One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or laryngitis
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia 
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications.

Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Should You Know

6 face washing mistakes that are damaging your skin, everyday!

Face-washing may be a simple everyday task that requires no great effort on your part. But when it?s not done right, it causes significant harm to your skin, each day. The mistakes that you may make while washing your face could lead to issues like irritation, dryness and even wrinkles. Read on to find out how you can avoid making these common errors, and save your skin from blemishes, ageing and lustreless look.

1. Using the wrong cleanser

The use of the wrong cleanser can throw your ph levels out of balance. The optimal ph balance of your skin is 5.5ph. This is the ideal level at which the thin protective layer on the surface of the skin (called acid mantle) can function to keep germs, toxins and bacteria at bay. You should therefore be picking your cleanser based on your skin type as it would come with the right ph balance. 

2. Not cleaning your hands before touching the face

Always clean the germs and dirt of your hands first before moving onto your face. Ignoring this crucial first step can cause you to transfer all the bacteria and dirt of your hands on your face, giving rise to common skin problems such as acne, pimples and blackheads.

3. Using a pre-used washcloth

To avoid the filth from clogging your pores, always clean the washcloth that you use with an antiseptic to keep germs and bacteria at bay. Once you're done washing your face, don't rub the cloth all over your face but pat dry it.

4. Washing face using with hot water

When it comes to the water that you splash on your face, you should always use lukewarm or room temperature water. This is because hot water leaves your skin dry as it washes away the skin's essential oils; and cold water can break the capillaries (fine blood vessels) of your skin. In contrast, mildly lukewarm water will keep your skin hydrated and healthy.

5. Not washing the face twice a day

Just as you shouldn't ignore this important skin care habit that keeps your skin clean, you also shouldn't go overboard with it. Excessive face-washing can hamper the natural oil production of your skin, giving rise to dryness and irritation as a result. Your skin requires the natural oil it produces to keep it smooth and supple. Ideally, you should wash your face twice daily - once in the morning for removing the bacteria and dirt that clogged your pores, and again at night before going to bed.

6. Rushing through the routine

Lastly, don't rush through your cleansing routine. Make sure to properly rinse your face of cleanser completely, otherwise the residues would cause your skin to dry up later on, leading to skin irritation.

It is therefore very important to pay attention to all the little details that make up your face-washing routine. By doing it right, you get to achieve the clear and blemish-free skin that you always wanted.

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6 Face Washing Mistakes that are Damaging Your Skin, Everyday!

What is DVT?

Deep vein thrombosis is a kind of vascular disorder. It happens when a thrombus (blood clot) forms in the deep vein anywhere in the body. It especially develops in the legs. This is a grave ailment and can actually be fatal for you unless you seek treatment right away.

What are the symptoms of DVT?

A worrying feature of deep vein thrombosis is that in most cases it shows no symptoms in the earlier phases. Moreover, what makes diagnosis hard is that even when symptoms manifest, they are very similar to those of other disorders like tissue or muscle inflammation or arthritis.

Here are some typical deep vein thrombosis symptoms:

  One or both of your legs become swollen
  Your legs feel tender and hurt a lot in all postures
  The skin of your legs always feel hot to the touch
  Your skin looks blotchy or discoloured
  You bleed when you cough
  Wheezing and breathing problems
  Dizziness
  Frequent and sharp chest pain

Who is susceptible to DVT?

Deep vein thrombosis usually happens when you sit or lie in one position for long stretches of time especially when you are recuperating after an illness or surgery. It can also happen to you for other reasons-

  Injury: An injury to your legs can narrow the blood vessels and that reduces the blood flow through the veins. That is why blood clots can develop there.
  Pregnancy: The additional weight that woman has to carry in the course of her pregnancy exerts extra pressure on the veins of the legs and pelvis and thus clots may form in the veins.
  Contraceptive pills: Birth control pills raise the chances of a woman getting deep vein thrombosis by four times.
  Obesity: Obesity means forcing extra pressure onto your veins.
  Smoking: Smoking interferes with the flow of blood through your veins and raises the possibility of getting blood clots.
  The family history of deep vein thrombosis: if anyone in your family has deep vein thrombosis, you might contract it too because it is hereditary.

Complications:

DVT becomes lethal if the blood clot becomes dislodged and travels from the legs to the lungs, it can cause a pulmonary embolism. This can lead to blockage of the artery of the lung and in that case, a person may die.

Treatment for deep vein thrombosis:

Treatment for DVT includes both invasive and non-invasive vascular techniques.

  Blood-thinning medicines: They prevent blood platelets from clumping together and reduce the size of the existing clots.
  Thrombolytic drugs: If medicines are not effective, work, these drugs will be injected into your veins. They travel down the veins to where the blockage is and disintegrate the clots so that blood can once again flow through the vein uninterrupted.
  Compression stockings: They exert pressure on the vein containing the clot, prevent it from moving, and do not allow new clots to develop. You have to wear them throughout the day.
  Surgery: In very rare cases, when non-invasive methods have no effect, you may have to undergo a kind of vascular surgery called venous thrombectomy. The surgeon will make a minute incision in the vein where the clot is lodged, siphon it out and then repair the damaged vein.

Deep vein thrombosis is easily curable with treatment. Do not delay it, as DVT has the potential to kill you.

Deep Vein Thrombosis (DVT) - All You Should Know About It!

Rectal problems in women are quite common. It is experienced by many women in some form or the other such as rectal itching, pain or bleeding. Rectal problems are more common in women than in men. These conditions need to be attended to immediately as severe rectal problems may cause several health problems. There are many ways to deal with rectal problems in women.

Treating rectal itching: Rectal itching is a common rectal problem. These can be treated by

    Improve hygiene: You should clean the rectum area gently using cotton balls moistened with water. You should apply mild ointments to prevent irritation and soothe the skin.
    Unscented toilet paper or unscented lotions and creams: You should use white toilet paper that does not have any scent. Scented soaps, creams or lotions should be avoided as it may cause further irritation. You can also apply ointments containing 1% hydrocortisone.
    Control excessive sweating: Rectal problems may occur due to excess sweating. You should avoid sweating too much by wearing light clothes and using talcum powder for the absorption of moisture.

In case of excessive itching, you should follow the following tips:

    Do not scratch the area as scratching may lead to further itching. You can take an oral antihistamine during the night to get better sleep.
    You can take a warm sitz bath after every bowel movement, for at least three days, every day. The anus should be dried properly after the bath.
    Abstain from foods that stimulate rectal itching like tea, coffee, aerated drinks, alcohol, chocolate, spicy food, tomatoes and excess vitamin C, for a period of two weeks.
    You must maintain short fingernails to avoid injuries during scratching. To prevent unconscious scratching during sleep, wear cotton gloves.
    Stress should be managed as increased stress may lead to enhanced rectal itching. When you are anxious, do not scratch the rectal area.

Treating rectal bleeding: Rectal bleeding is another problem, which may be accompanied by other rectal problems. In case of rectal bleeding, avoid taking aspirin or any other non-steroidal, anti-inflammatory drug. These drugs may cause bleeding in the digestive tract. This will increase the blood amount in your stool. Bleeding hemorrhoids can worsen by the intake of these medicines. For soothing pain, opt for an acetaminophen. Constipation and diarrhoea may also lead to rectal bleeding. However, it is advised to consult a doctor before consuming any medicine.

Prevention
For prevention of rectal problems, you must have a good sense of hygiene. Keep the rectum region clean and avoid sitting in the toilet for a long time. You should have a fiber-rich diet including fresh fruits and vegetables. Avoid food items, which may cause rectal problems. General rectal problems are not very serious and can be treated using simple measures. Maintaining proper rectal hygiene is very important to avoid rectal problems. It is highly recommended to visit a doctor if the problem persists.

Rectal Problems in Women - Doctor Recommended Tips

Ovarian cysts are fluid-filled sacs in the ovaries, often in multiples, which are very common in women. This is absolutely different condition from polycystic ovaries. Most of them are benign and not indicative of an underlying problem. They produce no specific symptoms and even if detected, can be watched over a period of time. Treatment may be required only if there are serious symptoms or there is higher possibility of cancerous nature of the cyst. Read on to know more. 

Types 

Functional: There are two types in this. The follicular variety is when the egg that is ready for fertilization does not completely shrink and stays for a few more days before it disappears. Another variety, the luteal ovarian cysts are formed when after the release of the egg, there is blood filling up in the corpus luteum. 
Pathological: There are many types here   dermoid, cystadenomas, endometriomas, cancerous cystadenocarcinomas etc. These are worrisome and need to be treated. Both varieties, once identified, should be monitored. The functional variety, though may not cause a problem, can cause infertility and so necessitate treatment. 
Symptoms 

Any ovarian follicle larger than 2 cm can be called as an ovarian cyst. They are usually benign and do not produce any symptoms. However, if they turn pathologic or grow in size, they can cause various symptoms such as: 

Irregular menstruation 
Heavy bleeding 
Intermittent spotting 
Painful and/or frequent urination 
Severe, recurrent abdominal pain 
Infertility 
Abdominal bloating 
Constipation or loose motions 
Nausea, sudden vomiting 
Fever, dizziness, and weakness 
While cysts are often quiet and do not produce any symptoms, they can cause intermittent, nonspecific symptoms like above. If there is a family history of ovarian cancers in mothers, maternal aunt, Sisters, Grandmothers etc then women should have regular Gynaecological checkups to have a check done for ovarian cysts. 

Why go for laparoscopic surgery? 

Laparoscopic surgery is considered to be one of the most effective ways of treating the condition of ovarian cysts. During the surgery, problem causing non-cancerous cyst can be removed without harming the ovaries. In the case of cancer, both ovaries along with uterus etc may have to be removed. This decision is taken by the operating surgeon depending upon age of the patient, characteristics and nature of the cyst and future fertility desires of the patient. 
The patient is given general anesthesia during the surgery. After the surgery, one is suggested to rest for a day and may be permitted to return to normal activities within a day s time. However, one needs to avoid any strenuous activity for almost a week. 
While some cysts can be watched for years, others need treatment. This would be specifically true in cases where the couple is facing infertility issues or if there is a higher possibility of cancerous cysts. Such cysts need urgent intervention and should be monitored by a gynecologist with an experience in oncology. There are few blood tests that are needed to be done to know the nature of the cyst if it is benign or cancerous.

Ovarian Cysts - Ways Laparoscopic Surgery Can Help! 

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