THE GYNECOLOGICAL EXAM

The medical procedure performed to check the health of the female sexual-reproductive system is called the gynecological or pelvic examination. For numbers of women, such exams are distasteful or anxiety producing. Lying on one’s back with one’s legs up in stirrups and one’s genitals exposed produces a feeling of vulnerability. If the woman is anxious and tense, a procedure which can otherwise be negligibly uncomfortable can be transformed into a painful and trying event. Since an annual pelvic exam is considered an important part of preventive health care, it is important to demystify the procedure. The medical practitioner first examines the external genitals. He or she then inserts a speculum into the vagina to look at the vaginal walls and cervix and to take cell samples from the cervix for a Pap smear, a laboratory test for the early detection of cancer. After removing the speculum, the examiner performs a bimanual (“internal’) exam. She or he inserts two fingers of a surgically gloved hand into the vagina and places the other hand on the lower abdomen. By applying pressure, she or he can usually locate the pelvic organs between the two hands. In this way, the size, shape, position, and mobility of the uterus and ovaries can be checked. The more knowledgeable a woman is about her anatomy and its functioning, the more she can become an active participant in the exam, with fear and excess anxiety replaced by understanding.
As the women’s movement in the late 1960s focused attention on health-related issues, the concept of self-examination developed. This procedure enables a woman to examine her own cervix with the aid of a plastic speculum, a mirror, and a light source such as a flashlight or high-intensity lamp.
By performing self-examination, a woman can learn to become familiar with the menstrual cycle changes in the appearance of her cervix and in the cervical mucus. She can also learn what constitutes the normal amounts and texture of her vaginal discharge. In this way, she can become aware of unusual changes, detect infections early, and, when necessary, provide a medical practitioner with appropriate information. If the woman has an IUD, she can check the placement of the string. Additionally, in some cases, a woman can detect early pregnancy: the cervix will take on a bluish color that is due to increased venous blood circulation. In general, the value of self-examination resides in the demystification of one’s anatomy and in the heightened comfort level and self-acceptance it can facilitate.
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REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: EATING FOR BETTER HEALTH – BASIC EATING GUIDELINES – DAILY GRAIN EATING

Most Americans consume only about half the amount of fiber that they should. Try to include at least 20 to 25 grams of fiber every day from various food sources. More than 50 grams has not been shown to be beneficial. If you include more fruits, vegetables, and grains in your diet, especially those that are fresh, raw, and whole, you will naturally increase your fiber intake.
New food labeling requirements will make it easier to determine which foods are good sources of fiber. Food manufacturers must show the total amount of dietary fiber per serving. Manufacturers have the option of providing information about the soluble and insoluble fiber content of the food.
Increase the amount of fiber in your diet gradually to let your body adjust. If you eat too much fiber when you are not accustomed to it, you may experience bloating, gas, and diarrhea.
As you increase the fiber in your diet, it is important to increase the amount of liquids you drinks fiber absorbs fluid as it passes through your body. To maintain fluid balance, drink 8 to 10 glasses of water a day.
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TESTING FOR PREGNANCY

II.CO. is the basis of the well-known pregnancy tests. It does not take long before H.CG. appears in the bloodstream. As its production increases, certain amounts are also excreted in the urine; the urine tests for pregnancy rely on detecting H.CG. If present, it is fairly positive evidence (hat pregnancy has taken place. However, it takes several days before adequate amounts appear in the urine, and a woman may have missed at least one, and maybe two, normal menstrual periods before the tests show up as positive.
More recently, a very delicate test called the radio-immunoassay test has been devised. This can pick up extremely minute amounts of H.C.G. in the Wood Using this test, pregnancy can now be accurately detected within days of conception and certainly many days before the first missed period. For women who wonder if they are pregnant, and have reason to suspect they are, it is worm bearing in mind that such a reliable test is now readily available to doctors.
In many countries the urine test is now available as ‘do-it-yourself’ kits. Many women have tried them. They are fairly reliable, although to an untrained eye and inexperienced women, it may be hard reading the test. But with a bit of practice, owe soon becomes adept at it. Just the same, if there is any query about a probable pregnancy, proper examination by the doctor is always the best idea.
Now supposing the reverse of this set of circumstances occurs, la short, suppose there are no male sperms In the Fallopian tube when the egg is making its journey towards the uterus. After intercourse, sperms remain alive for 2-1—18 hours. Nobody is quite certain of that full life endurance. It takes about 2-3 days for the egg to make its journey from one end of the tube to the other. Adding up all these probabilities, there is in theory only a very limited number of days per menstrual month when a woman may become pregnant, even when everything is in her favour.
It is startling, to say the least, that the world population remains at such a high level when these facts are considered. It must mean that an awful lot of people spend an awful lot of their time making love. Or is it just plain good luck (or bad luck, depending on your view).
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BACH FLOWER REMEDIES: VERVAIN REMEDY – SUBHASH’S CASE

Subhash, an exuberant and over-active young man took his newly wedded wife to Mussourie for honeymoon on one week’s leave. They returned after 3 days to the consternation of all relatives.
It was with difficulty that the cause could be ascertained from the girl—he had hugged her so tightly in an
embrace that her frail body felt ‘cracked’ and she became afraid of him as if her life was in danger, and she insisted that they return immediately.
It was with great difficulty that she accepted the explanation that Subhash was no brute – only over-zealous
in all his actions.
Mimulus T.D.S, was prescribed for the wife to remove her fear and Vervain Remedy was prescribed for Subhash to tone down his over-exuberance.
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OTHER APPROACHES TO EPILEPSY THERAPY: THE KETOGENIC DIET CONTAINING

The ketogenic diet contains a high ratio of fat to carbohydrate plus protein. Most of the calories are provided as fats, using butter and heavy cream. Seizure control is greatest when the diet contains a ratio of fat calories to protein/carbohydrate calories of 3 or 4:1. A typical meal might consist of a very small portion of meat, fish, poultry, or cheese, a slightly larger portion of fruit, additional fat served as butter or mayonnaise, and a serving of heavy (whipping type) cream. It doesn’t sound very palatable, does it? It is this perception of the diet as unappealing that has interfered with its more frequent use.
When your child is severely handicapped by seizures and massive amounts of medication, what do you have to lose by trying the diet? Not much! What do you have to gain? If it works, a lot. If it doesn’t, you’ve lost very little other than the time invested in learning how to prepare the diet. If your child is seizure-free and less drugged, then the rigors of the diet are worthwhile. If the child’s seizures continue after one to three months on the diet or if the diet is poorly tolerated, then the diet can be discontinued and the child returned to medication.
The diet is initiated with several days of starvation and limited fluid intake. The child should be carefully observed during this time for signs of hypoglycemia (low blood sugar)—paleness, sweatiness, unresponsiveness, or seizures. When the child is very ketotic (has a lot of ketones in the urine) and has lost about 10 percent of his body weight, one-third of the diet is begun. The diet is increased over the first two to three days. We usually do this in the hospital since this allows us to instruct the parents in diet preparation. Menus can be selected to fit the child’s food preferences. It is surprising how much variety an innovative parent can introduce into this restricted diet.
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LIFE WITH DIABETES: WHY MONITOR BLOOD GLUCOSE?

You have diabetes, albeit just “a touch of diabetes”. For one reason or another, your blood glucose levels have been found to be above the normal range.
If your blood glucose stays above normal for an extended period of time, you’ll be at risk for the development of serious complications, including:
•   Retinopathy – with loss of vision and blindness.
•   Neuropathy – nerve involvement that leads to pain in feet and hands or digestive or heart problems.
•   Nephropathy – kidney problems that could lead to loss of kidney function and possible death.
•   Large blood vessel problems – leading to heart attacks and strokes.
•   Sexual function problems – leading to impotence in men and lack of lubrication in women.
These are some of the bad things that can happen as the result of prolonged periods of high blood glucose levels. If these facts frighten you, that may be a good thing. These facts alone may provide you with the motivation to start now with a programme to keep your blood glucose under control and to stay with such a programme forever.
On the positive side, people with diabetes who keep their blood glucose levels in the normal range report they feel better, physically and emotionally. They say they feel in control of their diabetes, rather than having diabetes control their lives. This fact, too, may provide you with the necessary motivation to take charge of your diabetes.
The one way you can know, at any time, whether or not you have achieved control is through blood glucose monitoring.
It’s something you can do, without the help of your doctor or other health professionals, when you want to and where you want to. Blood glucose monitoring can be done in the privacy of your home, in your office, in a hotel room, at a resort, or even in the rest room of an airplane.
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CARDIAC ARREST

The heart is said to arrest when it stops beating. Up to 30 per cent of people suffering from heart attacks experience a cardiac arrest within the first few days of their illness. In 50 per cent of cases the heart fibrillates and this disorganized rhythm is not compatible with the continuation of life. Unless a patient receives prompt treatment they die. Fortunately fibrillation is reversible through the application of electrical stimuli and appropriate drug therapy. A patient stays alive by Cardio Pulmonary Resuscitation (CPR). Death does occur when CPR stops. The second abnormal cardiac rhythm that occurs with cardiac arrest is asystole. When asystole occurs the heart doesn’t even twitch. Asystole reverses with great difficulty and most victims die when the process of CPR stops.
Home Remedies
Governments invest millions of dollars in the provision of Coronary Care Units (CCU) that protect heart attack victims from cardiac arrests. They rarely stop to ask whether people going into CCUs are better off than people staying at home. There is still no strong evidence that CCUs are better than having your heart attack at home. Perhaps people do not present to CCUs soon enough with their heart attacks. It is the first few hours that are critical in the management of cardiac arrests. Most occur within 3-6 hours of a heart attack and on balance getting to hospital takes the average Australian 12 hours.
Always remember that CPR keeps people with cardiac arrests alive indefinitely. Do not give up until told to stop by an attending medical practitioner. It is always amazing to see people regain consciousness when they are receiving effective CPR. If the procedure is stopped they lapse into unconsciousness again and turn blue.
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RESEARCH INTO TREATMENT FOR GYNAECOLOGICAL CANCERS

Once you have adjusted to the diagnosis and treatment and feel confident about your doctor, ask about treatment options and any new cancer trials that may be suitable for you. Ask your oncologist if there is a trial of new therapy in your type of cancer. It is obvious that the only way to make progress is to study new treatments. If you decide to go into a trial your condition will be more actively monitored than usual…this can only be good for you! Remember the treatment you are advised to have has only been recommended as a result of having been part of a research program previously. Being part of a research programme may not help you, but it will certainly help those women who are diagnosed in the future.
Cancer treatments
Many women fear the side effects of conventional cancer treatments. This is because they are aware that in order to remove the cancer, other healthy body parts or cells are removed, damaged or die. And they are usually aware of the cancer experiences of others. However the human body has great restorative powers, both physically and emotionally. In most cases after accepting that the treatment was necessary to preserve life, women emotionally and psychologically adjust and go on to lead productive and satisfying lives
Not all gynecological cancers require the same treatment. The common treatment options are Surgery, Radiotherapy and Chemotherapy or a combination of two and occasionally all three. Recommendations for treatment that will be made to you will depend on your type of cancer, where it is situated and whether you have had treatment before. Your specialist will discuss in great detail the current range of treatment choices that will most likely give you the best chance of survival. Your local Cancer Council will also have a range of up-to-date resources that are usually freely available, and which we encourage you to access.
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OSTEOMYELITIS: PATHOPHYSIOLOGY AND MICROBIOLOGY

Osteomyelitis is the inflammation of the bone and marrow, typically caused by infection. Despite much study on adult osteomyelitis, the wide range of presentations and the complex diagnostic and management issues have made this a “hot topic” with many unanswered questions.
Pathophysiology
The origin of infection can be used to categorize osteomyelitis. The route of infection may be (1) hematogenous, (2) contiguous from an adjacent site of infection, or (3) secondary to direct inoculation.
Osteomyelitis can also be described as acute or chronic. Acute osteomyelitis implies a newly recognized infection. Chronic osteomyelitis suggests relapsing or untreated disease, or the presence of inert substrate for bacterial attachment that makes the infection refractory to antibiotics alone. Possible inert substrates include sequestrum, defined as necrotic bone resulting from ischemia caused by suppurative build-up, as well as prosthetic devices and other foreign bodies. Other pathologic findings of chronic osteomyelitis may include draining sinuses and formation of reactive bone, called involcrum.
Microbiology
Familiarity with the common pathogens in different types of osteomyelitis is important to direct empiric antibiotic therapy when culture results are not yet available. In approximately 50% of cases, no organism is isolated, and treatment must be directed against anticipated pathogens.
Among most types of osteomyelitis, Staphylococcus aureus (methicillin-susceptible or -resistant) is the microorganism most frequently isolated. Other types of bacteria, as well as fungi, have been associated with specific patient populations or clinical syndromes. Infections associated with prosthetic joints are typically caused by S. aureus or coagulase-negative staphylococci. Osteomyelitis due to diabetic foot infections is often polymicrobial, with aerobic and anaerobic bacteria. Osteomyelitis in intravenous drug abusers is commonly associated with staphylococci, gram-negative rods, or Candida species. Mycobacterium tuberculosis may cause osteomyelitis and typically affects the axial skeleton in adults (Pott’s disease). Pathogens related to specific exposures such as bites or animal contact, as well as the endemic mycoses (for example, blastomycosis and coccidioidomycosis) may also cause osteomyelitis in exposed individuals.
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HOW BDD AFFECTS LIVES – SOCIAL CONCEQUENCES: BDD AND RELATIONSHIPS

Many people have told me that they haven’t had children—or never will— because of their BDD. As one patient told me, “I grew up praying that my brothers wouldn’t look like me, and I was always reluctant to have children for the same reason.” Like this man, many are afraid that their children will be ugly. Others worry that their children will have BDD and don’t want them to suffer with such a painful illness.
BDD also often interferes with friendships. Friends may find it hard to understand why social events are missed or attended only after much urging and encouragement. They may be puzzled and frustrated by lateness and last-minute cancellations. Many a person with BDD has ended up spending an evening or day alone instead of with friends as planned.
“I can barely be with friends because I think they’re thinking how ugly I am,” a 28-year-old woman told me. “I haven’t seen my friends in the past 20 years,” another said. “The main reason is I’m afraid they’ll see how I’ve aged and that my hair is thinner. I become really upset whenever I see people I haven’t seen in a while. I think they’ll notice how I’ve changed. It’s gotten to the point where I totally avoid people. I’ve cut myself off.” Family get-togethers, weddings, and funerals may be anticipated with great trepidation and fear—or missed altogether. “I’ve missed a ton of social events because of my appearance,” Guy told me. “To tell you how bad it is, I missed my two best friends’ weddings! I felt too ugly to go. I’ve missed Christmas get-togethers. If I went, I wouldn’t enjoy myself because of how I look. I’ve hurt other people because of it, by not showing up. My BDD is too overwhelming to go. I’ve humiliated my parents by not showing up at relatives’. It really bothers me. My family and friends never knew the extent to which I was worried about this.”
It’s sometimes difficult to determine how much the BDD symptoms themselves are responsible for social problems such as these. It is simply the BDD? BDD is so often accompanied by social anxiety and low self-esteem that it can be hard to tease them aDart. But people with BDD generally say that their BDD symptoms are the cause of their social problems or significantly contribute to them. My research findings show that the more severe BDD symptoms are, the poorer social functioning is. This is also true for overall functioning. And when BDD responds to psychiatric treatment, social functioning usually improves, sometimes rapidly and dramatically and sometimes more slowly, especially if symptoms are long-standing and severe.
Researchers have shown that social anxiety and fear of social rejection are
more commonly experienced by less attractive people and by those with a negative body image. While people with BDD aren’t in reality less attractive on
average than other people, they think they are.
Teresa summed up what so many people with BDD feel: “I feel so ugly and unpresentable that I avoid parties and dates. I feel too anxious when I’m around other people. I think they’re evaluating how ugly I am and that they’re thinking I’m ugly and disgusting. I feel like a leper. I’ve stayed in a lot in the past few years. This problem has utterly and completely limited my social life.”
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