Tuesday, September 26

About Haemorrhoids


Haemorrhoids are swollen veins in the anus or lower part of the rectum.

Causes of Haemorrhoids

Haemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy, childbirth, and due to constipation. The pressure causes the normal anal veins and tissue to swell. This tissue can bleed, often during bowel movements.

Haemorrhoids may be caused by:

• Straining during bowel movements
• Constipation
• Sitting for long periods of time, especially on the toilet
• Certain diseases, such as liver cirrhosis

Haemorrhoids may be inside or outside the body.

• Internal haemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large they may fall outside (prolapse). The most common problem with internal haemorrhoids is bleeding during bowel movements.
• External haemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external haemorrhoid).
4 Grades of Internal Hemorrhoids
4 Grades of Internal Hemorrhoids
Symptoms of Haemorrhoids

Haemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.

Common symptoms include:

• Painless bright red blood from the rectum
• Anal itching
• Anal ache or pain, especially while sitting
• Pain during bowel movements
• One or more hard tender lumps near the anus

Exams and Tests

Most of the time, a health care provider can often diagnose haemorrhoids simply looking at the rectal area. External haemorrhoids can often be detected this way.

Tests that may help diagnose the problem include:

• Rectal exam
• Sigmoidoscopy
• Anoscopy

Treatment of Haemorrhoids
Haemorrhoids: Surgical Methods of Treatment
Haemorrhoids: Surgical Methods of Treatment
Treatments for haemorrhoids include:

• Over-the-counter corticosteroid (for example, cortisone) creams to help reduce pain and swelling
• Haemorrhoid creams with lidocaine to help reduce pain
• Stool softeners help reduce straining and constipation

Things you can do to reduce itching include:

• Apply witch hazel to the area with a cotton swab.
• Wear cotton underwear.
• Avoid toilet tissue with perfumes or colors. Use baby wipes instead.
• Try not to scratch the area.

Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

If your haemorrhoids do not get better with home treatments, you may need some type of office treatment to shrink the haemorrhoids.
Haemorrhoid Banding
Haemorrhoid Banding
If office treatment is not enough, some type of surgery may be necessary, such as removal of the haemorrhoids (haemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.

Possible Complications

The blood in the haemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove haemorrhoids with clots.

Rarely, severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss.

When to Contact a Medical Professional

Call for your health care provider if:

• Haemorrhoid symptoms do not improve with home treatment.
• You have rectal bleeding. Your provider may want to check for other, more serious causes of the bleeding.
Understanding Haemorrhoids
Understanding Haemorrhoids
Get medical help right away if:

• You lose a lot of blood
• You are bleeding and feel dizzy, lightheaded, or faint

Prevention of Haemorrhoids

Constipation, straining during bowel movements, and sitting on the toilet too long raise your risk for haemorrhoids. To prevent constipation and haemorrhoids, you should:

• Drink plenty of fluids.
• Eat a high-fiber diet of fruits, vegetables, and whole grains.
• Consider using fiber supplements.
• Use stool softeners to prevent straining.
Read More »

Friday, September 22

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This can irritate the esophagus and cause heartburn and other symptoms.

Causes Of Gastroesophageal Reflux Disease

When you eat, food passes from the throat to the stomach through the esophagus. A ring of muscle fibers in the lower esophagus prevents swallowed food from moving back up. These muscle fibers are called the lower esophageal sphincter (LES).

When this ring of muscle does not close all the way, stomach contents can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can also damage the lining of the esophagus.

The risk factors for reflux include:

• Use of alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking

Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy. Symptoms can also be caused by certain medicines, such as:

• Anticholinergics (for example, seasickness medicine)
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants

Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking a medicine without first talking to your provider.

Symptoms of  Gastroesophageal Reflux Disease

Common symptoms of GERD include:

• Feeling that food is stuck behind the breastbone
• Heartburn or a burning pain in the chest
• Nausea after eating

Less common symptoms are:

• Bringing food back up (regurgitation)
• Cough or wheezing
• Difficulty swallowing
• Hiccups
• Hoarseness or change in voice
• Sore throat

Symptoms may get worse when you bend over or lie down, or after you eat. Symptoms may also be worse at night.

Exams and Tests

You may not need any tests if your symptoms are mild.

If your symptoms are severe or they come back after you have been treated, your doctor may perform a test called an upper endoscopy (EGD).

• This is a test to examine the lining of the esophagus (the tube that connects your throat to your stomach), stomach, and first part of the small intestine.
• It is done with a small camera (flexible endoscope) that is inserted down the throat.

You may also need 1 or more of the following tests:

• A test that measures how often stomach acid enters the tube that leads from the mouth to the stomach (called the esophagus)
• A test to measure the pressure inside the lower part of the esophagus (esophageal manometry)

A positive stool occult blood test may diagnose bleeding that is coming from the irritation in the esophagus, stomach, or intestines.


You can make many lifestyle changes to help treat your symptoms.

Other tips include:

• If you are overweight or obese, in many cases, losing weight can help.
• Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain.
• Take all of your medicines with plenty of water. When your doctor gives you a new medicine, ask whether it will make your heartburn worse.

You may use over-the-counter antacids after meals and at bedtime, although the relief may not last very long. Common side effects of antacids include diarrhea or constipation.

Other over-the-counter and prescription drugs can treat GERD. They work more slowly than antacids, but give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs.

• Proton pump inhibitors (PPIs) decrease the amount of acid produced in your stomach
• H2 blockers also lower the amount of acid released in the stomach

Anti-reflux surgery may be an option for people whose symptoms do not go away with lifestyle changes and medicines. Heartburn and other symptoms should improve after surgery. But you may still need to take drugs for your heartburn.

There are also new therapies for reflux that can be performed through an endoscope (a flexible tube passed through the mouth into the stomach).

Outlook (Prognosis)

Most people respond to lifestyle changes and medicines. However, many people need to continue taking medicines to control their symptoms.
Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease
Possible Complications

Complications may include:

• Worsening of asthma
• A change in the lining of the esophagus that can increase the risk of cancer (Barrett esophagus)
• Bronchospasm (irritation and spasm of the airways due to acid)
• Chronic cough or hoarseness
• Dental problems
• Ulcer in the esophagus
• Stricture (a narrowing of the esophagus due to scarring)

When to Contact a Medical Professional

Call your health care provider if symptoms do not improve with lifestyle changes or medicine.

Also call if you have:

• Bleeding
• Choking (coughing, shortness of breath)
• Feeling filled up quickly when eating
• Frequent vomiting
• Hoarseness
• Loss of appetite
• Trouble swallowing (dysphagia) or pain with swallowing (odynophagia)
• Weight loss


Following heartburn prevention techniques may help prevent symptoms. Obesity is linked to GERD, so maintaining a healthy body weight may help prevent the condition.
Read More »

Thursday, September 21

Influenza And Your Baby

Influenza And Your Baby

Influenza (or Flu) is an easily spread infectious disease. Children under age 2 have a higher risk of developing complications if they get the flu.

The information in this article has been put together to help you protect children under age 2 from the flu. This is not a substitute for medical advice from your health care provider. If you think your baby may have the flu, you should contact a health care provider right away.

Flu Symptoms In Infants And Toddlers

Influenza or the flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby's health care provider if you notice any of the following signs:

• Acting tired and cranky much of the time and not feeding well
• Cough
• Diarrhea and vomiting
• Has a fever or feels feverish (if no thermometer available)
• Runny nose

How is the flu treated in Babies?

Children younger than 2 years old will often need to be treated with medicine that fights off the flu virus. This is called antiviral medicine. The medicine works best if started within 48 hours after symptoms begin, if possible.

Oseltamivir (Tamiflu) in liquid form will likely be used. Although this drug is not approved for use in children younger than 1 year of age, serious side effects are quite rare. After talking about the risk of side effects against the possible complications of the flu in your baby, you and your health care provider may decide to use this medicine to treat the flu.

Paracetamol, Ibuprofen or Acetaminophen (Tylenol) help lower fever in children. Sometimes, your health care provider will tell you to use both types of medicine.

Always check with your health care provider before giving any cold medicines to your infant or toddler.

Should My Baby Get The Flu Vaccine?

All infants 6 months or older should get the flu vaccine, even if they have had a flu-like illness. The flu vaccine is not approved for children under 6 months old.

• Your child will need a second flu vaccine around 4 weeks after receiving the vaccine for the first time.
• There are two types of flu vaccine. One is given as a shot, and the other is sprayed into your child's nose.
A Baby Receiving The Flu Shot
A Baby Receiving The Flu Shot
The flu shot contains killed (inactive) viruses. It is not possible to get the flu from this type of vaccine. The flu shot is approved for people age 6 months and older.

A nasal spray-type flu vaccine uses a live, weakened virus instead of a dead one like the flu shot. It is approved for healthy children over 2 years.

Anyone who lives with or has close contact with a child younger than 6 months old should also have a flu shot.

Will The Vaccine Harm My Baby?

You or your baby cannot get flu from vaccine. Some children may get a low-grade fever for a day or two after the shot. If more severe symptoms develop or they last for more than 2 days, you should call your health care provider.

Some parents are afraid the vaccine could hurt their baby. But children under 2 years of age are more likely to get a severe case of the flu. It is hard to predict how ill your child may get from flu because children often have a mild illness at first. They may become sick very fast.

A small amount of mercury (called thimerosal) is a common preservative in multidose vaccines. Despite concerns, thimerosal-containing vaccines have NOT been shown to cause autism, ADHD, or any other medical problems.

However, all of the routine vaccines are also available without added thimerosal. Ask your health care provider if they offer this type of vaccine.

How Can I Prevent My Baby From Getting The Flu?

Anyone who has flu symptoms should not care for a newborn or infant, including feeding. If a person with symptoms must care for the child, the caretaker should use a face mask and wash their hands well. Everyone who comes in close contact with your baby should do the following:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away after using it.
• Wash your hands often with soap and water for 15 to 20 seconds, especially after you cough or sneeze. You may also use alcohol-based hand cleaners.

If your baby is younger than 6 months old and has close contact with someone with the flu, inform your health care provider.

If I Have Flu Symptoms, Can I Breastfeed My Baby?

If a mother is not ill with the flu, breastfeeding is encouraged.

If you are sick, you may need to express your milk for use in bottle feedings given by a healthy person. It is unlikely a newborn can catch flu from drinking your breast milk when you are sick. Breast milk is considered safe if you are taking antivirals.

When Should I Call The Doctor?

Talk to your child's health care provider or go to the emergency room if:

• Your child does not act alert or more comfortable when the fever goes down.
• Fever and flu symptoms come back after they have gone away.
• The child does not have tears when crying.
• The child's diapers are not wet, or the child has not urinated for the last 8 hours.
Read More »

Wednesday, September 20

Blisters, Causes and Treatments

Blister On The Heel
Blister On The Heel
What Are Blisters?

They're bubbles that pop up when fluid collects in pockets under the top layer of your skin. They can be filled with pus, blood, or the clear, watery part of your blood called serum. Most are shaped like circles. Depending on the cause, your blister could itch or hurt a lot or a little. They can appear as a single bubble or in clusters.

Friction Blisters

Friction blisters, named for what causes them, are one of the most common kinds. Think back. Have you ever worn a new pair of hiking boots before you broke them in? Or raked the yard without a pair of garden gloves on your hands? Those are the kinds of things that could cause a friction blister on your heel, toe, thumb, or palm.

Cold and Heat Blisters

Go without gloves in winter and you could get blisters from frostbite. Stay out in the summer sun too long and you might get sunburn. The same thing can happen if you handle frozen goods or touch the stove burner. Both cold and heat are described as “blistering” for good reason: Extreme temperatures can hurt your skin. Blisters are a sign of a type of second-degree burn called partial thickness.

Contact Dermatitis

Rub up against a pesky plant like poison ivy, and you might end up with blisters of another sort. They're often a symptom of contact dermatitis, which happens when you touch something you're allergic to. It doesn't have to be poisonous, though. Some people react to soap, perfume, detergent, fabric, jewelry, latex gloves, or things used to make tools, toys, or other everyday objects.
Bed Bug Bites
Bed Bug Bites
Blisters Caused By Bug Bites

Insects can take the blame for some itchy blisters. Scabies are tiny mites that drill into your skin, sometimes leaving curved lines of blisters in their tracks. They often attack the hands, feet, wrists, and under the arms. Flea and bedbug bites can cause little blisters, too. The brown recluse spider has an extra-nasty bite that blisters before bursting to form a painful open sore. If that describes your blister, go to the doctor right away.

Herpes Simplex Blisters

Fever blisters on your lips, mouth, or genitals are a sign of the herpes simplex virus. The fluid in these sores carries and spreads the virus through sex, or by kissing or sharing utensils. Many people don't know they have herpes because symptoms are usually mild. If you have fever blisters or you think you've been exposed to herpes, talk to your doctor. There's no cure, but certain drugs can prevent or shorten outbreaks.
Shingles And Chicken Pox
Shingles And Chicken Pox
Chickenpox & Shingles Blisters

Some viruses can cause blisters. The herpes virus is a common culprit. It's present in chickenpox, a contagious illness that starts with red bumps that become blisters and then scab over. If you've had chickenpox, you also can get shingles, which targets nerves and causes a painful rash with blisters. The CDC says people 60 and older should get a one-time vaccination to prevent shingles. It also recommends two doses of chickenpox vaccine for anyone who hasn't had the disease.

Hand-Foot-and-Mouth Disease

This disease is named after the blisters it causes on these body parts. The infection mostly hits kids younger than 10. The virus spreads through contact with mucus, saliva, feces, or blisters of someone who's already sick. The infection starts out with a mild fever, runny nose, and sore throat. But the blisters are the big clue that leads to a diagnosis.

Keep It Clean and Dry

Some blisters get better on their own. Your skin absorbs the fluid, and the blister flattens and peels off. Until that happens, you can use a donut-shaped piece of moleskin padding or tape to help keep it from breaking open.

Don't Pop if You Don't Have To

Resist the urge to pop a blister unless it's so large - bigger than a nickel - or painful that you can't get around. If that's the case, your doctor might decide to puncture it with a sterile needle to let the fluid drain out. Once it's popped, whether your doctor does it or it breaks on its own, gently wash the area with soap and water and apply antibiotic ointment. Cover it with a bandage to keep it clean during the day, but take the bandage off at night to let it dry

When to See Your Doctor

Go to the doctor if you have a fever, chills, or other flu-like symptoms at the same time you have blisters. You could have a virus or an infection. Other symptoms of infection can include: pain, swelling, redness or warmth, red streaks leading away from your blister, or pus coming from it. Blisters around your eyes or on your genitals are also cause for concern.
Read More »

Preeclampsia Causes, Symptoms and Treatment

Preeclampsia Classic Triad
Preeclampsia Classic Triad
Preeclampsia is when a pregnant woman develops high blood pressure, edema and protein in the urine after the 20th week of pregnancy.

Causes of Preeclampsia

The exact cause of preeclampsia is unknown. It occurs in about 3% to 7% of all pregnancies.

• Autoimmune disorders
• Blood vessel problems
• Your diet
• Your genes

Risk factors include:

• First pregnancy
• Past history of preeclampsia
• Multiple pregnancy (twins or more)
• Family history of preeclampsia
• Obesity
• Being older than age 35
• History of diabetes, high blood pressure, or kidney disease

Symptoms of Preeclampsia

Often, women who have preeclampsia do not feel sick.

Symptoms of preeclampsia can include:

• Swelling of the hands and face or eyes (edema)
• Sudden weight gain over 1 to 2 days or more than 2 pounds (0.9 kg) a week

Note: Some swelling of the feet and ankles is considered normal during pregnancy.

Symptoms of severe preeclampsia include:

• Headache that does not go away
• Trouble breathing
• Belly pain on the right side, below the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus, or kicking by the baby
• Decreased urine output, not urinating very often
• Nausea and vomiting (a worrisome sign)
• Vision changes, including temporary blindness, seeing flashing lights or spots, sensitivity to light, and blurry vision.

Raised Blood Pressure and Protein in the Urine in Pre-eclampsia

Exams and Tests

The health care provider will do a physical exam. This may show:

• High blood pressure, often higher than 140/90 mm/Hg
• Swelling in the hands and face
• Weight gain

Pre-eclampsia Video - Shows how pre-eclampsia can affect the baby.

Blood and urine tests will be done. This may show:

• Protein in the urine (proteinuria)
• Higher-than-normal liver enzymes
• Platelet count that is low

Tests will also be done to:

• See how well your blood clots
• Monitor the baby's health

The results of a pregnancy ultrasound, non-stress test, and other tests will help your provider decide whether your baby needs to be delivered right away.

Women who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure need to be watched closely for other signs of preeclampsia.

Treatment of Preeclampsia

The only way to cure preeclampsia is to deliver the baby.

Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb

As a result, your provider may want your baby to be delivered so the preeclampsia does not get worse. You may get medicines to help trigger labor, or you may need a C-section.

If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has matured. The provider will recommend:

• Bed rest, and lying on your left side most or all of the time
• Drinking plenty of water
• Eating less salt
• Frequent doctor visits to make sure you and your baby are doing well
• Medicines to lower your blood pressure (sometimes)
• Sometimes, a pregnant woman with preeclampsia is admitted to the hospital. This allows the health care team to watch the baby and mother more closely.

Treatment in the hospital may include:

• Close monitoring of the mother and baby
• Medicines to control blood pressure and prevent seizures and other complications
• Steroid injections for pregnancies under 34 weeks gestation to help speed up the development of the baby's lungs

You and your provider will continue to discuss the safest time to deliver your baby, considering:

• How close you are to your due date
• The severity of the preeclampsia: preeclampsia has many severe complications that can harm the mother
• How well the baby is doing in the womb

The baby must be delivered if there are signs of severe preeclampsia. These include:

• Tests that show your baby is not growing well or is not getting enough blood and oxygen
• The bottom number of your blood pressure is over 110 mmHg or is greater than 100 mmHg consistently over a 24-hour period
• Abnormal liver function test results
• Severe headaches
• Pain in the belly area (abdomen)
• Seizures or changes in mental function (eclampsia)
• Fluid buildup in the mother's lungs
• HELLP syndrome (rare)
• Low platelet count or bleeding
• Low urine output, a lot of protein in the urine, and other signs that your kidneys are not working properly

Outlook (Prognosis) of Preeclampsia

Sign and symptoms of preeclampsia most often go away within 6 weeks after delivery. However, the high blood pressure sometimes gets worse the first few days after delivery.

If you have had preeclampsia, you are more likely to develop it again during another pregnancy. In most cases, it is not as severe as the first time.

If you have high blood pressure during more than one pregnancy, you are more likely to have high blood pressure when you get older.

Possible Complications of Preeclampsia

Rare but severe immediate complications for the mother can include:

• Bleeding problems
• Seizure (eclampsia)
• Fetal growth retardation
• Premature separation of the placenta from the uterus before the baby is born
• Rupture of the liver
• Stroke
• Death (rarely)

Having a history of preeclampsia makes a woman a higher risk for future problems such as:

• Heart disease
• Diabetes
• Kidney disease
• When to Contact a Medical Professional
• Call your provider if you have symptoms of preeclampsia during your pregnancy.

Prevention of Preeclampsia

There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy.

Alternative Names for Preeclampsia

Toxemia; Pregnancy-induced hypertension (PIH); Gestational hypertension; High blood pressure - preeclampsia
Read More »

Tuesday, September 19

Malnutrition Causes, Symptoms and Treatment

Malnutrition Causes, Symptoms and Treatment

Malnutrition is the condition that occurs when your body does not get enough nutrients.

Malnutrition Causes

There are many types of malnutrition, and they have different causes. Some causes include:
• Poor diet
• Starvation due to food not being available
• Eating disorders
• Problems with digesting food or absorbing nutrients from food
• Certain medical conditions that make a person unable to eat
You may develop malnutrition if you lack a single vitamin in your diet. Lacking a vitamin or other nutrient is called a deficiency.

Sometimes malnutrition is very mild and causes no symptoms. Other times it can be so severe that the damage it does to the body is permanent, even though you survive.
Malnutrition Causes, Symptoms and Treatment

Poverty, natural disasters, political problems, and war can all contribute to malnutrition and starvation, and not just in developing countries.

Some health conditions that are related to malnutrition are:

• Malabsorption
• Hunger
• Beriberi
• Binge eating
• Deficiency - Vitamin A
• Deficiency - Vitamin B1 (thiamine)
• Deficiency - Vitamin B2 (riboflavin)
• Deficiency - Vitamin B6 (pyridoxine)
• Deficiency - Vitamin B9 (folacin)
• Deficiency - Vitamin E
• Deficiency - Vitamin K
• Eating disorders
• Kwashiorkor
• Megaloblastic anemia
• Pellagra
• Rickets
• Scurvy
• Spina bifida
Malnutrition is a significant problem all over the world
Malnutrition is a significant problem all over the world
Malnutrition is a significant problem all over the world, especially among children. It is very harmful to children because it affects brain development and other growth. Children who suffer from malnutrition may have lifelong problems.

Symptoms of Malnutrition

Symptoms of malnutrition vary and depend on its cause. General symptoms include fatigue, dizziness, and weight loss.

Exams and Tests

Testing depends on the specific disorder. Most health care providers will do a nutritional assessment and blood work.

Treatment of Malnutirtion

Treatment most often consists of:
• Replacing missing nutrients
• Treating symptoms as needed
• Treating any underlying medical condition
Outlook (Prognosis)

The outlook depends on the cause of the malnutrition. Most nutritional deficiencies can be corrected. However, if malnutrition is caused by a medical condition, that illness has to be treated in order to reverse the nutritional deficiency.

Possible Complications

If untreated, malnutrition can lead to mental or physical disability, illness, and possibly death.

When to Contact a Medical Professional

Talk to your provider about the risk of malnutrition. Treatment is necessary if you or your child have any changes in the body's ability to function. Contact your provider if these symptoms develop:
• Fainting
• Lack of menstruation
• Lack of growth in children
• Rapid hair loss

Eating a well-balanced diet helps to prevent most forms of malnutrition.
Causes of Malnutrition
Causes of Malnutrition
Read More »

Monday, September 18

Knee Joint Replacement

Knee Joint Replacement: The Prosthesis
Knee Joint Replacement: The Prosthesis
Knee joint replacement is a surgery to replace a knee joint with a man-made joint. The artificial joint is called a prosthesis.

Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to be more active. Your doctor may recommend it if you have knee pain and medicine and other treatments are not helping you anymore.

When you have a total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a man-made surface of metal and plastic. In a partial knee replacement, the surgeon only replaces one part of your knee joint. The surgery can cause scarring, blood clots, and, rarely, infections. After a knee replacement, you will no longer be able to do certain activities, such as jogging and high-impact sports.


Damaged cartilage and bone are removed from the knee joint. Man-made pieces are then placed in the knee.

Knee joint replacement prosthesis

These pieces may be placed in the following places in the knee joint:

• Lower end of the thigh bone. This bone is called the femur. The replacement part is usually made of metal.
• Upper end of the shin bone, which is the large bone in your lower leg. This bone is called the tibia. The replacement part is usually made from metal and a strong plastic.
• Back side of your kneecap. Your kneecap is called the patella. The replacement part is usually made from a strong plastic.

You will not feel any pain during the surgery. You will have 1 of these 2 types of anesthesia:

• General anesthesia. This means you will be asleep and unable to feel pain.
• Regional (spinal or epidural) anesthesia. Medicine is put into your back to make you numb below your waist. You will also get medicine to make you sleepy. And you may get medicine that will make you forget about the procedure, even though you are not fully asleep.

After you receive anesthesia, your surgeon will make a cut over your knee to open it up. This cut is often 8 to 10 inches (20 to 25 centimeters) long. Then your surgeon will:

• Move your kneecap (patella) out of the way, then cut the ends of your thigh bone and shin (lower leg) bone to fit the replacement part.
• Cut the underside of your kneecap to prepare it for the new pieces that will be attached there.
• Fasten the 2 parts of the prosthesis to your bones. One part will be attached to the end of your thigh bone and the other part will be attached to your shin bone. The pieces can be attached using bone cement or screws.
• Attach the underside of your kneecap. A special bone cement is used to attach this part.
• Repair your muscles and tendons around the new joint and close the surgical cut.

The surgery takes about 2 hours.
Knee Joint Replacement Process

Most artificial knees have both metal and plastic parts. Some surgeons now use different materials, including metal on metal, ceramic on ceramic, or ceramic on plastic.

Why the Procedure is Performed

The most common reason to have a knee joint replaced is to relieve severe arthritis pain. Your doctor may recommend knee joint replacement if:
• You are having pain from knee arthritis that keeps you from sleeping or doing normal activities.
• You cannot walk and take care of yourself.
Your knee pain has not improved with other treatment.
• You understand what surgery and recovery will be like.
Most of the time, knee joint replacement is done in people ages 60 and older. Younger people who have a knee joint replaced may put extra stress on the artificial knee and cause it to wear out early.

Before the Procedure:

Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Prepare your home.
• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin), and other drugs.
• You may also need to stop taking medicines that can make your body more likely to get an infection. These include methotrexate, Enbrel, or other medicines that suppress your immune system.
• Ask your provider which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the provider who treats you for these conditions.
• Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, you need to stop. Ask your providers for help. Smoking will slow down wound and bone healing. Your recovery may not be as good if you keep smoking.
• Always let your provider know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.
• You may want to visit a physical therapist to learn some exercises to do before surgery.
• Set up your home to make everyday tasks easier.
• Practice using a cane, walker, crutches, or a wheelchair correctly.

On the day of your surgery:

• You will most often be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take the drugs you have been told to take with a small sip of water.
• You will be told when to arrive at the hospital.

After Knee Joint Replacement Procedure

You will stay in the hospital for 3 to 4 days. During that time, you will recover from your anesthesia and from the surgery itself. You will be asked to start moving and walking as soon as the first day after surgery.

Full recovery will take 4 months to a year.
Knee Joint Replacement On Xray
Knee Joint Replacement On Xray
Some people need a short stay in a rehabilitation center after they leave the hospital and before they go home. At a rehabilitation center, you will learn how to safely do your daily activities on your own.

Outlook (Prognosis)

The results of a total knee replacement are often excellent. The operation relieves pain for most people. Most people DO NOT need help walking after they fully recover.

Most artificial knee joints last 10 to 15 years. Some last as long as 20 years before they loosen and need to be replaced again. Total knee replacements can be replaced again if they get loose or wear out. However, in most cases the results are not as good as the first time. It is important not to have the surgery too early so you will need another surgery at a young age or have it too late when you will not benefit the most.

Alternative Names

Total knee replacement; Knee arthroplasty; Knee replacement - total; Tricompartmental knee replacement; Subvastus knee replacement; Knee replacement - minimally invasive; Knee arthroplasty - minimally invasive; TKA - knee replacement; Osteoarthritis - replacement; OA - knee replacement.
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Sunday, September 17

About Acute Ear Infection

Blocked Eustachian Tube Can Lead To Acute Ear Infection
Blocked Eustachian Tube Can Lead To Acute Ear Infection
Ear infections are one of the most common reasons parents take their children to the doctor. The most common type of ear infection is called otitis media. It is caused by swelling and infection of the middle ear. The middle ear is located just behind the eardrum.

An acute ear infection starts over a short period and is painful. Ear infections that last a long time or come and go are called chronic ear infections.

Causes of Acute Ear infection

The eustachian tube runs from the middle of each ear to the back of the throat. Normally, this tube drains fluid that is made in the middle ear. If this tube gets blocked, fluid can build up. This can lead to infection.

Ear infections are common in infants and children because the eustachian tubes are easily clogged.
Ear infections can also occur in adults, although they are less common than in children.

Anything that causes the eustachian tubes to become swollen or blocked makes more fluid build up in the middle ear behind the eardrum. Some causes are:

• Allergies
• Colds and sinus infections
• Excess mucus and saliva produced during teething
• Infected or overgrown adenoids (lymph tissue in the upper part of the throat)
• Tobacco smoke

Ear infections are also more likely in children who spend a lot of time drinking from a sippy cup or bottle while lying on their back. Getting water in the ears will not cause an acute ear infection, unless the eardrum has a hole in it.
Acute ear infection, Otitis Media
Acute ear infection, Otitis Media
Acute ear infections most often occur in the winter. You cannot catch an ear infection from someone else. But a cold that spreads among children may cause some of them to get ear infections.

Risk factors for acute ear infections include:

• Attending day care (especially centers with more than 6 children)
• Changes in altitude or climate
• Cold climate
• Exposure to smoke
• Family history of ear infections
• Not being breastfed
• Pacifier use
• Recent ear infection
• Recent illness of any type (because illness lowers the body's resistance to infection)
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Friday, September 15

Hyperemesis Gravidarum, Morning Sickness

Hyperemesis Gravidarum, Morning Sickness
Hyperemesis Gravidarum, Morning Sickness
Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration, weight loss, and electrolyte imbalances. Morning sickness is mild nausea and vomiting that occurs in early pregnancy.

Causes of Hyperemesis Gravidarum

Most women have some nausea or vomiting (morning sickness), particularly during the first 3 months of pregnancy. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG). HCG is released by the placenta. Mild morning sickness is common. Hyperemesis gravidarium is less common and more severe.

Women with hyperemesis gravidarum have extreme nausea and vomiting during pregnancy. It can cause a weight loss of more than 5% of body weight. The condition can happen in any pregnancy, but is a little more likely if you are pregnant with twins (or more babies), or if you have a hydatidiform mole. Women are at higher risk for hyperemesis if they have had the problem in previous pregnancies or are prone to motion sickness.

Symptoms of Hyperemesis Gravidarum

Morning sickness can cause decreased appetite, low level nausea, or vomiting. This is different from true hyperemesis because. people are typically still able to eat and drink fluids some of the time.
Symptoms of Hyperemesis Gravidarum
Symptoms of Hyperemesis Gravidarum
Symptoms of hyperemesis gravidarum are much more severe. They may include:

• Severe, persistent nausea and vomiting during pregnancy
• Salivating a lot more than normal
• Weight loss
• Signs of dehydration such as dark urine, dry skin, weakness, lightheadedness or fainting
• Constipation
• Inability to take in adequate amounts of fluid or nutrition

Exams and Tests

Your health care provider will do a physical exam. Your blood pressure may be low. Your pulse may be high.

The following laboratory tests will be done to check for signs of dehydration:

• Complete blood count
• Electrolytes
• Urine ketones
• Weight loss

Your provider may need to run tests to make sure you do not have liver and gastrointestinal problems.

A pregnancy ultrasound will be done to see if you are carrying twins or more babies. Ultrasound also checks for a hydatidiform mole.

Treatment of Hyperemesis Gravidarum

Morning sickness can most often be managed by avoiding triggering foods that trigger the problem and drinking plenty of fluids when the symptoms let up in order to stay hydrated.

If your nausea and vomiting causes you to become dehydrated, you will receive fluids through an IV. You also may be given anti-nausea medicine. If nausea and vomiting is so severe that you and your baby might be in danger, you will be admitted to the hospital for treatment. If you can't eat enough to get the nutrients you and your baby need, you may get extra nutrients either through an IV or a tube placed into your stomach.

To help manage symptoms at home, try these tips.

Avoid triggers. You may notice that certain things can trigger nausea and vomiting. These may include:

• Certain noises and sounds, even the radio or TV
• Bright or blinking lights
• Toothpaste
• Smells such as perfume and scented bathing and grooming products
• Pressure on your stomach (wear loose-fitting clothes)
• Riding in a car
• Taking showers

Eat and drink when you are able. Take advantage of the times you feel better to eat and drink. Eat small, frequent meals. Try dry, bland foods such as crackers or potatoes. Try eating any foods that appeal to you. See if you can tolerate nutritious smoothies with fruits or vegetables.

Increase fluids during times of the day when you feel least nauseated. Seltzer, ginger ale, or other sparkling drinks may help. You can also try using low-dose ginger supplements or acupressure wrist bands to ease symptoms.

Vitamin B6 (no more than 100 mg daily) has been shown to decrease nausea in early pregnancy. Ask your provider if this vitamin might help you. Another medicine called doxylamine (Unisom) has been shown to be very effective and safe when combined with Vitamin B6 for nausea in pregnancy. You can buy this medicine without a prescription.

Outlook (Prognosis)
Morning Sickness can begin between 4 and 8 weeks of pregnancy
Morning Sickness can begin between 4 and 8 weeks of pregnancy
Morning sickness typically is mild, but persistent. It can begin between 4 and 8 weeks of pregnancy. It typically goes away by 16 to 18 weeks of pregnancy. Severe nausea and vomiting may also start between 4 and 8 weeks of pregnancy and often goes away by weeks 14 to 16. Some women will continue to have nausea and vomiting for their entire pregnancy. With proper identification of symptoms and careful follow-up, serious complications for the baby or mother are rare.

Possible Complications

Severe vomiting is harmful because it leads to dehydration and poor weight gain during pregnancy. Rarely, a woman may have bleeding in her esophagus or other serious problems from constant vomiting.

The condition can make it difficult to continue to work or take care of yourself. It can cause anxiety and depression in some women that lingers after the pregnancy.

When to Contact a Medical Professional

Call your provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms:

• Signs of dehydration
• Unable to tolerate any fluids for over 12 hours
• Lightheadedness or dizziness
• Blood in the vomit
• Abdominal pain
• Weight loss of more than 5 lb
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