Tag Archives: Vagina

If You’re in Pain, Think UTI

Pain while passing urine, a desire to urinate every few minutes, an inability to pass urine despite the urge, high-coloured, cloudy urine, abdominal pain, high fever, shivering and vomiting — a few or all of these are symptoms of an infection somewhere along the urinary tract. In the elderly, the only symptom may be a change in mental status. In men, the pain may be felt in the rectal area. In children, after a period of dryness, bedwetting may recur. In babies, the temperature can fall instead of rise, and there may be jaundice. Almost 25 per cent of visits to a physician is due to this very common infection.
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Urinary tract infection (UTI) affects all age groups and both sexes. It is much more common in women, because of the shorter urethra, its proximity to the anus, pregnancy (when the uterus obstructs the free flow of urine) and minor trauma during sexual intercourse. Thirty five per cent of women have one episode of UTI before the age of 30. Men tend to develop UTI if their prostrate gland is enlarged as this obstructs the flow of urine. In both sexes kidney stones, structural abnormalities of the urinary tract, diabetes or lack of immunity (HIV, cancer medication) can increase susceptibility to infection. Pregnant women can develop asymptomatic UTI with bacteria detected in their urine on routine examination. This condition, called “asymptomatic bactinuria” of pregnancy, needs to be treated.
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Physicians suspect that UTI exists based on the symptoms. A routine urine examination shows abnormalities like pus cells or blood in the urine. A culture can be done to determine the organism responsible so that the appropriate antibiotic can be administered.

Untreated patients of UTI can sometimes recover spontaneously without treatment in a few months. But the infection can also enter the blood stream, causing potentially fatal septicaemia. The kidneys may become scarred, too. This leads to high blood pressure and kidney failure. During pregnancy, recurrent or chronic UTI or asymptomatic UTI compromises the placental blood supply. This affects the baby’s nutrition, leading to low birth weight and sometimes causing the mother to go into premature labour.

There are several regimens for treating UTI. Depending on the organism and antibiotic, in adult women a three-day course is usually sufficient for mild infection. In most cases and in the case of men, however, a 7-10 or 14-day course is required. Oral medication is usually sufficient. If the infection has affected the kidney, hospitalisation and intravenous medication may be required. It is important to follow the doctor’s instructions and complete the course of antibiotics even if you are symptomatically better. In women, if the symptoms do not respond and there is also white discharge, there may be an underlying pelvic infection. In men, non-responsiveness to treatment may be due to unrecognised prostatitis.

One of the ways to prevent UTI is to drink plenty of water. The urine becomes dilute and the bladder gets flushed regularly. An adult needs around 2.5 litres of water a day. In hot, humid climates and in people who exercise vigorously the requirement may go up to 4-6 litres a day. Also, drink a glass of water before going to bed. Empty the bladder before and after intercourse. Drink a glass of water after intercourse.

A few studies have shown that cranberry juice (available in India, Hindi name karaunda) and blueberry juice (not available) helps reduce the frequency and duration of UTI. This is because the juice contains vitamin C which acidifies the urine. It also contains natural chemicals that make the bladder wall slippery and prevent bacteria from sticking to it and initiating an infection. Other citrus juices and tablets of vitamin C are effective but not as efficient. A tablespoon of home-made curd taken on an empty stomach first thing in the morning naturally repopulates the intestines with “good lactobacillus”. This decreases the likelihood of the growth of disease-causing bacteria in the rectum, from where they can enter the urethra.

The pelvic muscles become lax after childbirth. This increases the possibility of the bladder and uterus descending downwards while straining. “Accidents” with leakage of urine and urgency can also occur.

All these increase the chances of infection. Keegles exercises should be done regularly soon after childbirth. Also while passing urine, consciously stop and start. This tones the pelvic muscles.

Women tend to lean forward while urinating. This position is inefficient as it increases the angle between the bladder and the urethra, creating an obstruction to the flow of urine. Women should consciously lean backwards. Also, when the area is being washed after urination or passing motion, wash from front to back. This decreases the likelihood of contamination of the urethra with rectal bacteria

Source: The Telegraph ( Kolkata, India)

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Some Health Quaries & Answers

Eating out, a lot :-..
Q: I eat in restaurants very often as my nature of work requires a lot of travel. Some of the places look unhygienic. What should I do?

A: To protect yourself, drink only mineral water. Preferably carry your own water. Do not eat salads and uncooked vegetables. Immunise yourself against typhoid and hepatitis (jaundice). Protection against hepatitis A requires two injections six months apart. Protection against typhoid requires one injection every three years.

Sleep interrupted :..
Q: I have to get up in the night several times to urinate. Even when I have finished, I feel there is more urine. That is really not the case as no matter how much I try, there is no more flow. I am 62 years old.

A: You may have an enlarged prostate. The organ is situated at the neck of the urethra, the pipe through which urine is passed. As age advances, it can increase in size obstructing free voiding of urine. The problem is usually benign prostatic hypertrophy or BPH, which is not cancer.

Your doctor can verify the diagnosis by examining you, doing an ultrasound and a blood test. As you wait for the results, you can ease your symptoms by avoiding caffeine and alcohol, passing urine regularly before you actually feel the urge, and staying away from antihistamine medicines.

HPV vaccine
Q: My wife is 32 years old and we have one child. I read about the cervical cancer vaccine and would like to know if she will benefit from it.

A: The guidelines for the human papillovirus vaccine (HPV) advise routine administration for all girls between the ages of nine and 11 years. The decision to vaccinate an older woman should be taken after assessing her risk for previous HPV exposure. There is no test to prove or disprove exposure to the virus. It depends on the woman’s sexual history and that of her male contacts. If she is already exposed, then any benefit from immunisation is likely to be minimal.

Hepatitis B
Q: I live with my aunt and I recently discovered she is hepatitis B positive. What should I do?

A: Check your hepatitis B status by doing a blood test in a recognised laboratory. If you are negative, immediately start on a course of vaccination. The dosage schedule is 0, 28 and 180 days. The injection has to be given in the arm and not the buttocks. But if you are already infected with hepatitis B, consult a hepatologist or gastroenterologist.

Breast lump
Q: My 23-year-old niece has a lump in her breast. The doctor said we could wait and see. But I am worried.

A: Breast cancer is commoner in older women, but it does not mean a young woman cannot develop it. Particularly those women who may be carrying the BRAC1/2 genes, which are linked with a higher incidence of breast cancer, are at risk. If your niece has a lump in the breast, it is better to have it evaluated by another surgeon. She needs an ultrasound / mammogram / biopsy depending on the size of the lump. A “wait and watch” approach is not logical or scientific until the preliminary tests are done.

Milky discharge
Q: My wife has milky discharge from both her nipples. It is seven years since the birth of our last child. She fed him for a year and a half and then the milk stopped by itself.

A: Discharge from both nipples is unlikely to be due to cancer. It can be a side effect of medications like perinorm or domperone. One of the pituitary hormones called prolactin triggers the production of milk. Some pituitary tumours cause excess prolactin secretion and this can lead to milky lateral nipple discharge. Thyroid disorders can also cause the same symptoms. Your wife’s condition needs evaluation.

 

Extra bones
Q: I have pain in the arms. It has been diagnosed as “cervical rib”.

A: Cervical ribs are extra bones attached to the neck vertebrae. They are present in 0.5 per cent of the population. They may cause no symptoms at all. In some individuals, these bones may compress the blood vessels and nerves to the arms. There may be tingling numbness and weakness of the muscles of the hands, particularly at the base of the thumb. In many individuals, it is possible to keep these symptoms at bay with regular exercise. Others may require surgery to remove the extra rib.

 

Scanty beard
Q: I have a scanty beard and want a thicker growth.

A: If you are genetically Oriental it is unlikely that your desire to grow a thick beard will meet with much success. Also, look around at your male relatives. Hair distribution on the face varies from family to family. Just to make sure everything is normal, check your testosterone levels. If that is normal, it means you are out of luck and destined to sport the clean-shaven look.

Source: The Telegraph (kolkata, India)

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Testing for Vaginitis (Yeast Infections, Trichomonas, and Gardnerella)

Posterior half of uterus and upper part of vag...

Image via Wikipedia

 

What is the test?
Vaginitis is inflammation or an infection of the vagina; symptoms usually include itchiness or irritation, abnormal discharge, and an unpleasant odor. Diagnosing the cause of vaginitis involves a simple examination of the vaginal fluid under a microscope or sending the sample to a laboratory for a culture….CLICK & SEE

How do you prepare for the test?
Because douches or vaginal creams can make it hard for the doctor to interpret test results, don’t use these products before the test. No other preparation is necessary.


What happens when the test is performed?

You’ll have a pelvic examination. The doctor uses a cotton swab to collect a sample of the fluid that moistens the lining of the vagina. This swab is rubbed against two glass slides, and a small drop of fluid is placed on each slide to mix with the vaginal fluid. If your doctor is testing for infection with gonorrhea or chlamydia, he or she might use a second cotton swab to take a sample of mucus from the middle of the cervix.

Your doctor or a technician examines the slides under a microscope for signs of infection with yeast, a tiny parasite called Trichomonas, or a bacterium called Gardnerella (which causes an infection called bacterial vaginosis). If a second cotton swab was used, the doctor sends it to a laboratory for gonorrhea or chlamydia testing.

A pelvic examination assesses the health of your vagina, uterus, fallopian tubes, and ovaries. This exam may be done in conjunction with a diagnostic or screening test. You lie on your back on an examining table with your knees bent and your feet in footrests. The doctor or the doctor’s assistant asks you to spread your knees apart. The exam has two parts: a speculum examination and a bimanual examination. The speculum examination allows the doctor to see inside you, and the bimanual examination allows him or her to feel inside you.

During the first part of the examination, the doctor inserts a speculum, a device used to separate the walls of your vagina (normally the walls are touching each other) so that he or she can see inside. You will feel some pressure when the doctor inserts the speculum. As it is inserted, the doctor also shines a light inside you, and can see the walls of your vagina as well as the cervix-the outermost part of your uterus. If you have a vaginal infection, an abnormal discharge may be visible in the vagina. The doctor can take a sample of that discharge and study it under a microscope to diagnose what kind of infection you have.

In the center of the cervix is a channel called the cervical os that leads to the interior of your uterus. If there is bleeding in the uterus, bloody material may be seen coming out through the cervical os. If there is an infection in the uterus, pus can be seen coming out through the os. With certain infections, the outer surface of the cervix can appear irritated, or may have tiny areas of bleeding.

Even if everything looks normal, the doctor may do a routine screening test such as a Pap smear or a diagnostic test such as an endometrial biopsy or colposcopy. These techniques identify various diseases or conditions that cannot be seen with the naked eye.

During the bimanual examination, the doctor determines the size and shape of your uterus. He or she presses inside your vagina with one or two fingers while pressing on your lower abdomen with the other hand. In this way, the uterus is lifted up toward your abdominal wall, making it easier to feel between the two hands. The doctor can feel if the uterus is enlarged, or whether it is lumpy from fibroids (very common but benign growths on or in the wall of the uterus). The doctor also sometimes can feel the ovaries and any masses in the fallopian tubes (the tubes that carry eggs from the ovaries into the uterus). Sometimes he or she will insert another finger into your rectum, to better feel the area between the uterus and rectum. That finger can also feel for any lumps in the wall of the rectum, and can obtain a sample of stool to be tested for any sign of bleeding.

What risks are there from the test?
There are no risks from this test.

Must   you do anything special after the test is over?
No.

How long is it before the result of the test is known?
Your doctor can tell you what he or she saw under the microscope right away. Testing for gonorrhea and chlamydia usually requires a few days. Yeast infections are the most common type of vaginal infection, affecting three out of four women at one point or another in their lives.Although a number of over-the-counter medications are available to treat yeast infections, it is best to consult a doctor before treating yourself-especially if you have never had a yeast infection before.

Source: https://www.health.harvard.edu/fhg/diagnostics/testing-for-vaginitis.shtml

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Candidiasis

 

Definition: CLICK FOR PICTURE
Candidiasis is an infection caused by a species of the yeast Candida, usually Candida albicans. This is a common cause of vaginal infections in women. Also, Candida may cause mouth infections in people with reduced immune function, or in patients taking certain antibiotics. Candida can be found in virtually all normal people but causes problems in only a fraction. In recent years, however, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in organ transplantations, and the use of invasive devices (catheters, artificial joints and valves)-all of which increase a patient’s susceptibility to infection.

Description:

Vaginal candidiasis..  CLICK FOR PICTURE
Over one million women in the United States develop vaginal yeast infections each year. It is not life-threatening, but it can be uncomfortable and frustrating.

Causes & Symptoms:
Most women with vaginal candidiasis experience severe vaginal itching. They also have a discharge that often looks like cottage cheese and has a sweet or bread-like odor. The vulva and vagina can be red, swollen, and painful. Sexual intercourse can also be painful.

Diagnosis
Often clinical appearance gives a strong suggestion about the diagnosis. Generally, a clinician will take a sample of the vaginal discharge or swab an area of oral plaque, and then inspect this material under a microscope. Under the microscope, it is possible to see characteristic forms of yeasts at various stages in the lifecycle.

Fungal blood cultures should be taken for patients suspected of having deep organ candidiasis. Tissue biopsy may be needed for a definitive diagnosis.

Treatment:
In most cases, vaginal candidiasis can be treated successfully with a variety of over-the-counter antifungal creams or suppositories. These include Monistat, Gyne-Lotrimin, and Mycelex. However, infections often recur. If a women has frequent recurrences, she should consult her doctor about prescription drugs such as Vagistat-1, Diflucan, and others.

Alternative treatment
Home remedies for vaginal candidiasis include vinegar douches or insertion of a paste made from Lactobacillus acidophilus powder into the vagina. In theory, these remedies will make the vagina more acidic and therefore less hospitable to the growth of Candida. Fresh garlic (Allium sativum) is believed to have antifungal action, so incorporating it into the diet or inserting a gauze-wrapped, peeled garlic clove into the vagina may be helpful. The insert should be changed twice daily. Some women report success with these remedies; they should try a conventional treatment if an alternative remedy isn’t effective.

Herbal Treatment:
Coral calcium with trace minerals, maitake mushroom, garlic extract, pau d’arco, una de gato extract, quercetin.

Quik Tip: Una de gato or Cat’s Claw is widely considered to be the world’s most powerful natural medicine, having been used for everything from arthritis and cancer to heart disease, overweight – and zits.

Oral candidiasis: > CLICK FOR PICTURE
Sign & Symptoms:
Whitish patches can appear on the tongue, inside of the cheeks, or the palate. Oral candidiasis typically occurs in people with abnormal immune systems. These can include people undergoing chemotherapy for cancer, people taking immunosuppressive drugs to protect transplanted organs, or people with HIV infection.

Treatment:
This is usually treated with prescription lozenges or mouthwashes. Some of the most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat) and clotrimazole lozenges.

Deep organ candidiasis:-  CLICK FOR THE PICTURE
Sign & Symptoms:
Anything that weakens the body’s natural barrier against colonizing organisms-including stomach surgery, burns, nasogastric tubes, and catheters-can predispose a person for deep organ candidiasis. Rising numbers of AIDS patients, organ transplant recipients, and other individuals whose immune systems are compromised help account for the dramatic increase in deep organ candidiasis in recent years. Patients with granulocytopenia (deficiency of white blood cells) are particularly at risk for deep organ candidiasis.

Treatment:
This is usually treated with prescription lozenges or mouthwashes. Some of the most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat) and clotrimazole lozenges.

Prognosis:-

Vaginal candidiasis
Although most cases of vaginal candidiasis are cured reliably, these infections can recur. To limit recurrences, women may need to take a prescription anti-fungal drug such as terconazole (sold as Terazol) or take other anti-fungal drugs on a preventive basis.

Oral candidiasis
These infections can also recur, sometimes because the infecting Candida develops resistance to one drug. Therefore, a physician may need to prescribe a different drug.

Deep organ candidiasis
The prognosis depends on the category of disease as well as on the condition of the patient when the infection strikes. Patients who are already suffering from a serious underlying disease are more susceptible to deep organ candidiasis that speads throughout the body.

Prevention
Because Candida is part of the normal group of microorganisms that co-exist with all people, it is impossible to avoid contact with it. Good vaginal hygiene and good oral hygiene might reduce problems, but they are not guarantees against candidiasis.

Because hospital-acquired (nosocomial) deep organ candidiasis is on the rise, people need to be made aware of it. Patients should be sure that catheters are properly maintained and used for the shortest possible time length. The frequency, length, and scope of courses of antibiotic treatment should also be cut back.

Sources:http://www.healthatoz.com/healthatoz/Atoz/clients/haz/general/custom/default.jsp

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Hysterectomy

A hysterectomy is a major surgical procedure. It always involves removal of the uterus, but can also include the removal of other parts of the genital tract.

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Are there different types of hysterectomy?

Yes. A total hysterectomy is the most common operation and this means removal of the uterus and cervix (neck of the womb).

A sub-total hysterectomy means the removal of the body of the uterus, leaving the cervix behind.

A radical hysterectomy involves the removal of the uterus, cervix, a small portion of the upper part of the vagina and some soft tissue from within the pelvis.

Why is it carried out?

A hysterectomy can help to ease many gynaecological complaints. These include:

* Heavy or very painful periods

* Fibroids: Swellings of abnormal muscle that grow in the uterus, and can cause heavy or painful periods, or problems with urination.

* Prolapse: Where the uterus, or parts of the vaginal wall, drops down.

* Endometriosis: A condition where the cells which line the uterus are found outside the uterus in the pelvis. This can cause scarring around the uterus, and may cause the bladder or rectum to ‘stick’ to the uterus or fallopian tubes.

* Various forms of cancer, including cancer of the cervix, uterus, fallopian tubes, or ovaries.

In most cases – except for cancer – the procedure is usually only used as a last resort.

How is the operation carried out?

The most common method is to cut through the lower abdomen, usually leaving a six-inch scar.

However, doctors may opt in some instances to remove the uterus through the vagina.

Are there any risks?

No operation is risk-free, especially surgery as major as a hysterectomy.

However, the vast majority of women undergo the procedure without any complications.

Obesity can make surgery more tricky, and increase the risk of post-operative complications, such as heavy bleeding.

There is also a small risk of damage to the bladder, or the tubes that carry urine from the kidneys to the bladder.

An uncommon – but serious – complication is the development of a blood clot in the veins of the leg.

Is it a common procedure?

Up to one in five women will undergo a hysterectomy during their lifetime so it is a relatively common operation.

Over 40,000 hysterectomies were carried out in the UK in 2004/2005.

The NHS drug and treatment watchdog, the National Institute for Health and Clinical Excellence (NICE), warned in January 2007 that too many women were ‘suffering in silence’ from heavy periods because they feared having to have a hysterectomy.

NICE stressed that drugs and minor surgery could often be effective alternative treatments.

What impact does it have on sex?

A woman who has had a hysterectomy should be able to enjoy a satisfying sex life – in fact many women report that their level of sexual pleasure improves following the surgery.

Provided the surgery goes well, it should be possible to resume a normal sex life about six weeks after the operation.

You may click to see:->Hysterectomy Surgical Procedure

>Medical Encyclopedia:Hysterectomy

Sources: BBC NEWS: February 12,2007

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