while some folklore is harmless, some can be

dangerous if it keeps

a person from correctl

y preventing or treating an illness.

Myth #

1 Ulcers: Spicy food and stress cause st

omach ulcers.

False - The truth is, the ma

jority of stomach ulcers are caused either by infection with a bacterium call

ed Helicobacter pylori (H. p

ylori) or by use of pain medications such as aspirin, ibuprofen,

or naproxen, the so-called nonsteroidal antiinflammatory drugs

(NSAIDs). Mos

t H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured w

ith time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is

appreciated that H. pylori and NSAIDs are th

e cause of most ulcers and patients are being managed appropriately, t

he ulcers that are com

ing to medical attention are increasingly likely to be unrelated to H. pylori or NSAIDs. Spic

y food and stress (except when associated with extreme medical condit

ions) may aggravate ulcer symptoms in some people, but they do not cau

se ulcers. Ulcers can also be ca

used by cancer.

cigarette

helps relieve heartburn.

False - Actually, cigarette smoking may contribute to heartburn. Heartburn occurs

when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash

back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by

increased reflux of acid, that is the basis of heartbu

rn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax

Myth # 3 Celiac Disease: Celiac disease

is a rare childhood disease.

False - Celiac disease affects both children and adults. A

bout 1 in 200 people in the United States have the genetic predisposition for celiac disease althoug

h not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhe

a, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any a

ge. These symptoms may be vague and therefore attributed to other conditions. Symptoms can in

clude bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involv

ement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due

to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonsp

ecific symptoms for several years before being correctly diagnosed and treated.

People with celiac disease should not eat any

foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or n

ot. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lini

ng of the small intestine, which interferes with the absorption of nutrients. Even a small amount of glute

n can cause damage, and sometimes no symptoms will be apparent.

Myth # 4 Bowel Regularity: Bowel regularity means a bowel movement every day.

False - The frequency of bowel movements among normal, healthy people varies from three a day to t

hree a week, and some perfectly healthy people fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. People with irritable bowel syndrome (IBS) may have fluctuating numbers of stools each day as well as fluctuating consistency of their stools.

Myth # 5 Constipation: Habitual use of enemas to treat constipation is harmless.

False? - It is not clear whether or not habitual use of enemas is harmless since there has been very little study of the effects of enemas or laxatives over the long term. Early studies showed that laxatives might injure the colon if taken chronically by impairing contraction of the colonic muscles, and this finding was extrapolated to include enemas. The data from the studies is not strong, however. In fact, some physicians feel that enemas are preferred over laxatives since they are a more "natural" means of stimulating a bowel movement. (Enemas mimic a large amount of stool in the rectum, the usual stimulus for a bowel movement.) An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.

Myth # 6 Diverticulosis: Diverticulosis is an uncommon and serious problem.

False - Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs or out-pouchings, called diverticula, develop in the wall of the colon. These sacs tend to appear and increase in number as individuals age. Most people have no symptoms and learn that they have diverticula after an X-ray or intestinal examination (for example, colonoscopy or barium enema) that is being done for a purpose unrelated to the diverticulosis. Less than 10 per cent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.

Myth # 7 Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease): Inflammatory bowel disease is caused by psychological problems.

False - Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may result from a virus or bacteria interacting with the body's immune system. No evidence has been found to support the theory that inflammatory bowel disease is caused by tension, anxiety, or any other psychological factor or disorder, although these can aggravate the discomfort caused by the disease.

Myth # 8 Cirrhosis: Cirrhosis is only caused by alcoholism.

False - Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage diseases, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals (like iron or copper) in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver. In adults, cirrhosis can also be caused by nonalcoholic steatohepatitis (NASH), which is becoming the most common liver disease in the United States, affecting 2 to 5 percent of Americans. NASH is associated with the increasing prevalence of obesity and diabetes.

Myth # 9 Ostomy Surgery: After ostomy surgery, men become impotent, and women have impaired sexual function and are unable to become pregnant.

False - Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Stool is collected in a bag taped to the skin over the opening. Alternatively, an internal pouch that collects the stool may be formed from a portion of the intestine. The pouch then can be emptied by insertion of a catheter at regular intervals.

Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not, or, if they do, it is temporary. This is caused by damage to the nerves that supply the penis. If erectile dysfunction persists, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution.

In women, ostomy surgery does not damage sexual or reproductive organs, so it is not a direct cause of sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.

COLITIS---INFLAMMATION OF COLON(ABDOMINAL PAIN)

2009-03-22T19:12:00.000+05:30

Colitis Overview

Colitis is the term used to described inflammation of the colon There are a variety of causes of colitis including infections, poor blood supply, and autoimmune reactions.

The colon (large bowel or large intestine) is responsible for collecting and storing the waste products of digestion. It is a long muscular tube that pushes undigested food towards the anus for eventual elimination as a bowel movement. As the liquid mixture of undigested food makes its journey, it mixes with mucus and normal bacteria residing in the colon. As well, water is reabsorbed into the bloodstream, and the feces start to solidify.

The colon is located in the abdominal cavity and is divided into the following parts: thececum, the ascending colon, the transverse, the descending colon, the sigmoid, therectum, and the anus. The right colon includes the cecum and ascending colon. The left colon includes the transverse segment to the sigmoid.

The wall of the colon has numerous layers. There is a smooth muscle layer that wraps the outside and is responsible for squeezing the undigested food through the length of the colon. The inner layers, or mucosa, come into contact with the fluid and allow water andelectrolyte absorption to help solidify the feces. The mucosal layer is where the colon inflammation occurs and is responsible for the symptoms of colitis.

As with any other organ, the colon has a blood supply with arteries delivering oxygen rich blood and nutrients to it, and veins that drain carbon dioxide and lactic acid from it.

Colitis Causes

Inflammation of the colon can be caused by a variety of illnesses and infections. Some of the most common causes are discussed below.

Infectious Colitis

Viruses and bacteria can cause colon infections. Most are food-borne illnesses or "food poisoning." Common bacterial causes include Shigella, E.Coli, Salmonella andCampylobacter. These infections often present with bloody diarrhea and can cause significant dehydration.

Pseudomembranous colitis is caused by the bacteria Clostridium difficile (C. difficile). This disorder is often seen in patients who have recently been taking antibiotics for an infection. The antibiotic alters the normal bacteria present in the colon and allows an overgrowth of the Clostridium bacteria. Clostridium bacteria produce a toxin that causes diarrhea. This is an infection, and often there is a fever present. The diarrhea is usually not bloody.

Ischemic Colitis

The arteries that supply blood to the colon are like any other artery in the body. They have the potential to narrow due to atherosclerosis (just like blood vessels in the heart, which can cause angina, or narrowed vessels in the brain can cause a stroke). When these arteries narrow, the colon loses it's blood supply and becomes inflamed.

The colon can also lose its blood supply for mechanical reasons. A couple of examples include volvulus, in which the bowel twists on itself, or an incarcerated hernia in which a portion of the colon gets stuck in an outpouching of the abdominal wall.

In patients who are at risk for decreased blood flow to the colon, ischemic colitis can occur if the blood pressure falls. This may occur with dehydration, anemia, or shock.

Ischemia or lack of blood supply causes significant pain, fever, and bloody bowel movements.

Inflammatory Bowel Disease

There ate two types of inflammatory bowel disease. The first, ulcerative colitis, is thought to be an autoimmune illness in which the body's immune system attacks the colon and causes inflammation. Ulcerative colitis begins in the rectum and may gradually spread throughout the colon. The signs and symptoms are generally abdominal pain and bloody bowel movements.

Crohn's disease is the second type of inflammatory bowel disease, and may involve any part of the digestive tract from the esophagus and stomach to both the small and large intestine. It often has skip lesions, that is diseased areas are interspersed with healthy areas of tissue.

Microscopic Colitis

Two diseases make up this group of colon inflammation, collagenous colitis andlymphocytic colitis. In these diseases, the inflammation is caused by some layers of the colon wall becoming engorged with either collagen or lymphocytes. Watery, non-bloody diarrhea is the most common symptom.

This is an uncommon illness that is seen more frequently in older women. The cause is unknown but an auto-immune potential may exist.

Chemical Colitis

If chemicals are instilled into the colon, inflammation and damage can occur. One of the complications of an enema is the inflammation of the mucosal lining of the colon caused by harsh chemicals.

Colitis Symptoms

Symptoms of colitis will depend upon the type of colitis that is present, but in general, colitis most often is associated with abdominal pain and diarrhea.

Other symptoms may inlcude:

Blood in the bowel movement may or may not be present.
Tenesmus may exist; this is the constant urge to have a bowel movement.
The abdominal pain may come in waves, building to diarrhea, and then waning.
There may be constant pain.
Fever, chills, and other signs of infection and inflammation may be present depending upon the cause of colitis.

Colitis Treatment

Self-Care at Home

If a person has bloody diarrhea, fever or intense pain, it is reasonable and appropriate to seek medical help by calling a health care practitioner or seeking care at a hospital emergency department.

Medical Treatment

The definitive treatment of colitis is dependent upon the cause. Many cases require little more than symptomatic care, including clear fluids to rest the bowel and medications to control pain. Some patients become acutely ill and will need intravenous fluids and other interventions to treat their illness.

Infections: Infections that cause diarrhea and colitis may or may not require antibiotics, depending upon the cause. Viral infections resolve with the supportive care of fluids and time. Some bacterial infections like Salmonella also do not need antibiotic therapy; the body is able to get rid of the infection on its own. Other bacterial infections like Clostridium difficilealways require treatment with antibiotics.
IBD: The inflammatory bowel diseases (IBDs), ulcerative colitis and Crohn's disease, are often controlled by a combination of medications that are used in a step-wise approach. Initially, anti-inflammatory medications are used, and if these are less than successful, medications that suppress the immune system can be added. In the most severe cases, surgery may be required to remove all or parts of the colon and small intestine.
Ischemic colitis: Treatment for ischemic colitis is initially supportive, using intravenous fluids to rest the bowel and prevent dehydration. If adequate blood supply to the bowel isn't restored, surgery may be required to remove parts of the bowel that have lost blood supply.
Diarrhea and abdominal pain: Most causes of colitis present with diarrhea and crampy abdominal pain. These symptoms are also found with mild illnesses like viral enteritis (inflammation of the colon). Initial treatment at home may include a clear fluid diet for 24 hours, rest, and acetaminophen (Tylenol) as needed for pain. Often symptoms resolve quickly and no further care is needed.

Surgery

Surgery may be required for ischemic colitis, Crohn's disease, or ulcerative colitis, depending upon the severity of the illness and its response to more conservative non-surgical treatments.

In ulcerative colitis, removal of the colon cures the disease.

For other illnesses, usually the part of the colon that is at risk or damaged is removed.

Prevention

Infectious colitis remains a common ailment worldwide, affecting millions daily. The lack of clean drinking water and adequate sanitation are the main causes, leading to thousands of potentially preventable deaths each day. In developed countries, poor hand washing and poor kitchen hygiene allow the potential for infectious colitis. Prevention lies in cleanliness.

Inflammatory bowel diseases may be difficult to prevent at the present time. The likely causes are heredity and perhaps an abnormal auto-immune response to an unknown stimulus in the body.

Since ischemic colitis is caused by narrowing of the blood vessels to the bowel, decreasing the risks for other types of circulatory problems such as peripheral vascular disease, heart attack, and stroke will also decrease the risk for ischemic colitis. The common risk factors are smoking and poor control of high blood pressure, high cholesterol levels, and diabetes.