PREGNANCY

DOC I AM PREGNANT
Pregnancy is the carrying of a fetus or embryo in the womb of a woman. 

The term embryo is used to describe the developing offspring during the first 8 weeks following conception while the term fetus is used from about 2 months of development until birth.

Human pregnancy is divided into three trimester periods:
1.The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus).
2.The second trimester, the development of the fetus can be more easily monitored and diagnosed.
3.The third trimester often approximates the ability of the fetus to survive outside of the uterus.

 Fertilization
The process leading to pregnancy occurs earlier usually in the fallopian tube when the female egg is penetrated by the male spermatozoon following the act of sexual intercourse.
This process is referred to as fertilization or conception.
The fertilized egg then travel down the fallopian and implants itself into the inner lining of the womb or uterus.
Once implanted in the uterus the embryo will grow to become a fetus at 2 months before coming out of a normal pregnant mother's womb at 38 weeks from conception to become a newborn baby.
After implantation into the lining of the womb, the embryo secretes a hormone named human chorionic gonadotropin which in turn stimulates the corpus luteum in the woman's ovary to produce progesterone.
The progesterone act to maintain the lining of the uterus so that the embryo will continue to be nourished by the glands in the lining of the uterus.
The capillaries will be stimulated to grow from the wall of the uterus to form the placenta which allow the embryo to receive vital nutrients from the woman's blood supply.The umbilical cord is the connecting cord from the embryo or fetus to the placenta and allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply.

The expected date of delivery is 40 weeks counting from the first day of the last menstrual period and birth usually occurs between 38 and 42 weeks.Even though pregnancy begins at conception, it is more convenient to date from the first day of a woman's last menstrual period.

Diagnosis of pregnancy:
The beginning of pregnancy may be detected by a pregnant woman without medical testing through a number of symptoms of pregnancy:
1. nausea and vomiting,
2. excessive tiredness and fatigue,
3. cravings for certain foods
4. frequent urination particularly during the night.

Signs of pregnancy include:
1.the presence of human chorionic gonadotropin (hCG) in the blood and urine can be detected as early as 12 days after implantation
2.missed menstrual period,
3.implantation bleeding during the third or fourth week after last menstrual period,
4.increased basal body temperature sustained for over 2 weeks after ovulation,
5.Chadwick's sign (darkening of the cervix, vagina, and vulva),
6.Goodell's sign (softening of the vaginal portion of the cervix),
7.Hegar's sign (softening of the uterus isthmus),
8.pigmentation of linea alba – darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around the 22nd week of pregnancy
9.Breast tenderness and darkening of the nipples is common
10.an early obstetric ultrasonography can determine the age of the pregnancy fairly accurately based on the last menstrual period.

LASIK SURGERY

DOC I HAVE LASIK SURGERY

LASIK (an acronym for laser-assisted in situ keratomileusis) is a type of refractive surgery done by ophthalmologists for correcting myopia, hyperopia, and astigmatism using excimer laser.

The LASIK technique use of the laser was to change the surface shape of the cornea first done in 1991.

The operation itself involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser.
The flap is repositioned and the eye is left to heal in the postoperative period.

Preoperative:
Patients who are wearing soft contact lenses are instructed to stop wearing them 5 to 21 days before operation.

The patient's corneas are examined with a pachymeter to determine their thickness and to measure their surface contour.

This process also discover astigmatism and other irregularities in the shape of the cornea.

With this information the eye surgeon calculates the amount and the locations of corneal tissue to be removed during the operation.

The patient typically is given a course of antibiotic beforehand to minimize the risk of infection.

Operation:
The operation is performed when the patient is awake and mobile although he/she is sometimes given a mild sedative (such as Valium) and anesthetic eye drops.

LASIK is performed in three steps.
A corneal suction ring is applied to the eye, holding the eye in place.
1.create a flap of corneal tissue.

Once the eye is immobilized, the flap is created with a mechanical microkeratome using a metal blade, or a femtosecond laser microkeratome that creates a series of tiny closely arranged bubbles within the cornea.
A hinge is left at one end of this flap.
The flap is folded back, revealing the stroma, the middle section of the cornea.

2.remodeling of the cornea underneath the flap with the laser.
An excimer laser (193 nm) is used to remodel the corneal stroma.
The laser vaporizes tissue in a finely controlled manner without damaging the adjacent stroma.

3.the flap is repositioned.
After the laser has reshaped the stromal layer, the LASIK flap is carefully repositioned over the treatment area by the surgeon and checked for the presence of air bubbles, debris, and proper fit on the eye.
This flap stays in position by natural adhesion until healing is completed.

Postoperative care:
Patients are usually given a course of antibiotic and anti-inflammatory eye drops.
Patients are usually told to sleep much more and are also given a darkened pair of shields to protect their eyes from bright lights and protective goggles to prevent rubbing of the eyes when asleep and to reduce dry eyes.
They also are required to moisturize the eyes with preservative-free tears.
Proper post-operative care is important to prevent the risk of complications.

LASIK surgery results:
The surveys determining patient satisfaction with LASIK have found most patients satisfied, with satisfaction range being 92–98 percent.

Complications:
Intraoperative complications
1.flap complications
2.slipped flap (a corneal flap that detaches from the rest of the cornea) is one of the most common complications.
3.Flap interface particles

Early postoperative complications
1.dry eye symptoms at 6 months period post surgery.
2.diffuse lamellar keratitis (DLK),
3.infection responsive to treatment.Infection under the corneal flap is possible.

Late postoperative complications
1.A subconjunctival hemorrhage
2.Surgery induced dry eyes or in severe cases chronic dry eye.Due to 70% of corneal nerves that are severed during the Lasik operation , the lubrication system of the eye is affected and nerves may never recover to pre-operative condition.
3.Overcorrection or undercorrection
4.Vitamin D deficiency from Sun sensitivity
5.Visual acuity fluctuation
6.Halos or starbursts around light sources at night
7.Light sensitivity
8.Ghost images or double vision
9.Wrinkles in flap (striae)
10.Decentered ablation
11.Debris or growth under flap
12.Thin or buttonhole flap
13.Induced astigmatism
14.Corneal Ectasia -decrease in the number of corneal keratocytes (fibroblasts) after LASIK.
15.Floaters
16.Epithelium erosion
17.Posterior vitreous detachment
18.Macular hole.
19.flap dislocations have been reported 1–7 years post-LASIK.
20.intraocular pressure, essential in glaucoma screening and treatment.
21.retinal detachment
22.choroidal neovascularization
23.uveitis
24.keratomileusis effected at a later age increases the incidence of corneal higher-order wavefront aberrations.
25.Microfolding -an almost unavoidable complication of LASIK usually negligible
26.Blepharitis,  with crusting of the eyelashes can lead to infection or inflammation of the cornea after LASIK.

Newer methods like Femtosecond laser intrastromal vision correction via all-femtosecond correction (like Femtosecond Lenticule Extraction, FLIVC, or IntraCOR), or other techniques that avoid permanently weakening the cornea with incisions and deliver less energy to surrounding tissues will replace LASIK Surgery.

CONGESTIVE HEART FAILURE

DOC I HAVE CONGESTIVE HEART FAILURE

Congestive Heart failure occurs when the heart can not pump enough blood to the rest of the body.

This condition may affect either the right side or the left side of the heart. Often both sides of the heart are involved.

The Causes of Congestive Heart failure are:

When the heart is unable to pump enough oxygen-rich blood out to the rest of the body, blood may back up in other areas of the body.

Fluid builds up in the lungs, liver, gastrointestinal tract, and the arms and legs.

This is called congestive heart failure.

The main causes are:
1.coronary artery disease (CAD) a narrowing of the small blood vessels that supply blood and oxygen to the heart.

2.cardiomyopathy-Heart failure can also occur when an infection weakens the heart muscle and the heart muscle enlarges to compensate.

3.Congenital heart disease -defects in the heart of the newborn affects the pumping action of the heart

4.Heart valve disease - abnormal valves affects the blood flow through the heart

5.Some types of abnormal heart rhythms(arrhythmias) affects efficiency of blood flow through the heart

6.Emphysema - chronic lung disease affect the heart lung circulation

7.Overactive thyroid - fast heart beat affects the heart pumping action

8.Severe anemia -insufficient blood affects the blood flow in the heart

9.Underactive thyroid - slow heart beats also affects the heart

Symptoms:

Symptoms of heart failure usually begin slowly.
1.breathing problems occurs even while resting.

2.Cough worse at night

3.Fatigue, weakness, faintness

4.Loss of appetite

5.Need to urinate at night

6.Pulse that is fast or irregular, or palpitations(feeling of fast heart beats)

7.Shortness of breath when active or lying down

8.Swollen (enlarged) liver or abdomen

9.Swollen feet and ankles

10.Waking up from sleep as a result of shortness of breath

11.Weight gain

Heart failure symptoms can also begin suddenly; for example, after a heart attack or other heart problem.

Signs

1.Fast or difficult breathing

2.Irregular or fast heartbeat and abnormal heart sounds

3.Leg swelling (edema)

4.Neck veins that stick out (distended)

5.Sounds (creps) from fluid buildup in lower parts of the lungs

6.Swelling of the liver or abdomen

Diagnosis:
An echocardiogram (ultrasound) is the best test to diagnose, find the cause of, and monitor the heart failure because it can check on the blood flow through the heart.

Imaging tests are useful:
1.Cardiac stress tests
2.Heart catheterization
3.MRI of the heart
4.Nuclear heart scans

Laboratory tests are done to check on:
1. kidneys condition (BUN, creatinine, creatinine clearance, urinalysis)

2.low blood count or anemia -- full blood count (FBC)

3.Test for brain natriuretic peptide (BNP)

4.sodium and potassium levels in your blood

Treatment:

MONITORING

1.Follow-up appointments to check the heart function.

2.Knowledge of symptoms indicating heart failure is getting worse
a.changes in your heart rate,
b.pulse rhythm
c.blood pressure,
d.weight.

3.Weight gain within a day or two may be a sign of extra fluid in the body and the heart failure is getting worse.

4.reduce the salt eaten and limit the fluid taken during the day.

5.Avoid alcohol

6.Avoid smoking

7.Keep active walking or riding a stationary bicycle. Avoid exercise on days when there is increased fluid or weight.

8.Lose weight if overweight.

9.Lower your cholesterol by diet

10.Rest is needed for the heart .

MEDICATIONS

Medicines treat the symptoms, prevent the heart failure from getting worse, and prolong life

Medicines like diuretics,aspirin and digoxin will:
1.Help the heart muscle pump better

2.Keep the blood from clotting

3.Lower the blood pressure

4.Open up the blood vessels or slow the heart rate

5.Replace potassium

6.Rid your body of excess fluid and salt (sodium)

Surgery:
1.Coronary bypass surgery (CABG) and angioplasty may help improve blood flow to the damaged or weakened heart muscle.

2.Heart valve surgery may be done if damages to the heart valve are causing heart failure.

3.A pacemaker can help treat slow heart rates or help both sides of the heart contract at the same time.

4.A defibrillator sends an electrical pulse to stop life threatening abnormal heart rhythms.

SEVERE HEART FAILURE
Severe heart failure occurs when treatments no longer work.
Certain treatments may be used when a person is waiting for a heart transplant:
1.Intra-aortic balloon pump (IABP)
2.Left ventricular assist device (LVAD)

Prognosis:

Very often the heart failure can be controlled by taking medicine, changing to a healthy lifestyle, and treating the underlying condition.

Heart failure can suddenly get worse due to:
1.Angina
2.Eating high-salt foods
3.Heart attack
4.Infections or other illnesses
5.Not taking medicines correctly

Heart failure is usually a chronic illness, which may get worse over time.
Some people develop severe heart failure, in which medicines, other treatments, and surgery no longer help.

ANTIOXIDANTS

DOC WHAT ARE ANTIOXIDANTS

Antioxidants are substances that may protect the  cells in the body against the effects of free radicals.

Free radicals are molecules produced by:

1. Oxidation—one of the body's natural chemical processes—can produce free radicals which are highly unstable molecules that can damage cells.

Free radicals are produced when the body breaks down foods like carbohydrates, proteins and fats for use as glucose, amino acids or fatty acids or storage in the body

2.environmental exposures like tobacco smoke, radiation, and environmental contaminants can produce free radicals from chemical reactions in the environment .

These free radicals can start  chain reactions which can occur in a cell resulting in  damage or death to the cell.

Free radicals can damage  the cells in the body and therefore may play a role in Alzheimer's disease, cancer, eye disease, heart disease, Parkinson's disease, and rheumatoid arthritis.

Antioxidants are found in many foods.

1.fruits and vegetables, nuts, grains

2. meats, poultry and fish.

Antioxidants are substances that may protect the cells  of the body from potentially disease-producing cell damage that can result from natural bodily processes and from exposure to certain chemicals.

The body can produce its own antioxidants and also obtain them from food.

Antioxidants are abundant in vegetables and fruits and are also found in grain cereals, teas, legumes, and nuts.

Antioxidant substances include anthocyanins, beta-carotene, catechins, coenzyme Q10, flavonoids, lipoic acid, lutein, lycopene, selenium, and vitamins C and E

People take antioxidant supplements in an effort to improve their health and to prevent various diseases

Systematic reviews of the research literature have concluded that there is not enough evidence to support the use of antioxidant supplements for preventing cancer, cardiovascular disease, and eye disease, and reducing overall mortality in healthy people and people with various diseases

One exception is the combination of antioxidants and zinc reduced the risk of developing advanced stages of age-related macular degeneration (AMD) by 25 percent in people who had intermediate AMD or advanced AMD in only one eye. Antioxidant supplements used alone reduced the risk by about 17 percent.

Safety of Antioxidants

Antioxidants in foods are generally considered safe.
However beta-carotene supplements have been found to increase the risk of lung cancer in smokers.
vitamin E supplements may increase the risk of bleeding in certain people.

Use of Antioxidants

Do not use antioxidant supplements:

1.as a replacement for a healthful diet

2.as conventional medical care,

3.to postpone seeing a doctor about a medical problem.

SCHIZOPHRENIA

DOC I HAVE SCHIZOPHRENIA

Schizophrenia is a complex mental disorder characterized by symptoms involving:
1.personality
2.Thinking non logically
3.emotionally unstable responses,
4.Behaving abnormally in social situations
5.tendency to withdraw from reality to a private personal world

Schizophrenia is a complex illness.
The cause is yet unknown.
1.genetic factors - schizophrenia has a history of
a family member with the disease.
2.environmental events may trigger schizophrenia in people who are genetically more at risk for it.
3.Schizophrenia affects both men and women equally.
4.It usually starts in the teen years or young adulthood, but may start later in life.
It usually begin later in women, and is milder.
5.Childhood-onset schizophrenia begins after age 5. Childhood schizophrenia is rare.

Schizophrenia symptoms develop slowly over months or years.
1.difficulty keeping friends and working.
2.anxiety,
3.depression,
4.suicidal thoughts or behaviors.

Early symptoms are:
1.Irritable or tense feeling
2.Difficulty sleeping
3.Problem concentrating
4.problems with thinking, emotions and behavior develop, including:
a. Lack of emotion (flat affect)
b. Strongly held beliefs not based in reality (delusions)
c. Hearing or seeing things that are not there (hallucinations)
d. Problems paying attention
e. Thoughts jump between unrelated topics ( loose associations)
f. Bizarre behaviors
g. Social isolation

Paranoid schizophrenia symptoms include:
1.Anxiety
2.Anger or argumentative
3.False believes that people are trying to harm him(paranoia).

Disorganized schizophrenia symptoms include:
1.Difficulty with thinking and expressing ideas clearly
2.Childlike behavior
3.Showing little emotion

Catatonic schizophrenia symptoms include:
1.Lack of activity
2.Muscles and posture rigidity
3.Grimaces or odd expressions on the face
4.No response to other people

Chronic:
All types of Schizophrenia tend to have the following:
1.blunting of affect or emotion
2.incoherant thought
3.delusions
4.hallucinations
5.apathy or withdrawl from society

Diagnosis
1.thorough interview of the person and family

members:
a.length of the symptoms
b.ability to function whether it has changed
c.Developmental background
d.Genetic and family history
2.Brain scans (such as CT or MRI) and blood tests to rule out other disorders

Complications
Having schizophrenia increases the risk for:
1.alcohol or drugs abuse:
Using alcohol or other drugs increases the risks of recurrence.
2.Physical illness:
People with schizophrenia may become physically sick due to an inactive lifestyle and side effects
from medication.
3.Suicide

TOOTHACHE

DOC I HAVE TOOTHACHE

Toothache is the pain around the teeth or jaws usually following a tooth problem.

Toothache can be very severe and may cause the sufferer many sleepless nights.

The causes of Toothache are:

Tooth Problems such as :
1.Dental caries which is caused by the action of the bacteria that lives in plague, a sticky coating of saliva and food debris that forms on the surface of the teeth.

2.a broken tooth

3.an exposed tooth root

4.dental abscess

5.gum disease

Disorders of the temporo-mandibular joints such as:
1.temporomandibular joint arthritis

2.injuries to the jaw or joint

The Symptoms of Toothache is basically pain.
However the pain can be mild to severe or excruciating and chronic.
The toothache may be made worse by chewing on hard food or cold or even heat.

The symptom of toothache and its causes can only be determined by a  professional dental examination which includes X-rays .

the most common cause of toothache is

1.the dental caries and abscess,
a.sensitivity of the tooth to hot/ cold foods and drinks.
b.Pain occurs when the dentin is damaged.
c.Visible pits or holes appear on the enamel

2.Gum disease is the second most cause ot toothache.
Gingivitis or infection of the gums can cause the erosion of gum and bone tissue that surrounds and keep the tooth in place.
As a result of the gum infection and destruction of the bone of the tooth, the nerve of the tooth is affected and send pain signals to indicated the severity of the gum and tooth infection.

3.Tooth roots that are exposed are no longer protected by the gums aand bone of the tooth. The exposed tooth roots can be become very sensitive to cold hot or sour foods.

4.Broken tooth means a fracture of the bone of the tooth. Biting on the bone fracture can severe excruciating pain.

5.Impacted tooth such as wisdom tooth can cause pain if the tooth is pressing against the gums and the nerve surrounding the gums.

6.Temporo-mandibular joints inflammation caused by habitual clenching of teeth
or grinding of teech can caused irritation of the temporo-mandibular joints resulting in spasm of muscles and jaw pain.

Treatment of Toothache:
1.scrape the teeth to remove plague
A flouride gel may be applied to protect the teeth from plague

2.If a cavity is present, the dental surgeon may fill the tooth with fillings made of dental amalgam in molars and premolars and composite resins for the front teeth.

3.in the case of a large cavity or a broken tooth, the dentist will drill the decayed portion of the tooth, fill the cavity and cover the tooth with an artificial crown.

4.root canal treatment involves removal of the tooth’s pulp and replacing it with an inert material.

5.The entire tooth is taken out if the decay is very advanced

6. Brufen or other NSAID pain killers are given for temporo-mandibular joints inflammation and also to relieve toothache in general.

7.Local anesthetic cream or clove oil has been used to apply to tooth with relief of pain

Preventing Decay
Tips for preventing caries include:
1.diet low in sugar
2.good oral hygiene:

a.Brushing teeth twice a day with fluoride toothpaste.
b.Cleaning between teeth daily with floss.

3.regular dental visits and assessment.

4.a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.

BIRTH CONTROL METHODS

DOC I NEED BIRTH CONTROL METHODS

Hormonal Methods:

1.Birth control pills

Birth control pills is taken daily.

Effects are reversible;

lessens menstrual cramps; makes the periods regular; reduces acne; reduces risks of developing ovarian and endometrial cancer;

no protection against STIs; may interfere with other medications

2.Hormonal Injections:

Depo-Provera is an injection that costs a little bit more than the pill but may prevent pregnancy
for 3 months.

Lunelle injection is a monthly progesterone injection but  can only prevent pregnancy for up to one month.

Effects are reversible;

only 4 times a year;

reduces the risk of developing endometrial cancer   

 May cause irregular bleeding or spotting;

no protection against STIs.

3.The Nuva Ring

The Nuva Ring or vaginal ring is a flexible ring that is inserted into the vagina for three weeks
before removal .
The ring contains chemicals such as estrogen and progesterone that releases this into the body.


The birth control patch releases hormones into the body like the the oral pill.

Other methods of birth control are:

1.The Intra Uterine Device

The Intrauterine Device or IUD is a small plastic device that contains hormones and copper.
It thickens the cervical mucus to decrease the chances of an egg from fertilizing as well
physically prevent the sperms from entering the uterus easily.
The device is long-lasting (up to 5 years); no interruption to intercourse;may cause irregular
bleeding or spotting; no protection against STIs; IUD rarely may fall out; a physician is required to insert and remove the IUD

2.Withdrawal Method

The withdrawal method is removal of the male penis out of the girl’s vagina before ejaculation. Effectiveness is 80%.no protection against STIs

3.Sterilization of women and Male reproductive tubes

Sterilization or tubal ligation closes the fallopian tubes permanently and prevent the sperms
from entering the fallopian tube to fertilize the egg.
Men can also have their spermatic duct ligated.
This is called a vasectomy.
Effectiveness is 99.5%;No interference with intercourse;Usually Irreversible; surgery risks; no
protection against STIs

4.Rhythm Method

Natural family planning is using the Rhythm method when sexual intercourse is avoided during the fertile period. Effectiveness is 70-80%; no protection against STIs


5.Abstinence

Abstinence is not engaging in sexual intercourse at all .Effectiveness is 100%.NO STIs.

How to choose your birth control method:

Factors such as  
1.age,
2.frequency of sexual activity,
3.family history regarding genetic disease
4.comfort level when using a particular method,
5.level of desire to be pregnant in the future
are important when choosing an appropriate birth control method.

The usage of a condom has the advantage of  protection against most STIs while hormonal method
is more effective as birth control.

BIRTH CONTROL

DOC I NEED BIRTH CONTROL

Birth Control or Contraception is a term used to prevent pregnancy and control births.

There are different ways of preventing pregnancy:
1.men - includes:
a.condoms
b.withdrawal before ejaculation
c.abstinence during the fertile period
d.vasectomy

2.women - includes:
a.female condom
b.diaphragm
c.cervical cap
d.contraceptic sponge
e.spermicides
f.oral contraceptives
g.birth control patch
h.Progesterone injections
i.Nuva ring
j.IUD
k.sterilization by tubal ligation
l.Rhythm method

Basically there are two major methods of birth control :
1. barrier
2. hormonal.

Other birth control methods include
1.sterilization otherwise known as surgery,
2.withdrawal,
3.natural family planning
4.abstinence which is the simplest method.

In the barrier method , the male or the female uses

1.the condom to prevent the sperm from ever entering the female’s uterus.
The male condom comes in many brands, color and flavors and is usually made of latex rubber.
The condom is placed over the penis when it is erect prior to intercourse.

The female condom on the other hand is made of polyurethane and is seven inches long.
This protect the cervix, vaginal canal and the  areas surrounding the vagina.
The female condom is inserted into the woman’s vagina also prior to intercourse.
Effectiveness is 95%;Protection against certain STIs;May break or slip; makes noises during
intercourse

2. Another barrier method is to use spermicides which is a chemical designed to kill sperm.
The spermicide is available as foam, jelly, foaming tablet or vaginal suppository.
Effectiveness 82% is greatly increased when it is used with a condom, diaphragm or cervical cap;May provide lubrication; can be used by women who breastfeed or smoke;No protection against STIs; may cause allergic reactions in some people

3.the diaphragm that is a soft rubber dome which stretches over a flexible ring that contains
spermicides in the form or cream or jelly.This is inserted inside the woman’s vagina and
placed over the cervix.
The diaphragm should not stay inside the vagina for more than 3 hours prior to intercourse.
Effectiveness 94%;Protection against certain STIs;  Proper insertion is required; may dislodge during intercourse; may cause allergic reactions in some people (due to the spermicide used)

4.The cervical cap is a small cup made of polyurethane just like the condom.
The cup is filled with spermicidal cream and inserted into the girl’s vagina and placed over the
cervix.Effectiveness is 91% (for women who have not given birth) 74% (for women who have given birth before)     Protection against certain STIs; can be fitted 24 hours before intercourse;Proper insertion is required; may dislodge during intercourse; may cause allergic reactions in some people (due to the spermicide used); may cause vaginal discharge and odour

5.the contraceptive sponge is a soft saucer shaped device made from polyurethane like the female
condom.

Besides the above Barrier methods, there are the hormonal birth control methods.

1.Hormonal birth control method can be in the form of an implant, patch, pill or injection.
The purpose is to a.prevent the woman’s ovaries from releasing an egg monthly
b.thicken  the cervical mucus so the sperm will have a difficult time penetrating the egg

c.thin the lining of the uterus so that the chances of a fertilized egg implanting on the uterus wall
is reduced.
d.effectiveness is 98-99%

BIPOLAR DISORDERS TREATMENT

DOC I NEED TREATMENT FOR BIPOLAR DISORDER

Treatment of Bipolar Disorders:

The main goals of treatment are to:
1.Avoid moving from one phase to another
2.Avoid the necessity for a hospital stay
3.Assist the patient function as well as possible between episodes
4.Prevent self injury and suicide by patient
5.Make the periods of manic and depressive phases less frequent and severe

The Doctor may also look for any triggers which may cause the bipolar condition and any medical or emotional problems that might affect treatment.

The  medicines used to stabilize moods are :
1.Carbamazepine
2.Lamotrigine
3.Lithium
4.Valproate (valproic acid) and other antiseizure drugs

Other drugs used to treat bipolar disorder include:
1.Antipsychotic drugs and anti-anxiety drugs (benzodiazepines) for mood problems
2.Antidepressant medications may be added to treat depression.
Some people with bipolar disorders are more likely to have manic or hypomanic episodes if they are put on antidepressants.
Because of this, antidepressants are used  only in people who also take a mood stabilizer.
3.Electroconvulsive therapy (ECT) can be used to treat the manic or depressive phase of bipolar disorder if it does not respond to medication.
ECT uses an electrical current to cause a brief seizure in the patient while the patient is under general anesthesia.
ECT is still the most effective treatment for depression not relieved with medications.
4.Transcranial magnetic stimulation (TMS) uses high-frequency magnetic pulses to target affected areas of the brain. It is used second after ECT.

Patients who are in the middle of manic or depressive episodes may be required to stay in a hospital until their mood is stable and their behavior is under control.

Complications of Bipolar Disorders:

Stopping medical treatment or taking it the wrong way may cause the symptoms to return and lead to the following complications:
1.Alcohol and/or drug abuse
2.Difficulties with relationships, work, and finances
3.Suicidal thoughts and behaviors

Prognosis of Bipolar Disorders:
1.Mood-stabilizing medication can help control the symptoms of bipolar disorder.It is important to help and support the patients to take medicine properly and to make sure that mania and depression are treated as early as possible.

2.Some patients stop taking the medication as soon as they feel better or because the mania feels good. However any stoppage of medication can cause serious problems.

3.Suicide is a very real risk during both mania and depression. People with bipolar disorder who think or talk about suicide need immediate emergency attention.

Prevention of Bipolar Disorders:

1.Support and education about bipolar disorder (psychoeducation) may help families cope and reduce the odds of symptoms returning.
2.Programs that offer outreach and community support services can help people who do not have family and social support.

Important support skills taught include:
1.Coping with symptoms which are present despite taking medications
2.Learning a healthy lifestyle especially getting enough sleep , eating well and staying away from recreational drugs
3.Learning to take medications properly and how to control side effects
4.Learning to look for the return of symptoms, and knowing what to do if they return
5.Family members and caregivers are very important in the treatment of bipolar disorder.
They can provide the right support services for patients and make sure the patient takes medication correctly.
6.Getting enough sleep is very important in bipolar disorder.
Lack of sleep can trigger a manic episode.
7.Treatment is always helpful during the depressive phase.
8.Bipolar disorder patients cannot always tell the doctor about their condition.Patients often cannot recognize their own manic symptoms.
9.Changes in mood with bipolar disorder are unpredictable. It is difficult to tell whether a patient is responding to treatment or naturally coming out of a bipolar phase.

Bipolar Disorders is difficult to treat and patients, their friends, and family must know the risks of death if bipolar disorder is not treated properly.

BIPOLAR DISORDERS

DOC I HAVE BIPOLAR DISORDER

Bipolar disorder is a condition in which people swings between periods of a very good or irritable mood and depression.

The exact cause is unknown, but it can occur in families of people with bipolar disorder.
Bipolar disorder affects both men and women equally.
It usually begins between ages 15 - 25.

The Types of bipolar disorder:
1.bipolar disorder type I have had at least one manic episode and periods of major depression.

2.bipolar disorder type II have never had full mania.
There are periods where there is high energy levels and impulsiveness but that is not as extreme as mania (called hypomania).
This hypomania episodes alternate with periods of depression.

3.mild form of bipolar disorder called cycloymia involves less severe mood swings alternating between hypomania and mild depression.

Triggers of a manic episode in people with bipolar disorder:
1.Life changes such as births
2.Medications such as antidepressants or corticosteroids
3.Periods of insomnia
4.Recreational drug usage

Symptoms
A.Manic phase -last from days to months:
1. Distracted easily
2.Little or no need for sleep
3.Poor judgement
4.Poor control of temper
5.Reckless behavior and poor self control
6.Binge eating, drinking, and/or drug usage
7.Sex with multiple partners (promiscuity)
8.Spending sprees
9.Very elevated mood
10.Hyperactivity
11.Increased physical energy
12.Over Talking
13.Very high self-esteem (false beliefs about self or abilities)
14.Very involved in activities
15.Upset easily (agitated or irritated)

These symptoms of mania occur usually with bipolar disorder I or Manic depression.
With bipolar disorder II, the symptoms of mania are similar but less intense.

B.Depressed phase of both types of bipolar disorder:
1.Daily poor mood or sadness
2.Problems in concentrating, remembering, or making decisions
3.Eating disorders
4.Loss of appetite and weight
5.Overeating and weight gain
6.Tiredness or lack of energy
7.Feels worthless, hopeless, or guilty
8.Loss of pleasure in activities once enjoyable
9.Loss of personal self-esteem
10.Thinking of death and suicide
11.Problem getting to sleep or sleeping too much
12.Avoiding friends or activities that were once enjoyable

There is a high tendency of suicide with bipolar disorder.
Abuse of alcohol or other substances  can make the symptoms and suicide risk worse.

Sometimes the two phases of manic attack and depression may overlap.
Manic and depressive symptoms can occur together or quickly one after the other in what is called a mixed state.

Diagnosis can be obtained from:

1.family medical history of bipolar disorder
2.history of recent mood swings and the length of time of mood swings
3.thorough examination to look for illnesses that may cause the symptoms
4.laboratory tests to check for thyroid problems or drug levels
5.consultation of family members regarding patient's behavior
6. medical history of any medical problems and  medications taken
7.Observation of behavior and mood

Note that drug usage may cause some symptoms but does not rule out bipolar affective disorder.
Drug abuse may be a symptom of bipolar disorder.

VITAMIN K DEFICIENCY

DOC I HAVE VITAMIN K DEFICIENCY

Vitamin K Deficiency is a medical condition caused by the deficiency of the human body of Vitamin K as a result of inadequate dietary intake or impaired absorption.

Vitamin K is present in all living human tissues as an important cofactor in the synthesis of prothrombin and clotting factors VII, IX, and X(the Vitamin K dependant clotting factors) in the liver.

There are 3 types of Vitamin K:
1.Vitamin K1- Phytomenadione
2.Vitamin K2- Menaquinone
3.Vitamin K3- Menadione
They help in forming the clotting factors in the liver.

Vitamin K is found primarily in
1.animal sources - liver.
2.vegetable sources: Vitamin K is found in fresh green and yellow vegetables, fruits and potatoes.

Optimal requirements of Vitamin K are:
1.adults and children above puberty: 20 mg to 50 mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 10 mg to 20 mg daily

Functions of Vitamin K:
1.Vitamin K together is essential for the formation and maintenance of prothrombin and clotting factors in the liver.

2.Vitamin K is synthesized in the intestine of the human host by intestinal bacteria.

Causes of Vitamin K Deficiency:
Vitamin K Deficiency occurs
1.when there is Vitamin K deficiencies due to
a.diet - lactating mothers should take more Vitamin K
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
c.Inadequate absorption resulting from abnormal intestinal bacterial flora (in hemorrhagic disease of newborns or after some antibiotics)

2.Severity of Vitamin K deficiency is inversely related to age.
It is more common in elderly people.

Symptoms of Vitamin K Deficiency:
1.Vitamin K Deficiency is a silent disease.
People with Vitamin K Deficiency often do not know that they have the condition.

2.Hemorrhagic tendercies and hemorrhages in many organ such as brain, muscles and intestines.

3.Body function-weakness and fatique

4.Mental-Brain dysfunction may occur in children with Vitamin K deficiciency because of bleeding.

Diagnosis of Vitamin K Deficiency:
1.Blood Vitamin K levels are low

Treatment of Vitamin K Deficiency:
The goal of Vitamin K Deficiency treatment is the prevention of increased fragility of red blood cells and low Vitamin K.

Therefore, prevention of Vitamin K Deficiency is as important as treatment. Vitamin K Deficiency treatment and prevention measures are:

Medications:
Vitamin K supplements
1.Vitamin K is given at 10 mg to 50 mg per day orally in mild bleeding until the response is adequate.

2.Vitamin K 10mg to 20 mg is also given intramuscularly or intravenously in slow or moderate bleeding

3.Vitamin K 25 mg to 50 mg intramuscularly or intravenously in  cirrhotic patients with severe gastrointestinal bleeding

4.1mg of Vitamin K is given to newborns as a single dose intramuscularly or subcutaneously as prevention from bleeding.

5.Vitamin K is also used for reversal of bleeding due to coumarin or inandione anticoagulant overdosage.

6.Vitamin K is also given in hypoprothrombinemia in liver disease or intestinal malabsorption,antibiotic treatment, salicylates
Side effects are:
1.Vitamin K may cause hemolytic anemia and kernictus in infants.

Prognosis of Vitamin K Deficiency:
1.good response to treatment in Vitamin K deficiciency.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin K Deficiency.

Prevention of Vitamin K Deficiency:
take more liver,diary products,potatoes and vegetables.

VITAMIN B7 DEFICIENCY

DOC I HAVE VITAMIN B7 DEFICIENCY
Vitamin B7(biotin) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B7 as a result of inadequate dietary intake or impaired absorption.
Functions of Vitamin B7:
1.Essential for energy production and the metabolism of fats and protein.
2.Required for healthy skin and hair.
Vitamin B7 works with the other B vitamins in helping to sustain a healthy nervous system.
Vitamin B7 is found primarily in
1.Egg yolk,eggs, organ meats,
2.brewer’s yeast, legumes, nuts, onions, cucumbers, yogurt, and molasses 
Optimal requirements of Vitamin B7 are:
1.adults and children above puberty: 30 mcg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 15 mcg daily
Causes:
Vitamin B7 Deficiency occurs
1.when there is Vitamin B7 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B7
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
 
2.Severity of Vitamin B7 deficiency is inversely related to age.
It is more common in elderly people.
Symptoms:
1.Vitamin B7 Deficiency is a silent disease in the early stages.
People with Vitamin B7 Deficiency often do not know that they have the condition.
2.change in appearance of the hair including hair loss
the texture and gloss of the hair may change from healthy and shiny to dull and somewhat lifeless.
3.dry, scaly patches of skin on the arms, legs, and in the groin area. If left untreated, the texture of the skin may become exceedingly rough and easily irritated.
3.Vitamin B7 works with the other B vitamins in helping to sustain a healthy nervous system.
4.tingling in the hands, numbness, paresthesia
5.depression,
6.personality changes,sleep disturbances
7.fatigue
Diagnosis:
1.Blood Vitamin B7 levels are low
Treatment:
The goal of Vitamin B7 Deficiency treatment is the prevention of peripheral neuropathy and skin amd hair lesions.
Therefore, prevention of Vitamin B7 Deficiency is as important as treatment. Vitamin B7 Deficiency treatment and prevention measures are:
Medications:
Vitamin B7 supplements
1.Vitamin B7 is given at 30 mcg per day orally until the response is adequate.
2.It is most effective when taken with the B group vitamins, Vitamin A, vitamin C and Vitamin E.
Side effects are:
1.Vitamin B7 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested
2.No side effects have been reported on dosage exceeding 10 g a day.
Prognosis:
1.good response to treatment in Vitamin B7 deficiency in early stages.
2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B7 Deficiency.
Prevention:
take more liver, egg yolks, cereals and fresh green vegetables.

VITAMIN B5 DEFICIENCY

DOC I HAVE VITAMIN B5 DEFICIENCY

Vitamin B5(Pantothenic acid) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B5 as a result of inadequate dietary intake or impaired absorption.

Functions of Vitamin B5:
1.Vitamin B5 plays an important role in the secretion of hormones, such as cortisone because of the role it plays in supporting the adrenal gland.
These hormones assist the metabolism:
2.It is essential for metabolism of fats,carbohydrates and protein 
to make fatty acids and cholesterol.
3.It help to fight allergies
4.It assists in the the maintenance of healthy skin, muscles and nerves.
5.It is used in the creation of lipids, neurotransmitters, steroid hormones and hemoglobin.
6.pantothenic acid is also helpful to fight wrinkles as well as graying of the hair.

Vitamin B5 is found primarily in
1.Beef,  eggs, organ meats. kidney,  liver,  pork,  saltwater fish,
2.fresh vegetables, legumes,mushrooms, nuts, torula yeast, whole rye flour, Whole grains,royal jelly,brewer’s yeast,

Optimal requirements of Vitamin B5 are:
1.adults and children above puberty: 5 mg to 10mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 5 mg daily

Causes:
Vitamin B5 Deficiency occurs
1.when there is Vitamin B5 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B5
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
2.Vitamin B5 can be lost in cooking -
a.particularly with roasting or milling,
b.when exposed to acids like vinegar,
c.alkali such as baking soda.
d.It is also destroyed to a large degree in canning.
3.People under stress,
4.prone to allergies,
5.consuming alcohol 
6.eating too many refined foods can develop a shortage of this vitamin.

Severity of Vitamin B5 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B5 Deficiency is a silent disease in the early stages.
People with Vitamin B5 Deficiency often do not know that they have the condition.

2.fatigue,

3.headaches,

4.nausea,

5.tingling in the hands, numbness, paresthesia (abnormal sensation such as "burning feet" syndrome)

6.depression,

7.personality changes,sleep disturbances

8.cardiac instability .

9.Frequent infection,

10.muscle weakness and cramps

Diagnosis:

1.Blood Vitamin B5 levels are low
2.lowered blood cholesterol,
3.decreased serum potassium, 
4.failure of adrenocorticotropin to induce eosinopenia.
5.increased insulin sensitivity,

Treatment:
The goal of Vitamin B5 Deficiency treatment is the prevention of peripheral neuropathy and skin lesions.

Therefore, prevention of Vitamin B5 Deficiency is as important as treatment. Vitamin B5 Deficiency treatment and prevention measures are:

Medications:
Vitamin B5 supplements
1.Vitamin B5 is given at 10-20 mg per day orally until the response is adequate.

2.It is most effective when taken with the B group vitamins, Vitamin A, vitamin C and Vitamin E.

Side effects are:
1.Vitamin B5 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested

2. diarrhea, digestive disturbances and water retention have been reported on dosage exceeding 10 g a day.

Prognosis:
1.good response to treatment in Vitamin B5 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B5 Deficiency.

Prevention:
take more red meat, liver, egg yolks, cereals and fresh green vegetables.

VITAMIN B3 DEFICIENCY

DOC I HAVE VITAMIN B3 DEFICIENCY

Vitamin B3(Niacin) Deficiency is a medical condition caused by the deficiency of the human

body of Vitamin B3 as a result of inadequate dietary intake or impaired absorption.

Vitamin B3 is present in all living human tissues as an important anti-oxidant and enzymes in the metabolism of food

Functions of Vitamin B3:
1.It helps the body make various sex and stress-related hormones in the adrenal glands and
other parts of the body.

2.It has a role in improving circulation and reducing cholesterol levels in the blood.
Niacin has been used to lower LDL or bad cholesterol and triglycerides in the blood.
It also increase the HDL or good cholesterol.

In fact it is even better than many branded cholesterol lowering medicines.

3.Because of its effect on the cholesterol and fats, it has been given to help prevent atherosclerosis. However niacin can also increase homocysteine levels in the blood which is associated with an increased risk of heart disease.

4.Osteoarthritis-it has been suggested that niacinamide can help relief arthritis and improve joint mobility and symptoms

5.Azheimer's Disease -studies show that people with higher niacin levels in the diet has lower risk of Alzeimer's disease.

6.Skin conditions - topical forms of niacin has been used as treatment foe acne, aging skin and
prevention of skin cancer.

7.All B vitamins help the body to metabolize food (carbohydrates, proteins, fats) into fuel (glucose, amino acids, cholesterol) and therefore improve energy.

Vitamin B3 is found primarily in
1.animal sources - beef liver, beef kidney, fish, salmon, swordfish, tuna
Foods that contain tryptophan, an amino acid the body converts into niacin, include poultry, red
meat, eggs, and dairy products.

2.vegetable sources: Vitamin B2 is found in fresh green and yellow vegetables, yeast, cereals,sunflower seeds,and peanuts

Optimal requirements of Vitamin B3 are:
1.adults and children above puberty: 14 mg to 16 mg daily
Pregnant mother and elderly may need double the amount.


2.Infants and children before puberty: 2 mg to 12 mg daily

Causes of Vitamin B3 Deficiency:
Vitamin B3 Deficiency occurs
1.when there is Vitamin B3 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B3
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis

2.Severity of Vitamin B32 deficiency is inversely related to age.
It is more common in elderly people.

3.It is rare for any person in the developed world to have vitamin B3 deficiency.
The main cause in the developed world is alcoholism.

Symptoms of Vitamin B3 Deficiency:
1.Vitamin B3 Deficiency is a silent disease in the early stages.
People with Vitamin B3 Deficiency often do not know that they have the condition.
They may have:
2.indigestion
3.fatigue
4.depression

In severe Vitamin B3 deficiency, a condition called pellegra develops with the following symptoms(the 3 D):
1.dermatitis -cracked scaly skin

2.dementia - mental confusion

3.diarrhea - loose stools

Other symptoms are burning sensation in the mouth and a swollen red bright red tongue.

Diagnosis of Vitamin B3 Deficiency:
1.Blood Vitamin B3 levels are low

Treatment of Vitamin B3 Deficiency:
The goal of Vitamin B3 Deficiency treatment is the prevention of pellegra.
Therefore, prevention of Vitamin B3 Deficiency is as important as treatment. Vitamin B3 Deficiency treatment and prevention measures are:

Medications:
Vitamin B3 supplements- 3 types are available:
niacin, niacinamide or inositol hexaniacinate
Vitamin B3 is given at 100 mg per day orally until the response is adequate.
Side effects are:
1.Vitamin B3 in high doses can give rise to side effects sucha s flushing of the face, stomach
upset, headache, giddiness and blurring of vision.

2. There is also a danger of liver damage.
It can interact with cholesterol lowering drugs, aspirin,blood pressure and diabetes medicines

Prognosis of Vitamin B3 Deficiency:
1.good response to treatment in Vitamin B3 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B3 Deficiency.

Prevention of Vitamin B3 Deficiency:
1.take more liver, egg yolks, cereals and fresh green vegetables.

2.avoid alcohol.