Treatment of Cervical cancer

Treatment of Cervical cancer

Treatment of Cervical cancer

Read Cervical Cancer First.

Treatment of cervical cancers depends on the staging and the depth of invasion. For example for invasion of less than 3 mm (stage IA-1) treatment includes a hysterectomy or the option of cervical conization in women who wish to preserve fertility. The staging of cervical cancer involves the following:

The International Federation of Obstetrics and Gynecology (FIGO). It permits assessment through biopsy, physical examination, cystoscopy, proctoscopy, excretory urography (intravenous pyelography or IVP), and plain film x-ray of the chest and skeletal system. The American Joint Cancer Committee staging is also involved.

Staging in cervical cancer

Read moreTreatment of Cervical cancer

Gout: Causes and also Diagnosis

Gout: Causes and also Diagnosis

Gout: Causes and also Diagnosis

Gout is some sort of arthritis. An attack could be due to it of unexpected burning pain, stiffness, and swelling in a joint, the big toe usually. These attacks can occur again and again unless gout can be treated. Over time, they are able to damage your joints, tendons, and other cells. Gout is many common in men.

What causes gout?

Gout is due to too much the crystals in the blood. The majority of the right time, having too much the crystals is not harmful many many people might never get gout therefore. However, when the crystals levels in the bloodstream are too high, the the crystals might form hard crystals in your joints.

Your likelihood of getting gout are higher in case you are overweight, drink an excessive amount of alcohol, or eat an excessive amount of fish and meats that are saturated in chemicals called purines. Some medications, such as for example water pills (diuretics), may bring on gout also.

Read moreGout: Causes and also Diagnosis

How to bleach your teeth

How to bleach your teeth

How to bleach your teeth

Tooth discoloration is the change in color from the normal white enamel to the darkening or brownish discoloration. Persistent tooth discoloration can also occur as a result of the gradual thinning of the enamel layer of the tooth.

This thinning allows for more yellow -brown dentin formation underneath becoming visible. This is called amelogenesis imperfecta

What causes tooth discoloration?

Several factors play a role in this process. Exposure to some chemical s can also promote tooth discoloration in some individuals.
In amelogenesis imperfecta, the enamel is often absent and the exposed dentin has a yellowish-brown discoloration. This condition is an inherited disorder with defective tooth enamel formation caused by various gene mutations. The condition is treated with resin veneers and jacket crowns for anterior teeth, as well as steel crowns for posterior teeth
Tooth discoloration may be due to substances such as Fluoride. Excessive exposure to fluoride from drinking water, tooth pastes, supplements, and infant formulas results in fluorosis a condition of excess fluoride in the system. The excess fluoride interacts with mineralizing tissues, causing alterations in the mineralization process especially in the teeth. fluoride in the drinking water in excess of 1.5 parts per million causes coloration

  • Color disturbance may also be due to secondary to inflammation
  • Vitamin deficiencies can also cause color changes in teeth
  • Trauma to the enamel leads to the exposure of denting that shows a yellow-brown coloration
  • An isolated tooth with a grayish – blue hue may indicate the presence of a necrotic pulp, often due to prior trauma.
  • A tooth that appears pink (pink tooth of Mummery) indicates an internal tooth resorption.
  • Yellow to violet staining that fluoresces under ultraviolet light is normally due to exposure to tetracycline. It is advisable to avoid these drugs during pregnancy and up to 18 years of age as the teeth are growing and developing. Tetracycline also destroys the calcium deposits
  • It has been shown that regular use of Mouthwashes that contain Chlorhexidine as their active ingredient increases the incidence of tooth discoloration.
  • Tobacco smoking may lead to tooth discoloration.
  • Excessive consumption of coffee may cause tooth discoloration.

There are various methods now in use for bleaching teeth.

The home based Bleaching Kits

This is a do-it-yourself method that you can use at home. The kit contains diluted dentist approved hydrogen peroxide (1% – 10%). Other kits may have carbamide Peroxide (at 10% – 20%) gel. The gel is applied topically to the teeth and left for some minutes. The gel is a good whitener for teeth that acts by breaking the stains. It also enters the enamel and dentin of the Teeth where it bleaches the stained substances.

Steps in bleaching the teeth include:

  1. Step one; Rinse the teeth with a mouth wash containing citric Acid. The acid helps to remove the pellicle, an enzyme layer that dental plaque clings to.
  2. After cleansing the teeth, use a cotton swab and dip in the hydrogen peroxide solution provided. Remember, it has to be in a concentration of 10% to 20%. You may also use the carbamide peroxide gel.
  3. The kit comes with the whitening substance such as titanium dioxide paste. After the gel application, allow a few minutes then apply the paste and polish to the surface clearly.
  4. Allow a few minute then rinse your mouth with distilled water

Please note that due to the lesser contact time of your teeth with the bleaching agents, the treatment results may not be displayed immediately. You may have to repeat this again till you get the result. If you are not comfortable with the kit, you may consult your dentist.

Dentist Supervised bleaching

This is a three step procedure that involves:

  1. Cleaning of the Teeth by the dentist to remove superficial stains. He may use the dental equipment to do this unlike what you use at home.
  2. Application of the gel to the teeth to allow bleaching and removal of the plaque. The carbamide Peroxide concentration used is about 35% – 44%. references
  3. The dentist will then provide a dental tray that is to be worn for approximately one hour everyday. This can be done at night while sleeping or during the day, which ever is comfortable to use. Note that the tray does not interfere with your speech.

Studies show that the dentist supervised bleaching is effective in about 90% of patients.

Cervical cancer

Cervical cancer

Cervical cancer

Introduction

Cervical cancer is uncontrolled growth of abnormal cells and tissue within the cervix (the neck of the uterus). The uterus is the womb where babies are grown. There is then an abnormal growth of cells presenting with hypertrophy (increase of cell size), hyperplasia (the increase of the numbers of cervical cells), anaplasia (formation of atypical shapes of cervical cell shape), and poor cervical cell function.The increasing cell size and numbers lead to an increase in the size of the surrounding tissues with the invasion of more abnormal cells from the cervix.

The cells are so aggressive and invade the surrounding tissues by competing for blood supply to the tissues. These cells are easily detected by a Pap smear test as they are shed from the.

Cervical cancer causes

There are several know causes of cervical cancer. The main cause of cervical cancer is an infection with Human papilloma virus (HPV) serotypes 16, 18, 31, 33, 45, and 56 which account for more than 80% of all invasive cervical cancers.

However most of the causes are associated with specific risk factors that women face. A regular Pap smear tests is important as a screening tool and a preventive measure for cervical cancer among women.

What are the risk factors for cervical cancer?

  • Associated risk factors include
  • Having multiple sexual partners
  • Women living in lower socioeconomic status
  • Cigarette smoking
  • A history of sexually transmitted diseases such as chlamydia, HPV infection
  • Immunosuppression
  • Oral contraceptive use.
  • Certain types of sexual behavior such as
    1. Women who have sex at an early age
    2. Women who have multiple sexual partners
    3. Women who have partners who have many other sex partners
    4. Women who have sex with uncircumcised men
  • Smoking or nicotine
  • Infections with Human immunodeficiency virus (HIV)
  • Diet with increased levels of homocysteine has been associated with increased risk of having cervical cancer. Vitamin deficiency has also been implicated in development of cervical cancer. Lack of
  • Prolonged use of oral contraceptives (birth control pills)
  • Women who have multiple pregnancies
  • Women living in low socioeconomic status
  • Injection with diethylstilbestrol (DES) drugs
  • Women who have relatives who had cervical cancer
  • Exposure to radiation of any type especially these on treatment for other cancers
  • Exposure to compounds that may affect nuclear genetic material such as benzene
  • Prolonged stressful conditions

Screening for cervical cancer

From the evidence obtained from large control studies, it is recommended that:

Screening for cervical cancer with a Pap smear test can achieve an 80% reduction in death rates from the cancer in the target population of women aged between 25 to 60 years.

It is also recommended that women have a screening interval of one year with conventional Pap smear tests or every 2 years using liquid-based cytology.

After the age of 30, women who have had three consecutive, technically satisfactory screening results may be screened every 2-3 years.

The American Cancer society recommend that cervical cancer screening should begin 3 years after the onset of vaginal intercourse and no later than age 21 years of age

Women who are age 70 years or older with an intact cervix and who have had 3 or more documented satisfactory cervical screening test results within the 10-yr period before age 70 may cease to have the routine cervical cancer screening tests

Those who have had uterus removal (with removal of the cervix need not undergo screening tests.

Cervical cancer epidemiology

Although cervical cancer is the third most common gynecologic cancer in the United States, it is the most common malignancy worldwide.

Cervical cancer is the second most common cancer in women in the world, with an estimated 500,000 cases in 2003.

Screening for cervical cancer with follow up and treatment has helped reduce the incidences of cancer. How ever this may not be true in some countries or regions such as the Latin America, the Caribbean, and Africa, where cervical cancer is the most common cause of cancer-related death in women

The incidences are high among the whites in the United States with an estimated 8.1 new cases per 100,000 each year as compared with 11 per 100,000 in African-American women and 14.4 per 100,000 in Hispanic populations.
Symptoms of cervical cancer

  • There are no symptoms in those in precancerous stage
  • There is an unusual vaginal bleeding, particularly after sex
  • A vaginal discharge with odor
  • Early invasive cancers may also present with no symptoms although some women will notice postcoital (after sex), between menses, or postmenopausal spotting.
  • Some women will present with malodorous vaginal discharge
  • Painful coitus (dyspareunia)
  • Cramping pelvic pain from uterine contractions
  • Chronic blood loss may result in symptoms of anemia in some patients
  • There may be pelvic pain
  • In advanced stages, there may b lower limb swelling (from occlusion of pelvic lymph vessels or thrombosis of the external iliac vein)
  • Advanced stages of disease may lead to anorexia, dysgeusia and unintentional weight loss

Diagnosing cervical cancer

  • The following tests may be performed to help in diagnosis of cervical cancer.
  • The healthcare provider will perform a detailed history and physical examination
  • Pelvic examination which includes examination of the vagina, cervical and related organs
  • Pap smear test.
  • Test for human papilloma virus (HPV) DNA. There is a high sensitivity for the detection of cervical intraepithelial neoplasia with these tests. This test helps to reduce the incidence of grade 2 or 3 cervical intraepithelial neoplasia (CIN) or cancer detected by subsequent screening examinations.
  • Colposcopy The method of examining the vagina and by means of a binocular instrument known as the colposcope, to screen for cancer of the cervix. The clinician may also use this test to do biopsy and endocervical curettage.
  • Complete blood count
  • A squamous cell carcinoma (SCC) antigen test
  • Carcinoembryonic antigen (CEA)
  • Chest x-ray examination

Continue reading about Treatment of Cervical cancer.

Breast Cancer

Breast Cancer

Breast Cancer

Definition

Breast cancer is an invasive cancer of the breast affecting both men and women. The local cells of the breast grow abnormally and uncontrollable increase in size and spread to other area s of the body.

Other names

Carcinoma of the breast

What causes breast cancer?

Various causes of breast cancer have been explained, but the exact cause is still unknown. There are numerous risk factors that increasingly relate to the development of breast cancer such as:

  • The increase in age of a person. It is estimated that close to 50% of women with breast cancer in the western world are more that 60years of age
  • The earlier a girl gets in to menarche especially at <12 year, the higher the risk of developing breast cancer.
  • When approaching menopause late especially at over 55 years, one has an increased risk of developing breast cancer. This is an indirect cause.
  • The increasing the number of menstrual cycles could predispose women to greater DNA damage in the proliferating breast ductal tissue and thus could increase the risk of mutations that directly lead to breast cancer.
  • Child bearing at a later age is a predisposing factor to breast cancer in women.
  • Any form of benign breast tissue disease may increase the risk of cancer
  • Women who live sedentary lifestyles and do not exercise often are at an increased risk of developing breast cancer
  • Breast cancer has been associated with women who live in upper socioeconomic classes. This may also be associated with more sedentary lifestyles
  • Personal history of breast cancer (in situ or invasive)
  • Postmenopausal hormone replacement treatments with estrogen hormones (with or without progestin) have been shown to increase the risk of getting breast cancer. The risk is increased by about 1.5times
  • Developing obesity after menopause increases the risks of breast cancer in women
  • The use of oral contraceptives increases breast cancer risk minimally if at all. It is t known whether estrogen replacement alone increases risk. However there is a much more increased risk in using these hormones in leaner postmenopausal women. The exact mechanism of cancer formation is unknown but there is a possibly of interaction of ovarian estrogen and other types of estrogens of external origin with breast tissue that leads to susceptibility to develop cancer of the breast
  • Alcohol is also associated with increased risks of developing breast cancer. Surveys show that moderate alcohol intake (two to three drinks/day) has a 1 to 1.8 times the risk of developing cancer.
  • Diet effects. Increased estrogen levels have been found in women with a higher BMI. These pose as an increased risk of developing breast cancer.
  • Family history of breast cancer is a risk factor in women. The risk in first degree relatives is 2 to 4 times more. Having relatives of known high risk factors also play a role. Having two first degree relatives with breast cancer increases the risk by 5 times.
  • Women with an increased bone density have been shown to have a risk of developing cancer.
  • Having children at a later age of more than 30 years poses as a risk to women to develop breast cancer. There is even an increased risk in non-child bearing women ( nulliparous)
  • Women with a personal history of endometrial cancer do have a risk of developing breast cancer.
  • Women with larger breast masses have a more breast density that increases the breast cancer risk. The density can be shown through mammography
  • Exposure to radiation to the chest poses as a risk of developing breast cancer in women.
  • Women with an established breast cancer gene BRCA-1 and BRCA-2 are associated with high risk of developing the cancer

Continue reading Epidemiology of breast cancer.

Common causes of hair loss in children

Common causes of hair loss in children

Common causes of hair loss in children

Hair loss in children is a common observation. There are several causes and most of them are easily treatable. Among the commonest know causes include:

Fungal infection (TINEA CAPITIS)

Fungal skin and scalp infections account for the majority causes of hair loss. The prevalence is about 90% of causes presenting to the doctor. The fungus has no known natural reservoir and persists for long periods on fomites, such as hairbrushes, combs, furniture, stuffed toys, and clothing. The highest incidence of this kind of infection is during school opening season when there is over crowding and contact with the infected persons. Most patients are between 1 and 10 years of age, but infection may occur at any age.

The infection survives in environments such as tight braiding, or the use of pomades.

How fungal infection presents:

The classic presentation is of one or more round to oval patches of partial to complete hair loss and with varying degrees of redness at the infection site. There may be repeated episodes of itchiness and scratching. The scratching may lead to secondary bacterial infection since there is introduction of bacteria to the injured area.

How is Tinea Diagnosed?

The bets diagnosis is clinical. The doctor examines and notices a clear pattern of presentation to the scalp. Some of the lesions may be noted on other sites such as the skin on the armpit, neck, fingers and interdigital spaces. A lab test with KOH staining also helps diagnose the fungi. The fungi are collected with a toothbrush on a culture plate or on a moistened culturette swab.

Treating fungal scalp infections

Treatment may be difficult in some patients due to various factors such as, repeated infections, poor drug compliance, incorrect diagnosis or resistance to treatment. Successful treatment requires a combination therapy with oral griseofulvin tablets and antifungal creams. Some antifungal shampoos are also available for use such as ketoconazole (candid –TV) shampoo. Griseofulvin is the agent of choice that is best taken with fatty food to promote absorption. The treatment may last 4 to 6 weeks or even up to 12 weeks depending on the response to treatment and severity.

Other types of shampoos in use include selenium sulfide 2.5%. This is done twice weekly

Partial hair loss (ALOPECIA AREATA)

Alopecia areata is a condition that is characterized by the sudden onset of asymptomatic round, bald patches located on any hair-bearing part of the body. The presentation is common on the head. There are no hair follicles and the patients have a scaly reddish crusting on the scalp. There may be pus formation too. Most patients recover well and have hair growing back in 1 to 2 years.

How alopecia areata is treated?

The main aim of treatment is to reduce the inflammation and infections. Treatments available include the use of topical steroids, topical minoxidil, tar preparations, and anthralin. Some healthcare providers may also use ultraviolet light to treat. The medications with minoxidil are used to promote hair growth and give good results.

TELOGEN EFFLUVIUM

This is a form of hair loss that is characterized by diffuse alopecia that is usually not clinically obvious to anyone but the patient and parent. The causes may be due to physiologic and pathologic stresses such as recent infections, high fever, severe influenza, surgery, and drugs. The hair follicles normally regress to the resting, or telogen, state of hair cycle. Telogen effluvium usually occurs 3 to 5 months after the stressor and is self-limited. The patients need not worry about it but may use minoxidil in cases of severe hair loss.

TRICHOTILLOMANIA

Trichotillomania is a type of hair loss that is caused by the compulsion to pull out one’s own hair. This applies traction to the hair leading to hair loss. The patients may present with areas of incomplete hair loss. Some of the hairs appear short and broken. Amazingly other areas involved include the eyebrows and eyelashes. This condition may be due to a psychiatric illness and treating it may help resolve the compulsion.

TRACTION ALOPECIA

Traction alopecia is hair loss that comes after forms of hairstyles that apply tension for long periods of time. Some patients also do like to pull on their hairs and this can cause hair loss (see Trichotillomania). The patients normally have noninflammatory linear areas of hair loss at the margins of the hairline, part line, or scattered regions, depending on hair styling or mode of traction used. The best treatment is avoidance of the causes of traction or styling products or styles that result in traction.