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Epididymitis


Definition:-
Epididymitis is a medical condition in which there is inflammation of the epididymis (a curved structure at the back of the testicle in which sperm matures and is stored). This condition may be mildly to very painful, and the scrotum (sac containing the testicles) may become red, warm and swollen. It may be acute (of sudden onset) or rarely chronic.
…..Click to see the picture..

click to see the pictures

1: Epididymis

2: Head of epididymis
3: Lobules of epididymis
4: Body of epididymis
5: Tail of epididymis
6: Duct of epididymis
7: Deferent duct (ductus deferens or vas
Epididymitis is the most frequent cause of sudden scrotal pain. In contrast with men who have testicular torsion, the cremaster reflex (elevation of the testicle in response to stroking the upper inner thigh) is not altered. If the diagnosis is not entirely clear from the patient’s history and physical examination, a Doppler ultrasound scan can confirm increased flow of blood to the affected epididymis.

Infection is the most common cause.
In sexually active men, Chlamydia trachomatis is the most frequent causative microbe, followed by E. coli and Neisseria gonorrhoeae. In children, it may follow an infection in another part of the body (for example, a viral illness), or there may be an associated urinary tract anomaly. Another cause is sterile reflux of urine through the ejaculatory ducts. Antibiotics may be needed to control a component of infection. Treatment otherwise comprises pain killers or anti-inflammatory drugs and bed rest if necessary, and symptom control by resting the scrotum in a supported position.
Males of any age can get epididymitis, but it’s most common in men between the ages of 20 and 39.

Classification
Epididymitis can be classified into acute and chronic.

Acute Epididymis:>-click & see    .Swelling in a patient with epididymitis

1. Ductus Deferens
2. Epididymis
3. Testicle

Chronic epididymitis..>.click & see
Chronic epididymitis is epididymitis which ensues for more than six weeks. Chronic epididymitis is characterised by inflammation even when there is no infection present. Tests are needed to distinguish chronic epididymitis from a range of other disorders that can cause constant scrotal pain. These include testicular cancer, enlarged scrotal veins (varicocele) or a cyst within the epididymis. As well, the nerves in the scrotal area are connected to those of the abdomen, sometimes causing pain similar to a hernia (see referred pain). This condition can develop even without the presence of the previously described known causes.

Typically, a second, longer round of treatment is used. It is believed that the hypersensitivity of certain structures, including nerves and muscles, may cause or contribute to chronic epididymitis. A procedure called a cord block is a last measure. This consists of an injection into the nerve that traces along the epididymis. The injection is a compound of several medications including a steroid, pain killers, and a high dose of an anti-inflammatory. This treatment can quell the pain for 2–3 months in ideal conditions. Some patients may only experience an even shorter duration of 2–3 days, while the fortunate ones in rare occasions are never bothered again. This procedure would of course have to be repeated when necessary, until the problem goes away completely, or until the routine is simply too bothersome. As a last resort, a patient may then decide to have the epididymis completely removed.

Symptoms:
Epididymitis symptoms depend on the cause. They can include:

#A tender, swollen, red or warm scrotum
#Testicle pain and tenderness, usually on one side — the pain may get worse when you have a bowel movement
#Painful urination or an urgent or frequent need to urinate
#Painful intercourse or ejaculation
#Chills and a fever
#A lump on the testicle
#Enlarged lymph nodes in the groin (inguinal nodes)
#Pain or discomfort in the lower abdomen or pelvic area
#Discharge from the penis
#Blood in the semen

Causes:-
#Infection is the most common cause of epididymitis. The bacteria in the urethra back-track through the urinary and reproductive structures to the epididymis. There can be associated urethritis (inflammation of the urethra). Rarely, the infection reaches the epididymis via the bloodstream.

In sexually active men, Chlamydia trachomatis is responsible for two-thirds of cases, followed by Neisseria gonorrhoeae and E. coli (or other bacteria that cause urinary tract infection). Particularly among men over age 35 in whom the cause is E. coli, epididymitis is commonly due to urinary tract obstruction. Less common microbes include Ureaplasma, Mycobacterium, and cytomegalovirus, or Cryptococcus in patients with HIV infection. E. coli is more common in boys before puberty, the elderly and homosexual men.

#Other infections. Boys, older men and homosexual men are more likely to have epididymitis caused by a non-sexually transmitted bacterial infection. For men and boys who’ve had urinary tract infections or prostate infections, bacteria may spread from the infected site to the epididymis. Rarely, epididymitis is caused by a fungal infection.

#Non-infectious causes are also possible
. Reflux of sterile urine (urine without bacteria) through the ejaculatory ducts may cause inflammation with obstruction. In children, it may be a response following an infection with enterovirus, adenovirus or Mycoplasma pneumoniae.

#The heart medication amiodarone. In some cases, this anti-arrhythmic medication causes inflammation of the epididymis. Epididymitis caused by amiodarone is treated by temporarily discontinuing the drug or reducing the dose.

#Tuberculosis. In some cases, tuberculosis can cause epididymitis.

#Urine in the epididymis. Known as chemical epididymitis, this occurs when urine flows backward into the epididymis. It may occur with heavy lifting or straining.

Epididymitis can also be caused by genito-urinary surgery, including prostatectomy and urinary catheterization. Congestive epididymitis is a long-term complication of vasectomy. Chemical epididymitis may also result from drugs such as amiodarone.

Diagnosis:-
Epididymitis can be hard to distinguish from testicular torsion. Both can occur at the same time. A urologist may need to be consulted.

Epididymitis usually has a gradual onset. On physical examination, the testicle is usually found to be in its normal vertical position, of equal size compared to its counterpart, and not high-riding. Typical findings are redness, warmth and swelling of the scrotum, with tenderness behind the testicle, away from the middle (this is the normal position of the epididymis relative to the testicle). The cremasteric reflex (if it was normal before) remains normal. This is a useful sign to distinguish it from testicular torsion. If there is pain relieved by elevation of the testicle, this is called Prehn’s sign, which is however non-specific.

Analysis of the urine may or may not be normal. Before the advent of sophisticated medical imaging techniques, surgical exploration was the standard of care. Nowadays, color Doppler ultrasound is the preferred test. It can demonstrate increased blood flow (also compared to the normal side), as opposed to testicular torsion. Nuclear testicular blood flow testing is rarely used.

Additional tests may be necessary to identify underlying causes. In younger children, a urinary tract anomaly is frequently found. In sexually active men, tests for sexually transmitted diseases may be done. These may include microscopy and culture of a first void urine sample, Gram stain and culture of fluid or a swab from the urethra, nuclear acid amplification tests (to amplify and detect microbial DNA or other nucleic acids) or tests for syphilis and HIV.

Treatment:-
Antibiotics are used if an infection is suspected. Fluoroquinolones are no longer recommended for sexually transmitted infections, because of the resistance of Neisseria gonorrhoeae . A cephalosporin (such as ceftriaxone) combined with doxycycline is an alternative. Azithromycin can be used for susceptible strains.

For cases caused by enteric organisms (such as E. coli), ofloxacin or levofloxacin are recommended.

In children, quinolones and doxycycline are best avoided. Since bacteria that cause urinary tract infections are often the cause of epididymitis in children, co-trimoxazole or suited penicillins (for example, cephalexin) can be used. If there is a sexually transmitted disease, the partner should also be treated.

Household remedies such as elevation of the scrotum and cold compresses applied regularly to the scrotum may relieve the pain. Painkillers or anti-inflammatory drugs are often necessary. Hospitalisation is indicated for severe cases, and check-ups can ensure the infection has cleared up. Surgery is rarely necessary, except, for example, in those rare instances where an abscess forms.

Home Remedies & Change of Lifestyle:-
Having epididymitis usually means you’re experiencing considerable pain and discomfort. To ease your symptoms, you may  try  the advices:

#Rest in bed. Depending on the severity of your discomfort, you may want to stay in bed one or two days.

#Elevate your scrotum. While lying down, place a folded towel under your scrotum.

#Wear an athletic supporter. A supporter provides better support than boxers do for the scrotum.

#Apply cold packs to your scrotum. Wrap the pack in a thin towel and remove the cold pack every 30 minutes or so to avoid damaging your skin.

#Don’t have sex until your infection has cleared up. Ask your doctor when you can have sex again.

Risk factors:-

Sexually transmitted epididymitis
Several factors increase your risk of getting epididymitis caused by an STD, including:

#High-risk sexual behaviors, such as having multiple sex partners, having sex with a partner with an STD and having sex without a condom.

#Personal history of an STD. You’re at increased risk of an infection that causes epididymitis if you’ve had an STD in the past.
Non-STD infections:-
Several things increase your risk of epididymitis caused by an infection other than an STD, including:

#Past prostate or urinary tract infections. Chronic urinary tract infections or prostate infections are linked to bacterial infections that can cause epididymitis.

#An uncircumcised penis or an anatomical abnormality of the urinary tract. These conditions increase your risk of epididymitis caused by a bacterial infection.

#Medical procedures that affect the urinary tract. Procedures such as surgery or having a urinary catheter or scope inserted into the penis can introduce bacteria into the genital-urinary tract, leading to infection.

#Prostate enlargement. Having an enlarged prostate that obstructs bladder function and causes urine to remain in the bladder puts you at higher risk of bladder infections, which increases the risk of epididymitis.

Epididymitis may eventually cause:

#Scrotal abscess, when infected tissue fills with pus

#Chronic epididymitis, which can occur when untreated acute epididymitis leads to recurrent episodes

#Shrinkage of the affected testicle (atrophy)

#Reduced fertility, but this is rare

If the condition spreads from your epididymis to your testicle, the resulting condition is known as epididymo-orchitis. Signs, symptoms and treatment options are basically the same as they are for epididymitis.

Prevention:-
If your epididymitis was caused by an STD, your partner also will need treatment. If your partner doesn’t get treatment, you may contract the STD again. Safer sexual practices, such as monogamous sex and condom use, help protect against STDs that can cause epididymitis.

If you have recurrent urninary tract infections or other risk factors for epididymitis, your doctor may discuss with you other ways to prevent epididymitis from recurring.

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:

http://en.wikipedia.org/wiki/Epididymitis
http://www.mayoclinic.com/health/epididymitis/DS00603

 

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FDA Warns About Eyelash Thickener Claims

The U.S. FDA has warned Allergan Inc. that the Web site for its eyelash thickener Latisse is misleading. The site downplays or fails to mention risks associated with the product.

The Latisse site either doesn’t mention potential side effects including bacterial eye infections, allergic reactions, excess hair growth outside the intended treatment area, and permanent changes in iris and eyelid pigmentation, or presents them in very small text.

The drug is approved to make eyelashes thicker, fuller and darker. Latisse, or bimatoprost, was already on the market as a treatment for glaucoma.

Source: MSNBC September 17, 2009

 

Metamucil-a wonderful fiber supplement

Pronounced: MET-uh-MEW-sil . Generic ingredients: Psyllium, Senna (Overnight Relief Perdiem only)Other brand names: Konsyl Powder, Konsyl for Kids Perdiem.

Constipation or any other type of bowel disorder is very hurmful for everyone. These are caused by the deficiency(lack) 0f particular neutrients and this dificiency prevents the bowel muscles from functioning the way they should function (neutrients are vitamins,minerals,enzymes etc. etc.) One should get rid of these problems just by taking some fibre supplement, and Metamucil is one of them.I myself used it and am very much satisfied with its effect.Metamucil is a bulk-producing laxative and fiber supplement manufactured by Proctar & Gamble.

What this drug is used for

Metamucil, Konsyl, and Perdiem, all of which are based on bulk-producing psyllium fiber, are used for constipation.

Metamucil and Konsyl Powder relieve chronic constipation and irritable bowel syndrome. Doctors also use them, along with other medications, to ease bowel movements in people with hemorrhoids and to treat the constipation that may accompany diverticular disease (a pouch in the wall of the bowel), occasional constipation during pregnancy, constipation during convalescence, and constipation in the very old. Metamucil is available in regular and smooth-texture powder form, as well as in wafers, in a variety of flavors. Konsyl Powder is sugar- and sugar substitute-free.

Perdiem products and Konsyl for Kids are used only for occasional constipation. Fiber Therapy Perdiem and Konsyl for Kids contain psyllium alone. Overnight Relief Perdiem also contains senna, a natural stimulant. Perdiem products come in granule form. Konsyl for Kids is a powder.

How should you take this medication?

Take these products with at least 1 full glass (8 ounces) of water or other liquid. Most produce results in 12 to 72 hours. Overnight Relief Perdiem acts in 6 to 12 hours.

* ADULTS AND CHILDREN 12 YEARS AND OVER
Metamucil
The usual dose is 2 wafers or 1 rounded tablespoonful, rounded teaspoonful, or packet (depending on the variety). Mix powder with 8 ounces of liquid. If mixture thickens, add more liquid and stir again. Wash down wafers with at least 8 ounces of liquid. Can be taken up to 3 times daily, if needed.

Konsyl
Place 1 rounded teaspoonful in a dry shaker cup or container that can be closed. Add 8 ounces of liquid and shake, don’t stir, for 3 to 5 seconds. Drink promptly. If the mixture thickens, add more liquid and shake again. Follow with an 8-ounce glass of liquid. Take this dosage 1 to 3 times daily. To avoid bloating and to help your body adjust, you may wish to start with half-teaspoonful doses for several days, then increase the dose gradually over several more days.

Konsyl for Kids
Add 2 rounded teaspoonfuls to at least 8 ounces of cool water, stir briskly for 3 to 5 seconds, and drink promptly. If the mixture thickens, add more water and stir again. Follow with more liquid. May be taken 1 to 3 times daily.

Perdiem
Take 1 to 2 rounded teaspoonfuls once or twice daily, in the evening and/or before breakfast. Put the granules in your mouth and wash them down with a full glass of cool liquid. Do not chew them.

* CHILDREN UNDER 12
Metamucil
Use half the adult dosage. For children under 6, consult your doctor.

Konsyl
Use half the adult dosage. For children under 6, consult your doctor.

Konsyl for Kids
Use 1 rounded teaspoonful 1 to 3 times a day. For children under 6, consult your doctor.

Perdiem
The usual dosage is 1 rounded teaspoonful once or twice daily. For children under 7, consult your doctor.

* STORAGE
Store at room temperature in a dry place.

Do not take this medication if…

Avoid these products if you have trouble swallowing, or have ever had an allergic reaction to psyllium. Also avoid them if you have an intestinal blockage or impacted stool. Check with your doctor before taking them if you have stomach pain, nausea, vomiting, or rectal bleeding, or have noticed a sudden change in bowel habits lasting 2 weeks or more.

Special warnings about this medication

Be sure to take each dose with at least 1 full glass of water. If you don’t use enough liquid, the product could choke you.

If you have chest pain, vomiting, or difficulty in swallowing or breathing after taking one of these products, see your doctor immediately.

If you are still constipated after 1 week or notice rectal bleeding, stop taking the medication and call your doctor.

When handling Metamucil powder, spoon it into a glass according to the directions on the label in order to keep psyllium dust from escaping into the air.

Do not take one of these products less than 2 hours before or after taking a prescription drug. If you must avoid phenylalanine, do not use the smooth-texture, sugar-free, orange-flavored variety of Metamucil.

Extracted from:http://www.pdrhealth.com/drug_info/otcdrugprofiles/drugs/fgotc146.shtml