TUMOR RECURRENCE AND TAMOXIFEN RESISTANCE: HOW DOES THE DOCTOR KNOW THAT I HAVE DRUG-RESISTANT BREAST CANCER?

Posted on July 22, 2011 by admin
During your regular examinations, your doctor keeps track of how well your breast cancer is responding to the drugs that you have been given. Results from your physical exam, mammography,
X-rays, scans, biopsies, and a variety of blood tests are evaluated to see if the disease is improving, staying the same, or getting worse. When the results show that the tumor is getting larger or has spread to new areas even though you are taking chemotherapy, your doctor may assume that the tumor is no longer responding to the drugs currently being administered. At this point the doctor may suggest to you that your breast tumor is drug resistant. In this situation he or she may either increase the dose of drug to see if the tumor responds to the higher amount or change the type of drugs being administered.
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THE ROLE OF THE SENSES IN SEXUAL AROUSAL: ‘NAMASTE’ CULTURE: ‘HE NEVER TOUCHES ME EXCEPT DURING SEX’

Posted on July 12, 2011 by admin
‘Tony thinks I am untouchable except when he wants to go to bed with me,’ moaned Celine. On my taking Tony to task, he said defensively, ‘If I touch her, doctor, she might think I want sex.’ It was impressed upon Tony and Celine that touching need not necessarily culminate in sex! It can be just touching your partner to reassure her that you love and care for her.
A woman’s greatest torment is her man’s indifference. ‘Oh, doctor, if only my husband would give me a hug or a kiss occasionally, how, different 1 would feel! Women are like little puppies. We long for the loving look or touch. A little male attention makes the world so wonderful,’ Sakar said wistfully.
Do you know, Mr. Tarzan, that touching plays a very important part in women’s sexuality? Physical affection for its own sake and not just sexual touching is important to women. They crave to be touched by their beloved. It costs you nothing to use your hand non-sexually, yet it will bring you lasting dividends—a contented and responding partner. Mere sexuality without adequate sensuality where body contact gives little or no pleasure to one or both partners, results in mechanical sex. When sensitivity to varying touches is heightened in both partners, either naturally or through exercises, a unique and totally sublimating experience is felt in sex.
Sensuality is the spark which ignites you sexually when you are not only giving but also receiving—in fact, total pleasuring. It is the hallmark of a great lover with a touch of class.
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REDUCING YOUR RISK OF CORONARY ARTERY DISEASE: RECOMMENDATION FOR A HEART-HEALTHY LIFE-STYLE

Posted on July 2, 2011 by admin
There will probably never be a prescription that guarantees the health of your heart. But, waiting until heart disease strikes and then hoping for a guarantee of a failproof treatment are unrealistic expectations, too.
You can take steps to prevent or delay heart disease and to improve your outlook if it has already occurred. The impact of these steps goes beyond potential protection from heart disease— they can even improve the way you look and feel today. All of these “lifestyle” factors involve decisions you make every day. Those individual decisions—such as whether to smoke, what to eat, how to make time for exercise, how to relax—become habits.
In addition to reducing cardiovascular risks, the facets of a heart-healthy life-style complement each other. For example, if you stop smoking, your capacity for exercise will probably improve. Many people find that regular exercise relieves stress and tension and provides a feeling of accomplishment. Better eating habits and exercise work together to help you lose weight, reduce cholesterol and triglyceride levels, and improve HDL cholesterol levels. If some of your habits do not promote your health, they can be changed. Changing begins with individual decisions that become lifelong healthful habits. Many people who adopt these habits find they feel so much better that it would be worth it even if cardiovascular disease was not prevented.
Don’t expect to change all your habits at once. You may find that tiny changes over years, become more permanent. Good health habits are the work of a lifetime.
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BACH FLOWER REMEDIES: GENTIAN – SURINDER’S & MRS. VIJAY CASES

Posted on June 30, 2011 by admin
Surinder had chronic headache for the last 6 years, and had mostly been treated by allopathic doctors, which could only give temporary relief. The headache had started after the patient accidently bumped his head against a rod in the bus.
As I was preparing a few powders of Arnica= 1M for the patient, Mr. Surinder suddenly asked, •Doctor would this medicine relieve my pain’.
His doubt in the effectiveness of the medicine led me to give him a couple of Gentian powders. After which Arnica= 1M, 3 doses gave him complete relief.
Later on I learnt, that earlier Dr. Sharma, another homoeopath had also given him Arnica, but he could only give him a partial relief, because he had not removed from his mind the lurking doubt in the efficacy of the homoeopathic treatment.
Mrs. Vijay was being treated in the dispensary for various ailments. There was steady progress in her condition and she was quite happy. One morning I found her unusually depressed, and there was a visible setback in her condition. She had received a message that her young brother had met with a serious road accident, and was lying in a precarious condition in the hospital. Gentian for depression and Red Chestnut for anxiety for others were given T.D.S for 2 days, which put her on even keel once more.
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PATELLA INJURIES: TREATMENT

Posted on June 12, 2011 by admin
Patellar Fractures
A hard blow to the patella could result in a bone fracture, and due to the small size of the patella, it can be very difficult to repair. The standard methods of bone repair, open reduction and internal fixation—using wires and screws to put a bone back in place—is not easily performed on a bone that is roughly 2 to 3 inches in diameter. There is always a risk that if the surgical repair doesn’t work, it could actually cause more problems. The problems are secondary to the postoperative problems that are attendant to the immobilization required for fracture healing. The patient might have to be casted for upward of 6 weeks, which could result in stiffness. However, since the patella is such a critical part of the extensor mechanism, we try very hard to save it when we can. This is really dependent on whether the fracture is comminuted (in multiple pieces) or has one or two large pieces. In some cases we can’t save the patella, and it must be removed. After patella surgery, it is essential to get the joint moving again as soon as possible, because if it is immobile even for a short period, the joint will become stiff.
Osteochondritis Dessicans of the Patella or the Trochlea
Osteochondritis dessicans is a rare condition that primarily strikes children. For some unknown reason, the blood supply to a particular portion of bone is cut off, resulting in the death of the particular bone. The bone either falls off, which requires surgical reattachment or removal, or it may reattach itself and heal on its own. In the case of osteochondritis dessicans of the patella or trochlea, the articular cartilage on the surface of the patella or the trochlea can be disrupted, resulting in pain. Osteochondritis dessicans is diagnosed by X ray and the symptoms are pain and sometimes locking is possible if the piece of bone falls off.
Patellar-femoral Arthritis
Isolated patellar-femoral arthritis is a very rare condition. More often than not, arthritis will affect the entire joint, that is, the three compartments: the patellar-femoral, the medial femoral-tibial, and the lateral femoral-tibial. It will not stay confined to one compartment. In fact, according to one cadaver study, only 4 percent had isolated patellar-femoral arthritis, and women with kneecap malalignment were more prone to this problem. Patellar-femoral arthritis is difficult to treat. In cases of more generalized arthritis, if the disease becomes so severe that there is significant raw bone causing a great deal of pain, the physician may recommend a total knee replacement, which involves the resurfacing of all the bones of the knee joint with a prosthesis. However, if only the patella is arthritic, there are few options. Surgery involving only a patellar-femoral replacement—that is, the surgeon resurfaces only the patella and the trochlea of the femur—has not been that successful. In fact, there is less than a 50 percent chance that it will work as compared to a 95 percent success rate for a total knee replacement. However, because the arthritis has not affected other sites, physicians are reluctant to perform a total knee replacement, which in that situation would require the removal of healthy bone and articular cartilage. Usually, in the case of patellar-femoral arthritis, physicians will encourage their patients to undertake a serious strengthening program to see if that can relieve some of the pain. If the patient is over fifty-five, the exercise program is not working, and the patient is absolutely miserable, the physician may recommend a total knee replacement.
Rehabilitation Training for Patellar-Femoral-Type Syndrome
Similar to rehabilitation training for arthritis, the basic exercise plan for kneecap pain is to minimize weight-bearing stress while strengthening the surrounding muscles to assist normal patella tracking.
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GUIDELINES FOR DIABETES CARE: CLINICAL ASSESSMENTS – GLUCOSE – LEVEL GLYCEMIA

Posted on June 1, 2011 by admin
One of the important findings in the DCCT was that there was no level glycemia below which the risks of retinopathy progression were eliminated. However, the risk over time differed in the two treatment groups: increased in the conventional group and remained relatively constant in the intensive group. Total glycemic exposure was the dominant factor associated with the risk of retinopathy progression. Similar results were seen when progression of albuminuria or neuropathy was examined.
Further analyses indicated that there was no glycemic threshold below which no further reduction in risk was seen. The risks of retinopathy progression and of developing microalbuminuria and neuropathy were continuous and nonlinear over the entire range of HbAlc values  the study. Proportional reductions in HbAlc were accompanied by proportional reduction in the risks of complications.
The absolute risks of sustained retinopathy progression over the c range observed in the DCCT is apparent that the risks increase in a curvilinear fashion in the conventional group that there is no apparent threshold, and that any degree of lowering HbA1 c is associated with a decreased risk for these microvascular e! points, especially in patients with HbAlc levels >8%.
Experiences in the United Kingdom Prospective Diabetes Study (UKPDS) in newly diagnosed type 2 diabetics have supported the DCCT findings on glycemic regulation and retinopathy progression in typi diabetes.
These data form the primary basis for the current recommendati by the American Diabetes Association for glycemic management of diabetes. These guidelines may be modified in patients with comorbid diseasj very young or older adults, and others with unusual conditions (i.e., current hypoglycemia). HbAlc should be measured quarterly if the peutic goals are not met and at least twice yearly in all diabetic patients.
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CHOLESTEROL: TARAHUMARAS – A CASE IN POINT

Posted on May 29, 2011 by admin
This point is demonstrated by the remarkable coronary health of the Tarahumara Indians of Mexico. The average American HDL level is 45 for men and 55 for women, and values much below 35 are considered an increased risk for coronary heart disease. But the Tarahumaras have HDL levels averaging “only” between 22 and 32 mg/dl. However, their total cholesterol levels are only between 120 and 150. The Tarahumaras’ HDL averages would be considered dangerously low by many Western clinicians if compared, for example, with the average American HDL range of 45 to 55- but because the Tarahumaras’ LDL cholesterol levels are below 100 mg/dl, and most have a total cholesterol level below 150, they are at minimal risk for heart attacks or strokes.
And, of course, it’s important to remember that under certain circumstances high HDL levels are no guarantee of good health: To look at another population, men in east Finland have high HDL levels—and also very high death rates from coronary heart disease. Because their total cholesterol levels are so high, their high HDLs simply aren’t taking care of the problem.
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THE IDENTIFIABLE CAUSES OF CANCER: SEX

Posted on May 19, 2011 by admin
The question the reader will ask at this point is ‘Given all this epidemiological study, do we know the causes of cancer?’ Broadly the answer is ‘yes’ in many circumstances and for many cancers, and the opportunities for prevention that this understanding generates are there to be taken. We do not always know how the factors that have been identified by the epidemiological studies discussed in this chapter link up to what is being learned in the laboratories of the molecular biologists. This connection is being made rapidly and will be increasingly clear by the end of the century. Epidemiology has been very successful in discovering or confirming which features of our lives in the Western world can be now identified as causes of cancer.
Sexual activity has been extensively investigated as a factor in the cause of certain cancers, particularly cancer of the neck of uterus. Certainly, the number of sexual partners appears to be
an association. In a woman with only a single lifelong sexual partner, the number of partners that her one sexual partner has had also seems to affect her risk. How this leads to a cancer, and particularly whether the cancer is caused by transfer of a virus, is the subject of current research focusing particularly on the human papilloma virus. The transfer of infectious agents which give rise to AIDS must also be considered under this heading because people with AIDS can get unusual types of cancer.
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ALCOHOLISM TREATMENT TECHNIQUES AND APPROACHES: FAMILY TREATMENT IN CONJUNCTION WITH THE ALCOHOLIC’S TREATMENT

Posted on May 10, 2011 by admin
Work with the family is equally important for the alcoholic who enters treatment. The family should be included as early as possible. The family members’ views of what the problem is, their understanding of alcoholism as a disease, their ability to provide support, and their willingness to engage in the treatment as well will have a bearing on the treatment plans for the alcoholic. If the family is in pure chaos, at a point at which concern for the alcoholic is lost under feelings of anger and frustration, inpatient care may be far preferable to outpatient treatment. On the other hand, if the family is very supportive and is able to marshal its collective resources on the alcoholic’s behalf, outpatient treatment may be the treatment of choice.
For these reasons a family meeting is becoming a routine part of any assessment process. At this time, the counselor will be seeking their view of what is happening. When this meeting is held will be determined by the alcoholic’s status, the severity of the alcohol problem, what is going on with the family, the receptivity and/or resistance to treatment. Say alcoholism is clearly evident—at such a stage it is diagnosable even by the parking lot attendant. In this situation, the family may be the only reliable source of even the most basic information, such as how much alcohol is being consumed, past medical history, prior alcohol treatment. The alcoholic’s judgment may be so severely impaired that realistically others will need to make the decision about admission for treatment. The postponement of formal family involvement may be indicated when the alcoholism is in the early stages, and the alcoholic’s life still has some semblance of order. In such circumstances the counselor may want to explore with the alcoholic his view of the world and develop a working relationship, before introducing possibly opposing views.
It is important to keep in mind that in initial contact with the family you don’t go into a family therapy routine. It is data-collecting time. The task is to understand how the alcoholic family sees and deals with the alcoholism in its midst. In joint meetings, be prepared to provide the structure and lay the ground rules. For example, explain that people often see things differently, and that you want to know from each of those present what has been going on. If need be, reassure them that everyone gets equal time, but no interruptions, please.
During the alcoholic’s treatment the family may become involved in regularly scheduled family counseling sessions, or participate in a special group for family members, or a couples’ group, in addition to attending Al-Anon. Some residential treatment programs are beginning to hold “family weekends.” The family joins the alcoholic in residence and participates in a specially structured family program of education, group discussion, and family counseling.
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TREATMENT OF LYME DISEASE: LIFE CYCLE

Posted on April 29, 2011 by admin
Understanding the tick life cycle is an important step in assessing the risk of Lyme disease after a bite and developing strategies to prevent infection. Ticks from the genus Ixodes, typically I. scapularis in the northeastern United States and I. pacificus on the West Coast, are the vectors of Lyme disease. The species differ in animal host and vegetation preferences, factors governed by geographic availability. The life cycle of Ixodes takes 2 years to complete.
The ticks develop through larval, nymphal, and adult stages, each requiring a blood meal to advance to the next stage. Adult ticks lay eggs in early spring and the eggs hatch into larvae in the summer. Larvae feed on small mammals and birds into late summer and early fall before they molt into nymphs and become dormant. In late spring, dormant nymphs emerge to feed on rodents, small mammals, and humans. After a blood meal, nymphs molt into adults in the fall. B. burgdorferi is transmitted during feeds. Large mammals, deer in particular, are the preferred hosts for adult ticks. Adults feed and mate on deer and then drop off to lay eggs in spring, beginning the cycle again. Animal hosts are not harmed by infection.
Nymphs transmit the majority of B. burgdorferi infections to humans. They feed from late May into early September, when humans are most I active and least covered. They typically occupy low-lying shrubs and grass, which allows them to crawl onto and attach to a host as it brushes past. The nymphs’ tiny size helps them to escape detection long enough for successful attachment and feeding. Adults also transmit B. burgdorferi, but they are often discovered early and removed before attachment. Larvae do not carry B. burgdorferi when they first feed and are not important in human infections.
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