Chest Radiography (Chest X-Ray, CXR)

Chest Radiography (Chest X-Ray, CXR)

Chest Radiography (Chest X-Ray, CXR)

Why its done

Chest x-ray is used to diagnose cancer, tuberculosis (MTB) and other lung diseases, and disorders of the mediastinum and bony thorax. The chest x-ray provides a record of the sequential progress or development of a disease. It can also be use to give valuable information about the condition of the heart, lungs, GI tract, and thyroid gland

How to prepare

No special preparation is required. However, the patient will be informed of the purpose and procedure process for the test. There there should be no discomfort. Pregnancy should be screened or at least inform of the last menstrual period.

Risks

The is an increased risk of fetal teratogenicity. The ould be a vasovagal response (hypotension, bradycardia) when instructed on breath-holding.

Results

There should be a normal appearing and normally positioned chest, bony thorax (all bones present, aligned, symmetrical, and normally shaped), soft tissues, mediastinum, lungs, pleura, heart, and aortic arch.

How its done

The patient is positioned sitting or standing upright in front of the x-ray machine, with arms held slightly out from the sides, chest expanded, and shoulders pressed forward. The x-ray film is placed against the anterior chest. For lateral views, the patientwill stand with arms raised from the shoulders. The film is placed against the right or left side of the chest. The patient is asked to hold very still and takes in a deep breath and hold as radiographs are taken. For portable x-rays, the patient is positioned sitting in a high-Fowler’s position, and the portable x-ray machine is moved into place in front of the chest for the radiographic exposure onto the plate positioned behind the back and chest.

Interpretation

The chest x-rays do provide records of progress or development of a disease. X-rays must be done after the insertion of chest tubes or subclavian catheters to determine their anatomic position as well as to detect possible pneumothorax related to the insertion procedure. A postbronchoscopy chest x-ray is done to ensure there is no pneumothorax following a biopsy. In addition, the position of other devices such as nasogastric or enteric feeding tubes can be determined and adjusted if necessary. Abnormal chest x-ray results indicate the following lung conditions: Presence of foreign bodies, aplasia, atelectasis, coccidioidomycosis, hypoplasia, lung or liver cysts, pneumonia( bronchopneumonia, lobar, aspiration, or viral ), brucellosis, abscess ( lung or liver), middle lobe syndrome, pneumothorax, pleural effusion, pulmonary tuberculosis, sarcoidosis, and pneumoconiosis (eg, asbestosis).
Westermark’s sign (indicates decreased lung vascularity, sometimes thought to suggest pulmonary embolus)
Abnormal conditions of the bony thorax include the following: Hemivertebrae, Bone destruction or degeneration, Heart enlargement, kyphosis, Osteoarthritis, Osteomyelitis, Scoliosis, and Trauma.

Factors affecting results

  1. Misinterpretation of a chest x-ray is possible because of tumor, post-operative changes, massive pulmonary emboli, false ventricular aneurysm and esophageal varices. Knowledge of the patient’s history is importanten.
  2. Clothing, jewelry, and metal objects cause shadows on the film.
  3. Movement during the procedure obscures the clarity of the picture.
  4. Poor patient positioning makes x-rays difficult to interpret.
  5. Overexposure or underexposure results in inadequate visualization.
  6. The experience of the radiologist in interpreting the films affects the accuracy and outcome of the findings.

Female Condom

Female Condom

Female Condom

What is it?

  • A female condom is a soft, loose fitting polyurethane pouch. It is larger and looser than the male condom with a closed end that fits over the cervix, inside the vagina.
  • It is approximately 3 inches in diameter and 6 to 7 inches long and looks a bit like a miniature wind sock.
  • There is an open end that is made to hang slightly outside and helps to protect the lips of the vagina. The female condom has two flexible rings; the smaller ring that fits on the cervix and the larger ring that hangs outside the vagina and covers the lips (vulva).
  • The condom is lubricated form the inside.
  • It is stronger than latex and has less pores and tears less easily than the latex condom
  • Like the male condom, it is meant for one-time use.
  • You do not need a prescription to buy the female condom and anyone can purchase it from the drug stores.

How do I use it?

  • Browse the instructions that include it before using it thoroughly
  • The shut eliminate of the feminine condom is made to match over the cervix, and the open up eliminate ring addresses the lips of the vagina. To place the feminine condom, pinch small ring at the shut eliminate of the condom in the middle of your thumb and middle finger.
  • You may put in a drop or two of extra lubricant to the exterior of the shut eliminate of the condom to create it simpler to insert but understand that too very much lubricant can make it hard to understand the ring firmly.
  • Put the condom in so far as it shall go. Make sure it generally does not twist and that the external ring is hanging beyond your vagina. It could be inserted up to 8 hours before having sex anytime.
  • If you are unfamiliar with your vaginal anatomy, take a look before you try inserting the condom. To do this, you may use your middle finger to find your cervix at the upper end. The cervix feels somewhat like the end of your nose, and it is about 3 inches from the vagina’s opening.
  • Do find a comfortable position such as sitting on the edge of a chair with your knees apart, or sit on the toilet, or lie on your back.
  • Using your finger spread the lubricant evenly on the inside of the long pouch, from bottom to top. The lubricant is designed to make the inside of the condom feel similar to the normally lubricated vagina. You may even place a drop of lubricant either on the end of the male organ or at the starting of the condom. It could produce using the condom convenient also. The manufactures provide a little bottle of lubricant with the container of condoms.
  • When the person is inserting, if the penis will not slide in and out during make use of easily, you can add even more lubricant from the excess supply in the bundle. It really is good to steer the penis inside together with your hands also
  • Usually do not use both the feminine and male condoms simultaneously.
  • After the guy has ejaculated, stick to your back to remove the condom. You may do that by squeezing and twisting the outer ring. Carrying out this prevents the semen from leaking.
  • Grab the condom out and wrap it in a paper gently.
  • Discard it in the trash may.
  • Usually do not flush condoms down the toilet.
  • Don’t utilize the same feminine condom more often than once.

What are the benefits of female condoms?

  • The polyurethane material creating the sheath of the feminine condom better compared to the latex and will not allow penetration of the sperm, bacteria and viruses
  • The outer and internal ring prevents contact between your male organ and the vagina
  • Female condoms give females more control over safeguarding themselves from pregnancy, STIs, warts, herpes and HIV. By having it inserted independently, they do not need to convince somebody who could be unwilling to use a condom
  • It is certainly an alternative for individuals who are allergic to latex
  • It is less inclined to tear just like the male latex condom
  • You only utilize them when you need them.
  • Some women found that the ring part of the condom that lies outside the body tended to stimulate the clitoris, adding to their pleasure
  • You can put the female condom in place up to 8 hours before intercourse
  • You do not need a spermicide for extra safety.
  • It is stronger than latex and has less pores and tears less easily than the latex condom
  • It is easier for a woman to empower herself by using the female condom than trying to convince the males to wear a condom
  • It is not affected by some oil based products such as Vaseline
  • When it was tested in actual use, about 30% of the men said they preferred the female condom over the male condom because it was roomier and that it felt more natural to them because the penis could move freely in and out.

What are the disadvantages of female condoms?

  • Some women and men find it uncomfortable to use
  • It costs a lot more than the male condom
  • Some people find the appearance of the female condom unappealing or awkward, especially when using for the first time.
  • If lovemaking is usually lengthy, the lubrication may get used up and the polyurethane will become somewhat dry. Some condoms come with extra lubrication just incase
  • If not well guided by the lady, the penis goes in next to the condom instead of inside the condom.
  • The typical use failure rates are 12-22% for female condom
  • Some women find them hard to put in.
  • Some women statement that the condom could be noisy at period. That is when the lubricant inside isn’t spread around the external expire or if it’s not enough evenly

Who qualifies to really have the TCu380A IUD?

Who qualifies to really have the TCu380A IUD?

Who qualifies to really have the TCu380A IUD?

Read Intrauterine devices (IUD) first.

  • Lactating ladies or after delivery however, not after 4 weeks
  • Ladies with liver disease, hepatitis or using medicines that affect the liver
  • Women with breast tumor, hypertension, hyperlipidemia, background of ischemic cardiovascular disease, stroke or multiple risk elements for cardiovascular disease.
  • Ladies with current deep vein thrombosis/pulmonary embolism.
  • Women who’ve had major medical procedures or trauma
  • Women with migraines with or without focal neurological symptoms.

Who qualifies for LNG-IUS?

  • Women with severe menstrual bleeding (menorrhagia)
  • Women with painful menses ( dysmenorrhoea)
  • Women with endometriosis.
  • Women with bleeding disorders or on anticoagulation treatment with heparin or warfarin
  • Women with thalassemia, sickle cell disease, or iron-deficiency anemia.
  • Breastfeeding women after 4-6 weeks post delivery

Read moreWho qualifies to really have the TCu380A IUD?

Staging bladder cancer using the TNM system

Staging bladder cancer using the TNM system

Staging bladder cancer using the TNM system

Read Bladder Cancer First.

  • T0 ; No tumor in specimen collected
  • Tis ; Carcinoma in situ ( CIS)
  • Ta: Noninvasive papillary carcinoma
  • T1: Tumor invades lamina propria
  • T2: Tumor invades muscle
  1. T2a: Invades superficial muscularis propria
  2. T2b: Invades deep muscularis propria
  • T3: Tumor invades perivesical tissue
  1. T3a: Microscopic perivesical fat invasion
  2. T3b: Macroscopic perivesical fat invasion (extravesical mass)
  • T4
  1. T4a: Invades adjacent organs (uterus, ovaries, prostate stoma)
  2. T4b: Invades pelvic wall, abdominal wall

Invasive of nodal status:

  • N0 No nodal involvement
  • N1-3 Pelvic nodes
  • N4 Nodes above bifurcation
  • Nx Unknown

Invasive of metastatic status:

  • M0 No distant metastases
  • M1 Distant metastases
  • Mx Unknown

Symptoms of bladder cancer

There is painless urination with bleeding( hematuria)

  • Persistent blood in urine
  • Frequency of passing urine
  • Some patients will experience pain on passing urine ( dysuria)
  • Lower abdominal pain
  • Abdominal mass and swelling
  • Lymphedema
  • In severe cases, kidney failure as the cancer spreads to affect the kidneys
  • Nausea and vomiting
  • Metastatic spread to other sites such as the bones will cases pain at the affected regions

Diagnosing bladder cancer

The healthcare provider will perform a thorough medical history and examination in trying to find out how it started. You will be asked about the pain on passing urine, any change in color of urine, any frequency of passing urine and changes to it among others.

The healthcare provider will request for urine tests to rule out any infections such as TB, schistosoma cysts, and blood in urine

The definitive test for diagnosing bladder cancer is the Cystoscopy test. Most urologists will perform these diagnostic cystoscopies in an outpatient setting using a 16F flexible cystoscope and local Intraurethral lidocaine for topical anesthesia.

If a bladder neoplasm is detected, an outpatient transurethral resection (TUR) or biopsy is done with anesthesia.

Radiological tests such as intravenous pyelogram (IVP), retrograde pyelogram, or computed tomography (CT) or magnetic resonance (MR) urogram are used to identify additional tumors and obstruction of the upper urinary tract due to bladder cancer

Other tests done include the complete blood counts, blood indices, Fibrin Degradation Products (FDP) and bladder cancer tumor markers.

Treating Bladder cancer

There are several modes used in treating bladder cancer including, the use of drugs, radiotherapy or both. Most bladder cancers recur in the bladder, but can be managed with a combination of transurethral resection (TUR) and intravesical medications or immunotherapy. Here are some guidelines

  • Bacillus Calmette-Guérin (BCG) vaccine is the most effective agent for treating high-grade superficial lesions. The use of this vaccine leads to reduction in progression rates and increases survival
  • Radical cystectomy (removal of bladder) with diversion of urine bypassing the normal route is the most effective means to eliminate bladder cancer. Types of diversion include; orthotopic diversion with a neobladder.
  • Radiation therapy in combination with TUR and a drug such as cisplatin, has been shown to be effective in preserving the bladder
  • The use of medications using urinary catheters such as methotrexate, vinblastine, doxorubicin, and cisplatin, has shown high levels of toxicity with poor results.
  • New drugs such as paclitaxel and gemcitabine are active, and combinations of these agents with platinum-based compounds have better results with less toxicity.

Why cystectomy (bladder resection) is done

  • When there is a cancer within a bladder diverticulum
  • In cases of primary, and muscle-invasive or high-grade tumors that allow complete excision with adequate surgical margins
  • Patients in whom there is an inability to adequately remove tumor by TUR alone because of size or location
  • When there is a tumor overlying a ureteral opening that may require ureteral reimplantation
  • Patient refuses to have urinary diversion
  • In poor-risk patients where diversion is not possible

Epidemiology of breast cancer

Epidemiology of breast cancer

Epidemiology of breast cancer

Read Breast Cancer first.

  • It is estimated that, worldwide, more than 1 million new cases of breast cancer are diagnosed yearly.
  • The incidence and death rates for breast cancer differ between races but the rates are more common in the Western nations and lowest among the developing world.
  • About 1% of breast cancers is found in males and 90% are estrogen receptor (ER)-positive
  • The risk of breast cancer increases with age
  • The genetically defined group of women with BRCA-1 or BRCA-2 identified to carry lifetime risk of as high as 80%. Women who carry a germ line mutation in BRCA1 genes have a cumulative lifetime incidence of 50% to 85% of developing breast cancer and 40% to 60% of developing ovarian cancer

Genes and breast cancer

The genetically defined group of women with BRCA-1 or BRCA-2 identified to carry lifetime risk of as high as 80%. These genes function in cells in a variety of ways such as

  1. Repair of damages DNA
  2. Cell-cycle regulation
  3. Transcriptional regulation
  4. Remodeling of chromatin in cells. Chromatin are the gene carrying vehicles in all cells
  5. BRCA-2 is involved primarily in DNA recombination and repair

The reason why these genes predispose primarily to breast cancers remains unknown. BRCA1 and BRCA2 genes can be carried and passed to children by men as well as by women. A drug tamoxifen has been shown to reduce the risk of contralateral breast cancer by about 50% in both BRCA1 and BRCA2 carriers.

The characteristics of BRCA1 and BRCA2 genes

  • BRCA-1 is located in chromosome 17 where as BRCA-2 in chromosome 13
  • The percentage contribution of BRCA-1 genes to hereditary breasts cancer is about 20 to 40% where as the BRCA-2 is 1- to 30%
  • The lifetime risk of developing breast cancer with is 60 to 85% in both genes
  • The lifetime risk of developing secondary breast cancer is about 50% in both
  • The risk of developing male breast cancer is minimal in BRCA-1 and about 4-6% in BRCA-2 genes
  • The risk of developing other types of cancers such as the cancer of the prostate , pancreas , stomach, ovary and melanoma

HER2 genes

Another gene, HER2 presents with its protein over expression in 20% of newly diagnosed breast cancers. HER2 stands for Human Epidermal growth factor Receptor 2.

HER2 gene positive breast cancer is associated with a more aggressive clinical course and decreased survival time compared to tumors with normal levels of HER2. Each normal breast cell contains copies of the HER2 gene found in the DNA of the cell. HER2 contains information that helps to make HER2 proteins.

The HER2 protein is the HER2 receptor found on the surface of some normal cells in the body. The proteins help send growth signals from outside the cell to the inside of the cell and pass the message for cells to grow and divide.

In HER2+ breast cancer, the cancer cells have an abnormally high number of HER2 genes per cell. When this happens, too much HER2 protein appears on the surface of these cancer cells. This is called HER2 protein overexpression. This causes the cells to grow and divide more aggressively. This contributes to growth autonomy and genomic instability where the cells growing hev no control at all.
Symptoms of breast cancer

  • Breast cancer is usually first detected as a palpable mass or as a mammographic abnormality. These masses and areas of asymmetrical thickening of breast tissue are the most common manifestations of breast cancer.
  • There is nipple discharge, retraction and flattening of the breast. Spontaneous bloody or watery discharge from the nipple is commonly associated with underlying breast neoplasm. Presence of milky discharge almost always has a noncancerous cause.
  • Changes in the skin over the breast. There is skin swelling, and erythema.
  • Breast pain. the breast pain typically is associated with a palpable lump
  • Paget’s disease of the nipple is a form of adenocarcinoma involving the skin and lactiferous sinuses of the nipple; it usually appears as an eczematous lesion of the skin of the nipple. It’s frequently associated with excoriation of the skin and discharge.
  • Lumps in the armpits and above the clavicles

What are some of the tests done in lung cancer?

What are some of the tests done in lung cancer?

What are some of the tests done in lung cancer?

Read lung cancer and How do those with lung cancer present first.

  • The most important examination at the early stage is plain chest x-ray.
  • Other tests include the endoscopic studies
  • CT scan of the chest
  • MRI of the chest
  • Tissue biopsy ( done during the endoscopy)
  • Flexible fiberoptic bronchoscopy
  • A transbronchial needle aspiration: done via a special needle passed through the bronchoscope. This technique can be used to sample out mediastinal masses or paratracheal lymph nodes
  • Transthoracic fine-needle aspiration biopsy with fluoroscopic or CT scan guidance
  • Mediastinoscopy
  • Pleural biopsy in patients with pleural effusion
  • Thoracentesis of pleural effusion and cytologic evaluation of the obtained fluid

Read moreWhat are some of the tests done in lung cancer?

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

Menopause : What is it and why do I need to know about it?

Menopause : What is it and why do I need to know about it?

Menopause : What is it and why do I need to know about it?

You may have heard about another friend’s menopause stories but menopause is different for every woman. It is therefore important to be well informed about this third stage of life in a woman.

It is a time of change. Change can be exciting, a bit scary….. BUT MENOPAUSE need not be scary. All the changes are perfectly normal.

What is menopause?

It is a time when women stop having their monthly periods. It is a change of life. It is a new beginning. It is a time when one’s ovaries have run out of follicles (eggs) and therefore stop producing hormones, especially estrogen. It is a normal part of being a woman, and all women go through it.

When?

No one can be sure. Every woman is different. Most women reach menopause around 50 years, but many women start the changes in their 40’s.

Your best clue to timing of your menopause is your mother. Your menopause will be around the time when she had hers, with few alterations depending on lifestyle e.g. women who smoke get menopause about 2 years earlier than they otherwise would have.

How do I know?

  • It doesn’t happen all at once. It is a slow process, usually taking 3-6 years, and is complete only when a woman hasn’t had periods for 12months in a row.
  • Natural menopause: Your body will give you few clues that the process might have started.
  • Changes in your periods: – Missing periods, having more frequent periods, bleeding lesser or more than usual. This may happen for one or more years before they stop forever
  • Hot flashes and nights sweats – feelings of heat in the face and upper part of the body for few seconds or minutes on and off.
  • Dry vagina with possible itching and uncomfortable feeling during sex.
  • Bladder control problems: – some women may leak urine when they sneeze; cough and sometimes if they don’t get to the bathroom on time.
  • Mood swings and easy irritability.
  • Memory changes.
  • Having aches in the bones. Bones become weak after menopause because of deficiency of estrogen hormone from the ovaries. The main bones affected are the back, hip and arms.

Will all these changes happen to everyone?

No!! Menopause is different for every woman. Some have many changes, others just a few.

What can one do to feel better and stay healthy at this time of change?

  • Don’t smoke.
  • Exercise regularly-walk, ride a cycle, use stairs.
  • Eat healthy and get enough calcium and vitamin D.
  • Stay in cool areas and wear loose clothing.
  • Talk to family and friends about it.
  • Learn new ways to relax e.g. meditation.
  • Laugh a lot.
  • Ask for HELP if you need it. Don’t suffer quietly.

Does one need to see a health care provider?

Yes. Your doctor can be a big help as you go through this transition. You can discuss about your changes in periods, how you are feeling and about your chances of having weak bones.

Does everyone need medication?

No!! Many women will not need medication during menopause, but some need them to help cope with severe symptoms.

Treatment options!

Treatment is varied and depends on the symptoms, ranging from dietary advice to herbal medicines (like soy proteins), to hormonal medicine for vasomotor symptoms and other medicines for bones only. One needs to see a doctor to advise an individualized management plan as per profile of the patient. Every woman is different and may require different treatment schedules.

Tips for Nail Maintenance

Tips for Nail Maintenance

Tips for Nail Maintenance

Read Nail Maintenance Tips first.

Step by step procedure

Shop for items such as the nail coat, tip guide strips, neutral polish and white polish.  Note that the neutral polishes are very pale, sheer shades with a pink, beige or peach cast.  Look for manicure kits that come with everything in one convenient box. Here is what you also need; alcohol swab, nail brush and files, manicure scissors, nail buffers, cotton, nail clippers and cleaners. The procedure:

  1. Cutting the nails. Make sure you do clip, file and shape your nails properly. Follow the contour of the finger cuticle. Tend to your cuticles, then wash and dry the nails completely.
  2. Apply the base/top coat and let it dry for some minutes. Make sure you do not react to the chemicals provided.
  3. After everything has dried up, remove the guide strip by peeling it off then fix it below the tip of a nail, following its natural curve. The guide will allow you to paint an even white tip with ease and precision. That’s how great painters work by the way.
  4. Be sure you place all guide strips on the nails you want painted. The longer the nail, the longer the white tip should be. Be sure that the arch of the guide is smooth and rounded and the lengths of tips are equal to give it a greater uniform look.
  5. Start by painting each nail tip white. Perform this by extending the brush stroke from the top of the guide to the end of the nail. Avoid getting any white polish on the body of the nail below the guide. Let the tips dry.
  6. After they are dry, remove all the guides.
  7. Dissolve leftover adhesive by rubbing it gently with an alcohol cotton swab
  8. Now apply 2 coats of the neutral polish, first by letting the first coat dry then apply the second coat.
  9. Finish with a thin layer of base/top coat.
  10. You can have your own color combination just to be different from the French style. Instead of the neutral, you may consider the white, red with black tips, red with gold tips or white with silver tips. It’s up to you.
  11. As you finish up, keep your hands very still as the polish dries to avoid denting or smudging it.

Important things to note

  • DO NOT USE YOUR NAILS AS TOOLS OR WEAPONS. Instead use your fingertip or knuckle to perform tasks.
  • You may trim cuticles once each week. First soften them with a specialized cuticle cream, and then trim carefully with a clipper.
  • You may moisturize nail beds regularly by rubbing nondrying nail lotion over the entire nail bed at least once a day or oil the nails daily by using creams such as aqueous cream with vitamin E. This helps to hydrate your cuticles and prevents peeling and separating of the natural nail from the acrylic.
  • Wear gloves whenever coming into contact with cleaning chemicals (kitchen/bathroom cleaner, bleach, ammonia, etc) as well as when gardening – dirt, fertilizer, and chemicals used for plant growth are harmful. Gloves protect your skin as well as your nails!
  • Do not use glue on your nails. Temporary patching with glue may trap dirt and /or bacteria in the nail which may damage the natural nail. In addition, glue is water soluble – so it will break down when you come into contact with water and you may re-break the nail, causing even more damage.
  • Eat a balanced diet especially full of vitamin B, calcium and protein to get stronger nails. You may also take supplements
  • Clip your nails regularly in a rounded or squared shape. On the toes nails, if you easily get ingrown toes nail conditions, trim the nails horizontally than curving them. Not that the more your nails point especially at the tips, the more likely it is to break off.
  • Avoid biting your nails as it is a sure way to create unhealthy and unsightly nails

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

Side Effects of cigarettes

Side Effects of cigarettes

Side Effects of cigarettes

Read Health Hazards of cigarettes first.

Smoking around children:

The Dangers of Secondhand Smoke to a kid:

  • Low birth weight for gestational age
  • Sudden Infant Death Syndrome (SIDS)- children whose mothers smoked during pregnancy have an increased risk of SIDS.
  • The EPA estimates that passive smoking is responsible for between 150,000 and 300,000 of these infections in children under 18 months annually
  • Asthma – According to the EPA, between 200,000 and 1,000,000 kids with asthma have their condition worsened by secondhand smoke every year. Also, passive smoking may also be responsible for thousands of new cases of asthma every year
  • Chronic respiratory symptoms such as cough and wheezing may be attributed to secondhand smoke.
  • Children who breathe in secondhand smoke are more likely to suffer from dental cavities, eye and nose irritation, and irritability
  • Middle ear infections – exposure to ETS causes buildup of fluid in the middle ear, resulting in 700,000 to 1 1.6 million physician office visits yearly in the U.S.

Read moreSide Effects of cigarettes

Dating

Dating

DatingLooking for someone?

Dating is a kind of courtship, and could include any public activity undertaken by, typically, two people with the purpose of each assessing the other’s suitability as somebody in an intimate romantic relationship or as a partner. The word identifies the act of achieving and participating in some mutually arranged cultural activity. Traditional dating actions include entertainment or meals.

In lots of cultural traditions, a date could be arranged by a 1 / 3 party, who could be a grouped relative, acquaintance, or professional matchmaker. Internet dating is becoming popular recently.

Although dating etiquette is becoming more relaxed during the twentieth century, there are considerable differences between social and personal values. For example, when an activity costs money (for example, a meal), traditionally the man was expected to pay; but in recent times the practice of «going Dutch» (splitting the expenses) has become more common and more acceptable. With the wider availability of information about traditionally secretive issues individuals are more open about their interest in sexuality both in form of dating language and dress. The difference in expectation of a date in the male / female view of dating is very marked and obviously shown by the public guidance disseminated by popular media, e.g. magazines, which is in stark contrast. The average duration of courtship before proceeding to engagement or marriage varies considerably throughout the world.

Read moreDating

Testing for Fertility in Men part two

Testing for Fertility in Men part two

Testing for Fertility in Men part two

Read Testing for Fertility in Men first.

The semen liquefaction

Semen analysis should begin with a simple inspection soon after liquefaction. This is done preferably at 30 minutes after ejaculation but no longer than one hour to prevent dehydration or changes in temperature from affecting semen quality. Normal liquefied semen samples may contain jelly-like granules (gelatinous bodies) which do not liquefy. These do not appear to have any clinical significance. Poor liquefaction means the sperm may not be released to fertilize the egg.

The following are the normal settings

Read moreTesting for Fertility in Men part two

The Top recommendations per age group

The Top recommendations per age group

The Top recommendations per age group

Read Men: 4 Things You Must Check With Your Doctor first.

Men Younger Than 20 Years

  • A complete physical examination that includes: quantitative blood check, urine test, cholesterol and stool test
  • Have an eye check up every 2 years. If you are at high risk, do this every year
  • Have dental check up every 6 months. If you are at high risk, follow your dentists recommendations
  • Blood pressure examination every 21⁄2 years beginning at once a year by the age of 20.

Read moreThe Top recommendations per age group

Valentines Day time: A complete woman’s guide

Valentines Day time: A complete woman’s guide

Valentines Day time: A complete woman’s guide

Read Valentines Day: A complete woman’s guide first.

How to look good for him, on this day

Let’s put it plain, Men have many traits in common;

  • They love their cars
  • They like to look at good breasts
  • They scan the best hips in the neighborhood
  • They love cute faces and the hair too.
  • Read the book of Solomon

Men are visual creatures by all means. Ever wondered why beer commercials have contents with the best hips and legs? The sexy connotations are not taken for granted. In her book called; Find a husband after 35, Rachel Greenwald advises women to wear dresses at all times. Studies prove that men love to see their women in dresses. With these parameters, you can use them to spice up your love. Remember, once in his eyes, some things are hard to forget. If you are walking down the streets with him and he notices a cute woman with a great body, this will linger in his mind for a while, if not a long time. You must erase it immediately. Tell you the truth, if you don’t erase it, and it happens over and over again, one thing will remain to be true; that the reason he is with you is that he can’t do better!

Read moreValentines Day time: A complete woman’s guide

How do those with lung cancer present

How do those with lung cancer present

How do those with lung cancer present

Read lung cancer first.

The early symptoms of lung cancer and their prevalence include:

  • Cough or altered cough in 60% of patients.
  • Coughing blood( Haemoptysis) in  27% of cases
  • Chest pain in 34%.
  • Difficulty in breathing (Dyspnea) in 46% of cases.
  • Loss of appetite
  • Weight loss 56%.

On examination of the patients

Read moreHow do those with lung cancer present

19 Mistakes Men Make During Sex

19 Mistakes Men Make During Sex

19 Mistakes Men Make During Sex

Introduction

This is for you men. And women who have guys who just wont get it, so that they can pass the message to them. Much as it is said that life is all about making mistakes and collecting bruises, learning from them, becoming transformed by them, some things are better learned once, even before making the mistakes. Men, lets admit that we will; change and do things better…no we will do things the right way. I have collected a few issues from women who during my practice and interaction with them, have candidly shared some of the crimes committed against them. Here are a number of them.

These are the crimes

  1. At first sight, you head straight to the groin. I wondered whether the name dogs came from
    this. Dogs at first sight will end up there, happy to see you back form where ever you have
    been. Women expect a kiss at first meeting ( OK this is for couples, pls don’t head for mouth to
    mouth with strangers). Avoiding her lips and heading straight to the 1% region as my colleague
    would call it makes her feel like she is not valued. Give her a proper passionate kiss as the
    Ultimate form of foreplay.
  2. Not calling her during the day. This is very common. Men a culpable in this by all means and expect it to be ok during the romantic moments. They say foreplay starts in the morning, or when you are leaving for work. As you part way in the morning, say goodbye with a kiss and immediately send her an email to her work address o leave a voice mail telling her how you miss her. That sets the ball rolling.
  3. Messing up her hair and massaging her roughly. You’re attempting to give her a sensual, relaxing massage to get her in the mood. Hands and fingertips are OK; If she has long hair, take time to brush with long slow strokes especially after she has had a shower or getting ready to bed.
  4. Breathing through her ear drum. There’s a clear difference between being erotic and blowing as if you’re trying to extinguish the candles on your 40th birthday cake. That hurts.
  5. Maintaining your shrubs. You must shave it off. Much as porcupines have their own means of romancing, remember she is human and steer clear of exposing her to your chin which you rake repeatedly across her face and thighs. If you have seen her turn her head from side to side, it’s not that she is fine, or having some passionate ,moments with you, it’s avoidance.
  6. Kneading her breasts and biting nipples. Most men still carry some traits from childhood, the attachment to the breasts. Please remember that those glands are heavily wired with nerve endings for touch, pain, and pressure. That makes them uncomfortable when you act like you are testing some oranges for ripeness. Do this; just gently stroke, caress, and smooth them, it takes them there. Never bite her nipples as if you are trying to deflate some balloons. Most nerve endings are located there and that increases the sensitivity. The best proven way is to lick, suck and flicking your tongue across them.
  7. Ignoring other body parts. Try to explore the who package lie you have just received some Christmas gift and you are trying to find a place to open it up. A woman is not a three point pit stop; Breast-ville East and West, and the subway tunnel. Other areas of her body are important too and may give you the same results.
  8. Unwrapping the gift awkwardly. Like the x-mas present, please find a gentle way of opening up the gift with a mind that you are environmental friendly and you will recycle the wrapping paper. That paper is her clothing. Another mistake comes with undressing prematurely. Always obtain consent for all procedures performed on them. Remember she will have to use it later. Be gentle.
  9. Attack on the clits. Too much direct pressure is painful and unpleasant. Be soft and try to caresses.
  10. Coming too soon. In fact this where the complaints come from. Women are not industrial plants, where the men stuff in the oil pipe ( penis) and pump in all the oil in to the plant and drop deada  sleep! Premature ejaculation is associated with ED, work on this. Build up slowly in sync wit her and take her there.
  11. Having a commercial break. Men are created differently. They can climb or near the climax, pause, then continue. In fact multiple orgasms happen this way. Women, unlike men, don’t pick up where they left off. When you stop, the go to have a drink or pick up a phone call, that it, they plummet back to square one very fast. If you can tell she’s not there, keep going at all costs, numb jaw or not. Please try and take her to climax,no matter what. Try to practice it. Most men would drop off dead asleep after the action with the lady wondering what’s up.
  12. Rough rides. Just be cause there are screams or near screams doe not mean you are the man. You could be causing some damage by going too hard especially when she is not ready or lubricated. If you are too heavy, try different styles. Lumping your whole body on her will turn her blue.
  13. Not coming too soon. Don’t think that because you thrust for an hour without climaxing is the mark of a Sex god. To her it’s more likely the mark of a numb vagina. You could just get her some wall hangings, so she has something to hold her interest while you’re on cross country business.
  14. Porn templates. Never use porn styles on her. In most scenes, the  women seem to love it when men ejaculate over them. In real life, it  means more laundry to do, more explanations to give too.
  15. Attempting anal sex and pretending it was an accident. This is how men earn a reputation for not being able to follow directions. Please ask before doing it and don’t think that being drunk is an excuse.
  16. Arranging her in weird poses. This is not a mannequin. If she wants to do advanced yoga in bed, fine, but unless she’s a Chinese gymnast, don’t get too ambitious. Just do what both of you are able to manage.
  17. Performing rectal examination. Read this carefully: Anal stimulation feels good for men because they have a prostate. Women don’t start looking for her prostate.
  18. Barking instructions. Please leave this to Sir Alex Ferguson.  It’s a big turn-off.
  19. Talking dirty during the action. If you have never done this before and especially if your spouse comes from a religious background, you have some explaining to do. If she wants  nasty talk, she’ll let you know

Typhoid fever

Typhoid fever

Typhoid fever

Introduction

Many times in Medical practice we come across patients who often complain of “Typhoid fever”. These patients have also been on treatment previously at peripheral centres for this diagnosis, commonly by unqualified personnel, or on a basis of non specific laboratory tests and often on clinical suspicion. This kind of practice has led to Overtreatment and irrational use, and thus potentially abuse, of antibiotic medications.

Other names

Enteric fever,Typhoid.

But what exactly is Typhoid fever?

Typhoid is a bacterial infection that is characterized by fever and abdominal pain and caused by dissemination of Salmonella Typhi or Salmonella Paratyphi types of bacteria. It is a clinically distinct diagnosis, though clinical features may resemble those of many other tropical diseases such as Malaria, Amoebiasis, Dengue fever, hepatitis, bacterial enteritis, Ricketsial infection, and Acute HIV infection among others.

It is thus important for you to note that there are many clinical scenarios similar to typhoid, thus it’s the duty of trained medical personnel to differentiate which one it is.

How is typhoid transmitted?

Salmonella that cause typhoid reside only on Humans, no Known Animal reservoir.
Infection is acquired by direct contact with an infected individual or indirectly via contaminated food or water. There is a story of “typhoid Mary” the cook in early 20th century NewYork who infected approximately 50 people, with 3 persons reported to have died,  highlights the person to person spread of this infection and role of asymptomatic carriers maintaining the cycle of infection.

Factors predisposing to infection include:

  1. Conditions increasing the PH of the stomach like
    • Increased use of Antacids
    • Low levels of hydrochloric acid in the stomach (Achlohydria)
    • Age of <1 year
  2. Inflammatory conditions such as Inflammatory bowel disease,
  3. Previous gastric surgery,
  4. Altered intestinal Normal Flora due to antibiotic usage.

What are the symptoms of Typhoid fever?

Following infection with Salmonella, there is an Incubation period of between 3 to 21 days, with average 10-14 days. There are no signs of disease at this time.

The length of this duration reflects the inoculum size and a person’s health and immune status. Infection leads to an onset of fever with other non specific symptoms. There non specific symptoms that often precede fever such as chills, headache, anorexia, cough, weakness, sore throat, dizziness, and muscle pains.

The Classic presentation of Typhoid in untreated person is divided into weeks is as follows:

First week of illness

Nonspecific symptoms including:

  • Persistent headaches
  • Malaise,
  • Rising remittent fevers also called the Step ladder fever. This is fever that rises exponentially over a tie period without remittion
  • Constipation
  • Mild nonproductive cough.

Second week

  • The patient looks toxic and apathetic
  • There is a sustained high temperature.
  • The abdomen slightly distended
  • There is an enlarged spleen (Splenomegally)

Third week

  • The patient becomes more toxic and ill.
  • There are persistently high fever episodes.
  • There may be intestinal bleeding and perforation, resulting in peritoneal infection (peritonitis).
  • There is abdominal distension that on auscultation, there are pronounced  scanty bowel sounds.
  • Diarrhoea common with liquid, foul smelling green-yellow stools.
  • The patient becomes delirious and a confusional state sets in (typhoid state)

Fourth week

  • Patients who survive have considerable weight loss.
  • Fever, mental state, and abdominal distension slowly improve.
  • Convalescence is slow.

How is Typhoid Fever Diagnosed?

Other than a positive culture, no specific laboratory test is diagnostic for enteric fever.
Cultures can be done on the following specimen:

  • Blood
  • Stool
  • Urine
  • Rose spots
  • Gastric or intestinal secretions
  • Bone Marrow; these remains positive in more than 90% of cases even after 5 days of good antibiotics.

Other tests that may give clues to the diagnosis of typhoid fever include a Complete Blod Count, Liver Function tests, Kidney function tests all which may change in various other disease states.

How about the Widal test?

The classic Widal test is widely available however, it has high rates of false positive and false negative, and thus this test is not clinically useful.

How is Typhoid fever treated?

Several Antibiotics are available for treatment of Typhoid fever, and since they are prescription only medicines, it’s wise to present to the doctor whenever you suspect Typhoid fever.

Dental Caries

Dental Caries

Dental Caries

What is dental caries?

This means continuous decay of teeth, eventually exposing the sensitive parts. The hard cover of the tooth s gradually eroded.

What teeth are mostly affected by caries?

The process affects flat teeth in premolar and molar region due to their physical appearance which allows food stagnation.

How does dental caries present?

The symptoms of caries include tooth pain and or sensitivity to cold or/and hot substances. This results from exposure of nerve endings occasioned by the decay. Other symptoms that will come with the caries include the swelling of jaws. Some patients may not have no symptoms except a visible tooth cavity.

What factors favor development of dental caries?

  • Certain foods that favor growth of bacteria
  • There must be bacteria on the teeth
  • A tooth whose surface favors food stagnation

What specific bacteria play a role in development of dental caries?

Certain species of bacteria called the streptococcus break down carbohydrates and release acids that dissolve calcium deposited in the tooth. Food particles left on the tooth also prevent the protective effect of the saliva and other oral secretions.

What are different types of caries?

These can be classified as follows:

  1. Enamel caries: affects enamel only, usually painless
  2. Dentine caries: affects both enamel and dentine, may be painful if pulp is exposed
  3. Caries of the cementum: affects cement, that is, the structure that attaches the tooth to the socket.

What are the complications of dental caries?

  • Pain
  • Spread of infections around the tooth
  • Distant spread of infections
  • Oral abscess and respiratory complications
  • Heart complications: infective endorcarditis, infection of heart valves
  • Worsening of existing medical illnesses such as diabetes.
  • Death may result from complication of dental caries

How are dental caries managed?

The methods used depend on extent of cavitation noted and presence of symptoms as well as complications. Usually, prevention of caries is the best approach. This is done by practicing good oral hygiene habits.

These include:

  • Proper brushing of the teeth after meals
  • Use of right kind of brush and changing regularly
  • Avoiding too sugary foods
  • Regular visits to dentist at least once per year for check up and advice

If dental caries are already established, they can be managed by any of the following methods singularly or in combinations:

  1. Filling
  2. Root canal treatment
  3. Crowns
  4. Tooth replacement
  5. Dentures
  6. Extraction under local anesthesia (XLA)

How can I know what kind of treatment is needed if I have dental caries?

The kind of treatment is determined by the dentist. This puts into consideration the cost of procedure, availability of procedure and materials, the extent of decay, aesthetic factors, other medical or surgical conditions present, and competence of the dental practitioner, and presence or absence of complications. Always consult a qualified personnel for advice.

What is the public health significance of dental caries?

  1. Loss of revenue through absenteeism from work
  2. Decreased quality of life
  3. Death and disability from complications such as spread of infections and respiratory compromise.
  4. Spread of infections due to use of unsterilized apparatus
  5. Increased legal cases against dental practitioners

Hand washing techniques (The beginning of infection control)

Hand washing techniques (The beginning of infection control)

Hand washing techniques (The beginning of infection control)

Introduction

There are hundreds of thousands of bacteria that live on our hands. We keep on adding and removing them with our hand washing methods. We keep adding some from the things we handle, the greetings we get and many more. Most bacteria are harmless but gain entry to the body after a small weakness in our defence systems. If you imagine all the places you visited today, from your office to the washroom, you must have handled many things. By frequently washing your hands the right way you will wash away germs, i.e. bacteria and viruses. Improper hand washing techniques is one of the many ways we breach our immune defence systems. The skin is one of the body’s defence organs against such germs, by washing your hands; you are performing one of the single most important-infection prevention procedures.

What is hand washing?

Hand washing is the removal of dirt, germs or micro-organisms and other organic materials that may be present on the hands by using water.

Why do we wash hands?

By performing this procedure, we are able to remove about 99% of micro-organisms with simple soap, water and friction. This helps to reduce the rate of infection from person to person or patient to patient, patient to health worker. By reducing the rates of transmission of these organisms, we are able to directly influence the rates of infections and complications that arise.

When should we wash hands?

Basically your hands should be washed after you have performed every act or procedure, whether domestic or at the place of work. The most important times are after:

  • After blowing your nose or coughing/sneezing
  • After using toilet
  • Before handling food
  • After handling food
  • Before and after handling patients
  • After handling pets and other animals
  • Before and after procedures
  • Before changing a diaper
  • Before touching newborns (neonates) as their immunity is not well developed.
  • When physically dirty

What to use when washing hands

The three most important things you need are:

  • Water
  • Soap
  • Antiseptic solution

Water is responsible for removing and rinsing all dirt from the hands. Soap helps dissolve some of the particles and materials that cannot dissolve in water and the antiseptic soaps hep I killing the germs.

How to wash hands

The most important thing to remember is never to touch the tap with dirty hands, wash the hands than return to the tap with clean hands to close it. Basically you end up having done nothing. In most health institutions, the types of taps used are different from the taps at home for the purpose of minimizing the risk of transfer of infections. You may use a paper towel to open the tap and let it flow especially if your hands are completely dirty. After doing this;

  1. Wet hands with running water
  2. Apply soap and distribute it over the hands.
  3. Away from running water rub the palm, back of hands, between fingers, back of  fingers, thumbs, finger tips and wrist and remove debris from under the finger  nails if any.
  4. Do this for at least 20 seconds.
  5. Thoroughly rinse and dry your hands using disposable towels or hand dryer
  6. Close the tap to save on water.

The use of antibacterial / antiseptic soaps

What is an antibacterial soap?

Antibacterial soaps are agents used to clean with the aim of removing or killing bacteria that are logged in the skin, nails and hair. The soaps contain the following antibacterial agents:

  • Triclosan
  • polyhexamethylene biguanide
  • benzethonium chloride
  • farnesol

Any benefits antibacterial soaps?

Most antibacterial soaps come with ingredients in combination or as triclosan alone. There may be other kinds of antibacterial agents. Research done in the department of Surgery, Columbia College of Physicians and Surgeons, Columbia University, New York, New York showed that the combination of Triclosan, polyhexamethylene biguanide, and benzethonium chloride-TPB or farnesol polyhexamethylene biguanide, and benzethonium chloride-PB showed superior rapid and broad-spectrum reduction of risk of organisms developing resistance than do soaps containing triclosan alone. Hand washing with TPB and FPB soaps by healthcare workers and the general population may reduce the transmission of germs, with a lower risk of promoting the emergence of resistant organisms.

When are the antibacterial soaps effective?

A study was done in the Dial Corporation, Microbiology Department, in Scottsdale Rd., Scottsdale,  USA ( link Janice.Fuls@us.henkel.com ) and found that the antibacterial soaps effectiveness depend on the following

  • The compliance of the person using them. If used on an on and off basis, the effectiveness is reduced and the chance of bacterial resistance increased. This is because the bacteria get clever and develop mechanisms of resistance or eliminating the antibacterial agents from inside their cells
  • The soap volume. The higher the amount of soap volume the better. Less amounts are more or less ineffective in destroying the bacteria altogether
  • How much time do you spend washing? It has been studied and found that the more time spend (minimum of 15 seconds) significantly reduced the bacteria transmission.

Unacceptable hand washing methods

About the antibacterial soaps

Much has been written about the potential hazards versus benefits of antibacterial (biocide)-containing soaps. A study be the department of epidemiology university of Michigan, Ann Arbor concluded that soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1%-0.45% wt/vol) were no more effective than plain soap at preventing infectious illness symptoms and reducing bacterial levels on the hands. Several laboratory studies demonstrated evidence of triclosan-adapted cross-resistance to antibiotics among different species of bacteria.

Please note the following

  • Triclosan is used in higher concentrations in hospitals and other clinical settings, and may be more effective at reducing illness and bacteria than the home setting
  • There are other soap ingredients that help fight bacteria such as savlon, peroxide hydrogen, povidone iodine or Betadine.
  • A combination of several drug ingredients is far much better than a single ingredient since it leads to faster bacterial resistance.
  • When using the soaps, allow at least 15 seconds or more wash time to be sure of the effectiveness
  • Most soaps contain only one type of ingredient ( always read the insert) and this becomes a problem when trying to reduce hand or skin bacteria
  • Not all that is seen in an advert may be true concerning eh effectiveness of some products. A lot of consumer knowledge and follow up is important

Based on the above details and research findings one should always ask him/herself; how long do I take to wash hands? Most of the time is after the dirt is gone or when the water that comes out of the hands is clear. These are practices that are not effective in removing bacteria and other organisms from the hands:

  • Not washing hands after every procedure
  • Irregular use of antibacterial soaps
  • Washing hands for less that accepted time. It is advised that you wash for at least 20 seconds
  • Using soaps that have not been medically tested and or registered as antiseptics
  • Using soaps that do not contains enough antibacterial ingredients
  • Reusing the water that is already contaminated
  • Using towels that are dirty and not frequently cleaned
  • Using wet towels to dry hands. Wet towels tend to adsorb dirt and accumulated more germs
  • Using the same towels for more than one purpose e.g. one towel for the washrooms being used in the kitchen

This week’s Bachelor Steak

This week’s Bachelor Steak

This week’s Bachelor Steak

Men are good at brunt offerings, from the days of Moses, Elijah, Solomon and David. They all did these especially to cleanse their sins or the sins of their families. In this week you may have had several ‘sins’ committed during the weekend.

But we are not going to help you up the Holy of Hollies, just a steak recipe to help you learn some stuff in the kitchen.

What you need:

  1. 1 sirloin steak, for you and the boys (nuff said)
  2. Soy sauce.
  3. The cheapest red wine available (ha!).
  4. Garlic. By the way did you read about the health benefits of garlic? One more thing, just avoid lots of this in case your spouse is thinking of you 9 months fro now.
  5. A garlic-smashing tool.
  6. Propane gas grills, if you have one.

Read moreThis week’s Bachelor Steak

Nail maintenance tips

Nail maintenance tips

Nail maintenance tips

Introduction

Nails are an important part of the body. The nail is one of the hardest parts of the human anatomy, and a durable and potent weapon. Although there are differences between fingernails and toenails, they are also quite similar

In many aspects. The fingernails growth at 3 mm/month compared with toenails at 1 mm/month. One of the reasons is because of poor blood flow to the toes compared to the fingers.

There are advantages of nails such as:

  • Protective coverings. They help protect the tips of the fingers and toes from injury or inflammation.
  • They may serve as effective weapons as anyone who has been scratched by sharp nails can confirm.

The nail anatomy

  • Nails are made of basically keratin, a fibrous protein that grows out of the front part of the top of the toe and slides forward over the nail bed. The same keratin is found in hairs.
  • The root of the nail is also called the matrix, or the growth plate.
  • The whitish area at the bottom of the nail is the lunula (half-moon), and the fold of skin lying directly over the root is the nail fold.
  • A skin layer next to the root is called the eponychium also known as the cuticle.

Keeping your nails healthy

Nails show many different indications of systemic diseases or conditions. For example in patients with anemia, the nails appear as whitish patches called apparent leuconychia which is spurious whiteness. On the other hand the nails are alive and need to be taken care of. The following are some of the facts on healthy nails:

  • A healthy nail is clear, with no discoloration on any part. There should be a normal growth pattern that follows the follows the contour of the toe or finger.
  • The nails have no nerve endings, meaning that there is no pain directly associated with damage to the nail itself. The pain that may arise may be due to the damage to the underlying tissue that has been traumatized.
  • The toenail serves no useful function to modern humans except for beauty especially in many women
  • The fingernails growth at 3 mm/month compared with toenails at 1 mm/month. One of the reasons is because of poor blood flow to the toes compared to the fingers.
  • Nails do not breathe. The nail plate is made of dead keratin and does not require oxygen. The nail bed, cuticle, and matrix do require oxygen because they are composed of live skin cells. These areas are supplied with oxygen rich blood from numerous capillaries.
  • Nails do not sweat since the bed does not contain sweat glands, so it can not perspire. While the nails do contain a lot of moisture the moisture does not build up under the acrylic nail. The moisture that causes problems under artificial nails occurs when the product lifts and moisture gets trapped underneath; most commonly caused by waiting to long between rebalances.
  • Nails do not eat and they do not need vitamin or minerals. Because nails are made from dead protein, they cannot be strengthened by vitamin or mineral supplements, or topical vitamin treatments. While severe vitamin, mineral, or protein deficiencies do affect the nails, healthy people rarely suffer from a deficiency severe enough to affect their nails.
  • The most common cause of nail  problems is an accidental or intentional, damage to them, and in most cases it is the big toe that is affected, just because it happens to be a bigger, better target than other nails
  • Some nail disorders are caused by ill-fitting shoes or erratic nail-cutting. When cutting nails, it is important to follow the contour of the cuticle

How to Give Yourself a French Manicure

This is a fairly difficult job, but after some time you easily get used to it. You must practice this. It will give you some attractive appearance from daytime denim to evening elegance. The white-tipped look will never leave you wondering whether your polish complements your outfit.

So if you want to look good, consider a French manicure.

Continue reading Tips for Nail Maintenance.

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.