Urinary incontinence is a common problem that afflicts many adults around the world. Stress related urinary incontinence is a fairly common problem that afflicts many as well. This form of incontinence is usually caused by physical activity, which exerts pressure on the bladder and may cause the leakage of small amounts of urine.

Triggers and Symptoms for stress urinary incontinence
In terms of urinary problems, stress is used to describe physical problems in particular and not mental stress. So the triggers or risk factors of it could be any of the following:
1. Exercise
2. Jumping
3. Sneezing
4. Coughing
5. Exercises
6. Sexual activity

This form of urinary incontinence is very common in women who are older or have already been through menopause. It may also be common for women who have recently given birth or are pregnant. The urethra or the bladder may become prone to external stress and then involuntarily leak out some urine.

Causes
The causes can be quite varied from patient to patient but are primarily attributed to the weakening of the pelvic muscles, bladder or the sphincter. If any of these muscles open involuntarily due to physical stress, it leads to urine leaking out. Some of the causes which may lead to this are:
1. Pregnancy and childbirth: Pregnancy or childbirth related problems may cause damage to the urethra or sphincter during childbirth; leading to stress urinary incontinence.
2. Surgery of the prostate: Another common problem, especially with men, is with surgical interventions to correct prostate problems.
3. Menopause: Many older women often complain about stress incontinence after menopause due to the weakening of the muscles.
4. Pelvic surgery: Any surgery to the pelvic area or illnesses which may cause the muscles to become relaxed or act involuntarily due to external stress, may cause incontinence.
5. Weakening of the pelvic muscles: Certain illnesses may cause the pelvic muscles to become weak and thus cause the sphincter as well as the bladder to react involuntarily. UTIs or urinary tract infections have also been known to cause incontinence due to the same reason.
6. Obesity: Obesity has been known to put stress on many of the bodily systems and it may affect the bladder and the urinary sphincters as well.

Causes and Symptoms of Stress Urinary Incontinence


The neck and back are closely related, and pain in one area can easily affect the other. Both neck and back pain have become lifestyle problems, due to prolonged sitting and incorrect working postures. Treating one area can help in subtly treating the other and also reduce the onset of pain. 

Pain in neck and back can be due to strained muscles, wrong posture, injury or stress due to knots in muscles and can be easily treated with a number of ways such as physical therapy, muscle relaxants and trigger point injection. Also, facet joint arthritis occurs due to degeneration of joints in elderly, excessive strain in some type of jobs or injury. Physical therapy along with injection in the nerves that carry a message from these joints to the brain along with medications that can numb sensation and Radiofrequency Rhizotomy for long-term relief is performed by pain specialists. Disc prolapse of neck/ lumbar vertebrae can also cause back pain.

Read on to know the best ways to manage back and neck pain, as the following techniques work for both.

Ice and heat therapy: Alternating heat and ice therapy can help reduce pain. It helps by reducing the sensation of pain and improving blood flow, thereby providing relief.
Physical therapy: Exercising and stretching, whether as a preventive measure or as a part of therapy, can work wonders. It improves the agility of the bones and tendons, improves movement, reduces stiffness, and relieves pain. A program should be drawn up based on the patient s overall health condition and symptoms. Patients should be monitored for any improvements or changes in symptoms.
Pain medication: When nothing else works, then pain medications become the next course of action. These can be taken for immediate relief, but cannot treat the pain permanenetly.
Steroids: Injecting corticosteroids into the bone and joint spaces can help with acute pain management.
Collar or brace: A neck collar or brace is used to keep the neck in place to reduce movement and provide support, thereby, it helps in reducing pain.
Acupuncture: Each area has associated pressure points in the body. These pressure points are identified and needles are applied to provide relief from pain.
Massage: The Massage can help by stimulating tissues, improve blood flow and also to relax muscles. The herbal oils that are used provide added benefit too, and so periodic massages are being widely used for pain management of neck and back.
Chiropractic therapy: This involves manipulation of the spinal cord with the belief that the spinal cord could be incorrectly settled. The cord is manipulated to get it to the correct location, thereby relieving pain and stiffness and improving movement
TENS (transcutaneous electrical nerve stimulation): The nerve in the affected area is stimulated by electrical impulses, thereby providing pain relief. This needs to be repeated at frequent intervals and is often reserved for acute cases.
Surgery: Often, used as a last resort, where all other measures have failed. Whether it is a herniated disk or a pinched nerve, the cause is identified and then surgery planned.


Back & Neck Pain - Different Ways Pain Can Be Managed!

Pregnancy is a time when your body undergoes a plethora of changes, both emotionally and physically. In such a situation, an acute liver failure only triggers further complications, threatening to affect both the mother and the fetus. The ambit of liver diseases range from mild complications to those that can be life threatening. Acute liver failure or ALF, as it is commonly known as in medical parlance is a condition which is caused when then there is a sudden impairment of the ability of the blood to clot. In spite of the erratic nature of the ailment and its ability to affect anybody with a complete disregard of the individual, s pre-existing history of liver problems, there are certain causes that are said to propel it. Some of them are-

Eclampsia with liver infraction: This is an extremely rare condition. Generally, eclampsia refers to the occurrence of convulsions in pregnant women, mostly in those who suffer from high blood pressure. Those women who suffer from eclampsia along with liver infraction are more susceptible to have a liver failure.
Hepatic rupture: Much like eclampsia, hepatic rupture is also caused in women who have high blood pressure. This heightens the risk of an impending liver failure in pregnant women.
Fatty liver: Sometimes excess of fat develops in the liver deterring its functioning. This is not only detrimental to your health but also poses a great danger in triggering a liver failure.
In spite of these, there have been multiple treatments which have developed to manage and curb it. Some of them are-

Remedial measure for coagulation: The inability of blood to clot blood is known as coagulation which is extremely fatal and one of the primary causes that leads to liver failure. Therefore timely and potent intervention of medicine is important to prevent that and in turn diminish the possibility of liver failure.
Volume replacement: Volume replacement refers to the condition where fluids are resuscitated or replenished into the body, those that were lost but at the same time are mandatory for the proper functioning of the body.

Acute Liver Failure in Pregnancy

Seasonal changes can be very exciting for most people. Each season brings with it a new set of colours and nature takes a new turn. However, for people with seasonal allergies, a seasonal change also comes with a set of allergies. From skin rashes to wheezing to breathing difficulties, the list of symptoms can be quite long. Asthma is the most common problem, and the attacks can be quite bothersome with wheezing attacks and breathing troubles.

With advancements in the field of medicine, there is a lot of relief for asthma patients. A little understanding on how asthma attacks happen will help in understanding how to control it. Asthma is an allergic reaction caused by narrowing of the airway with thick mucus, which makes breathing difficult. During an attack, the person can have a dry cough, face shortness of breath and wheezing.

Asthma is often triggered or worsened by some factors, and being aware of these can help prevent or manage an attack:

Common allergens like pollen, mites, ticks, furs of animals, bird feathers, specific foods (peanuts, milk products, eggs, etc.) and mold spores appear during change of season.
Environmental chemicals like cigarette smoke, car fumes, dust, etc., can also trigger an attack.
Attacks of cold or flu can lead to an asthma attack.
Workout during cold weather can be problematic, but exercise can also help control asthma attacks. Lung function improves sufficiently, but an exercise regime should be drawn up for the patient based on his condition.
Stressful emotions like anger and anxiety can also lead to an attack or make it worse.
Some medications like aspirin, beta blockers, glaucoma drops can aggravate attacks of asthma.
Once you know the triggers, here are some common measures that can help prevent and relieve the wheezing.

The preventers reduce the inflammation in the airway tube and the swelling. While they do not provide immediate relief during an attack, using these in the long term helps avoid attacks. These are low-dose inhaled corticosteroids such as beclomethasone, fluticasone, and budesonide. Doctors would advise their usage even when there are no symptoms, as asthma attacks can be triggered when they are not taking these medications for a while. Newer drugs include leukotriene antagonists like montelukast and zafirlukast. Relievers are used for symptom relief and include Salbutamol (short acting) and Salmeterol/Formoterol (long acting). Peak flow meter may be useful in acute attacks, wherein the peak flow rates can be reduced.
A good strategy is to use preventers regularly and rely on relievers during an attack. The first one helps build resistance and so reduces the incidence of attacks. Reach out to a doctor if a severe attack ensues (lasts more than 3 hours).


Tips to Control Allergy Driven Wheezing this Season

A stinging pain in the neck that makes you feel broken from the neck joint could be a reason to worry. It is often accompanied by an aching head or a throbbing shoulder joint. Neck pain, such as this occurs due to an injury in the area resulting from sudden back and forth movement of the neck. It is referred to as whiplash as the nature of the pain and subsequent discomfort resembles the snapping of a whip. The pain is more like a sprain, but not exactly so. This can affect athletes or even any person in general who has faced an accident in recent past. Whiplash is characterized by a tearing of ligaments and tendons that connect one bone to another.

Causes of whiplash:

1. Sports that involve contact- any extracurricular activity involving collisions or other forms of physical contact can cause neck injuries. Football and rugby players frequently suffer from whiplash.

2. Road accidents- public transport has a host of disadvantages. Reckless driving can make the tendons of your neck tear. Auto accidents cause immense strain on your neck; it can also lead to whiplash.

3. Any kind of physical abuse- if you have gotten into a violent fight with someone your neck could suffer from a whiplash. Instances of physical abuse where the neck is jerked or punched at can also result in neck strains. Domestic violence often leads to instances of neck strains.

Symptoms related to this condition:

1. You may or may not suffer from tinnitus. Tinnitus is a physical disorder where you hear ringing sounds. It is quite distracting.
2. Your vision might get blurry.
3. You can experience irregular sleep patterns.
4. You can find it hard to concentrate on any one thing for more than a while.
5. You can grow irritable at the drop of a hat.
6. Your memory may fail you. You might find it next to impossible to trace back a day's activity.

Some of the other direct symptoms are:

1. Your neck might turn stiff preventing you from moving it left, right, up or down.
2. Pangs of pain can be felt in and around your shoulders.
3. Your upper arms can grow numb and tender.
4. Your head can spin repeatedly or you could feel dizzy.
5. Whiplash can also result in serious fatigue.

All About Whiplash


- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

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