tag:blogger.com,1999:blog-30009638443364247082024-03-05T06:24:14.532-08:00holistic health tipsdr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.comBlogger76125tag:blogger.com,1999:blog-3000963844336424708.post-69893795714876513332019-11-20T20:38:00.001-08:002019-11-20T20:38:37.291-08:00Dates for suvarn prashna in 2019<div><b>Upcoming dates of Suvarna Prashan in 2019:</b></div><div><div class="MsoNormal"><b><u>Pushya Nakshatra date and time – India 2019</u></b><br><br> <b>21st January <span class="il">2019</span> (Monday)</b><br>From 21st Jan - 05:22 AM to 22nd Jan - 02:27 AM</div><div class="MsoNormal"><div dir="auto"><b>18th February <span class="il">2019</span> (Monday)</b></div><div dir="auto">From 17th Feb - 04:46 PM to 18th Feb - 02:02 PM</div><div dir="auto"><br></div><div dir="auto"><b>17th March <span class="il">2019</span> (Sunday)</b></div><div dir="auto">From 17th Mar - 02:13 AM to 18th Mar - 12:12 AM</div><div dir="auto"><br></div><div dir="auto"><b>13th April <span class="il">2019</span> (Saturday)</b></div><div dir="auto">From 13th Apr - 08:59 AM to 14th Apr - 07:40 AM</div><div dir="auto"><br></div><div dir="auto"><b>11th May <span class="il">2019</span> (Saturday)</b></div><div dir="auto">From 10th May - 02:21 PM to 11th May - 01:14 PM</div><div dir="auto"><br></div><div dir="auto"><b>07th June <span class="il">2019</span> (Friday)</b></div><div dir="auto">From 06th June - 08:29 PM to 07th June - 06:56 PM</div><div dir="auto">(Guru Pushya Amrut yog from 06th June - 08:29 PM to 07th June - before sunrise)</div><div dir="auto"><br></div><div dir="auto"><b>04th July <span class="il">2019</span> (Thursday)</b></div><div dir="auto">From 04th July - 04:39 AM to 05th July - 02:30 AM</div><div dir="auto">(Guru Pushya Amrut yog from 04th July - sunrise to 5th July - 02:30 AM)</div><div dir="auto"><br></div><div dir="auto"><b>01st August <span class="il">2019</span> (Thursday)</b></div><div dir="auto">From 31st July - 02:41 PM to 01st Aug - 12:11 PM</div><div dir="auto">(Guru Pushya Amrut yog on 01st Aug - from sunrise to 12:11 PM)</div><div dir="auto"><br></div><div dir="auto"><b>28th August <span class="il">2019</span> (Wednesday)</b></div><div dir="auto">From 28th Aug - 01:13 AM to 28th Aug - 10:55 PM</div><div dir="auto"><br></div><div dir="auto"><b>25th September <span class="il">2019</span> (Wednesday)</b></div><div dir="auto">From 24th Sept - 10:31 AM to 25th Sept - 08:53 AM</div><div dir="auto"><br></div><div dir="auto"><b>22nd October <span class="il">2019</span> (Tuesday)</b></div><div dir="auto">From 21st Oct - 05:32 PM to 22nd Oct - 04:39 PM</div><div dir="auto">(Diwali Pushya Nakshatra)</div><div dir="auto"><br></div><div dir="auto"><b>18th November <span class="il">2019</span> (Monday)</b></div><div dir="auto">From 17th Nov - 10:59 PM to 18th Nov - 10:21 PM</div><div dir="auto"><br></div><div dir="auto"><b>15th December <span class="il">2019</span> (Sunday)</b></div><div dir="auto">From 15th Dec - 05:03 AM to 16th Dec - 04:01 AM<br><br>(P.S:<b>Guru Pushya Amrut Yog</b> is the best time to give Suvarna Prashan)<div class="separator" style="clear: both; text-align: center;">
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</div>contact for suvarn prashna</div><div dir="auto">9416076402</div><div dir="auto">Dr.Jayant parkash</div></div></div>dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-27756041309381062762015-09-11T10:41:00.001-07:002015-09-11T10:48:14.936-07:00Swarnprashna(Ayurvedic vaccine)<p dir="ltr">In the world of medicines with harmful side effects, genetically modified food, chemically treated drinks, busy lifestyle, electronic distractions and unpredictable environment, It is a big challenge for parents to build a stronger & intelligent kids. Swarna Prashana is a natural, time tested, practiced for more than 1000s of years by our ancestors that builds over all health and intelligence naturally without leaving any harmful side effects.</p>
<p dir="ltr">Today it is now popularly known as an ayurvedic immunization program or “ayurvedic way of vaccination” promoted by many ayurvedic professionals. It is sometimes known by other names like, Swarna amruta prashana, Swarna prashana, Swarna prashan, Swarn prashan, Swarna bindu prashana or Suvarna prashan.</p>
<p dir="ltr">Since ancient times, our ancestors passed their best practices of holistic lifestyle to their next generations. Over a period of time they became a ritual that got integrated into their day to day life. These series of rituals are known as samskaras. They are connected with the major events of life such as pregnancy, childbirth, naming ceremony, education, marriage, etc. These samskaras enables us to live a complete fulfilling physical and spiritual life.</p>
<p dir="ltr">Swarna Prashana is one  of sixteen samskaras mentioned in ancient texts for paediatrics. It is an unique method to build long lasting health and intellect naturally without leaving any harmful side effects.</p>
<p dir="ltr">Suvarna prashan sanskar is one of the 16 essential rituals described in ayurveda for children.<br>
Definition : The process in which Suvarna bhasma (purified ash of gold) is administered with fortified ghee prepared with herbal extracts, and honey in liquid or semisolid form.<br>
Whom to administer : Suvarna prashan can be given to age group of 0-16yrs.<br>
Time of administration : suvarna prashan can be done daily early in the morning, or atleast on every Pushya nakshatra- an auspicious day- which happens to come after every 27 days, given on this day it bestows excellent benefits.<br>
Benefits of suvarna prashan :<br>
Suvarna prashan increases immunity power and developes resistance against common infections, thus prevents children from falling ill very oftenly.<br>
It builds physical strength in children and enhances physical activites, and also improves stamina for the same.<br>
Regular doses of Suwarna prashan improves child’s intellect, grasping power, sharpness, analysis power, memory recalling in an unique manner.<br>
It kindles digestive fire, improves digestion and decreases related complaints.<br>
Suvarna prashan also improves child’s appetite.<br>
It helps to nurture early physical and mental development.<br>
It developes an inbuilt strong defense mechanism in kids which acts as a safety sheild against diseases and complaints occuring due to seasonal change and other prevailing infections.<br>
It helps body to recover early in case of any illness.<br>
It guards children from various allergies.<br>
It protects children from ailments occuring during teething phase.<br>
Tones up skin colour.<br>
Overall it makes child healthier, children taking Suwarna prashan doses regularly can be easily distinguised from their remarkably outstanding physical and mental ability.</p>
dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com1Adampur, Adampur29.282253 75.47157tag:blogger.com,1999:blog-3000963844336424708.post-52772446394289059772014-12-02T09:11:00.001-08:002015-08-15T20:28:42.931-07:00Role of dairy products in child health<p dir="ltr">It is very important to include dairy products in a child's diet as they provide a lot of health benefits. Learn about the immense health benefits which children can reap by consuming dairy products.<br></p>
<p dir="ltr">Dairy foods like milk, cheese, yogurt, buttermilk, cream etc. are rich in calcium, magnesium, potassium, phosphorous, riboflavin, vitamin D, vitamin A, vitamin B12, and other essential nutrients. Yogurt is said to have more nutritional benefits than milk. It is prepared by fermentation of milk. Dairy foods are essential for the good health of kids and they form an important part of a complete balanced diet. Good amount of dairy products should be included in the diet of a kid. Read on to know more about the health benefits of dairy products for kids.<br></p>
<p dir="ltr">Healthy Bones</p>
<p dir="ltr">Calcium and phosphorous increases the bone density and mass. Milk and dairy products are rich in calcium and they should be given in adequate quantity to children for healthy development and maintenance of strong bones. Also, regular consumption of dairy products prevents the children from getting diseases like osteoporosis, which makes the bone brittle and weak at later stage of their lives.<br></p>
<p dir="ltr">Good Teeth</p>
<p dir="ltr">Dairy products are good for maintaining healthy and good teeth. Casein is a protein, which is found in abundance in milk and which is good for preventing tooth decay. Milk can be given to kids in between meals. Calcium, present in yogurt, milk, cheese, and other dairy products, helps in preventing gum diseases.<br></p>
<p dir="ltr">Prevents Dehydration</p>
<p dir="ltr">A child can get dehydrated due to some illness or excessive sweating. Fluids in the form of milk keep your kids hydrated. Apart from re-hydrating the body, milk provides instant energy. Sodium and potassium present in milk restores the fluid balance in the body effectively. Buttermilk with a pinch of salt is a good rehydration drink and very good for children especially in very hot weather.<br></p>
<p dir="ltr">Controlling Blood Pressure</p>
<p dir="ltr">High blood pressure can affect young kids too, which can damage the heart, blood vessels, and other organs of their body. Potassium-rich food is required for controlling blood pressure. Milk, yogurt, and other dairy products provide the potassium, which is required for controlling high blood pressure. Bioactive peptides are type of proteins found in milk and they help controlling blood pressure.<br></p>
<p dir="ltr">Prevents Obesity in Children</p>
<p dir="ltr">Obesity can lead to heart disease. Obesity in children is one of the main health concerns in children nowadays, which is increasing at an alarming rate. Globally, it is found that one out of 10 school going children are obese. It can however be controlled by proper intake of sufficient quantity of dairy foods. It is a wrong belief that dairy food makes a child fat. Calcium present in dairy food helps in breaking down the body fat. Children who drink flavoured milk are less attracted to other sweetened drinks.<br></p>
<p dir="ltr">Stay Healthy the Dairy Way</p>
<p dir="ltr">Dairy products take care of the normal growth and development of your child. Children grow quickly and they need liberal serving of dairy food on a regular basis. During early stages of childhood when their bones and teeth are developing, it is very essential to give them plenty of calcium rich food. Milk is the best source of calcium. Till the age of 10 years, your children require calcium in adequate quantity.</p>
<p dir="ltr">For children who do not like milk or are lactose-intolerant, you may substitute with soy milk or buttermilk. You may try giving your children, chocolate milk, or other flavoured milk. Most children love cheese. Various forms of cheese in different flavours are easily available in the market. You can make different types of snacks with cheese or even cheese sandwiches, which your children will love. Enjoy the benefits of dairy food with your children</p>
dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-44245290457001407542014-12-01T08:20:00.001-08:002015-08-15T20:27:24.130-07:00HIV --All about it<p dir="ltr"></p>
<p dir="ltr">एचआईवी एक ऐसी बीमारी है जिसके नाम से ही जिंदगी रूक जाती है,लेकिन ऐसा नहीं है अगर एचआईवी होने पर भी आप खुद को एक बेहतर लाइफ दे सकते हैं। आज एचआईवे डे पर हम आपको एचआईवी के बारे में बता रहे है ताकि आपको इसके बारे में पूरी जानकारी हो।</p>
<p dir="ltr">क्या है HIV ?</p>
<p dir="ltr">एचआईवी की फुल फॉर्म है ह्यूमन इम्यूनो वायरस। यह वायरस बॉडी के इम्यूम सिस्टम पर अटैक करता है। इसके चलते शरीर की बीमारियों के खिलाफ लड़ने की ताकत कम होती जाती है।<br>
अगर किसी को एचआईवी है, तो इसका मतलब यह है कि उसकी बॉडी में एचआईवी वायरस आ गया है। अगर वो दवाई नहीं लेता, तो यह एड्स में विकसित हो सकता है।</p>
<p dir="ltr">एचआईवी के Early Symptoms:</p>
<p dir="ltr">STAGE ONE:</p>
<p dir="ltr">एचआईवी संक्रमण के 7-10 दिन बाद, मरीज़ में ये लक्षण दिखते हैं:<br>
- गला खराब<br>
- बुखार<br>
- छाती पर रैश<br>
- थकान<br>
- उल्टी जैसा लगना<br>
- हैजा</p>
<p dir="ltr">STAGE TWO:</p>
<p dir="ltr">एचआईवी के ये early लक्षण पहचान पाना मुश्किल होता है, क्योंकि ये 2-3 हफ्तों में गायब हो जाते हैं। इन लक्षणों को कभी-कभार डॉक्टर्स भी मिस कर देते हैं। ऐसे में एचआईवी पॉज़िटिव शख्स कई साल तक इन लक्षणों के साथ जीता रहता है। आप मान लीजिए कि मरीज़ 10 साल तक इन लक्षणों के साथ जी सकता है।</p>
<p dir="ltr">STAGE THREE:</p>
<p dir="ltr">इस स्टेज पर पहुंचकर बॉडी का इम्यून सिस्टम बहुत वीक हो जाता है और वो बीमारियों से घिर जाता है। अब उसके शरीर में इन बीमारियों से लड़ने की ताकत भी नहीं बचती है। मरीज़ अब टीबी, निमोनिया, फंगल रोगों, बैक्टीरियल रोगों और वायरल रोगों से घिर जाता है। फिर मरीज़ को एचआईवी के लिए दवाई दी जाती है, ताकि उसका इम्यूम सिस्टम और डैमेज न हो।<br>
FACTS:</p>
<p dir="ltr">लगभग 90 प्रतिशत लोग एचआईवी की गिरफ्त में सेक्शुअल कॉन्टेक्ट से आते हैं।अगर एचआईवी पॉज़िटिवशख्स प्रोटेक्शन यूज़ किए बिना रिलेशनशिप बनाता है,तो उसके पार्टनर को भी एचआईवी पॉज़िटिव के पूरे चांसेस होते हैं। एचआईवी संक्रमित सुई, सीरिंज या अन्य इंजेक्शन लगाने वाले उपकरण से भी हो सकता है। एचआईवी का टेस्ट सलाइवा सैंपल से भी हो सकता है।<br>
एचआईवी थूक फेंकने, काटने या फिर बर्तन शेयर करने से नहीं फैलता।<br>
अगर प्रेग्नेंट महिला को एचआईवी है, तो इस केस में 1 प्रतिशत शिशुओं को एचआईवी का खतरा होता है। एचआईवी का रिज़ल्ट 15-20 मिनट में सामने आ जाता है। एचआईवी का कोई टीका या इलाज नहीं है। Myth: क्या HIV और AIDS एक ही होते हैं ?</p>
<p dir="ltr">Fact: इन दोनों का मतलब एक नहीं होता। अगर किसी को एचआईवी है, तो वो दवाई लेकर अपनी ज़िंदगी बढ़ा सकता है। जिस इंसान को एड्स होता है, उसका इम्यूम सिस्टम इतना कमज़ोर हो जाता है कि वो किसी भी बीमारी से लड़ नहीं पाता।</p>
<p dir="ltr">Myth: अगर दोनों में से एक पार्टनर भी एचआईवी पॉज़िटिव है, तो उनका बच्चा नहीं हो सकता ?</p>
<p dir="ltr">Fact: ऐसा नहीं है। अगर सही स्टेप्स उठाए जाएं, तो एचआईवी न तो पार्टनर को होगा और न ही बच्चे में आएगा। यूके में 1 प्रतिशत से भी कम चांस होते हैं कि एचआईवी मां से बच्चे को भी आ जाए। इसमें आपको डॉक्टर की सलाह माननी चाहिए और सही स्टेप्स फॉलो करने चाहिए।<br>
Myth: क्या HIV और AIDS एक ही होते हैं ?</p>
<p dir="ltr">Fact: इन दोनों का मतलब एक नहीं होता। अगर किसी को एचआईवी है, तो वो दवाई लेकर अपनी ज़िंदगी बढ़ा सकता है। जिस इंसान को एड्स होता है, उसका इम्यूम सिस्टम इतना कमज़ोर हो जाता है कि वो किसी भी बीमारी से लड़ नहीं पाता<br>
HIV कैसे हो सकता है ?</p>
<p dir="ltr">Fact: एचआईवी ब्रेस्ट मिल्क, सीमेन (वीर्य), वजाइनल फ्लूड्स और ब्लड से हो सकता है। डे-टू-डे कॉन्टेक्ट, किसिंग,थूक या एक ही कप और प्लेट शेयर करने से एचआईवी नहीं होता।</p>
<p dir="ltr">Myth: HIV पॉज़िटिव शख्स की जल्दी मृत्यु हो जाती है ?</p>
<p dir="ltr">Fact: वैसे तो एचआईवी का पक्का इलाज नहीं है, लेकिन आजकल ट्रीटमेंट्स इतनी एडवांस हो गई हैं कि एचआईवी पॉज़िटिव मरीज़ भी जी सकता है। यूके में एचआईवी पॉज़िटिव शख्स की आयु नॉर्मल ही होती है और वो एक्टिव लाइफ जीता है। अगर एचआईवी का जल्दी पता चल जाए, तो यह बॉडी को ज़्यादा हार्म नहीं पहुंचा पाता।</p>
<p dir="ltr">Myth: क्या ओरल सेक्स से भी HIV होने के चांसेस हैं ?</p>
<p dir="ltr">Fact: ओरल सेक्स से एचआईवी होने के चांसेस बहुत कम होते हैं, लेकिन यह हो सकता है। अगर मुंह में छाले, कट्स,मसूड़ों में खून की समस्या चल रही है, तो ओरल सेक्स अवॉइड करना चाहिए, क्योंकि इस केस में एचआईवी पॉज़िटिव होने के चांसेस बढ़ जाते हैं।</p>
<p dir="ltr">मैं खुद को और दूसरों को HIV इंफेक्शन से कैसे बचा सकता हूं ?</p>
<p dir="ltr">Fact: सेक्स के दौरान हमेशा प्रोटेक्शन यूज़ करनी चाहिए। एक दूसरे की सीरिंज, सुई बिल्कुल भी शेयर न करें।</p>
<p dir="ltr"> का है ज़्यादा रिस्क, ये हैं इसके 3 Stages और Facts<br>
Dainikbhaskar.com | Dec 1, 2014, 11:49:00 AM IST<br>
8 of 8 ImageAAA<br>
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Myth: HIV टेस्ट का रिज़ल्ट आने में कई महीने लग जाते हैं ?<br>
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Fact: आजकल मेडिकल काफी एडवांस हो गया है। यह सच नहीं है कि एचआईवी टेस्ट का रिज़ल्ट आने में 3, 6 या 12 महीने लग जाते हैं। आजकल एचआईवी टेस्ट का रिज़ल्ट 15-20 मिनट में ही आ जाता है। दरअसल, रिज़ल्ट टेस्ट पर निर्भर करता है।अगर किसी को भी लगता है कि वो एचआईवी एक्सपोज़र में आया है, तो उसे तुरंत टेस्ट करवाना चाहिए।<br>
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Myth: सिर्फ गे मैन को ही HIV होता है ?<br>
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Fact: इस बात में कोई दो राय नहीं है कि गे मैन को एचआईवी संक्रमण जल्दी हो जाता है, लेकिन एचआईवी किसी को भी हो सकता है। यूके में 37,000 से भी ज़्यादा गे मैन एचआईवी की गिरफ्त में हैं। </p>
dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-29093977877645615842010-05-01T06:11:00.000-07:002010-05-01T07:09:05.336-07:00About Kidney Transplantation* Definition of Kidney Transplantation<br /> * Description of Kidney Transplantation<br /> * Treatment of Kidney Transplantation<br /> * Questions To Ask Your Doctor About Kidney Transplantation<br /><br />Definition of Kidney Transplantation<br />Article updated and reviewed by Nader Najafian, MD, Assistant Professor of Medicine, Harvard Medical School and Associate Physician, Renal Division--Brigham & Women's Hospital on May 17, 2005.<br /><br />Kidney Transplantation is the surgical procedure of placing a fully functioning kidney into a person with severe kidney failure. This procedure is usually an elective one, performed in patients who have undergone careful preoperative assessment and preparation, since dialysis enables these patients to be maintained in relatively good condition until the time of surgery. The transplanted kidney may originate from a deceased donor (cadaver transplantation) or from a related or unrelated person (living transplantation).<br /><br />Description of Kidney Transplantation<br />The function of the kidneys is to filter the blood in the body and to purify it by ridding it of soluble waste products and excess water (which is then eliminated in the form of urine). Total kidney failure, which may be gradual or sudden in onset, results in the accumulation of these waste products and water in the blood. These waste products can poison you unless removed. In addition, the excess water can accumulate in the lungs and prevent the patient from getting enough oxygen. Either processes or a combination of both can result in death.<br /><br />The most common causes of kidney failure include:<br /><br /> * infection and inflammation of any part of the kidney structure<br /><br /> *<br /><br /> * damage to kidney tissue from some systemic diseases such as uncontrolled high blood pressure and untreated diabetes) or injury<br /><br /> * • damage to kidney tissue through some medications, including overuse of some over the counter pain killers such as Motrin and Aspirin<br /><br /> * polycystic kidneys (an inherited condition in which the tissues of the kidneys are gradually destroyed by cysts)<br /><br /> * failure of normal kidney development from before birth<br /><br />There are two major treatment modalities for patients with kidney failure: dialysis or transplantation. In dialysis, the blood is artificially filtered through a machine or by diverting the bloodstream through another permeable membrane in the body itself. Despite numerous medical and technological advances over the last few years, dialysis patients feel very unwell. This is not surprising as even the most efficient hemodialysis regimens can only remove 10-12% of the small solute toxins as compared to normal functioning kidneys. Even though the kidney dialysis can keep the patients alive, these patients still suffer from poor quality of life, extreme dietary restrictions and the psychological burden of depending on a machine. Kidney transplantation is the treatment of choice in qualified patients with kidney failure as it has the greatest potential for restoring a healthy and productive life. This operation allows a patient to lead an independent existence instead of being reliant on regular kidney dialysis. It also allows a liberating return to a normal diet. The transplant procedure success rate has improved over the last years with one-year graft survivals exceeding 90% in most centers. A critical shortage of donor organs is the major limitation to expanding the use of this treatment. Many patients with end-stage renal (kidney) disease are suitable for transplantation. Fifty percent of all kidney transplants are received from cadaver donors and the others are received from living, related, or unrelated donors.<br /><br />Regular kidney dialysis is a short-term solution to kidney failure: the blood is artificially filtered through a machine or by diverting the bloodstream through another permeable membrane in the body itself. The ideal treatment for total kidney failure is kidney transplantation.<br /><br />One-third to one-half of all patients with end-stage renal (kidney) disease are suitable for transplantation. Two-thirds of all kidney transplants are recieved from cadaveric donors, and one-third are recieved from living, related donors.<br /><br />Kidney Transplantation Surgery<br /><br />The aim of the surgery is to supply a single, fully functioning kidney. One kidney provides more than enough filtration and regulating capacity for all purposes and is grafted into its own position while the existing (non-functioning) kidneys remain in place. The existing kidneys are removed only if they cause persistent infection or high blood pressure, and they will not interfere with the transplant procedure or functioning of the new organ. As soon as the transplanted kidney is connected to the blood vessels, it will begin purifying the blood of waste products.<br /><br />Patients are required to take medications such as corticosteroids, cyclosporine, and/or azathioprine to suppress their immune system in order to prevent rejection of the transplanted kidney.<br /><br />Post-operative Effects<br /><br />More often than not, the first week after kidney transplantation is a grace period when things keep getting better. However, the clear sailing can be misleading, since many kidney recipients spend time in the hospital soon after discharge when the functioning of their new kidney diminishes. These episodes are almost always successfully treated by adjusting the medication regimen.<br /><br />By far the two most common causes of diminished renal function are rejection and the toxic effects of cyclosporine. About 70 percent of all recipients will manifest some signs of organ rejection, and most will also have some evidence of cyclosporine toxicity. Both problems manifest themselves as decreasing urinary output and rising laboratory values of blood BUN (Blood Urea Nitrogen) and creatinine (a component of urine). These problems are usually treated simultaneously by adding extra doses of steroids.<br /><br />Managing Rejection<br /><br />Immediately after kidney transplant surgery, the mainstays of drug therapy are prednisone and cyclosporine, and sometimes azathioprine. It should be emphasized that cyclosporine is enormously beneficial for two reasons: first, in improving long-term survival of the kidney; and second, in permitting the rapid tapering off of the prednisone. Nevertheless, it is critically important that, as long as the transplanted organ is functioning, some level of maintenance immunosuppression (suppression of immunologic response, usually with reference to grafts or organ transplants) is necessary. If at any point a recipient stops taking the medications, rejection can occur - even ten or fifteen years after the transplant.<br /><br />The important point to remember is that most recipients can expect to have some problems getting adjusted to their new organ, and that after the initial discharge it may be necessary to return to the hospital for one or more additional short stays. New drugs may be needed, and the doses of the anti-rejection medications will probably require adjustment. This fine-tuning is a normal part of recovering.<br /><br />The vast majority of renal transplants are successful. Thus, the statement that someone is suffering rejection, which understandably sounds disturbing, is not cause for undue alarm. Most cases of rejection can be reversed, and the other causes of abnormal renal function also can be corrected. Well over 80 percent of recipients leave the hospital with a kidney functioning sufficiently to keep them off of dialysis.<br />Text Continues Below<br /><br />Treatment of Kidney Transplantation<br />Kidney Transplantation Surgery<br /><br />The aim of the surgery is to supply a single, fully functioning kidney. One kidney provides more than enough filtration and regulating capacity for all purposes and is grafted into its own position while the existing (non-functioning) kidneys remain in place. The existing kidneys are removed only if they cause persistent infection or high blood pressure, and they will not interfere with the transplant procedure or functioning of the new organ. As soon as the transplanted kidney is connected to the blood vessels, it will begin purifying the blood of waste products. Patients are required to take medications that suppress the immune system for the rest of their lives to avoid the rejection of the kidney grafts.<br /><br />Post-operative Effects<br /><br />In most cases, particularly in patients that get good quality kidneys from family and friends (living donors), the transplanted kidneys start working immediately after transplantation and no further hemodialysis is required. In 20-30% of cases, particularly patients who get cadaver kidneys with poorer organ quality, the kidney may not function immediately and further dialysis may be needed. Regardless, all the transplant patients need to be monitored very closely in the first month after the procedure, as many of the immunosuppressive drugs need to be adjusted carefully. This usually requires clinic visits up to two to three times a week in the first month. By far the two most common causes of diminished renal function are rejection and the toxic effects of cyclosporine. About 30% of all recipients will manifest some signs of organ rejection, and most will also have some evidence of cyclosporine toxicity. Both problems manifest themselves as decreasing urinary output and rising laboratory values of blood BUN (Blood Urea Nitrogen) and cretonne (a component of urine). These problems are usually treated simultaneously by adding extra doses of steroids. As too low a dose of immunosuppressant drugs can result in rejection, too much of it can result in infections or cancer over time. That is the reason why patients need close follow-up by a kidney transplant specialist.<br /><br />Managing Rejection<br /><br />After kidney transplant surgery, the mainstays of drug therapy are usually a combination of two to three immunosuppressive medications, such as prednisone, cyclosporine, tacrolimus, or rapamycin, and sometimes azathioprine or cellcept. Initially, higher doses of these drugs are used as the risk of rejection is highest immediately after transplantation. With time, the levels of these drugs can then be tapered down. Nevertheless, it is critically important that, as long as the transplanted organ is functioning, some level of maintenance immunosuppression (suppression of immunologic response, usually with reference to grafts or organ transplants) is necessary. If at any point a recipient stops taking the medications, rejection can occur - even ten or fifteen years after the transplant.<br /><br />The vast majority of renal transplants are successful with over 90% of organs functioning after the first year. Thus, the statement that someone is suffering rejection, which understandably sounds disturbing, is not cause for undue alarm. Most cases of rejection can be reversed, and the other causes of abnormal renal function also can be corrected.<br /><br />Questions To Ask Your Doctor About Kidney Transplantation<br />How long is the waiting time to get a cadaver kidney?<br /><br />Who would be qualified to donate a kidney to me (family, spouse, and friends)?<br /><br />How can potential interested donors be evaluated?<br /><br />How is the surgery performed?<br /><br />How long does the surgery take?<br /><br />How many kidney transplantations have you performed?<br /><br />What medications will you be prescribing?<br /><br />What are the side effects of immunosuppressive drugs?<br /><br />How long will you prescribe steroids or any other medication?<br /><br />What should be expected after the surgery?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-74909985839339947232010-05-01T05:50:00.000-07:002010-05-01T06:04:28.363-07:00Juvenile Diabetes* Definition of Juvenile Diabetes<br /> * Description of Juvenile Diabetes<br /> * Causes and Risk Factors of Juvenile Diabetes<br /> * Symptoms of Juvenile Diabetes<br /> * Diagnosis of Juvenile Diabetes<br /> * Treatment of Juvenile Diabetes<br /> * Questions To Ask Your Doctor About Juvenile Diabetes<br /><br />Definition of Juvenile Diabetes<br />Juvenile diabetes mellitus is now more commonly called Type 1 diabetes. It is a syndrome with disordered metabolism and inappropriately high blood glucose levels due to a deficiency of insulin secretion in the pancreas.<br /><br />Description of Juvenile Diabetes<br />After a meal, a portion of the food a person eats is broken down into sugar (glucose). The sugar then passes into the bloodstream and into the body's cells via a hormone called insulin. Insulin is produced by the pancreas.<br /><br />Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes either the pancreas produces little or no insulin, or the cells do not respond normally to the insulin. Sugar builds up in the blood, overflows into the urine and passes from the body unused.<br /><br />Diabetes can be associated with major complications involving many organs including the heart, eyes, kidneys, and nerves, especially if the blood sugar is poorly controlled over the years.<br /><br />Types Of Diabetes<br /><br />Diabetes mellitus is a chronic disease caused by the inability of the pancreas to produce insulin or by the body to appropriately use the insulin it does produce. There are two main types of diabetes, Type 1 and Type 2.<br /><br /> Type 1 diabetes (also called insulin-dependent diabetes or juvenile diabetes) is caused by autoimmune destruction of the B cells of the pancreas which normally secrete insulin. Those patients require insulin injections for survival.<br /><br /> Type 2 diabetes (or non-insulin-dependent diabetes) is much more common and results from insulin resistance, mainly due to obesity, with inadequate additional production of insulin by the body. In other words, the pancreas produces a reduced amount of insulin or the cells do not respond to the insulin, or both.<br /><br />Complications of Diabetes<br /><br />If juvenile diabetes is left unmanaged, damage can occur to:<br /><br /> * Eyes - leading to diabetic retinopathy and possible blindness<br /><br /> * Blood vessels - increasing risk of heart attack, stroke and peripheral artery obstruction<br /><br /> * Nerves - leading to foot ulcers, impotence, and digestive problems<br /><br /> * Kidneys - leading to kidney failure<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Juvenile Diabetes<br />An estimated 17 million people in the U.S. have diabetes, of which about 1.4 million have Type 1 diabetes. The highest prevalence of Type 1 diabetes is in Scandinavia, where it comprises up to 20 percent of the total number of patients with diabetes.<br /><br />The prevalence of Type 1 diabetes is about 5-10 percent of the total number of diabetes patients in the U.S., while in Japan and China, less than 1 percent of patients with diabetes have Type 1. Approximately 35 American children are diagnosed with juvenile diabetes every day.<br /><br />The exact cause of Type 1 diabetes (juvenile diabetes) is still unclear. However, it is believed that Type 1 diabetes results from an infectious or toxic insult to persons whose immune system is genetically predisposed to develop an aggressive autoimmune response either against altered pancreatic B antigens (proteins) or against molecules of the B cell resembling a viral protein (called molecular mimicry). It is not caused by obesity or by eating excessive sugar.<br /><br />The risk of juvenile diabetes is higher than virtually all other severe chronic diseases of childhood. Juvenile diabetes tends to run in families. Brothers and sisters of a child with juvenile diabetes have at least 100 times the risk of developing juvenile diabetes as a child in an unaffected family.<br /><br />Symptoms of Juvenile Diabetes<br />The symptoms of Type 1 diabetes (juvenile diabetes) may occur suddenly, and include:<br /><br /> * Frequent urination<br /><br /> * Increased thirst<br /><br /> * Extreme hunger<br /><br /> * Unexplained weight loss<br /><br /> * Extreme weakness and fatigue<br /><br /> * Urinating at night (nocturnal enuresis)<br /><br /> * Blurred vision<br /><br /> * Numbness or tingling in the hands or feet<br /><br /> * Heavy or labored breathing<br /><br /> * Drowsiness or lethargy<br /><br /> * Fruity odor on the breath<br /><br />Diagnosis of Juvenile Diabetes<br />A child with the above symptoms must be seen by a physician as soon as possible.<br /><br />Besides a complete history and physical examination, the doctors will do a battery of laboratory tests. There are numerous tests available to diagnose diabetes such as urine test, blood test, glucose-tolerance test, fasting blood sugar and the glycohemoglobin (HbA1c) test.<br /><br />A urine sample will be tested for glucose and ketones (acids that collect in the blood and urine when the body uses fat instead of glucose for energy). A blood test is used to measure the amount of glucose in the bloodstream. A glucose-tolerance test checks the body's ability to process glucose. During this test, sugar levels in the blood and urine are monitored for 3 hours after drinking a large dose of sugar solution.<br /><br />The fasting blood sugar test involves fasting overnight and blood being drawn the next morning. The glycohemoglobin test reflects the cumulative effects of high blood glucose (and measures the degree of control over blood glucose after treatment begins).<br /><br />Treatment of Juvenile Diabetes<br />Treatment of Type 1 diabetes involves:<br /><br /> * Diet<br /><br /> * Insulin<br /><br /> * Self-monitoring of blood glucose<br /><br /> * Exercise<br /><br />Questions To Ask Your Doctor About Juvenile Diabetes<br />Does the child have Type 1 diabetes?<br /><br />How can this best be managed?<br /><br />What is diabetic ketoacidosis?<br /><br />What changes in diet will be required?<br /><br />Is there a specific meal plan?<br /><br />What type of insulin should be used - what is the frequency and dosage?<br /><br />How can exercise help the child - how much, and what type?<br /><br />At what age should the child self-administer insulin?<br /><br />What restrictions and limitations will be placed upon the child's life?<br /><br />Should the child's teacher or school nurse be alerted to the situation?<br /><br />Are there any support groups or organizations regarding the care of a child with diabetes?<br /><br />What is the prognosis?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-52181829146463441292010-05-01T05:21:00.000-07:002010-05-01T05:50:40.625-07:00Amniocentesis* Definition of Amniocentesis<br /> * Description of Amniocentesis<br /> * Questions To Ask Your Doctor About Amniocentesis<br /><br />Definition of Amniocentesis<br />Amniocentesis is a simple medical procedure used to obtain small samples of the amniotic fluid surrounding the fetus.<br /><br />Description of Amniocentesis<br />In the first half of the pregnancy (between the 14th and 18th week) the doctor may perform an amniocentesis when:<br /><br /> * The age of the mother is 35 years of age or older. The risk of bearing children with chromosomal birth defects increases as a woman ages, thus if a woman will be 35 or older at the time of delivery, most physicians offer the option of prenatal testing for chromosomal disorders. Among the most common of these disorders is Down syndrome, a combination of mental and physical abnormalities caused by the presence of an extra chromosome.<br /><br /> * A previous child or pregnancy resulted in a birth defect. If a couple already has a child (or pregnancy) diagnosed with a chromosomal abnormality, a biochemical birth defect, or a neural tube defect, the couple may be offered prenatal testing during subsequent pregnancies.<br /><br /> * Family history shows an increased risk of inheriting a genetic disorder. Couples without a previously affected child may also be offered prenatal testing if their family medical histories indicate their children may be at increased risk of inheriting a genetic disorder.<br /><br /> * One or both prospective parents may be "carriers" of a disorder, or a disorder may "run in the family." Prenatal testing would be done only if the suspected condition can be diagnosed prenatally.<br /><br /> * There is suspected neural tube defects. These defects of the spine and brain, including spina bifida and anencephaly, can be diagnosed by measuring the level of alphafetoprotein (AFP) in the amniotic fluid. Amniocentesis to measure AFP is offered if there is a family history of neural tube defects, or if earlier screening tests of AFP in the mother's blood indicate that the pregnancy is at increased risk.<br /><br /> * The doctor wants to assess fetal lung maturity. Fetal lung assessment is important if the mother needs to deliver the baby early. By testing the amniotic fluid doctors can tell whether the baby's lung's are developed enough to breathe on their own.<br /><br /> * Detection of Rh disease is needed. Rh disease causes antibodies in the mother's blood to attack fetal blood cells and an amniocentesis detects the disease and enables the doctors to take appropriate measures to reduce complications.<br /><br />Questions To Ask Your Doctor About Amniocentesis<br />Should an amniocentesis be done?<br /><br />Is there a possibility the baby will have birth defects?<br /><br />When should the amniocentesis be done?<br /><br />How will the test be done?<br /><br />What will the amniocentesis show?<br /><br />What are the possible outcomes?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-48289251482587692592010-05-01T05:13:00.000-07:002010-05-01T05:19:25.995-07:00Cesarean Section* Definition of Cesarean Section<br /> * Description of Cesarean Section<br /> * Questions To Ask Your Doctor About Cesarean Section<br /><br />Definition of Cesarean Section<br />Cesarean childbirth consists of an operation to deliver a baby through an incision in the abdomen.<br /><br />Description of Cesarean Section<br />Until recently the operation was usually used as a last resort because of a high rate of maternal complications and death. With the availability of antibiotics to fight infection and the development of modern surgical techniques, the once high maternal mortality rate has dropped dramatically. As a result, the cesarean childbirth rate has increased dramatically.<br /><br />There are three main types of cesarean operations, each named according the location and direction of the uterine incision:<br /><br /> Low Transverse, a transverse (horizontal) incision in the lower uterus<br /><br /> Low Vertical, a vertical incision in the lower uterus<br /><br /> Classical, a vertical incision in the main body of the uterus<br /><br />Today, the low transverse incision is used almost exclusively. It has the lowest incidence of hemorrhage during surgery as well as the least chance of rupturing in later pregnancies.<br /><br />Sometimes, because of fetal size (very large or very small) or position problems (breech or transverse), a low vertical cesarean may be performed.<br /><br />In the classical operation, a larger vertical incision allows a greater opening; it is used in some emergency situations as well as for fetal size or position problems. This approach involves more bleeding in surgery and a higher risk of abdominal infection. All subsequent deliveries must be by cesarean section after a classical delivery due to the higher risk of uterine rupture.<br /><br />Although any uterine incision may rupture during a subsequent labor, the classical is more likely to do so, and more likely to result in death for the mother and fetus than a low transverse or low vertical incision.<br /><br />There are many reasons why a woman might need to deliver by Cesarean section, although not all doctors agree on when one is really necessary. The most common reason is failure to progress (FTP) in labor, where labor has stalled because the cervix has stopped dilating or uterine contractions are weak. The second most common reason for cesarean section is fetal distress. Sometimes the baby can not tolerate the strong contractions associated with labor. When the fetal heart tracing becomes non-reassuring, a cesarean section is usually performed. Another common reason for cesarean section is previous cesarean section or surgery on the uterus. Women who delivered by a classical cesarean section in a previous pregnancy must deliver by cesarean section for all following pregnancies. However, women with a history delivering by low transverse cesarean section are given the choice of scheduling a repeat cesarean section or trying to deliver vaginally. Also some women with a history of surgery to remove fibroids may need to deliver by cesarean section.<br /><br />Other less common reasons for a cesarean section are listed below:<br /><br />Cephalopelvic Distortion (CPD. Another indication of cesarean delivery is cephalopelvic disproportion (CPD), a rare condition in which the baby's head is too large to fit through the mother's pelvis.<br /><br />Malposition of the fetus. In breech position, the baby's buttocks or feet are positioned to come out first instead of the head. Twins might need to be delivered by cesarean if the first baby or both are breech. Malposition of the fetus does not necessarily mean a cesarean delivery.<br /><br />Vaginal bleeding/placenta previa/placental abruption. Vaginal bleeding late in pregnancy often indicates placenta previa, a low-lying placenta that covers part or all of the inner opening of the cervix. If the bleeding does not stop with bedrest, the doctor probably will perform a cesarean, to prevent hemorrhage. Vaginal bleeding late in pregnancy also may indicate placental abruption, where the placenta separates from the uterine wall before delivery. In some cases of mild abruption, it may be possible to deliver vaginally. If there is heavy bleeding or fetal distress caused by abruption (abruption can lead to maternal shock, which, together with a reduced amount of functioning placenta, can deprive the fetus of adequate oxygen), a cesarean generally is necessary.<br /><br />Other situations. If you have vaginal herpes and active sores in the vaginal area, your doctor might do a cesarean to try to prevent your passing on the disease to your baby. A cesarean section is usually performed in mothers with HIV before labor to prevent transmission HIV from mother to baby. Women diagnosed with invasive cervical cancer who have bulky cancer lesions on the cervix are offered classical cesarean section to deliver the baby. Lastly, women pregnant with a baby with bleeding problems may be offered a cesarean section to prevent birth trauma to the infant.<br /><br />Malpractice concerns, a woman’s preference, obesity and insurance coverage are also factors which may play a role in whether to perform a cesarean delivery.<br /><br />Until recently, it was medically accepted that once a woman had a cesarean, she should have all of her children by cesarean because of the concern about tearing the incision. Yet studies have shown "once a cesarean, always a cesarean," no longer holds true for most women. Today, the option of attempting to give birth through the vagina is open to women who have had previous low transverse incision cesarean births, and over half of these have successful vaginal deliveries.<br /><br />If vaginal delivery is a possibility for you, here are some reasons why you may wish to attempt it:<br /><br /> Less risk. A vaginal delivery usually has fewer complications for the mother than a cesarean birth. As there is no abdominal incision, the risks of infection, bleeding, or other problems resulting from surgery or anesthesia are much lower.<br /><br /> Shorter recovery. Your stay in the hospital is likely to be briefer after vaginal delivery. The average time spent in the hospital is 1 to 3 days, whereas the average stay after a cesarean birth is 3 to 5 days. Recovery at home is faster as well, since women who deliver by cesarean must limit their activity for 4 to 6 weeks to allow the abdominal incision to heal.<br /><br /> More involvement. Some women wish to be awake and fully involved in the birth process. There may also be more limitations on the presence of others in the room during the cesarean birth process<br /><br />Questions To Ask Your Doctor About Cesarean Section<br />What circumstances require cesarean delivery?<br /><br />Are indications of fetal distress confirmed by a fetal scalp blood test?<br /><br />Is a second opinion sought before proceeding to all but emergency surgery?<br /><br />Must I have intravenous infusion during labor, or can I eat and drink lightly?<br /><br />What are some specifics about the facility where I will deliver. Does it require a specific management plan, such as active management of labor?<br /><br />Does it offer a constant labor companion, or allow you to bring your own?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com1tag:blogger.com,1999:blog-3000963844336424708.post-87486904706292440232010-05-01T05:04:00.000-07:002010-05-01T05:13:11.871-07:00CD4 Lymphocyte Monitoring* Description of CD4 Lymphocyte Monitoring<br /> * Questions To Ask Your Doctor About CD4 Lymphocyte Monitoring<br /><br />Description of CD4 Lymphocyte Monitoring<br />Monitoring lymphocyte counts in a patient with HIV infection is one way to assess the degree of immunosuppression and the risk of developing opportunistic infections.<br /><br />For several years after exposure to human immunodeficiency virus (HIV), an infected person will typically have either no symptoms or only minor ones such as chronically swollen lymph nodes. However, despite the absence of noticeable symptoms, HIV may be silently causing damage.<br /><br />HIV infects and kills certain white blood cells called CD4 lymphocytes, reducing their number. The number of CD4 cells usually declines over time in an HIV-infected person. CD4 lymphocytes act as the 'on switch' for part of the immune system, so as the number of CD4 cells drops, damage to the immune system may progress.<br /><br />Over time, individuals become increasingly susceptible to infections caused by organisms that are usually controlled by people with adequate immune systems. Those infections are called opportunistic infections.<br /><br />Years after infection, HIV-infected people may develop symptoms such as night sweats, chronic diarrhea, fatigue, fever, and various skin problems. These symptoms vary in severity for each individual. If the individual receives no treatment and further immune impairment occurs, the body becomes susceptible to life-threatening complications.<br /><br />Text Continues Below<br /><br />Questions To Ask Your Doctor About CD4 Lymphocyte Monitoring<br />What is the CD4 count?<br /><br />Has the count dropped since it was last taken?<br /><br />How accurate is the count?<br /><br />At what level should treatment begin?<br /><br />How can the symptoms be controlled?<br /><br />What preventive measures should be taken?<br /><br />When should the count be repeated?<br /><br />Is HIV counseling available?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-8334388023845701572010-05-01T04:53:00.000-07:002010-05-01T04:54:38.526-07:00Congestive Heart Failure* Definition of Congestive Heart Failure<br /> * Description of Congestive Heart Failure<br /> * Causes and Risk Factors of Congestive Heart Failure<br /> * Symptoms of Congestive Heart Failure<br /> * Diagnosis of Congestive Heart Failure<br /> * Treatment of Congestive Heart Failure<br /> * Questions To Ask Your Doctor About Congestive Heart Failure<br /><br />Definition of Congestive Heart Failure<br />Article updated and reviewed by Neil Siecke, MD, Clinical Insturctor, UCSD Division of Cardiology on July 28, 2005.<br /><br />Congestive heart failure (or heart failure) occurs when the heart is unable to pump enough blood (which provides oxygen) to the muscles, tissues, and other organs of the body.<br /><br />Statistics on Heart Failure<br /><br /> * A person aged 40 years or older has a one in five chance of developing heart failure.<br /><br /> * About five million Americans have been diagnosed with heart failure.<br /><br /> * About 550,000 new cases are diagnosed each year.<br /><br /> * Heart failure is the most common hospital discharge diagnosis with more than one million hospital stays each year.<br /><br /> * The costs of treating heart failure in the United States exceed $27 billion.<br /><br /> * The risk of heart failure increase with age: 10% of both men and women over 75 have been diagnosed with heart failure.<br /><br />Statistics derived from the American Heart Association, Heart Disease and Stroke Statistics — 2005 Update<br /><br />Description of Congestive Heart Failure<br />There are three ways that the pumping ability of the heart can be affected:<br /><br />1. The mechanical pump can be ineffective, reducing the ability of the heart to move blood forward.<br /><br />2. The valves that allow blood to go forward and prevent it from going backwards can fail.<br /><br />3. The electrical controls for the pump can fail.<br /><br />Problems with the Pump<br /><br />Problems with the pumping functions of the heart are the most common cause of heart failure. The heart is actually made up of two pumps, one which pumps blood to the lung (the right heart) and the other which pumps blood to the rest of the body (the left heart). The left heart is usually stronger and is also more likely to fail.<br /><br />The heart can fail for one of two reasons. If it is weak, it can not expel the appropriate amount of blood with each heart beat. It will try to compensate by beating faster, but there are limits to this. How much blood is expelled with each beat is called the ejection fraction (EF). Normally the heart expels about 50% of the blood in chamber with each beat; however, when the heart is weak, this number can fall to 30% or even lower. Symptoms typically begin when the EF falls to around 40%. This type of failure is known as systolic dysfunction.<br /><br />The other type of heart failure is called diastolic dysfunction. With diastolic dysfunction, the EF is normal. The problem is that the heart does not fill appropriately. It becomes too stiff and can not enlarge fast enough to accept the appropriate amount of blood into the chamber before contracting to move the blood forward. Because the heart is not filling fast enough, blood backs up behind the heart in the lungs.<br /><br />The right heart can also fail. The right heart is designed to pump against low pressure, as the blood pressure in the lungs is usually < 40 mmHg. If this pressure becomes elevated, the pump is unable to push the blood forward and it will collect in the veins of the legs and abdomen. The most common cause for high blood pressure in the lungs is backing-up from left heart failure, but other causes such as pulmonary hypertension, blood clots in the lungs, and severe emphysema can also raise this pressure.<br /><br />Causes for Systolic Dysfunction (Weak Hearts:<br /><br /> * A previous heart attack is the most common cause for a weak heart; the muscle tissue in this area dies and is replaced by scar tissue which has no pumping activity; just having multiple areas of blocked arteries can also weaken the heart<br /><br /> * Certain kinds of viral infections can attack the heart muscle<br /><br /> * Alcohol abuse<br /><br /> * Illicit drugs such as methamphetamine and cocaine<br /><br /> * Certain, mostly older, chemotherapy drugs<br /><br /> * Some auto-immune disorders<br /><br /> * Rarely the heart weakens after pregnancy, known as post-partum cardiomyopathy<br /><br />Causes for Diastolic Dysfunction (Stiff Hearts):<br /><br /> * High blood pressure for many years is the most common cause of a stiff hear; a blood pressure greater than 160/90 mmHg doubles the risk of a person with a blood pressure of 140/80<br /><br /> * Diabetes seems to worsen the effects of high blood pressure<br /><br /> * Hypertrophic Cardiomyopathy (a group of genetic abnormalities that results in thickened hearts)<br /><br /> * Infiltrative diseases such as amyloidosis<br /><br /> * Some valvular problems also cause the heart to become stiff<br /><br /> * Certain diseases of the pericardium, or lining, around the heart<br /><br />Problems with the Valves<br /><br />The heart has four valves that allow the blood to move forward and prevent it from going backwards. The valves can fail either because they become clogged and do not allow blood to move forward easily, or they can become leaky in which case too much blood flows backward, and not enough moves forward.<br /><br />Most valve problems will result in a murmur. The murmur may begin many years before the problem becomes noticeable, but this is not always the case.<br /><br />Reasons that the valves can fail include the following:<br /><br /> * Congenital (birth) defects<br /><br /> * Calcification of the valve<br /><br /> * Infection of the valve (Rheumatic Fever is the most common)<br /><br /> * Heart attacks can also damage the valve<br /><br />Problems with the Electrical Controls of the Heart<br /><br />The electrical system controls how often, or how fast, the heart beats and coordinates the movements among the various chambers of the heart for optimal efficiency. Beating too fast, too slow, or irregularly can all result in heart failure. The generic name for these problems is an arrhythmia.<br /><br />The normal heart rate is 60 to 80 beats per minute. The most common reason for the heart to beat to rapidly is excess stimulation, such as a thyroid problem. The most common reason for beating too slow is bad connection between the chambers (heart block). An irregularly beating heart is often caused by atrial fibrillation.<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Congestive Heart Failure<br />The two most common causes of heart failure are high blood pressure and coronary artery disease (disease of the artery). Up to 75 percent of all patients with heart failure have a history of high blood pressure, and at least 50 percent have a history of coronary artery disease.<br /><br />Specific causative factors for the four (4) forms of heart failure are listed below.<br /><br /> 1. Systolic heart failure can be caused by coronary artery disease; high blood pressure; metabolic disorders, such as thyroid disease, vitamin deficiency or diabetes; infection; toxin exposure to cobalt, alcohol, cocaine and chemotherapeutic agents; infiltrative diseases, such as cardiac amyloidosis and hemochromatosis; neuromuscular disease; collagen vascular disease; valvular heart disease or peripartum cardiomyopathy.<br /><br /> 2. Diastolic heart failure can be caused by coronary artery disease; high blood pressure; myocardial relaxation; left ventricular elastic recoil; ventricular-ventricular interaction; pericardial restraint; intrathoracic pressure or passive chamber properties.<br /><br /> 3. Left-sided heart failure can be caused by high blood pressure; hypertrophic cardiomyopathy (an enlarged left ventricle and a thick ventricular wall); anemia; hyperthyroidism; heart valve defect, such as aortic valve stenosis and aortic insufficiency; congenital heart defect; heart arrhythmias; myocardial infarction or cardiomyopathy (disease of the heart muscle).<br /><br /> 4. Right-sided heart failure can be caused by pulmonary hypertension; lung disease, such as chronic bronchitis and emphysema; tricuspid insufficiency or congenital heart defect, such as septal defect, pulmonary stenosis or tetralogy of Fallot.<br /><br />Symptoms of Congestive Heart Failure<br />All of the types of heart failure can result in similar symptoms, including the following:<br /><br /> * Shortness of breath, especially with activity such as walking<br /><br /> * Difficulty breathing when lying flat in the bed<br /><br /> * Waking up at night short of breath<br /><br /> * Fatigue<br /><br /> * Weakness<br /><br /> * Pale, blue or cool skin<br /><br /> * Palpitations<br /><br /> * Changes in blood pressure<br /><br /> * Fainting for no apparent reason<br /><br /> * Swelling in the abdomen<br /><br /> * Swollen legs<br /><br />Symptoms of right-sided heart failure include:<br /><br /> * Swollen legs<br /><br /> * Liver and spleen enlargement<br /><br /> * Swollen neck veins<br /><br /> * Fluid buildup in the stomach<br /><br /> * Swollen abdomen<br /><br /> * Slow weight gain<br /><br /> * irregular heart rhythm<br /><br /> * Nausea<br /><br /> * Vomiting<br /><br /> * Appetite loss<br /><br /> * Weakness<br /><br /> * Fatigue<br /><br /> * Dizziness<br /><br /> * Fainting episodes<br /><br />Diagnosis of Congestive Heart Failure<br />A health history, physical exam, chest x-ray, and electrocardiogram (EKG) should be done in every person suspected of heart failure. Most patients will also have an echocardiogram (an ultrasound study of the heart). A blood test (BNP) can also be useful in diagnosing heart failure.<br /><br />The health history will consist of questions about symptoms and how long they have been present, previous heart problems, other health problems, , and use of alcohol or other drugs.<br /><br />During the physical exam, the doctor will listen to the heart and lungs with a stethoscope to detect the sounds associated with heart failure (such as murmurs or the sound of fluid in the lungs).<br /><br />Additionally, the doctor will look for evidence of fluid build-up, such as swollen or enlarged neck veins, an enlarged liver, an expanding abdomen and swollen ankles.<br /><br />A chest x-ray may reveal an enlarged heart or fluid in the lungs. It may also suggest another reason for the symptoms such as pneumonia or damage to the lungs.<br /><br />An echocardiogram uses ultrasound waves to obtain images of heart structures. The echocardiogram can tell if the heart pumping ability is weak or stiff. It can also diagnose problems with the valves, or it may suggest that a person has had a previous heart attack.<br /><br />Treatment of Congestive Heart Failure<br />The treatments for heart failure have improved dramatically over the last five to 10 years. Most subjects can be managed to the point where they have few symptoms, but this often requires that they take five or more medications per day.<br /><br />When deciding how to treat heart failure, the most important question is what caused the heart failure in the first place and to reverse that if possible. If the problem is from a bad valve, surgery will usually be required to replace or repair the valve. If the problem is electrical, a pacemaker may be needed to regulate the heart beat or other treatments to slow the heart rate. If the problem is from blocked arteries, either an angioplasty or a bypass surgery is usually attempted. Most patients will end up taking several medications to improve their symptoms or help the heart recover.<br /><br />Medication<br /><br />The first treatment is usually a diuretic medication. These medicines work by forcing the kidney to excrete more salt and water. This will help to remove the excess fluid from the lungs and/or the legs. These medications can quickly make a patient feel better. Examples include furosemide (Lasix), bumetanide (Bumex), and hydrochlorothiazide (HCTZ).<br /><br />Angiotensin-converting enzyme inhibitors (ACE inhibitors) are used to reduce the blood pressure and to encourage the healthy recovery of the heart function. They work by restoring imbalances in several hormones. There are approximately 10 different brands available with similar effectiveness. Examples include: captopril (Capoten), enalapril (Vasotec), and lisinopril (Prinivil, Zestril).<br /><br />Some patients will develop a cough when treated with an ACE Inhibitor. They will usually be prescribed a closely related type of medication known as an angiotensin receptor blocker (ARB). Examples include valsartan (Diovan) and losartan (Cozaar).<br /><br />Recently, some studies have suggested that African-Americans may not respond as well as other ethnicities to ACE inhibitors. They may instead be prescribed a combination of hydralazine and isosorbide. Beta-blockers were originally thought to be harmful for subjects with heart failure as they tend to reduce the pumping ability of the heart. They work by blocking the effect of adrenaline, a stress hormone, that can be very high in patients with heart failure. We now know that adrenalin is harmful to the heart. Beta blockers can dramatically improve the function of the heart over time, but if the heart muscle is weak, they must be started at low doses and gradually increased over time. Examples of beta-blockers include carvedilol (Coreg) and metoprolol (Toprol XL).<br /><br />Digoxin (Lanoxin) has been used for several centuries to treat heart failure. It is an herbal extract that mildly increases the heart's pumping action so more blood is ejected with each heartbeat. Care must be taken to avoid high blood levels of this medication.<br /><br />Other medications may also be needed to lower the blood pressure, lower the level of cholesterol, replace potassium lost in the urine, or prevent blood clots.<br /><br />Electrical Devices:<br /><br /> * Defibrillators (ICDs) have been shown to prevent sudden cardiac death (a fatal arrhythmia) in certain groups of people with heart failure. These are small devices that are placed under the patient’s skin and monitor the electrical activity of the heart. If a problem is detected, the device will give the heart an electrical shock which is designed reset the heart and restore a healthy heart rhythm.<br /><br /> * Biventricular Pacemakers are advanced types of pacemakers that can stimulate both the right and left side of the heart at the same time if an electrical problem has caused them to become out of sync. These devices function much like typical pacemakers, but they require a more complicated installation to reach the left side of the heart.<br /><br />Dietary, Lifestyle and Health Changes<br /><br /> * Restrict salt (sodium) intake. Restricting sodium minimizes fluid retention.<br /><br /> * Avoid caffeine. Avoiding caffeine lowers the risk of an increased heart rate or abnormal heart rhythms.<br /><br /> * Limit or stop alcoholic beverage consumption.<br /><br /> * Check your weight everyday. If your weight suddenly increases, you may be retaining fluid and may need to adjust your medications.<br /><br /> * Don't smoke or chew tobacco.<br /><br /> * Don't use illegal drugs.<br /><br /> * Exercise regularly, within your doctor's guidelines.<br /><br /> * Rest. Adequate rest helps conserve energy and decreases demands on the heart.<br /><br /> * Reduce stress.<br /><br /> * Get a flu and pneumonia shot.<br /><br />Questions To Ask Your Doctor About Congestive Heart Failure<br />What form of heart failure is it?<br /><br />What is the cause of the condition?<br /><br />How serious is the condition?<br /><br />Should a specialist be consulted?<br /><br />What type of treatment will you be recommending?<br /><br />Will surgery be recommended?<br /><br />Will you be prescribing any medication?<br /><br />What are the side effects?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-11035119263304700302010-04-29T11:06:00.000-07:002010-04-29T11:15:24.920-07:00Baldness* Definition of Baldness<br /> * Description of Baldness<br /> * Causes and Risk Factors of Baldness<br /> * Treatment of Baldness<br /> * Questions To Ask Your Doctor About Baldness<br /><br />Definition of Baldness<br />Common baldness, sometimes called male- or female-pattern baldness, accounts for 99 percent of hair loss in men and women. Although its exact causes are unknown, heredity, hormones and age are contributing factors. Unlike hair loss resulting from disease or other non-hereditary factors, hair loss due to common baldness is permanent.<br /><br />Male baldness usually begins with thinning at the hairline, followed by the appearance of a thinned or bald spot on the crown of the head.<br /><br />Women with common baldness rarely develop bald patches. Instead, they experience a diffuse thinning of their hair.<br /><br />Description of Baldness<br />Hair is a conspicuous element in many cultural definitions of fashion, youth and sexuality. So, it is not surprising that many cringe at the first sign of thinning hair.<br /><br />Most people lose between 50 and 100 strands of hair daily, with little impact. As hairs fall out naturally, new hairs grow in. So there is no need to despair if you spot a hair or two in your sink. However, with age this natural regrowth process may slow or stop, and thinning and baldness may occur. If you are concerned about it, see your doctor for an evaluation to find out if your hair loss is due to an underlying medical disorder.<br /><br />Like your skin and nails, your hair goes through a finely tuned cycle of growth and rest. Excessive hair loss can occur at any time this delicate cycle is upset.<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Baldness<br />Factors such as diet, medications, natural hormones, pregnancy, improper hair care and certain diseases can cause temporary hair loss. Once the underlying cause is pinpointed and eliminated, the hair may grow back. See the Hair Loss report for more detailed causes of temporary hair loss.<br /><br />Treatment of Baldness<br />There is no cure for common baldness, but surgical hair replacement can give you back a head of your own hair. Available since the 1950s, surgical hair replacement is a low-risk procedure.<br /><br />Surgeons remove tiny plugs (grafts) of your hair-bearing skin and transplant them into tiny holes made in your scalp. They take these plugs from the band of hair extending from above your ears around the back of your scalp.<br /><br />During one session, your surgeon may transplant between 60 and 100 hair plugs, each about the diameter of a pencil eraser. Local anesthesia and mild sedation minimize discomfort during surgery.<br /><br />Hospitalization usually is unnecessary. Within a few days after the operation, tiny scabs form around each hair graft. When the scabs disappear, the donor hairs usually fall out. New hairs generally start to grow within a few months.<br /><br />If the baldness and thinning is extensive, one should not expect to walk out of the first surgery with a full, natural-looking head of hair. Even after the transplanted hairs begin growing, these widely scattered clumps may look conspicuous. Additional surgeries may be needed to fill the void. It may take a year or two before you will be pleased with your new appearance.<br /><br />The quest for a new look may cost in the range of $2,000 for each round of surgery. Typically, it takes three or fours sessions to cover a bald area.<br /><br />Questions To Ask Your Doctor About Baldness<br />Is the baldness caused by a medical disorder rather that the regrowth process stopping?<br /><br />If baldness runs in the family, will the male family members evidently start going bald?<br /><br />Will certain kinds of medicine cause hair loss?<br /><br />Do you recommend hair replacement?<br /><br />Is this procedure successful?<br /><br />Do you recommend using Rogaine or Propecia?<br /><br />What are the side effects of using these drugs?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-50965348454247934012010-04-29T10:58:00.000-07:002010-04-29T11:04:24.880-07:00Vitiligo* Definition of Vitiligo<br /> * Description of Vitiligo<br /> * Causes and Risk Factors of Vitiligo<br /> * Symptoms of Vitiligo<br /> * Diagnosis of Vitiligo<br /> * Treatment of Vitiligo<br /> * Questions To Ask Your Doctor About Vitiligo<br /><br />Definition of Vitiligo<br />Vitiligo, also called white spot disease or leukoderma, is a disease in which the skin loses its pigment due to the destruction of melanocytes.<br /><br />Description of Vitiligo<br />Melanocytes are pigment cells located in the surface layer of the skin called the epidermis and are responsible for producing melanin. Melanin is a dark pigment that gives skin its color and protects against ultraviolet radiation. When melanocytes stop producing melanin, the skin becomes pale, leaving areas of white patches - this is called vitiligo.<br /><br />Vitiligo can start at any age, but it often occurs between the ages of 20 and 30. Vitiligo may begin on the face above the eyes, or on the neck, armpits, groin, hands or knees. Vitiligo may appear as a few small pigmented patches or spread over the entire body. In many cases, initial pigment loss will occur, then, after several months, the number and size of the light areas become stable and may remain so for a long time. Episodes of pigment loss may appear again later.<br /><br />Vitiligo is present in about 1 percent of the population.<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Vitiligo<br />The actual cause of vitiligo is unknown, however researchers believe that there are many factors and/or conditions listed below that contribute to the disease:<br /><br /> * Heredity (over 30 percent of affected persons have reported vitiligo in a parent, sibling, or child)<br /><br /> * Exposure to chemicals such as phenol (disinfectant) or catechol (used in dyeing or tanning)<br /><br /> * Emotional or physical stress<br /><br /> * Autoimmune disorder is which the body may be destroying its own melanocytes<br /><br /> * Autotoxic response is which the melanocytes self-destruct leaving a toxic residue, that, in turn destroys new melanocytes<br /><br /> * Skin injury<br /><br /> * Burns<br /><br /> * Inflammatory skin disorders<br /><br /> * Associative disorders such as diabetes, pernicious anemia, hyper- and hypo-thyroidism, Addison's disease (adrenal insufficiency), uveitis (inflammation of the eyes) or alopecia areata (patches of hair loss).<br /><br />Symptoms of Vitiligo<br />The symptoms of vitiligo are:<br /><br /> * Chalk white patches of skin often located symmetrically on both sides of the body<br /><br /> * White hairs within depigmented patches<br /><br />Diagnosis of Vitiligo<br />The medical history is important, but diagnosis can usually be made solely by observation of characteristic skin changes. For fair-skinned people, the doctor will use a special light, called a Wood's lamp, to shine on the skin in a dark room to identify the vitiliginous patches. In some cases, a skin biopsy may be required.<br /><br />Treatment of Vitiligo<br />Depending on the severity of the condition, the treatment method may vary. Treatment methods include:<br /><br /> * Avoidance of tanning. For fair-skinned individuals, avoiding tanning of normal skin can make the areas of vitiligo almost unnoticeable.<br /><br /> * Use a sunscreen with an SPF of at least 30.<br /><br /> * Use a cosmetic cover-up solution. Make-up, self-tanning compounds with dihydroxyacetone, and dyes (such as Covermark, Walnut Stain, Vita Dye or Dermablend) help temporarily conceal the white patches of vitiligo.<br /><br /> * Repigmentation. The restoration of the normal pigment and can be achieved with repigmentation therapy or corticosteroids. To get repigmentation, new pigment cells must be produced from existing ones, such as ones found at the base of hair follicles, from the edge of the patch or from the patch itself if depigmentation is not complete.<br /><br /> In repigmentation therapy, a patient is given a psoralen drug (orally) and then is exposed to ultraviolet light A (UV-A) in the doctor's office. This therapy is called PUVA. When psoralen drugs are activated by UV-A, they stimulate repigmentation by increasing the availability of color-producing cells at the skin's surface. Psoralen is also available in a topical form that can be applied to the body for patients with small, scattered patches. Topical corticosteroids (such as Temovate or Psorcon) are prescribed for patients with small patches of vitiligo.<br /><br /> * Depigmentation is the destruction of the remaining melanocytes. Patients with vitiligo over half of their exposed body may want to consider using this method. A bleaching chemical called monobenzylether of hydroquinone (Benzoquin) is applied to normally pigmented skin. Treatment may take up to one year.<br /><br />Questions To Ask Your Doctor About Vitiligo<br />Is vitiligo contagious?<br /><br />Could there be an underlying condition causing this?<br /><br />Will this reoccur?<br /><br />What treatment method do you recommend?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-85496698004708618762010-04-29T10:55:00.000-07:002010-04-29T10:58:28.500-07:00Vertigo* Definition of Vertigo<br /> * Description of Vertigo<br /> * Causes and Risk Factors of Vertigo<br /> * Symptoms of Vertigo<br /> * Treatment of Vertigo<br /> * Questions To Ask Your Doctor About Vertigo<br /><br />Definition of Vertigo<br />Vertigo is a type of dizziness felt as a shift in a person's relationship to the normal environment (a feeling that the room is spinning is common) or a sense of movement in space.<br /><br />Although dizziness and vertigo are often used interchangeably, they are not the same thing. While all vertigo is dizziness, not all dizziness is vertigo.<br /><br />True vertigo, from the Latin "vertere," to turn, is a distinct, often severe form of dizziness that is a movement hallucination.<br /><br />Description of Vertigo<br />There are four major types of dizziness - vertigo, presyncope, disequilibrium, and lightheadedness.<br /><br />Most patients with true vertigo have a peripheral vestibular disorder, such as benign positional vertigo. This is usually associated with tinnitus and hearing loss.<br /><br />Central disorders, such as brain stem or cerebellar lesions, tend to be more chronic but less intense than peripheral disorders and are not associated with hearing loss. Central disorders account for only 15 percent of patients with vertigo.<br /><br />Vertigo is the illusion that you - or your surroundings - are moving. You may feel that you are spinning, tilting, rocking, or falling through space. You may vomit or have ringing in the ears (tinnitus). Also, your eyes may uncontrollably jerk back and forth (a condition called nystagmus).<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Vertigo<br />There are several causes of vertigo:<br /><br /> Benign positional paroxysmal vertigo (BPPV) is a disorder of the inner ear. The cause usually is unknown, but an upper respiratory tract infection or a minor blow to the head may be responsible. This type of vertigo occurs abruptly when you move your head up and down, or when you turn over in bed. Symptoms can be distressing but they fade in a few seconds. Avoiding positions that bring this on may reduce its occurrence.<br /><br /> BPPV is the commonest form of vertigo, with attacks lasting 30 to 60 seconds, typically set off when rolling over in bed, moving the head to one side or reaching for something ("top-shelf vertigo"). Sufferers can usually describe specific head movements that trigger it.<br /><br /> Although BPPV often occurs for no apparent reason, it can follow an ear infection, head or ear injury, and is thought to result from the dislodgement of normal crystalline structures in the ear's balance detectors. People with BPPV are often relieved to hear that it is due to an inner ear condition and does not signify some serious disorder such as a stroke or tumor.<br /><br /> Labyrinthitis refers to a variety of conditions within the inner ear. It may be associated with inflammation, an upper respiratory infection or nerve deterioration, but often occurs independently of other problems.<br /><br /> Central nervous system disorders that can cause vertigo as a symptom include multiple sclerosis, epilepsy, neck injuries, certain forms of migraine, acoustic neuroma, cerebellar and brain stem tumors, and TIAS (transient ischemic attacks).<br /><br />Symptoms of Vertigo<br />A patient may experience severe vertigo for days or weeks. Nausea, vomiting, and involuntary eye movements are common. The condition gradually improves, but symptoms can persist for weeks or months.<br /><br />Treatment of Vertigo<br />Treatment depends on the diagnosis. A complete medical evaluation is recommended for anyone with vertigo. This can reveal the true cause and suggest one or more solutions based upon treating the underlying disorder.<br /><br />Questions To Ask Your Doctor About Vertigo<br />Is it true vertigo?<br /><br />What is the probable cause?<br /><br />Is it related to a central nervous system disorder?<br /><br />How can the symptoms be controlled?<br /><br />Do I need to see a specialist?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-78417632853627416162010-04-29T10:44:00.000-07:002010-04-29T10:53:21.970-07:00Varicella (Chicken Pox)* Definition of Varicella (Chicken Pox)<br /> * Description of Varicella (Chicken Pox)<br /> * Symptoms of Varicella (Chicken Pox)<br /> * Treatment of Varicella (Chicken Pox)<br /> * Prevention of Varicella (Chicken Pox)<br /> * Questions To Ask Your Doctor About Varicella (Chicken Pox)<br /><br />Definition of Varicella (Chicken Pox)<br />Varicella, otherwise known as chicken pox, is a generalized infection caused by the varicella zoster virus. It is an extremely contagious disease that is characterized by a blistery rash. It occurs most frequently in children, between the ages of five and eight. Less than 20 percent of all cases in the U.S. affect people over the age of 15. Chicken pox is transmitted so easily that almost everyone gets the disease.<br /><br />Description of Varicella (Chicken Pox)<br />Chicken pox is contracted by touching an infected person's blisters or anything that has been contaminated by contact with them. The virus is also thought to be airborne since it may be caught from an infected person by coughing and sneezing even before the rash develops. Another way to get chicken pox is by exposure to shingles, a localized rash caused by the same virus.<br /><br />The incubation period (time between exposure to the illness and the appearance of symptoms) of chicken pox is 10 to 21 days. It is contagious for about six to eight days after the rash appears or until all of the blisters have dried out.<br /><br />Text Continues Below<br /><br />Symptoms of Varicella (Chicken Pox)<br />There are usually no symptoms before the rash occurs but occasionally there is fatigue and some fever in the 24 hours before the rash is noticed. The typical rash goes through a number of stages:<br /><br />1. First it appears as flat red splotches<br /><br />2. They become raised and may resemble small pimples<br /><br />3. They develop into small blisters, called vesicles, which are very fragile<br /><br />4. They may look like drops of water on a red base<br /><br />5. As the vesicles break, the sores become pustular and form a crust - the crust is made of dried serum, and not true pus. The crust falls away between days nine and 13. (Itching is severe in the pustular stage.)<br /><br />The vesicles tend to appear in crops within two to six days. All stages may be present in the same area. They often appear on the scalp and in the mouth, and then spread to the rest of the body, but they may begin anywhere. They are most numerous over shoulders, chest and back. There may be only a few sores, or there may be hundreds.<br /><br />The doctor should be called if the rash involves an eye, if fever is higher than 103, if there is much vomiting, or if there are signs of bacterial infection (such as a green or yellow discharge from the blisters, or any blisters with red streaks radiating outwards). Go to the emergency room if there is difficulty breathing or if the person is confused and disoriented or has seizures.<br /><br />Treatment of Varicella (Chicken Pox)<br />The major problem in dealing with chicken pox is control of the intense itching and reduction of the fever. Warm baths containing baking soda can help; sometimes cool compresses or cool baths will calm itching.<br /><br />Aspirin should not be used for children or adolescents with chicken pox because of the associated risk of Reye's syndrome, a rare but life-threatening condition. Fever can be treated with acetaminophen or ibuprofren.<br /><br />Cut the fingernails or use gloves to prevent skin damage from intense scratching. When lesions occur in the mouth, gargling with salt water may provide comfort. Drink cold fluids, and avoid hot, spicy and acidic foods (orange juice).<br /><br />Hands should be washed three times a day and all of the skin should be kept gently but scrupulously clean in order to prevent a complicating bacterial infection. A minor bacterial infection will respond to soap and time. If it becomes severe and results in the return of a fever, see a physician.<br /><br />Scratching and infection can result in permanent scars. A visit to the physician may not be necessary, unless a complication seems possible.<br /><br />Acyclovir (Zovirax), a drug primarily used for treating herpes simplex infections in adults, is a safe and effective treatment for chicken pox in normal children, especially older children and teenagers, when therapy is initiated during the first 24 hours of a rash. Adverse effects of acyclovir are minimal, the most common being gastrointestinal.<br /><br />Because chickenpox is extremely contagious, keep children home from daycare or school until the blisters are all crusted over.<br /><br />Prevention of Varicella (Chicken Pox)<br />Chicken pox can be prevented through vaccination (now recommended by almost all major national health and public health groups). Recommendations are:<br /><br /> * Children and Adolescents: Healthy children can be vaccinated, optimally at age 12 to 18 months or anytime up until the age of 13, if they have no history of chicken pox. Adolescents 13 years and older who have no history of chicken pox, should receive two doses of vaccine four to eight weeks apart. Duration of immunity after vaccination is not completely known. Re-vaccination with a booster dose may be required to sustain immunity through adulthood.<br /><br /> * Adults: Two doses of varicella vaccine four to eight weeks apart are recommended for healthy adults with no history of chicken pox or previous vaccination. Health care workers, daycare workers, employees of colleges or residential facilities, family members of immunocompromised individuals, and others who live or work in environments in which transmission may be easy are particularly encouraged to receive vaccination.<br /><br />Questions To Ask Your Doctor About Varicella (Chicken Pox)<br />Is someone contagious 24 hours prior to having a fever?<br /><br />At what age is the greatest risk of complications?<br /><br />Do you recommend calamine lotion to help the itching?<br /><br />Do you recommend any medications to decrease the severity of this virus?<br /><br />What are the side effects?<br /><br />Are showers less likely to spread the disease verses baths?<br /><br />Can you get chicken pox a second time?<br /><br />Does having a mild case or a severe case affect your chances of acquiring the virus?<br /><br />As a parent, what can I do to avoid acquiring chicken pox for the first time or as a repeat?<br /><br />Does chicken pox increase the chances of developing shingles?<br /><br />What are some of the complications?<br /><br />What are the signs and symptoms that should be reported to the doctor?<br /><br />Are there any measures that can help prevent scarring, such as vitamin E?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-54255867764669316512010-04-28T06:26:00.000-07:002010-04-28T06:27:59.258-07:00Birth Control* Definition of Birth Control<br /> * Description of Birth Control<br /> * Questions To Ask Your Doctor About Birth Control<br /><br />Definition of Birth Control<br />Birth control is a term used to describe an artificial or natural means to prevent pregnancy.<br /><br />Description of Birth Control<br />There are various methods of birth control available today. The most common artificial methods are male/female condoms, spermicides, sponge, diaphragm, cervical cap, oral contraceptives (birth control pills), injectable contraceptions (Depo-Provera, Lunelle), IUDs and surgical sterilization.<br /><br />The natural methods include complete abstinence (no sexual intercourse), periodic abstinence and withdrawal.<br /><br />Male/Female Condom<br /><br />The male condom (also known as a prophylactic or rubber) is a thin sheath, usually made of latex rubber, that covers the erect penis. When used correctly, a latex condom is about 85 percent effective, both for preventing pregnancy and decreasing the chance of contracting most STDs, including AIDS. Condoms can be made of animal membrane; however, some experts believe that the pores in such natural "skin" condoms may allow the virus to pass through. To be effective, the condom must be undamaged, applied to the erect penis before any genital contact, and must remain intact and snugly in place until completion of the sexual activity.<br /><br />The female condom is a lubricated sheath with a flexible polyurethane ring on each end. One ring is inserted into the vagina while the other remains outside. The ring outside covers the labia and keeps the condom in place during intercourse. When in place, the vaginal condom lines the vaginal wall and creates a covered passageway for the penis. To be effective, the condom must be undamaged and inserted before any genital contact. It must also remain inside of the vagina until the completion of intercourse. The estimated effectiveness of the female condom is 74 to 79 percent.<br /><br />Risks and side effects: The risks of using a male or female condom are minimal. Some people can experience a slight irritation and allergic reaction.<br /><br />Spermicides<br /><br />Spermicides are available in foam, jelly, gel and suppositories, and work by forming a physical and chemical barrier to sperm. They can be inserted into the vagina on a diaphragm, a cervical cap, a condom or alone, within an hour before sexual intercourse. If intercourse is repeated, more spermicide should be inserted. The estimated effectiveness is about 70 to 80 percent when used with other barrier contraceptives. They are not very effective when used alone. Risks and side effects: The risks of using spermicides are minimal. Some people can experience a slight irritation and allergic reaction.<br /><br />Sponge<br /><br />The sponge is made of white polyurethane foam (shaped like a small donut) and contains a spermicide. The sponge is inserted into the vagina to cover the cervix during and after intercourse. It is held in place by the vaginal walls and the dimple covering the cervix. It can be kept in place up to 24 hours. The estimated effectiveness is 72 to 82 percent. Risks and side effects: The risks of using a sponge are minimal. Some people may experience a slight irritation and allergic reaction, difficulty in removal, and very rarely, toxic shock syndrome (a bacterial infection associated with the use of highly absorbent tampons).<br /><br />Diaphragm<br /><br />A diaphragm is made of soft rubber and is shaped like a shallow cup. It has a flexible metal spring rim that fits snugly over the cervix. Before insertion, a spermicidial cream or jelly should be applied into the shallow cup. The diaphragm must be fitted by a health professional and the correct size must be prescribed to ensure a snug seal with the vaginal wall. It must be kept in the vagina at least six to eight hours after intercourse. It is most effective when used with a spermicide. The estimated effectiveness is 82 to 94 percent.<br /><br />Risks and side effects: The risks of using a diaphragm are minimal. Some people may experience a slight irritation, an allergic reaction, a bladder infection and very rarely, toxic shock syndrome (a bacterial infection caused by use of highly absorbent tampons).<br /><br />Women who have a severely displaced uterus, cystocoele (a protrusion of the bladder through the vaginal wall), fistulas (openings in the vagina), scoliosis (curvature of the spine), spina bifida, chronic urinary tract infections or a history of toxic shock syndrome, should not use a diaphragm.<br /><br />Cervical Cap<br /><br />The cervical cap is a thimble-shaped rubber cap that fits snugly over the cervix. Like the diaphragm, it blocks sperm from entering the cervical opening. Usually, a small amount of spermicide is used on the inside of the cap to kill any sperm that may break through the seal. The cervical cap must be fitted by a health professional and the correct size prescribed to ensure a snug seal. It must be kept in the vagina at least six to eight hours after intercourse. It is most effective when used with a spermicide. It has an estimated effectiveness of about 82 percent.<br /><br />Risks and side effects: The risks of using a cervical cap may include abnormal pap tests, vaginal or cervical infections, and very rarely, toxic shock syndrome.<br /><br />Women who have a severely displaced uterus, fistulas, scoliosis, spina bifida, chronic urinary tract infections, a history of toxic shock syndrome, cervical erosion or laceration, or an elongated or irregular cervix, should not use a cervical cap.<br /><br />Oral Contraceptives (Birth Control Pills)<br /><br />At present, more than 20 brand names and more than twice that number of formulations of oral contraceptives are available. Because they are 98 to 99 percent effective, oral contraceptives offer women the most reliable form of easily reversible contraception (other than abstinence) from sexual intercourse.<br /><br />Birth control pills use synthetic hormones similar to the ones made in the ovaries. There are two types of pills currently manufactured in the United States: a combination pill, with both synthetic progesterone (progestin) and synthetic estrogen; and mini-pills, which contain only progestin.<br /><br />Although all oral contraceptives prevent sperm from uniting with an egg, they work in slightly different ways. The combination pill keeps the ovaries from releasing an egg. The mini-pill is less reliable in suppressing egg release, but creates changes in the cervix and uterus that make conception less likely.<br /><br />The mini-pill is less effective than the combination pill, but does not have the risks attributed to estrogen, such as increased possibility of blood clots and nausea. However, the mini-pill causes more problems with spotting and bleeding between periods and therefore, its use is not widespread.<br /><br />Combination pills come in two types. One provides the same combined dose of synthetic progestin and synthetic estrogen throughout the entire cycle. Others, sometimes called biphasic or triphasic pills vary the levels of these two hormones to more closely approximate a woman's normal hormonal variations. In some women, these pills have a lower risk of side effects.<br /><br />The pill essentially works by interfering with a woman's normal fluctuations in hormone levels, which in turn prevents the egg from maturing and being released. It also acts on the climate of the cervix, uterine lining and fallopian tubes, making them all inhospitable for egg, sperm or embryo.<br /><br />Combination pills are packaged in several ways: the most common is the 21-day pack. One pill is taken each day for 21 days, then none during the next seven days (for the average 28-day cycle during which menstruation occurs). There are also 28-day packs, with 21 active pills followed by seven inactive ones (placebos).<br /><br />The mini-pills must be taken at the same time (within three hours) every day.<br /><br />In addition to effectiveness in preventing conception, oral contraceptives offer other benefits. Menstrual periods are usually lighter, making iron deficiency less likely, and there may be less cramping. Ovarian cysts, ovarian cancer, and perhaps endometrial cancer occur less often among pill users. In addition, ectopic pregnancy occurs less frequently among pill users (in the rare instance when pregnancy occurs at all).<br /><br />Risks and side effects: Minor side effects include headaches, sore breasts, weight gain, feeling sick to your stomach, irregular bleeding, and depression. Serious possible side effects are more likely to occur in women over the age of 35. These include an increased risk of heart attack, stroke and formation of blood clots in the veins (thrombosis). These side effects are even more likely to occur among women who smoke; thus, the pill is not recommended for women who smoke. Women with a history of blood clots, high blood pressure, severe diabetes, or breast or uterine cancer, should not take the pill.<br /><br />Possible Interactions: There is a possibility that the herb St. John’s wort may interfere with the pill’s effectiveness, therefore it is best not to take this herb at the same time that you are on the pill. Also, several antibiotics can interfere with the effectiveness of the birth control pill. It is best to consult with a pharmacist or your doctor to determine if any medication you are taking might interfere with the pill.<br /><br />Ortho Evra, Contraceptive Patch<br /><br />The Contraceptive Patch has the similar properties as the oral birth control pill, but is applied to the skin of the lower abdomen, buttocks, upper arm or upper body. It is worn continuously for 7 days and then replaced with another patch every week for 3 weeks, followed by one week without a patch. Estrogen levels are higher with the patch than with birth control pills. In theory, higher estrogen levels may increase the risk of blood clots. It is currently unclear if women who use the patch have higher risks of blood clots when compared to women who use birth control pills.<br /><br />Risks and side effects: Side effects of the Contraceptive Patch may include nausea or breast tenderness, and rare risks of blood clots, heart attack and stroke, particularly if women smoke while using the contraceptive.<br /><br />Contraceptive Vaginal Ring<br /><br />The contraceptive vaginal ring or NuvaRing is a plastic ring coated with both estrogen and progesterone. It has similar properties to birth control pills but it is inserted in the vagina. It is worn continuously for three weeks followed by one week without the ring. Lower doses of hormones are released from the NuvaRing than from birth control pills.<br /><br />Risks and side effects: Side effects of the vaginal ring may include nausea or breast tenderness, and rare risks of blood clots, heart attack and stroke, particularly if women smoke while using the contraceptive.<br /><br />Depo-Provera<br /><br />Depo-Provera is an injectable form of a progestin (like the oral minipill). Each injection provides contraceptive protection for 14 weeks. It is injected every three months into a muscle in the buttocks or arm. Its estimated effectiveness is 99 percent.<br /><br />Risks and side effects: The risks of using Depo-Provera may include menstrual cycle irregularity, headaches, nervousness, depression, nausea, dizziness, change of appetite, breast tenderness, weight gain, enlargement of ovaries and/or fallopian tubes, excessive growth of body and facial hair. Depo-Provera can also cause bone loss. Women who use this method for two years or longer should get a special X-ray to measure the strength of their bones.<br /><br />Implanon<br /><br />Implanon is a progesterone-only implant. It lasts for three years and is effective within 24 hours of insertion. It is inserted in the upper arm in a doctor’s office using local numbing medicine. It is made to gradually release progesterone. Its estimated effectiveness is 99 percent.<br /><br />Risks and side effects: The risks of using Implanon are rare but may include rash, infection or movement of the rod in the arm. Other effects may include menstrual cycle irregularity, change of appetite, breast tenderness, and weight gain.<br /><br />The Morning After Pill (Emergency Contraceptive)<br /><br />The morning after pill (MAP) is an increasingly accepted means of contraception. It is best used in situations when intercourse happens infrequently or unexpectedly. The MAP is a special formulation of the same (or similar) hormones used in birth control pills. It is given in one or two doses. To be effective, the first dose must be taken within 72 hours of intercourse, the sooner the better.<br /><br />Risks and side effects: It can cause nausea and breast tenderness, and it can disrupt the regularity of the menstrual cycle.<br /><br />RU486<br /><br />Approved in the U.S. in September 2000, RU486 (mifepristone) causes the uterine lining to shed after an egg is implanted. It is taken as a series of pills over the course of a few weeks and will interrupt a very early pregnancy. It is very widely used in Europe and has been approved in the U.S. since September 2000. It is best to have this pill prescribed by a physician or health care setting that is familiar with its use and can follow users carefully to assure optimal outcomes.<br /><br />Risks and side effects: Possible side effects include weight gain, sore breasts, menstrual cycle irregularity, and very rarely life-threatening infection.<br /><br />IUDs<br /><br />IUDs are small devices that fit inside the uterus. Some contain copper or synthetic progesterone; others are made of white plastic. One or more strings are usually attached to IUDs. When the IUD is in place, these strings extend into the upper vagina. The IUD alters the uterine and tubal fluids, which inhibits the transport of sperm through the cervical mucus and uterus. Its estimated effectiveness is 96 percent.<br /><br />Risks and side effects: The risks of using IUDs are cramps, bleeding, pelvic inflammatory disease (PID) an infection of the uterus and fallopian tubes, infertility, and very rarely, perforation of the uterus.<br /><br />IUDs should not be used by women who are pregnant, who have an active/recent or recurrent pelvic infection, acute cervicitis, vaginitis, abnormal pap tests, irregular or abnormal pelvic bleeding, disorders of the blood, endometriosis, exposure to DES in utero, an abortion within the last three months that led to an infection, diabetes, sickle cell anemia, anemia, bicornate uterus, cervical stenosis, endometrial polyps, severe menstrual cramps or bleeding, small uterus or valvular heart disease.<br /><br />Surgical Sterilization<br /><br />Female sterilization (tubal ligation) involves either cutting, constricting, clipping cutting or blocking the fallopian tubes to prevent the male sperm from reaching the ova. This can be done with a laparoscope (camera through the belly button) or hysteroscope (camera through the vaginal to the uterus). Male sterilization (vasectomy) involves cutting the two vas deferens (the ducts that carry sperm from the testes to the seminal vesicles).<br /><br />Both of these procedures are about 99 percent effective.<br /><br />Risks and side effects: Both of these have the normal risks associated with surgery, including infection or bleeding after the operation.<br /><br />Complete Abstinence and Periodic Abstinence<br /><br />Complete abstinence is not engaging in any type of sexual intercourse. Periodic abstinence is not having sexual intercourse during a woman's fertile period. Also called "natural family planning" or the "rhythm method", periodic abstinence is dependent on the ability to identify the approximate 10 days in each menstrual cycle that a woman is fertile. Its estimated effectiveness varies from 53 to 86 percent. However, it is important to recognize that many experts in family planning feel that the actual effectiveness of this method is much lower. This is because many women vary from month to month with respect to when they are most fertile.<br /><br />Withdrawal<br /><br />Withdrawal involves removing the penis from the vagina just before ejaculation so that the sperm is deposited outside the vagina and away from the lips of the vagina, as well. Withdrawal is not very effective, because the drops of fluid that come out of the penis right after it becomes erect can contain enough sperm to cause pregnancy.<br /><br />Text Continues Below<br /><br />Questions To Ask Your Doctor About Birth Control<br />Which birth control method do you recommend?<br /><br />If the condom is recommended, which is more effective - the male or female condom?<br /><br />What should be done if the condom breaks during intercourse without our knowledge?<br /><br />If sponges, diaphragms or cervical caps are recommended, how will I know if they are inserted correctly?<br /><br />Which birth control pill do you recommend?<br /><br />What happens if I miss a pill?<br /><br />How long can a woman remain on the pill?<br /><br />What are the side effects?<br /><br />Can I have a prescription for the morning after pill, just in case I need it?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-31656090401205239652010-04-28T06:07:00.000-07:002010-04-28T06:18:16.068-07:00Attention Deficit/Hyperactivity Disorder* Description of Attention Deficit/Hyperactivity Disorder<br /> * Causes and Risk Factors of Attention Deficit/Hyperactivity Disorder<br /> * Symptoms of Attention Deficit/Hyperactivity Disorder<br /> * Diagnosis of Attention Deficit/Hyperactivity Disorder<br /> * Treatment of Attention Deficit/Hyperactivity Disorder<br /> * AlternativeAttention Deficit/Hyperactivity Disorder<br /> * Questions To Ask Your Doctor About Attention Deficit/Hyperactivity Disorder<br /><br />Description of Attention Deficit/Hyperactivity Disorder<br />Attention Deficit/Hyperactivity Disorder (ADHD) is a genetically determined hereditary disorder. It is a syndrome characterized by chronic behavior patterns of inattentiveness, lack of impulse control and excess energy (hyperactivity). The symptoms may be mild or severe and are associated with functional deviations of the central nervous system without signs of major neurologic or psychiatric disturbance.<br /><br />Inattentiveness is when the child is easily distracted and has difficulty focusing or concentrating on a task.<br /><br />Lack of impulse control is when the child may get into frequent fights or act aggressively toward others with little cause.<br /><br />Hyperactivity is when the child seems to fidget, squirm and move about constantly and can't sit still for any length of time.<br /><br />It is important for parents, teachers and caregivers to understand that ADHD is not caused by poor parenting or a chaotic home environment. ADHD affects approximately 3 to 5 percent of all American children. The syndrome is 4 to 6 times more likely to occur in males than in females. In about half the cases, the age of onset occurs before age 4.<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Attention Deficit/Hyperactivity Disorder<br />A single biologic model to explain the syndrome has not been established. Some researchers believe that ADHD is due to a genetic defect that results in altered brain biochemistry. Differences in biochemistry are considered to be the cause of poor regulation of attention, impulsivity and motor activity.<br /><br />In 1990, the New England Journal of Medicine published a landmark study by researchers at the National Institute for Mental Health which documented the neurobiological effects of ADHD through brain imaging. The rate at which the brain uses glucose, its main energy source, was shown to be lower in persons with ADHD, especially in the portion of the brain that is responsible for attention, handwriting, motor control and inhibition responses.<br /><br />Additionally, some researchers suggest that prenatal conditions such as maternal alcohol or drug abuse and birth complications may contribute in some cases.<br /><br />Symptoms of Attention Deficit/Hyperactivity Disorder<br />ADHD characteristics often arise in early childhood. The Diagnostic and Statistical Manual, 4th Edition (DSM-IV) lists the following symptoms for Childhood ADHD:<br /><br />Inattention<br /><br /> * often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities<br /><br /> * often has difficulty sustaining attention in tasks or play activities<br /><br /> * often does not seem to listen when spoken to directly<br /><br /> * often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)<br /><br /> * often has difficulty organizing tasks and activities<br /><br /> * often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)<br /><br /> * often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books or tools)<br /><br /> * often easily distracted by extraneous stimuli<br /><br /> * often forgetful in daily activities<br /><br />Hyperactivity-Impulsivity<br /><br /> * often fidgets with hands or feet or squirms in seat<br /><br /> * often leaves seat in classroom or in other situations in which remaining seated is expected<br /><br /> * often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)<br /><br /> * often has difficulty playing or engaging in leisure activities quietly<br /><br /> * is often "on the go" or often acts as "driven by a motor"<br /><br /> * often talks excessively<br /><br /> * often blurts out answers before questions have been completed<br /><br /> * often has difficulty awaiting turn<br /><br /> * often interrupts or intrudes on others<br /><br />Diagnosis of Attention Deficit/Hyperactivity Disorder<br />The fact that the child exhibits ADHD-like behaviors does not prove that they are suffering from this disorder. It is quite possible that some other problem is causing these symptoms. In order to correctly diagnose ADHD, the doctor must first rule out these "look-alike" factors by conducting a thorough physical examination and administering laboratory and other diagnostic tests:<br /><br /> Medical conditions. Allergy and effects of allergy medication, hearing loss, thyroid disorders, visual disturbances, genetic disorders (such as Fragile X syndrome), seizure disorders and chronic medical conditions.<br /><br /> Mental disorders. Anxiety disorders, conduct disorder, depressive disorders, oppositional defiant disorder, pervasive development disorder or Tourette's syndrome.<br /><br /> Behavioral and neurologic conditions. Articulation problems, coordination problems, encopresis (a type of soiling problem whereby children defecate in inappropriate places), enuresis (bed-wetting), night terrors and sleep difficulties.<br /><br /> Learning and language disabilities. Difficulties with listening, speaking, thinking, reading, writing, reasoning and performing mathematical calculations.<br /><br />Additionally, the doctor will take a thorough medical history and consult rating scales to confirm ADHD. The history should include a family, birth and general medical history gathered from family as well as school and day-care (if applicable) workers.<br /><br />Children suspected of having ADHD can be evaluated at the school’s expense and, if found to be eligible, provided services under either of two federal laws: (1) the Individuals with Disabilities Education Act (IDEA), or (2) Section 504 of the Rehabilitation Act of 1973.<br /><br />Treatment of Attention Deficit/Hyperactivity Disorder<br />Most ADHD therapy today involves a "biopsychosocial" approach - "bio" refers to medication, "psycho" refers to counseling and psychotherapy and "social" refers to instruction in self-management and training in social skills.<br /><br />Medications<br /><br /> For decades, medications have been used to treat the symptoms of ADD. Medications in the class of drugs known as stimulants seem to be the most effective in both children and adults. These are methylphenidate (Ritalin, Methlyn), mixed salts of single entity amphetamine product (Adderall), and dextroamphetamine (Dexedrine or Dextrostat), and pemoline (Cylert). Cylert may cause serious liver damage.<br /><br /> For many people, these medicines dramatically reduce the hyperactivity and improve their ability to focus, work and learn. The medications may also improve physical coordination, such as handwriting and ability in sports.<br /><br /> Stimulants are not appropriate for every child with attention disorder. For instance, they are not intended for anyone with a primary psychiatric illness (such as schizophrenia, in which the person loses touch with reality) because they can worsen the disturbances. They can aggravate emotional problems, such as anxiety. They can bring out tics (involuntary movements) in a patient with a family history of tics.<br /><br /> Even a correctly administered stimulant can cause adverse effects, for no drug is completely without risk. The side effects most frequently reported are decreased appetite and insomnia. Less common are drowsiness, hypersensitivity, weight loss, headache, nausea, and blood pressure changes.<br /><br /> Whether a child should be given stimulants is a case-by-case decision in which the benefits are weighed against the risks. In the past, most stimulant treatments for ADHD were prescribed only for two to three years and only for children. But today, treatment may extend over longer periods and may be given to adolescents and adults. Stimulants clearly are not intended to be the sole treatment.<br /><br /> Other medications prescribed for symptoms of ADHD include clonidine (Catapres) and tricyclic antidepressants.<br /><br />Behavior Modification<br /><br /> Parents and children can be instructed in positive reinforcement techniques for rewarding desirable behavior and reducing negative behavior. Here are some strategies:<br /><br /> o Discipline can best be maintained by establishing a few consistent rules with immediate consequences whenever each rule is broken. Rules should be phrased positively in terms of what the child should do. Praise the child and reward him or her for good behavior.<br /><br /> o Structure a system of rewards for good behavior. This system encourages the child to work to earn privileges or rewards he or she wants by accumulating points for desired behaviors and removing points for undesirable behaviors.<br /><br /> o Make a written agreement (a contract) with the child in which the child agrees to do his or her homework every night or to demonstrate other desired behavior in return for a privilege.<br /><br /> o Provide a specified time-out location for when the child is out of control. This should not be seen as a place of punishment but as a "calm down" spot.<br /><br /> o Set up a study area away from distractions and establish a specific time each day to do homework.<br /><br /> o Have the teacher make a checklist of homework to be done.<br /><br /> o Put up a calendar of long-term assignments and other tasks.<br /><br /> o Avoid emotional reactions such as anger, sarcasm and ridicule.<br /><br />Counseling and Psychotherapy<br /><br /> There are three different types of psychotherapy available: individual psychotherapy, cognitive behavioral therapy and family therapy.<br /><br /> Individual therapy helps children with anxiety, difficulties with self-esteem, depression and other emotional problems. Cognitive behavioral therapy teaches children to modify their behavior by correcting the way they think about it. Family therapy assists the child and his or her family in understanding the condition.<br /><br /> Close communication between the physician and school personnel is essential.<br /><br />Self-management/Social Skills<br /><br /> Self-management and training in social skills helps children curb aggressive, impulsive and socially maladaptive behaviors.<br /><br />AlternativeAttention Deficit/Hyperactivity Disorder<br />There is no evidence to support the use of dietary management. Megavitamins, restriction of sugar, and supplementary trace minerals do not appear effective. Diets low in food additives or coloring are not effective.<br /><br />Questions To Ask Your Doctor About Attention Deficit/Hyperactivity Disorder<br />Can my child have ADHD and not be hyperactive?<br /><br />How do you diagnose a hyperactive child?<br /><br />How do you know the child's disorder is caused by deviations of the central nervous system versus just environmental discipline problems?<br /><br />Would you prescribe a medication for part of the treatment?<br /><br />What are the side effects?<br /><br />How should I expect the child's behavior to change after starting the medication?<br /><br />How long will the medication have to be taken?<br /><br />Are there any drug-free treatments for ADHD?<br /><br />What can be done to prevent social and emotional problems?<br /><br />Does eliminating sugar and caffeine products help reduce hyperactivity?<br /><br />What kind of behavior therapy will be planned?<br /><br />And will someone be able to work with the family and teachers to follow the behavioral plan?<br /><br />Does my child qualify for special education or other assistance from his/her school?<br /><br />With medications and behavior-modification techniques, when should we start to see a change in the child's behavior and learning problems?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-91741357121128447582010-04-28T06:04:00.001-07:002010-04-28T06:06:04.078-07:00Angina Pectoris* Definition of Angina Pectoris<br /> * Description of Angina Pectoris<br /> * Causes and Risk Factors of Angina Pectoris<br /> * Symptoms of Angina Pectoris<br /> * Diagnosis of Angina Pectoris<br /> * Treatment of Angina Pectoris<br /> * Questions To Ask Your Doctor About Angina Pectoris<br /><br />Definition of Angina Pectoris<br />Angina pectoris is a term that describes chest pain caused by myocardial ischemia - a condition in which the amount of oxygen getting to the heart muscle is insufficient. It usually occurs on exertion and is relieved by rest. Angina generally is a symptom of coronary artery disease. In most severe cases, it may occur with minimal effort or at rest.<br /><br />Description of Angina Pectoris<br />Angina pectoris is a common manifestation of coronary artery disease. The pain is caused by reduced blood flow to a segment of heart muscle (myocardial ischemia). It usually lasts for only a few minutes, and an attack is usually quickly relieved by rest or drugs (such as nitroglycerin). Also, it is possible to have myocardial ischemia without experiencing angina.<br /><br />Typically, angina is described as a "pressure" or "squeezing" pain that starts in the center of the chest and may spread to the shoulders or arms (most often on the left side, although either or both sides may be involved), the neck, jaw or back. It is usually triggered by extra demand on the heart: exercise, an emotional upset, exposure to cold, digesting a heavy meal are common examples.<br /><br />Some people experience angina while sleeping or at rest. This type of angina may be caused by a spasm in a coronary artery, which most commonly occurs at the site of atherosclerotic plaque in a diseased vessel.<br /><br />Most people with angina learn to adjust their lives to minimize attacks. There are cases, however, when the attacks come frequently and without provocation - a condition known as unstable angina. This is often a prelude to a heart attack and requires special treatment, primarily with drugs. Angina affects both men and women, usually in middle age. Men are much more likely than women to experience it before age 60. It may develop weeks, months or even years before a heart attack, or may be experienced only after a heart attack has occurred.<br />Text Continues Below<br /><br />Causes and Risk Factors of Angina Pectoris<br />The two main causes of angina are coronary artery spasm, and atherosclerotic plaque buildup which causes critical blockage of the coronary artery.<br /><br />The risk factors include:<br /><br /> * smoking<br /><br /> * sedentary lifestyle<br /><br /> * high blood pressure, or hypertension<br /><br /> * high blood fats or cholesterol<br /><br /> * hypercholesterolemia<br /><br /> * diabetes<br /><br /> * family history of premature ischemic heart disease <br /><br />Men are at higher risk than women.<br /><br />Symptoms of Angina Pectoris<br />Classic or typical angina occurs predictably with physical exertion or strong emotional reactions, and goes away just as predictably with rest. Starting immediately behind the sternum (breast bone), the pain may radiate to the left arm and shoulder or up to the jaw.<br /><br />Most people describe the pain as a kind of squeezing pressure, tightness or heaviness.<br /><br />There may be anxiety, increased or irregular heart rate, paleness and cold sweat, and a feeling of doom. The symptoms are like the ones for a heart attack.<br /><br />In some instances, chest pain results from other types of heart problems, including diseases that affect the heart muscle itself or the valves that control blood flow through the heart. Occasionally, ulcers, gallstones, abnormal contractions of the esophagus or severe anxiety and panic attacks can cause chest pain. However, if you do experience these symptoms, your best plan of action is to get immediate help. Stop doing whatever is causing the symptoms and call 911. Lie down with your head slightly elevated. If you are not allergic to it, take one adult aspirin.<br /><br />Diagnosis of Angina Pectoris<br />Diagnosis of angina is based upon the classic history of chest pain on exertion and by means of tests, demonstrating the presence of coronary artery disease.<br /><br />Treatment of Angina Pectoris<br />In most instances, drugs are recommended for the treatment of angina before surgery is considered. The major classes of drugs used to treat angina include the following:<br /><br />Nitrates. These come in several forms: nitroglycerine tablets to be slipped under the tongue during or in anticipation of an attack; ointment to be absorbed through the skin; long-acting medicated skin discs; or long-acting tablets. The latter three forms are used mostly to prevent rather than relieve attacks. The nitrates work by reducing the oxygen requirements of the heart muscle.<br /><br />Beta-blocking Drugs. These agents act by blocking the effect of the sympathetic nervous system on the heart, slowing heart rate, decreasing blood pressure, and thereby, reducing the oxygen demand of the heart. Recent studies have found that these drugs also can reduce the chances of dying or suffering a recurrent heart attack if they are started shortly after suffering a heart attack and continued for two years.<br /><br />Calcium-channel Blocking Drugs. These drugs are prescribed to treat angina that is thought to be caused by coronary artery spasm. They can also be effective for stable angina associated with exercise. All muscles need varying amounts of calcium in order to contract. By reducing the amount of calcium that enters the muscle cells in the coronary artery walls, the spasms can be prevented. Some calcium-channel blocking drugs also decrease the workload of the heart and some lower the heart rate as well.<br /><br />Questions To Ask Your Doctor About Angina Pectoris<br />Could the chest pain be the result of any other disorder other than heart disease?<br /><br />What is the cause of the angina?<br /><br />Are there any tests recommended to determine the degree of heart disease?<br /><br />What is the procedure for this test?<br /><br />What medications will be prescribed?<br /><br />What are the side effects?<br /><br />Do the medications just relieve the symptoms or do they help relieve the cause?<br /><br />What are the chances that surgery will be needed?<br /><br />What other procedures are used to alleviate the coronary problem?<br /><br />What preventive measures can be taken to decrease the risk of angina and the chance of a heart attack?<br /><br />If angina is brought on by exercise, then what form of physical activity can be done to decrease heart disease and keep me healthy?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-22007192618011265922010-04-28T06:04:00.000-07:002010-04-28T06:05:56.382-07:00Angina Pectoris* Definition of Angina Pectoris<br /> * Description of Angina Pectoris<br /> * Causes and Risk Factors of Angina Pectoris<br /> * Symptoms of Angina Pectoris<br /> * Diagnosis of Angina Pectoris<br /> * Treatment of Angina Pectoris<br /> * Questions To Ask Your Doctor About Angina Pectoris<br /><br />Definition of Angina Pectoris<br />Angina pectoris is a term that describes chest pain caused by myocardial ischemia - a condition in which the amount of oxygen getting to the heart muscle is insufficient. It usually occurs on exertion and is relieved by rest. Angina generally is a symptom of coronary artery disease. In most severe cases, it may occur with minimal effort or at rest.<br /><br />Description of Angina Pectoris<br />Angina pectoris is a common manifestation of coronary artery disease. The pain is caused by reduced blood flow to a segment of heart muscle (myocardial ischemia). It usually lasts for only a few minutes, and an attack is usually quickly relieved by rest or drugs (such as nitroglycerin). Also, it is possible to have myocardial ischemia without experiencing angina.<br /><br />Typically, angina is described as a "pressure" or "squeezing" pain that starts in the center of the chest and may spread to the shoulders or arms (most often on the left side, although either or both sides may be involved), the neck, jaw or back. It is usually triggered by extra demand on the heart: exercise, an emotional upset, exposure to cold, digesting a heavy meal are common examples.<br /><br />Some people experience angina while sleeping or at rest. This type of angina may be caused by a spasm in a coronary artery, which most commonly occurs at the site of atherosclerotic plaque in a diseased vessel.<br /><br />Most people with angina learn to adjust their lives to minimize attacks. There are cases, however, when the attacks come frequently and without provocation - a condition known as unstable angina. This is often a prelude to a heart attack and requires special treatment, primarily with drugs. Angina affects both men and women, usually in middle age. Men are much more likely than women to experience it before age 60. It may develop weeks, months or even years before a heart attack, or may be experienced only after a heart attack has occurred.<br />Text Continues Below<br /><br />Causes and Risk Factors of Angina Pectoris<br />The two main causes of angina are coronary artery spasm, and atherosclerotic plaque buildup which causes critical blockage of the coronary artery.<br /><br />The risk factors include:<br /><br /> * smoking<br /><br /> * sedentary lifestyle<br /><br /> * high blood pressure, or hypertension<br /><br /> * high blood fats or cholesterol<br /><br /> * hypercholesterolemia<br /><br /> * diabetes<br /><br /> * family history of premature ischemic heart disease <br /><br />Men are at higher risk than women.<br /><br />Symptoms of Angina Pectoris<br />Classic or typical angina occurs predictably with physical exertion or strong emotional reactions, and goes away just as predictably with rest. Starting immediately behind the sternum (breast bone), the pain may radiate to the left arm and shoulder or up to the jaw.<br /><br />Most people describe the pain as a kind of squeezing pressure, tightness or heaviness.<br /><br />There may be anxiety, increased or irregular heart rate, paleness and cold sweat, and a feeling of doom. The symptoms are like the ones for a heart attack.<br /><br />In some instances, chest pain results from other types of heart problems, including diseases that affect the heart muscle itself or the valves that control blood flow through the heart. Occasionally, ulcers, gallstones, abnormal contractions of the esophagus or severe anxiety and panic attacks can cause chest pain. However, if you do experience these symptoms, your best plan of action is to get immediate help. Stop doing whatever is causing the symptoms and call 911. Lie down with your head slightly elevated. If you are not allergic to it, take one adult aspirin.<br /><br />Diagnosis of Angina Pectoris<br />Diagnosis of angina is based upon the classic history of chest pain on exertion and by means of tests, demonstrating the presence of coronary artery disease.<br /><br />Treatment of Angina Pectoris<br />In most instances, drugs are recommended for the treatment of angina before surgery is considered. The major classes of drugs used to treat angina include the following:<br /><br />Nitrates. These come in several forms: nitroglycerine tablets to be slipped under the tongue during or in anticipation of an attack; ointment to be absorbed through the skin; long-acting medicated skin discs; or long-acting tablets. The latter three forms are used mostly to prevent rather than relieve attacks. The nitrates work by reducing the oxygen requirements of the heart muscle.<br /><br />Beta-blocking Drugs. These agents act by blocking the effect of the sympathetic nervous system on the heart, slowing heart rate, decreasing blood pressure, and thereby, reducing the oxygen demand of the heart. Recent studies have found that these drugs also can reduce the chances of dying or suffering a recurrent heart attack if they are started shortly after suffering a heart attack and continued for two years.<br /><br />Calcium-channel Blocking Drugs. These drugs are prescribed to treat angina that is thought to be caused by coronary artery spasm. They can also be effective for stable angina associated with exercise. All muscles need varying amounts of calcium in order to contract. By reducing the amount of calcium that enters the muscle cells in the coronary artery walls, the spasms can be prevented. Some calcium-channel blocking drugs also decrease the workload of the heart and some lower the heart rate as well.<br /><br />Questions To Ask Your Doctor About Angina Pectoris<br />Could the chest pain be the result of any other disorder other than heart disease?<br /><br />What is the cause of the angina?<br /><br />Are there any tests recommended to determine the degree of heart disease?<br /><br />What is the procedure for this test?<br /><br />What medications will be prescribed?<br /><br />What are the side effects?<br /><br />Do the medications just relieve the symptoms or do they help relieve the cause?<br /><br />What are the chances that surgery will be needed?<br /><br />What other procedures are used to alleviate the coronary problem?<br /><br />What preventive measures can be taken to decrease the risk of angina and the chance of a heart attack?<br /><br />If angina is brought on by exercise, then what form of physical activity can be done to decrease heart disease and keep me healthy?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com1tag:blogger.com,1999:blog-3000963844336424708.post-77540178284788618162010-04-28T05:26:00.000-07:002010-04-28T05:47:51.847-07:00Jaundice In Newborns* Definition of Jaundice In Newborns<br /> * Description of Jaundice In Newborns<br /> * Causes and Risk Factors of Jaundice In Newborns<br /> * Diagnosis of Jaundice In Newborns<br /> * Treatment of Jaundice In Newborns<br /> * Questions To Ask Your Doctor About Jaundice In Newborns<br /><br />Definition of Jaundice In Newborns<br />The cause of jaundice is a yellow bile pigment called bilirubin, which is carried in the blood and deposited in the skin, mucous membranes, and sclera (whites of the eyes). The result is that these areas of the body turn yellow.<br /><br />Anything that causes a significant increase in the amount of bilirubin in the blood will lead to jaundice.<br /><br />Description of Jaundice In Newborns<br />More than 25 percent of all healthy, full-term newborns become slightly jaundiced, usually on the third or fourth day of life. In premature babies the incidence of jaundice is higher.<br /><br />The exact level of bilirubin in the blood is determined by a simple blood test.<br /><br />No one can predict with certainty whether a newborn will develop jaundice, but Asian and Native American babies tend to have higher bilirubin levels than white babies, who have higher levels than black infants.<br /><br />Breastfed babies are more likely to develop jaundice than those who are fed formula, although researchers are not certain why. Some older studies have suggested that breastmilk contains a hormone that inhibits the liver's ability to process bilirubin, but more recent research has shown no link between hormones in breast milk and liver function. Still, in many instances, if breastfeeding is discontinued for 24 hours and formula is substituted, bilirubin levels decline and "breastfeeding jaundice" clears up more rapidly.<br /><br />The frequency of bowel movements also has been associated with jaundice. An infant's stool contains bilirubin, and if he passes stool too infrequently, some of the pigment is reabsorbed into the bloodstream and must be reprocessed by the liver, prolonging the symptoms of jaundice.<br /><br />Text Continues Below<br /><br />Causes and Risk Factors of Jaundice In Newborns<br />The two most common causes of jaundice in the newborn are an immaturity of the baby's liver, which is known as physiologic jaundice, and blood-group incompatibilities. There are many other, less common causes of jaundice in the newborn.<br /><br />Diagnosis of Jaundice In Newborns<br />Doctors diagnose jaundice through a simple blood test. A bilirubin level of less than 12 milligrams per deciliter of blood in the first few weeks of life is generally considered normal for a healthy, full-term baby.<br /><br />Doctors determine whether a newborn needs treatment for jaundice based “risk factors” and the baby’s age. Risk factors include jaundice in the first day of life, gestational age less than 38 weeks, mothers and babies blood being incompatible, brother or sister had jaundice after birth, male, collection of blood under the scalp, mother more than 25 years old, high blood counts, east Asian ethnicity and very high birth weight. Recommendations are:<br /><br />Low risk: No risk factors - phototherapy should be started if bilirubin is greater than 12 (24 hours), 15 (48 hours), or 18 (72 hours) mg/dL<br /><br />Medium risk: Term baby with risk factors or less than 38 weeks with no risk factors - phototherapy should be started if bilirubin is greater than 10 (24 hours), 13 (48 hours), or 15 (72 hours) mg/dL<br /><br />High risk: Baby 35-37 weeks gestation with risk factors - phototherapy should be started if bilirubin greater than 8 (24 hours), 11 (48 hours), or 13 (72 hours) mg/dL<br /><br />Treatment of Jaundice In Newborns<br />A major concern with jaundice is the risk of very high concentrations of bilirubin reaching the brain and causing damage. But studies show that most babies who suffer such brain damage have underlying illnesses or conditions, such as complete inability of the liver to process bilirubin.<br /><br />Doctors usually use phototherapy, or light treatment, to bring down bilirubin levels. The infant is placed under special fluorescent lamps that convert the excess bilirubin into a water-soluble form that can be excreted in bile and urine. The infant receives treatment usually in an incubator, for approximately two to three days. During that period, parents can take the baby out of the incubator for feeding, or they can reach in and touch their child.<br /><br />In some instances, hospitals are able to arrange for parents to rent home phototherapy equipment - long fluorescent lights that hang over the crib. Some hospitals are offering a fiber-optic "blanket" - a sheet of plastic that has fiber-optic tubing running through it so that the entire blanket becomes a light source. Many parents prefer the blanket because they are able to hold and cuddle their baby during treatment. Doctors will decide based on the baby’s risk factors and bilirubin levels if treatment at home is safe.<br /><br />If bilirubin levels remain high or doctors are concerned that the baby will be at risk for worsening jaundice, they may recommend “intensive phototherapy” that includes the entire baby’s body. In very severe cases, they have to perform an exchange transfusion (remove some of the baby’s blood and replace it with a transfusion).<br /><br />During phototherapy, it is very important to ensure the baby received plenty of fluids in the form of breast milk or formula or IV fluids. He should also where protective eye wear.<br /><br />Questions To Ask Your Doctor About Jaundice In Newborns<br />Why does the baby have jaundice?<br /><br />What is the bilirubin level?<br /><br />What is the probable cause?<br /><br />Should breastfeeding be avoided or discontinued?<br /><br />Should the baby have light treatment?<br /><br />Can we do this at home?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com1tag:blogger.com,1999:blog-3000963844336424708.post-40318979951651346572010-04-28T05:22:00.000-07:002010-04-28T05:26:08.977-07:00Autism* Definition of Autism<br /> * Description of Autism<br /> * Causes and Risk Factors of Autism<br /> * Symptoms of Autism<br /> * Diagnosis of Autism<br /> * Treatment of Autism<br /> * Questions To Ask Your Doctor About Autism<br /><br />Definition of Autism<br />Autistic disorder (known also as infantile autism or childhood autism) almost always develops before the age of three and is characterized by impaired verbal and non-verbal communication, social interaction, some form of repetitive and restricted stereotyped interest, ritual, or other behavior.<br /><br />Description of Autism<br />Children with autism often have extreme difficulty developing normal relationships with others. They tend not to share in the interests their peers have. In many cases these children are not able to interpret non-verbal cues of communication like facial expressions. Most people with autism have some impairment in language and many never speak at all.<br /><br />About 8.7 of every 10,000 children are autistic, and more than 1 in 300 children have some form of pervasive developmental disorder (PDD). PDD means that some, but not all, symptoms of autism are present.<br /><br />Autism is a lifelong disease that ranges in severity from mild cases in which the autistic person can live independently, to severe forms in which the patient requires social support and medical supervision throughout his or her life.<br /><br />Causes and Risk Factors of Autism<br />There are physical bases for autism's development including genetic, infectious, and traumatic factors. Viral infection including rubella during the first trimester of pregnancy, have been studied as possible causes of autism. Children with Fragile X syndrome or tuberous sclerosis have higher rates of autism than the general population.<br /><br />Autism affects males four times more often than females, and there is a genetic basis for the disease.<br /><br />Contrary to previous notions, autism is not caused by upbringing.<br /><br />Symptoms of Autism<br />The symptoms vary greatly but follow a general pattern. Not all symptoms are present in all autistic children.<br /><br />Autistic infants may act relatively normal during their first few months of life before becoming less responsive to their parents and other stimuli. They may have difficulty with feeding or toilet training; may not smile in recognition of their parents' faces, and may put up resistance to being cuddled.<br /><br />As they enter toddlerhood, it becomes increasingly apparent that these children have a world of their own. They do not play with other children or toys in the normal manner, rather they remain aloof and prefer to play alone. Parents often mention that their child is so undemanding that he or she is “too good”.<br /><br />Verbal and nonverbal communication skills, such as speech and facial expressions, develop peculiarly. Symptoms range from mutism to prolonged use of echoing or stilted language. When language is present, it is often concrete, unimaginative, and immature.<br /><br />Another symptom of autism is an extreme resistance to change of any kind. Autistic children tend to want to maintain established behavior patterns and a set environment. They develop rituals in play, oppose change (such as moving furniture), and may become obsessed with one particular topic.<br /><br />Other behavioral abnormalities that may be present are: staring at hands or flapping arms and hands, walking on tiptoe, rocking, tantrums, strange postures, unpredictable behavior and hyperactivity.<br /><br />An autistic child has poor judgment and is therefore always at risk for danger. For instance, an autistic child may run into a busy street without any sign of fear.<br /><br />Diagnosis of Autism<br />Properly diagnosing autism is very important, since confusion may result from inappropriate and ineffective treatment.<br /><br />Deafness is often the first suspected diagnosis, since autistic children may not respond normally to sounds and often do not speak.<br /><br />The children's appearance and muscle coordination are often normal.<br /><br />Occasionally, an autistic child has an outstanding skill (splinter skills), such as an incredible rote memory or musical ability. Such children may be referred to as "autistic savants", and occur in almost 10% of cases of autism. These skills can be quite astonishing. One example is the ability to play a piece of music almost perfectly after hearing it one time.<br /><br />Many children with autism have a second psychiatric disorder or a neurologic disorder. Mental retardation and seizure disorders are very common in autistic children and a thorough neurologic and psychiatric evaluation is necessary in every case of autism to ensure all the child’s medical problems are being addressed.<br /><br />Treatment of Autism<br />Appropriate early intervention is important. Once the diagnosis has been made, the parents, physicians, and specialists should discuss what is best for the child. In most cases, parents are encouraged to take care of the child at home.<br /><br />Special education classes are available for autistic children. Structured, behaviorally-based programs, geared to the patient's developmental level have shown some promise.<br /><br />Most behavioral treatment programs include:<br /><br /> * clear instructions to the child<br /><br /> * prompting to perform specific behaviors<br /><br /> * immediate praise and rewards for performing those behaviors<br /><br /> * a gradual increase in the complexity of reinforced behaviors<br /><br /> * definite distinctions of when and when not to perform the learned behaviors<br /><br />Parents should be educated in behavioral techniques so they can participate in all aspects of the child's care and treatment. The more specialized instruction and behavior therapy the child receives, the more likely it is that the condition will improve.<br /><br />Medication can be recommended to treat specific symptoms such as seizures, hyperactivity, extreme mood changes, or self-injurious behaviors.<br /><br />The autistic child requires much of the parents' attention, often affecting the other children in the family. Counseling and support may be helpful for the parents.<br /><br />The outlook for each child depends on his or her intelligence and language ability. Some people with autism become independent adults. A majority can be taught to live in community-based homes, although they may require supervision throughout adulthood.<br /><br />Questions To Ask Your Doctor About Autism<br />When will the symptoms appear?<br /><br />What type of symptoms will there be?<br /><br />What if the child just likes to be left alone as opposed to being autistic?<br /><br />What type of test is given to diagnose autism?<br /><br />Where is testing done?<br /><br />How accurate is the test?<br /><br />Is the autism mild or severe?<br /><br />Will the child be able to attend public school if they have mild autism?<br /><br />Is there a cure?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-83485066998642691332010-04-28T05:21:00.000-07:002010-04-28T05:22:13.638-07:00Dementia* Definition of Dementia<br /> * Description of Dementia<br /> * Causes and Risk Factors of Dementia<br /> * Symptoms of Dementia<br /> * Diagnosis of Dementia<br /> * Treatment of Dementia<br /> * Questions To Ask Your Doctor About Dementia<br /><br />Definition of Dementia<br />Dementia is a permanent decline in cognitive function and memory from a previous level of function.<br /><br />Description of Dementia<br />Dementia is a brain disorder with permanent loss of memory or other higher cognitive function.. Dementia can either be progressive, such as in Alzheimer's disease, or may remain stable, as can be seen after a stroke or head injury. Different types of dementia can affect various cognitive functions such as memory, personality, or executive function.<br /><br />By definition, dementia is permanent. A brief change in cognitive function is more often called a "delirium". Different types of dementia can affect different abilities. Some patients may get lost, have trouble remembering things, become unable to remember names of objects and people, or have trouble calculating numbers, among other problems.<br /><br />In many cases, dementia may progress very slowly and it is difficult to determine when the problem precisely began. In some cases, such as when a patient has a stroke, the beginning is very sudden and noticeable.<br />Text Continues Below<br /><br />Causes and Risk Factors of Dementia<br />Physicians generally recognize two broad categories of dementia:<br /><br />Primary dementias are those like Alzheimer's in which the dementia itself is the major sign of an organic brain disease not directly related to any other organic illness.<br /><br />Secondary dementias are those caused by, or closely related to, some other recognizable disease - such as AIDS, head injury, stroke, multiple sclerosis, or one of numerous other identifiable mental conditions.<br /><br />Pseudodementia is another category of dementia that, as the name implies, is not a true dementia but rather a set of similar symptoms that mimic the condition, often seen in patients with depression.<br /><br />Symptoms of Dementia<br />All dementias - whether primary or secondary, treatable or untreatable - share a few clinical characteristics in common. Loss of memory and inability to perform routine tasks - such as losing one's way in the neighborhood, difficulties in job performance, language problems - are particularly common.<br /><br />The most recent memories are lost sooner than older ones, and new memories, perhaps of something that happened minutes earlier, are difficult to retain. For example, a woman might ask her husband when they are scheduled to visit their children. "Saturday," he might reply. Just minutes later, she might ask the identical question. In the early stages of the dementia, however, she probably will have no difficulty identifying photos of the children, or even of casual friends, taken 30 years earlier.<br /><br />In certain forms of dementia, behavioral changes (such as increased aggressiveness), may be prominent.<br /><br />As the disease progresses, patients lose the ability to function independently and become increasingly disoriented to time and place. Wandering may become a significant problem. Patients become unable to care for themselves and grooming and dressing standards deteriorate rapidly. Patients often dress inappropriately for the season and confuse underwear with outer garments.<br /><br />In the progressive dementias, recent memory, retention and attention span deteriorate steadily. Language skills, particularly ability to name objects (anomia) or generate a word list decline until a patient can no longer use full sentences.<br /><br />Diagnosis of Dementia<br />The diagnosis of dementia is based upon a good clinical history and an examination to determine the nature of the organic or non-organic cause of mental confusion. Often, a physician may perform a simple group of memory tests called the "mini mental status examination". In some cases, special neuropsychological testing may be necessary to confirm dementia, as opposed to effects of normal aging. Blood work and a picture of the brain (CAT scan or MRI) are useful to exclude any treatable condition.<br /><br />Treatment of Dementia<br />In some cases, blood tests or imaging studies may reveal a condition responsible for the cognitive decline. Disorders such as vitamin deficiency, infection, or hydrocephalus can be treated with specific therapies that can reverse the symptoms in some cases.<br /><br />In most of the progressive dementias, such as Alzheimer's disease, a specific cure is lacking. However, there are several agents available which have been proven to slow the progression of cognitive decline. These agents also enable patients to maintain their independence for a longer period of time. These medications also reduce burden on the caregiver. However, these drugs do not stop the progressive nature of the disorder and patients eventually decline further.<br /><br />Questions To Ask Your Doctor About Dementia<br />What is the cause of the dementia?<br /><br />Is the dementia secondary to some other disease?<br /><br />Is the person with dementia safe to be left alone or is supervision always necessary?<br /><br />What medications or other therapy may help improve function?<br /><br />What treatments are available?<br /><br />How can we best cope?<br /><br />What is the prognosis - what can we expect?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-67855061751431262122010-04-28T05:08:00.000-07:002010-04-28T05:14:02.952-07:00Alzheimer's Disease* Definition of Alzheimer's Disease<br /> * Description of Alzheimer's Disease<br /> * Causes and Risk Factors of Alzheimer's Disease<br /> * Symptoms of Alzheimer's Disease<br /> * Diagnosis of Alzheimer's Disease<br /> * Treatment of Alzheimer's Disease<br /> * Self Care<br /> * Questions To Ask Your Doctor About Alzheimer's Disease<br /><br />Definition of Alzheimer's Disease<br />Alzheimer's disease is a group disorders involving the parts of the brain that control thought, memory, and language. It is marked by progressive deterioration, which affects both the memory and reasoning capabilities of an individual.<br /><br />Description of Alzheimer's Disease<br />Alzheimer's disease is the most common form of dementia (mental deterioration of memory and thought processes) among the elderly. It is estimated that 4.5 million Americans over the age of 65 are affected with this condition. After the age of 65, the incidence of the disease doubles every five (5) years and, by age 85, it will affect nearly half of the population.<br /><br />Alzheimer's disease was first described in 1906 by German neurologist Alois Alzheimer. The disease causes irreversible changes in the nerve cells of certain vulnerable areas of the brain. It is characterized by nerve-cell loss, abnormal tangles within nerve cells and deficiencies of several chemicals, which are essential for the transmission of nerve messages.<br /><br />The disorder leads to behavioral and personality changes, forgetfulness, confusion, inability to learn new material, paranoia and motor activity problems. Language difficulties also are common in people with Alzheimer's disease. The disease typically progresses to the stage where it is difficult for the patient to be understood by others or to understand others, and in the final stages, the patient is bedridden.<br /><br />Although nearly half of those over 85 may have Alzheimer's disease, it is not a 'normal' part of aging.<br />Text Continues Below<br /><br />Causes and Risk Factors of Alzheimer's Disease<br />The cause of Alzheimer's disease has yet to be determined, but there are five (5) theories that warrant further investigation:<br /><br /> 1. Chemical Theories<br /><br /> A. Chemical Deficiencies. One of the ways in which brain cells communicate with one another is through chemicals called neurotransmitters. Studies of Alzheimer's diseased brains have uncovered diminished levels of various neurotransmitters that are thought to influence intellectual functioning and behavior.<br /><br /> B. Toxic Chemical Excesses. Increased deposits of aluminum have been found in Alzheimer's disease brains.<br /><br /> 2. Genetic Theory.<br /><br /> Researchers have linked late-onset Alzheimer's to the inheritance of a gene that directs production of apolipoprotein (ApoE). In early-onset Alzheimer's, researchers identified a mutation on chromosome 14, which accounts for 10 percent of Alzheimer's cases. Additionally, a mutation was found on chromosomes 1 and 21. In 1997, researchers found another mutation on chromosome 12 that is linked to late-onset Alzheimer's.<br /><br /> 3. Autoimmune Theory.<br /><br /> The body's immune system, which protects against potentially harmful invaders, may erroneously begin to attack its own tissues, producing antibodies to its own essential cells.<br /><br /> 4. Slow Virus Theory.<br /><br /> A slow-acting virus has been identified as a cause of some brain disorders that closely resemble Alzheimer's.<br /><br /> 5. Blood Vessel Theory.<br /><br /> Defects in blood vessels supplying blood to the brain are being studied as a possible cause of Alzheimer's.<br /><br />The chances of getting Alzheimer's disease increases with age and it usually occurs after the age of 65, after which the chances of getting the disease double every five years.<br /><br />There are only two definite factors that increase the risk for Alzheimer's disease before age 65: a family history of dementia or Alzheimer's, and Down syndrome. Down syndrome is a combination of physical abnormalities and mental retardation characterized by a genetic defect in chromosome pair 21.<br /><br />Symptoms of Alzheimer's Disease<br />The U.S. Agency for Health Care Policy Research provided this list of questions to help recognize the condition:<br /><br /> * Learning and retaining new information. Does the person misplace objects and/or have trouble remembering appointments or recent conversations? Is the person repetitive in conversation?<br /><br /> * Handling complex tasks. Do familiar activities like balancing a checkbook, cooking a meal, or other tasks that involve a complex train of thought, become increasingly difficult?<br /><br /> * Ability to reason. Does the person find it difficult to respond appropriately to everyday problems, such as a flat tire? Does a previously well-adjusted person disregard rules of social conduct?<br /><br /> * Spatial ability and orientation. Does driving and finding one's way in familiar surroundings become impossible? Does the person have problems recognizing familiar objects?<br /><br /> * Language. Does the person have difficulty following or participating in conversations? Does the person have trouble finding the words to express what they want to say?<br /><br /> * Behavior. Does the person seem more passive or less responsive than usual or more suspicious or irritable? Does the person have trouble paying attention?<br /><br />The onset and symptoms of Alzheimer's disease are usually very slow and gradual, seldom occurring before the age of 65. It occurs in the following three (3) stages:<br /><br /> Stage 1: forgetfulness, poor insight, mild difficulties with word-finding, personality changes, difficulties with calculations, losing or misplacing things, repetition of questions or statements and a minor degree of disorientation<br /><br /> Stage 2: memory worsens, words are used more and more inappropriately, basic self-care skills are lost, personality changes, agitation develops, can't recognize distant family or friends, has difficulty communicating, wanders off, becomes deluded and may experience hallucinations<br /><br /> Stage 3: bedridden, incontinent, uncomprehending and mute<br /><br />Diagnosis of Alzheimer's Disease<br />An estimated 5 to 10 percent of all mental deterioration in persons over the age of 65 is due to reversible conditions, such as depression, underlying physical disease (metabolic disorders, cardiovascular disease or pernicious anemia), excessive and inappropriate drug use, loss of social support or change in social environment. Therefore, it is important to diagnose Alzheimer's disease to ensure that any mental impairment is not reversible.<br /><br />In order to diagnose Alzheimer's disease, a physician must:<br /><br /> * take a detailed medical history<br /><br /> * conduct physical and neurological examinations<br /><br /> * consult the diagnostic criteria stated below<br /><br /> * conduct laboratory examinations, such as urine tests, a CAT scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) to detect structural abnormalities of the head and brain<br /><br /> * conduct a functional and mental status assessment test<br /><br /> * do a complete inventory of any prescription and over-the-counter drugs the patient is taking<br /><br />The diagnostic criteria for dementia and Alzheimer's disease is as follows:<br /><br />Dementia<br /><br />A. Multiple cognitive deficits manifested by both 1 and 2<br /><br /> 1. Impaired short- or long-term memory<br /><br /> 2. One or more of the following cognitive disturbances:<br /><br /> * Impaired language ability<br /><br /> * Impaired ability to carry out motor activities<br /><br /> * Impaired ability to recognize objects<br /><br /> * Impaired abstract thinking (e.g., planning and organizing)<br /><br />B. Deficits in A are sufficient to interfere with work or social activities and represent a significant decline in function.<br /><br />C. Deficits do not occur exclusively during the course of delirium.<br /><br />Alzheimer's disease<br /><br />Dementia as determined by A through C (stated above), plus:<br /><br />D. Disease course is characterized by gradual onset and continuing cognitive decline.<br /><br />E. Cognitive deficits are not caused by any of the following:<br /><br /> * Another progressive central nervous system disorder (e.g., Parkinson's or Huntington's disease)<br /><br /> * A systemic condition (e.g., hypothyroidism or niacin deficiency)<br /><br /> * A substance-induced condition<br /><br />F. Disturbance is not better explained by another disorder (e.g., major depressive disorder or schizophrenia).<br /><br />Treatment of Alzheimer's Disease<br />Although there is currently no cure for Alzheimer's disease, a great deal can be done to manage it. There are four (4) approaches to managing the disease. The approaches and solutions are:<br /><br /> * Relieve behavioral symptoms associated with dementia, including depression, agitation and psychosis. Medications, called cholinesterase inhibitors, such as tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon) or galantamine (Reminyl), enhance the effectiveness of acetylcholine (the chemical messenger found in the neurotransmitter system which coordinates memory and learning) by slowing its breakdown. Unfortunately, these medications only temporally improve the symptoms associated with Alzheimer's. The effects of the drugs will fade as the deterioration of brain cells progresses. More recently, memantine (Namenda) was approved by the FDA. Memantine blocks the effects of a different chemical, glutamate, which is felt to overstimulate nerve cells and cause their degeneration. Additionally, doctors may prescribe antidepressants, antipsychotics, anticonvulsants, beta blockers, benzodiazepines, serotonin reuptake inhibitors, and drugs such as Desyrel, BuSpar, and Eldepryl, to control the agitation, psychosis, depressive features, anxious features, apathy and disturbances in sleep and appetite.<br /><br /> * Relieve cognitive dysfunction to improve memory, language, attention and orientation. Doctors may prescribe precursors, cholinesterase inhibitors and cholinergic receptor agents.<br /><br /> * Slow the rate of illness progression, thereby preserving quality of life and independence.<br /><br /> * Delay the time of onset of illness. Medications and therapies to combat these problems are still in the development and clinical trial stages. For instance, the research shows that vitamin E slows the progress of some consequences of Alzheimer’s for about 7 months, and scientists are investigating whether ginkgo biloba can delay or prevent dementia in older people, and if estrogen can prevent Aalzheimer’s in women with a family history of the disease. Researchers are looking at methods to enhance cerebral metabolism, stabilize membranes, promote neuronal sprouting, decrease inflammation, neurotoxins and excitatory amino acids, as well as alter metabolism of key proteins.<br /><br />In addition to the pharmaceutical approaches, conservation methods also can be beneficial to the management of Alzheimer's disease, such as:<br /><br /> * eating a proper diet<br /><br /> * getting daily exercise<br /><br /> * continuing intellectual stimulation and social contact<br /><br /> * implementing memory aids, such as a prominent calendar, lists of daily tasks and labels on frequently used items that can help compensate for memory loss and confusion<br /><br /> * providing a comfortable and stimulating environment and always trying to give simple and easy to understand instructions<br /><br /> * participating in support groups<br /><br />Self Care<br />The physical, emotional and financial burdens of caring for a person with Alzheimer's disease can be enormous. Family members and other caregivers may become exhausted and demoralized by the all-consuming task. They lose freedom and privacy and sacrifice their own needs, often without receiving much gratitude or even acknowledgment. Any resentment they feel may be heightened by fear of inheriting the disease and compounded by guilt - about their anger, past mistakes, lying to the patient in small ways or denying the patient's wishes.<br /><br />Existing family problems may be intensified and old family conflicts revived. A formerly passive husband or wife may find it difficult to make decisions for the patient. It is not surprising that caregivers have a higher rate of depression than patients with Alzheimer's disease themselves.<br /><br />Some caregivers join support groups to relieve their isolation, comfort one another and exchange advice. These groups are organized by local chapters of the Alzheimer's Association (http://www.alz.org).<br /><br />Most of all, caregivers need time to lead their own lives. This can be made possible by respite care: housekeepers, home attendants, visiting nurses, day care centers, senior citizen programs, day hospitals and case managers who can coordinate services. Unfortunately, many families know too little about these services or are too shy or proud to seek help.<br /><br />At any given time, family members care for most people with Alzheimer's disease, but the demands eventually become too great for even the most devoted wife, daughter, husband or son. Most Americans with this disease ultimately end up in nursing homes. Researchers have recently estimated that 40 percent of people who turn 65 will eventually enter a nursing home; 25 percent will stay for at least a year and nearly 10 percent for five years or more. The average age of the 1.5 million patients in these homes is 86. More than two-thirds of these patients are women, and at least two-thirds have Alzheimer's disease.<br /><br />About two-thirds of all people placed in nursing homes die within three years, mainly because many families take this step only after their resources are exhausted and the demented person is near death. Families sometimes wait too long and have to be persuaded by outsiders to acknowledge the need. To avoid having to make a hasty decision during a crisis, it is better to start investigating the options as soon as the patient begins to need supervision.<br /><br />Questions To Ask Your Doctor About Alzheimer's Disease<br />What tests need to be done to accurately diagnose this condition?<br /><br />Does the individual have Alzheimer's or could it be some other condition or disorder?<br /><br />Can it be cured?<br /><br />Must it necessarily become progressively worse or can deterioration be halted?<br /><br />Can mental or thinking abilities be improved?<br /><br />Can motor activities be improved?<br /><br />Is there a special diet that may help?<br /><br />How can the family get help to cope with this disease?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-32825156546841145012010-04-28T05:03:00.000-07:002010-04-28T05:07:56.631-07:00Definition of Animal Bites* Definition of Animal Bites<br /> * Questions To Ask Your Doctor About Animal Bites<br /><br />Definition of Animal Bites<br />Bite wounds can become infected with bacteria or other organisms in the saliva or mouth of the biting animal. Bites can cause everything from mild, local infections to generalized serious and sometimes fatal illness.<br /><br /><br />Questions To Ask Your Doctor About Animal Bites<br />What is the extent of the injury caused by the cat?<br /><br />Is there any sign of infection?<br /><br />Is it cat-scratch disease?<br /><br />Should antibiotics be taken?<br /><br />Is there any possibility of exposure to rabies?<br /><br />Are any preventive measures called for?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-47718691448285216752010-04-28T04:45:00.000-07:002010-04-28T05:03:14.683-07:00AIDS and HIV InfectionDefinition of AIDS and HIV Infection<br />AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is a serious condition that weakens the body's immune system, leaving it unable to fight off illness.<br /><br />AIDS is the last stage in a progression of diseases resulting from a viral infection known as the Human Immunodeficiency Virus (HIV or AIDS virus). The diseases include a number of unusual and severe infections, cancers and debilitating illnesses, resulting in severe weight loss or wasting away, and diseases affecting the brain and central nervous system.<br /><br />There is no cure for HIV infection or AIDS nor is there a vaccine to prevent HIV infection. However, new medications not only can slow the progression of the infection, but can also markedly suppress the virus, thereby restoring the body’s immune function and permitting many HIV-infected individuals to lead a normal, disease-free life.<br /><br />Description of AIDS and HIV Infection<br />The immune system is a network of cells, organs and proteins that work together to defend and protect the body from potentially harmful, infectious microorganisms (microscopic life-forms), such as bacteria, viruses, parasites and fungi. The immune system also plays a critical role in preventing the development and spread of many types of cancer.<br /><br />When the immune system is missing one or more of its components, the result is an immunodeficiency disorder. AIDS is an immunodeficiency disorder.<br /><br />Lymphocytes (white blood cells) are one of the main types of immune cells that make up the immune system. There are two types of lymphocytes: B cells and T cells. (T cells are also called CD4 cells, CD4 T cells, or CD4 cell lymphocytes). B cells secrete antibodies (proteins) into the body's fluids to ambush and attack antigens (foreign proteins such as bacteria, viruses or fungi). T cells directly attack and destroy infected or malignant cells in the body.<br /><br />There are two types of T cells: helper T cells and killer T cells. Helper T cells recognize the antigen and activate the killer T cells. Killer T cells then destroy the antigen.<br /><br />When HIV is introduced into the body, this virus is too strong for the helper T cells and killer T cells. The virus then invades these cells and starts to reproduce itself, thereby not only killing the CD4 T cells, but also spreading to infect otherwise healthy cells.<br /><br />The HIV virus cannot be destroyed and lives in the body undetected for months or years before any sign of illness appears. Gradually, over many years or even decades, as the T cells become progressively destroyed or inactivated, other viruses, parasites or cancer cells (called "opportunistic diseases") which would not have been able to get past a healthy body's defense, can multiply within the body without fear of destruction. Commonly seen opportunistic diseases in persons with HIV infection include: pneumocystis carinii pneumonia, tuberculosis, candida (yeast) infection of the mouth, throat or vagina, shingles, cytomegalovirus retinitis and Kaposi's sarcoma.<br />Text Continues Below<br /><br />Causes and Risk Factors of AIDS and HIV Infection<br />AIDS is transmitted via three main routes:<br /><br /> * The most common mode of transmission is the transfer of body secretions through sexual contact. This is accomplished through exposure of mucous membranes of the rectum, vagina or mouth to blood, semen or vaginal secretions containing the HIV virus.<br /><br /> * Blood or blood products can transmit the virus, most often through the sharing of contaminated syringes and needles.<br /><br /> * HIV can be spread during pregnancy from mother to fetus.<br /><br />You cannot get AIDS/HIV from touching someone or sharing items, such as cups or pencils, or through coughing and sneezing. Additionally, HIV is not spread through routine contact in restaurants, the workplace or school. However, sharing a razor does pose a small risk in that blood from a minor nick can be transmitted from one person to another.<br /><br />Symptoms of AIDS and HIV Infection<br />Immediately following infection with HIV, most individuals develop a brief, nonspecific “viral illness” consisting of low grade fever, rash, muscle aches, headache and/or fatigue. Like any other viral illness, these symptoms resolve over a period of five to 10 days. Then for a period of several years (sometimes as long as several decades), people infected with HIV are asymptomatic (no symptoms). However, their immune system is gradually being destroyed by the virus. When this destruction has progressed to a critical point, symptoms of AIDS appear. These symptoms are as follows:<br /><br /> * extreme fatigue<br /><br /> * rapid weight loss from an unknown cause (more than 10 lbs. in two months for no reason)<br /><br /> * appearance of swollen or tender glands in the neck, armpits or groin, for no apparent reason, lasting for more than four weeks<br /><br /> * unexplained shortness of breath, frequently accompanied by a dry cough, not due to allergies or smoking<br /><br /> * persistent diarrhea<br /><br /> * intermittent high fever or soaking night sweats of unknown origin<br /><br /> * a marked change in an illness pattern, either in frequency, severity, or length of sickness<br /><br /> * appearance of one or more purple spots on the surface of the skin, inside the mouth, anus or nasal passages<br /><br /> * whitish coating on the tongue, throat or vagina<br /><br /> * forgetfulness, confusion and other signs of mental deterioration<br /><br />It can take as short as a year to as long as 10 to 15 years to go from being infected with HIV to "full-blown" AIDS.<br /><br />According to the Center for Disease Control and Prevention, a person is considered to have AIDS when they have a T cell count (also called CD4 cell count) of 200 or less (healthy T cell levels range from 500 to 1500) or they have an AIDS-defining condition. The AIDS-defining conditions are:<br /><br />· Candidiasis<br /><br />· Cervical cancer (invasive)<br /><br />· Coccidioidomycosis, Cryptococcosis, Cryptosporidiosis<br /><br />· Cytomegalovirus disease<br /><br />· Encephalopathy (HIV-related)<br /><br />· Herpes simplex (severe infection)<br /><br />· Histoplasmosis<br /><br />· Isosporiasis<br /><br />· Kaposi's sarcoma<br /><br />· Lymphoma (certain types)<br /><br />· Mycobacterium avium complex<br /><br />· Pneumocystis carinii pneumonia<br /><br />· Pneumonia (recurrent)<br /><br />· Progressive multifocal leukoencephalopathy<br /><br />· Salmonella septicemia (recurrent)<br /><br />· Toxoplasmosis of the brain<br /><br />· Tuberculosis<br /><br />· Wasting syndrome<br /><br />People who are not infected with HIV may also develop these diseases; the presence of any one of these conditions does not mean the person has AIDS. To be diagnosed with AIDS, a person must be infected with HIV.<br /><br />Some people infected with HIV may develop a disease that is less serious than AIDS, referred to as AIDS Related Complex (ARC). ARC is a condition caused by the AIDS virus in which the patient tests positive for AIDS infection and has a specific set of clinical symptoms. However, ARC patients' symptoms are often less severe than those with classic AIDS because the degree of destruction of the immune system has not progressed as far as it has in patients with classic AIDS.<br /><br />Symptoms of ARC may include loss of appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of resistance to infection or swollen lymph nodes.<br /><br />Note: Not everyone who has been infected with HIV develops AIDS. Very rarely, some individuals can be infected with HIV yet maintain normal immune function and general good health even after 20 years of infection.<br /><br />Diagnosis of AIDS and HIV Infection<br />Screening for HIV infection is most commonly done by testing blood for HIV antibodies. A newer test, the Orasure test, involves collecting secretions between the cheek and gum and evaluating them for HIV antibodies. Orasure is essentially as accurate as a blood test, and, because it doesn't involve a needle stick, it is favored by many individuals. Orasure is available through physicians’ offices and many public health clinics. Finally, a new urine test available for screening, although if the test is positive, blood tests need to be performed for confirmation of the presence of HIV.<br /><br />In 1996, a home HIV blood test (called Home Access) became available to the public. These home kits are available in pharmacies and by mail. The kit contains a few sharp tools called lancets, a piece of blotting paper marked with a unique identification number and a prepaid return envelope with a protective pouch. After pricking the finger with the lancet, a few drops of blood are blotted onto the paper, sealed into the envelope and sent to the address on the envelope. In about a week, the person calls a toll-free number to get the results of the test.<br /><br />Treatment of AIDS and HIV Infection<br />Anti-HIV (also called antiretroviral) medications are used to control the reproduction of the virus and to slow or halt the progression of HIV-related disease. When used in combinations, these medications are termed Highly Active Antiretroviral Therapy (HAART). HAART combines three or more anti-HIV medications in a daily regimen, sometimes referred to as a "cocktail". Anti-HIV medications do not cure HIV infection and individuals taking these medications can still transmit HIV to others. Anti-HIV medications approved by the U.S. Food and Drug Administration (FDA) fall into four classes:<br /><br />1. Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs), such as nevirappine (Viramune) and efavirenz (Sustiva), bind to and block the action of reverse transcriptase, a protein that HIV needs to reproduce.<br /><br />2. Nucleoside Reverse Transcriptase Inhibitors (NRTIs), such as zidovudine (Retrovir), tenofovir DF (Viread), and stavudine (Zerit), are faulty versions of building blocks that HIV needs to make more copies of itself. When HIV uses an NRTI instead of a normal building block, reproduction of the virus is stalled.<br /><br />3. Protease Inhibitors (PIs), such as lopinavir/ritonavir (Kaletra), disable protease, a protein that HIV needs reproduce itself.<br /><br />4. Fusion Inhibitors, such as enfuvirtide (Fuzeon ), are newer treatments that work by blocking HIV entry into cells.<br /><br />(View more complete list of HIV drugs).<br /><br />How many pills you will need to take and how often you will take them depends on what medications you and your doctor choose.<br /><br />There is no one "best" regimen. You and your doctor will decide which medications are right for you. For people taking HAART for the first time, the recommended regimens are:<br /><br /> * Sustiva + Truvada, Sustiva + Epzicom, or Atripla<br /><br /> * Kaletra + Truvada, Kaletra + Epzicom, or Kaletra + Combivir<br /><br />In general, taking only one or two drugs is not recommended because any decrease in viral load is almost always temporary without three or more drugs. The exception is the recommendation for pregnant women, who may take Combivir plus nevirapine to reduce the risk of passing HIV to their infants. If you are pregnant or considering becoming pregnant, there are additional treatment considerations. Recently, a number of drugs have been developed that combine two or even three separate medications in a single pill. Some of these, such as Truvada (emtricitabine + tenofovir) and Epzicom (abacavir + lamivudine) need be taken only once daily. Atripla (emtricitabine + tenofovir + efavirenz) combines three drugs in one pill and needs to be taken only once daily, thereby providing a complete HAART regimen with one pill once daily.<br /><br />The treatment of HIV infection and AIDS is in a highly dynamic state. Individuals with this condition are advised to seek out experts in their local community who are current with the latest modes of therapy and ongoing clinical trials for evaluating newer therapies.<br /><br />The following is a partial list of drugs approved for the treatment of HIV infection.<br /><br />Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)<br /><br />Delavirdine (Rescriptor, DLV) Pfizer<br /><br />Efavirenz (Sustiva, EFV) Bristol-Myers Squibb<br /><br />Nevirapine (Viramune, NVP) Boehringer Ingelheim<br /><br />Nucleoside Reverse Transcriptase Inhibitors (NRTIs)<br /><br />Abacavir (Ziagen, ABC) GlaxoSmithKline<br /><br />Abacavir,Lamivudine, Zidovudine (Trizivir) GlaxoSmithKline<br /><br />Didanosine (Videx, ddI, Videx EC) Bristol-Myers Squibb<br /><br />Emtricitabine (Emtriva, FTC, Coviracil) Gilead Sciences<br /><br />Lamivudine (Epivir, 3TC) GlaxoSmithKline<br /><br />Lamivudine, Zidovudine (Combivir) GlaxoSmithKline<br /><br />Stavudine ( Zerit, d4T) Bristol-Myers Squibb<br /><br />Tenofovir DF (Viread, TDF) Gilead Sciences<br /><br />Zalcitabine (Hivid, ddC) Hoffmann-La Roche<br /><br />Atripla (tenofovir, emtricitabine, efavirenz) Gilead Sciences<br /><br />Zidovudine (Retrovir, AZT, ZDV) GlaxoSmithKline<br /><br />Protease Inhibitors (PIs)<br /><br />Amprenavir (Agenerase, APV) GlaxoSmithKline, Vertex Pharmaceuticals<br /><br />Atazanavir (Reyataz, ATV) Bristol-Myers Squibb<br /><br />Fosamprenavir (Lexiva, FPV) GlaxoSmithKline, Vertex Pharmaceuticals<br /><br />Indinavir (Crixivan, IDV) Merck<br /><br />Lopinavir, Ritonavir (Kaletra, LPV/r) Abbott Laboratories<br /><br />Nelfinavir (Viracept, NFV) Agouron Pharmaceuticals<br /><br />Ritonavir (Norvir, RTV) Abbott Laboratories<br /><br />Saquinavir (Fortovase, SQV) Invirase Hoffmann-La Roche<br /><br />Tipranavir (Aptivus) Boehringer-Ingelheim<br /><br />Darunavir (Prezista) Tibotec Therapeutics<br /><br />Fusion Inhibitors<br /><br />Enfuvirtide (Fuzeon, T-20) Hoffmann-La Roche, Trimeris<br /><br />Prevention of AIDS and HIV Infection<br />The only way to protect from contracting AIDS sexually is to abstain from sex outside of a mutually faithful relationship with a partner whom the person knows is not infected with the AIDS virus. Otherwise, risks can be minimized if they:<br /><br /> * Don't have sexual contact with anyone who has symptoms of AIDS or who is a member of a high risk group for AIDS.<br /><br /> * Avoid sexual contact with anyone who has had sex with people at risk of getting AIDS.<br /><br /> * Don't have sex with prostitutes.<br /><br /> * Avoid having sex with anyone who has multiple and/or anonymous sexual partners.<br /><br /> * Avoid oral, genital and anal contact with partner's blood, semen, vaginal secretions, feces or urine. Unless they know with absolute certainty that their partner is not infected, a latex condom should be used during each sexual act, from start to finish. The use of a spermicidal agent may provide additional protection.<br /><br /> * Avoid anal intercourse altogether.<br /><br /> * Don't share toothbrushes, razors or other implements that could become contaminated with the blood of anyone who is or might be infected with the AIDS virus.<br /><br /> * Exercise caution regarding procedures, such as acupuncture, tattooing, ear piercing, etc., in which needles or other nonsterile instruments may be used repeatedly to pierce the skin and/or mucous membranes.<br /><br /> Such procedures are safe if proper sterilization methods are employed or disposable needles are used. Ask what precautions are taken before undergoing such procedures.<br /><br /> * If an individual is scheduling surgery in the near future, and is able, they could consider donating blood for their own use. This will eliminate completely the already very small risk of contracting AIDS through a blood transfusion. It will also eliminate the risk of contracting other bloodborne diseases (such as hepatitis) from a transfusion.<br /><br />If a person is an IV drug user, adhere to the prevention tips mentioned earlier, as well as:<br /><br /> * Get professional help for terminating the drug habit.<br /><br /> * Do not share needles or syringes. Be aware that some street sellers are resealing previously used needles and selling them as new.<br /><br /> * Clean the needle before using.<br /><br />Some people apparently remain well after infection of the AIDS virus. They may have no physically apparent symptoms of illness. However, if proper precautions are not used with sexual contacts and/or intravenous drug use, these infected individuals can spread the virus to others.<br /><br />Anyone who thinks he or she is infected, or who is involved in high-risk behaviors, should not donate his/her blood, organs, tissues, or sperm as they may now contain the AIDS virus.<br /><br />Questions To Ask Your Doctor About AIDS and HIV Infection<br />What tests need to be done to diagnose this condition?<br /><br />How accurate is the test?<br /><br />Does a positive test mean AIDS?<br /><br />What type of treatment will you be recommending?<br /><br />How successful is it?<br /><br />Will you be prescribing any medications to prevent the development of some AIDS related infections?<br /><br />Are there any alternative treatments available?<br /><br />Are there experimental protocols in which I might participate?<br /><br />What are the chances of remaining well?<br /><br />For how long?<br /><br />Are there any support groups in the area?dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0tag:blogger.com,1999:blog-3000963844336424708.post-31682761906658801372010-04-27T16:32:00.000-07:002010-04-27T16:33:36.293-07:00Adverse Effects of HRT in menopauseAdverse Effects of HRT.<br /><br /> * Heart Disease. In spite of estrogen's benefits on cholesterol levels and other factors that affect the heart, evidence suggests that HRT does not prevent heart disease. In fact, it may actually be harmful for women with existing heart disease, at least in the first few years, and may also worsen the outlook after a heart attack. However, a 2004 review of 30 studies found that HRT does not significantly impact mortality from cardiovascular disease.<br /> * Stroke. Studies have reported a slightly increased risk of stroke in women taking HRT within the first two years of treatment and in HRT users with a history of major stroke or small strokes (transient ischemic attacks). A 2005 review found that HRT increased the risk of stroke, particularly ischemic (a type of stroke caused by an interruption in blood flow to part of the brain) stroke. In addition, HRT appears to worsen the outlook for women who have had a stroke.<br /> * Mental Decline. Observational studies had suggested that hormone replacement therapy (HRT) helped prevent mental decline and even Alzheimer's disease after menopause. Other studies have found no differences in mental performance and no protection from Alzheimer's disease in women taking HRT compared to non-users. A 2004 review of the Women’s Health Initiative Memory Study found that combined HRT did not reduce the risk of cognitive impairment, and actually increased the risk of dementia among women ages 65 and over.<br /> * Thromboembolism. HRT is associated with a higher risk for thromboembolism, in which blood clots form in deep veins. This places women at risk for pulmonary embolism, in which the blood clot travels to the lungs.<br /> * Breast Cancer. Because breast tissue growth is highly sensitive to estrogens, the more a woman is exposed to estrogen over her lifetime, the higher the risk for breast cancer. A number of studies have now reported a higher risk for breast cancer in postmenopausal women taking HRT that contains both estrogen and progestin. A 2005 study suggested that HRT with no or low progestin is safer than standard combination therapy. Several 2006 studies of women who had a hysterectomy indicated that estrogen alone does not increase overall breast cancer risk when the drug is used for 7 years or less. However, women who take the drug for 15 years or more do have an increased risk. Women who are at low risk for breast cancer tend to have fewer breast cancers with estrogen alone, while women at higher risk tend to have more breast cancers. In addition, estrogen therapy may cause abnormal mammogram results. Breast tissue density increases with HRT, which makes mammograms more difficult to read and leads to more breast biopsies. Women who take estrogen HRT should be aware that they need frequent mammogram screenings.<br /> * Endometrial (Uterine) Cancers. Estrogen overstimulates the tissue lining the uterus (the endometrium) and causes uncontrolled cell growth, a condition known as hyperplasia, which is a strong risk factor for cancer. Taking unopposed estrogen replacement therapy (ERT) increases the risk of endometrial cancer at least five-fold. Adding progestin to HRT appears to pose no risk for this cancer.<br /> * Ovarian Cancer. Whether HRT increases the risk for ovarian cancer is unclear, although evidence does seem to suggest a higher risk with the use of unopposed estrogen. Short term used of combined HRT in one study did not increase the incidence of ovarian cancer. Another study reported that women who had used unopposed estrogen or HRT with sequential use (but not continuous use) of progestins were at higher risk. Studies to date, however, have been limited. (Ovarian cancer is very uncommon, with the mortality rate being 43 out of every 100,000 women. Even among long-term HRT users this rate increases only to 64.)<br /> * Gallstones. HRT is associated with a higher risk for gallstones.<br />Other Drugs Used for Menopausal Symptoms<br /><br />Despite its risks, hormone replacement therapy appears to be the best treatment for hot flashes.dr.jayanthttp://www.blogger.com/profile/04103689129093174891noreply@blogger.com0