Bent penis (Peyronie’s Disease)

What is Peyronie’s disease?

Named after a French surgeon, Fran├žois de la Peyronie, who first described Peyronie’s disease in 1743, this is a disorder of the penis, in which fibrosis (hardened cells) forms under the skin on one side of the penis.

It begins as a localised inflammation and can develop into a hardened scar. This feels like a firm nodule when the penis is flaccid, but causes the penis to bend at a sharp angle when the penis is erect. A plaque on the top of the shaft causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both top and bottom, leading to shortening of the penis.

Erections can be difficult and sexual intercourse painful and the consequent emotional stress can be significant.

What causes Peyronie’s disease?

The cause is unknown, although it may be caused by:

  • An injury that causes bleeding inside the penis.
  • An immune system problem.
  • An abnormality in the man’s collagen (a tissue-building substance).
  • It may be hereditary.

About 30% of men with Peyronie’s disease will develop fibrosis in other elastic tissues of the body, such as on the hand or foot.

Who is affected?

Peyronie’s disease is most common in men aged 40 to 60. However, men of all ages may develop it although it is very rare in younger men.

What are the symptoms of Peyronie’s disease?

  • The penis becomes curved when erect.
  • Loss of erection may be experienced.
  • The patient will probably experience some sort of pain in the penis, especially during erection.
  • Penetration during sexual intercourse may prove difficult or even impossible.

Is medical treatment always necessary for Peyronie’s disease?
No. Occasionally the problem goes away on its own, but this is rare. Therefore if you have this problem, you ought to seek medical advice. The longer you leave it, the more anxious and self-conscious you may become.

What is the treatment for Peyronie’s disease?

Since the cause of the disease and its development are not well understood, doctors treat the disease by prescribing and using treatments that seem to help. Generic Cialis 20mg online

There are a number of treatments your doctor may suggest for this disease. These may include topical applications or oral medication. Unfortunately, there is currently no one method which is known to have superior results over another. Generic Levitra 20mg online

If the curvature is severe, and no other treatment has worked, the patient may require surgery. The two most common surgical methods involve removing the plaque and replacing it with a graft of normal tissue or artificial material, or removing or pinching tissue from the side of the penis opposite the plaque, which cancels out the bending effect. Surgical correction is usually quite successful in restoring sexual function, although there are potential problems with both options. Alternatively, a penile implant can increase rigidity of the penis and, in some cases, straighten the penis. Viagra Soft Online 50mg

It is very important that the psychological aspects of this disease are treated as well. A person with Peyronie’s disease may suffer anxiety or even depression because of this condition. It may affect their relationships, and be a cause of great embarrassment to them.

How to use condoms - 10 simple steps to getting it right

1. Resist the urge to buy extra large condoms - if a condom is too large, it will be too loose on the penis and is more likely to slide off. Be realistic and buy a size that fits securely on your erect penis.

2. Open the package carefully and don’t use sharp objects like scissors or your teeth to open the wrapper. Take care that the condom is not damaged with fingernails, jewellery etc.

3. Press out the air at the tip of the condom before putting it on — an air bubble in the condom could result in the condom tearing or falling off. Make sure the foreskin is pulled back before you put on the condom.

4. With the rolled rim on the outside, put the condom over the erect penis — don’t waste your time trying to put a condom on a flaccid penis. Be careful to put the condom on before there is contact with your partner’s vaginal area.

5. Unroll the condom down over the entire erect penis. If there is a reservoir tip, first squeeze out the air. If there is no tip, leave a half-inch space at the end for semen and squeeze the air out.

6. Smooth out any air bubbles and check that the condom fits securely.

7. After ejaculation, but before the penis is soft, hold the condom firmly at the rim and carefully withdraw from your partner. This is to ensure that semen is not leaked.

8. Don’t even think of re-using a condom. Equally, if you put a condom on backwards and it doesn’t unroll easily, don’t just flip it over. There may be semen in the condom, so use another.

9. Store condoms in a cool, dry place. Extreme temperatures and body heat weaken condoms, so don’t store them in your wallet, trouser pocket or glove compartment for more than a couple of weeks. Oil-based jellies and creams, such as Vaseline, will damage condoms. However, water-based lubricants such as KY Jelly are safe.

10. Condoms do not get better with age — throw them away if they’re past the expiry date or four years past the manufacturing date.

Facts About Types Of Abortion Procedure!

Abortion is a medical process of terminating a pregnancy before the fetus develops outside the uterus to survive.

Abortion procedures are of two types: medical abortion and surgical abortion.

To have an abortion, you need to confirm your pregnancy and it can be done through home pregnancy tests or the tests recommended or performed by your doctor.

Once the pregnancy is confirmed, your doctor determines the stage or trimester of the pregnancy and the type of abortion procedure.

Acupuncture refers to the weeks of a pregnancy. A pregnancy is divided into three periods or trimesters. Week 1 to week 12 refers to first trimester, week 13 to week 26 refers to second trimester and week 27 to end of pregnancy refers to third trimester.

However, the abortion procedure depends on the trimester or stage of your pregnancy as well as your personal preference.

During the first trimester of your pregnancy, abortion can be done through medical or surgical abortion procedure. Remember that medical abortion works efficiently only up to nine weeks of your pregnancy.

The medical abortion procedure is performed using drugs such as misoprostol alone, methotrexate and misoprostol, mifepristone and misoprostol.

The medical abortion procedure using the combination of methotrexate and misoprostol is generally prescribed till the first seven weeks of pregnancy.

However, the drugs mifepristone and misoprostol are prescribed till the seven to nine weeks of pregnancy. The medical abortion is 95% effective in terminating a pregnancy.

On the other hand, a surgical abortion procedure called Suction Aspiration, also known as vacuum aspiration, is used to empty the uterus during the first trimester of your pregnancy.

During second trimester, medical abortion procedure is ineffective to end your pregnancy.

Surgical abortion such as Dilation and Curettage (D&C), Dilation and Evacuation (D&E), and Induction Abortion are used during the second trimester. It is to be noted that surgical abortion procedure is usually done under local anesthesia.

Dilation and Curettage is also known as suction curettage. It is generally preferred between 13-15 weeks of pregnancy.

Dilation and Evacuation is also known as D&E. It is used to empty the uterus between 15-21 weeks of your pregnancy.

Induction Abortion is a rare surgical abortion procedure, which makes use of substances such as salt water (saline), urea, or potassium chloride to inject into the amniotic sac to start uterine contractions and terminate pregnancy.

Prostaglandins are introduced into the vagina for uterine contractions and to empty the uterus. On the other hand, Oxytocin (pitocin) is injected intravenously (in to the veins) to empty the uterus.

Medical abortion procedures are not used during third trimester. However, surgical abortion procedures such as Induction Abortion, Dilation and Extraction are used for terminating your pregnancy.

As said earlier, Induction Abortion terminates your pregnancy through medications. The medications make uterine contractions and eject the uterine contents through the cervix.

Dilation and Extraction (D&X), also known as partial birth abortion, is a third trimester surgical abortion procedure in which the fetus is removed from the uterus through the cervix. It is preferred between 24-36 weeks of pregnancy.

Know about the above facts of abortion and select the safe procedure.

Are Your Effects Of Abortion Major Or Minor?

Although there is advancement in the techniques of abortion, there are people who don’t realize that it is actually a dangerous procedure and still have a higher possibility of negative physical side effects, and also certain negative emotional side effects.

Abortion is a process that disrupts one of the primary functions of the human body where physical and emotional problems may occur due to ending of pregnancy.

The causes of abortion may be pathological changes in the ovum, the uterus, or in both. It may be due to inherited or acquired diseases (syphilis [Syphilis Symptoms], tuberculosis, chlamydia [Chlamydia Vaccine]). It may be induced with the help of drugs, or instruments, or both.

Generally, abortions performed by trained, licensed health care providers are generally very safe. Moreover, the occurrence of the effects of abortion when it is done by trained health care professional is very low.

It is found that according to national statistics, about 10% of women undergoing induced abortion experience immediate abortion effects, of that one-fifth are major effects to the health.

Over one hundred effects of abortion can come across with an induced abortion. The minor effects of abortion are: infections (minor), fevers, vomiting, bleeding, gastro-intestinal troubles, chronic abdominal pain, and Rh sensitization.

However, the most common major effects of abortion are major infection, heavy bleeding, embolism, endotoxic shock, damage of the uterus, hemorrhage, cervical injury, and, complications with anesthesia.

There is a wide range of abortion effects that can result from abortions, such as, future miscarriages, infertility and ectopic pregnancies, and even breast cancer.

The effects of abortion that occur immediately are usually treatable, but if left untreated they can lead to long-term damage of reproductive organs. Consult your doctor if you find any of the following symptoms:

Severe abdominal pain, fever over 100°F (37.8°C), dizziness or fainting, foul-smelling discharge from the vagina, bleeding that is more than a heavy period or consists of large blood clots, signs of continued pregnancy such as breast tenderness, fatigue, and nausea.

It has been found that there are many emotional effects of abortion that change the psychological well being of women who undergo an abortion. These psychological effects of abortion include guilty feelings, nervousness, depression, anger, and suicide.

Most of the women believe abortion as a way to get rid of the problem (pregnancy), and the evidence is showing that the process of terminating pregnancy brings even more problems in future.

The effects of abortion that lead to severe consequence are severe birth complications in future. Whatever the reason behind your abortion is, the consequences will be more severe if not treated early.

So, understand the abortion effects and help others to truly make an informed decision.

Does Abortion Affect Your Health? Know About Abortion Risks!

For most of the women abortion is not just medical procedure, but it is considered as life changing event, which can bring significant physical, emotional, and spiritual consequences.

Apart from being a simple medical procedure, it has considerable risks involved with it. Some of the significant abortion risks are discussed below.

Significant risks involved in abortion:

  • Heavy bleeding: Bleeding after the abortion procedure is quite common. But if your cervix is torn or punctured then it can lead to heavy, abnormal bleeding. This kind of severe bleeding after abortion is known as hemorrhaging. Only in some cases, this kind of abortion risk needs surgery.

  • Infections: Any fetal part left inside the womb (abnormal or incomplete abortion) can cause infections for your pelvic parts. These infections can also be caused due to the surgical instruments which are inserted into the uterus during the surgery. The pelvic infection can be identified with persistent fever.

  • Incomplete abortion: Some times the abortion can be incomplete with some unwanted fetal parts left inside the uterus. This can lead to severe complications after the abortion.

  • Perforation of the uterus: The major risk in abortion is puncturing or perforation of the uterus. This can be due to improper use of surgical instruments during the surgery. This kind of risks in abortion can lead to hysterectomy that is removal of uterus.

  • Damage to internal organs: The surgical procedure involved in abortion has many complications. During the surgery, the surrounding organs near the uterus can be injured. This is also one of the major factors of abortion risks.

  • Scars on the uterus lining: Because of suction tubing, curettes and the use of other surgical instruments there is a chance for permanent scars on uterus lining.

  • Cervix injury: Cervix puncture is a considerable risk in abortion. Damage or injury to cervix can cause severe vaginal bleeding which in turn needs a surgical repair.

  • Anesthesia: There are several complications involved with the use of general anesthesia during the surgery. It can cause heart attack, convulsion in body functions and in some rare cases it can lead to death.

Other significant abortion risks:

  • Breast cancer: This is considered as major risk in abortion. About 50% of women are affected by this type of cancer after abortion.

  • Premature delivery: When you go through one or more induced abortion surgeries, there is a significantly increased risk of premature delivery in future. This kind of abortion risk is mainly associated with several complications like cerebral palsy, prematurity in brain, eye problems and several bowel diseases.

  • Infertility: This is a very rare case in the risks of abortion, where a woman might not get pregnancy in future.

  • Pelvic inflammatory diseases: This can be a life threatening risk for you after abortion, which can lead to infertility and ectopic pregnancy. About 5% of women suffer with pelvic inflammatory diseases.

Psychological effects of abortion:

Many women suffer with emotional and psychological problems after experiencing abortion. Some of these problems are depression, acute feeling of grief and fear of disclosure, eating disorders, suicide tendencies, anxiety and also increased consumption of alcohol and drugs.

These are some of the risks involved in abortion. So think before you go for an abortion surgery. Avoid abortion, unless and until it is obligatory in terms of your health.

Abortion And Miscarriage Bring Psychiatric Risk

Drug and alcohol problems and psychiatric disorders are more likely in women who have had an abortion or miscarriage, a University of Queensland study has found.

PhD candidate Kaeleen Dingle found young women who lost a pregnancy were more susceptible to depression, anxiety, alcohol dependency and illicit substance abuse than women who had never been pregnant.

Ms Dingle said her study expanded on recent evidence that suggested abortions were associated with later psychiatric disorders, by finding miscarriage held the same risks.

“Our findings suggest that this increased risk of psychiatric problems in some women after an abortion may be associated with pregnancy loss rather than caused by the experience of having an induced abortion,” she said.

“We found that young women having a miscarriage or an abortion were three times more likely to experience a drug or alcohol problem during their lifetime.”

Ms Dingle said the study had implications for caregivers, who may need to give more counselling and support to women who have lost a pregnancy.

“Also, health professionals involved in the care of young women with mental health problems need to take good pregnancy histories, as young women can have complex pregnancy (pregnancy complications) histories involving births, miscarriages and abortions,” she said.

Ms Dingle’s PhD project is examining common mental health outcomes of young people who enter adulthood earlier than their peers through circumstances such as early parenting, early live-in parenting and early independent living.

Her research uses data from a long running Brisbane-based birth cohort study, which started in 1981 and followed a group of mothers and their children over 21 years.

Family Stress Causes More Heart Attacks In Women

If you are a woman living in a multi-generational household—you, your husband, your children, and your parents all under one roof, for example—you are twice as likely to have a heart attack or find yourself needing heart surgery as women who live only with their husbands, or with their husbands and children.

It is thought that this is due to the added stress of a multi-generational household. Interestingly, the results did not hold true for the men in such situations, only the women.

This news is especially relevant now as many families explore multi-generational living as an option to combat rising costs of housing and shrinking incomes.

If you find yourself in a multi-generational household, here are some tips to help you manage:

  • Understand everyone’s roles. Who will be responsible for bills, helping with chores, providing care for younger and older family members, etc.? It is especially important for grandparents not to interfere in the job of parenting the younger children.

  • Everyone should contribute to the well-being of the family. Even children can be given age-appropriate chores.

  • Understand your limits. As much as we would like to be all things to all people, we simply can’t. Know your limits, and understand that asking for help is a sign of strength, not weakness.

  • Care for the caregiver. Caregiver burnout is a very real problem. Take good care of yourself first, because if you don’t care for yourself first, you can’t help care for anyone else.

New Contraception Options For Women Over 30

Facing problems with your contraceptive method? Cramps, bleeding or not remembering to pop up a pill? There is good news for you – there are safe and more effective contraception options for women who have children or who are over 30.

A recent meta-analysis in the “The New England Journal of Medicine” discloses that many women can safely take “the combo pill”, which serves up low doses of estrogen and progestin three weeks a month to suppress egg release — right into menopause.

The combo pill can also ease symptoms of perimenopause like mood swings, irregular bleeding and hot flashes.

What’s more, it may help prevent ovarian and uterine cancers, says study author Andrew M. Kaunitz, M.D., professor of obstetrics and gynecology at the University of Florida College of Medicine at Jacksonville.
Read full story at:

Ovarian Cysts Could Interrupt Your Plans Of Getting Pregnant

No woman wants to hear that they have cysts on their ovaries.

Ovarian types of cysts are usually benign. These types of cysts can be detected by the use of an ultrasound.

An ultrasound will help to determine if a cyst is cancerous or not. Your physician will be looking to see if these cysts are filled with fluid and that they do not have thick walls.

It is not uncommon to have these cysts while you are pregnant and although they can be benign there are complications that can arise from having them.

Complications from Cysts

If a large ovarian cyst was to rupture while you are pregnant it can cause you a lot of pain. Usually the large cysts give you the most problems. You could lose your baby or your baby could be born too early if this should happen.

Your physician will want to remove these large cysts preferably in your second trimester to prevent rupturing from occurring. These large types of ovarian cysts usually cannot be removed by using laparoscopy procedure because of their enormous size. Depending on the size of the ovarian cysts, surgery may be your only option.

Types of Cysts

If you are a woman who has endometriomas then you may have trouble with ovarian cysts. This condition can make uterine cells that will grow on the outside of the uterus. Uterine cells may stick to your ovary and cause these ovarian cysts to grow.

Dermoid cysts are another type of ovarian cysts and they can have human substances such as teeth, pieces of skin, and even hair in them. One more type of ovarian cysts can form while you are pregnant. These are called Cyst adenomas.

You will find that these cysts will be full of mucous or a watery liquid. Types of cysts like these usually get very large and are the type that can make your pregnancy complicated.

Things to do to Prevent Cysts

Physicians have not yet found a way to definitely stop these ovarian cysts from growing. It is suggested that you go for pelvic exams at least once a year. This will help to diagnose any changes to your ovaries.

You will also want to keep track of your menstrual cycle and take heed if you feel any changes that are different from your usual menstruation cycle.

If you do feel any changes that last for more than a couple of menstrual cycles then you will probably want to consult your physician as soon as possible.

It would be a good thing if you could be diagnosed with ovarian cysts before you become pregnant so that they would be easier to deal with. If worse comes to worse and your physician suggests that you need to have one of your ovaries removed you will still have a good chance of getting pregnant.

As you can see going to your physician and early detection of ovarian cysts are the best courses of action if you are considering getting pregnant.

Effects That Fibroids Have On Your Chances Of Getting Pregnant

Having fibroids can be a problem if you are a woman who wants to become pregnant.

These fibroid tumors can attach themselves to your uterine or abdominal cavity and even inside your uterus’s walls.

Fibroid tumors can be found in singles or clusters. They are usually found to be a benign tumor but some fibroids can cause certain complications.

Some abdominal and uterine fibroids do not have any symptoms while others have a wide range. These types of tumors are more dominant in a woman that is premenopausal, overweight, and ethnic. But they can happen in any woman.

Symptoms and effects of Fibroid Tumors

You may find that you are going to the bathroom more often than usual when you have fibroid tumors. Also you may have symptoms of constipation that could be very uncomfortable for you.

Bleeding can be another problem with fibroid tumors and this can cause you to develop anemia.

These problems come from the size of the fibroid tumor, how many tumors that you have, and where your tumors are located. Sometimes these fibroid tumors can affect your uterine cavity. Fibroid tumors are a cause of infertility in some cases.

Medical Therapy

Progesterone therapy is one medical therapy that your physician may consider if you have fibroid tumors. Your physician will usually start you off with a high dose.

It may take several months for the fibroids to be consumed by your body. This type of therapy will relieve your pain and will help you with severe bleeding.

Myolysis Treatment for Fibroids

Myolysis is a treatment that is performed using a laser. Sometimes it is performed also with bipolar needles. These treatments will affect the blood flow of your fibroid tumors and will help them to disappear.

Your physician may use another treatment with myolysis to help prevent the bleeding that can come from these fibroids.

Increased Risk with Fibroids

It is sad to say but having fibroid tumors while you are pregnant can somewhat increase your chances of having a miscarriage. Sometimes they can even cause preterm labor.

Usually though you will not be able to tell if you have the fibroids while you are pregnant unless they become too large. Then this could cause you some complications. These large sized tumors can block your labor from happening if the large tumor is in the birth canal.

Myomectomy and Fibroids

It is not uncommon for your physician to send you to a surgeon if all other treatments fail. A surgeon will surgically remove all of your fibroid tumors but it will leave your uterus intact.

Usually this surgery is done using laparotomy. There are other surgeries that your surgeon may want to try such as endoscopic and hysteroscopic myomectomy.

f you get pregnant after one of these procedures your physician will probably recommend that you deliver your baby by cesarean section.

Treatments should take care of these fibroid tumors so that you will be able to get pregnant and have a beautiful baby.

Why Do Women Suffer From Low Progesterone In Their Bodies?

If you are a woman who is low on reproductive hormone in your body then you are low on progesterone.

You may be trying to get pregnant and are not succeeding. This could be due to your low levels of progesterone because progesterone is what gets your uterus ready for an egg to become implanted.

It will also help you to have a healthy pregnancy. This reproductive hormone will also keep you from ovulating while you are pregnant.

This is why the right levels of progesterone in your body can be really important to your ability to get pregnant and remain pregnant. Your progesterone levels should be very high while you are pregnant.

Before and After Menopause

You may have come to the age where you will soon be going through menopause. You might be having anovulatory cycles.

Anovulatory cycles are cycles when your ovaries will not develop any progesterone. These cycles are prevalent before menopause and when menopause finally arrives they will increase. You can expect your progesterone level to drop almost to zero right before menopause starts.

Problems from Low Progesterone

Your body can get a hormonal imbalance when it starts to have anovulatory cycles. When this happens you may see an increase in your having irregular periods.

You may start to have heavy bleeding during your period. Tenderness in your breasts will start to occur which can be very uncomfortable.

With all of these changes going on inside your body you could suffer mood swings and feel really cranky. If you have any of these problems you need to contact your physician as soon as possible.

Low Progesterone and Testing

If you are going through a pregnancy that is considered high risk then your physician may advise testing for the health of your unborn baby.

Another reason to get tested would be if they suspect that you are having an ectopic pregnancy or that you may be having a miscarriage.

Sometimes your physician will give you injections of progesterone to help you to not have a miscarriage and they will want to test to see if your levels are alright.

You may be suffering from abdominal bleeding and your physician will test for low progesterone to find out what kind of problem you are having. Your physician may also order testing to see if you are ovulating normally so that they can understand why you are not able to conceive a baby.

Methods for Testing

There are certain methods that can be used to do testing for low progesterone. Your physician may ask you to make a chart of your fertility cycle. They will request that you have a blood test but only after you have ovulated.

Also if you are having an ovulation period that is less than usual you may need to be tested for low progesterone.

As you can see low progesterone can affect the womanly functions of your body. With the right care from the right physician you should be able to get your low progesterone levels under control.

Tiny Ovarian Tumors Hard To Detect

Researchers reported in a study that tiny ovarian tumors exist unobserved in fallopian tubes for an average of four years before they grow large enough to be detected and therefore the diagnosis of those tumors comes too late to save a woman’s life.
The researchers said as the cancer is hard to detect before it has spread, they are finding ways to improve the cancer testing.
Howard Hughes Medical Institute researcher Dr. Patrick Brown of Stanford University in California, who led the study, said in a statement, “Reliable early detection can save more lives than many new anticancer drugs”.
Ovarian cancer kills 140,000 women every year globally and 15,000 in the United States alone. Genetic mutations are known to raise the risk, but most patients do not have a clear genetic risk, and no good screening test exists.

Stress Incontinence Is A Major Interruption In A Woman’s Life

Stress incontinence, in a woman, is a common thing. This type of problem can happen when pressure is put on the bladder. It is more prevalent in women than it is in men.
If you suffer from this awful condition, embarrassment is something that you are probably used to. It is no fun to be a woman who has to watch her every movement.
Stress incontinence can be brought on by physical exercise or activity. Getting a cold and having to cough or sneeze can be very uncomfortable for you.
You probably have noticed if you do any heavy lifting that this can also trigger the release of urine. There are things that you can do to help with your stress incontinence.
Why Incontinence?
When your muscles that hold up your bladder do not perform right anymore you will have stress incontinence. This can also happen if your muscles that control your urine quit functioning like they should.
The way the bladder is supposed to work is that it holds your urine and does not release it through your urethra until it is time for you to go to the bathroom.
Your urethra is supposed to stay closed until this time. With stress incontinence this does not happen.
The urethra will release your urine too early when your muscles in that area are not working correctly. This usually happens when your bladder is full but this is not always the case.
Factors That Cause Incontinence
There are several things that can make stress incontinence worse. Sometimes when you have an infection in your urinary tract you may have more accidents than usual [urinary tract infections]. Being overweight is not a good thing when you have stress incontinence.
Also if you are a woman who has diabetes then your body may produce more urine which will make the occurrence of stress incontinence harder to deal with. Too much drinking of alcohol or caffeinated drinks will also affect your stress incontinence. Even medication can sometimes cause this problem.
Stress Incontinence Treatments
Your physician will tell you to cut down on the amount of fluids that you are drinking. This will keep your bladder from being full all the time. They may want you to go on a diet to lose weight if you are carrying around too many extra pounds.
Kegel exercises are something that your physician may recommend. These exercises will really help you to strengthen your pelvic muscles. You will have to do these Kegel exercises regularly to see any benefit from them.
If you need help with these exercises your health care professional should be able to help you.
Another thing that your physician may suggest is that you go to the bathroom more often. This will relieve your bladder before an accident can happen.
If worse comes to worse your physician may want you to use a device to help control your problem or they may even suggest surgery.
With all these treatments that are available you should be able to feel better in no time.

Note for a child of 12 years Has a Road Accident

A child of 12 years has been admitted following a road accident. At emergency laparotomy the surgeon announces that the
liver is ruptured. Describe your management of the case up to the end of the operation
Notes for an answer:
This is severe road trauma and needs a comment about search for, and possible presence of, other injuries, especially head injury.
• organise massive blood crossmatch, and supplies of fresh frozen plasma;
• circulatory support (drugs and colloids and crystalloids in severe haemorrhage), citrate problems;
• diagnosis of blood clotting abnormalities, with intraoperative coagulation screening;
• keeping the patient warm;
• blood glucose support;
• organisation of ITU;
• keeping parents informed of progress;
• perhaps consider secondary transfer to liver unit.
Serious omissions likely to cause a fail:
Failure to mention managing massive transfusion.

The Issues with ED Treatments - Secrecy

Erectile Dysfunction can have a profound effect on a man’s life and on his relationship. It can cause loss of intimacy, lack of dialogue and resentment between partners. This is because impotence strikes at the very heart of a man’s self-confidence, so when it occurs, many men instinctively try to avoid both sex and discussion of the problem with their partner.

From a partner’s perspective, the inexplicable communication breakdown can be confusing. Contrary to the fears of many women, a penis that won’t get erect is not evidence of a lack of male sexual desire.

Any number of issues (anxiety chief among them) may override even a strong libido. Suffers may emotionally and physically withdrew from their partners due to the fear that any physical affection will precipitate a request or desire for intercourse and remind them of their inability to achieve an erection. This may prompt their partner to struggle with the notion that they are no longer attractive, Even if they are assured to the contrary.

A third of ED cases are due to psychological reasons, with the rest caused by physical conditions or more frequently, a combination of the two. In most cases, the situation is “mixed,” with significant secondary psychological and social components such as guilt, depression, anxiety, tension or marital discord being present in addition to one or more underlying physical causes. The presence of ED will normally cause some anxiety in a man which, in turn, will make it more difficult to get an erection next time – and so on. This is a common cause of temporary impotence and there can be very few sexually active men who have never experienced it in their lives. This ‘betrayal’ by their bodies leaves men depressed, vulnerable and often close to despair. As a result of these negative emotions, the taking of ED treatments are often shrouded in shame and secrecy, furthering the gulf between partners.

This secrecy may also extend to newer relationships. Many men take ED treatments to help alleviate performance anxiety and help sell themselves as a sexual superman early in a relationship. But once things get serious, he may find it difficult to perform without the support of ED treatments yet he may have never told his partner that he was taking treatments in the first place. This lie of omission could prove hurtful and difficult to forgive for the relevant partner.

Taking ED treatments creates a potential set of dilemmas. Scientists have found that, while men don’t develop physical dependencies on the drugs or loss of normal function if they stop taking them after extended use, psychological dependence is a different matter altogether. The effect of this psychological dependence may be twofold when the man is taking treatments in secret and is unable to discuss the issue with his partner. Erectile dysfunction does not respond well to neglect and may erode a relationship if not discussed in an open and frank fashion.

Author: James Kirby Phd

How to treat kidney stones

Patients of suffer serious pain in the back, smelly urine,feeling/being sick,a repeated urge to urinate, or a burning sensation throughout urination and fever and chills .

Patients of who have never passed a kidney stone may not realize the seriousness of the symptoms with unbearable pain other than seek emergency care. The ureter contracts in response to the stone, producing serious pain in the flank or lower back that frequently radiates to the groin, in men to the testis. Those who with nephrolithiasis commonly cannot get comfortable and will always alter position in an effort to get release from the embarrassment.

Home treatment may be proper for those who have a long history of stones.

However, the treatment is he/she should be recommended to drink oral liquids. Ibuprofen can be utilized as an anti-inflammatory instrument with calling the major care provider may allocate stronger narcotic pain medication to be laid down.Patient acre located in a tub of warm, purified water which operates as a means for passing on these non-electrical shockwaves.

Different from removal method mentioned above is regularly utilized if the stone is very large or in a place that does not permit effectual use of ESWL.

Ureteroscopic stone removal is used by passing a small fiberoptic instrument through the urethra and bladder into the ureter. The surgeon afterward locates the stone and either removes it with a cage-like tool or breaks it with a particular instrument that creates a form of shockwave. A small tube (or stent) possibly left in the ureter for more than a few days after treatment to assist the lining of the ureter to heal.This last removal method for kidney stone is to open the affected area and removing the stone(s). The surgeon creates an incision and unlocks the pelvis of the kidney or the ureter in order to remove stones.Shock waves are used to break down a big stone into smaller bits that can then pass in the course of the urinary system.

How to Dissolve Kidney Stones

form due to some excess substances we get from our diet. Unfortunately, we will get to know about the symptoms of only if we are already affected. It can be very alarming though since it can affect anyone, even infants.

may stem from several reasons such as diet, climate, and in some cases, heredity. Once a person becomes a sufferer, it will result to some changes in lifestyle. These are often times permanent in nature because disorder is recurring. In fact, it can be very frustrating if it keeps coming back.

The hard part about disorder is that you will get to feel the symptoms only when it is too late. Only when the reach the ureter will you begin to feel the pain that comes with the disorder. For more details, below are the descriptions of kidney stone symptoms. You may be experiencing some of them but you're simply unaware that what has been bothering you are in fact problems. The pain usually starts at the flank or side region of our body and slowly moves down the groin.

The stones may cause bursts of excruciating pain because the stones as they are forced out of the ureter. This is usually the case if the stones are large enough to block the most part of the ureter. Since the block the ureter , the pulsing pressure of the liquid that wants to pass causes a painful throbbing sensation.

In extreme cases, the urine may contain blood because of the damaged ureters. This could be an untoward incident because it may lead to further complications like infection. However, the absence of blood can also be a serious matter since this could mean that the kidney stone/s have already blocked the ureter.

The best thing to do is to treat them as early as possible. Early detection of will help prevent further and more serious damage to the urinary tract. Consult your doctor immediately and arrange a treatment that can suit your current condition.

The hard part about disorder is that you will get to feel the symptoms only when it is too late. You have already amassed some excesses in your urine and crystallines have already formed without you knowing it. Only when the reach the ureter will you begin to feel the pain that comes with the disorder. The pain usually starts at the flank or side region of our body and slowly moves down the groin.

For more details, below are the descriptions of kidney stone symptoms. You may be experiencing some of them but you're simply unaware that what has been bothering you are in fact problems:

are formed naturally in the body, so it would make sense for them to be eliminated naturally as well. One of the most favored of all the natural ways to dissolve is a the Chinese tea which contains herbs such as bark,Joe-Pye weed, plantain leaf, corn silk, wild yam root and hydrangea root.

It can be purchased ready prepared but it should be more effective if it is made fresh at home and there are a few recipes for this that can be found on the internet.

Corn silk and dandelion are two other natural compounds that can be made to form a kind of tea that acts as a diuretic. Again, another tea that is reported to dissolve , the tea can be made at home or bought in various and specialist stores and should ideally be consumed both in the morning and the evening to be at its most effective. Cranberry juice is renowned for being rather acidic and although it can actually cause the stones in some cases.

Goldenrod is a herb that grows wild in North America and again has been reported to be effective when looking at trying to dissolve . There are a few recipes on the internet that can be used to make a concoction containing this herb.

One of the best things that can be used to dissolve which are more commonly found at home is phosphoric acid and although you may not be able to place the name at first, if you look at the back of fizzybottle at the ingredients, you will find that many of them will contain this.

The best thing to do about these symptoms is to treat them as early as possible. Early detection of will help prevent further and more serious damage to the urinary tract. Consult your doctor immediately; he is in the best position to arrange a treatment that can suit your current condition.

Helping Youth to eradicate acne

Getting ready to go anywhere -- school, out with friends, out to a party -- was a hassle during her high school years, recalls Sarah, now a 19-year-old college freshman in New York City.

The problem? Acne. "I hated not being able to just get out of the shower and go straight out," says Sarah, who asked that her last name not be used. Instead, she would carefully apply acne medication and then cover that up with makeup to camouflage the blemishes.

Her dedication to the dermatologist-recommended routine seemed futile at times, she says. "It was getting really frustrating. Nothing seemed to be working."

While the majority of teens may not have the severe acne that Sarah experienced, nearly 100% will have some acne -- ranging from an occasional breakout to chronic acne -- during adolescence. The skin problems can put a damper on social life and thwart self-confidence.

"It's not uncommon for a patient to come see me for the first time and have tears in their eyes," says Amy Derick, MD, a dermatologist in Barrington, Ill.

"Teens avoid school if they have lots of zits," says Cynthia Chen, MD, a resident in dermatology at the University of California, San Francisco, who surveyed teens with acne about their feelings.
The good news: research on skin conditions such as acne has progressed greatly even in the past 10 years, with more treatment options for acne than ever before.

The not-so-good news? Obstacles to treatment are common, dermatologists say, and that slows resolution of the skin problems.

Acne Treatments: A Host of Solutions

During the past decade, the number of acne treatments has expanded greatly, according to the American Academy of Dermatology. Among the significant advances:

  • Newer topical products such as retinoids (derived from vitamin A), help unplug follicles. Although retinoids can irritate skin, new ones are made for different types of skin and promise to be less irritating.

  • Combination treatments are becoming more common, with many doctors prescribing a topical retinoid together with a topical antimicrobial or an oral antibiotic to fight bacteria. Combination creams, putting ingredients such as the cleansing agent benzoyl peroxide and the antibiotic clindamycin in one product, are more common.

  • Prescribing oral contraceptives for teenage girls with acne is becoming more accepted. At low doses, some types of birth control pills may help clear acne.

  • Oral isotretinoin (or Accutane) can help in severe cases that haven't responded to other medications. Because the drug has been associated with depression and suicidal thoughts, patients who use it are closely followed for any changes in mood. Blood tests monitor any potential adverse effects, such as elevated cholesterol levels.

When Should You Seek Treatment for Acne?
Even with the ever-expanding treatment arsenal, getting acne relief isn't typically easy or quick. Teens and parents often disagree about whether professional help is needed and, if so, which treatment is best.

Teen Acne Solutions

Alex Girard of Barrington, Ill., began having breakouts at age 13. "It didn't really bother me that much but my mom suggested I should go get it checked out," he says.

Chris, his mother, says she had bad acne as a teen and then again as an adult. (She went on oral isotretonin as a teen and again after her third child was born and her acne cleared.) "Knowing I had bad skin and my husband also did, we figured, they are doomed," Chris says about their children.

She pressed, and Alex decided it was a good idea. His mother's philosophy: "You don't have to have acne today."

Derick, who treated Alex, says parents are typically more aware that treatments have progressed -- and that parents who have suffered themselves as teens tend to seek help sooner.

What to Do When Parents and Teens Disagree on Acne Treatment

Sarah and her mother initially disagreed on the best treatment. Sarah wanted to give oral isotretinoin a try, but her mom resisted. "My mom was hesitant at first due to the warnings," she says. Women are required to use two forms of birth control while on the drug, usually taken for about six months, because the drug is associated with birth defects and miscarriage if the woman becomes pregnant while taking it.

But after Sarah's dermatologist, Diane Berson, MD, a New York City practitioner, explained everything, it became less scary, Sarah says. Her mother talked at length with her daughter's adolescent medicine doctor about it. "She was very reassuring," Sarah's mother says.

With close monitoring, Berson and Derick agree, it's an extremely effective drug.

It's important for teens and their parents to talk jointly with the doctor about all acne treatments. Ask questions about any concern. With so many acne treatments on the market, there's sure to be one that's effective and comfortable for both the teen and the parents.

Besides decisions on which treatment is best and when to see a dermatologist, there are several other obstacles to acne treatment, according to patients, parents, and dermatologists. Knowing about them -- and how to overcome them -- can speed results.

Have Patience During 'Trial-and-Error' Phase of Acne Treatment

With multiple remedies, some of them new, doctors often use "trial-and-error" to figure out what medicine works for which person. And before even seeing a dermatologist, many teens and their parents conduct their own trial-and-error experiments with drugstore acne remedies.

Alec, 22, of San Francisco, did just that for a while. When puberty hit, so did the acne, he recalls. Off to the drugstore he went. "I tried everything I could find," he says, buying over-the-counter acne treatments. But nothing gave him clear skin.
So he and his mother checked in at a teen clinic, where the doctor recommended a prescription cream that combined benzoyl peroxide with the antibiotic clindamycin. The combination cream worked well for Alec.

As he got older and had fewer blemishes, Alec switched to a 10% benzoyl peroxide cream available over the counter, which he continues to use to this day. "I use the benzoyl peroxide every night," he says. He's also fairly religious about washing his face before bed. The payoff? His skin is mostly clear. "I probably have one pimple a week." That, he can live with.

Alex Girard knows all about trial-and-error, too. He went to three dermatologists before seeing Derick, and tried everything they prescribed, without much success. "They kept saying 'try this, try that,'" remembers his mother. He tried an oral antibiotic, and two acne creams. "Nothing seemed to help," recalls his mom.

However, with newer products geared to skin type, teens can expect a shorter trial-and-error period. Working with his doctor, Alex was able to find a treatment that -- after six months -- finally cleared his acne.

Stick With Your Acne Treatment Plan
It take time for most acne treatments to work -- and teens often stop using acne medication before it's had a chance to work, dermatologists say. Especially boys. "I don't want to generalize, but females are more attuned to taking care of their skin and having a daily routine," says Berson, who is also an assistant clinical professor of dermatology at Weill Medical College of Cornell University, New York.

The compliance issue "causes frustration between parents and children," says Chen. And that frustration can cause parents to nag their teens about using the medications.

Nagging rarely works with teens, as most parents soon realize. Instead, doctors suggest that parents encourage the teen to use acne medicine daily as directed, but leave it to the teen to follow through. Most teens begin to use their acne medicine regularly once they're fed up with acne.

"I was getting so frustrated having bad skin that I was willing to do anything I could to get good skin," says Sarah.

Get the Truth About Acne and Your Diet

Myths about acne persist. Parents may believe one thing and teens another -- and often parents are wrong.

Parents may pass on some of the old myths about acne that flourished as truth during their teenage years. One persistent myth: you get acne from chocolate or greasy foods.

In fact, studies have not found a link between acne and foods such as chocolate, french fries, and pizza, according to the American Academy of Dermatology.

The link between acne and foods "is very controversial," Derick says.

"Studies have come out recently, saying a high-sugar diet is implicated," she says, but "I don't think the data is good enough to say 'Lay off sugar.''

Don't Over-wash Your Face

Another common myth: "Teens feel acne is caused by dirty skin," Berson says. Not so, she says. Rather, hormonal changes leading to excess oil production are to blame.

"They feel if they are vigilant and obsessive about cleaning, it will help," Berson says. In fact, she says, "Too much cleaning and abrasive cleaners will make the skin more irritated."

She recommends twice-a-day gentle cleaning of the face.

Berson also regularly warns teens with acne: "Don't pick." It doesn't make blemishes better, she warns, and makes it more likely they will become inflamed.

Give Your Acne Treatment Enough Time to Work

"Teenagers want to see results immediately," Berson says. But even the very best acne treatments take time to clear your skin.

"The reality is it can take a good four to eight weeks [to see results] when you start a regimen, depending on how severe the acne is to begin with," she says. And it can often take a few months to totally clear your skin.

Berson also warns teens about another surprising bump in the road: "You might get worse before you get better." She cautions them not to stop the medicine if it's getting worse. "Stick with it until you are back at your follow-up exam," she says. If teens have a skin reaction, she adds, they should check in with the dermatologist sooner.

Remember, Acne Treatment Pays Off in Many Ways

When acne treatment works -- and the majority of patients so get relief if they adhere to the treatment plan -- teens say they feel more confident in many ways.

"I don't have to worry about having to cover up my blemishes," says Sarah, who as a college freshman gets an occasional breakout now and then. Her friends who didn't know her before, she says, "can't imagine that I had bad skin."

Alex's mother Chris says her son's skin is now very clear, calling the results "excellent."
How does Alex think it feels to be pimple-free? "Really good," he acknowledges. Then he laughs. "My friends ask, 'What happened to all your zits?''

This context is the Copyright of WebMD

3 Tips to Take Care Your Eyes

Take care of your "delicate" eyes.This info' is sure to help PC users very much.During a recent visit to an optician, one of my friends was told of an exercise for the eyes by a specialist doctor in the US that he termed as 20-20-20." It is apt for all of us, who spend long hours at our desks, looking at the computer screen.I thought I'd share it with you. 20-20-20 *******

Step I :-After every 20 minutes of looking into the computer screen, turn your head and try to look at any object placed at least 20 feet away. Thischanges the focal length of your eyes, a must-do for the tired eyes. *******

Step II :-Try and blink your eyes for 20 times in succession, to moisten them.

Step III :- Time permitting of course, one should walk 20 paces after every 20 minutes of sitting in one particular posture. Helps blood circulation for the entire body.Circulate among your friends if you care for them and their eyes. They say that your eyes are mirror of your soul, so do take care of them, they are priceless................

Safe Sex - Topic Overview

Sexually transmitted diseases (STDs) are spread by sexual contact involving the genitals, mouth, or rectum, and can also be spread from a pregnant woman to her fetus before or during delivery. STDs, which affect both men and women, are a worldwide public health concern.

Although most STDs can be cured, some cannot, including HIV (which causes AIDS), genital herpes, and human papillomavirus (HPV), which can cause genital warts.

STDs can be spread by people who don't know they are infected. Always use protection every time you have sex, including oral sex, until you are sure you and your partner are not infected with an STD.

If you are in a relationship, delay having sex until you are physically and emotionally prepared, have agreed to only have sex with each other, and have both been tested for STDs.

Abstinence as prevention

Completely avoiding sexual contact (abstinence), including intercourse or oral sex, is the only certain way to prevent an infection.

Discuss safe sex with your partner

Discuss STDs before you have sex with someone. Even though a sex partner doesn't have symptoms of an STD, he or she may still be infected.

Questions to ask someone before having sex include:

  • How many people have you had sex with?

  • Have you had sex without a condom?

  • Have you ever had unprotected oral sex?

  • Have you had more than one sex partner at a time?

  • Do you inject illegal drugs or have you had sex with someone who injects drugs?

  • Have you ever had unprotected sex with a prostitute?

  • Have you had a test for HIV? What were the results?

  • Have you ever had an STD, including hepatitis B or hepatitis C? Was it treated and cured?

Safe sex practices

Some STDs, such as HIV, can take up to 6 months before they can be detected in the blood. Genital herpes and the human papillomavirus (HPV) can be spread when symptoms are not present. Even if you and your partner have been tested, use condoms for all sex until you and your partner haven't had sex with another person for 6 months. Then get tested again.

  • Watch for symptoms of STDs, such as unusual discharge, sores, redness, or growths in your and your partner's genital area, or pain while urinating.

  • Don't have more than one sex partner at a time. The safest sex is with one partner who has sex only with you. Every time you add a new sex partner, you are being exposed to all of the diseases that all of their partners may have. Your risk for an STD increases if you have several sex partners at the same time.

  • Use a condom every time you have sex. A condom is the best way to protect yourself from STDs. Latex and polyurethane condoms do not let STD viruses pass through, so they offer good protection from STDs. Condoms made from sheep intestines do not protect against STDs.

  • Use a water-based lubricant such as K-Y Jelly or Astroglide to help prevent tearing of the skin if there is a lack of lubrication during sexual intercourse. Small tears in the vagina during vaginal sex or in the rectum during anal sex allow STDs to get into your blood.
    Avoid douching if you are a woman, because it can change the normal balance of organisms in the vagina and increases the risk of getting an STD.

  • Be responsible. Avoid sexual contact if you have symptoms of an infection or if you are being treated for an STD or HIV. If you or your partner has herpes, avoid sexual contact when a blister is present and use condoms at all other times.

This context is the Copyright of WebMD

Back pain at work: Preventing aches, pains and injuries

Back pain can make it hard to do your job. Understanding what causes workplace back pain can help you avoid it.
Whether it's dull and annoying or screaming for attention, back pain can make it hard to concentrate on your job.

Many occupations — such as nursing, construction and factory work — may place significant demands on your back. Even routine office work can worsen back pain if you fall into risky habits.

But you often can avoid back pain and injuries by understanding what causes them and focusing on prevention.

What causes back injuries?

Doctors aren't sure about all of the causes of back pain. In fact, most back problems are probably the result of a combination of factors. Some factors, such as family history, aren't preventable. You can control other factors, such as weight, fitness and flexibility, by changing your lifestyle. Still other factors are work related, and you may or may not be able to modify these to prevent injury.

Four work-related factors are associated with increased risk of back pain and injury:

  • Force.Exerting too much force on your back may cause injury. If your job is physical in nature, you might face injury if you frequently lift or move heavy objects.
  • Repetition. Repetition refers to the number of times you perform a certain movement. Overly repetitious tasks can lead to muscle fatigue or injury, particularly if they involve stretching to the limit of your range of motion or awkward body positioning.
  • Posture. Posture refers to your position when sitting, standing or performing a task. If, for instance, you spend most of your time in front of a computer, you may experience occasional aches and pains from sitting still for extended periods. On average, your body can tolerate being in one position for about 20 minutes before you feel the need to adjust.
  • Stress. Pressures at work or at home can increase your stress level and lead to muscle tension and tightness, which may in turn lead to back pain.

How to avoid injuries

Your best bet in preventing back pain and injury is to be as fit as you can be and take steps to make your work and your working environment as safe as possible.

Be fit
Even if you move around a lot on your job or your job requires physical exertion, you still need to exercise. Regular activity is your best bet in maintaining a healthy back. First of all, you'll keep your weight in check, and carrying around a healthy weight for your body's frame minimizes stress on your back. You can do specific strengthening and stretching exercises that target your back muscles. These exercises are called "core strengthening" because they work both your abdominal and back muscles. Strong and flexible muscles will help keep your back in shape.

Pay attention to posturePoor
posture stresses your back. When you slouch or stand with a swaybacked position, you exaggerate your back's natural curves. Such posture can lead to muscle fatigue and injury. In contrast, good posture relaxes your muscles and requires minimal effort to balance your body.

  • Standing posture. If you stand for long periods, occasionally rest one foot on a stool or small box. While you stand, hold reading material at eye level. Don't bend forward to do desk work or handwork.
  • Sitting posture. To promote comfort and good posture while sitting, choose a chair that supports your back. Adjust the chair so that your feet stay flat on the floor. If the chair doesn't support your lower back's curve, place a rolled towel or small pillow behind your lower back. Remove bulky objects, such as a wallet, from your back pockets when sitting because they can disrupt balance in your lower back.

Lift properly There's a right way and a wrong way to lift and carry a load. Some key tips for lifting the right way include letting your legs do the work, keeping objects close to your body and recruiting help if a load is too heavy.

Adjust your work space Look at the setup of your office or work area. Think about how you could modify repetitive job tasks to reduce physical demands. Remember that you're trying to decrease force and repetition and maintain healthy, safe postures. For instance, you might use lifting devices or adjustable equipment to help you lift loads. If you're on the phone most of the day, try a headset. Avoid cradling the phone between your shoulder and ear to free up your hands for yet another task. If you work at a computer, make sure that your monitor and chair are positioned properly.

Adopt healthy work habits Pay attention to your surroundings and comfort on the job. Take these steps to prevent back pain:

  • Plan your moves. Reorganize your work to eliminate high-risk, repetitive movements. Avoid unnecessary bending, twisting and reaching. Limit the time you spend carrying heavy briefcases, purses and bags. If you're carrying something heavy, know exactly where you intend to put it and whether that space is free from clutter.
  • Listen to your body. If you must sit or stand for a prolonged period, change your position often. Take a 30-second timeout every 15 minutes or so to stretch, move or relax. Try standing up when you answer the phone, to stretch and change positions. If your back hurts, stop activities that aggravate it.
  • Minimize hazards. Falls can seriously injure your back. Think twice before wearing high heels. Low-heeled shoes with nonslip soles are a better bet. Remove anything from your work space that might cause you to trip.
  • Work on coordination and balance. Just walking regularly for activity can help you maintain your coordination and balance. You can also perform balance exercises to keep you steady on your feet.

Address mental health concerns Being under stress causes your muscles to tense, making you more prone to injury. And the more stress you feel, the lower your tolerance for pain. Try to minimize your sources of stress both on the job and at home. Develop coping mechanisms for times when you feel especially stressed. For instance, perform deep-breathing exercises, take a walk around the block or talk about your frustrations with a trusted friend.

In addition, both depression and substance abuse increase the risk that low back pain will persist. Talk to your doctor if you think you may be affected by either of these issues. Effective treatments are available.

By Mayo Clinic staff
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