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Ailmemts & Remedies

Bone Cancer

Definition:
Cancer that starts in a bone is rare.Bone cancer can begin in any bone in the body, but it most commonly affects the long bones that make up the arms and legs.

Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

Some types of bone cancer occur primarily in children, while others affect mostly adults.

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Bone cancer also doesn’t include blood cell cancers, such as multiple myeloma and leukemia, that begin in the bone marrow — the jelly-like material inside the bone where blood cells are made.

Symptoms:
The symptoms of bone cancer depend where the tumour grows (about half occur in or near the knee). By the time a lump or swelling is detectable, the cancer may have been present for some time. (Swelling and tenderness near the affected area)

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Pain, especially at night, is a common problem and may cause a limp if the leg is affected, because weight-bearing is uncomfortable or the cancer interferes with the way the joints work.

There may also be generalised symptoms such as weight loss, sweats, fever and lethargy , tiredness or fatigue. Sometimes, bone cancer is discovered incidentally – when an x-ray is taken after an accident, for example – or occasionally when the bone breaks due to weakness caused by the cancer.

Weakened bones, sometimes leading to fractures.

Causes:
It’s not clear what causes most bone cancers. Doctors know bone cancer begins as an error in a cell’s DNA. The error tells the cell to grow and divide in an uncontrolled way. These cells go on living, rather than dying at a set time. The accumulating mutated cells form a mass (tumor) that can invade nearby structures or spread to other areas of the body.

Unlike most cancers, bone cancer tends to affect the young. Osteosarcoma usually appears in children and young adults, while Ewing’s sarcoma is most common between the ages of 10 and 20.

Other risk factors include:

•Previous radiotherapy treatment, especially at a young age. Some chemotherapy drugs also increase the risk of osteosarcoma
•As many as one in eight people who develop a tumour of the eye will go on to develop an osteosarcoma, possibly because of a genetic susceptibility to both conditions and the additional effect of anti-cancer treatments
•Genetic conditions linked to bone tumours including Li-Fraumeni syndrome, HME, inherited breast cancer and congenital umbilical hernia (Ewing’s sarcoma is three times more common in children with this condition)
•Paget’s disease, a bone disease that generally occurs in older people and increases the risk of osteosarcoma, as does another bone condition called chondroma
•Bone cancer has often been linked to injuries to a limb, but it’s questionable and may simply be that the injury draws attention to a tumour that was already growing

Diagnosis:
Imaging tests :-
What imaging tests you undergo depends on your situation. Your doctor may recommend one or more imaging tests to evaluate the area of concern, including:

*Bone scan
*Computerized tomography (CT)
*Magnetic resonance imaging (MRI)
*Positron emission tomography (PET)
*X-ray
Removing a sample of tissue for laboratory testing
Your doctor may recommend a procedure to remove (biopsy) a sample of tissue from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. Testing may also reveal the cancer’s grade, which helps doctors understand how aggressive the cancer may be.

Types of biopsy procedures used to diagnose bone cancer include:

*Inserting a needle through your skin and into a tumor. During a needle biopsy, your doctor inserts a thin needle through your skin and guides it into the tumor. The needle is used to remove small pieces of tissue from the tumor.

*Surgery to remove a tissue sample for testing. During a surgical biopsy, your doctor makes an incision through your skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incisional biopsy).

Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won’t interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to an appropriate surgeon before your biopsy.

Tests to determine the extent (stage) of the bone cancer
Once your doctor diagnoses your bone cancer, he or she works to determine the extent (stage) of your cancer. The cancer’s stage guides your treatment options.

Stages of bone cancer include:

*Stage I. At this stage, bone cancer is limited to the bone and hasn’t spread to other areas of the body. After biopsy testing, cancer at this stage is considered low grade and is not considered aggressive.

*Stage II. This stage of bone cancer is limited to the bone and hasn’t spread to other areas of the body. But biopsy testing reveals the bone cancer is high grade and is considered aggressive.

*Stage III. At this stage, bone cancer occurs in two or more places on the same bone.

*Stage IV. This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.

Treatment:
The treatment options for your bone cancer are based on the type of cancer you have, the stage of the cancer, how far it has spread, your overall health and your preferences. Bone cancer treatment typically involves surgery, chemotherapy, radiation or a combination of treatments.

Bone cancer that hasn’t spread outside the bone may be treated with surgery and may not require chemotherapy. More abnormal bone cancer that has spread will be more difficult to treat, and chemotherapy as well as surgery is usually recommended.

In general, treatment of bone cancer has a good outlook, especially if it’s in the early stages and can be completed during surgery. About two-thirds of people with primary bone cancer can be cured. But if the cancer is more advanced or has spread, the prognosis may not be so good, with five-year survival rates of only 10-20 per cent. It’s vital that you talk to your specialist to get a picture of how successful treatment is likely to be in your individual case.

Treatment usually consists of surgery often combined with chemotherapy to shrink the tumour and make it less likely to recur. Because surgery involves removing bone, it can be quite drastic. Where possible, the surgeon will try to replace the diseased bone with a graft of bone from elsewhere in the body or an implant, but sometimes amputation is necessary.

Some bone cancers, such as Ewing’s sarcoma, respond well to chemotherapy and other treatments such as radiotherapy.

Newer biological therapies based on natural body chemicals such as interferon are also being used. These may work, for example, by encouraging the body’s immune system to attack the cancer cells. A number of different research trials are looking at different combinations of these treatments in an effort to improve results.

After initial treatment, regular follow-ups are essential to check for recurrences and to manage the consequences of treatment, such as the use of an artificial limb.

You may click to see:-
*Bone and Tissue Transplantation
*Bone Sarcoma in the Upper Extremity
*Ewing’s Family of Tumors (PDQ)…(Also available in Spanish)

*Osteosarcoma/Malignant Fibrous Histiocytoma of Bone (PDQ) …..(Also available in Spanish)

*Surgical Management of Cancer that Spreads to the Bone

*Vertebroplasty and Kyphoplasty

Prevention, Genetics, Causes:-
Information related to prevention, genetics, and risk factors:

Understanding Gene Testing

Search: Cancer Genetics Services Directory

Cancer Genetics Overview
[ health professional ]

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/in_depth/cancer/typescancer_bone.shtml
http://www.mayoclinic.com/health/bone-cancer/DS00520/DSECTION=treatments-and-drugs

http://www.cancer.gov/cancertopics/types/bone

http://bone-cancer-symptoms.org/

http://www.beltina.org/health-dictionary/bone-cancer-symptoms-prognosis-treatment-survival-rate-primary-metastatic.html

Pain In Bones? Fear For Bone Cancer!

http://www.cancersymptomspage.com/bone-cancer-symptoms.html

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Health Problems & Solutions

Some Health Quaries & Answers

Stop the bottle, spare the teeth  :

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Q: My three and a half-year-old daughter has a poor appetite. She is only 10 kg while the expected weight is 15 kg (as per the pediatrician’s calculation). The doctor prescribed de-worming medication several times as well as tonics. I give her milk with Pediasure in a bottle at night. She has several decayed teeth and frequently complains of toothache.

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A: Your daughter probably has caries. The bottle will worsen her cavities because the milk will stick to the teeth which will allow bacteria to thrive in her mouth. These milk teeth will eventually fall off and you may feel they do not require any treatment. But food will get stuck there and cause discomfort. This will make her reluctant to eat, resulting in inadequate weight gain. Also, she is old enough to discard the bottle. You are probably giving it to her in the hope that she receives some calories. Stop the bottle and take her to a dentist. He might be able to fill the cavities.

Hiatus hernia
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Q: I have heart burn all the time. After some tests the doctor found that I have hiatus hernia. What should I do?
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A: The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth to the stomach.The esophagus passes through the diaphragm just before it meets the stomach, through an opening called the esophageal hiatus.

 

A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.


Hiatus hernia is a condition where part of the stomach slides into the chest cavity. Many hiatus hernias are asymptomatic. Pain occurs because of acid reflux from the stomach into the esophagus.

You can get relief by losing weight, not lying down for an hour after food, and using medications like omeprazole and pantoprazole. If the hiatus hernia is long-standing with severe symptoms, surgery may be required.

Sugar free
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Q: I am diabetic and have been taking Sugar Free in my coffee, tea and curd. Is it safe?
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A: There are many natural and synthetic sugar substitutes available. In India, the ones commonly used are saccharin and aspartame. Both have been certified as safe although initially saccharin was found to cause bladder cancer in mice. Aspartame consumption should not be more than 40 mg a day. In these circumstances, perhaps it is better for you to get used to tea and coffee without sugar.

Vital fluid
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Q: I am a 37-year-old woman. I am pale and the doctor said I am anaemic. My haemoglobin is 7gm. He gave me a capsule containing iron and zinc to be taken twice a day. After three months there has been no improvement. What should I do?

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A: Your anaemia needs to be investigated. You may be losing blood because of heavy periods, piles or a stomach ulcer. Or you may have intestinal parasites that are depleting you of blood. Rarely, cancer may present itself as anaemia. If there is no cause for the anaemia other than iron and zinc deficiency, it should respond to supplements. The binding sites on the intestines for iron and zinc absorption are identical. If you consume a tablet containing both these elements they compete for the binding site and block it. To be effective, iron and zinc have to be taken as separate tablets or capsules 12 hours apart (one in the morning and the other in the evening). Or, you take iron one day and zinc the next.

Health hour
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Q: My son is unable to run or jog owing to a tight work schedule. Can he follow some other form of exercise?

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A: The requirements of exercise for the maintenance of health have increased from 30 minutes three times a week to an hour a day. If you son is unable to spare that kind of time, he can get more or less the same benefits by skipping or continuous stair climbing (up and down) for 20 minutes. Cross training and doing different activities probably deliver the best benefits as compared to repeating the same one. Different sets of muscles are used, producing all-round toning.

Source: The Telegraph ( Kolkata, India)

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Ailmemts & Remedies Pediatric

Biliary Atresia

DEfinition:
Biliary atresia is a rare condition in newborn infants in which the common bile duct(that carry a liquid called bile from the liver to the gallbladder) between the liver and the small intestine is blocked or absent. If unrecognized, the condition leads to liver failure — but not kernicterus, as the liver is still able to conjugate bilirubin, and conjugated bilirubin is unable to cross the blood-brain barrier. The cause of the condition is unknown. The only effective treatments are certain surgeries such as the kasai procedure, or liver transplantation.

.….You may click to see the picture

Biliary atresia is a very rare disorder. About one in 10,000 to 20,000 babies in the U.S are affected every year. Biliary atresia seems to affect girls slightly more often than boys. Within the same family, it is common for only one child in a pair of twins or only one child within the same family to have it. Asians and African-Americans are affected more frequently than Caucasians. There does not appear to be any link to medications or immunizations given immediately before or during pregnancy.

This is now effective surgery which can relieve symptoms in most cases. Liver transplant is also an option, and as a result, survival rates are now above 90 per cent.

Causes & b Risk Factors:
Biliary atresia is due to a progressive fibrosis or scarring of the bile ducts responsible for draining bile from the liver, which eventually leads to atresia or loss of the biliary system. It’s not clear how or why this occurs, and many factors may be involved. It may be due to a problem in the developing embryo (10 to 20 per cent – other congenital abnormalities may also be present) or around the time of birth or shortly afterwards (80 to 90 per cent). It occurs more often in Asian and African-American newborns than Caucasian.

Bile is made by the liver and helps with the digestion of fats. If bile is not removed from the liver, it builds up and begins to damage it. The baby will then develop jaundice, or a yellow colour of the skin as levels of the bile chemical bilirubin rise in the blood. Other symptoms include dark coloured urine and pale stools. Many newborn babies become jaundiced but this is usually temporary. Jaundice lasting for longer than 14 days, especially if there are other symptoms such as an enlarged liver or failure to thrive, is a worrying sign and must be investigated further.

Pathophysiology:
There is no known cause of biliary atresia. There have been many theories about ethiopathogenesis such as Reovirus 3 infection, congenital malformation, congenital CMV infection, autoimmune theory. This means that the etiology and pathogenesis of biliary atresia are largely unknown. However, there have been extensive studies about the pathogenesis and proper management of progressive liver fibrosis, which is arguably one of the most important aspects of biliary atresia patients. As the biliary tract cannot transport bile to the intestine, bile is retained in the liver (known as stasis) and results in cirrhosis of the liver. Proliferation of the small bile ductules occur, and peribiliary fibroblasts become activated. These “reactive” biliary epithelial cells in cholestasis, unlike normal condition, produce and secrete various cytokines such as CCL-2 or MCP-1, Tumor necrosis factor (TNF), Interleukin-6 (IL-6), TGF-beta, Endothelin (ET), and nitric oxide (NO). Among these, TGF-beta is the most important profibrogenic cytokine that can be seen in liver fibrosis in chronic cholestasis. During the chronic activation of biliary epithelium and progressive fibrosis, afflicted patients eventually show signs and symptoms of portal hypertension (esophagogastric varix bleeding, hypersplenism, hepatorenal syndrome(HRS), hepatopulmonary syndrome(HPS)). The latter two syndromes are essentially caused by systemic mediators that maintain the body within the hyperdynamic states. There are three main types of extrahepatic biliary atresia:- Type I: atresia restricted to the common bile duct. Type II: atresia of the common hepatic duct. Type III: atresia of the right and left hepatic duct. Associated anomalies include, in about 20% cases, cardiac lesions, polysplenia, situs inversus, absent vena cava and a preduodenal portal vein.

Symptoms:
Newborns with this condition may appear normal at birth. However, jaundice (a yellow color to the skin and mucous membranes) develops by the second or third week of life. The infant may gain weight normally for the first month, but then will lose weight and become irritable, and have worsening jaundice.

Other symptoms may include:

•Dark urine
•Enlarged spleen
•Floating stools
•Foul-smelling stools
•Pale or clay-colored stools
•Slow growth
•Slow or no weight gain

Diagnosis:
The health care provider will perform a physical exam, which includes feeling the patient’s belly area. The doctor may feel an enlarged liver.

Tests to diagnose biliary atresia include:

•Abdominal x-ray
•Abdominal ultrasound to examine the liver and bile ducts
•A blood test to look for raised levels of bilirubin and check liver enzyme levels and blood clotting
•Hepatobiliary iminodiacetic acid (HIDA) scan, also called cholescintigraphy, to help determine whether the bile ducts and gallbladder are working properly
•Liver biopsy to determine the severity of cirrhosis or to rule out other causes of jaundice
•An abdominal x-ray to look for an enlarged liver and spleen
•X-ray of the bile ducts (cholangiogram)
•An scan to determine how well bile is flowing (HIDA or TEBIDA)

Treatment :
TreatmentIf the intrahepatic biliary tree is unaffected, surgical reconstruction of the extrahepatic biliary tract is possible. This surgery is called a Kasai procedure (after the Japanese surgeon who developed the surgery, Dr. Morio Kasai) or hepatoportoenterostomy.

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If the atresia is complete, liver transplantation is the only option(currently has a greater than 95 per cent survival rate at one year). Timely Kasai portoenterostomy (e.g. < 60 postnatal days) has shown better outcomes. Nevertheless, a considerable number of the patients, even if Kasai portoenterostomy has been successful, eventually undergo liver transplantation within a couple of years after Kasai portoenterostomy.

Recent large volume studies from Davenport et al. (Ann Surg, 2008) show that age of the patient is not an absolute clinical factor affecting the prognosis. In the latter study, influence of age differs according to the disease etiology—i.e., whether isolated BA, BASM (BA with splenic malformation ), or CBA(cystic biliary atresia).

It is widely accepted that corticosteroid treatment after a Kasai operation, with or without choleretics and antibiotics, has a beneficial effect on the postoperative bile flow and can clear the jaundice; but the dosing and duration of the ideal steroid protocol have been controversial (“blast dose” vs. “high dose” vs. “low dose”). Furthermore, it has been observed in many retrospective longitudinal studies that steroid does not prolong survival of the native liver or transplant-free survival. Davenport at al. also showed (hepatology 2007) that short-term low-dose steroid therapy following a Kasai operation has no effect on the mid- and long-term prognosis of biliary atresia patients.

Prognosis:
Early surgery will improve the survival of more than a third of babies with this condition. The long-term benefit of liver transplant is not yet known, but is expected to improve survival.

Possible Complications:
•Infection
•Irreversible cirrhosis
•Liver failure
•Surgical complications, including failure of the Kasai procedure

Prevention:
The earlier biliary atresia is detected, the less damage it will have done to the liver and the better the chance of a successful outcome to treatment. The current target is to treat babies before they are eight weeks old.

If the liver has not yet been damaged by cirrhosis, the condition is usually treated through an operation called a Kasai portoenterostomy (or a similar procedure). This involves using a loop of bowel to form a duct to drain the bile from the liver. The operation is named after the Japanese surgeon, Professor Morio Kasai, who developed it in 1959. It was first introduced in the UK in the 1960s.

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/biliary_atresia.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001145.htm
http://en.wikipedia.org/wiki/Biliary_atresia

http://www.mikylah.com/pictures.html

http://www.chw.health.nsw.gov.au/parents/factsheets/biliary_atresia.htm

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Ailmemts & Remedies

Anal Stenosis

Definition:
Anal stenosis refers to a narrowing of the anal opening, which makes it difficult for stool contents to pass through easily. Symptomatic children tend to be particularly colicky babies, because of the discomfort associated with the stool backing up. The stool may exit under pressure and look almost like a squirt gun. Treatment of this disorder usually involves gentle dilation of the anal opening. This is typically done twice a day. Every week a slightly larger lubricated dilator is passed to stretch the anus until it reaches normal size. In very mild cases, softening the stool may be sufficient until the anus grows sufficiently. Suppositories can make the child comfortable in the short run, but do run the risk of dependence. At around 4 months, apple or even prune juice may help the child to pass stool. Rarely, surgery is needed to insure an opening of adequate caliber. If this is an isolated anomaly, the prognosis is excellent.

You may click to see the picture
Some children are born with no anal opening at all. This is called an imperforate anus. The rectum ends in a blind pouch, about 2 cm inside the perianal skin. Usually the sphincters are well developed. For these children, a colostomy is indicated during the newborn period, but once the final surgery corrects the defect, the prognosis is likewise excellent.

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The most frequent anorectal defect seen in boys is the recto-urethral fistula, or a communication between the rectum and the lower part of the urethra. These children also require a colostomy before the definitive repair period. The long term prognosis for normal urethral and rectal function is good.

Scar formation after perianal fistulae, trauma, severe anal sac disease, or treatment for neoplasia may result in a reduced lumen and particularly a loss of the capacity to dilate with passage of feces. Straining, passage of ribbon-like feces and constipation result.

Symptoms
The restriction of the anal canal prevents the normal expulsion of faeces, resulting in difficulty and pain when trying to open the bowels, and leading to constipation. Babies may also experience pain when trying to open their bowels.

click to see the pictures

Causes and risk factors:
Anal stenosis may be present from birth, when it might be accompanied by malformations of the anal opening. This happens in one in several thousand births.

Sometimes the opening appears further forward than normal. In girls, it’s usually immediately behind or inside the female genitalia. In boys, there may be no obvious opening at all or just a small area of bulging skin or a tiny channel under the skin.

More commonly, stenosis develops as a result of scarring from a tiny fissure, or crack, in the anal canal. This is usually the reason why adults develop anal stenosis, but it can also occur in babies.

Anal stenosis may also develop after surgery to the anus, for example after the removal of piles or haemorrhoidectomy.

Treatment and recovery:
Low-risk treatments:

Laxatives, suppositories and other treatments are used to help loosen motions and lubricate the anal canal, to make it easier to empty the bowels. There’s little risk the person affected will come to any harm from these treatments if they’re used as prescribed and only for a matter of months while the problem settles. (It must be remembered that the risks are considerably less than those that might occur if the affected person becomes very constipated).

One solution to this problem is to simply insert a plastic tube known appropriately as an “anoscope” and relieve the obstruction. ..You may click to see the  picture.

Individuals suffering from anal stenosis aren’t likely to become dependent on the laxatives and suppositories.

However, its also important to make dietary changes (such as plenty of raw fruit and vegetables to provide natural fibre, and plenty of fluid to avoid dehydration) in order to keep the motions soft. Regular exercise also helps keep a regular bowel habit.

Surgical treatments:
In mild cases, gentle and gradual dilation by the regular passage of normal motions may be enough. But quite often surgery is needed, especially in more severe cases. The surgical treatment of anal stenosis depends on the extent of the problem. In most cases all that’s needed is for the anal canal to be stretched. Often this can be done by the doctor in the hospital clinic, without the need for anaesthetic.

If the stenosis is severe, dilation may performed under anaesthesia. More major surgery is only needed if the anal canal needs reconstructing or (in small children with congenital anal stenosis) it needs repositioning or there are other malformations that require surgery.

You may click to see:Recent Colorectal Surgery Articles  :

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.drgreene.com/qa/anal-stenosis-and-anorectal-malformations
http://medical-dictionary.thefreedictionary.com/anal+stenosis
http://meded.ucsd.edu/clinicalimg/gu_anal_stenosis.htm
http://www.yourerdoc.com/anal-stenosis/

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Health Problems & Solutions

Some Health Quaries & Answers

I want to shed weight fast :
Q: I am getting married in a month’s time and want to lose weight fast. I have to shed six kilos. How do I do that?

A: Crash diets work for short lengths of time, but they aren’t healthy and shouldn’t be continued indefinitely. If you follow a balanced diet of 1,200 calories (60 per cent from carbohydrates, 30 per cent from proteins and 10 per cent from fat), you will have a daily deficit of 800 calories. Once you lose 3,500 calories, you would have lost around half a kilogram of body weight. This means you will lose 3.5kg in a month. Try to combine this with 40 minutes of aerobic activity. That’s a deficit of another 200 calories. The exercise will help develop muscle tone so you don’t have a sagging, aged and unhealthy appearance after the hard gained weight loss.

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Hip surgery:

Q: I have severe pain in my right hip, so much so that I can’t bend. This makes it difficult for me to sit, squat or even walk. I went to an orthopaedic surgeon who advised hip replacement surgery. At 78, I am nervous.

A: Generally, non-surgical treatment with pain relieving medication and physiotherapy is first recommended to reduce hip joint pain, improve joint function and increase the range of movement. Replacement is performed when these have failed. Senior citizens with osteoarthritis who undergo total hip replacement are able to care for themselves, thereby improving the quality of life. Studies have shown that though it is an expensive and invasive process, it is safe. There’s no age limit for hip replacement surgery.

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No rice

Q: I don’t like rice, but am told it’s necessary and without it my health will suffer. Please advise.

A: Basically, 60 per cent of your calorific requirement needs to come from carbohydrates. Rice and other grains aren’t the only source of carbohydrates — they are also found in nuts, dairy products, fruits and vegetables. If you dislike rice, you can switch to wheat or oats. In Western countries, people hardly eat rice yet are healthy.

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Self medication:
Q: I had high fever. I went to a pharmacy and purchased some tablets recommended by the man behind the counter. I now have redness in the groin and armpit, itching and redness in the corners of my mouth. Could this be an allergy?

A: It could be an allergy. Maybe some of the tablets you took were antibiotics. They may have changed your normal bacterial flora so that there is now an overgrowth of a fungus called Candida. You may also have precipitated a vitamin B deficiency. See a doctor to find out what exactly it is. You can then receive appropriate treatment.

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Stretch marks:
Q: I was suffering from polycystic ovarian syndrome for the last two years. I consulted an endocrinologist who suggested regular exercise with medication. Now I have recovered. But I still have reddish marks on my lower abdomen. The doctor had said they would disappear with recovery.

A: The reddish marks on your abdomen are called stretch marks. They develop because of damage to the underlying layers of skin with rapid weight gain. They can be prevented to some extent with regular oiling. Coconut oil, olive oil, baby oils, vitamin E and aloe vera have all been used with some degree of success. Once the marks have developed, oils and creams work slowly over a prolonged period of time.

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Surgical removal can be done with laser treatment, dermal ablation or tummy tucks. This is faster and more successful.

Immunity against tetanus

Q: I want to know about the tetanus vaccine and treatment for the disease. If I take a tetanus toxoid vaccine, how many weeks of immunity would it give? I’ve heard there’s a schedule of three doses (for adults) that gives immunity for three years. Please give me the timetable. If one is afflicted with tetanus, is there any life saving treatment?

A: Tetanus immunisation is provided free by the government to all children. It is given as a combined vaccine with those for diphtheria, pertussis and polio. Three doses are given in the first year and boosters at one, one and a half, five, 10 and 16 years. Pregnant women who have been immunised in childhood are given two doses in their first pregnancy. After the immunisation is complete — that is, up to 16 years — a booster needs to be taken once in 10 years.

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Tetanus is caused by a bacterium called Clostridium tetani, which is found in the human intestine and soil. Once it causes an infection, it releases a poison that binds to the nervous tissue. Spasms of the muscles occur, making it difficult for the patient to swallow or breathe. This can eventually result in death. Individuals have survived with aggressive treatment with artificial muscle paralysis and ventilators for breathing.

Source: The Telegraph ( Kolkata, India)

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