Archive for May 2009

COMMON INFECTIONS OF CHILDHOOD: COLDS (UPPER RESPIRATORY TRACT INFECTIONS)

Upper respiratory tract infections are the commonest cause of illness in children as well as in adults. A number of terms are used (sometimes inaccurately) to describe these ailments. They include ‘colds’, ‘flu’, ‘tonsillitis’, or ‘pharyngitis’. The average preschool child has at least six colds a year. Sometimes, especially in winter, it seems that the child is unwell for weeks at a time, barely getting over one cold before becoming sick again. Young children are particularly susceptible because they have not had a chance to build up immunity to the many viruses that are responsible for colds. As the child grows older, the frequency of upper respiratory tract infections decreases because he gradually builds up his immunity.

Cause

Most colds are caused by a virus. In fact there are over two hundred types of virus that can cause the common cold. This is the reason it is not possible to be immunised against a cold.

Colds are more common in the winter months. Cold weather by itself does not increase the chance of getting a cold, but people are in closer contact with each other because they stay indoors and are more likely to infect each other. The viruses which cause colds are spread by sneezing, coughing and hand contact.

Clinical features

These are well known to all parents and are essentially the same as in adults. There will be various combinations of a stuffy or runny nose, sneezing, sore throat, cough, headache, red eyes, swelling of lymph glands, and occasionally fever. Often there will be a loss of appetite, and sometimes nausea and some vomiting. Children may be miserable or irritable.

The actual symptoms will vary from child to child, and from illness to illness. Usually the symptoms will last anywhere from a few days to a week or more, and the child recovers fully without any problems.

Very occasionally there are complications such as ear infection, laryngitis, croup, or a lower respiratory tract infection such as bronchiolitis or pneumonia. These are relatively uncommon illnesses compared to the uncomplicated cold, which is widespread.

Investigations

Very occasionally the doctor will order a blood test, throat swab or, rarely, a chest X-ray, but for the majority of children with upper respiratory tract infections no investigations are necessary.

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PREGNANCY/EVERYDAY LIFE: BLOOD TESTS AND ULTRASOUND SCAN

Blood tests

Some abnormalities can be detected through specific blood tests. This involves taking blood from a vein in the mother’s arm. Blood tests are done routinely and regularly throughout pregnancy. Tests are done to check for rubella, anaemia, and bleeding tendencies. At around 16-18 weeks a test is done to check the level of alphafetoprotein in the mother’s blood, which can help to determine whether the foetus has any serious neurological defects such as spina bifida. The timing of this test is crucial and if dates are inaccurate, the results may be interpreted incorrectly. If the test result is abnormal, and you are sure of your dates, it will probably be repeated, and an amniocentesis will be recommended so that a more certain diagnosis can be made.

Ultrasound scan

An ultrasound scan is routinely performed at around 20-22 weeks to check the progress of the pregnancy, especially the size and maturity of the foetus. It also shows whether there is more than one foetus present. It is your baby’s ‘first photo’ and can be quite an exciting event for the parents. Occasionally the sex of the baby can be detected if the genitalia are clearly seen. You may both decide that you do not wish to know the sex of your baby until it is born. If so, make sure you let the doctor who is performing the ultrasound know, so he can respect your wishes. The test converts sound waves into images on a television screen and is not dangerous. Interpreting ultrasound images requires a lot of experience. Make sure with your GP that the doctor performing the ultrasound is an expert in the field.

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YOUR MARITAL HEALTH/SEX AND PROBLEMS OF DAILY LIVING: BELIEVE IT OR NOT

Our daily living style makes little room for beliefs, and clinging to morals that many view as old-fashioned has become difficult. The fear of AIDS has resulted in some people attempting to modify their sexual behavior to prevent illness or death. While behavioral change is necessary during the crisis of AIDS, we should also be busy asking ourselves about the meaning of sexual intimacy. We should be busy not only trying to prevent the spread of a deadly disease, but busy spreading a value system that teaches the emotional and physical immunity provided by mutually pleasing, exclusive sexual intimacy. If we fail to learn from AIDS and other sexually transmitted diseases, another disease will simply replace AIDS after it is conquered medically.

The couples were asked early in the program to make at least one time a week “worship time.” It didn’t matter what they did during that time, but they were asked to go somewhere and worship living, love, and life together. One wife reported, “You know what we did? We did every church and temple we could find. We took the kids every Saturday or Sunday morning and went to any place of worship. Just sitting there together was relaxing. It was really the only time other than watching television, or going to funerals, or weddings that we have ever sat together quietly, respectfully, spiritually and just were together.”

Sex and Problems of Daily Living: Why Nobody Has a Sex Life 271 Super marital sex is the most highly advanced, exclusive, high-level form of human relationship possible. It requires attention to all of the dirty dozen. It requires an effort, commitment, and willingness to change first and think about it later. Unlike the first three perspectives of sexuality, the fourth perspective upon which super marital sex is based emphasized a totality of life involvement, a cleaning up of the dirty dozen.

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SURGERY AIMED AT PREVENTING OR RELIEVING SYMPTOMS – CONCLUSION

If your situation is life threatening your decision is more difficult. As well as questions like those above you would also need to ask yourself and your doctor: What do I stand to gain and to lose by going through a major operation which is likely to result in me living a bit longer? What could that extra time be like? How much of it is likely to be spent in hospital? What new problems could the cancer cause in that time? What might I die of later if I don’t die of bowel obstruction now? Can my present unpleasant symptoms be controlled by some other means if I decide to let nature take its course?

It takes a very courageous person to refuse a temporarily life saving treatment of any sort. This is definitely not ‘taking the easy way out’ or ‘giving up’. Even though it might be best for everybody, including you, such a refusal is never easy. I hope that whenever the time is right for you, you will be realistic, brave and tough enough to say ‘No’.

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HYPERTENSION – SELF-MONITORING

Some doctors ask their patients, under treatment for hypertension, to buy and use such machines for self-monitoring, so the doctor can have a more accurate assessment of the daily fluctuations of the levels.

It is my belief that monitoring one’s own blood pressure without instruction and interpretation may cause anxiety and serve no useful purpose.

High blood pressure causes no symptoms and therefore is usually detected only at routine checking. Symptoms, when they do develop, are most often late and due to damage to various organs.

Headaches may be common in well-established and severe hypertension, but the symptom is so common it may be unrelated to the level of pressure.

Persistent high blood pressure places a strain on the left ventricle of the heart. This is the chamber which pumps blood through the aorta to all the body. Persistent strain causes this side of the heart to enlarge.

This pattern of left ventricular strain or hypertrophy (enlargement) may show on the electrocardiogram, or ECG.

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ALLERGIES TO FOOD – CAUSES

Allergic conditions are a little like rheumatic disorders — they’re common in our community but tend to be forgotten when there’s money for research.

Figures show that between 10 and 20 per cent of the population suffer from one or more allergies and over 80 per cent of families have a sufferer.

It’s not only pollens and dust which may offend — but food. Allergy to food may cause a variety of symptoms, including hives or urticaria, asthma, rhinitis or nasal problems, eczema, gastro-intestinal troubles and even migraine.

Allergy to foodstuffs has been incriminated in hyperactivity in children and may be a factor in Meniere’s syndrome (which causes giddiness) and in the bowel disorder of ulcerative colitis.

Animal foods such as cow’s milk and hen’s eggs are the most common but shell fish, some vegetables and fruit are also recognised as potent allergens.

A great deal of attention has been focused on cow’s milk because of its widespread use in infant feeding. The gut of infants appears to be able to absorb the proteins of this food without digesting them so they enter the bloodstream and can provoke the onset of allergy.

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ENDOMETRIOSIS: THE NORMAL MENSTRUAL CYCLE

During the second half of the menstrual cycle—the two weeks that begin with ovulation and end with menstruation—the endometrium, or lining of the uterus, prepares for conception. Activated by the ovarian hormones estrogen and progesterone, the lining becomes swollen with blood and glandular tissue. Estrogen, the first female hormone, essentially primes the body for ovulation and fertilization. Progesterone changes the uterine lining, preparing it for the eventuality of nourishing a fertilized egg by turning the lining soft and spongy and increasing it to about ten times its normal thickness.

The cycle begins this way: immediately after menstruation, the hormone FSH (follicle-stimulating hormone) is released from the pituitary gland and stimulates the ovaries to produce estrogen. On approximately the fourteenth day of the cycle, when the estrogen level is sufficiently high, a second hormone—LH, or luteinizing hormone—is released from the pituitary and triggers ovulation, that is, the release of the egg from the ovary. This egg is one of about four hundred eggs, from a reserve of almost half a million eggs, that will ripen during a woman’s lifetime.

If the egg is not fertilized by sperm, resulting in pregnancy, the endometrium follows another course. First, the female sex hormones drop and a third hormone, prostaglandin, is released. Then the enriched endometrial tissue breaks down. The menstrual cycle starts as the uterus begins its rhythmic contractions. The unused endometrial tissue detaches from the womb and is normally flushed out of the body in the form of menstrual blood.

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PSYCHE AND THE SKIN TREATMENT: RELAXATION EXERCISES

These exercises are very beneficial in promoting a general feeling of well-being and relaxation. In fact, they combine a mixture of hypnotic induction and yoga with reassuring suggestions about inner calmness. These exercises can be learnt under the auspices of the Council of Adult Education, at the Cairnmillar Institue, and elsewhere.

A useful adjunct to this type of treatment is the series of tape-recordings put out by the Australian College of Recorded Education in Sydney. One of their medi-talk series is called, for example, ‘How to relax’.

Hospitalization. Occasionally, a patient requires hospitalization for the treatment of a severe skin disorder. Not infrequently, children with bad eczema require five to ten days in hospital to bring their condition under control and help their mothers learn to manage.

Many other skin disorders subside dramatically following hospitalization. This no doubt is due to a change in environment and the escape from the daily stresses and strains, as well as to the psychological effect of the patient turning himself over to physicians and nurses, who then fulfil the role of parent substitutes.

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MAIN FOOD SOURCES OF FAT: DIETARY FAT

The major food sources of fat in the Australian diet as determined by the CSIRO Division of Human Nutrition. The personal pattern of fat intake will need to be considered when advising individuals about eating for fat loss.

What is dietary fat? Dietary fats or triglycerides are made up of three fatty acids joined together by a glycerol molecule. Oils are fats in liquid form and these have the same energy value (i.e. 9kcal/g) as ‘hard’ fats. Hence all fats and oils have been generally thought to have the same effect on body fat storage, although there is now some controversy about this. In terms of other health issues such as blood cholesterol level, the type of fat is known to be more important. Fatty acids in foods can be divided into two major categories: saturated and unsaturated. Within the unsaturated category, there are also two major classes: monounsaturated and polyunsaturated.

Fats in food contain a mixture of all types of fatty acids but in different proportions. For example, com oil contains around 14 per cent saturated, 32 per cent monounsaturated and 52 per cent polyunsatured oil and butter contains about 52 per cent saturated, 23 per cent monounsaturated and 1 per cent polyunsaturated fat. It’s a common misconception that only animal fats are saturated. Most plants and oils contain some saturated fat and in coconut and palm kernel oil, the saturated fats are the dominant ones (based on the fatty acid of greatest concentration).

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TREATMENTS TO HELP MANAGE PAIN: REFLEXOLOGY AND BEING POSITIVE

Thoughts about pain which are negative can lead to anxiety, tension and stress and ultimately more pain.

If negative thoughts and emotions can be removed and your perception of pain is altered then your coping abilities and lifestyle improve, often leading to a significant decrease in actual pain.

You have to accept that there is no instant cure for your pain and discomfort and that you need to take steps to do something positive about dealing with it.

Included in this chapter are some suggestions on how you can act more positively and counteract your negative feelings.

Reflexology

Reflexology is again similar to acupressure and is derived from the belief that discomfort and pain arises from blockings of the body’s vital energy.

It is believed that every organ of the body has a corresponding point on the foot. To treat problems affecting a particular part of the body, the appropriate point is located on the foot and then manipulated and massaged. This massage results in a stimulation and improvement of the energy flow to the affected organ and therefore brings about pain relief.

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