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Health Quaries

Some Health Quaries & Answers

Mum’s milk, please   :-
Q: I had a caesarian for my first pregnancy. I plan such a delivery for my current pregnancy too. Last time I was unable to breast-feed the baby. I do not want that to happen again.

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A: If you are committed to breast-feeding, you will surely succeed. It does, however, take a little longer for the milk flow to become established after a caesarian. Ask for the baby and hold him or her as soon as possible after birth. Establish skin-to-skin contact and give the baby a chance to nuzzle at your breast. Try to breast-feed early and often. Take only non-sedating painkillers for the postoperative pain, because if you are drowsy you will not be able to hold the baby properly.

Violent child:-
Q: My 12-year-old son develops a blank stare and then starts to attack everyone around, beating and biting. Later he seems to have no recollection of what happened.

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A: Your son may be having seizures (epilepsy). Unfortunately, people associate seizures with violent movements of all four limbs and loss of consciousness. This is not the case. Seizures may take many forms and manifest themselves as repetitive, incomprehensible, unrecollected actions. Consult a neurologist who may advise an EEG to record the electrical signals from the brain. Seizures can be treated and controlled with proper medication.

Nodes in neck :-
Q: I developed swellings on the right side of my neck around two years ago. It was diagnosed as tuberculosis (TB). I underwent treatment as prescribed for four months. The swellings have reappeared. They are not painful. I am scared it might be cancer.

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A: TB is very common in India. Any part of the body can be affected. The nodes in the neck are frequently infected. The diagnosis is made with fine needle aspiration cytology, by taking a little fluid from the swelling with a syringe. The appearance of TB is fairly typical and very different from cancer. The infection usually requires short-term intensive chemotherapy for six months. In the first two months isoniazid, rifampicin, pyrazinamide and ethambutol or streptomycin is given, followed by isoniazid and rifampicin for the next four months. The rifamicin has to be taken first thing in the morning on an empty stomach. Not a single dose of medication can be missed. Some patients need to have the nodes removed surgically despite adequate medication. Also, you seem to have taken the medication only for four months instead of six. That may explain the recurrence.

Pain in scrotum :-
Q: I am 25 years old. I have pain in my scrotum on one side. I went to the doctor and he said it is “epididymitis”. He also asked a lot of questions about my sex life. Since I am not married I was embarrassed and did not go back.

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A: Epididymitis is common in young men between 20 and 40. It is caused by bacterial infections, TB or STDs (sexually transmitted diseases). It can occur after a urinary tract infection. That is the reason for the queries on your sex life. Depending on your answers, he needs to make a selection of antibiotics for treatment. The important thing is to take the entire course of antibiotic in the dosage prescribed.

Fit but fat :-
Q: I am very fit but everyone says I am fat. My weight is 88 kg. My height is 1.54m.

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A: Weight divided by height in metre squared should ideally be 23. Yours seems to be around 37. Though you may be fit and energetic, technically, you are obese. Unless you lose the extra weight, you are in danger of eventually developing other illnesses like diabetes, heart disease and arthritis.

Loosing weight is an uphill task. The important thing is persistence. You need to have a negative calorific balance to lose weight. Eat a diet of 1,500 calories. Exercise by walking for two hours a day. Do some yoga and other core strengthening exercises. This way, you will lose around 700 calories a day. To lose 1 kilo, you need a negative balance of 7,000 calories.

Anal fissure :-
Q: I developed recurrent painful swellings near my anal opening. They burst and now discharge pus. The doctor said it is a fissure and that I need surgery. Please advise.

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A: Fissures tend to recur because the drainage of the pus from the initial lesion is never complete unless the entire area is laid open surgically. Medicines (allopathy or homeopathy) will not cure the problem. Until a date is fixed for surgery, take sitz baths morning and evening. Make sure you are not constipated — eat four to five helpings of fruit and vegetables every day. Also take isabgol husk — two teaspoons dissolved in a glass of water — every night.

Source: Tne Telegraph  (Kolkata, India)

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Health Quaries

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.

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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.

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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.

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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.

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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.

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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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Ailmemts & Remedies

Nongonococcal Urethritis and Chlamydial Cervicitis

Nongonococcal urethritis and chlamydial cervicitis are sexually transmitted diseases caused by the bacterium Chlamydia trachomatis and various other microorganisms that produce inflammation of the urethra and cervix.

Several different microorganisms cause diseases that resemble gonorrhea. These microorganisms include Chlamydia trachomatis, Trichomonas vaginalis, and several different types of Mycoplasma. In the past, these microorganisms were hard for laboratories to identify, so the infections they caused were simply called “nongonococcal” to indicate that they were not caused by Neisseria gonorrhoeae, the bacterium that causes gonorrhea.

Chlamydia trachomatis infection (chlamydia) is very common, with 659,000 reported cases in the United States in 1999. Because the infection sometimes produces no symptoms, even more people may be affected. In men, chlamydia causes about half of the
urethral infections not caused by gonorrhea. Most of the remaining male urethral infections are caused by Ureaplasma urealyticum. In women, chlamydia accounts for virtually all of the pus-forming cervical infections not caused by gonorrhea. Both sexes may acquire gonorrhea and chlamydia at the same time.

CLICK & SEE THE PICTURES

Symptoms:
Many women remain symptom-free. if symptoms do occur, they may include:
·abnormal vaginal discharge.
·frequent urge to urinate.
·pain in the lower abdomen.
·pain on deep penetration during sex.

If left untreated, chlamydial cervicitis can sometimes lead to pelvic inflammatory disease, which is a major cause of infertility in women. If the infection enters the bloodstream, the disorder may lead to a form of arthritis.

Between 4 and 28 days after intercourse with an infected person, an infected man typically has a mild burning sensation in his urethra while urinating. A clear or cloudy discharge from the penis may be evident. The discharge is usually less thick than the discharge that occurs in gonorrhea. Early in the morning, the opening of the penis is often red and stuck together with dried secretions. Occasionally, the disease begins more dramatically. The man needs to urinate frequently, finds urinating painful, and has discharge of pus from the urethra.

Although most women infected with Chlamydia have few or no symptoms, some experience frequent urges to urinate and pain while urinating, pain in the lower abdomen, pain during sexual intercourse, and secretions of yellow mucus and pus from the vagina.
Anal infections may cause pain and a yellow discharge of pus and mucus.

Diagnosis:

In most cases, a doctor can diagnose chlamydia by examining discharge from the penis or cervix in a laboratory. Newer tests that amplify DNA or RNA, such as the polymerase chain reaction (PCR), enable a doctor to diagnose chlamydia or gonorrhea from a urine sample. These tests are recommended for screening of sexually active women between the ages of 15 and 25. Genital infections with Ureaplasma and Mycoplasma are not diagnosed specifically in routine medical settings, because culturing of these microorganisms is difficult and other techniques for diagnosis are expensive. The diagnosis of nongonococcal infections is often presumed if the person has characteristic symptoms and no evidence of gonorrhea.

If chlamydia is not treated, symptoms usually disappear in 4 weeks. However, an untreated infection can cause a number of complications. Untreated chlamydial cervicitis often ascends to the fallopian tubes (tubes that connect the ovaries to the uterus), where inflammation may cause pain and scarring. The scarring can cause infertility and ectopic pregnancy (see Pregnancy at High-Risk :Risk Factors That Develop During Pregnancy). These complications can occur in women without symptoms and result in considerable suffering and medical costs. In men, chlamydia may cause epididymitis, which produces painful swelling of the scrotum on one or both sides (see Penile and Testicular Disorders: Epididymitis and Epididymo-orchitis).

Whether Ureaplasma has a role in these complications is unclear.

Treatment:

Chlamydial and ureaplasmal infections are usually treated with tetracyclineSome Trade Names:

ACHROMYCIN V

TETRACYN

SUMYCIN

, doxycyclineSome Trade Names:

VIBRAMYCIN

, or levofloxacinSome Trade Names:

QUIXIN

LEVAQUIN

taken by mouth for at least 7 days or with a single dose of azithromycinSome Trade Names:

ZITHROMAX

taken by mouth. Because the symptoms are so similar to those of gonorrhea, doctors usually give an antibiotic such as:

ceftriaxoneSome Trade Names:

ROCEPHIN

to treat gonorrhea at the same time. Pregnant women are given erythromycinSome Trade Names:

E-MYCIN

ERYTHROCIN

ILOSONE

instead of tetracyclineSome Trade Names:

ACHROMYCIN V

TETRACYN

SUMYCIN

or doxycyclineSome Trade Names:

VIBRAMYCIN

. If symptoms persist or return, treatment is then repeated for a longer period.

Complications of Chlamydial and Ureaplasmal Infections :

In men  ……..   Infection of the epididymis

In women:………Narrowing (stricture) of the urethra

Infection of the fallopian tubes and linings of the pelvic cavity

Infection of the surface of the liver

In men and women:

Infection of the membranes of the eyes (conjunctivitis)
In newborns

Conjunctivitis

Pneumonia

Prevention & Precautions:

Infected people who have sexual intercourse before completing treatment may infect their partners. Also, partners who are infected may re-infect the treated person. Thus, sex partners are treated simultaneously if possible. The risk of a repeat infection of chlamydia or another STD within 3 to 4 months is high enough that screening may be repeated at that time.

Click to learn more about Chlamydia infection

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.merck.com/mmhe/sec17/ch200/ch200d.html
http://www.charak.com/DiseasePage.asp?thx=1&id=340