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Rheumatoid arthritis is an autoimmune disorder affecting the joints, symmetrically (usually). The joints become swollen, red, hot, painful & tender. The joint movement becomes limited due to pain & swelling
It starts with inflammation of the synovial membrane but may involve the joint capsule and other surrounding soft tissues.
It is a self limiting disease. But by the time it leaves, the patient is crippled due to contractures & deformities.
Acute phase can be managed with medicines.
Commonly used medicines are ibuprofen/paracetamol/aspirin in therapeutic doses. They help to control symptoms of pain and swelling of the joints in most of the cases by their anti inflammatory properties. Fever is also controlled.
Vitamins, minerals, anti oxidents & other supportive medicines are also needed. Omega 3 fatty acids have a very definite role to play in improving the response to the treatment.
Physiotherapy helps in preventing contractures & deformities.
The patient should do general exercises & keep active.
He may have to be further investigated.
In established cases of rheumatoid arthritis dmard (disease modifying drugs) e. G. Methotrexate, hcq, leflunomide, saaz etc. Have to be used.
They all are toxic drugs & can cause bone marrow depression along with other side effects. They should be taken under medical supervision.
Sometimes steroids may have to used.
The dose of these medicines should be adjusted to the minimum required, to control the symptoms.
Blood, urine tests & other investigative procedures should be done periodically to rule out any side effects.
X rays of the affected part should be done to confirm diagnosis & assess the extent of damage.
Diabetes, vitamin d deficiency or any other metabolic disorder should be ruled out. Sometimes they mimic the symptoms & create confusion in diagnosis. Associated disorders like these, most certainly affect recovery adversely.
It should be ascertained that the patient is not allergic to any of the medicines that he is going to take.
Rheumatoid arthritis is a chronic disorder that lasts over many years with acute exacerbation & remissions. The earning capacity of the family is adversely affected. The cost of medical treatment is high. If the patient needs surgery, it is further escalated. Most of the population in india is not covered by any medical insurance. All these factors put together create an atmosphere of depression in the family. Patient feels morally degraded & may even develop suicidal tendency.
In a situatation like this it becomes essential that a moral support is provided to the patient by his friends & relations. Treating doctor has a very definite role to play in keeping up the moral of patient.
I am suffering itching around vagina & vulva since 5 days. It started when I used some hair removing cream. No other symptoms or problems. Please suggest some medicine to treat it.
Related to sex .Sex krne ke liye jo foreplay ke liye kaha jata hai wo hota kya hai .kaise krte hai? Yeah sab yaha puch raha hu kyu ki mujhe jaida pta nii hai inn baato kaa aur kahi aur puchne me sharam aati hai .isliye sab detail me btaiye please tell?
With the modernization of all economies around the world, one health hazard that has become one of the largest perils within both developed and developing nations is the incidence of cancers of the female reproductive system, especially cervical and breast cancer.
Breast cancer is the formation of malignant tumors within the breast tissues of a woman. Usually, breast cancer affects women in the age range of 40 to 50, but there have been many reports of it occurring earlier. About 48 % percent of the Indian women having breast cancer have been reported to be under 50. This is an almost 17 percent jump compared to figures 25 years earlier.
Alarming Signs of Breast Cancer:
- The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded.
- Swelling of all or part of a breast (even if no distinct lump is felt)
- Skin irritation or dimpling
- Breast or nipple pain
- Nipple retraction (turning inward)
- Redness, scaliness, or thickening of the nipple or breast skin
- Nipple discharge (other than breast milk)
Screening Guidelines for Breast cancer:
- Mammography: US Preventive Services Task Force (USPSTF) recommends mammography once in every 2 year for females between age group 50-75 years. Women with a family history has a benefit of starting at age 40 years. After 75 years there are insufficient evidence of benefit of screening mammography.
- Breast Self Examination and annual Clinical examination: breast self examination is easy to learn and and any abnormality should be reported to the oncologist.
- For High Risk/ Genetic risk factors: screening should start by age 25 or 10 years earlier of youngest relative affected. Annual mammogram and MRI or Doppler ultrasound alternating at 6 month interval can be considered.
Some of the common treatment options for breast cancers are:
Breast conservation surgery - This is where the tumors are removed without cutting out too much of the surrounding breast tissue.
Mastectomy - If the cancer has spread too far then large amounts of breast tissue has to be removed along with the tumor to stop its spread any further.
Sentinel lymph node Biopsy - it's part of both surgical procedures, it decreases morbidities of lymph node dissection first draining lymph nodes only are removed in patients with clinically negative axilla. If negative on frozen section further axillary dissection is avoided. It avoids the morbidity of complete axillary clearance.
Cervical cancer ( Carcinoma Cervix)
Cervical cancer is the cancer of the cervix, which is the opening of the uterus and connects the uterus to the vagina. Indian women in particular are susceptible to cervical cancer as more than 1/3rd of the cervical cancer related deaths in the entire world happens here in India, which is about 74000 deaths annually. The leading cause for cervical cancer is HPV or Human Papillomavirus infection, which if left untreated and unchecked will result in cancer.
Alarming Signs of Cervical Carcinoma:
- Early lesions and precancerous lesions have no symptoms
- Abnormal vaginal bleeding such as bleeding after vaginal intercourse, bleeding after menopause, bleeding and spotting between periods or longer/heavier periods
- Abnormal vaginal discharge
- Pelvic pain
- Late stage disease may cause lower extremity swelling, problem with urine and/or stool passage
- Cervical cancer screening is most effective screening programme of any cancer disease resulting in significant decrease in mortality from carcinoma cervix
- United state preventive services task force (USPSTF) recommend cervical cancer screening starting at age 21 yrs.
- Between age 21-30 years cytology recommended at 3 year interval and HPV testing is not recommended.
- Between 30-65 years cytology every 3 year or cytology +HPV testing every 5 year.
- If previously adequately screened screening can be discontinued after 65 years.
- Women with prior total hysterectomy and no CIN can discontinue screening.
Apart from breast and cervical cancers, certain other cancers have also reported an alarming increase such as:-
Ovarian cancer (Carcinoma Ovary)
Starting in the ovaries, diagnosis of this type of cancer is usually delayed due to lack of visible symptoms in the initial stages. About 85% to 90% of ovarian cancers are epithelial ovarian carcinomas. Epithelial ovarian cancers tend to spread to the lining and organs of the pelvis and abdomen (belly) first. This may lead to the buildup of fluid in the abdominal cavity (called ascites). As it advances, it may spread to the lung and liver, or, rarely, to the brain, bones, or skin. The main treatments for ovarian cancer are surgery and chemotherapy.
Cancer of the endometrium (Carcinoma Endometrium)
Endometrium is the lining of the uterine wall and has along with ovarian, uterine and cervical cancer is also increasing in occurrences throughout India and the world.
The grade of an endometrial cancer is based on how much the cancer forms glands that look similar to those found in normal, healthy endometrium.
- Grade 1 tumors have 95% or more of the cancerous tissue forming glands.
- Grade 2 tumors have between 50% and 94% of the cancerous tissue forming glands.
- Grade 3 tumors have less than half of the cancerous tissue forming glands. Grade 3 cancers tend to be aggressive and have a poorer outlook than lower-grade cancers.
Cervical cancer along with Ovarian, uterine and endometrial cancer can be treated using the following methods:
1. Surgery: Radical Hysterectomy primarily preferred option for early stage disease. Both open and minimal invasive approaches are suitable.
- For precancer high grade lesion conisation is also option for compliant patient.
- In young suitable patient willing for childbearing trachelectomy is also possible in very early lesion.
- Depending on risk factors after surgery adjuvant treatment may be advised.
2. Radiation therapy or Combined Radiation therapy+Chemotherapy: Alternative to surgery in early stage and choice in late stage.
Certain prevention techniques that would be advisable to detect cancer in its early stages would be,
- Regular Pap smear tests for cervical cancer
- Taking vaccines for cervical cancer
- Regular mammograms and checkups for breast cancer
- Changing lifestyles to reduce stress
- Changes in diet to reduce risks
- Leading a healthy lifestyle with regular exercise
I am 37 old female having vaginal wart near valva what is it treatment can I have sex with my husband.?
Recognising the Symptoms: The very first thing to do is to come out of denial and recognise the symptoms that are caused by this kind of depression. Usually, any long term or chronic problem can lead a person to look at himself or herself as a hopeless case. This can cause symptoms like dejection, a negative attitude towards everything and sudden outbursts of anger and frustration which may crop up in other areas of the patient's life. Since this is an intimate problem that one cannot discuss with everyone, the problem of depression gets all the more challenging. In such cases, the best thing to do is to be aware of the symptoms.
Getting help: Simply being aware of the symptoms is not enough that is merely the first step. One will need to go ahead and do something about the symptoms. Visiting a sexologist or a sex therapist is the next step. With the help of therapy and discussions, the patient and the doctor can actually reach the root cause of the issue and help in realigning the attitude and thinking of the patient to come out of stress that is creating the issue, or to deal with medical repercussions of the issue in a more stable manner.
Psychotherapy: One of the foremost methods used by most therapists includes psychotherapy that can help in unravelling the cause and finding a way to cope with the problem in a way that is focussed on discussions.
Cognitive Behavioural Therapy: This form of therapy examines all aspects of the person's life and reality so as to find the cause of the problematic behaviour and reprogram the brain of patient with great deliberation.
Antidepressants: While some medications can affect sexual functioning, there are antidepressants that do not have major sexual side effects. Please consult a Psychiatrist and discuss about this option too.
Tackling depression and erectile dysfunction is a matter of striking a fine balance with professional help.
ये औषधियां शुगर के लिए दी जाने वाली अग्रेजी दवाओं के हानिकारक प्रभाव (side effects) को कम करतीं हैं,शुगर के कारण होने वाली शारीरिक क्षति से सुरक्षा करतीं है । एवं शरीर में शुगर की मात्रा को नियंत्रित रखने में मदद करतीं हैं।
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I m 27 yrs old suffering from fungal infection after c -sec on near my vagina .Doctor suggest me zenoderm but its not working kindly suggest some best powder or cream for anti fungal and anti bacterial infection
I am 25 year's female, I am in a relationship with my boyfriend from last 5 years. And some time we make sexual relation between each other, but by mistakenly I have got pregnant about 1.5 months right now through my previous relation with my boyfriend. We both are career seekers and can't think about baby on this stage, my family is also too rude to tell. So I want to abort this, please Dr. Help and tell me about some medicine, with help of I abort this pregnancy. Please help me. .
. I am 25 years old. I am going to try anal sex for the first time. Please suggest me some lubricant available in local medical.
Hello Doctor, We are trying for baby past 3 months at the time of ovulation but no positive result, because of this my periods come before date with heavy pain, please suggest me, I am 28 year old and my husband is 29, year, my office schedule is also very hectic, daily travelling need,
I am a vegetarian. After two c-sections my weight became 55-75 kgs. I've back pain and knee pains too. please suggest to reduce my weight to 60 kgs.
Dear sir/ madam, im a young athlete I had 2 unprotected and 1 protected sex with unknown 3 partners with the gap of 1 year each. And psychologically I depressed thar I may get any STD's like. Pls suggest me that what to do? What not to do?
Hii doctor, I had conceived after 1 month of my marriage i. E in january 2015 and miscarriage in march 2015 and had D&C. After that no success till now. What should I do now if hsg test showed one of my tube block and other partially blocked. As I am very upset and much worried. I want to conceive fast and solve all my problem. What should I Do. As I am financially not so strong. please guide me and tell me effective way.
Laughter is the best medicine, they say. Apart from making you happy and thawing a potentially anxiety ridden atmosphere, laughter can also promote good health. A deep rooted laughter session once in a while can actually rejuvenate you and give you a dose of health.
If this surprises you, then you need to read the rest of this article to find out how a bout of stress free laughter can help you in the health department. Read on to know more!
- Blood Pressure: Laughing can helping in keeping your blood pressure low, as per various medical studies. This can potentially reduce the risk of falling prey to heart attacks and strokes. The blood pressure will genuinely come down when you laugh heartily, which is especially helpful in situations for patients of hypertension so as to bring down the stress levels.
- Immunity: Did you know that the immune system of the body can get affected by the stress hormone levels? When your brain brings on signals that hint at stress and anxiety, laughter can also help in bringing down the stress levels simply by sharing a joke and laughing about a funny episode with someone close to you. This also gives a boost to the body's immune system. Also, when you laugh really hard, the T cells of the body get activated, which is how the immunity gets a boost so that the next time you are about to catch a cold or flu, the immunity takes over naturally.
- Cardiac Health: Laughter is great for the cardiac health because it helps the heart pump and burns the same number of calories that one would during a long walk. It is a great cardio workout that is ideal for people who are bed ridden due to illness or injury.
- Abs: A long and heartfelt laughter session can actually work your abs as it helps the inactive muscles of the area in contracting and relaxing. This is similar to a moderate work out for the abs. So getting a toned tummy can actually be as easy as having a good laugh.
- Endorphins: The body's natural pain killers reside in the Endorphin hormone. So have a good laugh and release these hormones as a natural side effect of laughing hard. This can help in reliving chronic pain as well.
The best part about laughter is that it generally increases the feel good factor inside you and helps you achieve a more relaxed mind and body where the immunity, heart health and general wellbeing are taken care of. So laugh your way to good health and get a well-functioning immune system with a well-toned body as well.