El ácido hialurónico

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En este video ofrezco un estudio en mi consulta, ya sea por adeslas, sanitas, o por cualquier seguro médico. Si es necesaria una infiltración la pongo gratuitamente siempre que el paciente traiga su BIOVISC ORTHO o BIOVISC ORTHOSINGLE. Las demás marcas también las pongo, pero ahí os cobro el precio que estable la clínica por cada infiltración. Yo os recomiendo, como sabéis, comenzar desde un tratamiento más conservador, siempre. Las infiltraciones son «un parche» que dura un año, pero es mejor atajar el problema articular (meniscopatía, condropatía, gonartrosis, compromiso subacromial o tendinopatía del supraespinoso, poer ejemplo) con productos como el Blisscolágeno. Quiero hablaros hoy, brevemente, del ácido hialurónico. Contestando alguna de las cuestiones que nos habéis mandado por escrito, en principio lo ácido hialurónico como sabéis se puede infiltrar en las articulaciones en enfermedades como la artrosis como la artritis patología degenerativa articular. Tiene muchas ventajas sobre el plasma enriquecido con plaquetas (PRP), es una alternativa más cara digamos un procedimiento más oneroso (el PRP). También, los estudios que hay actualmente con las células madre, pues están en desarrollo, porque muchas veces e infiltran células madre y luego estas desaparen en la articulación es decir bueno hemos infiltrado unas células madre vamos a ver cómo evolucionan y de prontno no se encuentran, es decir que todavía está en desarrollo lo mismo que el PRP, el plasma enriquecido Lo más seguro es lo que ya conocemos y que da buenos resultados: el ácido hialurónico; por supuesto hay un límite de infiltraciones con el ácido orgánico además es lo que bañan las articulaciones de manera natural en nuestro organismo es distinto de las infiltraciones corticoanestéscias, que tienen tan mala fama porque bueno, quizás, se ha hecho abuso en algunos casos de deportistas o en el caso de gente mayor, en los que por culpa de el corticoide( no del anestésico) de las infiltraciones corticoanestésicas, el corticoide, digamos que descalifica un poco el hueso. Entonces las de ácido hialurónico serán mejor alternativa. Hay un ácido hialurónico por supuesto que podéis comprar en nuestra página web de summarios y yo lo puedo infiltrar a coste cero (la infiltración de esta marca). Para eso tenéis que contactar con nosotros. Es muy fácil: pincháis abajo, y me preguntáis sobre las dudas Yo llevo 25 años infiltrando, o quiero decir que tengo una experiencia como Mesto en cirugía ortopédica y traumatología. Hice la Residencia en FREMAP hace años (años 90) y la verdad es que todas las estadísticas, que estoy acumulando y grabando en una hoja excel, pues realmente, lo más beneficioso sin duda, o con lo que más se reducen los síntomas es con el ácido hialurónico.

Cervical cancer

Cervical cancer

Cervical cancer

Catch that cancer before it catches you

Your 50 year-old auntie has been complaining of severe back pain for 2 months, she is also having difficulty holding her urine on and off. With your busy schedule you have done your best to take her to a clinic in your neighbourhood. She is being treated for lower back pain but the symptoms disappear for a few days and come back in full force. Finally she develops vaginal bleeding and you dedicate a whole day off work to take her to the gynecologist, where she is diagnosed with an advanced cervical cancer. The doctor mentions that the chances of survival are bleak.

Sadly this typical story could happen to any of your female relatives. It could be your sister, your mother, your grandmother or any friend within the child-bearing age. Of course cancer can be a scary ordeal for the patient and family members dealing with the disease. But the purpose of this article is to provide you with guidance and the HOPE that this disease is perfectly preventable. This is especially true if check-ups for cervical cancer are made routine within your medical care.

What does statistics show?

There has been a good deal of media and public health attention on breast cancer and screening programs for it. This is a good thing and should not be faulted. However, World Health Organization (WHO) statistics show that of the cancers affecting Ugandan women Cervical Cancer is the number one culprit, followed by Kaposi’s Sarcoma (an HIV/ AIDS related cancer) with Breast Cancer coming third in total cancer cases within Uganda.

  • In Uganda, Cervical Cancer is the leading cause of female cancer deaths
  • It accounts for 45 – 50% bed occupancy in Mulago hospital
  • Gynecological wards
  • The average woman diagnosed is 47years old

How does Cervical Cancer develop?

Cervical cancer is caused by a group of viruses called Human Papilloma Virus. These viruses are present in some men. Once sexual activity begins, there is exposure to Human Papilloma Virus from the woman’s partner. The lining of the cervix begins to change and grow. When this growth becomes excessive, it becomes what doctors call cancer. Furthermore women who are HIV positive, have a weakened immune system so being infected by HPV means that cervical cancer develops faster in their bodies.

Simple ways to identify Cervical Cancer

  • Vaginal bleeding after sexual intercourse
  • Extra bleeding between monthly periods
  • Foul smelling vaginal discharge
  • Persistent lower abdominal pain and backache
  • Difficulty holding urine or stool (incontinence)

Importance of Cervical Cancer screening

  • 3 years after a woman’s first vaginal intercourse encounter she should have a Pap test or Pap smear done by a trained medical professional
  • If the Pap smear is abnormal your doctor will recommend further testing such as an exam under anesthesia to fully visualize the cervix and to obtain cells for viewing under a microscope
  • If the test is normal the doctor or mid-wife will advise you on when next to make a return appointment based on your individual age and risk factors

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

Sonrisas Dulces



Migueláñez y la asociación Pablo Ugarte (APU) han organizado una campaña solidaria para la investigación y la lucha sobre el cáncer infantil.

Por cada visualización del anuncio, Miguelañez dona una cantidad para este proyecto. 


Por tanto sería estupendo si lo pasáis a todos vuestros contactos y lo veis varias veces.



Mi experiencia en Oncología



Esta entrada la escribo. No creo que fuera capaz de hablar de ello delante de la cámara y porque, aunque una imagen (y no digamos un vídeo) vale más que mil palabras, a veces es más fácil expresar sentimientos y recuerdos por escrito, que mirando al objetivo.

En la entrada del "Practicum I" relato cómo fue mi primer día hasta que entré por la puerta de esta unidad.

Éste fue en el primer sitio en el que empecé mis prácticas el año pasado. Mis primerísimas.
Llegué muy nerviosa, muy muy nerviosa. Yo no había hecho prácticamente nada antes y ahora me encontraba en una planta difícil, triste y dura. No sabía si iba a estar preparada para enfrentarme a aquello, y la incertidumbre y el miedo habían aumentado debido a que, ya que yo estaba en el turno de tarde, había ido a ver a mis compañeras de por mañana, que estaban muy tranquilas y resueltas, y aquello no había hecho otra cosa que ponerme más nerviosa aún (no lo hagáis).

Leer más »

INFORMATION & IMPORTANCE OF BLOOD DONATION

INFORMATION & IMPORTANCE OF BLOOD DONATION

INFORMATION & IMPORTANCE OF BLOOD DONATION

The earliest documentation of blood transfusion is found in the religious text of many civilizations.

Karl Landsteener discovered the ABO blood grouping system in 1901, which is one of the most important landmark discoveries in the transfusion medicine. In the 1970s voluntary donors were accepted as blood donors. Blood transfusion lead to the discovery of Hepatitis B transmitted by donated blood. Since then testing for the hepatitis B antigen was implemented. Further studies since then have included tests for Malaria, Syphilis, AIDS, and Hepatitis C to make donated blood as safe as possible to the recipient.

Eligibility criteria for blood donors

  • Both men and women can donate blood.
  • Should be between 18-60 years of age with a weight of 50 kg or above with normal pulse rate, body temperature and blood pressure.
  • Donors with history of epilepsy, psychotic disorders, abnormal bleeding tendencies, severe asthma, cardiovascular disorders, and malignancy are permanently unfit for blood donation.
  • Donors suffering from disease like hepatitis, malaria, measles, mumps, and syphilis may donate blood after full recovery with 3-6 months gap.
  • People who have undergone surgery may safely donate blood after 6-12 months.
  • Women donors who are pregnant or lactating cannot donate as their iron reserves are already on the lower side.

How much blood can be taken during blood donation?

Our body has 5.5 litres of blood of which only 350 ml – 450 ml (one unit) of blood is taken depending upon weight of donor. Majority of healthy adults can tolerate withdrawal of one unit of blood. The withdrawn blood volume is restored within 24 hours and the hemoglobin and cell components are restored in 2 months. Therefore it is safe to donate blood every three months.

What is done with the blood collected?

The blood is collected in sterile, pyrogen free containers with anticoagulants like CPDA (an anticoagulant used in blood collection bags) or CPDA with SAGM (a solution that gives the red blood cells optimum viability). This prevents clotting and provides nutrition for the cells. This blood is stored at 2-6 C or -20 C depending on the component to be prepared. Donated blood undergoes various tests like blood grouping, antibody detection, testing of infections like hepatitis, AIDS, Malaria, syphilis and before it reaches the recipient it undergoes compatibility testing with the recipient blood.

One unit of whole blood is separated into components making it available to different patients according to their requirement. Thus one unit of blood is converted into packed cell volume, fresh frozen plasma, platelet concentrate, cryoprecipitate and granulocytes concentrate.

AAR BLOOD DONOR CLUB

Requirement of safe blood is increasing and regular voluntary blood donations are vital for blood transfusion services.  At AAR we have a blood donors club that was launched last year and has tremendously grown with over 200 registered members. From the clubs membership, we were able to save lives of two patients who critically needed blood.

Membership is free and open to all men and women between the ages of 18 to 60.  Once someone joins they will be grouped according to their blood type and will be issued with a membership card.  Incase of a request for a certain blood group, members with that blood type will be requested to go to the hospital the patient is admitted in and donate blood.

Blood transfusions save lives and this can only be possible if we all volunteer to donate blood. And as said by an unknown author, “Nobody can do everything, but everyone can do something” we should all endeavor to give blood.

Why isn’t my medication working???

Why isn't my medication working???

Why isn't my medication working???

One of the common problems patients, or people in general face nowadays is that they need to consult a doctor repeatedly for the same medical issues they may have…they present with the question that heads this article: “why isn’t my medication working???

I as a medical doctor would like to give a brief overview of the common reasons for this happening and hopefully in the process make most of you say to yourselves “Ahaa…that makes more sense now…”

Its always important to keep some very basic facts in mind when your body shows you any symptom. These include:

A symptoms is the bodies way of communicating with us about a problem that its facing

If you think about it, when you get hurt in your body, Imagine if you couldn’t feel exactly where…you would end up causing much more damage to that area before you can rest it  or treat it. The body needs to make you feel pain in order for you to know which part of you is being damaged. This blessing is sometimes missing in diabetics whose nerves have been effected. Ask any of them the importance of pain, and how it can be used to avoid the amputation of a limb!

Some conditions are not treatable, they’re just manageable

Doctors are not God, and there are quite a few conditions that we cannot treat. In such cases we offer advice and on how to manage the condition that you may have on a long term basis to prevent the severe symptoms that one may be experiencing. In other words we may have to give you tips on how to prevent things from getting worse…this is known as tertiary prevention. The concept is not so easily digested by most patients. There comes a time when our patient come to us and tell us “we stopped the medicines because we saw no improvement”. Ensure you confirm with the doctor if the medicines were meant to prevent worsening, as in osteoarthrtitis, before you decide they are not working!!

Some conditions are self limiting, the medications given just help temporarily alleviate the symptoms while the infection takes its course

The common cold is appropriately named, as the cases are really too common. An important thing to note is that it is one of the conditions that we don’t cure. Our bodies’ immune systems is what we rely on to fight this, we only assist the symptoms that may be quite severe with our medication and allow the disease to take its course. So if the medication is not causing a lasting effect, or if the condition is persistent because of habits like exposing ones self to cold or playing in the rain, don’t think its the medication that is ineffective

As much of a nuisance some symptoms may seem, it may be playing a very important role in limiting the disease that you have… so sometimes its good to bear some of the symptoms rather than get rid of all of them!

It has been proven that the high temperatures during a fever also limit the growth of bacteria causing the infection, and the cough that one may develop in a cold is a very effective way of getting rid of the trapped pathogens in our mucus membranes…so stopping the cough or maintaining a low temperature of 36 degrees Celsius may not necessarily be a good thing all the time

When you feel better because of medication, that doesn’t mean you can resume all the stressful and difficult activities… your body mostly will require some time for recuperation

Out of site, out of mind!!! when people don’t feel their sickness any more they immediately resume their stressful and difficult activities. It’s important to remember that the result of such actions is a slow recovery and a high chance of recurrence of the problem.

The body needs rest so it can focus on rebuilding itself, and combating the remnants of the infection or disease that one has.

If you don’t help you’re body, it will not help you!

As long as you don’t understand the cause of the disease, you will never be able to stop it from recurring

When we fall sick it’s imperative to understand the source of the infection or cause of the illness. It’s not enough to just feel happy that the symptoms have gone after taking medication. Recurrent amoebic dysentery, because some patients take medicines then go back to drink the same contaminated water, has been found in many cases. The medicines may be working after all, but the disease keeps being brought back into your system before you can enjoy the medicines positive effects!!!

With the above tips, it should be clear that treatment consists of more than just taking of pills prescribed by a doctor at the appropriate dose…it’s about understanding what illness you have and how your body works to get rid of it.

I wish all the patients best of luck with their conditions as we pray for their recovery, but I advise them, and everyone in the general population to adopt the informed approach to illnesses and other medical conditions so that they may know what to expect.