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SEXUALITY AND GYNECOLOGICAL CANCER: SEX SURVIVAL STRATEGIES

admin — Sat, 23 Jul 2011 19:30:17 +0000

• Don’t place unrealistic expectations on yourself-discuss with each other what aspects of intimacy and sex you can cope with at each phase of your recovery• Have a very supportive partner whom can act as an advocate in consultations, particularly when you are not well enough to think clearly• Maintain a sense of humour – try and build in times for laughter and relaxation with your partner and others who can laugh with you during this tumultuous time• Try to accept the changes in your physical appearance as necessary to preserving your life – most partners will be relieved you are still living• Try to feel better about your physical appearance -buy some hats, new clothes, make-up, fragrance, facial. Ask friends to donate some of these as gifts instead of flowers. The physical outcomes of treatment (hair/weight loss) may be the hardest things to cope with• Participate in a free ‘Look Good, Feel Better’ session at your treatment centre – does wonders for the soul and reminds you that you are still a ‘glamour puss!’• Pamper your partner as well as yourself- as often as possible! This is the one time when you both deserve extra attention• Communicate, communicate, communicate*44/144/5*

SIDE EFFECTS OF OCD TREATMENT USING MEDICATION

admin — Tue, 19 Jul 2011 19:20:53 +0000

Sperhaps the main reason why SRIs are among the most widely prescribed drugs in the world is that they have relatively few side effects. A recent study involving more than six thousand patients showed that far fewer patients (13.9 percent) stopped SRIs because of side effects than stopped standard antidepressants. In my own clinical practice I have treated hundreds of patients with SRIs. The dose has usually needed to be adjusted, the type of SRI has often needed to be changed, and on occasion medication has needed to be stopped all together. But I have never had a patient who experienced either a nonreversible or a medically harmful side effect.Unfortunately, misinformation abounds regarding the side effects of these drugs. Probably the most common unfounded belief about SRIs is that they cause addiction. The truth is that not a single study has shown them to be habit-forming. Furthermore, the personality of the OCDer, guilt-prone and overly responsible, tends to prevent addiction to anything. I have never treated, nor even heard of, a patient who became addicted to an SRI prescribed for OCD.Another common but unfounded fear is that the SRIs can cause suicidal, or even homicidal, behaviors. This specter was raised by a 1990 article in the American Journal of Psychiatry which reported that 6 out of 172 hospitalized patients on Prozac had become preoccupied with suicidal thoughts. Subsequent studies on many thousands of patients, however, proved that suicidal and homicidal thoughts are no more common with Prozac than with other antidepressants. The number of people who have been prescribed Prozac to date—over 40 million—dictates that almost everything will have happened to someone while on the drug, simply by chance. Yet the mistaken idea that Prozac causes Jekyll-and-Hyde personality changes surfaced once again when defense lawyers tried to argue that David Wisbecker, who in 1989 killed eight of his coworkers in a plant in Kentucky with an assault rifle, did it because he was on Prozac. The issue, hopefully, was put to rest permanently in 1995, when the courts completely discredited the “Prozac defense” in the Wisbecker case. The Federal Drug Administration, whose mission it is to oversee the safety of medications prescribed in the United States, and which is often criticized for being too restrictive, subsequently rejected a petition that the Prozac label include even a warning about suicidal or violent behavior. The FDA has repeatedly reaffirmed the safety of Prozac and the other SRIs.Some widely available books do a good job of realistically appraising the risks of side effects of SRIs and other psychiatric medications. I found three good ones in my local bookstore: Complete Drug Reference ; Essential Guide to Psychiatric Drugs by Jack Gorman (St. Martin’s Press, 1995); and Prozac: Questions and Answers by Ronald Fieve, M.D. (Avon Books, 1994), the eminent psychiatrist at Columbia University who did much of the pioneering work on bipolar disorder. Unfortunately, the “product inserts” that accompany medications and the Physicians Desk Reference, a compilation of product inserts, do a poor job of appraising side effects. They are designed largely to prevent malpractice suits against pharmaceutical companies and simply list every side effect that has ever been reported.The truly significant side effects of the SRIs—all affecting only a minority of patients—are nausea, nervousness, sexual problems, irritability, and nightmares.
Gastrointestinal Symptomsnausea, and sometimes vomiting of diarrhea, are among the most common side effects of SRIs: 20-30 percent of people experience them in the first one to two weeks of treatment. These side effects usually respond to either dose reduction or taking medications with food; often, however, they are the reason patients stop treatment with a given agent. These side effects are most troublesome with sertraline (Zoloft) and fluvoxamine (Luvox).
Nervousness, Headaches, and Insomniathese side effects, affecting 15-20 percent of people taking the SRIs, are all related to an activating effect of these medications that some patients describe as being like the “caffeine jitters.” Such reactions are strongest with fluoxetine (Prozac) and are, indeed, the most common reason why people stop that medication. These side effects usually last only a few months, and then the body adjusts to them. After that, they are sometimes replaced by their opposites, apathy and sleeping too much. All respond immediately to lowering the dose of medication. All can also be effectively treated by the addition of an antianxiety medication such as clonazepam (Klonopin) or lorazepam (Ativan).Interference with Sexual Functioningthis side effect—most often either an inability to attain orgasm or a loss of interest in sex—was underreported at first, but it is now clear that it occurs in fully 30—40 percent of people taking SRIs. This side effect, too, usually responds to dose reduction. A number of my patients on short-acting SRIs, such as paroxetine (Paxil), sertraline (Zoloft), and fluvoxamine (Luvox), have reported that skipping medication for two days allows a return of full sexual function without a loss of antiobsessional effect. Two recent studies have supported this observation. Adding medications of various types to an SRI can also reverse sexual side effects, and yohimbine (Yocon), buspirone (Buspar), buproprion (Wellbutrin), trazodone (Desyrel), and cyproheptadine (Periactin) have all been tried in this regard. In my practice, however, these counteractive drugs have proved disappointing. Only Yocon and Desyrel have worked at all, and those in only a few patients.
Irritability and Nightmaressince the data are strong that the neurotransmitter serotonin plays a role in regulating anger (for instance, violent criminals have low levels of serotonin metabolites in the spinal fluid), it is not surprising that SRIs have an effect on irritability. Fortunately, this is usually a positive effect. Typical is the story of an eighteen-year-old woman who had been kicked off sports teams, run away from home, and been punished by her parents since age six for her short fuse and overly aggressive behaviors. After three months on an SRI she told me, “I’m much calmer now. I think before I act. For the first time ever, I sat down and talked to my sister for a full hour.” A study at Harvard in 1991 looking at outbursts of anger among people on SRIs found that outbursts went down in 71 percent of patients and up in 6 percent.The increased irritability that does occur in a small number of people can, it must be admitted, be a problem. I have had several patients, all with prior histories of hostile behaviors, who had to stop SRIs because of marked increases in anger. One patient, for instance, who had served time for assault and battery, had to stop his SRI because, as he put it, “It made me feel like when I was on steroids: say hello and I snap out.” I should add, however, that I have never had a patient who acted harmfully because of the effects of these medications.A larger problem with the SRIs is the occurrence of nightmares, often of physical harm. Rather than the 0-5 percent reported in clinical trials, perhaps 10—15 percent of my patients are bothered by vivid, troublesome dreams. These patients respond to decreasing the dose of medication, or changing to a different SRI.Other Side Effectstremor and sleeping excessively can occasionally become problems after many months of treatment with an SRI. Patients so affected usually respond to a lowered dosage. Allergic reactions, primarily rash, occur in about 3 percent of people taking SRIs. Because tetatogenic effects (adverse consequences of drugs on the developing fetus) have not been well studied, SRIs should be stopped, if possible, during pregnancy. Large numbers of pregnant women have taken SRIs, however, and so far there have been very few problems reported.Dry mouth, constipation, drowsiness, and memory loss occur as a group and are referred to as anticholinergic effects. They are by far the most frequently seen with clomipramine (Anafranil) and occur to a lesser extent with paroxetine (Paxil). Anticholinergic side effects always respond to dose reduction. Chewing sugarless gum or sucking on lemon drops (which stimulates salivation) can also be helpful for dry mouth. Other potential problems specific to clomipramine (Anafranil) are heart conduction abnormalities (patients who are over forty should have an electrocardiogram before starting Anafranil) and a lowering of the seizure threshold.
Medication Interactionsthe sris — in this case clomipramine (Anafranil) much less than the others—have a strong effect on the liver’s metabolism of certain medications. As a result, the SRIs have the potential to dangerously increase the blood levels of many drugs, including antidepressants, anticonvulsants, blood sugar medications, heart medications, pain medications, and allergy medications. Although I have never had a patient who ran into a major problem in this regard, these drug interactions are potentially serious. For the older person on a number of medications, these drug interactions represent the major drawback to the use of an SRI.
Alcoholcan a patient drink while on medications? Psychiatrists tend to take the conservative position that it is better not to consume any alcohol while on any psychiatric medication. It should be pointed out, however, that many patients drink socially while on SRI medications without a problem. There is, in fact, no direct, harmful interaction between alcohol and the SRI drugs. The case is somewhat different with benzodiazepine medications, such as lorazepam (Ativan), clonazepam (Klonopin), and alprazolam (Xanax). Here there is an interaction, and alcohol should be avoided.*28/338/2*

WHY YOU CAN’T STAY AWAKE: OTHER TYPES OF DOES – SLEEP PARALYSIS

admin — Tue, 05 Jul 2011 17:59:15 +0000

As we have seen, narcoleptics occasionally experience muscle paralysis associated with the onset or termination of sleep. The same problem can afflict nonnarcoleptic people as well. Patients lie unable to move any muscles, except those around the eyes. In some cases the victim suffers formication—the frightening sense that bugs are crawling over the body—or other hallucinations. Sleep paralysis, which is inherited through the mother, may be a dysfunction of the REM mechanism responsible for inhibiting muscle movement during dreams. There may also be a dietary basis for the problem in hypokalemic individuals—those with low or depleted levels of potassium, an electrolyte necessary for muscle function.If you suffer from an attack of sleep paralysis, concentrate on moving your eyes as vigorously as you can. Blink, if possible. Then try moving individual muscles in your face, slowly and systematically working your way down your body. Such activity has been shown to terminate the paralysis.*160\226\8*

CARDIOVASCULAR DISEASE: KEY FACTORS IN EARLY DETECTION AND PROGNOSIS

admin — Wed, 22 Jun 2011 09:10:38 +0000

As more research is done concerning diagnosis and treatment of CVD among women, it is becoming clear that women sometimes experience different symptoms and benefit from different treatment than men do. Consider the following:
Feeling painOver the years, it has been widely assumed that men, being the stronger, tougher sex, were much more tolerant of pain than women and thus didn’t complain until pain became excruciating or intolerable. Today we have more accurate information. In fact, several studies have documented that women experience pain more acutely and more frequently than men, indicating that the sexes may detect and react to pain differently. In a study of dental patients, women responded more favorably than men to a class of pain relievers known as kappa opioids, including pentazocine, suggesting that receptors for inhibiting pain may vary by sex. Also, women appear to be less responsive than men to non-steroidal anti-inflammatory drugs, such as ibuprofen. Women typically need slightly lower doses of aspirin and should be forewarned that taking 325 mg of aspirin per day may result in anticoagulation levels that exceed those of men. Surgical risks, accidents that lead to excessive bleeding, and so on, may be greater for aspirin-using women.
Noting heart attack symptomsAlthough we are taught that the classic chest-crushing pain, the main symptom of a heart attack, is the first big signal to call 911, this type of pain is not all that common in women. Women’s heart attacks, by contrast, tend to show up as shortness of breath, fatigue, and jaw pain, stretched out over hours rather than minutes. Women tend to suffer their first heart attack 10 years later than men, and in part because they are older when they have these attacks, they tend to have greater rates of death among first-time victims. Because women have the benefits of estrogen for so many years and because estrogen helps keep blood vessels elastic and free of plaque formation, they have a decreased risk of heart disease than men do during their early years. Estrogen also is believed to signal the liver to produce more HDL, or good cholesterol.
Treating CVDInterestingly, drugs typically used to break up clots and stabilize erratic heart-beats are less effective in women than in men. Beta blockers, one common form of treatment for reducing blood pressure and migraines, take longer to metabolize in women than in men, meaning that women often have more difficulty regulating dosage and preventing certain side effects. Hormone replacement therapy – estrogen and progestin – has been shown to help. Currently several studies are investigating the role of estrogen in CVD and cancer. Recent studies have shown that angiography, a technique in which a small flexible catheter is inserted in coronary vessels to break up plaque and clear blocked arteries, is one of the best techniques for reducing risk of heart attack. However, angiograms are done much less frequently on women than on men.*18/277/5*

REDUCING YOUR RISKS OF CANCER: WHAT IS CANCER?

admin — Sun, 12 Jun 2011 09:06:00 +0000

Cancer is the name given to a large group of diseases characterized by the uncontrolled growth and spread of at normal cells. It may seem hard to understand how normal healthy cells become cancerous, but if you think of a cell as a small computer, programmed to operate in a particular fashion, the process will become clearer. Under normal conditions, healthy cells are protected by a powerful overseer, the immune system, as they perform their daily functions of growing, replicating, and repairing body organs. When something interrupts normal cell programming, however, uncontrolled growth and abnormal cellular development result in a new growth of tissue serving no physiologic function, which is called a neoplasm. This neoplasmic mass often forms a clumping of cells known as a tumor.Not all tumors are malignant (cancerous); in fact, most are benign (noncancerous). Benign tumors are generally harmless unless they grow in such a fashion as to obstruct or crowd out normal tissues or organs. A benign tumor of the brain, for instance, is life threatening when it grows in a manner that causes blood restriction and results in a stroke. The only way to determine whether a given tumor or mass is benign or malignant is through biopsy, or microscopic examination of cell development.Benign and malignant tumors differ in several key ways. Benign tumors are generally composed of ordinary-looking cells enclosed in a fibrous shell or capsule that prevents their spreading to other body areas. Malignant tumors are usually not enclosed in a protective capsule and can therefore spread to other organs. This process, known as metastasis, makes some forms of cancer particularly aggressive in their ability to overcome bodily defenses. By the time they are diagnosed, malignant tumors have frequently metastasized throughout the body, making treatment extremely difficult. Unlike benign tumors, which merely expand to take over a given space, malignant cells invade surrounding tissue, emitting claw-like protrusions that disrupt chemical processes within healthy cells. More specifically, malignant cells disturb the ribonucleic acid (RNA) and deoxyribonucleic acid (DNA) within the normal cells. Tampering with these substances, which control cellular metabolism and reproduction, produces mutant cells that differ in form, quality, and function from normal cells.*3/277/5*

VIRAL DISEASES: MEASLES AND RABIES

admin — Sat, 04 Jun 2011 08:51:34 +0000

MeaslesTechnically referred to as rubeola, measles is a viral disorder that often affects young children. Symptoms, appearing about 10 days after exposure, include an itchy rash and a high fever. German measles (rubella) is a milder viral infection that is believed to be transmitted by inhalation, after which it multiplies in the upper respiratory tract and passes into the bloodstream. It causes a rash, especially on the upper extremities. It is not generally a serious health threat and usually runs its course in three to four days. The major exceptions to this rule are among newborns and pregnant women. Rubella can damage a fetus, particularly during the first trimester, creating a condition known as congenital rubella, in which the infant may be born blind, deaf, retarded, or with heart defects. Immunization has reduced the incidence of both measles and German measles. Infections in children not immunized against measles can lead to fever-induced problems such as rheumatic heart disease, kidney damage, and neurological disorders.
RabiesThe rabies virus infects many warm-blooded animals. Bats are believed to be asymptomatic (symptom-free) carriers. Their urine, which they spray when flying, contains the virus, and even the air of densely populated bat caves may be infectious. In most other hosts, the disease is extremely virulent and usually fatal. A characteristic behavior of rabid animals is the frenzied biting of other animals and people. Not only does this behavior cause injury but it also spreads the virus through the infected animal’s saliva. The most obvious symptoms of the disease are extreme cerebral excitement and rage, spasms in the pharynx (throat) muscles, especially at the sight of water, and the inability to drink water.The incubation period for rabies is usually one to three months, yet may range from one week to one year. The disease may be fatal if not treated immediately with the rabies vaccine. Anyone bitten by an animal that may carry rabies should seek medical attention as soon as possible and try to bring the animal along for testing.*16/277/5*

BIOLOGICAL FILLERS: HUMAN INJECTABLE TISSUE

admin — Sun, 22 May 2011 08:21:10 +0000

Cymetra (not yet available in the UK) A mixture of collagen, elastin and glycosaminoglycans – three substances that are found naturally in the dermis of the skin -Cymetra is derived from donated human cadaver skin. An advantage of Cymetra is that it poses no risk of an allergic reaction and therefore the need for skin testing is eliminated. A disadvantage is that the injection is more painful than bovine collagen as there is no anaesthetic in the syringe. Also, because Cymetra is available in just one thickness, it lacks the versatility of other fillers. On average, its use is limited to the treatment of superficial lines and wrinkles.Isolagen (not yet available in the UK) Isolagen is a material with various benefits, but speediness is definitely not among them. First, fibroblasts – the skin cells that produce collagen – are retrieved from behind the patient’s ear and sent to an outside lab where they are allowed to multiply. After the cells are returned to the physician the patient has just a short window of opportunity for the cells to be injected into the skin. If too much time elapses, the cells will die and be rendered useless. It’s important to remember that since fibroblasts, not collagen, are injected into the skin the patient does not leave the office with visible results. Realistically, it could take as long as four months after the treatment for enough collagen to be synthesised by the fibroblasts to see a noticeable improvement in a patient’s wrinkles. *66\82\8*

DIET IN DIABETES: FIBRES AND FRUITS

admin — Sun, 15 May 2011 08:03:33 +0000

FibresDietary fibre is derived from plant cell components and is resistant to digestive secretions of the gastrointestinal tractType-1 FibresBenefitsType -II FibresSource BenefitsThese are water insoluble – cellulose, hemicellulose, lignin.Source : Cereals and milletsDecrease the intestinal transit time, increase the fecal bulk and therefore are useful in constipation.These are water soluble fibres – pectin, gums and mucilageVegetable, fruits & legumes1. These are more effective in controlling blood glucose and triglycerides2. These provide Omega 3 (W3) fatty Acid and antioxidants.FRUITSFruits are must for a diabetes patient and should be included in a meal plan. Fruits provide —1. Vitamins2. Minerals3. Fibres4. Antioxidants5. CaloriesFruit should be taken in correct amount (allowance)Mosambi- 100 gm(one medium)Orange- 100 gmOnePear- 100 gmsmall oneApple- 100 gmhalfGrapes- 55 gm(8-10nos.)Banana- 40 gml/2peiceMango- 60 gmone sliceGauva- 100 gmone smallPapaya- 120 gmone sliceWater Melon- 300 gmetcHowever banana, mango, grapes, jackfruit are notrecommended for a diabetic patient.Fruit allowance: one fruit of one variety in the recommended amount at a time. Fruit juice is not recommended.*29\329\8*

EMERGENCIES: SNAKEBITES

admin — Fri, 06 May 2011 07:58:56 +0000

Most are not poisonousMore than 45,000 people are bitten by snakes each year, but only about 8,000 of those are by poisonous snakes. Fewer than 15 fatalities result from snakebites annually, and many of those occur because the bites are not treated.
Determining if the snake is poisonousMost venomous snakes in the United States (such as rattlesnakes, copperheads and water moccasins) are characterized by:Triangular-shaped headElliptical-shaped (slit-like) eyesA depression (or pit) midway between the nostrils and eyesRattlesnakes produce a characteristic rattling sound with their tail. The water moccasin has a whitish, cottony lining in its mouth. The copperhead has a large, coppery head. Poisonous coral snakes have red, yellow and black rings along their body.If you know, or suspect, the snake was poisonous, it is especially important to seek emergency medical care. If medical help is more than 30 or 40 minutes away, use a commercial snakebite kit within five minutes of the bite. Never use your mouth to suction the wound.
If the snake is not poisonousBites from nonpoisonous snakes generally are not harmful. If bitten by a snake you know is not poisonous:Rinse and clean the wound with soap and water.Don’t try to stop the bleeding unless it is severe.Get a tetanus shot if you haven’t had one in five or more years or if you didn’t complete your primary series of tetanus shots.Watch for signs of infection.What you can do while you wait for medical attentionLie down and try to remain calm. Stay as quiet as possible.Keep your body warm.Keep the bitten area lower than the level of the heart.Remove all jewelry near the affected area.Snugly wrap a bandage several inches above a bite on an arm or leg.Do not move the wounded area. Use a splint if possible.DO NOT take any drugs, including aspirin or alcohol. DO NOT apply heat or ice to the wound. DO NOT use a tourniquet. DO NOT cut into the wound to try to drain or suck out the venom.*14\303\2*

BACH FLOWER REMEDIES: KEY-NOTE SYMPTOMS – MUSTARD REMEDY

admin — Fri, 22 Apr 2011 07:31:03 +0000

A sudden depression which descends like a cloud and envelops the un-suspecting person without any warning, leaving him thoroughly distressed. The cloud lifts after sometime by itself as suddenly as it came. One does not know, when it would come, how long it would last and when would it come again. So long this depression lasts, the subject is thoroughly non-plussed, with beads of sweat covering his face and forehead, anxiety writ large on his face and hair standing on edge, anybody can see that the man is unwell, but if asked what is the matter with him, he would invariably say “Oh, nothing. I am alright”. Sometimes, we also experience some moments when without any reason, we have a fit of depression when nothing can give us any joy. Mustard Remedy would dispel that fit of depression.*39\308\8*