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Diseases Of The Prostate Gland

July 17th, 2010
Sajeena Ali asked:




Prostate is a glandular organ present only in males. It surrounds the neck of bladder and the first part of urethra and contributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.

Common Diseases of the prostate glands are:

Prostatitis: This is the inflammation of the prostate gland due to bacterial infection.

Benign enlargement of the prostate: This is a non cancerous tumor of the prostate seen after the age of 50.

Cancer of the prostate: This is the 4th most common cause of death from malignant diseases in males.

Prostate Cancer: Prostate Cancer is directly linked with the male sex hormones – Androgens. If the levels of sex hormone increases the growth rate of cancer also increases. It is found that after the removal of testes there is marked reduction in the size of tumor. Prostate cancer is mainly found in the posterior lobe. The gland becomes hard with irregular surface with loss of normal lobulation. Histologically prostate cancer is an adenocarcinoma.

Growth of Prostate Cancer: Growth rate is very fast in prostate cancer. The tumor compresses the urethra and produce difficulty in urination. Metastasis in cancer of prostate is very early. From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles. Tumor cells also move to the neck and base of the urinary bladder. Cancer cells reach the internal and external illiac group of lymph nodes through the lymph vessels. From there cells move to retroperitoneal (Behind the peritoneum) and mediastinal lymph nodes (in the chest). Spreading of cancer cells take place through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.

Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen:

No symptoms: Tumor is small and only in the posterior lobe. This is diagnosed accidentally.

Slight difficulty in urination: Here the tumor is enlarged and urethra is slightly compressed. Shortly there will be frequent urge for urination with difficult urination. When the tumor spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding. Urine may come out drop by drop.

Retention of urine: When the urethra is completely compressed there will be retention of the urine. This can may lead to hydronephrosis, renal failure etc. In this condition patient may get convulsions due to renal failure and finally to coma.



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Stop Labor Pains – Does Childbirth Hurt? Best Pain Relief For Painful Contractions

July 16th, 2010
Kacy Carr asked:




Stop Labor Pains – Sorry girls like it or not, although pregnancy is a beautiful thing there is the labor/labour pains to bear just before the anticipated time of giving birth to a healthy baby son or daughter. In the US it is spelt Labor, and in the UK Labour; if there is an issue of either being right or wrong in the spelling is irrelevant because they both mean the same thing. Labor pains say baby’s on the way. The vast majority of pregnant women worry more about labour pains than the actual birth, or any other matter included in pregnancy. If it’s any consolation the pain is bearable, if it wasn’t women wouldn’t be having their second and third child. If you’re still worried senseless then you can do things to reduce the pain labor causes.

It’s natural to feel pain giving birth because the uterus has to steadily squeeze baby down towards the birth canal, where he/she pushes their head through the cervix and out through the vagina. This is childbirth girls, and unfortunately nothing can be done to stop labor pains; however things can be made a lot easier with aid of modern medicine to help you manage you’re discomforts.

Some women brave the storm and choose to deliver their baby naturally without drugs. But the option is there should they change their mind if the pain becomes unbearable. Many moons ago when women experienced their first sharp spasm of labor to the last exhausting pushpain relief was not up for negotiation, because there was none. Times have changed considerably and women have choice. Women today write their own birth plan which might include going without medication, opting for alternative medicine and non-drug approaches to manage their pain, or choose to give birth with help from anesthetics.

Is there medicine to stop labor pains, no, but there is medication to help take severe pain down to mild.

Epidural

An epidural is a pain relief method used for all types of operations, and also commonly used in delivery rooms. Women appointed for an epidural are fully conscious of the whole delivery experience, with a minimal amount of discomfort. A full epidural can be used during a c-section to fully numb the lower body. An epidural is administered through a thin tube (catheter) inserted into your lower back during active labour, distinguished by strong, regular contractions and cervical dilation of at least 4 centimeters. Women should be able to push with their contractions; however, not the case if too much epidural is administered which can prevent this, therefore assistance with pushing, or forceps or a vacuum to help the infant through the birth canal will be given. Epidurals are not available for homebirths because only skilled anesthetists can do this.

Pethidine

Pethidine, another painkilling drug used to reduce pain of childbirth. It is also an anti-spasmodic which means it helps you relax. I myself had pethidine injected in the leg with my second child, and when the effects of the drug kicked in I didn’t have a care in the world and could have had baby after baby. I can’t remember ever being offered pain relief with my first son oh how I must have suffered when I think back. There was an eighteen year gap between my two boys so this explains why I suffered with one, and not the other. Pethidine is an opiate drug making it much similar to morphine. It’s a clear liquid administered into your muscle, usually in the top of the leg or buttock. It impedes the pain receptors to your brain which make you aware of pain. It’s a sedative and muscle relaxant which can cause drowsiness. It’s fast working (10-15 minutes) which is good for women experiencing excruciating pain. The full benefit of the drug normally takes effect after about half an hour and normally lasts for 3-4 hours.

There are a lot of strong women who ignore pain relief and go natural. I’m not suggesting women who do have pain relief aren’t strong just not quite as much as them having natural births. Some women prefer to have their baby delivered at home, while this is an option depending on mother and baby’s health, I believe hospital be the safest place to bring baby into the world. Should anything go wrong at the birth, everything for treating complications, and “doctors” are close to hand.

In a report given by the National Birthday Trust about UK home births, found that 95% of home birth mothers said they enjoyed the birth, compared to 76% of hospital birth mothers. I’m not one to question evidence of this sort, but could that 95% have just been lucky that everything went smoothly, or they be one of the minute few with good pain threshold.

For those women who enjoyed their births, we must assume their pain relief to have been adequate. In the same research, 62% of women felt in control during labour, compared to 29% of hospital birth mothers; and a fortunate 14% of home birth mothers felt either no pain or very little pain, compared to 8% of hospital birth.

No one can ever predict how they will cope with pain till it happens, and for this reason pregnant women need to know of the pain relief available to them.

There are natural methods of pain relief for labor, but if you’re to practice any of them make sure to ask your GP is it safe to do so. You shouldn’t rely on gas & air, pethidine and epidural which come with side effects to try and stop labor pains. Remember no pregnancy is ever the same; this also applies to the women carrying babies – so, there will be some pain relief that works for one pregnant woman and which may not for the other?

Tips:

You’re in complete control with Tens semi-natural method. You release tiny electrical impulses into your nerves just below the skin.

If aromatherapy is carried out by an expert during labor it is very relaxing.

Attending active birth classes will teach you breathing exercises and certain positions that can be used to ease labor pain during childbirth. This is common practice for women seeking help and support, and who want to be around other pregnant women.

Acupressure, not many women are aware of this method because it’s only just beginning to get noticed as a strong rival against medicinal drugs. Particular pressure points on your body, if manipulated properly can cause the release of a natural human painkiller.

Take a warm bath

Relaxation and movement, e.g. yoga

The birth ball you can sit on in labour or beforehand, and roll your hips around on it. You can also lean over it. It can be kept for later use when the kids are growing up to have fun with.

Hot compress works wonders, heat helps relax tense muscles and known to provide relief from labour pains. Warm your back, tummy, or groin using a wheat bag or a hot water bottle.

Herbal remedies, although deemed reliable natural sources can be dangerous if wrongly used. Talk to the herbalist.

Take sips of isotonic drinks or water in between contractions

Ask questions if you’re confused; being frightened can worsen the pain

A full bladder can slow labour down, use the toilet when needed

Because you can’t stop labor pains, then good advice to follow is to have plenty of rest to preserve your energy to help cope with painful contractions.

?



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Doctor. Do Rubs Work For Arthritis?

July 16th, 2010
Nathan Wei asked:




Treatments for arthritis pain vary in terms of type, effectiveness, and mode of administration. Types of therapies include oral analgesics, topical analgesics, oral non-steroidal anti-inflammatory drugs (NSAIDS), topical NSAIDS, oral narcotics, and parenteral (meaning intramuscular or intravenous) narcotics.

As a general rule, for mild to moderate pain, narcotics should not be used. What this means is that the non-narcotic analgesics or NSAIDS are the drugs of choice.

The next decision to be made is, “Do I use an oral drug or will a topical agent, a rub, work just as well?”

So how does a patient choose?

One significant measure is efficacy. Does the agent really work?

The perception among many patients as well as physicians is that topical agents may not be as effective as oral drugs.

A recent study looked at this issue of effectiveness and patient preference in regards to oral versus topical NSAIDS.

Their conclusion? “In older patients with knee osteoarthritis, treatment with either oral or topical non-steroidal anti-inflammatory drugs (NSAIDs) had an equal effect on knee pain after one year,” according to the results of this randomized controlled trial reported in the British Medical Journal.

The study was conducted among patients from 26 general practices in the United Kingdom.

Patients eligible for study participation were over the age of 50 and had a history of knee pain on most days of the month for at least 3 months. All participants had been treated for knee pain in the 3 years before study enrollment. Patients with a history of peptic ulcer, significant indigestion, or kidney problems were excluded from study participation.

There were 2 treatment groups. In 1 group, patients were randomized to receive a recommendation for either topical or oral ibuprofen, at a dose determined by the patient. In the other intervention group, patient volunteers were left to decide for themselves whether they used topical or oral ibuprofen.

The volunteers were observed for 24 months. The primary outcome measure was the WOMAC Osteoarthritis Index questionnaire, which was used to assess knee pain and stiffness at 1 year. The WOMAC (Western Ontario McMaster) scale is typically used in arthritis studies to assess quality of life issues.

282 patients were included in the randomized trial and 303 patients participated in the patient preference study. The average age of the volunteers was 64 years, and baseline characteristics were similar regardless of study treatment. The mean global score on the WOMAC at baseline was 40 of a possible 100.

224 subjects in the preference study opted for topical treatment, whereas 79 chose oral ibuprofen. Patients with more severe or widespread pain generally selected oral therapy.

There was a modest change in WOMAC scores at 1 year, regardless of study therapy. WOMAC pain scores at 24 months slightly favored oral therapy, but this difference was not considered significant.

More patients in the topical ibuprofen group experienced significant pain at 3 months, which prompted 11% of the volunteers receiving topical treatment to change to oral ibuprofen.

Quality-of-life scores were similar between the oral and topical ibuprofen groups.

There were no differences in the rate of major side effects in the topical and oral ibuprofen groups. However, oral ibuprofen was associated with side effects involving the respiratory tract in 17% of participants compared to only 7% of subjects receiving topical ibuprofen. In addition, signs of kidney malfunction occurred more frequently in the oral ibuprofen treated patients.

Rates of changing treatment because of adverse effects were 1% and 16% in the topical and oral ibuprofen groups, respectively.

The conclusions were:

Patients with knee pain consider topical NSAIDs effective for mild pain but reserve oral NSAIDs for more severe or persistent pain. Patients generally believe that topical NSAIDs do not have adverse effects, but they will tolerate mild adverse effects associated with oral NSAIDs.

The current study suggests that topical NSAIDs are similarly effective to oral NSAIDs for knee pain for 1 year, and oral NSAIDs are associated with a higher rate of adverse effects.

Dr. Martin Underwood, who was the spokesperson for the research group conducting the study stated, “If topical NSAIDs are as effective as oral NSAIDs for reducing knee pain but produce fewer adverse effects, then topical treatment might be preferred.”

In our practice, we have found that topical agents are generally useful for patients with mild to moderate localized pain. However, if a patient has generalized pain, it makes no sense for them to slather a goo all over themselves.

A big bugaboo though with oral NSAIDS are the potential side effects, particularly in older patients.

One area not explored in the study was the use of pain patches. Lidoderm, which is a patch containing lidocaine, has been found to be helpful for some patients with arthritis, although an FDA approval has not yet been secured for this indication.

Newer NSAID patches containing diclofenac will also be available soon and these look very promising for local arthritis-related pain.

As far as topical agents that don’t contain NSAID, my favorite is Myorx which contains Omega-3 fatty acids. This helps provide anti-inflammatory effect without the potential problems associated with NSAIDS. For more information about Myorx, you can visit http://www.aocm.org or call the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800.



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