Tag Archives: Human papillomavirus

Torticollis

 

Alternative Names : Wry neck; Loxia

DEFINITION:
Torticollis is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.It is a stiff neck associated with muscle spasm, classically causing lateral flexion contracture of the cervical spine musculature. The muscles affected are principally those supplied by the spinal accessory nerve.

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Symptoms:
•Limited range of motion of the head
•Headache
•Head tremor
•Neck pain
•Shoulder is higher on one side of the body
•Stiffness of neck muscles
•Swelling of the neck muscles (possibly present at birth)

Types of Torticollis:

Temporary Torticollis: This type of wry neck usually disappears after one or two days. It can be caused by:

*swollen lymph nodes
*an ear infection
*a cold
*an injury to the head and neck that causes swelling

Fixed Torticollis:  Fixed torticollis is also called acute torticollis or permanent torticollis. It is usually due to a problem with muscle or bone structure.

Muscular Torticollis:
This is the most common type of fixed torticollis. It is caused by scarring or tight muscles on one side of the neck

Klippel-Feil Syndrome:
This is a congenital form of wry neck. It occurs when the bones in an infant’s neck have formed incorrectly. Children born with this condition may have difficulty with hearing and vision.

Cervical Dystonia:
This rare disorder is sometimes referred to as spasmodic torticollis. It causes neck muscles to contract in spasms. If you have cervical dystonia, your head twists or turns painfully to one side. It may also tilt forward or backward. Cervical dystonia sometimes goes away without treatment. However, there is a risk of recurrence.

This type of wry neck  or Torticollis can happen to anyone. However, it is most commonly diagnosed in middle age. It affects more women than men.

CAUSES:
Torticollis  can be inherited. It can also develop in the womb. This may happen if the fetus’ head is in the wrong position. It can also be caused by damage to the muscles or blood supply to the neck.

Anyone can develop wry neck after a muscle or nervous system injury. However, most of the time, the cause of wry neck is not known. This is called idiopathic torticollis.

DIAGNOSIS:
Evaluation of a child with torticollis begins with history taking to determine circumstances surrounding birth and any possibility of trauma or associated symptoms. Physical examination reveals decreased rotation and bending to the side opposite from the affected muscle. Some say that congenital cases more often involve the right side, but there is not complete agreement about this in published studies. Evaluation should include a thorough neurologic examination, and the possibility of associated conditions such as developmental dysplasia of the hip and clubfoot should be examined. Radiographs of the cervical spine should be obtained to rule out obvious bony abnormality, and MRI should be considered if there is concern about structural problems or other conditions.

Evaluation by an ophthalmologist should be considered in children to ensure that the torticollis is not caused by vision problems (IV cranial nerve palsy, nystagmus-associated “null position,” etc.). Most cases in infants respond well to physical therapy. Other causes should be treated as noted above.

TREATMENT:
Common treatments  might involve a multi-phase process:

1.Low-impact exercise to increase strong form neck stability
2.Manipulation of the neck by a chiropractor, physical therapist, or D.O.†
3.Extended heat application.
4.Repetitive shiatsu massage.

†An Osteopathic Physician (D.O.) may choose to use Cranial techniques to properly position the occipital condyles – thereby relieving compression of cranial nerve XI in children with Torticollis. This is an example of Osteopathic Manipulative Treatment.

Acquired torticollis:
Acquired torticollis occurs because of another problem and usually presents in previously normal children and adults…..

*A self-limiting spontaneously occurring form of torticollis with one or more painful neck muscles is by far the most common (‘stiff neck’) and will pass spontaneously in 1–4 weeks. Usually the sternocleidomastoid muscle or the trapezius muscle is involved. Sometimes draughts, colds or unusual postures are implicated; however in many cases no clear cause is found. These episodes are rarely seen by doctors other than a family physician.

*Trauma to the neck can cause atlantoaxial rotatory subluxation, in which the two vertebrae closest to the skull slide with respect to each other, tearing stabilizing ligaments; this condition is treated with traction to reduce the subluxation, followed by bracing or casting until the ligamentous injury heals.

*Tumors of the skull base (posterior fossa tumors) can compress the nerve supply to the neck and cause torticollis, and these problems must be treated surgically.

*Infections in the posterior pharynx can irritate the nerves supplying the neck muscles and cause torticollis, and these infections may be treated with antibiotics if they are not too severe, but could require surgical debridement in intractable cases.

*Ear infections and surgical removal of the adenoids can cause an entity known as Grisel’s syndrome, a subluxation of the upper cervical joints, mostly the atlantoaxial joint, due to inflammatory laxity of the ligaments caused by an infection. This bridge must either be broken through manipulation of the neck, or surgically resected.

*The use of certain drugs, such as antipsychotics, can cause torticollis.

*Antiemetics – Neuroleptic Class – Phenothiazines

There are many other rare causes of torticollis.

Spasmodic torticollis:
Torticollis with recurrent but transient contraction of the muscles of the neck and esp. of the sternocleidomastoid. “intermittent torticollis . “cervical dystonia”

TREATMENT: Botulinum toxin has been used to inhibit the spastic contractions of the affected muscles.

In animals:.CLICK & SEE
The condition can also occur in animals, usually as a result of an inner ear infection but sometimes as a result of an injury. It is seen largely in domestic rodents and rabbits, but may also appear in dogs and other different animals.

Possible ComplicationsComplications may include:

•Muscle swelling due to constant tension
•Neurological symptoms due to compressed nerve roots

Prognosis:
The condition may be easier to correct in infants and children. If the condition becomes chronic, numbness and tingling may develop as nerve roots become compressed in the neck.

The muscle itself may become large (hypertrophic) due to constant stimulation and exercise.

Botulinum toxin injections often provide substantial relief.

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/Torticollis
http://www.nlm.nih.gov/medlineplus/ency/article/000749.htm
http://www.umm.edu/imagepages/19090.htm

http://commons.wikimedia.org/wiki/File:Sternocleidomastoideus.png

http://www.healthline.com/health/torticollis#Causes2

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Human Papilloma Virus (HPV)

 

 

Definition:
HPV, short for Human Papillomavirus, is a group of over 100 different kinds of viruses, some of which cause warts on the hands and feet and others which cause genital warts and cervical cancer. This health guide is about the sexually transmitted types of HPV. If you are sexually active, or thinking about becoming sexually active, your best protection is to learn the facts about how HPV is spread and how to prevent getting it.
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HPV (Human Papillomavirus) is one of the most common sexually transmitted diseases. There are many different types of HPV and more than 30 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers, such as 6, 11, 16, and 18.

Some sexually transmitted HPV types may cause genital warts. Persistent infection with “high-risk” HPV types—different from the ones that cause skin warts—may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer. However, most infections with these types do not cause disease.

Some types (such as 6 and 11) cause genital warts, others (such as 16 and 18) cause pre-cancerous changes on the cervix that can later lead to cancer of the cervix. In rare cases, the virus can cause other types of cancers to the vulva, vagina, and anus in girls and the anus and penis in guys.

HPV is passed on through genital contact, usually during vaginal and anal sex, as well as during oral sex. People with weakened immune systems, such as those on chemotherapy or people with HIV are more susceptible to HPV infection.

At least 1 in every 2 sexually active young women has had a genital HPV infection. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. HPV is mainly spread by sexual contact. Very rarely, a mother who is infected with the HPV virus can infect her newborn baby during the delivery.

Symptoms:
It’s estimated that by the age of 27, most sexually active people have been exposed to some strain of HPV, usually without them knowing, and very rarely do doctors know which strain.

Most people with HPV don’t develop symptoms or further health problems, as in around 90 per cent of cases the body’s immune system has naturally cleared it within two years.

However, certain types of HPV (most commonly strains 6, 11, 16 and 18) can cause genital warts in men and women, while other HPV strains (especially 16, 18 and 39) can cause cellular changes that lead to cancer of the cervix and possibly other less common but serious cancers including:

 

•vulval cancer
•cancer of the vagina
•cancer of the penis
•anal cancer
•head and neck (tongue, tonsils and throat) cancers
It’s possible to have HPV present years after sexual contact with an infected person, and it’s also possible to be exposed to more than one strain of HPV.

There is currently no easy way to spot which people affected by HPV exposure will go on to develop cancer or other serious health problems.

Very rarely, a pregnant woman can pass HPV to her baby during birth and the child can develop recurrent respiratory papillomatosis – a chronic lung condition where growths block the airways.

Causes:
*The infected area of your body remains totally normal (called latent or inactive infection). You may never know about it, but you may give the infection to others. Your body then usually clears the infection.

*Bumps, called genital warts, can be seen in your genital area. They almost never lead to cancer.

*Changes in the cells of your cervix can result in an abnormal Pap test. Most of the time, if you are a teenager, your body will clear the HPV and the Pap test will become normal again over several years. However, sometimes the HPV infection persists in your cervix which can lead to cervical cancer. This is why your doctor will want to see you for follow-up visits if you have had an abnormal Pap test.

Risk Factors:
*You had sexual contact at an early age.

*Either you or your sexual partners have had many different sexual partners at any time.

*You or any of your sexual partners have had a history of sexually transmitted diseases.

*Any of your sexual partners did not wear a condom.

HPV and cancer risks:
We don’t fully understand the way in which HPV affects cells. Both high-risk and low-risk strains of HPV can cause the growth of abnormal cells, but only the high-risk types of HPV appear to lead to cancer.

Several types of cancer (up to five per cent worldwide), while linked to other risk factors, are now also associated with HPV exposure:

•cervical cancer (the most common HPV-associated cancer)
•vulval and vaginal cancer (40 to 70 per cent linked to HPV)
•penile cancer (possibly 40 per cent linked)
•anal cancer (around 85 per cent linked)
•cancers of the head and neck (although most are linked to tobacco and alcohol use, it’s now thought about 25 per cent of mouth and 35 per cent of throat cancers may be linked to HPV exposure (in particular HPV strain 16)

Diagnosis:
Sometimes it’s hard to know if you have HPV. Although genital warts are usually seen on, around, or inside your vagina or anus, they may be small and hard to see. And you may not have any symptoms such as pain or bleeding.

In March 2003, the U.S. Food and Drug Administration (FDA) approved a test manufactured by Qiagen, which is a “hybrid-capture” test, as the primary screening tool for detecting HPV cervical infection as an adjunct to Pap testing. The test may be performed during a routine Pap smear. It can detect the DNA of the 18 HPV types that most commonly affect the cervix and distinguish between “low” and “high-risk” HPV types, but it cannot determine the specific HPV types.

According to the National Cancer Institute, “testing samples of cervical cells is an effective way to identify high-risk types of HPV that may be present. The FDA has approved an HPV test as a follow-up for women who have an ambiguous Pap test and, for women over the age of 30, for general cervical cancer screening. This HPV test can identify at least 13 of the high-risk types of HPV associated with the development of cervical cancer. The test can detect high-risk types of HPV even before there are any conclusive visible changes to the cervical cells.”

The recent outcomes in the identification of molecular pathways involved in cervical cancer provide helpful information about novel bio- or oncogenic markers that allow monitoring of these essential molecular events in cytological smears, histological or cytological specimens. These bio- or onco- markers are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. E6 and E7 mRNA detection PreTect HPV-Proofer, (HPV OncoTect) or p16 cell-cycle protein levels are examples of these new molecular markers. According to published results these markers, which are highly sensitive and specific, allow to identify cells going through malignant transformation.

Other testing:
Although it is possible to test for HPV DNA in other kinds of infections, there are no FDA-approved tests for general screening in the United States or tests approved by the Canadian government, since the testing is inconclusive and considered medically unnecessary.

Genital warts are the only visible sign of low-risk genital HPV, and can be identified with a visual check. These visible growths, however, are the result of non-carcinogenic HPV types. 5% acetic acid (vinegar) is used to identify both warts and squamous intraepithelial neoplasia (SIL) lesions with limited success by causing abnormal tissue to appear white, but most doctors have found this technique helpful only in moist areas, such as the female genital tract. At this time, HPV test for males are only used in research.

Treatment:
There is currently no specific treatment for HPV infection. However, the viral infection, more often than not, clears by itself. According to the Centers for Disease Control and Prevention, the body’s immune system clears HPV naturally within two years for 90% of cases. However, experts do not agree on whether the virus is completely eliminated or reduced to undetectable levels, and it is difficult to know when it is contagious.

Health management is based on prevention, by advising condom use and vaccination.

There is treatment for some of the diseases that HPV can cause, including:

•Genital warts, which can be cauterised or treated chemically.
•Abnormal cervical cells, which can be removed by various techniques.

Treatments for genital warts range from acid medicines, to creams, to laser therapy. The treatment will remove visible warts and unwanted symptoms such as itchiness. The type of treatment your doctor recommends will depend on the number, location and size of the warts and the cost and side effects of the different treatments. It’s important to talk with your health care provider about treatment choices and what type of follow-up you will need. Tell your health care provider if you think you are pregnant so that the right therapy is chosen.

Do NOT use over-the-counter “wart medicine” on genital warts. (These medicines are not meant for the very sensitive skin around your genital area).

Prevention:
Condoms offer some protection against genital infection,  but any exposed skin can transmit the virus. In short, condoms are not 100% effective in preventing HPV. Genital HPV infection is the most frequent sexually transmitted disease in the world.

Vaccines:
Two vaccines are available to prevent infection by some HPV types: Gardasil, marketed by Merck, and Cervarix, marketed by GlaxoSmithKline. Both protect against initial infection with HPV types 16 and 18, which cause most of the HPV associated cancer cases. Gardasil also protects against HPV types 6 and 11, which cause 90% of genital warts.

The vaccines provide little benefit to women who have already been infected with HPV types 16 and 18—which includes most sexually active females. For this reason the vaccine is recommended primarily for those women who have not yet been exposed to HPV during sex. The World Health Organization position paper on HPV vaccination clearly outlines appropriate, cost-effective strategies for using HPV vaccine in public sector programs.

Both vaccines are delivered in three shots over six months. In most countries they are approved only for female use, but are approved for male use in countries like USA and UK. The vaccine does not have any therapeutic effect on existing HPV infections or cervical lesions.

Women should continue to seek cervical screening, such as Pap smear testing, even after receiving the vaccine. Cervical cancer screening recommendations have not changed for females who receive HPV vaccine. Without continued screening, the number of cervical cancers preventable by vaccination alone is less than the number of cervical cancers prevented by regular screening alone.

Both men and women are carriers of HPV. Possible benefits and efficacy of vaccinating men are being studied. According to a study by Harvard University Medical School, to vaccinate boys may not be cost effective, especially if a widespread vaccination of girls continues.

No efficacy trials for children under 15 have been performed. Duration of vaccine efficacy is not yet answered by rigorous methodologic trials. Cervarix efficacy is proven for 7.4 years with published data through 6.4 years while Gardasil efficacy is proven for 5 years. Age of vaccination is less important than the duration of efficacy.

Condoms:
The Centers for Disease Control and Prevention says that male “condom use may reduce the risk for genital human papillomavirus (HPV) infection” but provides a lesser degree of protection compared with other sexual transmitted diseases “because HPV also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom.”

Studies have suggested that regular condom use can effectively limit the ongoing persistence and spread of HPV to additional genital sites in individuals who are already infected. Thus, condom use reduces the risk that already infected individuals will progress to cervical cancer or develop genital warts.

Microbicides:
Ongoing research has suggested that several inexpensive chemicals might serve to block HPV transmission if applied to the genitals prior to sexual contact. These candidate agents, known as topical microbicides, are currently undergoing clinical efficacy testing. A recent study indicates that some sexual lubricant brands that use a gelling agent called carrageenan prevent papillomavirus infection in animal model systems. Clinical trial results announced at the 2010 International Papillomavirus Conference indicate that a carrageenan-based personal lubricant called Carraguard is effective for preventing HPV infection in women. The results suggest that use of carrageenan-based personal lubricant products, such as Divine No 9, Bioglide and Oceanus Carrageenan may likewise be effective for preventing HPV infection.

Oral infection:
A review of scientific studies in healthy subjects has found carcinogenic HPV in 3.5% of the studies subjects and HPV16 in 1.3%. Men have higher prevalence of oral HPV than women.

Oral HPV infection is associated with HPV-positive oropharyngeal cancer. Odds of oral HPV infection increases with the number of recent oral sex partners or open-mouthed kissing partners. Nonsexual oral infection through salivary or cross transmission is also plausible

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://www.bbc.co.uk/health/physical_health/conditions/hpv.shtml
http://www.youngwomenshealth.org/hpv.html
http://en.wikipedia.org/wiki/Human_papillomavirus

http://www.hivandhepatitis.com/recent/2009/060909_d.html

What are the health consequences of HPV

http://w-cancer.com/anal-cancer/

http://e-cervicalcancer.com/human-papilloma-virus-cervical-cancer/

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Vitamin D May Have The Best Results In Preventing Illnesses

Vitamin D, a powerful antioxidant, may have the strongest results when it comes to preventing diseases, according to an article published in the Journal of the American Medical Association.
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For example, a study found that men and women who had a high intake of vitamin D were less likely to suffer from high blood pressure, according to The Boston Globe. Another trial showed that high levels of vitamin D could help balance blood sugar levels, and lessen the risk of developing diabetes.

In another study, a total of 1,000 post-menopausal women were asked to take natural supplements that contained vitamin D and calcium. The researchers found that the participants had a much lower risk of being diagnosed with breast cancer, the news source reports.

While researchers across the country have found many benefits from a high intake of vitamin D, investigators conclude that further studies are necessary to rule out potential negative effects of the nutrient.

JoAnn Manson, a professor at Harvard Medical School, stated that “I do think vitamin D is one of the most promising nutrients for prevention of cardiac disease and cancer, and I believe in it strongly.” She added that “[however], the evidence is far from conclusive.”

In addition to being a potent antioxidant, vitamin D can also prevent bone density loss, osteoporosis, altered bone marrow cells and low bone mass.

Vitamin D… America’s Single Deadliest Deficiency…

Nine out of 10 Americans are deficient in vitamin D… the sunshine vitamin. And surprisingly, even people that spend plenty of time in the sun can still lack this vital inflammation fighter.

This is dangerous because inflammation is a major cause of heart and brain attacks… high blood pressure… joint pain… bone loss… digestive problems… blood sugar imbalances and a host of other serious health problems.

But the good news is: You can quickly restore healthy levels of vitamin D with Advanced D3 Plus™ from Health Resources™ and even REVERSE many of your most dangerous health problems.

But you must have the RIGHT kind of natural vitamin D combined with the best quality ingredients for optimum bone, heart and brain health. To find out more, Click Here… :http://www.healthresources.net/p-142-advanced-d3-plus.aspx

Source: BETTER Health Research 15th.JUL.2010

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Cancer Prevention

Cancer conjures up images of mutilating surgery, chemotherapy, radiation, years with doctors and in hospitals, and — most terrible — death. It comes in many avatars and can attack any part of the body. The risk factors for the ailment are many. It has been found to have associations with infections, lifestyle, genetic factors and heredity. If an injection is available to prevent cancer, it is hard to imagine anyone opting not to take it!

Viruses have long been known to cause infections that can progress to cancer. Previously, the association was suspected but not proven. Today, with electron microscopes, DNA sequencing and other advanced techniques, the association between certain viral infections and cancer has been conclusively proven. Of these, two types of cancer — of the cervix and some cancers of the liver — can be prevented with timely immunisation.a

The statistics speak for themselves. Cervical cancer (or cancer of the neck of the uterus) accounts for 25 per cent of all cancers in women. It is commoner than breast cancer (14 per cent). Around 1,30,000 cases are detected annually in India and half of these women eventually succumb to the disease.

Cervical cancer has long been associated with certain risk factors. It is more likely to occur if the woman smokes, does not have a healthy diet with plenty of fruits and vegetables, is exposed to multiple male sexual partners, has her first sexual contact before the age of 17 years, or has multiple pregnancies. A higher incidence is also noted if the woman has other sexually transmitted infections like Chlamydia or infection with HIV.

Recently, the association between infection with HPV (Human Papilloma Virus) and cervical cancer has been conclusively established. More than 95 per cent of the women with cervical cancer have evidence of HPV infection. Although 75 per cent of normal women have evidence of HPV infection, the virus persists and goes on to cause cancer in 5-10 per cent.

There are 130 identified types of HPV. Some cause infection but produce no symptoms like fever or pain, and are harmless. The patient may remain totally unaware of the infection. Other subtypes of HPV may cause warts on the skin. Around 30-40 types of the virus is transmitted through sexual contact. They may produce no symptoms when the infection first occurs. The virus can persist in the surface mucosa of the moist ano-genital areas. It can produce disfiguring warts in these areas. It can extend into the vaginal areas and cervix. Cancerous changes occur 20-30 years after the initial infection, when the woman is in her 40s and 50s.The progression depends on the type of virus and is more likely to occur if the infection occurred with the subtypes 15-20.

Once the association between cervical cancer and HPV was established, the scientific community got to work and produced a vaccine. It has been extensively studied and is now marketed in India by two companies under the trade names “Gardasil” and “Cervarix”. This is a major scientific breakthrough and cervical cancer can now be prevented in future generations of women.

The dosage schedule advised for HPV vaccine is as follows. The first dose is given between nine and 11 years of age. The second dose is administered two months later, and the third six months after that. No booster doses are advised at present. Women who have not been immunised can have the first dose at any time up to the age of 26 years. If they have already been exposed to HPV, the vaccine will only protect them against the strains to which they have not been exposed. Immunisation is not advised in pregnancy but can be given to breast-feeding mothers. Side effects are rare and include fever and rash.

For those of us who are older and have not had access to the vaccine, a screening test called “pap smear” (Papanicolaou test) can be done to detect cervical cancer in its early stages. The test is widely used and is effective. Screening should ideally be done three years after sexual activity has started and then continued every three years after that. Many Indian women do not have access to this test or are unaware of it.

Liver cancer and chronic liver disease can occur in people who develop hepatitis B infection. This too is a viral disease which is spread by contact with infected body fluids (blood transfusions, sexual intercourse). Infection can be prevented by three doses of hepatitis B vaccine. The second dose is given a month after the first and the third six months later.

Men and women should receive immunisation against Hepatitis B. At present, HPV vaccine is advised only for girls. Perhaps we have forgotten that women get the infection from their infected male partners, making a case for non-gender specific universal immunisation of all children.

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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