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Showing posts with label Medical Helth Care-General. Show all posts
Showing posts with label Medical Helth Care-General. Show all posts

Saturday, January 2, 2010

TETRALOGY OF FALLOT

It is a congenital disorder.It occurs as a result of developmental anomaly.The heart wont be able to function normally due to lack of it’s proper functional structures.


Tetralogy of FALLOT is characterized by obstruction to the right ventricular outflow,hypertrophy of right ventricle,ventricular septal defect and dextroposition of aorta with septal override.

CLINICAL MANIFESTATIONS:-

It depends on the degree to which right ventricle is obstructed,time of onset of symptoms and degree of cyanosis.Cyanosis(bluish colour on lips,oral cavity,face) may be present or absent at birth.It precipitates usually by one year.The other clinical manifestations are clubbing,dyspnea(difficulty to breath)on exertion,squatting at times of attack.Cyanotic attacks precipitate as the child becomes active in his later stages of life and lasts for minutes to hours.The growth of the child will be delayed.The associated symptoms are convulsions,restlessness,hyperpenic,gasping respiration,hypoxia and acidosis.It lasts for minutes to hours.

On examination the heart beat will be normal.On x ray examination a concavity can be seen on the left heart border and elevation of heart border.

Major Complications are:-

Cyanotic spells,cerebral thrombosis,brain abcess,infection of the heart wall with bacteria,Congestive cardiac failure.

TREATMENT:-

Treatment is done by a systematic approach.Severe obstruction to the outflow of right ventricle is treated to increase pulmonary blood flow by keeping pulmonary duct by administration of PGE1 and this is a temporary measure till surgery.In less severe cases,medical management is by prevention and prompt treatment of dehydration.oral propanolol administration.

CYANOTIC SPELL is managed by eeiping the patient in a knee-chest positon,administering oxygen and glucose,morphine .2mg/kg,propanolol I.V 0.1mg/kg,correction of acidosis.

Complications like brain absess is treated by administration of antibiotics for 6 weeks,polycytemia by adequate hydration,phlebotomy and volume replacement,bacterial endocarditis by administration of antibiotics for 6 weeks.

SURGICAL MANAGEMENT:-

1.PALLIATIVE PROCEDURE:-decrease hypoxia,improves growth,augments pulmonary artery growth and increae pulmonary artery blood flow.

2.CORRECTIVE SURGERY:-Often aimed at curing.The patient can lead a near normal life.It is performed in early infancy.

Tuesday, December 29, 2009

MANAGEMENT OF DIABETES

It is a chronic metablic disorder charactersied by hyperglycemia with or withour glucosuria resulting from an absolute or relative deficiency of insulin.


The major clinical features of diabetes are:-Non healing ulcers,unexplained weight loss,recurrent respiratory or urinary tract infections,onset of cataract before 50 years,loss of sensations in the periphery,impotence in young males,history of overweight babies and recurrent fetal loss in women,recurrent infections like moniliasis,balanoposthitis and vulvitis,premature onset of stroke,heart disease and valvular occlusions,any vague ill health.

Diabetic patient is adviced to keep a check on his/her lifestyle,take oral anti-diabetic agents and insulin if indicated.

DIET AND LIFESTYLE:-It is the starting point and mainstay treatment in 1 and 2 type diabetes mellitus.It is also helpful in reducing weight in obese patients,to improve glycemic control and to reduce chronic vascular diseases like hyperlipedimia and hypertension.

CALORIE REQUIREMENT:-It is the basic requirement of the body which is about 20-25kcal/kg of desirable body weight.Additional energy required for sedentary persons is 30kcal/kg,for moderate working persons about 40kcal/kg and for people with strenuous lifestyle about 50kcal/kg.We will get 45-60% of total calories from carbohydrates,<35%from fats and 10-15% from proteins.

CARBOHYDRATES:-The major strategies to be followed in carbohydrate uptake are

1.maintain a regular intake of carbohydrate in meals throughout the day.

2.Avoidiing refined carbohydrates

3.Restriction of total intake of carbohydrates.

5.Taking food with low glycemic index.eg:-whole grain food,legumes,fruits,nuts,barley,oats.They cause only a slow gradual rise in blood glucose.



FAT:-Take saturated fat < 10%,monounsaturated fat 10-20%.eg:-- oils made from olive , groundnut .They help to reduce total & LDL cholesterol without reduction in HDL.Polyunsaturated fat <10% helps to reduce total, LDL & HDL cholesterol.w3 fatty acids can be taken once or twice weakly.eg:-mackerals, sardines.



WEIGHT MANAGEMENT:-Reducing energy intake,increasing energy expenditure through physical activity and regular exercise in the form of walking,swimming,cycling for approximately 30 minutes daily improves insulin sensitivity,lipid profile and lowers B.P.Alchohol intake in moderate amounts along with a meal is advisable.Quitting smoking,salt restriction to 6gmm/d-3gm/d in hypertensives is advisable.The patients must intake low calorie,sugar free drinks and foods.Avoid biscuits,cake and take nuts and fruits instead.Eat regular meals avoiding fried and sugary food.Eating plenty of vegetables,whole fruits and limit consumption of animal products like red meat,eggs,liver,high fat diary products.Replace those foods with lean meat,fish,poultry(without skin),low fat diary products.Patients must not overeat in any occasions.

TREATMENT:-Tretement by terapy with insulin secretogogues like suphonylureas,meglitinides and Insulin sensitizers like metformin,thiazolidinediones.

Liver decreases glucose output.Drugs like metformin,thiazolidinediones also do the same action.Pancreas increases insulin secretion and suplhonylureas and meglitinides are used to aid pancreas in insulin secretion.Peripheral glucose uptake is increased by metformin.Alpha gucosidase inhibitors are used to delay glucose absorption.Thaizolidinediones help in increasing insulin sensitivity.

SULPHONYLUREAS:-They are used to treat non-obese patients when lifestyle modification alone doesn’t work.The major limitations are hypoglycemia and weight gain.

METFORMIN:-They are used to treat diabetes in diabetic patients.Their action is synergestic with sulphonylureas and insulin.The major limitations are impaired hepatic/renal function,alcoholic shock and hypoxia.

THAIZOLIDINEDIONES:-Used to treat patients with severe insulin resisitance(abdominal abesity).The major limitations are liver dysfunction,salt and water retention and these drugs are avoided in cardiac failure.

INCRETINS:-Oral glucose ingestion induces the release of GLP-1 which is a gut hormone.It amplify glucose induced insulin release.It suppresses glucagon secretion and improve PP hyperglycemia.It also delays gastric emptying.EXENATIDE is a GLP-1 receptor agonist.S.C.injection twice a day 60 mins before breakfast and dinner is iadvised for type 2 DM patients.Adding Sulphonylureas or metformin further reduces B.glucose.The effects of this drug are weight loss,nausea and hypoglycemia.

PRAMLINTIDE:-Synthetic analogue of islet amyloid polypeptide.It delays gastric emptying,suppress glucagon secretion and decrease appetite.Subcutaneous injection immediately befor meal is done for type 1 and insulin treated type type 2 Diabetes mellitus patients.The effects of this drug are initial weight loss,nausea and hypoglycemia.

INSULIN:-It is advised for patients with type1 Diabetes mellitus,pregnancy induced diabetes,OHA failure,A/C disease atate and surgery.

TYPES OF INSULIN are :-

1.Rapid acting(lispro,aspart)

2.short acting(soluble/regular)

3.Intermediate acting(Lente insulin)

4.Long acting(ultralente)

5.Long acting insulin analogues(glargine,detemir)

ROUTES OF INSULIN DELIVERY:-Insulin is deliverd by means of a syringe/pen.It is delivered subcutaneously to anterior abdominal wall,upper arms,upper thigh,buttocks.

The rate of absorption of insulin depends upon the site,depth,volume,warmth,local message and exercise.Other routes of drug delivery are intra muscular,Intra venous,peritoneal,intrapulmonary.it is also deliverd through continuous S.C or I.V infusion.SIDE EFFECTS of insulin are-hypoglycemia,weight gain,peripheral oedema,insulin antibodies,lipodystrophy,local allergy and phenomena like somogyi,DAWN phenomenon.

The major golas of therapy are maintain glucose level at a range of 90-130,peak post pandrial plasma glucose at <180 and HbA1C<7.

The patient can keep himself completely free from the complications and panic of diabetes by follwing the below mentioned steps.

1.Check HbA1C level 2-4 times/year.

2.Eye check up annually.

3.Foot examination 1-2 times/year by a physician,and daily by the patient.

4.B.P check up quarterly.

5.Lipid profile annually.

6.Educating the patient by giving proper guidance.

FIBROMYALGIA

It is a syndrome of widespread chronic muscular pain and tender joints without any definable musculoskeletal pathology.Patient may complain with a pain either axial pain with severe pain in the axial spine and in atleast two contralateral sides or a chronic pain for atleast 3 months duration with tender points(patient may have physical humps which are in the size of a grain upto the size of an apple) of more than 11 out of 18 total tender points.Associated symptoms are fatigue,disturbed sleep,depression,anxiety.There are other associations with this disease like irritable bowel syndrome and chronic fatigue.


The etiology of this disease is unknown.It is defined in psychiatry as an abnormal sensitivity to pain.Cognitive therapy and therapy with analgesics like diclofenac sodium are often advised.

There is no specific treatment for this condition.The treatment will not be beneficial for the patient.The patient need not find any improvement in his condition.The patient may be counseled instead,advising him to live with it and avoiding unnecessary further drug treatment and investigations.

Sunday, December 27, 2009

ENTERIC FEVER

                                                    ENTERIC FEVER

EPIDEMIOLOGY:-


It is an endemic disease caused by salmonella enterica.Transmitted by ingestion of contaminated food water or milk.Natural reservoir of the microorganism is humans.It transmits over congenitally and by intrapartum means.

Convalescent carriers-excrete salmonella for 3 months after the illness.Period of communicability is as long as bacteria is present in the exctreta.The disease spreads rapidly in hot summer months,over crowding,breakdown in safe water supply and sewage disposal.

PATHOGENESIS:-

Risk increases with increase in inoculum size,stomatch acidity,possession of Vi antigen.The microorganism invade peyers patches,then get transported to intestinal lymph nodes,multiply inside monocytes and gets carries to mesenteric lymph nodes.Macrophages then engulf bacteria and gets carried away alng with it to blood stream through thoracic duct which eventually causes primary bacteremia.Results in onset of fever.The microorganism spread to liver,spleen and bone moarrow causing more complications.It multiplies in liver and spleen and release antigens causing secondary bacteremia.

CLINICAL MANIFESTATIONS:-

Incubation period is 7-14days.Its less common under 2 years.It has got a gradual onset.Fever is of step ladder pattern and it is continuous generally.Patient suffers rapid increase in fver,headache and vomiting.Constipation,diarrhea and abdominal pain may also occur.Tongue will get a white coat at the center and clear at margins.Patient may have bradycardia.Typhoid rash appears on 6th day.Appears in crops called as rose spots for a few hours and fade on pressure.On second and 3rd week abdomen gets distended with a tympanic resonance.Splenomegaly of about 1-2 cm.The patient will be in a typhoid state which is characterized by dull sensorum,apathy,stupor,muttering delirium,pick at clothes.For school aged children and adolescents,initial symptoms are fever,malaise,anorexia,myalgia,headache and abdominal pain develop over 2-3days.Dirrhoea have a pea soup consisitency.Constipation becomes a prominent symptom later.Cough and epistaxis are also symptomatic.

In 2nd week of illness major symptoms are-high fever,fatigue,cough,abdominal symptoms and severe lethargy.PHYSICAL FINDINGS-a relative bradycardia disproportionate to fever.In 50% subjects,macular or maculopapular rash measuring 1-5mm appears.Rose spots appear on 7th-10th day.The lesions are slightly raised and blanch on pressure.10-15 lesions appear on the lower chest and abdomen and lats for 2-3 days.They lave a brown discolouration.

IN INFANTS-this disease is not so common.Mild fever and malaise with diarrhoea accompaniying are the symptoms.

All fever more than 7 days,low heart rate,blood tinged fecal matter all points to this disease.

THERAPY DEPENDS UPON-age,health sattus,serotype,and complications.Mortality if untreated is 10%.The disease recurs in 10-20% subjects.Typhoid is treated by using antibilocs,analgesics.

Thursday, September 3, 2009

Cancer

What is Cancer?

There are many kinds of cancer - Acute Lymphoblastic Leukemia and Medulloblastoma and Vulvar cancer - just to mention a few examples. But, all of these malignancies have something in common.

Loss of Control

Each individual cell in your body is regulated by hormones like Atrial-natriuretic peptide and Renin from outside the cell and some other chemicals inside the cells. These substances will control the actions of the cell. They will pass on to the cells when to grow and how much, how active they should be and how they should interact with other cells.

Cancer cells have those controls shut off. They act without limit. They are constantly active at their highest activity. They also lose their ability to work with their neighboring cells and then can move away and metastasize.

Changes in DNA

All malignant tumors have lost their controls because the DNA in the cell has been damaged. DNA is the chemical programming inside the cell that marks out all of its activities. That DNA is damaged by being broken, nuclear radiation or free radicals. It will start to act out of control. Viruses have also been shown to cause the DNA damage leading to a cancerous tumor.

Damaged DNA can also be inherited. That DNA can change a cell into a cancer if there is either some trigger that the cell contacts or another spot on the DNA that receives damage.

Immortal Cells

The cells normally will only live a certain amount of time and then die (with some exceptions). They will then be replaced by new healthy cells. Cancer cells don't usually die. Even if they are extremely abnormal, they keep on dividing. Then those cells produce tumors and spread.

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There will be good days and bad, which means that some days I may be cranky and some days really cranky! - Memo to Peter Jenning's staff announcing that he had been diagnosed with lung cancer. (April 2005)

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Types of Cancer

All of those types of cancer can be grouped into five common types. Those are Central nervous system cancers, Leukemia, Carcinoma, Sarcoma as well as Lymphoma and Myeloma.

Central nervous system cancers - these are cancer tumors that start in the brain and spinal cord. Leukemia - these cancers start in the tissues that produce blood - such as the bone marrow - and then release the cells into the blood. Carcinoma - these are cancers that start in the skin or the tissues that line internal organs. Sarcoma - Sarcomas are cancer tumors that start in connective tissue. Connective tissue is the tissue between the organs and other structures. Those tissues include things like fat, bone, muscle, blood vessels and cartilage. Lymphoma and myeloma - these cancers start in the cells that normally protect the body - the immune system.

Now that you know what a cancer is, you can learn how to possibly prevent it, or if needed how to treat it.

The Cancer Prevention Diet

The Cancer Prevention Diet

You may know how painful it is to die from Kaposi Sarcoma or Pharyngeal Cancer. That is true, but there is good news.

Oncologists have known for lots of years that diet can help you avoid disease. In fact, it is now thought that about 34% of all cancer is associated with your diet. And it has also been shown that diet can reduce your chances of getting cancer.

Nutrients in some food can decrease your chance of cancer. You can also improve your chances of not getting cancer by avoiding some foods. You might have to cut out the Cheese Flavoured Moments and Torba cheese.

The Power of Fruits and Vegetables

Fruits (like Plum and Jaboticaba (Myrciaria cauliflora; Myrtaceae) and Durian (Durio spp.; Bombacaceae) and Lychee (Litchi chinensis; Sapindaceae) and Sapodilla (Achras/Manilkara zapota; Sapotaceae) and Santol (Sandoricum koetjape; Meliaceae)) and vegetables are proven to help prevent many types of cancer including cancer of the lung and colon. Currently, it is unknown if there are any specific nutrients in the fruits and vegetables that provide the protection. There have been experiments on some of the nutrients found in fruits and vegetables like beta-carotene. However, isolating these substances from the original source have not been found to prevent cancer. In fact, some by themselves are found to be harmful. So remember - the whole fruit is many times better than some supplement taken from that food.

So, you should eat at least one serving of a fruit or vegetable with each meal. They can be fresh, canned or dried. But, they should not be fried like chips.

Whole Grains Keep You Moving

Whole grains like fonio brown rice, cracked wheat and corn on the cob are excellent sources of vitamins, minerals and fiber. These are well known to help prevent colon cancer. Although fiber is very important, just using a fiber supplement is not as effective because you don't get the other nutrients.

Oncologists think that the increased fiber helps to keep the stool in the bowel moving smoothly. This prevents slow passage in the colon. That being said, there is no evidence that laxatives or any colon cleansing regimen is of any help. In fact they have often been shown to be harmful.

Foods to Avoid

Red meat has been shown to be a culprit of especially colon cancer and cancer of the prostate. The current recommendation is that you make sure to limit the amount you eat to less than three ounces a day. Cutting it out altogether is even better.

Any food high in fat will have much the same effect. All of those onion rings and corn chips that you have been eating? Well, they may contribute to your chance of growing a cancer.

And now another bit of bad news for some of you, alcohol is another culprit. The latest research shows that any alcohol can increase your chance of getting cancer. But, it is especially dangerous if you order up more than two drinks a day for men and one for women. Sorry ladies. Alcohol along with cigarettes contribute to cancer of the mouth, esophagus and larynx (your voice box). So, be sure you limit those Stouts and Krupniks.

The Four Rules of Diet

1. Choose most of the foods you eat from plant sources.

2. Limit your intake of high-fat foods, particularly from animal sources.

3. Get moving: Achieve and maintain a healthy weight. Ok. So this one is not directly diet related - except that you should cut down to what you need to keep your weight at a good level.

4. Cut back on the alcohol, if you drink at all.

Use these tips and you will dramatically decrease your chances of getting diet related cancer.

Malignant melanoma

Melanocytes are the cells that produce melanin. Melanin gives dark or tan color to the skin. But, when one of these cells gets out of control, it can produce one of the most dangerous cancers known. And more than 52,2929 people are told that they have malignant melanoma every year just inside the United States.

Causes of Melanoma

The most common risk factor for malignant melanoma known is over exposure to ultraviolet rays. When melanoma was first studied, it was found that people who had jobs outside were those who tended to show up with melanoma. Furthermore, people who had gotten a sunburn that caused blisters were those who tended to go on to get a malignant melanoma.

People with fair skin are much more likely to get malignant melanoma. This may be due to the fact that they are more likely to get skin damage by sun exposure. But, this is not a hard and fast fact.

Those who have lots of nevi (moles) are at higher risk for malignant melanoma, particularly those who have over 50. Also, those with a particular type of mole called a dysplastic nevus are at higher risk.

Some people have had other skin cancers successfully treated including squamous cell carcinoma. Those people are more likely to get melanoma.

If you have had other family members that had melanoma, then you are more likely to get a melanoma as well.

Finally, those who have a problem with their immune system get malignant melanomas more frequently. Whether a person has AIDS, an organ transplant needing medications to curtail the immune system or others using those medications, that person will have a higher risk.

There was one case that showed the role of genetics in melanoma. A man who was a chimera got melanoma. A chimera is someone who has different parts of the body having two different sets of DNA. This apparently happens when twins are formed and somehow join into one body. This man had large metastatic lumps of melanoma tumors on one side of his body and none at all on the other!

How to Identify a Malignant Melanoma

The only way to be sure whether a bump on your skin is a melanoma or not is to have your doctor take it off and get it studied by a pathologist. However, there are some ways to know if you should be suspicious of one of those lumps or bumps.

Uneven Border - A melanoma will typically have an irregular border. The average mole has a sharp border. You can point to any spot on your skin and say for sure whether it is part of the mole or not. This is not the case with melanoma.

Assymetric Shape - The melanoma lesions typically have two halves that don't look like mirror images.

Different Color - Malignant Melanomas often will have different parts of the tumor that have different colors.

Size - most melanomas are larger than other moles. And they also tend to grow and may bleed or itch.

If you have a supicious lesion that you are not sure about, get it examined by your doctor early. Getting that tumor removed early gives you a much better chance of a cure. Especially if the bump is still tiny.

Pipe Collecting

Pipe Collecting

Introduction

The historic use of pipes to smoke goes back to about 500 B.C. The Native Americans introduced pipe smoking to the Europeans around the 16th century, and the habit spread quickly.

Pipes have been created from all sorts of material, but the most commonly were carved from briar wood. Since the pipe was initially implemented by the Europeans, pipes have been made of oak, mesquite, cherrywood, corncobs, and clay. Pipes made from glass are not well suited for smoking tobacco but some people do use them. A pipe consists of two parts; the bowl designed for burning the tobacco and a hollow mouthpiece that allows the smoke to be drawn into the mouth.

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Divine in hookas, glorious in a pipe When tipp'd with amber, mellow, rich, and ripe;... Yet thy true lovers more admire by far Thy naked beauties - give me a cigar! ~George Gordon, Lord Byron, The Island



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Why Collect Pipes?

There is a nearly limitless mixture of designs and materials that make up a pipe. Some of these pipes have been very carefully designed and etched with beautiful busts of heads of people like Enrico Fermi and Norman Mailer, shapes of animals and other creatures like the American Moose and the Nene Goose and the Hummingbirds. You might even find one with the mythical Aitvaras or the Surma or the Inkanyamba or the Hag.

Most collectors are interested in the intricate design, or a certain shape, or the unusual length and curvature of the various pipes. That makes an excellent reason to start a collection of them. The age of the pipe as well as the complexity of the design, the material that the pipe is made from, and the quality are what collectors look for. Many pipes in people's private collections are worth a lot of money.

The Varieties of Pipes

The variety of the different types of pipes are nearly unbelievable. They are made in numerous shapes, sizes, and designs. Pipes may be made from one type of wood and combined to another type of material. An example would be a bowl made from erica arborea and a metal stem, or corncob or meerschaum connected with a reed stem.

Conclusions

whatever type of pipe you are thinking about collecting, whether you are collecting pipes from certain time periods, or certain designs, maybe you do not even have a theme for your pipe collection. Maybe you are just collecting unusual pipes of any type, your collection will not disappoint you. Pipes are something to treasure, and in the long run will be a valuable investment, if that is what you choose to do.

Chemicals in Tobacco.

Chemicals in Tobacco.

Pipe-smokers spend so much time cleaning, filling and fooling with their pipes, they don't have time to get into mischief. Bill Vaughan

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One way to help make things easier to stop smoking would be to check out the chemistry of tobacco. Of all of the deaths that occur each year, over 400,00 could have been avoided if the deceased didn't smoke cigarettes. You should do some research into what exactly is contained in that smoke prior to lighting up.

The tobacco industry is one of the largest and riches businesses in the world. Previously, various media depicted those who smoked as being cool. Once there was a direct link between cancer and tobacco use smoking began to be frowned on in the movies. Unfortunately, the addiction to cigarettes already happened.. Nicotine, a major component of tobacco's make-up, is more habit-forming than heroin. Tobacco companies have often used improved tobacco flavor as a reason for toxic additiives.

One study has linked hydrogen peroxide in cigarette smoke is the cause of lung cancer. Tobacco smoke contains more than four thousand chemical compounds, including forty-three chemicals proven to cause cancer. There are over 200 poisonous chemicals found in the chemisty of tobacco. The scary list of chemicals traveling through your blood stream and into your lungs include a deadly mixture of formaldehyde, arsenic, ammonia, carbon monoxide, methanol, and hydrogen cyanide.

In a recent, US survey adult men and women smokers were asked about serious health risk from tobacco use. The majority of those who participated smoked one pack of cigarettes daily and had been smoking since they were sixteen. With all the efforts to educate people on the dangers of smoking, the results were alarming. Even though smokers believe the connection between smoking and cancer, they think it will happen to someone else. As many as forty percent of smokers feel that heredity plays more of a factor in lung cancer than smoking does. One third of people who smoke feel that they can counter act harmful side effects with vitamins and excercise.

Tobacco use is a serious health risk and qiutting can be hard, know there is nicotine patches and gum to help you quit the habit. If you are struggling with chemical dependency, then ask for support. The chemistry of tobacco is a fight for your life.

The History of Tobacco.

The History of Tobacco.

Tobacco has years and even centuries of use, even though it's been an issue that people around the world have had differing points of view about. You should check out the history of the tobacco plant if you'd like to know more about tobacco, as it can give you context on its present use.

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My smoking might be bothering you, but it's killing me. Colette

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My smoking might be bothering you, but it's killing me. Colette

Origins

Tobacco comes from North America, and it was in wide use by the tribes that lived here long before European settlers showed up. In these days, tobacco was used for a variety of things. While serving for many ritual uses, it is also considered a good for trading. Due to the fact that tobacco could be smoked, chewed, or turned into a juice and drank, it had a great deal of currency as something with which to seal deals, and also for use in religious rituals. Several North American peoples believed that tobacco was a gift from the Creator and that the smoke was a way to convey thoughts and prayers to the divine forces.

Recreational Uses

When the European settlers first came to the new world during the 1500s, tobacco was quickly imported to Europe and quickly caught on as a new fad.

Several Native American groups believed that tobacco had been given to them by the Creator as a gift; the smoke was a vehicle by which prayers could be conveyed to the heavens. The growth of tobacco as a cash crop helped spur the immigration to the new world, and in the South, it was one of the major crops of the day.

The harvesting of tobacco had a hand in the proliferation of African slave labor, and by the 1600s, tobacco was being grown quite regularly and quite reliably. Since for a lingering it was an advantageous and known as brown gold.

Tobacco's Purpose

Tobacco has served a variety of purposes and needs throughout history. Of course, modern people are familiar with its use in cigarettes, where dried tobacco is smoked, but you'll find that it is also used as a moist powder known as snus, which can deliver the same feelings as smoking a cigarette would. It can be used as snuff and in a chewing tobacco format for fun, however you can get tobacco water, used for pesticides and paste, it's uses include treating insect bites.

Hypertension in Pregnancy

Hypertension in Pregnancy

Hypertension in pregnancy is the most likely problem to happen during your pregnancy. In fact two to three percent pregnant women have Hypertension in pregnancy.

Tina Chapman of Mesquite had Hypertension in pregnancy during her fourth pregnancy. She found out on her second doctor visit.

As she found out, first pregnancy, a family history of preeclampsia in a first-degree relative, being a member of a black race, a history of preeclampsia, and time since your last pregnancy of less than 2 years or more than 10 years increase the chances to have Hypertension in pregnancy.

Other risk factors for Hypertension in pregnancy are chronic hypertension, thrombophilia, systemic lupus erythematosus and obesity.

Hypertension in pregnancy might not cause any symptoms. But, it can cause visual disturbances like scintillations (flashes of light) and scotomata (blind spots) - probably from spasm of cerebral arteries, upper abdominal pain from swelling and inflammation of the liver, headache and rapid weight gain. Upper abdominal pain might suddenly occur and is usually constant and fairly severe. Headaches are often in the front, throbbing and similar to migrane headaches.

The big problem of Hypertension in pregnancy is that it can cause thromboembolism (blood clots), fluid on the lungs, protein in the urine and even death of the mother. In fact, from 1991 to 1999 over 15% of the deaths of women during pregnancy were caused by Hypertension in pregnancy.

There are three types of Hypertension in pregnancy: Chronic Hypertension, Preeclampsia and Transient hypertension.

Chronic Hypertension

Usually chronic hypertension has no other cause. However, it can be caused by kidney disease like polycystic kidneys, glomerular or interstitial disease, coarctation of the aorta, too much growth hormone, hormone problems such as adrenocorticosteroid or mineralocorticoid excess, pheochromocytoma, hyperthyroidism or hypothyroidism or even using oral contraceptives.

Preeclampsia

Nobody knows for sure what causes preeclampsia. One thing that we know is that it is caused by a problem with the inside lining of the blood vessels. This causes the blood vessels to spasm. When the arteries get smaller, the blood pressure increases. The damage also causes the blood vessels to leak causing swelling. It can cause problems with the brain, lungs and kidneys. These changes also can cause lower blood flow to the growing baby.

Transient hypertension

The elevated blood pressure called transient hypertension just happens late in pregnancy. Then after delivery, the blood pressure goes back to normal. But, it probably increases your chances of getting high blood pressure later in life.

Hypertension in pregnancy is one of the major reasons that you should keep your regular appointments with your OB-Gyn doctor.

Hypertension Causes, Prevention and Treatment

Hypertension Causes, Prevention and Treatment

Gabriel Phillips of Palmdale couldn't believe it. Dr. Ramos at the Palmdale East Clinic broke the bad news. He had hypertension.

Gabriel had a good excuse. After all, as a salesman in Quantum Chemical, he certainly had his share of stress. And, let's not even talk about the cigar.

According to Dr. Ramos just being male was a factor. The fact that he was 49 years old certainly didn't help.

Unfortunately, hypertension rarely causes any symptoms until it has caused some significant damage. In fact, arterial hypertension can be markedly high before there are any symptoms.

Your arterial blood pressure goes up and down throughout the day. If you do some skateboarding your pressure will go up. Even if you just see a stimulating scene on your DVD you will see a rise in your arterial blood pressure.

If you took your pressure right after that, it would read high, but not be important.

Things you eat, drink and smoke can also increase your pressure. Caffeine drinks like coffee orcola drinks will do the same. Nicotine from cigarettes stimulates the heart to increase your pressure as well.

You may think that alcohol relaxes you, but the long term effects of all those alcohol, cocktails, and liquers drinks take their toll as well.

Spending too much time in your favorite recliner instead of getting some exercise increases your chances of blood pressure problems.

Fortunately, there are many places you can get your blood pressure checked today. Many stores and pharmacies have automatic blood pressure machines you can use. Just sit down for a couple minutes and get it checked. If you pressure is up slightly three different times, you should see a doctor. If it is over about 160 just once, you should also seek medical advice.

Rest makes your pressure go down. Because of that, the best time to take your blood pressure is during a time of no stress.

But, back to Gabriel. His family history made a big difference in his arterial hypertension. He had a father who died at age 50 of a stroke. Genetics can really increase your chances of needing treatment for arterial hypertension.

Fortunately, these days, there is a lot you can do to decrease arterial hypertension.

Changing your diet will definitely help. You will improve your blood pressure as well as your overall health by increasing your intake of fruits and vegetables. You should get regular exercise, lots of water and a good night's sleep. If you can stop using tobacco and limit or cut out your alcohol altogether that will help a great deal.

If you don't completely normalize your blood pressure by those means, many different medications are available today that will help. You will want to find a physician that you can work with on keeping your pressure normal.

Pregnancy hypertension treatment

Hypertension in Pregnancy Treatment

You may recall seeing the case of Roberta Miller of Arlingtonc who got hypertension during her pregnancy. It was diagnosed her first month of her pregnancy. And it was complicated by liver dysfunction.

Her Obstetrician had some important difficult choices to make. Fortunately Dr. Richards was able to use the best treatment and things turned out alright for mom and baby.

The treatments that Dr. Richards had to choose from included medication, hospitalization and early delivery of the baby through pitosin or C-section.

Several types of treatment are still considered even though there is no proof that they work. Those include restricting activity and dietary changes. Supplemental calcium, salt restriction, supplemental magnesium, and fish oil therapy have been tried without evidence of helping. There is some evidence that low dose aspirin does help.

Medications used for hypertension in pregnancy include Alpha-adrenergic inhibitors such as Methyldopa (Aldomet), Calcium channel blockers like Nifedipine (Adalat, Procardia), Beta-adrenergic receptor blockers such as Labetalol (Normodyne, Trandate), Pindolol (Visken), Oxprenolol (Apsolox, Trasicor, Captol), Metoprolol (Lopressor, Toprol XL) and Atenolol (Tenormin), Vasodilators like Nitroprusside (Nitropress) and Hydralazine (Apresoline) and Anticonvulsants like (Phenytoin (Dilantin) and Magnesium sulfate.

The Alpha-adrenergic inhibitors are probably the safest during pregnancy and are usually the first medication most doctors would use. If there is an allergy to the medicine or liver problems it is not as safe. But, there has not been any studies that show any harm to the baby.

Beta-adrenergic receptor blockers include some medications that are very safe and some not quite as safe. The safe ones can also be the first choice for treatment.

Calcium channel blockers may not be as safe. They have been labled 'C' because their safety for use in pregnancy has not been proven.

Centrally acting alpha-adrenergic agonists are usually saved for use in those that can't take the more frequently used medications. Like the calcium channel blockers, it has not been proven safe in pregnancy. (However, that does not mean they should not be used - but you should discuss it with your doctor.)

Diuretics also have a 'C' rating so their use is limited to cases where your doctor has determined that other safer drugs cannot be used and your high blood pressure is dangerous to you or your baby.

Vasodilators have to be given intravenously so are restricted to in hospital use. Therefore, you have to have pretty bad hypertension problems to have these used.

The seizure medications include the only medication in the group with an 'A' rating meaning that it is absolutely safe in pregnancy. That is magnesium sulfate. This is used in women who have severe pregnancy induced hypertension (eclampsia or preeclampsia) to prevent any dangerous seizures.

Naturally, any of these pharmaceuticals need to be used under your Obstetrician's care and frequent doctor appointments will be required.

Bone strength

Bone Strength

The strength of the bones in your body - for instance the lacrimal bone or clavicle or sacrum - is determined by a few simple factors. By taking some easy steps, you can improve your bone strength.

Exercise

Yeah, I know. Your doctor always says you need lots of exercise. And if you are not getting much exercise, they have it right.

There are two types of cells that alter the strength and curves of your different bones. The osteoclasts lay down more bone and the osteoblasts absorb it. The activity of these cells is altered by electric currents. The stress of causes a small current of electricity to pass through your bone. The osteoclasts are then directed to build up bone as a result in the parts of the bone that has been stressed. The osteoblasts are designed to absorb small particles of bone that is not needed.

This action on the cellular level will even tend to straighten out a bone that has been fractured and set crookedly.

Diet

The structural integrity of your bones comes from a crystal called apatite. Apatite requires much calcium and some phosphorus. That is why calcium is such an important part of your diet. Vitamin D makes the body absorb and utilize Calcium. That is why Vitamin D is a milk additive.

Dairy products have lots of calcium and are a good source of protein as well. That is fortunate if you are a fan of exotic cheeses like Pa�ki sir or Saloio cheese. Ice cream, cream cheese, cottage cheese as well as milk all are good sources of calcium.

However, you can get all the calcium you need in your diet without any dairy products. There are two reasons for this. First of all, many nuts, legumes, green leefy vegetables and grains are full of calcium.

Secondly, the protein in dairy products binds the calcium so you lose it. Therefore, although there is plenty of calcium in dairy products, it is harder to digest and absorb. So, if you are a vegan, you can get plenty of calcium.

One more thing. If your doctor asks you to take a calcium supplement, there is a great cheap and easy way to do this. Tums and Rolaids are mostly calcium carbonate. They provide plenty of calcium. However, don't use them for an antacid because calcium actually makes your stomach secrete more acid. And take them with your meals.

By using a sensible diet and a regular exercise program, you can take good strides toward ensuring that you have great bones. Take care that you include calcium and vitamin D in your meals and exercise at least three times a week.

Sprain

The Best Treatment For Your Sprain

On October 26, 2008, Sachin C  sprained his right knee in the cricket field. He was worried, because without a spectacular recovery he would not be able to play in the next Friday's season finals. As you can see, sprains can be a painful and somewhat crippling problem. If you have ever sprained your shoulder, you know that it can be very painful.

Even if you are doing sports like Sprinting or Triathlon or Racquets or Telemark skiing or Motorcycle speedway just for fun, you can get a significant sprain.

What Happens When You Get A Sprain

Your joints are located where bones are joined. The joints are supported by a fibrous capsule. The capsule is further strengthened by ligaments which are thicker collections of fibers. The muscles and tendons that cover the joint give even more strength to the joint.

When a joint is forced out of its normal position, some of those fibers, joints and muscles are damaged. Some of the fibers are actually torn.

First Aid For A Sprain

When you sprain your elbow, you also tear some of the small blood vessels in the joint resulting in a bruise. Other tissue damage causes swelling.

There are two highly useful techniques that will minimize bruising and swelling.

Ice is tremendously helpful in decreasing swelling and bruising in a sprained joint. Ice will decrease the amount of blood flow to a sprain. Ice causes the blood vessels in the area to constrict.

Another very helpful remedy is the pressure dressing. Applying a little pressure to the sprain will help minimize the blood and fluid from leaking out of blood vessels and tissues.

Sprain Recovery

Over the counter anti-inflammatory medications can help get rid of swelling, bruising and soreness quicker. Ibuprofen and Naproxen are good examples.

After the first two days, start using heat. Heat will dilate the blood vessels and help with healing. Often, alternating heat and cold will stimulate healing even more.

Make It Work For You

Even if you are not some big name athlete, and even if you don't participate in Kneeboarding or Korfball or Surfboat or Carambole billiard, you can get knee sprains. Use these quick therapies to make sure you get better painlessly.

Hip fracture

Hip Fractures

My friend Febin was recently in the hospital because of a broken hip. He had been hiking in Campus in and fell. It was quite an ordeal with a rescue by air rescue.

Once in the emergency department, febin was informed that he had a nondisplaced subcapital fracture of the left hip. Fortunately, he did not fracture his pelvis too.

hhe had surgery the next morning and is back home now. He is even starting to hike again. But he is stil pending to pay his hospital bills.

Fortunately, today, most people with a broken hip end up walking with a new scar. They get some new surgical steel in their hips and get on with their lives. However, it would be nice if that broken bone could be prevented! You would sure save a lot of money and pain.

The good news is that you can do a lot these days to prevent hip fractures. That is because most hip fractures happen because the bone is weak to begin with. In fact the bone will often break because it is weak and the person will fall because of the broken bone. The weakness or thinning of the bone is called osteoporosis.

Factors That Increase Osteoporosis

Something we all tend to do as we get older is give up activities. Unfortunately for those of us who like to sit around all day, the bones get more fragile when we are not hiking as much. So, they break easier. In fact, most hip fractures occur after the age of 65.

Women get two to three times as many more hip fractures as men. That is because after menopause, the change in the hormones makes it more likely to get osteoporosis.

If others in your family tended to have fractures late in life, you have a higher risk of getting them also.

What you eat and your personal habits affect your bone strength. A diet low in calcium causes weaker bones. Also, you can be taking in enough calcium, but if you are taking it in with lots of meat and milk, you actually need more, because those foods make it harder for your body to absorb it. Smoking and alcohol use also contribute to thinner bones. Nutrition. A low calcium dietary intake or reduced ability to absorb calcium. Vitamin D is also necessary to absorb and use your calcium.

Preventing Osteoporosis and Hip Fractures

Weight bearing activity causes a tiny electrical current to stimulate the cells on the outside of the bone into making your bones more durable. Exercise also strengthens the muscles supporting your joints. A regular exercise program will therefore better your bone health.

There are medications that your family doctor can recommend that will help your bones get stronger. Your doctor can do a bone density test to see if you need specific medications such as hormone replacement therapy and calcitonin to help your bones.

Some things can cause you to fall more easily and break your hip even if it is not weakened by osteoporosis. Some medications can make you dizzy. If your eyesight is poor or you have trouble with your balance, you can fall more easily. You should compensate for these problems with a walker or changes in glasses.

Finally, avoid those things that make your bones thin like smoking and excessive alcohol intake.

Using these simple steps can greatly improve your bone strength and diminish your chances of ever breaking your hip.

Diabetes and Kidney Disease

Diabetes and Kidney Disease

Diabetes is a disaterous problem that affects kidneys, heart and every other organ in the body. It is a disease in which the body is unable to properly use or produce insulin. Insulin, a hormone that is necessary for converting starches, sugar and other food into energy. The thing that leads to diabetes is unknown and there is no known cure. However, effective management may be achieved under a doctor's care.

Endocrinologists are specialists that treat diabetes. They are easy to find in most areas. Here are some examples: David Alster, MD of Tucson AZ, James Chappell, MD, FACE of Denver, CO, Dr Rosario Briones-Urbina of Toronto, Dr Yolanda Groenewoud of Toronto, Dr Anne Kenshole of Toronto, Dr Timothy M Murray of Toronto

In 2005, it was estimated that there were 20.8 million adults and children who are afflicted by this disease. That is approximately 7% of the population. Of that figure, 14.6 million people were diagnosed, but 6.2 million people were estimated to have diabetes but it had not been discovered yet. Also, approximately 54 million adults and children are pre-diabetic with one and a half million new disease found in people over 20, found yearly.

Diabetes is the most common cause of renal disease. Truly, hypertension and diabetes are the major causes of kidney disease. This is responsible for about 70 percent of renal failure cases with diabetes accounting of 44 percent of kidney failure cases. The early stages of kidney disease have no symptoms or signs . It quietly attacks your body and when it is detected, the pathology is so far advanced that it often is too advanced to prevent failure of the kidneys. Once your kidneys fail, you have two options: kidney transplant or dialysis. If you do not receive either one of these, you will eventually die.

How Diabetes causes Kidney Disease

When both kidneys are serving as they should, the glomeruli (tiny filters that are in the kidneys) keep your serum proteins inside of your body. Protein is necessary for a variety of functions inside of your body and are required for keeping you healthy. Diabetes creates an increased concentration of glucose in the blood which damages the glomeruli. The result is that they can't maintain the protein in the body and it leaks into the urine from the glomeruli.

When the kidneys are damaged they no longer function correctly and do not clean our waste and extra fluids as they should. When this occurs, the fluids and waste build up in the serum instead of being secreted through urine. The longer this happens, the worse the damage becomes until the kidneys eventually cease to function.

The Progression of Renal Disease

It often takes years for kidney disease from diabetes to develop. Some diabetics experience hyperfiltration in the first few years of their having diabetes. This means that the glomeruli actually function at a much higher capacity than normal. Once the damage starts, however, it is progressive. As a person develops kidney disease, they will have a blood protein known as albumin that finally begins to leak into the urine in small amounts. At this time, the glomeruli are actually working normally.

The progression of the disease will lead to more protein leaking into the urine and the glomeruli begin to progressively fail as the filtering apparatus begins to decrease. Waste is retained in the serum due to the filtration failure. Finally, the kidneys fail.

How to Prevent Kidney Problems if you have Diabetes

If you have diabetes, you can often prevent kidney failure. Use these suggestions to protect yourself: * Control your diabetes by eating well and getting good exercise * Take your medicine as your doctor has directed * Have your endocrinologist test your blood and urine routinely for kidney disease * If the laboratory test shows that you do have kidney disease, consider medicines such as ACE inhibitors and ARBs (angiotensin II receptor blockers) that can help keep your kidneys healthy.

A diagnosis of diabetes does not have to mean kidney disease. As long as you adequately treat your condition, manage it well and follow your physician's orders, there is no reason that you can't live a long, healthy, happy life - without kidney disease.

An Introduction to Type 1 Diabetes

An Introduction to Type 1 Diabetes: The facts you should know

Thought to be a fairly uncommon disease process, Type I diabetes affects nearly one out of every 250 people, both old and young, living in the United States today. Although "juvenile" has long been the appellation of this type of the disease, as in Type I juvenile onset diabetes, the disease process may actually occur at any time in life, and appears equally among both girls and boys.

There are innumerable things that can go wrong with your body. Consider this short list:

11 beta hydroxylase deficiency - Chalazion - Addiction - Chronic erosive gastritis - Alpha-thalassemia-abnormal morphogenesis - Beardwell syndrome - Cataract, congenital, with microcornea or slight microphthalmia - Congenital mixovirus - Free sialic acid storage disease - Compartment syndrome - Feingold syndrome - Forney Robinson Pascoe syndrome

Fortunately, even most doctors have not heard of some of these. But even though it is considered fairly uncommon, you probably know someone with insulin dependend diabetes.

Symptoms

While the signs and symptoms of Type I diabetes tend to be subtle in most cases, if not treated, they will eventually become fairly severe. Some of the most common symptoms include:

Blurry vision - Increased thirst - Heavy or labored breathing for no apparent reason - Nausea

Several serious signs and symptoms associated with Type I diabetes that mandate an urgent need for medical attention may include:

Abdominal pain Shaking, trembling Rapid breathing and heart rate Fruity or sweet smelling breath

Causes

Scientists still aren't aware of a variety of the factors leading one to have Type I diabetes. But, they do know that a susceptibility to the condition may be inherited from one or both parents. Researchers have discovered that this form of diabetes may also be caused by something in the environment that causes the wrong reaction within the body's immune system. However, they are not sure as to the origins of these triggers.

Diagnosis

For an accurate diagnosis of Type I diabetes, a doctor must check for abnormal blood sugar levels by performing a blood test, or also testing for the presence of sugar in the urine. With today's knowledge, there is no way to test for impending Type I diabetes, or a method to prevent one from developing this type of diabetes.

Treatment

There are many people, of all ages, who enjoy long, healthy lives despite having Type I diabetes. It's imperative to keep blood sugar levels within their normal range, which may be achieved by eating the right foods, exercise, and having insulin therapy on a regular basis. Anyone with this form of the disease is require to have insulin injections in order to properly manage their blood sugar level, which will also have to be tested regularly.

Without treatment, Type I diabetes may evolve into several serious conditions, some of which may be life-threatening. Kidney damage is a fairly frequent problem in those with the disease with a condition known as nephropathy. Other possible complications include retinopathy, which causes a loss of vision, heart disease, poor blood circulationand abdominal disorders which may also result without medical treatment.

Although a serious disease, Type I diabetes is a problem that can still be successfully managed with the right medical care.

Treatment of Type II Diabetes

Treatment of Type II Diabetes

As Jack Hibler Blalock, Jr., MD, FACE of Columbus, GA could tell you, type II diabetes is the most common of the two diabetes forms in existence. With this type, which outnumbers type I diabetes nearly 9 to 1, the diabetic is non-insulin dependent and has many different symptoms. Some symptoms might include sexual impotence, abnormal hunger, abnormal thirst, burning sensations, difficulties in healing wounds, yeast infections, numbness, blurred vision and increased urination.

Non-insulin dependent diabetes almost always affects adults, and does so for a variety of reasons. These reasons include obesity, and many other elements. There are many different treatments for Type II diabetes that a diabetic should consider.

Diet and Exercise

One of the prime methods to manage your non-insulin dependent diabetes is to eat the right foods and maintain a good cross training program. Maintaining the right weight for your height is very important to improve your diabetes. Obesity is an aggravating cause and initiating and sticking to a good is a great way to avoid having to take medication and can sometimes eliminate diabetes altogether. You will want to begin with a diet that is not only healthy, but also one that will help your body deal with the insulin and how it is used.

Exercise not only helps you diminish your weight, but also helps your body properly use insulin.

Medication

Medication is required when exercising and diet is not helping to lower the sugar levels within your serum. However, if you neglect to intiate any type of diet and activity program into your daily life, you will have to take prescription medication. There are many different types of medication that your doctor may prescribe. For example, oral medications such as Meglitinides, Biguanides, Alpha-Glucosidase, and Sulfonylureas are common elements in medications.

However, if your oral medications do not work or you have some sort of reaction to them, your doctor will likely prescribe an injection type of insulin instead. Most people try to manage their diabetes in other ways, without the use of insulin.

Natural Remedies

There are many natural treatments that may aid you in treating diabetes, these remedies include home remedies, as well as herbal supplements and vitamins. Before you choose to treat your Type II diabetes with natural remedies, you want to try to research all options and make the right choice for your health needs with your doctor.

Choosing the right treatment for Type II diabetes means understanding all options and alternatives that may be available to you and taking the that feels right and is most effective for your diabetes.