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PROSTATE CANCER

Introduction:-

Prostate is a glandular organ present only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.

Diseases of the prostate gland:-

1) Prostatitis:-

This is the inflamation of the prostate gland due to bacterial infection.

2) Benign enlargement of the prostate:-

This is a non cancerous tumour of the prostate seen after the age of 50. 3,Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.

Cancer of the prostate.

Cancer of the prostate 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 removel of testes there is marked reduction in the size of tumour.

Site of tumour:-

Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.

Changes in the gland in cancer:-

The gland becomes hard with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)

Growth :-

Growth rate is very fast in prostate cancer .The tumour compresses the urethra and produce difficulty in urination.

Spread of tumour:-

Metastasis in cancer of prostate is very early.

1) Local spread:-

From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.

2) Lymphatic spread:-

Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)

3) Spread through the blood:-

Spread of cancer cells takeplace 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 of prostate cancer:–

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

1) No symptoms:-

Tumour is small and only in the posterior lobe. This is diagnosed accidentely.

2) Slight difficulty in urination:-

Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.

3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.

4) Retention of urine:-

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

5) Signs of metastasis:-

Some patients come with the signs and symptoms of metastasis.

a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.

b) Fracture of spine due to cancerous growth in the spine.

c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.

d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.

e) General weakness due to spread of cancer to different parts of the body.

f) Anaemia due to involment of bone marrow and increased destruction of RBCs.

Clinical examination :-

Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.

Investigations:-

1) Complete blood investigations;-

RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.

2) Urine analysis:-

Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.

3) Renal function tests:-

Blood urea level,serum creatinine level,electrolyte level ect.

4) Serum acid phosphatase:-

Increased in cancer of prostate.

5) x-ray of the spine:-

To detect any tumour or fracture.

6) Ultra sonography;-

Gives idea about prostate,bladder,kidney ect.

7) C T scan:-

More detailed information about organs and tumour.

8) MRI of the spine:-

Gives detailed information about spine ,disc and nearby soft tissues.

9) Lymphangiography:-

Gives idea about lymphatic spread of cancer.

10) Biopsy to confirm cancer:-

Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This will detect the presence of cancer cells.

Treatment:-

1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)

Partial prostatectomy :-

Here only the affected lobe is removed.

Radical prostatectomy :-

Total removal of prostate along with nearby lymphnodes.

5, Hormone therapy :-

Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.

6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.

7) Radiotherapy is also done for some cases.

8) Homoeopathy:-

Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms.Constitutional homoeopathic medicine will give great relief and can increase the life span.

9) Yoga and meditation is also healpful.

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    BRIEF IDEA ABOUT PILES (Hemorrhoids)

    What is piles ?

    Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.

    Depending upon the situation there are two types of piles.

    1) External piles. 2) Internal piles.

    1) External piles:-

    This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.

    2) Internal piles:-

    It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.

    Some times internal and external piles occure in same individual.

    Factors responsible for piles:–

    1) This is a familial disease.

    2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.

    3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.

    4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.

    5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.

    6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.

    Signs and symptoms of piles:–

    1) Pain:-

    Pain is common in external piles which will be worse while straining at stool.

    2) Bleeding:-

    Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.

    3) Protruding mass:-

    In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.

    4) In some cases there will be discharge of mucus with itching around the anal orifice.

    Complications of piles:–

    1,Infection: The infection can spread to deep veins resulting in septicaemia.
    2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.
    3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.
    4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.
    5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

    Treatment of piles:–

    Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.

    1) The thrombosed external pile is excised under local anaesthesia.

    2) Sclerosant injection therapy can reduce the size of piles.

    3) Rubber band ligation around the neck of piles is useful in some cases.

    4) Cryosurgery is very effective.

    5) Anal dilatation can reduce constipation and pain.

    6) Haemorrhoidectomy is the surgical removal of piles.

    How to prevent piles?

    1) Eat plenty of fruits and vegetables.

    2) Take fibrous food.

    3) Avoid excess intake of meat,prawns,crabs ect.

    4) Keep a regular timing for food.

    6) Drink sufficient quantity of water.

    7) Keep a regularity in bowel habits.

    8) Take treatment for constipation.

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      HOMOEOPATHY – Introduction

      Homoeopathy is a system of medicine introduced by a german physician Dr Samuel Hahnemann.He was basically an allopathic doctor who has left the practise because of side effects and temporary relief of symptoms of allopathy.For his bread and butter he started translating the medical books to different languages.While he was translating cullen’s materia medica he came across a herbal medicine called cinchona.It was written that cinchona can cure malaria and it can also produce symptoms similar to malaria on healthy individuals.This point clicked hahnemann’s brain and he prepared an extract of cinchona bark and taken himself.To his surprise he developed some symptoms of malaria like chills and achings.He started doing the same experiment on different individuals and the result was the same.

      By this experiment hahnemann came to know that any drug which can produce a set of symptoms on a healthy humanbeing can be used to cure the similar symptoms in a diseased person.He gave cinchona to various malaria patients and the result was wonderful and a system called homoeopathy originated.The word homoeo means similar,pathy means suffering.The basic principle of homoeopathy is ‘similia similibus curantur’ means like cures cure.Hahnemann prepared some other drugs using alcohol as a vehicle and started experimenting on different age groups and noted down the symptoms produced in them.He proved nearly 30 drugs and the symptoms produced were noted down systematically.The symptoms collected by drug proving were categorised in the order in a book form named materia medica pura.

      Hahnemann noticed that by diluting the crude drug substences in spirit a dynamic power is developed and is responsible for producing the symptoms on healthy people.Hahnemann started giving treatement to somany diseased persons with the medicines prepared by him on applying the principle similia similibus curantur and got wonderful cures and homoeopathy started spreading all over the world.

      He gave medicines to some patients and noticed that symptoms are coming back again.So he understood that the cause for the disease should be treated .After doing experiments and observations he came to know that diseases are actually caused by some dynamic forces and he named them as miasms.[psora ,syphilis,sycosis] He noticed that to cure a person completely these miasms should be eradicated using a similar dynamic force.This idea lead to antimiasmatic drugs which are drugs having disease producing power similar to miasms.He developed anti miasmatic drugs and experimented on diseased persons and got wonderful cures.

      Developement of homoeopathy

      The principles of homoeopathy was written in book form and he named it organon of medicine.Lateron he started publishing these works and six editions of organon were published.Right from the beginning of homoeopathy somany doctors of other system started working against homoeopathy.But those who were against homoeopathy lateron came to know the truth behind homoeopathy and started practising the same.Physicians like Dr J T Kent,Dr Hering,Dr Boenonghausen ect followed Dr hahnemann’s mission and developed the system.They all started preparing somany other drugs on the basis of guidlines given by Hahnemann.Physicians came to know that by diluting the drug substance in spirit in a systematic way the medicinal power is increasing eventhough the quantity of drug decreases.Since diseases are due to dynamic causes the medicine also should be dynamic.By a process called potentisation same drug in different levels of potencies were made.They found that by increasing the potency the penetrating power of medicine is increased so that it act on a higher level than the usual material form of drugs used in other systems.This unique nature of homoeopathic medicine is the reason for the wonderful cures of even the mental diseases.

      General principles

      Homoeopathy treats the diseased individual as a whole rather than treating diseased parts or organs.The physical,mental,emotional,social spheres of a person is considered for a permanent cure.This system believes that the diseases are caused due to the derangement of vital force which is an invisible power in every individual.In a healthy state the vital force maintains the equilibrium of mind body and soul .During this man will have normal sensations and functions.When the vital force gets affected there will be external manifestations in the form of signs and symptoms.The imbalance in the body functions makes a shelter for forign organisms(bacteria,viruses,fungi,protozoa ect) and allow them to proliferate &produce so called diseases.Homoeopathy believes thet the real desease comes before the bacteria & viruses,hence the root cause of the disease has to be treated for a permenent cure.The antibacterial and antiviral agents only remove the secondary causes mentioned above.

      Diseases are produced by noxious morbific agents called Miasms which are dynamic influences which affect the vital force.There are mainly three miasms PSORA ,SYPHILIS&SYCOSIS. These three causes are accepted by other schools of medicine but called by different names. Psora causes functional disturbances, syphilis causes structural changes in the form of destructions and sycosis causes changes in the form of overgrowth.These three miasms can act individually or in combined form to produce different disease conditions.

      Preperation of medicine in homoeopathy

      In homoeopathy medicines are prepared from different sources like minerals, plants, animals, toxins, diseased parts ect. Medicines are prepared from these substances by a special process called potentisation.Here the soluble substances are potentised by diluting(mixing with spirit with a downward stroke) with spirit and insoluble substances by grinding(trituration) with sugar of milk.The crude drug substance is first mixed with a calculated quantity of spirit and water and kept for few days .From this mixture extract is taken and is called mother tincture(denoted as Q).From this mother tincture dilutions are prepared by potentisation.Potentisation is a mathematical process by which the quantity of original drug substance reduces but medicinal power increases. Depending upon the ratio of quantity of drug substance and vehicle(spirit or sugar of milk)there are different scales for this process.Each scale has got different potencies which indicate power of medicine.Example in decimal scale the drug substance vehicle ratio is1/10 and the availables potencies are 3x,6x.12x ect.In centismal scale the ratio is 1/100 and the available potencies are 30c,200c ect,in LM potency the ratio is 1/50000 and the available potencies are 0/1,0/2,0/3 ect.Potency is written after the name of every medicine

      Same medicine is available in different potencies. Suitable potency is selected according to so many facters like severity,depth of disease,condition of the patient ,nature of disease ,type of symptoms,age of patient and ect.

      Subjects studied in homoeopathy:-

      History of medicine

      History & developement of homoeopathy

      Pioneers of homoeopathy

      Organon of medicine

      Homoeopathic philosophy

      Materia medica

      Homoeopathic pharmacy & pharmacognosy

      Homoeopathic repertory

      Homoeopathic case taking

      Homoeopathic therapeutics

      General medical subjects:

      ( Anatomy,physiology,pathology,microbiology,parasitology,toxicology,forensic medicine,social & preventive medicine,surgery ,ENT ,gynaecology & obstetrics, opthalmology, dentistry, orthopedics, surgery,general medicine,pediatrics,dermatology ,psychiatry and ect)

      Homoeopathic case taking and prescription.

      Cure by a homoeopathic medicine is rapid ,gentle and permenent if correct remedy in suitable dose is given. . Just giving one drug for one disease (specific drugs)may not give good result.To come to a correct remedial diagnosis we should have the symptomatology of the person .It is the total symptoms of a person which includes mental generals,physical generals,particular symptoms ect.

      All signs and symptoms (mental&physical)of the person is taken in detail.Knowledge about past illness,family history of diseases,food & bowel habits,notable causes,relation to climatic changes and constitution ect are noted down in a systematic order.

      Mental symptoms:

      Example: fear,anxiety,depression,anger,jealousy and ect….

      Physical symptoms:

      Example: Body makeup, appetite, thirst, desires, aversions, bowels, urination, sleep, taste, nature of smell, discharges any abnormal sensations like pain, burning, climatic changes, thermal relations, and etc…

      Peculiar uncommon symptoms:

      This is the speciality of homoeopathic system of medicine.For the selection of a suitable remedy these symptoms are very important.common symptoms which are seen almost in all patients are least important. This is the reason for giving different medicines to different individuals suffering from same disease.Example: Five people suffering from typhoid may get five different remedies because of changes of individual symptoms.

      Particular/local signs&symptoms:

      This include signs &symptoms related to body parts &organs.

      Example: Part affected,any swelling,discolouration ect.

      Systemic examination:-

      Different systems are examined in a systematic order.(Respiratory system ,digestive system,nervous system,cardio vascular system and ect….) Vital signs

      Pulse,blood pressure,temperature,respiratory rate ect are checked here.

      General physical examination:

      Here body parts are examined from head to foot to findout any changes.

      provisional disease diagnosis; Here probable diseases are diagnosed. In homoeopathy disease diagnosis is not that much important for the selection of a remedy,but needed for general management and to know the prognosis.

      Investigations : This includes lab investigations and other methods to find out any other major illnesses.

      Final disease diagnosis:

      After doing all investigations the disease is diagnosed.

      Remedial diagnosis:

      This is the most importnant part as far as homoeopathy is concerned. For this the selected symptoms are arranged in a systematic order on the basis of importance. Symptoms are analysed to find out the importance of each symptom for the selection of a remedy.Remedies are selected on the basis of similarity.

      Suitable remedies are diagnosed by a process called repertorisation. Here books called repertories are used. Repertory is the index of symptoms of materia medica(books which contain the symptoms of drugs).Nowadays computer softwares are used for repertorisalion.By this process we will get the remedies covering maximum important symptom of the patient.

      Amoung this group of remedies the most suitable remedy is selected by referring various books and considering the life space investigation of the patient..The selected medicine is given in suitable potency & dose.

      ANTI MIASMATIC TREATMENT:

      The root cause of disease is miasms which should be eradicated using suitable anti miasmatic drugs.Every drug can eradicate the miasm if there is symptom similarity.There are anti psoric drugs,anti syphilitic drugs and anti sycotic drugs.After diagnosing the miasm suitable anti miasmatic drug has to be given to complete the cure.

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        Heart Rate Monitors

        Heart rate monitors used to be exclusively operated by physicians and nurses alone but that was soon rectified with today’s multi-tasking generation. Every person seemed to want to know about everything that was related to them and that of course included monitoring their own heartbeats.

        What is a Heart Monitor
        Also known as a cardiac monitor, a heart monitor is a piece of electronic equipment that can be used to track or observe heart functions continuously. It allows people to place a numerical value on their healthiness based on their heart rate and have a target heart rate to work for. The more complex versions of the heart monitor allow physicians to see any signs of deterioration or improvement and make the necessary adjustments immediately.

        Types of Heart Monitors
        Today, heart monitors are produced by the millions and designed to cater specific types of individuals. Some heart monitors are primarily designed for weight loss programs while others are meant for the use of athletes or fitness programs. Some are wireless or come as a built-in feature of exercise equipment like a treadmill or an exercise bike. It can be strapped to your wrist or of considerable size. It may or may not emit any electromagnetic waves, depending on its purpose. A fetal heart monitor, for instance, must not produce any waves at all as this may affect the health of the baby.

        Factors on Selecting the Best Heart Monitor for You

        ECG-Accurate Monitors with Chest Straps – Heart monitors that come with chest straps are more often not the most accurate of heart monitors. The chest strap is strapped around your chest, a few centimeters below your breast. It contains a device that’s able to detect electrical activity of your heart and transmit it to the brain of the machine – just like an ECG. The results are shown on the display monitor, which most of the times is attached to your wrist like a watch. Others however prefer results to be transmitted through audio messages via earphones.

        Upon choosing heart monitors with chest straps, you need to remember to keep the strap constantly connected to your body lest you want the heart monitor to produce inaccurate readings.

        Lastly, the only alternative against buying heart monitors with chest straps are the ones that rely on pulses on your fingertips. These however do not provide readings as accurate as those with chest straps.

        Heart Monitor Features – Basic and lower end models tend to display only your heart rate and maybe the elapsed exercise time as well. This of course does not provide sufficient information if you want to know exactly how much you need to improve before you can be qualified as a completely healthy individual. Higher end models will naturally offer a wider range of features – for a price. Examples of such features are – but not limited to – heart rate zone alarms, timers and number of calories burned. It may also allow users to set pre-programmed workouts along with a targeted heart rate.

        Ease of Use – Lastly, you must purchase a heart rate monitor that you will have no problems of using. What good would a high end heart monitor do if it takes you an hour to operate it? Are the numbers and words appearing in the heart rate monitor readable? Can it be used in no-light situations? Are buttons well-labeled and ergonomically positioned?

        To Buy or Not to Buy a Heart Monitor
        Heart monitors can be especially costly, more so if you are intent on purchasing higher-end models. If you have a limited budget, you should ask yourself whether or not you truly need to buy a heart monitor. You can of course purchase one of the lower-end models but low quality heart monitors can lead to inaccurate results and that sort of defeats the purpose of buying one.

        If you are intent on purchasing a heart monitor, you need to ask yourself another question: do you need to make a solo purchase or is it alright with you to use the heart monitor that comes as a built-in feature of a treadmill? Lastly, you should remember as well that you can always pay your doctor regular visits and have him monitor your heart rate for you.

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          Cross Training for Fitness and Fatloss

          The numbers on your scale do not indicate whether you are fit or fat. Far more significant than your total body weight is the composition of your body tissue. If a man’s fatty tissue is bigger than 14% up to 15% of his body mass, or if a woman’s is more than 20% to 22%, he or she is overweight, or more precisely, overfat.

          A small amount of fat is needed for padding the internal organs and as insulation under the skin. Excess fat leads to such diseases as diabetes, gout, high blood pressure, coronary artery disease, and gallbladder problems. There are very few, very fat persons. The reason is that the fittest, not the fattest survive.

          The problem now is focused on how to resolve the problem. The problem with most people who want to lose weight is that they have the propensity to concentrate more on getting those numbers lower than what they are seeing now. What happens next is that they strive harder to achieve a lower weight, according to the “ever reliable” result of the weighing scale.

          It would be more important to think of the human body as a heat-exchange engine that works on the basic principles of energy physics. The caloric balance equals the total calorie intake minus the total calorie expenditure.

          Some of the calories people ingest are used for basal metabolism. As people get old, their bodies require fewer calories for this basic upkeep. Some calories are excreted as waste products. Some go into “work metabolism,” the energy expenditure required for any physical activity.

          Hence, if people take in more calories than are used by these functions, there is a definite caloric excess. By the laws of physics, energy is transformed rather than destroyed. In this case, each excess of 3,500 calories is changed into a pound of fat. If people want to reverse this process, they have to burn up 3,500 calories to lose a single pound.

          Winning the War Against Fat

          When you think of fighting fat with exercise, you probably think of hours of hard, sweaty exertion. If this is the case, then, you will not get any farther. This is because people who are so much into losing more by exerting more effort tend to get bored easily.

          Why? Because experts contend that when people exert more effort than what they are capable of doing creates a tendency to develop weariness and ennui. Hence, they give up, stop doing their routine exercises, and end up sulking in the corner with a bag of chips that seems to have all the bad calories in this world.

          Now, you might ask, “What should be done instead?” The answer: cross training.

          After some intensive studies and experimentations, health experts were able to come up with the concept of incorporating cross training in order to overcome or break the monotony or dullness in an exercise program.

          Cross training refers to the integration of diverse movements or activities into a person’s conventional exercise routine. The main purpose of incorporating cross training into an exercise program is to avoid overdoing excess muscle damages and to put a stop to an imminent boredom.

          Three of the most commonly used activities whenever a person decides to engage into cross training are swimming, running, and cycling.

          In cross training, distance is one way to extend your activity as your condition improves. For this reason, you need to traverse a measured distance.

          If possible, swim the course and measure the distance. If you will be using a running track, such courses usually are a quarter-mile per lap for a complete circuit.

          Cross training offers a variety of benefits for fitness and fatloss. It builds up the strength and endurance of the heart, lungs, and blood vessels. It has also some tranquilizing effect on the nerves, and it burns up calories as much as it makes your “losing weight” more bearable.

          Cross training has three basic components:

          1. Endurance exercises to condition the heart, lungs, and blood vessels and to induce relaxation. These begin with a careful planned walking and jogging regimen, depending on fitness level.

          2. Exercises to strengthen the muscles, particularly those important to good posture. These include some activities that are selected to encourage some people who are already burnt out with a particular routine.

          3. Exercises to improve joint mobility and prevent or relieve aches and pains. These consist of a series of static stretching positions that are safe and effective for most of the people who wish to try to lose some fat.

          Indeed, cross training is a great way to modify the concept of exercising and losing fat without having to endure monotonous activities. In fact, the idea of exercising is to like what you are doing, hence, if you engage into cross training, you will be aware of it that you have already achieve your desired weight.

          Boiled down, cross training is, certainly, one way of having fun.

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            Precautions to be taken while combing hair

            Hair combing is a routine activity of almost all people.Some people keep a particular hair style throughout their life and some especially younger generation adopt new styles according to new trends and fashion.Hair styles has got close relation with the personality of a person.The hair of an unhygeinic person is usually tangled and dirty because of lack of washing and combing.To have a healthy scalp hair proper nutrition is needed.General health has got direct relation with the quality and quantity of hair.Regular washing,use of hair oil,proper combing ect are also needed to make the hair beautiful.General hints for combing is discussed here.

            1) Different varieties of combs are available in the market.The best comb is selected by considering the nature of hair(hard or soft,long or short) ,style and convenience.

            2) Combing should be done with utmost care and concentration.Some people especially gents think about some other matters and comb without any care which may be harmful to the hairs.

            3) Combing should be gentle .A vigorous combing can increase hairfalling.

            4) Do not comb if the hair is wet. First dry it with a towel and then put some oil and gently massage it.Now the combing will be easy and harmless.

            5) Should not be combed in the opposite direction of hairs.This can increase hair falling.

            6) Vigorous combing in backward direction can produce traction baldness.

            7) Frequent combing can damage the scalp and the hair follicles.Those who carry pocket comb use it frequently and make it a habit.Combing two or three times in a day is sufficient.

            8) The tooth of the comb should not be sharp and it should not be pressed too tightly on the scalp.

            9) Always clean the comb before and after use because hair and dirt deposited in the gap will make combing diffucult and painful.

            10) Others comb should not be used.This helps to prevent fungal and bacterial infections.Head lice can also spread from one person to other by sharing the combs.

            11) Combing the tangled hair is difficult and painful.Hence use some shampoo for cleaning and after drying put oil and make the hairs free for an easy combing.

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              CEREBRAL PALSY

              It is a non progressive neuromuscular disorder causing mild to severe disabilities throughout life.This condition is manifested as a group of persisting qualitative motor disorders which appear in young children due to damage to the brain during delivery or due to some pathological conditions in the intrauterine life.The neuroligical problems are multiple but non progressive in nature.Approximately 2 per 100 live birth is having this problem.This disease is having no hereditary tendency.

              Causes of cerebral palsy:

              1) Injury to the brain during delivery.

              2) As a complication of forceps delivery.

              3) Lack of oxygen supply to the baby during delivery.

              4) Infections during delivery.

              Signs and symptoms of cerebral palsy:–

              The signs and symptoms may not be similar in all babies affected.Depending upon the damage to the brain there may be mild to severe lesions.

              Mild cases:- 20% children will have mild disability.

              Moderate cases:-50% cases are having moderate disability.The affected children require self help for assisting their impaired ambulation capacity.

              Severe cases:-About 30% of the affected children are totally incapacited and bedridden and they allways need care from others.

              Abnormal findings in cerebral palsy:-

              1,Abnormal neonatal reflexes.

              2,Stiffness of all muscles with awkward motion.
              3,Extention of extremities on vertical suspension of the infant.

              4,Scissoring of the lower limbs due to spasm of the adductor muscles of the thigh.

              5,In severe cases the back bend backwards like and arch.

              6,May have total or partial paralysis.

              7,Arrest of neurological and behavioral developement.

              8,Swallowing may be difficult in some cases.

              9,Drooling of saliva.

              10,Mild to severe mental retardations.

              11,Abnormal movements are seen in some cases.

              12,Tremors with typical movements.

              13,If cerebellum is affected there will be loss of muscle tone with difficulty in walking.

              14,Complete or partial loss of hearing.

              15,Speech may be affected.

              16,Squint and other visual problems may be associated.

              17,Convulsions may be seen in some children.

              Cerebral palsy is diagnosed by detailed clinical examination and by eliminating other similar diseases like brain tumour, progressive atrophy ect.All investigations like CT scan,MRI and routine investigations are needed to ruleout other diseases.

              Management of carebral palsy:–

              General management:

              This includes proper nutrition and personal care. Symptomatic medicines are needed to reduce convulsions and muscle stiffness. Diazepam can reduce spasticity and athetosis.
              Dantrolene sodium helps to relax skeletal muscles.

              Physiotherapy:

              Here massage,exercise, hydrotherapy and ect are needed.Special training is given to train walking,swallowing and talking.The affected children are also trained to hold articles for routine activities.

              Rehabilitation:

              Moral and social support should be given to these children.They should be send to special schools where special training can be given by trained staff.Mentally retarded children need special training.Depending up on the disabitity special instruments and machines are given for locomotion and to assist their daytoday activities.

              Occupational therapy:

              This is given by occupational therapists.They train the disabled people to do some suitable works so that these people can have their own income.

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                Nails in Healt and Disease

                Introduction:

                The nails are present at the end of each finger tip on the dorsal surface. The main function of nail is protection and it also helps for a firm grip for holding articles. It consists of a strong relatively flexible keratinous nail plate originating from the nail matrix. Under the nail plate there is a soft tissue called nail bed.Between the skin and nail plate there is a nail fold or cuticle.Normal healthy nail is slight pink in colour and the surface is convex from side to side.Finger nails grow 1 cm in three months and toe nails take 24 months for the same.

                Importance of nails in disease diagnosis:

                The colour ,appearance,shape and nature of the nails give some information about the general health and hygiene of a person . Nails are examined as a routine by all doctors to get some clues about underlying diseases.Just looking at nails we can makeout the hygiene of a person.The abnormal nail may be congenital or due to some diseases.The cause for changes in the nail extend from simple reasons to life threatening diseases.Hence the examination by a doctor is essential for diagnosis .Some abnormal findings with probable causes are discussed here for general awareness. Читать далее »