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Diagnonistic Test

Flexible Sigmoidoscopy

Flexible sigmoidoscopy (SIG-moy-DAH-skuh-pee) enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).

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CLICK & SEE

For the procedure, you will lie on your left side on the examining table. The physician will insert a short, flexible, lighted tube into your rectum and slowly guide it into your colon. The tube is called a sigmoidoscope (sig-MOY-duh-skope). The scope transmits an image of the inside of the rectum and colon, so the physician can carefully examine the lining of these organs. The scope also blows air into these organs, which inflates them and helps the physician see better.

If anything unusual is in your rectum or colon, like a polyp or inflamed tissue, the physician can remove a piece of it using instruments inserted into the scope. The physician will send that piece of tissue (biopsy) to the lab for testing.

Bleeding and puncture of the colon are possible complications of sigmoidoscopy. However, such complications are uncommon.

Flexible sigmoidoscopy takes 10 to 20 minutes. During the procedure, you might feel pressure and slight cramping in your lower abdomen. You will feel better afterward when the air leaves your colon.

Preparation

The colon and rectum must be completely empty for flexible sigmoidoscopy to be thorough and safe, so the physician will probably tell you to drink only clear liquids for 12 to 24 hours beforehand. A liquid diet means fat-free bouillon or broth, gelatin, strained fruit juice, water, plain coffee, plain tea, or diet soda. The night before or right before the procedure, you may also be given an enema, which is a liquid solution that washes out the intestines. Your physician may give you other special instructions.

Sources:http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm

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News on Health & Science

‘Ibuprofen Best’ for Child Fevers

Ibuprofen is better at alleviating childhood fever than paracetamol and should be the drug of first choice, say UK researchers.


Most symptoms of a fever in young children can be managed at home

The Bristol-based trial involving 156 children aged between six months and six years showed ibuprofen reduced temperature faster than paracetamol.

The British Medical Journal work also says alternating the two drugs could help, which some GPs already recommend.

But experts advised against this, in line with official guidance.

The concern is the relative ease with which children could receive an overdose.

Fever is very common in young children, affecting seven in every 10 preschool children each year. “Parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first”..Says Lead researcher, Dr Alastair Hay

It can be miserable for the child and cause anxiety for parents. Most fevers will settle by themselves but a few are caused by serious infections such as pneumonia.

Guidelines published last year by the National Institute for Health and Clinical Excellence (NICE) say either ibuprofen or paracetamol can be used for children unwell or distressed with fever.

But they say that, due to the lack of evidence, the two drugs should not be given together or alternated.

The researchers from the University of Bristol and the University of the West of England, recruited children who had a temperature between 37.8 and 41 degrees centigrade, due to an illness that could be managed at home.

Alternating drugs:

Children were randomised to receive either paracetamol plus ibuprofen, just paracetamol, or just ibuprofen.

The medicines were given over a 48-hour period, with the group of children on both paracetamol and ibuprofen receiving them as separate doses.

This group received one dose of paracetamol every four to six hours (maximum of four doses in 24 hours) and then one dose of ibuprofen every six to eight hours (maximum of three doses in 24 hours).

The children’s condition was followed up at 24 hours, 48 hours and at day five.

The researchers found that in the first four hours children given both medicines spent 55 minutes less time with fever compared to those given paracetamol alone.

But giving two medicines was not markedly better than just giving ibuprofen.

However, over a 24 hour period, children given both medicines experienced 4.4 hours less time with fever than those given just paracetamol, and 2.5 hours less time with fever than those just given ibuprofen.

Safety issues:

Childhood fever :-

*A normal temperature is between 36-36.8C (96.8-98.24F)

*In children, any temperature of 38C (100.4F) or above is considered high and is called a fever

*To find out if your child has a fever, place a thermometer under your child’s armpit or use a special ear thermometer

Dr Alastair Hay, consultant senior lecturer in primary health care at the University of Bristol, who led the study, said: “Doctors, nurses, pharmacists and parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first.

“If more sustained symptom control over a 24-hour period is wanted, giving both medicines alternately is better than giving one on its own.

“However, parents should keep a careful record of when doses are given to avoid accidentally giving too much.”

He said he thought it would be appropriate for NICE to review its guidance in light of the new study, saying the current guidance was too cautious.

In an accompanying editorial in the BMJ, Dr Anthony Harnden from the University of Oxford, warned of the relative ease with which children could receive an overdose.

He said that a “more complicated alternating regimen of paracetamol and ibuprofen may be less safe than using either drug alone”.

A spokeswoman for NICE said the 2007 guidance recommended that more research should be conducted on the effectiveness and safety of alternating doses of paracetamol and ibuprofen in reducing fever in children who remain febrile after the first fever-reducing medicine.

She said: “Any newly published research will need to be thoroughly assessed by independent experts as part of the process of updating clinical guidelines.

“This is essential to ensure that any new evidence is of the highest standards before any potential updates can be made to existing guidance.”

Professor Steve Fields, chairman of the Royal College of General Practitioners, advised parents and carers of children with fever to follow the NICE guidance.

“We believe parents should keep it simple. We do not see at this moment any need to change the advice.

“However, this paper does demonstrate that using ibuprofen initially is more effective at reducing temperature and may demonstrate that using both ibuprofen and paracetamol together could have a positive effect.”

“We believe parents should keep it simple. We do not see at this moment any need to change the advice ” … Says Professor Steve Fields, chairman of the Royal College of General Practitioners

Sources: BBC NEWS: 2nd. Sept.’08

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Key To Way Stomach Expands Found

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Scientists believe they may have found a potential new way to treat obesity by stopping the stomach from expanding….CLICK & SEE

…….The stomach expands to accommodate the food we eat

They have identified two cell proteins that relax the gut and help accommodate a big meal.

In theory, a drug which blocked this relaxation would reduce a person’s ability and desire to gorge on excessive amounts of food.

The University College London study appears in the Journal of Pharmacology and Experimental Therapeutics.

The two proteins identified by the researchers P2Y1 and P2Y11 – control both fast and slow relaxations of the gut.

The human stomach has a “resting” internal volume of 75 millilitres, but by relaxing its muscular wall can expand to an internal volume of two litres or more.

This expansion is controlled by nerves inside the stomach wall which release molecules that stimulate P2Y1 and P2Y11, which are embedded in muscle cells, also in the gut wall.

New approach :

Researcher Dr Brian King said: “The mechanism of slow relaxation of the stomach might represent a future drug target in the fight to control weight gain and reverse obesity.

“We are looking to identify drugs that would block the P2Y11 receptor and, therefore, prevent slow relaxation of the stomach.

“As a result of blocking the P2Y11-based mechanism, meal size would be smaller, offering the person a better chance of regulating their food intake.”

Dr King said this would represent a new approach to weight control.

At present, gastric banding or stomach stapling are used to reduce the maximum volume of the stomach.

But these are tricky surgical procedures, and carry a risk of serious side effects.

Dr Ian Campbell, medical director of the charity Weight Concern, agreed that an alternative treatment for obesity would be useful.

He said major surgery such as gastric banding was expensive and risky, and although current drugs that focused on appetite suppression, or on reducing fat absorption by the body did work, their long term effects remained unclear.

“We still have much to learn about the complex way we control our appetite, and food intake,” he said.

“For many the use of medication can be an important help towards their weight loss goals, but lifestyle change remains the best way of controlling weight.”

Click to see:->Weight Concern and National Obesity Forum

Sources: BBC NEWS:3rd.March.’08

Categories
Health Problems & Solutions

Few Health Questions and Answers

 

Q: Regarding weaning food. Many varieties are available in the market. What do you recommend I start with?

Weaning can begin with simple preparations like powdered rice cooked in water and milk with a little sugar .

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A: Weaning should not be started till at least the 120th day. The World Health Organization (WHO) recommends breastfeeding exclusively for six months. Homemade preparations are superior to the packaged, ready-to-eat premixes available in the market. You could begin with powdered rice cooked in water and milk with a little sugar and no salt. The consistency should be like that of breast milk. Start with one feed, gradually increasing the number after a week or so.

Careful dosage :
Q: How is the dosage of medicine for children calculated? My mother says I can give my daughter, aged seven, half a tablet of the usual adult medicines.

A: Dosage of medicine for children has to be carefully calculated based on the body weight; it is not a matter of giving one tablet to an older child and half to a smaller one!

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In case of Paracetamol, the dosage is 10-15 mg/kg/dose every 4-6 hours. For many antibiotics, it is 20 or 40 mg/kg/day while for others it is 8 mg/kg/dose. Consult a paediatrician who will weigh the child and assign the dosage appropriately. Do not self-medicate.

Unlatching baby
Q: My baby sucks so hard at my breast that I am unable to pull his mouth loose when needed. Please advise....click & see

A: Pulling yourself backwards or trying to pry the child loose will not work. Instead, insert your little finger into the corner of his mouth to reduce the suction effect. His mouth can then be pried loose.

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Master check-up
Q: I am a 50-year-old woman. I want to have a master health check-up. What tests should I ask for?

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A:
You need the following tests in addition to the regular ones offered as part of the check-up

Get your weight and height measured to calculate your Body Mass Index (BMI). This should be between 25 and 27. A high BMI indicates obesity and places you at risk for diabetes, hypertension, arthritis, osteoporosis and cancer

Blood tests to screen for diabetes, cholesterol and triglycerides

A bone densitometry if you are post menopausal

A pap smear for cervical cancer

Breast evaluation by mammogram and monthly self-examination

Dental check-up

Eye check-up

The normal values are usually noted on the side. If any of your results are not in the normal range, please follow it up with the concerned consultant. If the follow-up of check-up is not done adequately, your money is wasted.

Facial hair
Q: I am a 23-year-old woman. My problem is that I have a moustache. I think it was there earlier but of late it has become very noticeable. My mother says I should leave it alone. However, I feel self-conscious. What should I do?

A: Please check with an endocrinologist/dermatologist/gynaecologist if you have other associated symptoms like menstrual irregularities or more-than-normal hair on your arms and legs. In the meanwhile, you can always go to a beauty parlour and have the hair on your upper lip removed by threading or waxing. Hair-removing creams can cause allergies. Also, please avoid shaving.

Foul odor

Q: I have terrible body odor in summer. Please help.

A: Perspiration is odourless. The smell arises due to the action of skin bacteria on the sweat. To avoid this .

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Wear cotton clothes which will allow the sweat to evaporate and not trap it inside

Bathe twice a day with Neko soap. The bacterial cell wall is destroyed by this soap

Do not apply the soap directly. Use a loofa or wash rag

Avoid talcum powder

Use a deodorant stick or spray.

Nagging cough
Q: I have diabetes and hypertension. Both are well controlled with diet and medication. I have a terrible hacking cough though. I have seen several doctors but to no avail   all they have done is take X-rays and prescribe antibiotics. I do not have fever or sputum so I don’t think I need these antibiotics.

A: Some anti-hypertensive medications cause cough. You can try adding Vitamin C 500 mg at night to your current medication. Also, you can take a cough suppressant like codeine linctus. Avoid exposure to allergens such as incense sticks, cigarette smoke and mosquito repellents (mats, coils as well as liquids). Take steam inhalation twice a day.

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Tummy trouble

Q: My stomach sticks out, making me look very ugly. Will a tummy trimmer work?

A: Spot reduction of the stomach alone is not possible unless you opt for liposuction. You need to go on a diet, exercise and reduce weight overall. In the process, you can also tone up your stomach with crunches or a trimmer.

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Answered by :Dr Gita Mathai ,paediatrician with a family practice at Vellore.India

Published in the Telegraph (Kolkata,India)

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