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Category : All ; Cycle : May 2010
Medical Articles
May18
Bleeding per rectum
Paasage of a few drops per rectum is a very common symptom. people do not get alarmed seeing blood in the toilet pan as much as they do when they see blood in the wash basin. But the problem is not that simple.

Majority of the times a few drops of blood in the toilet is not a grave thing to worry about. But this symptom shouldnt be ignored either.

The commonest cause of bleeding per rectum is piles(haemorrhoids) or fissure in ano. The difference between these two is quite obvious. If there is pain while passing motion it is quite often a fissure causing the trouble. Piles do not generally pain. A small skin tag which is felt at the anus is generally mistaken for piles . This tag is called the sentinel pile seen in pts with fissure in ano.
Rare causes of bleeding per rectum may be ulcerative colitis, non-specific colitis and rarely cancer of the rectum.
Most of the piles and fissures do not require any active treatment. If the problem is very persistent and troublesome surgery becomes necessary which is a fairly simple one. One should avoid getting theirs anal problems by quacks and self styled medical men.

Cancer of rectum should always be ruled out in every patient with bleeding per rectum and hence this symptom should not be ignored and allopathy is the ideal choice of treament


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May16
VOMITING BLOOD,COMMON QUESTIONS AT DOCTOR'S OFFICE
QUESTIONS TO EXPECT,
WHEN DID THE VOMITING BEGIN?HAVE YOU EVER VOMITED BLOOD BEFORE?HOW MUCH BLOOD WAS IN THE VOMIT?APPROX)CLOTTED OR FRESH BLOOD?
WHAT COLOUR WAS THE BLOOD?BRIGHT RED ,LIGHT OR DARK COFFEE GROUND?
HAVE YOU HAD ANY NOSE BLEEDS,RECENT ENT ,GI SURGERIES,DENTAL WORK UP,VOMITING,STOMACH PROBLEMS,OR EXCESSIVE COUGHING?
WHAT OTHER SYMPTOMS DO YOU HAVE?
WHAT MEDICAL CONDITIONS DO YOU HAVE?
WHAT MEDICATIONS DO YOU TAKE?
DO YOU DRINK ALCHOHOL OR SMOKE?
ANY HISTORY OF LIVER DISEASE OR EXCESSIVE BLEEDING PROBLEMS.


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May15
Vomiting of blood
Vomiting of blood called as haemetemsis in medical jargon is different from Haemoptysis - coughing out blood. Quite often patients cannot differentiate between the two and undergo un-necessary investgations. Rarely bleeding gums may confuse the issue.

Haemetemesis is a serious complaint. Although 90 out of 100 patients with haemetemsis may settle down without any active treatment, all patients with haemetemesis need to see a doctor and get investigated.

A bleeding ulcer in the stomach is the commonest cause of upper GI bleeding. Ulcer disease or ulcers caused by swallowing pain killers maybe the cause. When bleeding is due to liver disease it can grave.

Rarely bleeding can be so massive requiring hospitalisation, blood transfusions, endoscopy and treatment. Very rarely life-saving emergency operation may be required to stop the bleeding.

So vomiting of blood is an ominous symptom and should never be ignored and is mandatory to see a gastroenterologist at the earliest.


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May13
Fast track surgery
The art and science of surgery has evolved and refined tremendously in recent years. We practice fast track surgery these days. Many minor to moderate surgical procedures are done as a day care without the patient staying overnoght in the hospital.
Incisions have become smaller and hence the pain is less and the need for analgesics and sedation has come down. Patients are allowed to take oral fluids / feeds at the earliest usually hours after completion of even major abdominal surgery.
Tubes through nose , drains pipes from the abdomen and other cavities are removed much earlier than they used to be.
All this leads to early return to normal activity and more than that reduces expenditure and costs dratically. So if one is in the need of a surgical procedure - he should choose a centre where these fast-track practises are followed.


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May13
risk factors for breast cancer
What causes breast cancer?
It is not clear exactly what causes breast cancer , but many factors can slightly increase a woman’s risk of developing breast cancer.

!. The risk of breast cancer increases with age.
2,. Family history of breast cancer. About 5-10% of all breast cancers are thought to be caused by inherited cancer genes. Two breast cancer genes have been identified (BRCA 1 and BRCA 2) and others may be found in the near future. You should see a breast doctor if there are
a. Three close blood relatives from the same side of the family who developed breast cancer at any age,
b. Two close relatives from the same side of the family who developed breast cancer under the age of 60
c. One close relative who developed breast cancer under the age of 40
d. History of male breast cancer in the near family
e. History of cancer in both the breasts .

3. Having had breast cancer on one side increases the risk of developing the cancer on the other side slightly.
4. Having been diagnosed certain type of benign breast disease like atypical ductal hyperplasia or papillomatosis slightly increases the risk of breast cancer.
5. Women who did not have children and who did not breast feed are slightly more at risk.
6. Women who start their period early (before 10 yrs of age) and women who reach menopause (after 50 yrs) are slightly more at risk of breast cancer.
7.Being overweight , particularly after reaching menopause, slightly increases risk of breast cancer.


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May12
Auriculotherapy for DeToX and de-addiction
Background

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear.

Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.

Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear. Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.
Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Proponents claim that auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Technique

During a typical treatment, the practitioner, called an auriculotherapist, takes the complete medical history of the patient. The practitioner often examines the ear for slight variations in coloring, flaking skin, large veins, and other topical irregularities. The ear may also be palpated with the finger or special instruments for patient sensitivity. Treatment focuses on the presenting concern. Sessions may be as brief as 10 minutes or may last as long as an hour. The duration of the therapy varies according to the response of the patient to treatment and the severity of their condition.

A treatment may occur in an individual or group setting. The treatment is usually relatively painless, and some patients fall asleep during treatment.

Auriculotherapy is often combined with somatic acupuncture because of the synergy between the two treatment systems.

Auriculotherapists perform this therapy with a variety of tools, including TENS unit, a laser, press balls, or a magnet. Though a TENS unit involves the insertion of needles into the ear, the needles are not similar to those used for acupuncture. However, both of these practices might use the electrical current of the TENS unit to enhance stimulation of a point. Practitioners might also treat the patient's prescribed ear points with a laser, where the ray of a laser focuses on a particular point on the ear. Or, magnets or press balls may be taped to the auricle with medical tape. Press balls are small seeds, which are typically held against the ear.

Auriculotherapists may also practice bleeding, which is removing a couple drops of blood at certain points of the ear, or electroacupuncture, which is sending small electric currents through the ear or the body, to treat a variety of conditions.

Auriculotherapists must be licensed health care providers, such as an acupuncturist or chiropractor, to put needles into the ear. However, any individual may practice auriculotherapy with lasers, tape magnets, or press balls.

Theory/evidence

Whereas the acupuncture diagnostic and treatment system focuses on paths of energy running through the body, auriculotherapy focuses on connections between the ear, the affected organ(s), and the central nervous system. While ear acupuncture uses needles without an electrical current, auriculotherapy uses a TENS unit or a laser.

The exact mechanism of auriculotherapy's action is unclear, and the efficacy of this therapy is controversial. However, a 1980 study partially designed by contemporary auriculotherapy expert Terry Olsen and published in the journal Pain found a significant correlation between the "inverted fetus" somatotopic map and localized musculoskeletal pain. Auriculotherapy is currently under investigation to treat pain and neurological disturbances.

The capability of reflex points on the external ear to alter neuromuscular and neuropathic disorders has been attributed to the descending pain inhibitory pathways of the central nervous system. The inverted fetus perspective of the somatotopic arrangement of auricular acupuncture points was first described in the 1950s by Dr. Paul Nogier of France, and has received scientific support from double-blind studies examining auricular diagnosis of musculoskeletal and of coronary disorders. Acupuncture points on the ear and on the body have lower levels of electrical skin resistance than surrounding tissue. These electrodermal differences are apparently related to autonomic control of blood vessels rather than increased sweat gland activity. The heightened tenderness of reactive acupuncture points may be explained by the accumulation of noxious, subdermal substances. Electrical stimulation of specific points on the external ear leads to site-specific neural responses in different regions of the brain. Behavioral analgesia produced by auricular acupuncture can be blocked by the opiate antagonist naloxone, indicating the role of endorphinergic systems in understanding the underlying mechanisms of auriculotherapy. The anatomical structures and electrical application of the auricle are described as they relate to the localization of master points, musculoskeletal points, internal organ points, and neuroendocrine points.

The scientific community has not reached a consensus on the efficacy of auriculotherapy. Most trials of this practice are of poor design quality; the results are often difficult to analyze. Based on one randomized, controlled trial, auriculotherapy appears to have no effect for the treatment of cervical myofascial pain. In this study, somatic acupuncture was used together with auriculotherapy, and although both somatic acupuncture alone and the combined technique had positive effects in reducing pain, there was no significant difference between the two groups, indicating that auriculotherapy did not have any strong additive effects.
A study that tested auriculotherapy as an aid for smoking cessation found that after two months of treatment, 15 people (38.5%) had stopped completely and 24 people had reduced their smoking by more than half. Details of this study are unclear, and more research is needed to confirm these findings.

Safety

Caution is advised in pregnant women. Acupuncture somatotopic systems strictly prohibit the needling of some points in pregnant women, because they theoretically move vital essences and might induce a miscarriage.
Some patients may become lightheaded during treatment.


Bibliography
Auriculotherapy.com. www.auriculotherapy.com. Last accessed May 30, 2006.
Auriculotherapy Training Institute. www.auriculotherapy.org. Last accessed October 4, 2007.
Ceccherelli F, Tortora P, Nassimbeni C, et al. The therapeutic efficacy of somatic acupuncture is not increased by auriculotherapy: a randomized, blind control study in cervical myofascial pain. Complement Ther Med. 2006 Mar;14(1):47-52.
Electrotherapy Association. www.electrotherapy.com. Last accessed October 4, 2007.
King CE, Clelland JA, Knowles CJ, et al. Effect of helium-neon laser auriculotherapy on experimental pain threshold. Phys Ther. 1990 Jan;70(1):24-30.
Oleson T. Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation. 2002;17(1):49-62.
Oleson TD, Kroening RJ, Bresler DE. An experimental evaluation of auricular diagnosis: the somatotopic mapping or musculoskeletal pain at ear acupuncture points. Pain. 1980 Apr;8(2):217-29
Oleson, T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture. London: Churchill Livingstone. 2002.


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May12
problems with mammogram
Problems with breast screening

• Breast screening does not prevent cancer. It only detects it early.
• Many women find mammograms uncomfortable or painful, but this is normally just for a short time.
• Having mammograms involves radiation. Mammograms done with current good machines, only give a very low amount of radiation. The radiation dose given by breast screening x rays is continually monitored to make sure that it remains as low as possible, while still providing a good quality image.
• Mammograms require special machines , films and skills in reading and reporting the x rays. Unfortunately, these facilities are not available with a uniform standard in our country. Poor quality mammograms, and lack of specialist skills can miss cancer and give a false sense of reassurance.
• Sometimes mammograms will show an abnormal area which will need further tests but often further tests show that the abnormality is not a cancer and this can be very worrying.


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May12
Diet after abdominal surgery
The commonest question patients ask after any surgery i(which ncludes toe-nail removal ) is about foods they need to avoid? Food is such an important player in an Indian's daily life and also has medical relevance as far as Ayurvedic , unani and other indigenous medical treatments are concerned, one shouldnt be surprised by such a question.
For most abdominal surgeries like appendicectomy, cholecystectomy (removal of gall bladder), Hysterectomy(removal of uterus), Caserean section etc there is no restriction on any diet. Patients can be on a normal diet 2nd or 3rd day after surgery. Avoiding Dal to avoid pus is a myth. Avoiding fatty foods after gall bladder removal is again a myth. Severe dietary restriction after a delivering a baby is absolutely meaningless. So please donot listen to neighbours or family memebers advice on dietary restrictions after surgery. It is always good to avoid oily and spicy food in general whether you had an operation or not.


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May11
What is a mammogram ?
X-ray of the breast is called a mammogram. This is usally done in women over 40 to screen for any abnormalities in the breasts. Not all abnormalities are cancerous. However if there are any suspicious lesions are seen on a mammogram by a specialist, further tests such as a biopsy needs to be done.
It is important that the mammogram is done technically well and should be interpreted by a specialist. Mammograms are better done after the periods as the breasts are less tender and talcum powder should be avoided on the day of test.
The modern full field digital mammograms offer several advantages over the conventional film based ones.
If you are over forty please get a mammogram done. You will lose nothing and as the saying goes ' early detection of anything ominous will save your life'


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May10
STRESS AND TRUE SELF
STRESS
AND
TRUE SELF



DR.
SHRINIWAS
KASHALIKAR

The study of stress leads to many questions.

One of them is; “What is true self?”

It is true that most of the experiences of life (including the questions in our mind); are determined by our cognition, affect and conation; which in turn are produced by the physiological processes described (and not described) in physiology and other the literature.

The physical pain and pleasure, the instinctual deprivation and fulfillment, the emotional sadness and happiness, the intellectual confusion and clarity; and the subsequent behavior; constitute individual life and that is “individual self”. This individual self veils the “true self”, which “is” there; but not restricted by individual limitations and “is” beyond the purview of individual life and three dimensions.

As and when; one begins the practice of NAMASMARAN; the veils of individual self become rarefied and the true self (which “is” already there) surfaces. When the “true self” thus surfaces or manifests; the cognition, affect and conation begin to rise above the limitations of individual physiology; and one’s cognition, affect and conation begin to be universal. The universal phenomena (the sickness and health of the billions i.e. universal or cosmic self) begin to determine the cognition, affect and conation, of “somebody”! That “somebody” is referred to as “cosmic self”, “God”, PARAMATMA and “is” “true self”, which is universal, immortal and destination; of every thing in universe; or in other words; everything in the universe is contingent in it.

The surfacing or manifestation of the true self is inevitably associated with actual ushering of cosmic homeostasis through the universal (holistic) perspective, policies, plans, programs and implementation!

This transition of individual self to merger with true self is also inevitable and contingent in the true self.

This transition can be “quick or slow” in accordance with the degree of ignorance, apathy, indolence and fossilization of the individual self.

Having said this much it has to be appreciated that Veda has declared that the true self is beyond description, by the words “Neti, neti” i.e. “indescribable”, but every seer has affirmed that it is realizable, through the practice of NAMASMARAN and SWADHARMA i.e. participation in SUPERLIVING.


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