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Posted by admin under Cardio & Blood-Cholesterol

Man has always been acquainted with blood. Inevitable wounds caused it to flow and the spurting from arteries showed that there was great pressure back of it. Yet it was not until the time of the Pilgrims’ coming to America that William Harvey showed how the blood was continually pumped by the heart through the arteries and returned by way of the veins.
Harvey was one of the great observers. Philosophers had said that the hen broke the egg open to free the chick. Harvey looked and found that the chick itself did the pecking open. After he had studied at Caius College, Cambridge, (pronounced “keys” and still the great training school for English physicians) he began to study the heart and blood vessels in men and animals. It was known that both arteries and veins were filled with blood, but it was thought that it just surged back and forth. Harvey studied the action of the heart; he saw that the valves prevented back flow; and he estimated the capacity of the heart and the rate of the flow. When he was through, there was no disputing his theory of the circulation.
During the English Civil War he was an intimate of Charles I and accompanied him on his campaigns. There is a pretty story of his sitting under a hedge at one battle reading a book to the royal children, the Prince of Wales and the Duke of York, until a cannon ball grazed the ground near them. Charles lost the war and was beheaded, but Harvey was not bothered by the Parliamentarians. He was evidently somewhat the type of his namesake of whom Samuel Johnson said, “If you call a dog Hervey, I shall love him.”
We must consider Harvey’s work all the more remarkable as we realize that he could not know or demonstrate part of the course of the blood. It was some years later that the microscope was perfected so that Malpighi could see and describe the capillaries. These are the minute vessels through which the blood gets from the arteries to the veins; they are so small that the red blood corpuscles have to go through single file. In the days of small distances we were impressed to learn that if all one’s capillaries were placed end to end they would reach two and a half times around the earth at the equator.


Posted by admin under Cancer

Next tool is the observation of the development of cancers in people. Work on the location of cancers and where they spread was mainly carried out in the nineteenth and early twentieth centuries and this process of careful description of what happens to patients, allied to very detailed descriptions of the behaviour of tumours, can still contribute useful knowledge. There remains a role for the doctor or group of doctors who keep meticulous records of the findings with large numbers of patients and the outcome for each and every one of them. This kind of clinical science is important but probably has now contributed most of what it can to our knowledge of cancer.
The third kind of method which helps us understand cancer is the study of the development of cancers in communities and of the links between the cancers seen in communities and other features of life in those communities, This is the science of epidemiology and it has, in many ways, been the most revealing of all of the sciences in the study of cancer in chit century (although many scientists practising in the laboratory might not share this view). In fact, epidemiology and experimental science and clinical observation are all complementary and, together, can tell us much about the different causes of cancer.
The study of the development of cancers in populations is best illustrated by the link between lung cancer and smoking. This topic merits a chapter in its own right, which will follow later, but the essence of the observations allows us to illustrate how epidemiology can work. As smoking increased in communities in Western Europe and North America so did lung cancer. Within those communities, it seemed to be mainly people who smoked who got lung cancer. Different groups within the society who had different exposure to cigarette smoking had different rates of lung cancer and when particular groups, for instance doctors, reduced their smoking, lo and behold, they got less lung cancer. This is a simple statement of a very complicated story and the net result has been to reveal the single most important known cause of human cancer, cigarette smoke. All of these observations were made by studying the patterns of cancer within communities, although they went extended by experiments in which the important elements of cigarette smoke, particularly ear, were mixed with cells and were shown to be capable of causing cancerous changes. The link between cigarette smoking and lung cancer remains the strongest clearest and most important link in our entire knowledge of cancer, and the one that presents the greatest potential for winning the war against cancer, at least on that front. In other areas, the links between cancer and lifestyle are much less clear, but they may turn out to be even more important; they certainly require very careful study.
In this chapter we are going to explain how a researcher can work on these problems, how certain of the observations he makes may be very compelling and also what the pitfalls and uncertainties may be. This will provide the basis for discussing each of the important potential causes of cancer, one by one, in ensuing chapters. The values and the limitations of epidemiology are an extremely complex topic and are frequently only well understood by people who are deeply immersed in the subject professionally. Misunderstandings about the strengths and weaknesses of this science have generated considerable confusion among the general public and also among healthcare professionals, and it is worth spending some time looking at how the suggestions of epidemiology are studied and evaluated, how they become more certain and how they may well remain unproven despite many years of careful work.


Posted by admin under Anti-Infectives

Evaluation of the febrile traveler should include careful documentation of the associated symptoms and signs, since these can help guide the clinician toward the correct diagnosis. The mode of onset of the illness (acute versus gradual) and the precise sequence of symptoms should also be ascertained.
A thorough physical examination must also be performed to elicit additional clues.

Vitals Signs
Although rarely diagnostic, determination of a fever pattern may be helpful. Several fever patterns have been identified. However, it is logistically difficult to obtain accurately recorded temperatures, and the administration of antipyretics interferes with this task. In particular, although fevers every 48 to 72 hours are typical of malaria, these characteristic cyclical fevers are rarely seen in travelers, since they are much more likely to occur in a relapse of malaria rather than an initial infection. A pulse rate that is slow for the degree of fever (pulse-temperature dissociation) may suggest typhoid fever or rickettsial infections.

Many febrile patients have a rash that can assist in the diagnosis. A maculopapular rash may be seen with many travel-related infections, notably dengue fever, leptospirosis, and typhus, as well as with acute human immunodeficiency virus and acute hepatitis B. A drug eruption should also be considered in the differential diagnosis of a maculopapular rash. Rose spots, crops of pink macules (2 to 3 mm in diameter) on the chest or abdomen, suggest typhoid fever. An eschar, a black necrotic ulcer with erythematous margins, may be found with many rickettsial diseases. Dengue fever, meningococcemia, Rocky Mountain spotted fever, and viral hemorrhagic fevers may present with petechiae, ecchymoses, or hemorrhagic lesions.

The eyes should be examined for evidence of conjunctivitis (consider leptospirosis) or retinal hemorrhages (consider subacute bacterial endocarditis).

Sinuses, Ears, and Teeth
These are common sites of occult infection, and attention to these areas can help to avoid unnecessary testing for other causes of infections.

Heart and Lungs
Auscultation of the lungs should focus on the detection of inspiratory crackles and wheezes, and auscultation of the heart is performed to evaluate for the presence of a murmur, since subacute bacterial endocarditis is always a major consideration.

The presence of splenomegaly should be determined, since this is associated with a number of diseases, notably mononucleosis, malaria, visceral leishmaniasis, typhoid fever, and brucellosis.

Localized lymphadenopathy may be seen in many infections, and its presence is often less helpful than other signs. Generalized lymphadenopathy, however, has a more limited differential diagnosis, and this finding may be more useful.


Posted by admin under Cardio & Blood-Cholesterol

Congenital heart disease refers to defects of the heart that are present at birth. About 6 to 8 babies out of every 1,000 who are born alive have a congenital heart defect.
When you consider that 3 weeks after conception the heart consists of a tiny tube that folds, fuses, excavates, and molds itself so that all of its basic structures are present by the eighth week of development, it is more amazing that things turn out right as often as they do.
If your child has a congenital heart defect, you probably have many questions. What exactly is wrong? How did it happen? How will it affect your child’s life? What can be done about it? Your doctor will answer these questions specifically as they relate to your family, but this section provides a general background to help you understand the information.


Posted by admin under Anti-Infectives

Pre-travel immunizations and chemoprophylaxis taken during travel must be determined, since these will influence the probability of acquiring infections. These interventions vary in efficacy. The proper administration of vaccines against hepatitis A, hepatitis B, and yellow fever effectively rules out each of these infections as a cause of a patient’s illness. However, vaccines against typhoid fever or use of immunoglobulin for the prevention of hepatitis A is only 70% to 80% effective, so these infections should still be considered among patients who have been immunized. Childhood immunizations against diseases such as polio, diphtheria, and measles may not provide adequate protection in adults unless a booster has been administered or natural disease reported. Immigrants from developing countries may not have received routine immunizations.
For travelers to malaria-endemic areas, the use of personal protective measures (insect repellents, bed nets) and chemoprophylaxis must be assessed. Note that no antimalarial chemoprophylactic regimen is completely protective. Furthermore, poor compliance with antimalarials among travelers is a well-documented cause of failure.
The health of the patient prior to travel is also of importance. The presence of underlying medical conditions (cardiopulmonary diseases, immunosuppression, asplenia) may increase susceptibility to various infections. Knowledge of the medications taken for treatment of a patient’s illness prior to and during travel is also essential, since these may alter the presentation of certain diseases.


Posted by admin under Anti Depressants-Sleeping Aid

Up to now the sleep disorders we have examined are those involving disruptions in the physiological process of falling asleep or maintaining sleep and those involving the daytime consequences of disturbed sleep. At this point let’s turn our attention to phenomena that are not directly related to malfunctions of the sleep process itself but can interfere with, or are exacerbated by, sleep. Such disorders, some of which affect children almost exclusively, are given the name “parasomnias,” a word that translates roughly as “events associated with sleep.” Parasomnias account for nearly one out of ten diagnoses of sleep disorders.
Parasomnias are disorders involving unwanted or abnormal events, including sleepwalking, bed-wetting, and behaviors such as teeth grinding or head banging. (While nightmares and the panic disorder known as night terrors are also forms of parasomnia. A patient with a parasomnia will usually complain about the problem itself— bed-wetting, for example—rather than about the disturbed sleep the problem is causing.
Generally speaking, the cluster of parasomnia disorders tends to occur at the threshold between wakefulness and sleep, or during deep sleep—Stages 3 and 4 of the sleep cycle. And, because the longest periods of deep sleep occur in the first part of the cycle, most parasomnia events tend to take place early in the night, usually about an hour after the onset of sleep. I use the term “cluster” because often more than one form of the disorder afflicts the same person. For example, the same problem that is manifested as sleepwalking may also be the underlying cause of bed-wetting.


Posted by admin under Asthma

Stinging insects such as bee, wasp and hornet produce an immediate allergic reaction. This may vary from redness and swelling at the site to redness of the whole part, or even generalized swelling, urticaria, choking, difficulty in breathing, unconsciousness and death. Honey Bee
Those who have hay fever, eczema, asthma and drug reaction are more liable to get different grades of severe reactions to stinging insects. Diagnosis can be made easily from the history of the child.
The best prophylactic is to avoid a situation where one can be stung by insects, and to keep the body well covered while moving outdoors specially in fields and gardens. As soon as a child is stung, the sting should be removed from the site with a pin or needle without rubbing it in. If the sting is on a limb, a tourniquet i.e., an appliance for compressing the blood vessels, should be tied tightly just above the site of the sting. This will prevent the spread of the venom in the whole body. The tourniquet should be loosened a bit at periodic intervals of about five minutes and then removed after about half an hour. If possible and available, an ice-pack should be applied to the area of sting. An antihistamine tablet can also be given.
If a child with history of allergic reaction is bitten by an insect, the child should be rushed to the nearest doctor or hospital, where appropriate treatment would be administered.
Hyposensitization against the sting venom of different insects is practised now-a-days with very good results.


Posted by admin under Weight Loss

Eat at least three servings of fruit each day. A serving of fruit is one medium-size piece (visualize the size of a baseball) or one cup of cut-up fruit. The research about tricking your stomach into feeling full, which I just discussed with respect to vegetables, applies to fruits as well. Once again, this occurs because fruits are rich in fiber and water. Also, think as “bright” as you can when choosing fruits and definitely go with seasonal fruits when possible. If you stay in season, the cost of fresh fruit is affordable, if not a bargain.
It is so easy to include three servings of fruit if you try the following:
•    Start your day with a piece of fruit. Regardless of what you may decide upon for your entire breakfast, be sure to include one piece of fruit. This is doable even if you are on the go, since apples and pears are easy to carry and eat, as are bananas (though I want you to eat only two bananas each week, because they are lower in water than most other fruits). You may decide to eat fresh fruit with low-calorie yogurt on top for breakfast. That way, you get protein and calcium from the yogurt and a serving of fruit. You’ve just created a winning strategy to lose weight.
•     Add some fruit to your favorite cereal. When I was little, I always wanted to have perfect strawberries fall on top of my cereal like they did on the cornflakes commercial. Those of you over thirty-five must remember that visual (how they kept the milk in the bowl I will never know). So start with a portion-controlled serving of cereal, some skim milk, and fresh berries on top. Once again, you get protein and calcium from the skim milk and a serving of fruit.
•    Make fruit a snack. A friend shared this trick: Place fresh seedless grapes in the freezer and eat them as snacks or treats. Red or green grapes are both approximately 5 calories each for an average size. You have no idea how great they are when they are frozen. They taste like a major treat and give you a little crunch. Same goes for blueberries. Give it a try.


Posted by admin under Skin Care

Even leaning your cheek on your hand too often can cause wrinkles.
For openers: Moisturize! Moisturization is essential to maintaining young-looking skin and staving off wrinkles. The best time to do it is after bathing or washing. You want the skin to absorb the water and then seal it in with oil or some other lubricant.
Most dermatologists recommend not adding bath oil to your tub immediately, but waiting until you’ve soaked for at least fifteen minutes, if you want your skin to benefit.
Supplements of vitamin C, 1,000 mg. and pantothenic acid, 1,000 mg. daily can help stave off wrinkles.
Keeping your body supplied with vitamin С will keep collagen – which is responsible for the stability and strength of practically all bodily tissues, including the skin – strong and elastic.
Vitamins A, B complex, fatty acids, and minerals are also important.
To reduce and prevent wrinkles, avoid your skin’s enemies and try not to stretch your facial skin by both gaining and losing weight rapidly, frowning or squinting, or even leaning your cheek on your hand too often.


Posted by admin under Men's Health-Erectile Dysfunction

The next structure below the clitoris is the urethral orifice or opening. This opening is sometimes difficult to locate because it is relatively small; a mirror is useful to help locate the urethral opening. This structure is the least important in terms of sexual functioning. Some women like stimulation of the area around this opening; others find it irritating. It is not a good idea to insert any objects (other than for bona fide medical purposes) into this opening.
On either side of the urethral opening is a tiny (not always visible) opening to a duct which leads to the Skene’s glands. These are small vestigial structures (homologously related to the male prostate gland; see Chapter 6), which may occasionally become infected.
The glands on either side of the vaginal opening are the Bartholin’s glands. Before Masters and Johnson demonstrated the self-lubricating property of the vagina (Masters and Johnson, 1966), it was believed that these glands produced the lubrication present during sexual arousal. While they do secrete a drop or two of fluid during excitement, the major portion of vaginal lubrication is produced within the vagina itself. Bartholin’s glands can become infected or form cysts; pain in this area, indicative of these conditions, should receive medical attention.
The area of skin and muscle between the vagina and the anus is called the perineum and, as previously stated, has the potential for sexual stimulation in some individuals.

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