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IVF

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Introduction:
IVF or in vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the woman’s womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

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IVF was developed in the 1970s. The first British test tube baby was Louise Brown, who was born in 1978.Some 30,000 test tube babies have been born in the UK since then.
There are several different techniques, but the main process involves the women taking fertility drugs to help her produce more eggs.The eggs are then harvested and fertilised in the laboratory.
The woman is given hormone drugs to prepare her womb to receive the fertilised eggs. The fertilised eggs are placed inside the womb and a normal pregnancy follows.

The term in vitro, from the Latin root meaning in glass, is used, because early biological experiments involving cultivation of tissues outside the living organism from which they came, were carried out in glass containers such as beakers, test tubes, or petri dishes. Today, the term in vitro is used to refer to any biological procedure that is performed outside the organism it would normally be occurring in, to distinguish it from an in vivo procedure, where the tissue remains insided the living organism within which it is normally found. A colloquial term for babies conceived as the result of IVF, test tube babies, refers to the tube-shaped containers of glass or plastic resin, called test tubes, that are commonly used in chemistry labs and biology labs. However in vitro fertilization is usually performed in the shallower containers called petri dishes. (Petri-dishes may also be made of plastic resins.) However, the IVF method of Autologous Endometrial Coculture is actually performed on organic material, but is yet called in vitro.

Around 6,000 babies a year are born in the UK to otherwise infertile couples as a result of in vitro fertilisation.

But the techniques used often arouse huge controversy and some say the process can falsely raise would-be parents’ hopes since it only has a success rate of around 15%.

There have also been cases of fertilised eggs being mixed up in the laboratory and the wrong embryo being transferred to the woman, leading to fears about how the process is carried out.

New techniques coming on stream:

One of the biggest and most controversial advances in IVF in recent years has been the introduction of a technique called ICSI – intra-cytoplasmic sperm injection.

This works by injecting a single sperm directly into an egg.

Some people fear the technique could increase the risk of genetic defects that make the donor infertile being passed on to babies.

ICSI was introduced during the 1990s, but new advances are helping men with a very low sperm count to benefit from it.

These include operations to search for sperm which can be retrieved and injected into an egg.

Another advance being developed at St George’s Hospital in London involves a 3D ultrasound device which helps to spot fertility problems before IVF begins.

For example, it can test whether there are any blockages in a woman’s fallopian tubes that could harm her chances of having a healthy pregnancy.

Other doctors at the hospital are pioneering a technique that could mean an end to hormone treatments and the painful retrieval of eggs from infertile women.

The technique involves collecting thousands of immature eggs from the ovary and developing them in the laboratory.

It works by removing a bit of the skin of the ovary which masks the place where immature eggs develop.

It takes five months to grow there properly and lots of nourishment.

The eggs can be frozen so that they can be used whenever the woman wants.

Again, the technique is controversial because it means a woman could store the eggs and use them at any age.

It is likely to be available in the next 10 years, say doctors at the hospital.

Dr Ian Findlay is also developing a test that can check for 10 genetic abnormalities in one go before a fertilised egg is placed in the womb. He said: “This could lead to a dramatic reduction in miscarriages as the vast majority of miscarriages are due to abnormalities.”

The politics of IVF

IVF is only successful in 15% of cases and a recent report from the College of Health shows that success rates vary widely across the country.

Only 18% of IVF treatment is funded by the NHS and waiting times can differ greatly.

It can cost up to £2,000 per cycle for a couple to go private.

Most couples have three cycles at an average cost of £3,420.

One way of getting free treatment is for women to donate their eggs to other infertile couples.

Opponents of IVF argue that it falsely raises would-be parents’ hopes that they will be able to have a baby when the chances are not that high.

They also argue that it can be a traumatic experience to go through repeated IVF attempts, only to find that the woman does not get pregnant.

Another possible drawback is the fact that IVF treatment increases the chance of having multiple births which the couple may not have planned for.

One to two per cent of pregnant women give birth to more than one child, but with fertility treatment the odds are raised to 25%.

Most of the babies born are twins, but bigger births are on the rise.

Many doctors are worried that they are being put under increasing pressure to use more of the fertility drugs to produce more eggs and so increase the chance of the woman getting pregnant.

Some believe fertility drugs could cause ovarian cancer.

Liz Tiberis, author of ‘No Time to Die’, believes her ovarian cancer was the result of nine attempts at IVF.

But fertility doctors say the link has not been proven.

The Cancer Research Campaign is investigating.

Who regulates the IVF process?

In the UK, the Human Fertilisation and Embryology Authority regulates and licenses fertility clinics under the 1990 Human Fertilisation and Embryology Act.

One area of controversy involves the processes clinics have for ensuring mix-ups do not occur over embryos.

This follows a US case where one woman wrongly received the fertilised egg of another.

Fertility experts say procedures in the UK are very tight and there is unlikely to be the same mix-up here.

But the Medical Protection Society recently reported the case of an expert who transferred three embryos from one woman into another by mistake.

However, he realised his error in time.

Calls have been made for procedures for matching eggs with mothers to be tightened, for example, by stipulating that doctors have to do a DNA test before implantation goes ahead rather than relying on written records.

You may click to learn more about IVF

BBC NEWS:31 March , 1999

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Vasectomy: Safe, Simple and Little Used

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Newer surgical techniques reduce the risk involved with having a vasectomy.
Vasectomy is a simple, painless procedure that is very effective in preventing pregnancy. Men usually have no side effects from vasectomy, and no change in sexual performance or function.

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Newer surgical techniques reduce the risk involved with having a vasectomy.

In Short:-

Vasectomies are safer and more cost-effective than tubal ligations, the sterilization technique for women, but remain relatively underused.

A new no-scalpel vasectomy technique significantly reduces complications.

The rate of unwanted pregnancies after vasectomy remains low; most of those pregnancies can be traced to patient error.

A tiny puncture and a little snip, done under local anesthetic — that’s essentially all there is to a vasectomy.

“Vasectomies are the safest, simplest, most cost-effective method of contraception we have,” said Dr. Edmund Sabanegh Jr., director of the Clinic for Male Fertility at the Cleveland Clinic Foundation.

They are also strikingly little-used. About 500,000 American men have the operation each year. More than twice as many women undergo tubal ligation for permanent contraception, even though that operation costs three to four times as much, requires general anesthesia and an abdominal incision, and carries a small but real risk of serious complications.

“There’s something about having a surgeon fiddling around down there with a scalpel that makes even tough guys squeamish,” said Dr. Marc Goldstein, director of the Center for Male Reproductive Medicine and Microsurgery at the Weill Medical College of Cornell University in New York.

And then there are the misconceptions that discourage many men from having vasectomies, especially the widespread and groundless worry that the procedure will lower testosterone levels and affect sexual performance.

Whatever the reasons in the United States, the situation is not the same among men everywhere. By the time they reach their 50s, roughly half of men in New Zealand have undergone vasectomies, according to Dr. Sabanegh, compared with fewer than one in six in the United States. In Canada, vasectomies outnumber tubal ligations.

Experts hope that recent advances in vasectomy techniques will ease some of the fears.

The chief advance is the no-scalpel vasectomy, a technique pioneered in China in the 1970s that has been steadily gaining popularity in the United States. In a traditional vasectomy, doctors make two half-inch incisions on either side of the scrotum to sever the vas deferens, the two narrow tubes that carry sperm from the testicles during ejaculation. The no-scalpel approach does away with the need for incisions.

In the new technique, doctors use their fingers to locate the vas deferens by feel through the thin skin of the scrotum.

“Once we’ve located the vas, we make a tiny poke-hole over it,” said Dr. Phillip Werthman, director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles. The hole can be gently expanded in a way that pushes blood vessels aside rather than cutting through them, so there is almost no bleeding. Using a hooked instrument, surgeons pull the vas through the hole, then cut it.

“A lot of men can’t even tell where the procedure was done afterwards, the hole we make is that small,” said Dr. Goldstein, who was the first Western doctor to travel to China to learn the technique. Compared with traditional techniques, no-scalpel vasectomies result in less bleeding, less postoperative pain and quicker recovery. They also require less time to perform — a little more than 10 minutes in the hands of an experienced surgeon.

Although the traditional incision method is still more widely used, that is likely to change as more and more medical schools teach the no-scalpel approach.

In another bid to win over squeamish males, some doctors have replaced the needles used to inject anesthesia into the scrotum with high-pressure jets that deliver painkillers through the skin.

“A lot of men’s biggest fear is that needle,” Dr. Werthman said, even though the actual needle used is so narrow that most men barely feel it. “Pressure injection takes the psychological edge off that,” he said, though many patients find the loud popping sound it makes unpleasant.

In the end, the success or failure of a vasectomy depends not on how surgeons reach the vas but how they block it. Many doctors use several methods to ensure that sperm don’t find another path. Along with cutting out a small section of the tube, they may burn the inner lining of the two remaining ends, clamp them and separate them.

With current techniques, the chance of an unwanted pregnancy occurring in the first year after a vasectomy is 1 in 1,000, Dr. Sabanegh said. Some of those failures are the fault of the patient, not the procedure. Because it can take several months for sperm remaining after a vasectomy to be washed out, men are counseled to use other contraception methods until tests show that their semen is free of active sperm. Many men don’t bother. In a 2006 study of 436 vasectomies, researchers at the Cleveland Clinic Foundation found that only three out of four returned for follow-up semen analysis, and only 21 percent followed the full instructions to continue to be tested until two specimens came up negative.

Sources: The New York Times : June 29, ’08

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Do Arthritis Drugs Cause Cancer?

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The U.S. Food and Drug Administration (FDA) is investigating whether four drugs used to treat rheumatoid arthritis and other immune system diseases might increase the risk of cancer in children.

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The FDA has received reports of 30 cases of cancer among children and young adults treated with the drugs. The agency did not make clear how many children had taken the drugs.

The drugs involved are:

1. Enbrel, sold by Amgen and Wyeth
2. Remicade, sold by Johnson & Johnson and Schering-Plough
3. Humira, sold by Abbott Laboratories
4. Cimzia, sold by the Belgian company UCB

All of the drugs block a protein called tumor necrosis factor, and are therefore known as TNF-blockers. They are used to treat not only rheumatoid arthritis but also psoriasis, Crohn’s disease and other immune diseases.

Because the drugs block part of the immune system, it’s long been known that they might contribute to a higher risk of cancers and infections. The drugs’ labels contain warnings as such, including warning about a risk of lymphomas, which are cancers of immune system cells.

Among adults, meanwhile, one study found that those given Humira or Remicade to treat rheumatoid arthritis had 2.4 times the cancer rate of those in control groups.

Sources: New York Times June 5, 2008

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Kidney Failure

Kidney failure is a serious disease which can have a major impact on life, and can ultimately be fatal. However, it can be successfully treated.

What do the kidneys do?

In order for blood to perform its essential functions of bringing nutrients and oxygen to the cells of the body, and carrying waste materials away from those cells, the chemical composition of the blood must be carefully controlled.

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The kidneys play a crucial role in this process by filtering the blood under high pressure and removing potential toxins, which are excreted from the body in the urine.

Every day the kidneys filter the body’s entire blood volume seven or eight times.

What is kidney failure?.....CLICK & SEE

When the kidneys start to fail, toxins are not f & iltered out of the blood, and start accumulate in the tissues. This can lead to a range of problems.

Build up of two waste products, urea and creatinine, can lead to tiredness, weakness, loss of appetite and vomiting.

Accumulation of acid generated during the body’s metabolic processes can lead to a condition called metabolic acidosis.

Failure to get rid of phosphate, causes the blood phosphate level to increase and calcium level to fall.

When calcium level is low, bones will become brittle.

The kidney may also lose its ability to produce erythropoietin, resulting in anaemia.

Kidney failure is also associated with an increase in the volume of water in the body which can result in a swelling of the tissues.

Excess salt and water retention may cause high blood pressure, swelling of the legs, face, abdomen and breathlessness.

What causes kidney failure?

There are many possible causes of kidney damage or kidney failure. They include:

* Decreased blood flow, which may occur with extremely low blood pressure caused by trauma, surgery, serious illnesses, septic shock, hemorrhage, burns, or dehydration
* Acute tubular necrosis (ATN)
* Infections that directly injury the kidney such as acute pyelonephritis or septicemia
* Urinary tract obstruction (obstructive uropathy)
* Autoimmune kidney disease such as interstitial nephritis or acute nephritic syndrome
* Disorders that cause clotting within the thin blood vessels of the kidney
o Idiopathic thrombocytopenic thrombotic purpura (ITTP)
o Transfusion reaction
o Malignant hypertension
o Scleroderma,
o Hemolytic-uremic syndrome
o Disorders of childbirth, such as bleeding placenta abruptio or placenta previa

The most common causes of kidney failure are glomerulonephritis (inflammation of the kidney) and diabetes mellitus.

Other causes of kidney failure are kidney stones, kidney cysts, an immune disorder called systemic lupus erythematosus, uncontrolled high blood pressure and drugs.

What are the symptoms?

As the kidneys begin to fail the following symptoms can begin develop:

* Decrease in amount of urine (oliguria)
* Urination stops (anuria)
* Excessive urination at night
* Ankle, feet, and leg swelling
* Generalized swelling, fluid retention
* Decreased sensation, especially in the hands or feet
* Decreased appetite
* Metallic taste in mouth
* Persistent hiccups
* Changes in mental status or mood
o Agitation
o Drowsiness
o Lethargy
o Delirium or confusion
o Coma
o Mood changes
o Trouble paying attention
o Hallucinations
* Slow, sluggish, movements
* Seizures
* Hand tremor (shaking)
* Nausea or vomiting, may last for days
* Brusing easily
* Prolonged bleeding
* Nosebleeds
* Bloody stools
* Flank pain (between the ribs and hips)
* Fatigue
* Breath odor
* High blood pressure

* pale and sallow complexion
* fatigue
* shortness of breath
* body itch
* sometimes nausea and vomiting
* swelling of the face and legs
* disruption of urination patterns

How it is diagnosed?
Exams and Tests:

Examination and testing can help diagnose acute kidney failure and help rule out other problems that can affect kidney function.

Many patients have generalized swelling caused by fluid retention. The doctor will use a stethoscope to listen to the heart and lungs. A heart murmur, crackles in the lungs, inflammation of the lining of the heart (pericarditis), or other related to extra fluid may be heard.

The results of laboratory tests may change suddenly (within a few days to 2 weeks).

* Urine tests (urinalysis) may be abnormal.
* Serum creatinine, BUN, creatinine clearance, and serum potassium levels may increase.
* Arterial blood gas and blood chemistries may show metabolic acidosis.
* Kidney or abdominal ultrasound are preferred tests, but abdominal x-ray, abdominal CT scan, or abdominal MRI can tell if there is a blockage in the urinary tract.
* Blood tests may help reveal the underlying cause of kidney failure.

How is it treated?

Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal. Usually, you have to stay overnight in the hospital for treatment.

The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the build-up of toxins normally handled by the kidneys. This diet may be high in carbohydrates and low in protein, salt, and potassium.

You may need antibiotics to treat or prevent infection. Diuretics (“water pills”) may be used to help the kidneys lose fluid.

It will be very important to avoid dangerous hyperkalemia (increased blood potassium levels) by using IV (intravenous) calcium, glucose/insulin, or potassium exchange resin (Kayexalate).

Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your serum potassium is dangerously high. Dialysis will also be used if your mental status changes, your potassium level starts to rise, you stop urinating, develop pericarditis, become overloaded with fluid, or cannot eliminate nitrogen waste products from your body.
The most common treatment is by dialysis, a technique which artificially mimics the action of the kidneys.

What is dialysis?

There are two types of dialysis.

Haemodialysis is the most frequently prescribed type of dialysis treatment….CLICK & SEE

It involves circulating the patient’s blood outside of the body through a series of tubes.

The blood is filtered in a way similar to that used by the kidneys by using a chemical bath to draw out waste products.

Most haemodialysis patients require treatment three times a week, for an average of 3-4 hours per dialysis.

Less common is a technique known as peritoneal dialysis, in which the lining of the abdomen acts a blood filter.….CLICK & SEE

>Kidney Failure Herbs

Is a transplant an option?….CLICK & SEE

For the right patient at the right time, a transplant is the best treatment for kidney failure.

If it works well the patient will be totally free from dialysis. Many patients with kidney failure are suitable for a transplant.

Prognosis:
While acute kidney failure is potentially life-threatening and may require intensive treatment, the kidneys usually start working again within several weeks to months after the underlying cause has been treated.

In cases where this does not happen, chronic renal failure or end-stage renal disease develops. Death can occur, but is most common when kidney failure is caused by surgery, trauma, or severe infection in someone with heart disease, lung disease, or recent stroke. Old age, infection, loss of blood from the intestinal tract, and progression of kidney failure also increase the risk of death.


Possible Complications :

* Loss of blood in the intestines
* Chronic (ongoing) kidney failure
* End-stage renal disease
* Damage to the heart or nervous system
* Hypertension (high blood pressure)

Prevention: Treating disorders such as high blood pressure can help prevent acute kidney failure. Unfortunately, prevention is not always possible.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
BBC NEWS:OCT 15, 2001
http://www.nlm.nih.gov/medlineplus/ency/article/000501.htm#Definition

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FDA Forced to Admit That Mercury Fillings are Hazardous

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If you’re like most people, you probably have cavities that have been filled with metal or a silver-mercury amalgam. While you probably recognize that such fillings are unattractive in your smile, you might not realize that they’re hazardous to your teeth.

Silver-mercury fillings react to temperature changes, expanding and contracting within your delicate tooth. This movement can weaken the tooth, causing it to break. It can also create a space between the tooth surface and filling that allows bacteria to enter, causing decay.

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Old, broken mercury fillings were replaced with beautiful, strong Porcelain onlays.

The U.S. Food and Drug Administration (FDA) has finally admitted that metal dental fillings containing mercury can cause health problems in pregnant women, children and fetuses.
As part of the settlement of a lawsuit filed by several consumer advocacy groups, the FDA agreed to alert consumers about the potential risks on its Web site and to issue a more specific rule next year for fillings that contain mercury.

The FDA’s Web site now states that: “Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.”

Charles Brown, a lawyer for advocacy group Consumers for Dental Choice, said the agency’s move represented an about-face. According to Brown, “Gone, gone, gone are all of FDA’s claims that no science exists that amalgam is unsafe … The impact of the re-writing of its position on amalgam can hardly be understated. FDA’s website will no longer be cited by the American Dental Association in public hearings.”

You may click to see:->Mercury in your brain from amalgam fillings in your mouth.

>Amalgam Fillings: They are Hazardous to Your Health

Sources:

* eMax Health

* Reuters June 4, 2008

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