Medical revolution

Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

Over time, having too much glucose in your blood can caus serious problems. It can damage your

eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed.

What is for Sterility?

Sterility, also referred to as infertility, is defined as an inability to conceive a child after trying to do so for at least one year. Sterility can affect both men and women, with the cause involving either one or both parties.

For a man to be fertile, the testicles must produce enough healthy sperm to be ejaculated effectively into the woman's vagina.

For a woman to be fertile, the ovaries must release healthy eggs regularly. In addition, her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized and implanted in the uterus.

Diagnosing Sterility

If you and your partner have been trying for more than a year to become pregnant, or both of you are over thirty and battling, it is good idea consult your gynecologist, obstetrician or urologist for further investigation.

It is important to undergo a thorough fertility evaluation to determine the problem.

What Causes Sterility?

Sterility is classified into two groups, primary and secondary.

• Primary sterility means that a pregnancy has never occurred.
• Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility. A woman who keeps having miscarriages is also considered infertile.

Risk factors for both men and women are the same and these include age, stress, being underweight or overweight, diet, smoking, alcohol and drugs.

Age plays quite a critical role, as fertility peaks for both men and women in their mid-twenties. Male fertility starts declining in their thirties, while women older than 35 years may experience problems conceiving.

Certain medical conditions such as diabetes, thyroid deseases and anemia may also affect fertility.

Help for Sterility

Sexual problems such as importance or premature ejaculation should be addressed. If a lack of sperm is suspected, surgery, hormones and assisted reproductive surgery can correct the problem.

It is also important to increase the frequency of intercourse by having well-timed sex regularly to improve fertility.

Infertility in women may be treated with ovulation drugs, surgery, artificial insemination or assisted reproductive technology (ART). Other methods of ART also include donor eggs and embryos or gestational carriers (surrogate mothers). These treatments are quite costly and it is best to choose the one that you are most comfortable with.

Many of these treatment options may have harmful or unpleasant side effects such as nausea, headaches and weight gain. Fertility treatments have also been known to increase a woman’s chance of having twins, triplets or other multiples.

Natural and holistic treatments have been used for centuries to enhance fertility in men and women. Herbal and homeopathic remedies are gentle enough to support the reproductive system and its delicate mechanisms while still promoting libido, sexual stamina and sex drive. In addition, men should ejaculate regularly to improve the quality of sperm.

Definition of Ulcer

In general, ulcers in the stomach and duodenum are referred to as peptic ulcers.

Description of Ulcer

An ulcer is the result of an imbalance between aggressive and defensive factors. On one hand, too much acid and pepsin can damage the stomach lining and cause ulcers. On the other hand (and more commonly), the damage comes first from some other causes, making the stomach lining susceptible to even an ordinary level of gastric acid.

If a person does not receive treatment for ulcers, it could lead to a bleeding ulcer (the ulcer has eaten into blood vessels and the blood has seeped into the digestive tract), a perforated ulcer (the ulcer has eaten a hole in the wall of the stomach or duodenum and bacteria and partially digested food has spilled into the hole, causing inflammation) or a narrowing and obstruction of the intestinal opening preventing food from leaving the stomach and entering the small intestine.

The stomach defends itself from hydrochloric acid and pepsin by creating a mucus coating (that shields stomach tissue), by producing bicarbonate and by circulating blood to the stomach lining to aid in cell renewal and repair. If any of these functions are impaired it can lead to the formation of an ulcer.

The primary cause of ulcers is the bacterium called Helicobacter pylori (H. pylori). H. pylori is a spiral-shaped bacterium found in the stomach. Unlike other bacterium, H. pylori is able to twist through the layer of mucous that protects the stomach cavity and attach to cells on the surface of the stomach wall, where it produces urease, an enzyme that generates ammonia.

Urease generates substances that neutralize the stomach's acid and allows H. pylori to thrive. H. pylori weakens the stomach's defenses by thinning the mucous coating of the stomach, making it more susceptible to the damaging effects of acid and pepsin; inflaming the area; poisoning nearby cells and producing more stomach acid.

Although H. pylori is the primary cause of ulcers, there are other factors that play a role in ulcer development. These factors are the use of nonsteroidal anti-inflammatory drugs (NSAIDs), a person's lifestyle and the stomach's inability to defend itself against digestive fluids, hydrochloric acid and pepsin.

NSAIDs such as aspirin, ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Anaprox), or piroxicam (Feldene) interfere with the stomach's ability to produce mucus and bicarbonate (a chemical produced in the stomach that neutralizes and breaks down the hydrochloric acid and pepsin into substances less harmful).

NSAIDs also affect blood flow to the stomach, hinder cell repair and cause the stomach's defense mechanisms to fail.

Lifestyle factors such as smoking, drinking caffeine, consuming alcohol and stress are also associated with ulcers.

Smoking slows the healing of ulcers and makes them likely to recur.

Caffeine stimulates acid secretion in the stomach, thus aggravating the pain of an existing ulcer.

Studies on alcohol consumption and ulcers have been less conclusive, although alcoholic cirrhosis has been linked to an increased risk of ulcers, and heavy drinking has been shown to delay the healing of ulcers.

Although emotional stress is no longer thought to be a cause of ulcers, people with ulcers often report that emotional stress increases ulcer pain. However, physical stress increases the risk of developing gastric ulcers.

Symptoms of

• A gnawing or burning pain in the abdomen between the breastbone and the navel. The pain is usually worse a couple of hours after a meal or in the middle of the night when the stomach is empty.
• Nausea
• Vomiting
• Loss of appetite
• Loss of weight
• Tiredness (a symptom of a bleeding ulcer)
• Weakness (a symptom of a bleeding ulcer)
• Blood in vomit or stool. When blood is in the stool, it appears tarry or black (symptom of a bleeding ulcer).

Diagnosis of Ulcer

If the doctor suspects ulcers, an upper GI (gastrointestinal) series (x-rays) of the esophagus, stomach and duodenum will usually be performed. The patient will swallow a chalky liquid that contains barium, which makes the ulcer visible on the x-ray.

The doctor may also order a gastroscopy, in which a flexible tube-shaped device with a special light-conducting properties will be put down the throat to enable the doctor to see the ulcer and obtain tissue samples for microscopic examination to determine if the ulcer is cancerous.

Confirming the presence of H. pylori is important in diagnosing an ulcer because elimination of H. pylori is likely to cure the ulcer. H. pylori can be detected using a blood, breath or tissue test. The blood test uses a blood sample to identify and measure H. pylori antibodies. Approved in 1996, the Meretek UBT Breath Test requires that a person first drink a liquid or swallow a capsule containing a small amount of a protein. The person is then asked to blow through a straw into a balloon. A lab technician checks the exhaled air for evidence of the H. pylori bacteria. If the doctor previously performed an endoscopy, the tissue obtained through that procedure is cultured and watched for growth of H. pylori organisms.

Treatment of Ulcer

Medications

H2-blockers reduce the amount of acid that the stomach makes. These medicines include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). A single bedtime dose starts healing a duodenal ulcer in four weeks and a gastric ulcer in six to eight weeks.

Proton-pump inhibitors modify the stomach's production of acid by stopping the stomach's acid pump - the final step of acid secretion. The recently approved and now available drug, omeprazole (Prilosec), is 10 times more powerful in suppressing stomach acid production than the H2-blockers, able to promote duodenal ulcer healing in two to four weeks. This potent acid-inhibitor can suppress about 95 percent of stomach acid production. It is especially useful for treating people whose ulcers fail to respond to H2-receptor blockers or other medications and those with Zollinger-Ellison syndrome.

Mucosal protective agents protect the stomach's mucous lining from acid. The prescription medications are sucralfate (Sulcrate or Carafate) and misoprostol (Cytotec). The non-prescription medications are antacids (such as Tums and Rolaids) and bismuth subsalicylate (Pepto-Bismol).

Antibiotics. With the discovery of the link between ulcers and H. pylori peptic ulcers can be treated by a short course of combined high dose antibiotic therapy rather than acid-suppression alone. Without antibacterial therapy, there is a 75 percent chance of the ulcer reoccurring. With antibacterial therapy, there is a 1 percent chance of the ulcer reoccurring. There are two types of combination therapies currenly being used: triple therapy and dual therapy.

Triple therapy involves:

• Metronidazole (Flagyl)*, an antibiotic taken four times a day
• Tetracycline (Achromycin or Sumycin)**, an antibiotic taken four times a day
• Pepto-Bismol taken four times a day

This regimen lasts two weeks. This treatment is 90 percent effective in destroying the H. pylori bacteria and in reducing the risk of reoccurrence. (*doctor may substitute amoxicillin (Amoxil or Trimox); **doctor may substitute clarithromycin (Biaxin))

Dual therapy involves:

• Amoxicillin two to four times a day or Biaxin three times a day
• Prilosec two times a day

This regimen lasts two weeks. This treatment is 80 percent effective in destroying the H. pylori bacteria and in reducing the risk of reoccurrence.

Surgery

The most common types of surgery for ulcers are vagotomy, antrectomy and pyloroplasty.

Vagotomy involves cutting the vagus nerve that transmits messages from the brain to the stomach. This interruption reduces acid secretion.

Antrectomy removes the lower part of the stomach (antrum) which produces a hormone that stimulates the stomach to secrete digestive juices. This enlarges the opening into the duodenum and small intestine (pyloris), enabling contents to pass more freely from the stomach.

Pyloroplasty may be performed with a vagotomy.

Questions To Ask Your Doctor About Ulcer

Will you be prescribing any medications?

What are the side effects?

How much of the over-the-counter antacids can be taken daily?

What are the best antacids to take?

Does diet affect the ulcer?

Are there some foods that should be?

Do you have any printed pamphlets on the foods to avoid?

Is milk helpful in relieving ulcer pain?

Are there any symptoms that may be serious and should be reported right away?

Glaucoma refers to a group of diseases that affect the optic nerve and involves a loss of retinal ganglion cells in a characteristic pattern. It is a type of optic neuropathy. Raised intraocular pressure is a significant risk factor for developing glaucoma (above 22 mm Hg or 2.9 k Pa). One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Glaucoma can be divided roughly into two main categories, "open angle" and "closed angle" glaucoma. Angle closure can appear suddenly and is often painful. Visual loss can progress quickly but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress more slowly and the patient may not notice that they have lost vision until the disease has progressed significantly.

Glaucoma has been nicknamed the "sneak thief of sight" because the loss of vision normally occurs gradually over a long period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field can never be recovered. Worldwide, it is the second leading cause of blindness. Glaucoma affects 1 in 200 people aged fifty and younger, and 1 in 10 over the age of eighty. If the condition is detected early enough it is possible to arrest the development or slow the progression with medical and surgical means.

Symptoms

There are rarely any symptoms in the early stages of the disease so regular eye checks by qualified professionals are important. Ophthalmologists and optometrists will diagnose glaucoma on the basis of intraocular pressure, visual field tests and optic nerve head appearance.

Patients will sometimes notice patchy loss of peripheral vision or reduced clarity of colours and these people may benefit from a review by an eye specialist.

Symptoms of angle closure glaucoma can include pain in or around the eye ball, headache, nausea / vomiting and visual disturbances e.g halos around lights. In some cases there are no symptoms.

For more details contact 03335199480

Marrow types

There are two types of bone marrow: red marrow (consisting mainly of myeloid tissue) and yellow marrow (consisting mainly of fat cells). Red blood cells, platelets and most white blood cells arise in red marrow. Both types of bone marrow contain numerous blood vessels and capillaries.

At birth, all bone marrow is red. With age, more and more of it is converted to the yellow type. About half of adult bone marrow is red. Red marrow is found mainly in the flat bones, such as the hip bone, breast bone, skull, ribs, vertebrae and shoulder blades, and in the cancellous ("spongy") material at the epiphyseal ends of the long bones such as the femur and humerus. Yellow marrow is found in the hollow interior of the middle portion of long bones.

In cases of severe blood periods, the body can convert yellow marrow back to red marrow to increase blood cell production.

Stroma

The stroma of the bone marrow is all tissue that isn't directly involved in the primary function of hematopoiesis. The yellow bone marrow belongs here, and makes the majority of the bone marrow stroma, in addition to stromal cells located in the red bone marrow. Yellow bone marrow is found in the Medullary cavity.

Still, the stroma is indirectly involved in hematopoiesis, since it provides the hematopoietic microenvironment that facilitates hematopoiesis by the parenchymal cells. For instance, they generate colony stimulating factors, affecting hematopoiesis.

Macrophages contribute especially to red blood cell production. They deliver iron for hemoglobin-production.

Bone marrow barrier

The blood vessels constitute a barrier, inhibiting immature blood cells from leaving the bone marrow. Only mature blood cells contain the membrane proteins required to attach to and pass the blood vessel endothelium.

Hematopoietic stem cells may also cross the bone marrow barrier, and may thus be harvested from blood .

Blood cancer or leukaemia is a growing disease in Pakistan, affecting both genders and all age groups. This observation was made by consultant oncologist Dr. Saleem Siddiqui while addressing media persons here at Shifa International on Tuesday.

Although there is no credible data to measure the incidence or prevalence of leukaemia, or for that matter, many diseases in Pakistan, doctors make such observations on the basis of increasing number of patients visiting their clinics with a specific disease, in this case leukaemia.

Dr. Siddiqui said, blood cancer is a deadly but silent disease that can effectively be controlled if diagnosed on time. The real management of the disease involves bone marrow transplant; however, there are certain reservations about such an intervention. Firstly, it is a costly treatment and not common in Pakistan.

Secondly, it needs a donor whose bone marrow matches with that of the patient. Thirdly, the mortality rate among those who opt for bone marrow transplant is about 30%, and in 40% of the cases, there is a chance of reoccurrence of the disease after treatment. “On the other hand, Dr. Salim Siddiqui said, “Continuous medication for blood cancer is effective and makes the life of the patient comfortable till the medicine works.” Dr. Siddiqui said many patients cannot get themselves treated due to non-affordability. “Shifa International felt its responsibility and came forward to serve the needy. With the support of Pharma Co. Novartis, Shifa has been able to arrange and to provide free medicines for blood cancer patients. This facility covers patients belonging to upper Punjab, Islamabad and Rawalpindi, NWFP, Fata, Azad Kashmir and Afghanistan. “These patients are either referred to us by doctors in these areas, or they come to us directly,” he informed.

Dr. Siddique shared that a patient’s monthly dosage of medicines costs Rs120,000 to 200,000. “When a patient comes to us, some screening through tests is done to determine the suitability of drugs. In 95% cases, it is positive. All patients return to the clinic for follow-up every 4 to 6 weeks. At that time, certain tests are performed to determine the effectiveness of the medicine taken,” said Dr. Siddiqui. Shifa has been facilitating such patients for the last 4 years. “Currently, we have 592 registered patients. The medicines provided to them cost Rs721 million per year, with the monthly expense on these patients being approximately Rs60 million,” he shared.

Dr. Siddiqui assured that regardless of their number, all patients who test positive for the available drug will be served by Shifa without discrimination. At present, about 180 patients are coming through Shifa Foundation alone; these patients pay only Rs50 as initial registration while the rest pay only the consultancy fee and a discounted charge for the required tests.

Dr. Siddiqui concluded with an appeal to the media to support this noble cause by providing the right information to the general public.

Source: The News International, 12-feb-09

AIDS stands for Acquired Immune Deficiency Syndrome:

• Acquired means you can get infected with it;
• Immune Deficiency means a weakness in the body's system that fights diseases.
• Syndrome means a group of health problems that make up a disease.

AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you get infected with HIV, your body will try to fight the infection. It will make "antibodies," special molecules to fight HIV.

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. People who have the HIV antibodies are called "HIV-Positive." Fact Sheet 102 has more information on HIV testing.

HOW DO YOU GET AIDS?

You don't actually "get" AIDS. You might get infected with HIV, and later you might develop AIDS. You can get infected with HIV from anyone who's infected, even if they don't look sick and even if they haven't tested HIV-positive yet. The blood, vaginal fluid, semen, and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

• having sex with an infected person
• sharing a needle (shooting drugs) with someone who's infected
• being born when their mother is infected, or drinking the breast milk of an infected woman

Getting a transfusion of infected blood used to be a way people got AIDS, but now the blood supply is screened very carefully and the risk is extremely low.

There are no documented cases of HIV being transmitted by tears or saliva, but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing, especially if you have open sores in your mouth or bleeding gums. For more information, see the following Fact Sheets:

150: Stopping the Spread of HIV
151: Safer Sex Guidelines
152: How Risky Is It?

The Centers for Disease Control and Prevention (CDC) estimates that 1 to 1.2 million U.S. residents are living with HIV infection or AIDS; about a quarter of them do not know they have it. About 75 percent of the 40,000 new infections each year are in men, and about 25 percent in women. About half of the new infections are in Blacks, even though they make up only 12 percent of the US population.

WHAT HAPPENS IF I'M HIV POSITIVE?

You might not know if you get infected by HIV. Some people get fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash for one or two weeks. Most people think it's the flu. Some people have no symptoms. Fact Sheet 103 has more information on the early stage of HIV infection.

The virus will multiply in your body for a few weeks or even months before your immune system responds. During this time, you won't test positive for HIV, but you can infect other people.

When your immune system responds, it starts to make antibodies. When this happens, you will test positive for HIV.

After the first flu-like symptoms, some people with HIV stay healthy for ten years or longer. But during this time, HIV is damaging your immune system.

One way to measure the damage to your immune system is to count your CD4 cells you have. These cells, also called "T-helper" cells, are an important part of the immune system. Healthy people have between 500 and 1,500 CD4 cells in a milliliter of blood. Fact Sheet 124 has has more information on CD4 cells.

HOW DO I KNOW IF I HAVE AIDS?

HIV disease becomes AIDS when your immune system is seriously damaged. If you have less than 200 CD4 cells or if your CD4 percentage is less than 14%, you have AIDS. See Fact Sheet 124 for more information on CD4 cells. If you get an opportunistic infection, you have AIDS. There is an "official" list of these opportunistic infections put out by the Centers for Disease Control (CDC). The most common ones are:

• PCP (Pneumocystis pneumonia), a lung infection;
• KS (Kaposi's sarcoma), a skin cancer;
• CMV (Cytomegalovirus), an infection that usually affects the eyes
• Candida, a fungal infection that can cause thrush (a white film in your mouth) or infections in your throat or vagina

AIDS-related diseases also includes serious weight loss, brain tumors, and other health problems. Without treatment, these opportunistic infections can kill you.

IS THERE A CURE FOR AIDS?

There is no cure for AIDS. There are drugs that can slow down the HIV virus, and slow down the damage to your immune system. There is no way to "clear" the HIV out of your body.

The HCV infection takes years to produce symptoms in those infected with this virus. About 35% of the infected people may produce symptoms while the rest may not produce symptoms at all. Hepatitis C does not have prominent symptoms in the early stage. The infected individual may experience vague symptoms such as abdominal pain, impaired digestion, loss of appetite, lassitude, weakness, itching, etc. However, these symptoms are so common that it is hard to point towards the diagnosis of Hepatitis C. The severity of the symptoms is not directly proportional to the intensity of liver dysfunction, however. Patients in the advanced stage may experience more severe symptoms such as yellow sclera, sometimes paleness (whiteness) of eyes, loss of appetite, depression, bleeding from rectum, bloody vomiting, exhaustion and weight loss. Advanced stage symptoms of Hepatitis C are those due to chronic inflammation of liver (hepatitis), cirrhosis (scarring of tissues) of liver and/or liver failure. The patients with acute Hepatitis C present with lethargic feeling, loss of appetite, nausea, vomiting, body pain, and exhaustion. Objectively, one may observe yellowness of sclera (icterus or jaundice as it is called

Cardiac Surgery

Cancer Overview
Cancer, also called malignancy, is characterized by an abnormal growth of cells. There are more than 100 types of cancer, including breast cancer, skin cancer, lung cancer, colon cancer, prostate cancer, and lymphoma.Cancer symptoms vary widely based on the type of cancer. Cancer treatment includes chemotherapy, radiation, and surgery. If you’re considering complementary treatments for cancer, discuss this with your doctor as they may interact with other cancer treatment.