• ENDOMETRIOSIS: HOW CULDOSCOPY IS DONE

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    08 May 2009 /  Women's Health

    Doctors prefer to do endoscopies in a hospital with patients put under local anesthesia. Before the culdoscope can be inserted properly, the woman is positioned on the table in a kneeling position, leaning forward with her bottom higher than her chest and her head resting on her arm. Before the procedure, the vagina is washed to the point of sterilization. This is the first possible snag of culdoscopy. Since complete vaginal sterilization is impossible, there is an inherent risk of infection and doctors must proceed cautiously. After she is coveted with a sterile drape, the doctor administers a spinal or epidural anesthetic, or the woman can be given a painkiller like Demerol as well A specialized speculum is then inserted into the vagina to permit a better view of the cervix. About now, a local anesthetic is injected into the vagina and a small probe inserted blindly through the vaginal wall. When the probe is in place, a larger probe containing the culdoscope is inserted. Looking through the culdoscope, the doctor can inspect the area just behind the uterus, the ovaries, and the tubes. Since the intestines tend to fall forward while in this kneeling position, the doctor has a less obstructed view to check for any abnormality in the area.

    As with laparoscopy, there is a range of therapeutic procedures, though more limited, that may be performed while the culdoscope is in place, fine operating instruments may be inserted through it for use in minor operations, the most common of which are tubal sterilization and the removal of small adhesions.

    Aftereffects of culdoscopy are usually not troublesome. If you are scheduled for one, expect minimal pelvic pain for a day or two after surgery. Doctors will advise abstinence from intercourse for three or four weeks or until complete healing has occurred. Unlike laparoscopy, which is not as debilitating, culdoscopy will require rest at home for a week or two and avoidance of stress-filled work schedules.

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  • SKIN CARE: SYPHILIS

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    08 May 2009 /  Skin Care

    Syphilis is capable of producing the most varied of all skin changes. It may also mimic a wide variety of internal diseases. Consequently it is essential to bear in mind the possibility of any unusual rash being due to syphilis.

    Syphilis is a chronic infectious disease caused by the bacillus Treponema pallidum, which is acquired by intimate contact with an infected person or as a congenital infection in infancy. In the western world it is most easily transmitted, under moist conditions, by genital or oral contact. It may also be transmitted by an infected mother from the fifth month of pregnancy onwards. In underdeveloped countries a form of syphilis occurs which is spread by intimate contact rather than by sexual intercourse; it is usually associated with bad living conditions and poor hygiene.

    In Europe, from 30000 to 40000 cases of contagious syphilis are registered every year, the greatest incidence being amongst homosexual men. As with all venereal diseases, it is more common during times of unstable social conditions and war. After World War II cases rapidly declined. However the past 20 years has seen a marked resurgence. The reasons for this are speculative but may include the following: increased travel, both tourist and migratory; altered moral standards; a more liberal attitude to homosexuality; the effect of oral and intrauterine contraceptives on human sexual behaviour; the diminished use of condoms, and the widespread use of drugs.

    Syphilis may be thought of as occurring in four stages. Primary infection occurs 10-30 days after contact, and takes the form of a persistent chancre or sore. Associated with this there are enlarged tender lymph glands. The chancre usually appears on the genitals, in the anal area, or in or around the mouth. It may take 3-8 weeks to heal, leaving a small scar. At this stage, it is best diagnosed by a direct bacterial examination of the sore.

    Secondary syphilis will usually occur 1-2 months after the primary stage. This stage may manifest a wide variety of different rashes, and is best diagnosed by appropriate blood tests. At this time the person is highly contagious, and bacteria may be found on most parts of the body. This stage may persist for up to two years. The rashes may resemble measles, chicken pox, hives, drug allergies, tinea, eczema, warts, and psoriasis, to name but a few conditions. However invariably there are other associated symptoms, such as a fever, tiredness, patchy hair loss, joint pains and headaches, particularly at night. This stage is also accompanied by enlarged, but not tender, lymph glands.

    Latent syphilis, which is the stage without symptoms, may last from 2-20 years. It is only diagnosed from an adequate history and positive blood tests.

    The final stage, tertiary syphilis, may affect all organs of the body; more commonly, though, it affects the heart, brain, and liver. In the skin it appears either as odd patterns of grouped nodules or large, painless ulcers. This stage is not infectious.

    The treatment for syphilis is penicillin. For primary and secondary stages, this is either given on ten consecutive days or in one very large single dose. These people require follow-up treatment, including blood tests for two years. Contact tracing of people who are likely to have become infected is an essential part of the proper management of this contagious and important disease. Cases of syphilis which are of longer than 12 months duration require more intensive therapy over a longer period.

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  • FAD DIETS AND DIETING FOR FAT LOSS: FAD DIET MODELS

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    08 May 2009 /  Weight Loss

    Most of the fad diets incorporate a strategy that has some potential merit in fat loss, or perpetuate a belief that has existed for many years. These diets pick and select amongst the techniques and package them as the new wonder diet. Almost all fad diets require strict adherence to a plan, which means that people are not learning how to cope with their own environment. Very few use the main principle espoused in this book which is that for a fat loss plan to be successful, it has to be something that can be done comfortably for life.

    Some of the characteristic strategies employed by fad diets, which may be useful in a more ‘balanced’ food intake program, but which are ineffective when used alone are:

    Monotony: (e.g. Meal replacements, single food groups/items, fasting (with or without juice), ‘macrobiotic’ diets. These limit the selection of foods in an effort to reduce temptation and often use foods that people believe are ‘healthy5 or to have special properties that bum fat. Examples are the ‘grapefruit diet and high-protein diets.

    Aversive conditioning: (e.g. Water-drinking diets, grapefruit diets, fibre supplements, meal replacements). These work through two general methods: (a) by either linking an unpleasant task such as being sick prior to eating (particularly if about to ‘binge’), or (b) by eating a least-liked/filling food first. Examples are ‘bran diets’ and the ‘water diet’.

    Ritual: (e.g. Single food items, fibre supplements, soup diets, meal replacements, fasting). Rituals may take many forms and have a basis in behavioural therapy. Eating may be delayed by completing a set ritual such as setting the table or by preparing an appetiser of raw vegetables. Food may only be consumed in one place with no other distractions (including conversation!) And food records must be updated prior to eating. Enjoyment does not figure greatly here. Examples are the ‘egg diet’ and the ‘macrobiotic diet’.

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  • HYSTERECTOMY: THE UTERUS

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    08 May 2009 /  Women's Health

    The uterus is situated deep within the pelvis. It makes its presence felt during the reproductive years, when its inner lining bleeds intermittently and its lower portion, the cervix, produces mucus secretions. During a woman’s fertile years the uterus is the most prominent of the female reproductive organs, drawing attention with activities like menstruation and pregnancy. In contrast, before a girl reaches puberty and after a woman has her menopause, it moves through phases of change slowly and unobtrusively.

    Position in the pelvis. Some women can accurately locate the position of their uterus because of the contractions they feel during orgasm or menstruation. These uterine contractions can be like pleasant ripples and are an enjoyable part of sex for some, while other women find them painful. For women who don’t experience these clues, it can be helpful to picture where the uterus sits inside the abdomen: the vagina is below, the bladder in front, the loops of the bowel above, and the rectum behind.

    Strong support tissues called ligaments hold the uterus in place in the pelvis. If these ligaments are not able to provide the necessary support and the uterus becomes displaced (this is one type of prolapse), this can create pain or changed function in the four surrounding organs. For example, pain during sex may result from the uterus pressing on and even into the vagina, while pressure on the bladder from the uterus can lead to urinary incontinence.

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  • SLEEP WITHOUT DRUGS: GENERAL

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    08 May 2009 /  Anti Depressants-Sleeping Aid

    The first hurdle is to understand your own sleeping problem. Insomnia is very common and about 20 per cent of healthy normal adults suffer from insomnia at some time during their lives.

    What is insomnia? Insomnia is the distress and the anxiety of not being able to fall asleep when you want to. Insomnia does not equate with not sleeping. Some people who suffer from insomnia can stay up all night playing card games or enjoying themselves at wild parties without any distress at all. People complain of insomnia only when they stay in bed and cannot sleep. They develop a phobia of sleeping in bed. They may be able to sleep happily in the park or on the sofa in front of the television. They may try to exhaust themselves by reading in bed until their eyes are so heavy and red that they can hardly stay open. They are fearful of their inability to sleep whilst in bed. They feel distress when they lose control of their innate mechanism to sleep.

    Sleep is something we have no control over. We cannot close our eyes and give the magic word sleep, as sleep may not follow. In studies of how people fall asleep, it is observed that we are not folly awake one second and asleep the next. We all go through a very brief hypnotic state, which is called the Transitional Hypnotic State or THS. Although we have no control over sleep itself, we can be taught to go into THS. Once you can go into THS, which is the precursor of sleep, you will have indirect control on sleep itself and consequently substantial control over falling asleep.

    THS is the transit stage between the awake mode and the sleeping mode.

    People who suffer from insomnia appear to have a block between the awake mode and the THS mode. THS is the switch, and with practice you can have full control of the switch and switch off every night.

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