- 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
- Pleural biopsy in patients with pleural effusion
- Thoracentesis of pleural effusion and cytologic evaluation of the obtained fluid
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 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
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:
- Enamel caries: affects enamel only, usually painless
- Dentine caries: affects both enamel and dentine, may be painful if pulp is exposed
- Caries of the cementum: affects cement, that is, the structure that attaches the tooth to the socket.
What are the complications of dental caries?
- 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.
- 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:
- Root canal treatment
- Tooth replacement
- 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?
- Loss of revenue through absenteeism from work
- Decreased quality of life
- Death and disability from complications such as spread of infections and respiratory compromise.
- Spread of infections due to use of unsterilized apparatus
- Increased legal cases against dental practitioners
Have you ever had trouble concentrating, found it hard to sit still, interrupted others
during a conversation or acted impulsively without thinking things through? Can you
recall times when you daydreamed or had difficulty focusing on the task at hand?
Most of us can picture acting this way from time to time. But for some people, these and
other exasperating behaviors are uncontrollable, persistently plaguing their day-to-day
existence and interfering with their ability to form lasting friendships or succeed in
school, at home and with a career.
Experts used to believe children would grow out of ADHD by the time they were adults.
In recent years, it’s been recognized that ADHD can continue on into adulthood. This
relatively recent acceptance of adult ADHD means that many adults remain
undiagnosed and aren’t aware their symptoms and behaviours are actually part of an
Unlike other mental disorders such as depression, ADHD does not start in adulthood.
Adult ADHD is a continuation of ADHD from childhood. The main difference is in the type
of difficulties and symptoms experienced. Adults are less likely to have intense
Rather than problems at school, its work lives and relationships that prove troublesome.
Instead of hyperactivity, one is likely to feel restless, fidget a lot, have difficulty relaxing
and feel on edge a lot of the time.
A typical ADHD adult may have gone through life being constantly misunderstood:
One’s behavior and actions may have caused difficulties with teachers, friends and work
colleagues. One may have been called clumsy, hyper, rude, abrupt, lazy, insensitive and
irresponsible. Smoking, drinking alcohol and, in some cases, drug taking are also more
common among ADHD adults.
What are the symptoms of adult ADHD?
Like childhood ADHD, adults share the symptoms of inattention, impulsiveness and
hyperactivity. For some adults, the hyperactivity part of things calms down and is more
controllable as they get older.
Adults can experience ADHD in different ways, but some of the common symptoms
- Concentration problems
- Forgetfulness and poor short-term memory
- Lack of organization
- Problems with creating and maintaining routines
- Lack of self-discipline
- Impulsive behaviour
- Low self-esteem
- Restless mind
- Poor time management
- Impatience and frustration
- Poor social skills and making inappropriate remarks
- Feelings of underachievement.
Diagnosis difficulties with adult ADHD
As an adult, getting a diagnosis of ADHD is not straightforward. ADHD adults will have
experienced their symptoms for most of their life and, despite frustration, are likely to
have reluctantly accepted them as part of their unique make-up. Some will have learnt to
develop their own coping strategies and may remain unaware they have a recognisable
condition. In most instances it’s friends, family or work colleagues who instigate a visit to
What treatment is available?
Although there’s no complete cure for ADHD, a number of treatments can significantly
help with the management and control of symptoms. The most appropriate treatment
regime varies according to individual needs and set of symptoms. The best treatment
should accommodate all areas of need.
Treatment focuses on helping behaviour, emotional problems and social difficulties
caused by ADHD. The main treatments for adult ADHD are:
It helps one learn about the disorder and ways to manage it effectively. For example,
manage and maintain daily schedules better through making lists, cope with large
projects at work by breaking them down into smaller chunks.
Psychotherapy helps treat the emotional disturbances of people with ADHD. Sessions
can take place:
- on a one-to-one basis with a professional
- in a group
- in conjunction with a partner if relationship difficulties are the main problem.
Psychotherapy can help remove or modify troublesome emotional symptoms and help
you cope with the daily challenges of living with ADHD.
Is usually used alongside other therapies; The most common medication for adults is
stimulants, but some people benefit from taking antidepressants – particularly if they
have co-existing symptoms such as anxiety and mood swings.
It is important to note that a treatment plan is developed according to the
individual needs of each person.
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
- Oral contraceptive use.
- Certain types of sexual behavior such as
- Women who have sex at an early age
- Women who have multiple sexual partners
- Women who have partners who have many other sex partners
- 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.
This is primary lung malignancy that arises from the lung tissue. There are several types of primary cancer of the lung including squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and large cell carcinoma. Here are some of the listed types
Adenocarcinomas: These types of cancers are common in North America and Japan. They tend to occur among smokers, although nonsmokers are more likely to develop adenocarcinoma than other lung cancer types. On radiological examination, they are found more peripherally, but can occur almost anywhere, and can be multifocal. They have been known to fill the entire lobe of the lung tissue. Other x-ray findings show that they are associated with solid opacities, ground-glass opacities, or mixed patterns. Epidemiologically, Adenocarcinomas represent 35%-40% of lung carcinomas. The variants of adenocarcinomas include types such as signet ring, clear cell, mucinous, and fetal adenocarcinomas
Squamous cell (Epidermoid): This type of cancer tends to occur centrally and is highly associated a history of smoking. It’s a malignancy that shows squamous differentiation 20% to 30% of lung cancers. It spreads by locally invading the surrounding tissues and forms cavities in the lungs. The differential diagnosis includes reactive processes that may result in squamous metaplasia with reactive atypia as seen during infections or radiation-induced injury
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.
How to treat tooth discoloration
Tooth discoloration is an uncomfortable situation in many individuals. The causes can easily be treated and re-coloration established.
The following are some of the substances that can help treat the tooth discoloration
- Use of toothpastes that contain substance such as soluble pyrophosphates as active ingredients may help to minimize the discoloration caused by chlorhexidine-containing Mouthwashes.
- When applied to the teeth topically, or used as chewing gum, sodium bicarbonate help to reverse the discoloration by whitening the teeth. The substance also helps to remove stains from the teeth
- Substances such as casein phosphopeptide when used topically to the teeth may remove the tooth discoloration by whitening them.
- The commonest used bleaching agents for tooth discoloration include carbamide Peroxide (10% – 44%). This is an active ingredient in many bleaching agents and has shown success. It has to be used by a dentist for treatment
- Hydrogen Peroxide (1% – 10%) is also an active ingredient in many other tooth bleaching gels used. Some of the gels can be purchased as over the counter drugs. Cautions; never buy the undiluted peroxide as it is very corrosive to the skin and mucous membranes.
- Titanium Dioxide has for some time been used in tooth whiteners as a whitening pigment to polish the teeth.
Consult your dentist in management of this condition.