Source

Written by familydoctor.org editorial staff.

American Academy of Family Physicians

Article from http://familydoctor.org/online/famdocen/home/healthy/firstaid/bites/203.printerview.html

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

What Are the Symptoms of Sleep Disorders?

Insomnia

Insomnia is itself often a symptom of other problems. Typical patterns of insomnia include the inability to fall asleep or stay asleep at night, waking up earlier than usual, and daytime fatigue. Most people with insomnia don’t fall asleep in inappropriate situations, like driving. If this does occur, it may signal that a medical disorder (such as sleep apnea) is the cause of insomnia.

Sleep Apnea

Excessive daytime sleepiness is the primary symptom. Some people will deny sleepiness but feel fatigued. Other symptoms are snoring, snorting, and gasping sounds when you sleep — often first noticed by a sleeping partner. Restless or unrefreshing sleep is also typical, as are headaches in the morning.

Narcolepsy

Excessive sleepiness during the day, alleviated by naps, is a symptom of narcolepsy. Dreaming during naps and experiencing dream-like hallucinations as you fall asleep are also warning signs. Loss of muscle control (called cataplexy) that occurs with emotion, such as laughing or anger, and the inability to move as you’re going to sleep or waking up (called sleep paralysis) are also symptoms.

Restless Leg Syndrome

The primary warning sign is the irresistible urge to move your legs shortly after you get into bed, in the middle of the night after awakening, or even when wide awake during the day. It usually feels better if you get up to walk around or rub your leg. “Creepy-crawly” or twitching feeling in your calves, feet, thighs, or arms are symptoms of restless leg syndrome — the sensations of discomfort can be quite varied. Kicking or twitching leg movements during sleep, and sometimes while awake, may be warning signs.

Call Your Doctor If:

• Your sleep does not improve with self-help techniques, such as establishing good sleep hygiene, cutting down on caffeine, exercising, and using relaxation techniques.
• You think your sleep problems may be related to an underlying condition, such as depression or heart failure.
• You snore loudly or make snorting or gasping noises while you sleep — or your partner observes these things while you’re asleep.
• You fall asleep doing normal activities, such as talking or driving.
• You regularly feel unrefreshed on awakening and are constantly fatigued. Sleep disorders are among the many possible causes for fatigue.
• You suspect your medication is causing your sleep problems.

Article from: http://www.webmd.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

High Cholesterol: Cholesterol Basics

Have you been diagnosed with high cholesterol? Is lowering your cholesterol a goal? The first step is to find out: what is cholesterol?

Cholesterol is a waxy, fat-like substance made in the liver and found in certain foods, such as food from animals, like dairy products (whole milk), eggs and meat.

The body needs some cholesterol in order to function properly. Its cell walls, or membranes, need cholesterol in order to produce hormones, vitamin D and the bile acids that help to digest fat. But, the body needs only a small amount of cholesterol to meet its needs. When too much is present health problems such as coronary heart disease may develop.

What Is Coronary Heart Disease?

When too much cholesterol is present, plaque (a thick, hard deposit) may form in the body’s arteries narrowing the space for blood to flow to the heart. Over time, this buildup causes atherosclerosis (hardening of the arteries) which can lead to heart disease.

When not enough oxygen-carrying blood reaches the heart chest pain — called angina — can result. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.

Types of Cholesterol

Cholesterol travels through the blood attached to a protein — this cholesterol-protein package is called a lipoprotein. Lipoproteins are classified as high density, low density, or very low density, depending on how much protein there is in relation to fat.

• Low density lipoproteins (LDL): LDL, also called “bad” cholesterol, can cause buildup of plaque on the walls of arteries. The more LDL there is in the blood, the greater the risk of heart disease.
• High density lipoproteins (HDL): HDL, also called “good” cholesterol, helps the body get rid of bad cholesterol in the blood. The higher the level of HDL cholesterol, the better. If your levels of HDL are low, your risk of heart disease increases.
• Very low density lipoproteins (VLDL): VLDL is similar to LDL cholesterol in that it contains mostly fat and not much protein.
• Triglycerides: Triglycerides are another type of fat that is carried in the blood by very low density lipoproteins. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.

What Factors Affect Cholesterol Levels?

A variety of factors can affect your cholesterol levels. They include:

• Diet. Saturated fat and cholesterol in the food you eat increase cholesterol levels. Try to reduce the amount of saturated fat and cholesterol in your diet.
• Weight. In addition to being a risk factor for heart disease, being overweight can also increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as increase HDL cholesterol.
• Exercise. Regular exercise can lower LDL cholesterol and raise HDL cholesterol. You should try to be physically active for 30 minutes on most days.
• Age and Gender. As we get older, cholesterol levels rise. Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, women’s LDL levels tend to rise.
• Diabetes.  Poorly controlled diabetes increases cholesterol levels.  With impovements in control, cholesterol levels can fall.
• Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
• Other causes. Certain medications and medical conditions can cause high cholesterol.

How Much Cholesterol Is Too Much?

Everyone over the age of 20 should get their cholesterol levels measured at least once every 5 years.

When being tested, your doctor may recommend a non-fasting cholesterol test or a fasting cholesterol test. A non-fasting cholesterol test will show your total cholesterol and HDL cholesterol. A fasting cholesterol test, called a lipid profile or a lipoprotein analysis, will measure your LDL, HDL, and total cholesterol. It will also measure triglycerides.

Your doctor may start with a non-fasting cholesterol test and then recommend a lipid profile, based on your results.

Doctors recommend your cholesterol stay below 200. Here is the breakdown:

Your LDL, HDL and triglyceride levels are important as well.

How Can I Lower My Cholesterol and Reduce My Risk of Heart Disease?

A few simple changes can help lower your cholesterol:

• Eat low cholesterol foods. The American Heart Association recommends that you limit your average daily cholesterol intake to less than 300 milligrams. If you have heart disease, limit your daily intake to less than 200 milligrams. People can significantly lower their dietary cholesterol intake by keeping their dietary intake of saturated fats low and by avoiding foods that are high in saturated fat and that contain substantial amounts of dietary cholesterol.
• Quit smoking. Smoking lowers HDL (“good”) cholesterol levels. This trend can be reversed if you quit smoking.
• Exercise. Exercise increases HDL cholesterol in some people. Even moderate-intensity activities, if done daily, can help control weight, diabetes, and high blood pressure — all risk factors for heart disease.
• Take medication as prescribed by your doctor. Sometimes making changes to your diet and increasing exercise is not enough to bring your cholesterol down. You may also need to take a cholesterol lowering drug.

How Is High Cholesterol Treated?

The main goal in lowering cholesterol is to lower your LDL and raise your HDL. There are two key ways to lower cholesterol: eat a heart-healthy diet and take cholesterol-lowering medications.

Doctors determine your “goals” for lowering LDL based on the number of risk factors you have for heart disease.

• If you have 0-1 risk factor for heart disease, you are at low-to-moderate risk. Lifestyle changes are recommended to keep the cholesterol in check.
• If you have 2 or more risk factors, you are at moderate risk or next-highest risk, depending on what heart disease risk factors you have. Sometimes your doctor will try lifestyle changes, but most of these people require cholesterol-lowering drugs.
• If you have known heart disease, diabetes or multiple risk factors, you are at high, or very high, risk. These people require a combination of cholesterol-lowering drugs and lifestyle changes to control their cholesterol levels.

What Drugs Are Used to Treat High Cholesterol?

Cholesterol-lowering drugs include:

• Statins
• Niacin
• Bile-acid resins
• Fibric acid derivatives

Cholesterol-lowering medicine is most effective when combined with a low-cholesterol diet.

Reviewed by the doctors in the Department of Preventive Cardiology and Rehabilitation at The Cleveland Clinic Heart Center.

Article from: http://www.webmd.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

What causes acne?

Acne commonly starts in the early teen years, when the oil glands in the body start making more sebum (oil). In people who have acne, dead skin cells mix with the extra oil and plug up hair follicles in the skin. Bacteria that grows in the hair follicles causes more skin irritation.

A “whitehead” occurs when the hair follicle is plugged with oil and skin cells. If the follicle is plugged near the surface of the skin and the air touches it, it turns black and is called a “blackhead.” A blackhead isn’t caused by dirt.

If the wall of a plugged follicle breaks, the area swells and turns into a red bump. If the follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the wall breaks deep in the skin, acne nodules or cysts can form. This is called “cystic acne.”

Things that often make acne worse

• Oil-based makeup, suntan oil and hair products
• Stress
• Hormonal changes, especially during menstruation
• Squeezing or picking at blemishes
• Hard scrubbing of the skin

Things that don’t cause acne

• Dirt
• Chocolate or french fries
• Sexual activity
• Masturbation

Who gets acne?

Both boys and girls get acne. But it may be worse in boys because they have more skin oils.

Heredity also plays a role. If your mother and father had bad acne, you may too.

Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles.

For many people, acne fades by the age of 25, but it can continue well into the adult years.

How can acne be treated?

Many treatments are available for acne, including over-the-counter creams and prescription medications. Talk with your doctor about which options are right for you.

Can an over-the-counter acne product help?

Yes. Benzoyl peroxide, resorcinol, salicylic acid and sulfur are the most common over-the-counter medications used to treat acne. These medications are available in many forms, such as gels, lotions, creams, soaps or pads.

In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning or redness. Tell your doctor if you have side effects that are severe or that don’t go away over time.

Keep in mind that it can take up to eight 8 weeks before you notice an improvement in your skin. If an over-the-counter acne product doesn’t seem to help after 2 months, get advice from your doctor.

What can my doctor prescribe?

Your doctor may recommend antibiotics, which can be very effective for treating acne. They can be taken by mouth or used on the skin in a lotion, cream or gel.

Retinoids, such as tretinoin (brand names: Retin-A, Avita, Altinac cream) and adapalene (brand name: Differin), are usually rubbed onto the skin once a day. Be sure not to get them near your eyes, mouth and the area under your nose.

If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of getting a very bad sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene (brand name: Tazorac) because it can cause birth defects.

How is severe cystic acne treated?

Isotretinoin (brand name: Accutane) may be used to treat severe cystic acne that doesn’t get better with other treatments. It’s a pill that is taken once a day by mouth for 15 to 20 weeks.

Isotretinoin should never be taken during pregnancy. It can cause serious side effects such as birth defects and miscarriages. Women on isotretinoin must use 2 types of birth control or not have sex starting 1 month before she begins taking the medication and lasting 1 month after she stops taking it.

There is a possibility that other serious side effects may occur, so people taking isotretinoin should be closely monitored by their doctor.

Does acne cause scars?

Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments are available.

Article from: http://familydoctor.org/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

Who gets acne?

Both boys and girls get acne. But it may be worse in boys because they have more skin oils.

Heredity also plays a role. If your mother and father had bad acne, you may too.

Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles.

For many people, acne fades by the age of 25, but it can continue well into the adult years.

Return to top

How can acne be treated?

Many treatments are available for acne, including over-the-counter creams and prescription medications. Talk with your doctor about which options are right for you.

Return to top

Can an over-the-counter acne product help?

Yes. Benzoyl peroxide, resorcinol, salicylic acid and sulfur are the most common over-the-counter medications used to treat acne. These medications are available in many forms, such as gels, lotions, creams, soaps or pads.

In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning or redness. Tell your doctor if you have side effects that are severe or that don’t go away over time.

Keep in mind that it can take up to eight 8 weeks before you notice an improvement in your skin. If an over-the-counter acne product doesn’t seem to help after 2 months, get advice from your doctor.

Return to top

What can my doctor prescribe?

Your doctor may recommend antibiotics, which can be very effective for treating acne. They can be taken by mouth or used on the skin in a lotion, cream or gel.

Retinoids, such as tretinoin (brand names: Retin-A, Avita, Altinac cream) and adapalene (brand name: Differin), are usually rubbed onto the skin once a day. Be sure not to get them near your eyes, mouth and the area under your nose.

If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of getting a very bad sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene (brand name: Tazorac) because it can cause birth defects.

Return to top

How is severe cystic acne treated?

Isotretinoin (brand name: Accutane) may be used to treat severe cystic acne that doesn’t get better with other treatments. It’s a pill that is taken once a day by mouth for 15 to 20 weeks.

Isotretinoin should never be taken during pregnancy. It can cause serious side effects such as birth defects and miscarriages. Women on isotretinoin must use 2 types of birth control or not have sex starting 1 month before she begins taking the medication and lasting 1 month after she stops taking it.

There is a possibility that other serious side effects may occur, so people taking isotretinoin should be closely monitored by their doctor.

Return to top

Does acne cause scars?

Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments are available.

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

An abscessed tooth is a painful infection at the root of a tooth or between the gum and a tooth. It’s most commonly caused by severe tooth decay. Other causes of tooth abscess are trauma to the tooth, such as when it is broken or chipped, and gingivitis or gum disease.

These problems can cause openings in the tooth enamel, which allows bacteria to infect the center of the tooth (called the pulp). The infection may also spread from the root of the tooth to the bones supporting the tooth.

What Are the Symptoms of an Abscessed Tooth?

A toothache that is severe and continuous and results in gnawing or throbbing pain or sharp or shooting pain are common symptoms of an abscessed tooth. Other symptoms may include:

Fever

Pain when chewing

Sensitivity of the teeth to hot or cold

Bitter taste in the mouth

Foul smell to the breath

Swollen neck glands

General discomfort, uneasiness, or ill feeling

Redness and swelling of the gums

Swollen area of the upper or lower jaw

An open, draining sore on the side of the gum

If the root of the tooth dies as a result of infection, the toothache may stop. However, this doesn’t mean the infection has healed; the infection remains active and continues to spread and destroy tissue. Therefore, if you experience any of the above listed symptoms, it is important to see a dentist even if the pain subsides.

How Is an Abscessed Tooth Diagnosed?

Your dentist will probe your teeth with a dental instrument. If you have an abscessed tooth, you will feel pain when the tooth is tapped by your dentist’s probe. Your dentist will also ask you if your pain increases when you bite down or when you close your mouth tightly. In addition, your dentist may suspect an abscessed tooth because your gums may be swollen and red.

Your dentist may also take X-rays to look for erosion of the bone around the abscess.

How Is an Abscessed Tooth Treated?

Strategies to eliminate the infection, preserve the tooth, and prevent complications are the goals of treatment.

To eliminate infection, the abscess may need to be drained. Achieving drainage may be done through the tooth by a procedure known as a root canal. Root canal surgery may also be recommended to remove any diseased root tissue after the infection has subsided. Then, a crown may be placed over the tooth.

The tooth may also be extracted, allowing drainage through the socket.

Finally, a third way to drain the abscess would be by incision into the swollen gum tissue.

Antibiotics are prescribed to help fight the infection. To relieve the pain and discomfort associated with an abscessed tooth, warm salt-water rinses and over-the-counter pain-reducing medication like ibuprofen (Advil or Motrin) can be used.

The inflammation and pain of abscesses can be relieved with a low-level laser, making the patient more comfortable to receive the injection in a more painless way.

Can an Abscessed Tooth Be Prevented?

Following good oral hygiene practices can reduce the risk of developing a tooth abscess. Also, if your teeth experience trauma (for example, become loosened or chipped), seek prompt dental attention.

Article from: http://www.webmd.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

How to know if my child has poor vision?

Normally a child should be able to recognize mother and have a social smile by 6-8 weeks of age. If the child has poor vision in both the eyes, then he/she may not recognize the mother or may not respond to the visual stimuli. Once the child starts walking, he/she may frequently bump into objects.

If the child has poor vision in only one eye then it may be difficult to notice it. The eye with poor vision may not be aligned properly with the other eye, thus causing squint (strabismus). The child may also have rhythmic jiggling movements of the eyes (nystagmus).

Sometimes the cause of poor vision may be visible as a whiteness of the cornea or whiteness behind the pupil. In some cases the eyes of child with glaucoma may be watering and very sensitive to light.

The poor vision may also be noticed incidentally when the child is being examined by a doctor or during vision screening in the school.

What are the causes of poor vision in a child?

These causes are:

• Refractive error
• Cataract
• Glaucoma
• Squint (strabismus)
• Injury to the eye (sometimes the child may not tell about the injury to parents)
• Diseases of cornea
• Diseases of retina and optic nerve
• Inherited disorders
• Tumor (Retinoblastoma)
• Other eye abnormalities

What to do if I suspect that my child does not see properly?

As we see, there can be many causes for poor vision in a child. Some of these are very simple and treated easily, while others may be very difficult to manage and sometimes may even be life threatening. Therefore it is prudent to contact an ophthalmologist at the earliest if you suspect poor vision in your child. He or she will confirm poor vision and then look for the cause of the same. A timely treatment is very crucial in saving the sight and sometimes the life of the child.

How can one determine the vision in a small child who will not cooperate for vision testing?

There are many special tests available which help the doctor in determining the visual acuity of children in all age groups. The ophthalmologist will decide which tests to use and will get an idea of the visual loss and the chances of getting good vision after treatment.

Why is it important to detect poor vision in child?

If the poor vision in child is not treated early enough, the eye may not develop properly and develop a condition called amblyopia (lazy eye). Therefore, if the eye is treated at a later stage, the eye may not get good vision. It is very important to treat the cause of poor vision, e.g., refractive error, cataract, glaucoma, diseases of cornea etc. as early as possible to prevent amblyopia. 
Early detection is also very important in case of tumor (retinoblastoma), which if detected early, may be treated easily without having to remove the eye. If it is not detected, then it may even lead to loss of life.

I have a child with poor vision. Can my other children also have some eye problem?

The chances of other children getting affected depend upon the cause of poor vision. Many of these conditions may be hereditary and may require examination of other siblings of the child. Also in hereditary diseases, a genetic counseling may be done to the parents if they plan to have another baby in future.

Article from: http://health.indiamart.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

How does the brain store information?

Information is stored in different parts of your memory. Information stored in the short-term memory may include the name of a person you met moments ago. Information stored in the recent memory may include what you ate for breakfast. Information stored in the remote memory includes things that you stored in your memory years ago, such as memories of childhood.

How does aging change the brain?

When you’re in your 20s, you begin to lose brain cells a few at a time. Your body also starts to make less of the chemicals your brain cells need to work. The older you are, the more these changes can affect your memory.

Aging may affect memory by changing the way the brain stores information and by making it harder to recall stored information.

Your short-term and remote memories aren’t usually affected by aging. But your recent memory may be affected. For example, you may forget names of people you’ve met recently. These are normal changes.

Things to help you remember

• Keep lists.
• Follow a routine.
• Make associations (connect things in your mind), such as using landmarks to help you find places.
• Keep a detailed calendar.
• Put important items, such as your keys, in the same place every time.
• Repeat names when you meet new people.
• Do things that keep your mind and body busy.
• Run through the ABC’s in your head to help you think of words you’re having trouble remembering. “Hearing” the first letter of a word may jog your memory.

What about when I know a word but can’t recall it?

This is usually just a glitch in your memory. You’ll almost always remember the word with time. This may become more common as you age. It can be very frustrating, but it’s not usually serious.

What are some other causes of memory problems?

Many things other than aging can cause memory problems. These include depression, dementia (severe problems with memory and thinking, such as Alzheimer’s disease), side effects of drugs, strokes, head injury and alcoholism.

How does Alzheimer’s disease change memory?

Alzheimer’s disease starts by changing the recent memory. At first, a person with Alzheimer’s disease will remember even small details of his or her distant past but not be able to remember recent events or conversations. Over time, the disease affects all parts of the memory.

How can I tell if my memory problems are serious?

A memory problem is serious when it affects your daily living. If you sometimes forget names, you’re probably okay. But you may have a more serious problem if you have trouble remembering how to do things you’ve done many times before, getting to a place you’ve been to often, or doing things that use steps, like following a recipe.

Another difference between normal memory problems and dementia is that normal memory loss doesn’t get much worse over time. Dementia gets much worse over several months to several years.

It may be hard to figure out on your own if you have a serious problem. Talk to your family doctor about any concerns you have. Your doctor may be able to help you if your memory problems are caused by a medicine you’re taking or by depression.

Memory problems that aren’t part of normal aging

• Forgetting things much more often than you used to
• Forgetting how to do things you’ve done many times before
• Trouble learning new things
• Repeating phrases or stories in the same conversation
• Trouble making choices or handling money
• Not being able to keep track of what happens each day

Article from: http://familydoctor.org/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

Cardiovascular disease is the term used to describe problems involving the heart (cardio) or blood vessels (vascular). The most devastating complications of cardiovascular disease are stroke and heart attack; these can often be fatal. In fact, cardiovascular disease is the number one cause of death overall in the United States; the statistics that one in five Americans has cardiovascular disease includes women.

Active, exercising women already have lowered their risk of cardiovascular disease, as exercise affords the best heart protection. The recommendation by the American Heart Association is 30 minutes of moderate to intense physical activity 5 days a week. Aerobic exercise, which raises heart rate and uses up oxygen, improves cholesterol levels and maintains the peak functioning efficiency of heart and blood vessels. It also trains the cells to carry oxygen more efficiently and improves the rate of oxygen uptake in breathing.

High blood pressure is a precursor to heart and blood vessel disease. Blood pressure is necessary to promote exchange of nutrients from the blood into the capillaries and into the body. If there are problems such as hardened arteries, slow or inefficient heart functioning, or increased body demands due to poorly trained muscles, blood pressure rises. Because regular exercisers do not usually have these problems, blood pressure remains low. This reduces the occurrence of bad side effects of blood pressure such as heart attack and stroke. Studies have recently shown that regular exercise of moderate intensity for one hour five days a week is as effective as medication in managing high blood pressure.

The unmodifiable factors that can also increase your risk of cardiovascular disease are family history of stroke or heart attack, especially in family members under the age of 50; high cholesterol or triglycerides; and diabetes. Modifiable factors include smoking, obesity, and inactivity. Less clear but risky lifestyle behaviors are high stress and poor diet (high sugar and saturated fat/high cholesterol/low fiber). If you have any of these increased risks, you should see your doctor to discuss prevention methods in addition to exercise. These may include an aspirin a day, a low-cholesterol, unsaturated fat, high-fiber diet, and medications.

Factors That Increase Risk of Cardiovascular Disease

• High LDL cholesterol
• Obesity
• High triglycerides
• Inactivity
• Diabetes
• Stress
• Family history
• Poor diet
• Smoking
• Older age

Because women who have been through menopause are at an increased risk of heart disease and stroke, and women taking oral contraceptives or hormone replacement can be at an increased risk of stroke and blood clots, if you are in these categories and have the risk factors mentioned above, consult with your doctor for the best prevention strategies. Other heart-protective dietary behaviors can include a high-fiber, low glycemic index diet, increasing amount of omega-3 fatty acids, adding soy products, and having (only) one alcoholic drink per day.

Health Benefits of Aerobic Exercise

• Prevents heart disease
• Decreases osteoporosis risk
• Lowers blood pressure
• Reduces depression
• Reduces strokes
• Reduces cancer
• Prevents obesity
• Reduces stress
• Prevents diabetes
• Improves sleep
• Reduces cholesterol

Article from: http://life.familyeducation.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

The pituitary gland is a tiny organ, the size of a pea, found at the base of the brain. As the master gland of the body, it produces and secretes many hormones that travel throughout the body, directing certain processes stimulating other glands to produce different types of hormones. The pituitary gland controls biochemical processes important to our well-being.

The pituitary gland makes these types of hormones:

• Prolactin – Prolactin stimulates milk production from the breasts after childbirth to enable nursing. It also affects sex hormone levels from ovaries in women and from testes in men.
• Growth hormone (GH) – GH stimulates growth in childhood and is important for maintaining a healthy body composition and well-being in adults. In adults it is important for maintaining muscle mass as well as bone mass. It also affects fat distribution in the body.
• Adrenocorticotropin (ACTH) – ACTH stimulates the production of cortisol by the adrenal glands. Cortisol, a so-called “stress hormone” is vital to our survival. It helps to maintain blood pressure and blood glucose levels.
• Thyroid-stimulating hormone (TSH) – TSH stimulates the thyroid gland, which regulates the body’s metabolism, energy, growth, and nervous system activity. This hormone is also vital to our survival.
• Antidiuretic hormone (ADH) – ADH, also called vasopressin, regulates water balance. If this hormone is not released properly, it can lead to too little hormone (called diabetes insipidus), or too much hormone (called syndrome of inappropriate ADH). Both of these conditions affect the kidneys. Diabetes insipidus is different from the more well-known diabetes mellitus (or type II diabetes), which affects the levels of glucose in our bodies.
• Luteinizing hormone (LH) – LH regulates testosterone in men and estrogen in women.
• Follicle-stimulating hormone (FSH) – FSH promotes sperm production in men and stimulates the ovaries to enable ovulation in women. Luteinizing hormone and follicle-stimulating hormone work together to cause normal function of the ovaries and testes.

Pituitary Tumors

The most frequent cause of pituitary disorders is pituitary gland tumors. The pituitary gland is made of several cell types. Sometimes these cells grow too much or produce small growths.

These growths are called pituitary tumors, and they are fairly common in adults. These are not brain tumors and are not a form of cancer. In fact, cancerous tumors of this sort are extremely rare. Pituitary tumors, however, can interfere with the normal formation and release of hormones.

Two types of tumors exist – secretory and non-secretory. Secretory tumors produce too much of a hormone, creating an imbalance of proper hormones in the body. Non-secretory tumors cause problems because of their large size or because they interfere with normal function of the pituitary gland.

The problems caused by pituitary tumors fall into three general categories:

1. Hypersecretion – Too much of any hormone secreted into the body is usually caused by a secretory pituitary gland tumor. Many secretory tumors make too much prolactin, the hormone that triggers milk production in new mothers. Other tumors may affect the adrenal glands, making too much of the hormones that stimulate them and causing a hormone imbalance. Tumors also can make excess growth hormone or too much of the hormone that stimulates the thyroid gland leading to overproduction of thyroid hormones.
3. Hyposecretion – Too little of any hormone secreted into the body is usually caused by a non-secretory pituitary gland tumor, which interferes with the ability of the normal pituitary gland to create hormones. It can, however, also be caused by a large secretory tumor. Hyposecretion can also happen with surgery or the radiation of a pituitary gland tumor.
5. Tumor mass effects – As a pituitary gland tumor grows and presses against the normal pituitary gland or other areas in the brain, it may cause headaches, vision problems, or other health effects related to hyposecretion. Tumor mass effects can be seen in any type of pituitary tumor that grows large enough. Injuries, certain medications, and other conditions can also affect the pituitary gland. Loss of normal pituitary function also has been reported after major head trauma.

NOTE: If you think you have a problem with your pituitary gland, it is important that you see a pituitary specialist who can determine whether you have a pituitary gland tumor or another endocrine system disease. An endocrinologist is an expert in hormone-related conditions and some endocrinologists make the pituitary gland their specialty. You may be referred to other doctors if you need surgery or radiation treatments.

Article from: http://www.hormone.org/Pituitary/overview.cfm

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

Lately, it seems as though your child is looking up to classmates — literally. The other kids in the class have been getting taller and developing into young adults, but your child’s growth seems to be lagging behind. Classmates now tower over your child.

Is something wrong? Maybe, maybe not. Some kids just grow more slowly than others because their parents did, too. But others may have an actual growth disorder, which is any type of problem that prevents kids from meeting realistic expectations ofgrowth, from failure to gain height and weight in young children to short stature or delayed sexual development in teens.

Variations of Normal Growth Patterns

A couple of differences seen in the growth patterns of normal children include these common conditions, which are not growth disorders:

Constitutional growth delay: This condition describes children who are small for their ages but who are growing at a normal rate. They usually have a delayed “bone age,” which means that their skeletal maturation is younger than their age in years. (Bone age is measured by taking an X-ray of the hand and wrist and comparing it with standard X-ray findings seen in kids the same age.) These children don’t have any signs or symptoms of diseases that affect growth. They tend to reach puberty later than their peers do, with delay in the onset of sexual development and the pubertal growth spurt. But because they continue to grow until an older age, they tend to catch up to their peers when they reach adult height. One or both parents or other close relatives often had a similar “late-bloomer” growth pattern.

Familial (or genetic) short stature: This is a condition in which shorter parents tend to have shorter children. This term applies to short children who don’t have any symptoms of diseases that affect their growth. Kids with familial short stature still have growth spurts and enter puberty at normal ages, but they usually will only reach a height similar to that of their parents.

With both constitutional growth delay and familial short stature, kids and families need to be reassured that the child does nothave a disease or medical condition that poses a threat to health or that requires treatment. However, because they may be short or may not enter puberty when their classmates do, some may need extra help coping with teasing or they may need reassurance that they will go through full sexual development eventually. In a few normal children who are very short or very late entering puberty, hormone treatment may be helpful.

Growth Disorders

Diseases of the kidneys, heart, gastrointestinal tract, lungs, bones, or other body systems may affect growth. Other symptoms or physical signs in kids with these illnesses usually give clues as to the disease causing the growth delay. However, poor growth can be the first sign of a problem in some.

Growth disorders include:

Failure to thrive, which isn’t a specific growth disorder itself, but can be a sign of an underlying condition causing growth problems. Although it’s common for newborns to lose a little weight in the first few days, failure to thrive is a condition in which some infants continue to show slower-than-expected weight gain and growth. Usually caused by inadequate nutrition or a feeding problem, it’s most common in kids younger than age 3. It may also be a symptom of another problem, such as an infection, a digestive problem, child neglect, or abuse.

Endocrine diseases (diseases involving hormones, the chemical messengers of the body) involve a deficiency or excess of hormones and can be responsible for growth failure during childhood and adolescence. Growth hormone deficiency is a disorder that involves the pituitary gland (the small gland at the base of the brain that secretes several hormones, including growth hormone). A damaged or malfunctioning pituitary gland may not produce enough hormones for normal growth.Hypothyroidism is a condition in which the thyroid gland fails to make enough thyroid hormone, which is essential for normal bone growth.

Turner syndrome, one of the most common genetic growth disorders, occurs in girls and is a syndrome in which there’s a missing or abnormal X chromosome. In addition to short stature, girls with Turner syndrome usually don’t undergo normal sexual development because their ovaries (the sex organs that produce eggs and female hormones) fail to mature and function normally.

Diagnosing a Growth Disorder

The tests a doctor may recommend to detect a growth disorder depend on the findings at each step of evaluation. A short child who’s healthy and growing at a normal rate may just be observed throughout childhood, but a child who has stopped growing or is growing more slowly than expected will often need additional testing.

Your doctor or an endocrinologist will look for signs of the many possible causes of short stature and growth failure. Blood tests may be done to look for hormone and chromosome abnormalities and to rule out other diseases associated with growth failure. A bone age X-ray might be done and special scans (such as an MRI) can check the pituitary gland for abnormalities.

To measure the ability of the pituitary gland to produce growth hormone, the doctor (usually a pediatric endocrinologist) may do a growth hormone stimulation test. This involves giving the child medications that cause the pituitary gland to secrete growth hormone, then drawing several small blood samples over time to check growth hormone levels.

Treating a Growth Disorder

Although the treatment of a growth problem usually isn’t urgent, earlier diagnosis and treatment of can help some kids catch up with peers and increase their final height.

If an underlying medical condition is identified, specific treatment may result in improved growth. Growth failure due to hypothyroidism, for example, is usually treated with thyroid hormone replacement pills.

Growth hormone injections for children with growth hormone deficiency, Turner syndrome, and chronic kidney failure may help kids reach a more normal height. Human growth hormone is generally considered safe and effective, although full treatment may take many years and not all kids will have a good response. And the treatment can be costly (about $20,000 to $30,000 per year), although many health insurance plans cover it.

What about growth hormone treatment for short children who aren’t growth hormone deficient when tested? The U.S. Food and Drug Administration (FDA) has approved its use in such children if they’re predicted to reach a very short final height (under 4 feet 11 inches [150 centimeters] for a girl or 5 feet 4 inches [163 centimeters] for a boy).

Talk with your doctor for more information about treatment options if you’re concerned.

Helping Your Child

You can boost your child’s self-esteem by providing positive reinforcement and emphasizing other characteristics, like intelligence, personality, and talents. Try to take the focus off of height as a measure of social acceptance.

Kids who are very self-conscious about their size may need some additional help in coping. In some cases, evaluation and treatment by a mental health professional may be needed.

If You Suspect a Problem

If you’re concerned about your child’s growth, speak with your doctor, who may refer you to a pediatric endocrinologist, who can help diagnose and treat specific growth disorders.

It’s also important to watch for the social and emotional problems that kids with growth disorders face. It’s not easy being the shortest kid in the class and it’s never any fun being teased. Helping your child build self-esteem and emphasizing strengths — regardless of how tall he or she may grow — might be just what the doctor ordered.

Article from: http://kidshealth.org/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

You can treat many minor eye irritations by flushing the eye with water, but more serious injuries require medical attention.

Injuries to the eye are the most common preventable cause of blindness, so when in doubt, err on the side of caution and call your doctor for help.

What to Do:

Routine Irritations
(sand, dirt, and other foreign bodies on the eye surface)

• Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
• Do not touch, press, or rub the eye itself, and do whatever you can to keep your child from touching it (a baby can be swaddled as a preventive measure).
• Do not try to remove any foreign body except by flushing, because of the risk of scratching the surface of the eye, especially the cornea.
• Tilt the child’s head over a basin or sink with the affected eye down and gently pull down the lower lid, encouraging the child to open his or her eyes as wide as possible. For an infant or small child, it’s helpful to have a second person hold the child’s eyes open while you flush.
• Gently pour a steady stream of lukewarm water (do not heat the water) from a pitcher or faucet over the eye.
• Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
• Because a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if there continues to be any irritation afterward.
• If a foreign body is not dislodged by flushing, it will probably be necessary for a trained medical professional to flush the eye.

Embedded Foreign Body
(an object penetrates or enters the globe of the eye)

If an object, such as a piece of glass or metal, is sticking out of the eye, take the following steps:

• Call for emergency medical help.
• Cover the affected eye with a small cup taped in place. The point is to keep all pressure off the globe of the eye.
• Keep your child (and yourself) as calm and comfortable as possible until help arrives.

Chemical Exposure

• Many chemicals, even those found around the house, can damage an eye. If your child gets a chemical in the eye and you know what it is, look on the product’s container for an emergency number to call for instructions.
• Flush the eye (see above) with lukewarm water for 15 to 30 minutes. If both eyes are affected, flush them in the shower.
• Call for emergency medical help.

Call your local poison control center for specific instructions. Be prepared to give the exact name of the chemical, if you have it. However, do not delay flushing the eye first.

Black Eye, Blunt Injury, or Contusion

A black eye is often a minor injury, but it can also appear when there is significant eye injury or head trauma. A visit to the doctor or an eye specialist may be required to rule out serious injury, particularly if you’re not certain of the cause of the black eye.

For a black eye:

• Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, make sure it’s covered with a towel or sock to protect the delicate skin on the eyelid.
• Use cold compresses for 24 to 48 hours, then switch to applying warm compresses intermittently. This will help the body reabsorb the leakage of blood and may help reduce discoloration.
• If the child is in pain, give acetaminophen — not aspirin or ibuprofen, which can increase bleeding.
• Prop the child’s head with an extra pillow at night, and encourage him or her to sleep on the uninjured side of the face (pressure can increase swelling).
• Call your doctor, who may recommend an in-depth evaluation to rule out damage to the eye. Call immediately if any of the following symptoms are noted:
  • increased redness
  • drainage from the eye
  • persistent eye pain
  • any changes in vision
  • any visible abnormality of the eyeball
  • visible bleeding on the white part (sclera) of the eye, especially near the cornea

If the injury occurred during one of your child’s routine activities, such as a sport, follow up by investing in an ounce of prevention — protective goggles or unbreakable glasses are vitally important.

Reviewed by: Sharon Lehman, MD

Article from: http://kidshealth.org/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

What Is Bronchitis?

Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes, the tubes that carry air to your lungs, become inflamed.

People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.

Overview

There are two main types of bronchitis: acute (short term) and chronic (ongoing).

Acute Bronchitis

Infections or other factors that irritate the lungs cause acute bronchitis. The same viruses that cause colds and the flu often cause acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis.

Acute bronchitis lasts from a few days to 10 days. However, the cough that occurs may last for several weeks after the infection is gone.

Several factors increase the risk for acute bronchitis. Examples include tobacco smoke (including secondhand smoke), air pollution, dust, and fumes. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.

Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that need medical care.

Chronic Bronchitis

Chronic bronchitis is an ongoing, serious condition. It occurs when the lining of the bronchial tubes is constantly irritated and inflamed.

Bronchitis is “chronic” if you have a cough with mucus on most days for at least 3 months a year and 2 years in a row (without another apparent cause). Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. When this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis also have periods when symptoms get much worse than usual.

Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting cigarette smoking and avoiding secondhand cigarette smoke, can help people live better with this condition. The chance of complete recovery is low for people who have severe chronic bronchitis.

What Causes Bronchitis?

Acute Bronchitis

Infections or other factors that irritate your lungs cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition.

Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to cigarette or cigar smoke, air pollution, dusts, vapors, or fumes raises your risk. These lung irritants also can make symptoms worse.

Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis.

Chronic Bronchitis

Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of this condition.

Breathing in air pollution and dust or fumes from the environment or the workplace also can lead to chronic bronchitis.

People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis.

Who Is At Risk for Bronchitis?

Bronchitis is a very common condition. Millions of cases occur every year.

Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups. People of all ages can get chronic bronchitis, but it occurs more often in people who are older than 45. Women are more than twice as likely to be diagnosed with chronic bronchitis as men.

Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with chemical fumes, vapors, and dusts from certain jobs—such as those in coal mining, textile manufacturing, and grain handling—also increases your risk for the condition.

Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke.

What Are the Signs and Symptoms of Bronchitis?

Acute Bronchitis

Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea.

The main symptom of acute bronchitis is a cough. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks.

Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain.

If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity.

Chronic Bronchitis

The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough is often called “smoker’s cough.”

How Is Bronchitis Diagnosed?

Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you’ve had it, what you’re coughing up, and how much you cough.

Your doctor also will likely ask:

• About your medical history
• Whether you’ve recently had a cold or the flu
• Whether you smoke or spend time around others who smoke
• Whether you’ve been exposed to air pollution, dust, or fumes

Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may:

• Look at your mucus to see whether you have a bacterial infection
• Test the oxygen levels in your blood using a sensor attached to your fingertip or toe
• Order a chest x ray, lung function tests, or blood tests

How Is Bronchitis Treated?

The main goals of treating acute and chronic bronchitis are to relieve symptoms and help make breathing easier.

If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever.

Antibiotics usually aren’t prescribed for acute bronchitis. This is because they don’t work against viruses—the most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics.

A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go right to your lungs.

Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists).

To lower your risk of getting bronchitis, your doctor also may suggest a flu shot and/or a pneumonia vaccine (if you’re aged 60 or older).

If you have chronic bronchitis and have also been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form).

Sometimes people who have chronic bronchitis need oxygen therapy to help them breathe better and get enough oxygen to their bodies.

One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to the lungs. If you smoke cigarettes, it’s very important to quit. Talk to your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke. Also, try to avoid places with a lot of dusts, fumes, vapors, or air pollutants.

How Can Bronchitis Be Prevented?

You can’t always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both types of the condition. The most important step is to quit smoking or not start smoking.

Try to avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other things with strong fumes. This will help protect your lungs.

Wash your hands often to reduce exposure to germs and bacteria. Get a flu shot every year, especially if you have lung problems. Get a pneumonia vaccine as your doctor advises if you’re aged 60 or older.

Living With Chronic Bronchitis

If you have chronic bronchitis, you can take steps to control your symptoms. Lifestyle changes and ongoing care can help you manage the condition.

Lifestyle Changes

The most important step is to quit smoking or not start smoking. Avoid other lung irritants, such as secondhand smoke, fumes, air pollution, and dust. This will help keep your lungs healthy.

Wash your hands often to lower your risk for a viral or bacterial infection. Also, try to stay away from people who have colds or the flu. See your doctor right away if you have signs or symptoms of a cold or the flu.

Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.

For more information on following a healthy diet, see the National Heart, Lung, and Blood Institute’s Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” and “Your Guide to Lowering Your Blood Pressure With DASH.” All of these resources include general advice about healthy eating.

Ongoing Care

See your doctor regularly and take all your medicines as prescribed. Also, talk to your doctor about getting a yearly flu shot and/or a pneumonia vaccine.

If you have chronic bronchitis, pulmonary rehabilitation (rehab) may help improve your breathing. Pulmonary rehab is a breathing exercise program that’s supervised by a respiratory therapist. This is a health care worker who knows about lung treatments. Talk to your doctor about whether rehab may benefit you.

People who have chronic bronchitis often breathe fast. Talk to your doctor about a breathing method called pursed-lip breathing. This breathing method may help you feel better because it slows down your breathing. To do pursed-lip breathing, take a deep breath. Then, slowly breathe out through your mouth. At the same time, hold your lips as if you’re going to kiss someone.

Article from: http://www.nhlbi.nih.gov/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

What is dysphagia?

People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.

How do we swallow?

Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to move food from the mouth to the stomach. This happens in three stages. First, the tongue moves the food around in the mouth for chewing. Chewing makes the food the right size to swallow and helps mix the food with saliva. Saliva softens and moistens the food to make swallowing easier. During this first stage, the tongue collects the prepared food or liquid, making it ready for swallowing.

The second stage begins when the tongue pushes the food or liquid to the back of the mouth, which triggers a swallowing reflex that passes the food through the pharynx (the canal that connects the mouth with the esophagus). During this stage, the larynx (voice box) closes tightly and breathing stops to prevent food or liquid from entering the lungs.

The third stage begins when food or liquid enters the esophagus, the canal that carries food and liquid to the stomach. This passage through the esophagus usually occurs in about 3 seconds, depending on the texture or consistency of the food.

How does dysphagia occur?

Dysphagia occurs when there is a problem with any part of the swallowing process. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage of air.

Other problems include not being able to start the swallowing reflex (a stimulus that allows food and liquids to move safely through the pharynx) because of a stroke or other nervous system disorder. People with these kinds of problems are unable to begin the muscle movements that allow food to move from the mouth to the stomach. Another difficulty can occur when weak throat muscles cannot move all of the food toward the stomach. Bits of food can fall or be pulled into the windpipe (trachea), which may result in lung infection.

What are some problems caused by dysphagia?

Dysphagia can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight.

Sometimes, when foods or liquids enter the windpipe of a person who has dysphagia, coughing or throat clearing cannot remove it. Food or liquid that stays in the windpipe may enter the lungs and create a chance for harmful bacteria to grow. A serious infection (aspiration pneumonia) can result.

Swallowing disorders may also include the development of a pocket outside the esophagus caused by weakness in the esophageal wall. This abnormal pocket traps some food being swallowed. While lying down or sleeping, a person with this problem may draw undigested food into the pharynx. The esophagus may be too narrow, causing food to stick. This food may prevent other food or even liquids from entering the stomach.

What causes dysphagia?

Dysphagia has many causes. Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. For example, people with diseases of the nervous system, such as cerebral palsy or Parkinson’s disease, often have problems swallowing. Additionally, stroke or head injury may affect the coordination of the swallowing muscles or limit sensation in the mouth and throat. An infection or irritation can cause narrowing of the esophagus. People born with abnormalities of the swallowing mechanism may not be able to swallow normally. Infants who are born with a hole in the roof of the mouth (cleft palate) are unable to suck properly, which complicates nursing and drinking from a regular baby bottle.

In addition, cancer of the head, neck, or esophagus may cause swallowing problems. Sometimes the treatment for these types of cancers can cause dysphagia. Injuries of the head, neck, and chest may also create swallowing problems.

How is dysphagia treated?

There are different treatments for various types of dysphagia. First, doctors and speech-language pathologists who test for and treat swallowing disorders use a variety of tests that allow them to look at the parts of the swallowing mechanism. One test, called a fiber optic laryngoscopy, allows the doctor to look down the throat with a lighted tube. Other tests, including video fluoroscopy, which takes videotapes of a patient swallowing, and ultrasound, which produces images of internal body organs, can painlessly take pictures of various stages of swallowing.

Once the cause of the dysphagia is found, surgery or medication may help. If treating the cause of the dysphagia does not help, the doctor may have the patient see a speech-language pathologist who is trained in testing and treating swallowing disorders. The speech-language pathologist will test the person’s ability to eat and drink and may teach the person new ways to swallow.

Treatment may involve muscle exercises to strengthen weak facial muscles or to improve coordination. For others, treatment may involve learning to eat in a special way. For example, some people may have to eat with their head turned to one side or looking straight ahead. Preparing food in a certain way or avoiding certain foods may help other people. For instance, those who cannot swallow liquids may need to add special thickeners to their drinks. Other people may have to avoid hot or cold foods or drinks.

For some, however, consuming foods and liquids by mouth may no longer be possible. These individuals must use other methods to nourish their bodies. Usually this involves a feeding system, such as a feeding tube, that bypasses the part of the swallowing mechanism that is not working normally.

What research is being done on dysphagia?

Scientists are conducting research that will improve the ability of physicians and speech-language pathologists to evaluate and treat swallowing disorders. All aspects of the swallowing process are being studied in people of all ages, including those who do and do not have dysphagia. For example, scientists have found that there is great variation in tongue movement during swallowing. Knowing which tongue movements cause problems will help physicians and speech-language pathologists evaluate swallowing.

Research has also led to new, safe ways to study tongue and throat movements during the swallowing process. These methods will help physician and speech pathologists safely reevaluate a patient’s progress during treatment. Studies of treatment methods are helping scientists discover why some forms of treatment work with some people and not with others. For example, research has shown that, in most cases, a patient who has had a stroke should not drink with his or her head tipped back. Other research has shown that some patients with cancer who have had part or all of their tongue removed should drink with their head tipped back. This knowledge will help some patients avoid serious lung infections and help others avoid tube feedings.

Where can I get help?

If you have a swallowing problem, you may need to consult with an otolaryngologist (physician with special training in disorders of the ear, nose, and throat) or a speech-language pathologist trained in dysphagia. You may need to consult with a neurologist if a stroke or other neurologic disorder causes the swallowing problem. Other trained professionals who may provide treatment are occupational therapists and physical therapists.

Article from: http://www.nidcd.nih.gov/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety. These things include:

First, he or she will need to make sure that other health problems aren’t causing your physical symptoms. If your symptoms aren’t caused by other health problems, you and your doctor can address the emotional causes of your symptoms. Your doctor may suggest ways to treat your physical symptoms while you work together to improve your emotional health.

If your negative feelings don’t go away and are so strong that they keep you from enjoying life, it’s especially important for you to talk to your doctor. You may have what doctors call “major depression.” Depression is a medical illness that can be treated with individualized counseling, medicine or with both.

Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation–such as your family doctor, a counselor or a religious advisor–for advice and support to help you improve your emotional health.

Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.

Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change, and keeping things in perspective.

Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.

Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.

Article from: http://familydoctor.org/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

Most people will experience neck pain at some point in their lives. Neck pain can be acute, meaning it lasts a few hours to a few weeks, or it can be chronic. Neck pain that lasts several weeks or longer is considered chronic neck pain.

Most causes of neck pain aren’t serious. Poor posture at work, such as leaning into your computer, and during hobbies, such as hunching over your workbench, are common causes of neck pain.

But sometimes neck pain can signify something more serious. If your neck pain is so severe that you can’t touch your chin to your chest despite a few days of self-care, seek immediate medical attention.

Symptoms

Neck pain takes many forms. Signs and symptoms of neck pain may include:

• Pain in your neck that may feel sharp or dull
• Stiffness in your neck
• Difficulty going about your daily tasks because of pain or stiffness in your neck
• Shoulder pain in addition to neck pain, in some cases
• Back pain in addition to neck pain, in some cases

Causes

• Muscle strains. Overuse, such as too much time spent hunched over a steering wheel, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even such minor things as reading in bed or gritting your teeth can strain neck muscles.
• Worn joints. Like the other joints in your body, your neck joints experience wear and tear with age, which can cause osteoarthritis in your neck. Neck (cervical) osteoarthritis can cause pain and stiffness in your neck.
• Disk disorders. As you age, the cushioning disks between your vertebrae become dry and stiff, narrowing the spaces in your spinal column where the nerves come out. The disks in your neck also can herniate. This means the inner gelatinous cartilage material of a disk protrudes through the disk’s tougher cartilage covering. Neck pain may occur or nearby nerves can be irritated. Other tissues and bony growths (spurs) also can press on your nerves as they exit your spinal cord, causing pain.
• Injuries. Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and back, stretching the soft tissues of the neck beyond their limits.

When to seek medical advice

Neck pain doesn’t always require medical care. Rarely, it can be a sign of an emergency.

When to try home care
Neck pain caused by muscle irritations is usually easy to self-diagnose, and it usually gets better on its own within a few of days. This type of neck pain typically develops after excessive activity, a period of overuse or prolonged postures that put excessive strain on your neck muscles. If your neck pain doesn’t let up within a week or two, see your doctor.

When to seek immediate medical care
See your doctor if the following signs and symptoms occur in conjunction with neck pain:

• Severe pain from an injury. After head or neck trauma, such as whiplash or a blow to your head, see your doctor immediately. Severe pain over a bone might indicate a fracture or an injury to a ligament.
• Shooting pain. Pain radiating to your shoulder, through your shoulder blades or down your arm, with or without numbness or tingling in your fingers, may indicate nerve irritation. Neck pain from nerve irritation can last from weeks to six months or longer. More sophisticated tests and treatments are available for this type of continued nerve irritation, so see your doctor.
• Loss of strength. Weakness in an arm or a leg, walking with a stiff leg, or shuffling your feet indicates a possible neurological problem and needs immediate evaluation.
• Change in bladder or bowel habits. Any significant change, especially a sudden onset of incontinence, could indicate a neurological problem.

Tests and diagnosis

Your doctor often will be able to diagnose the cause of your neck pain and recommend treatment just by asking questions about the type, location and onset of your pain.

In less clear-cut cases, your doctor may use imaging techniques or other tests such as:

• X-rays
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT) scans
• Electromyography (EMG)

Treatments and drugs

Most neck pain responds well to home care. If neck pain persists, your doctor may recommend other treatments.

Self-care for neck pain
Self-care measures you can try at home to relieve neck pain include:

• Over-the-counter pain relievers. Try over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and acetaminophen (Tylenol, others).
• Alternate heat and cold. Reduce inflammation by applying cold, such as an ice pack or ice wrapped in a towel, for up to 20 minutes several times a day. Alternate the cold treatment with heat. Try taking a warm shower or using a heating pad on the low setting. Heat can help relax sore muscles, but it sometimes aggravates inflammation, so use it with caution.
• Rest. Lie down from time to time during the day to give your neck a rest from holding up your head. Avoid prolonged rest, since too much inactivity can cause increased stiffness in your neck muscles.
• Gentle stretching. Gently move your neck to one side and hold it for 30 seconds. Stretch your neck in as many directions as your pain allows. This may help alleviate some of the pain.
• Over-the-counter pain creams. Creams and gels made to relieve muscle and joint pain may provide some temporary relief from neck pain. Look for products with ingredients such as menthol and camphor.

Treatment for persistent neck pain
For pain that doesn’t get better with simple home-care measures, your doctor may recommend one or more treatments, such as:

• Neck exercises and stretching. Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches, so that you can do them on your own at home. Exercises may improve pain by restoring muscle function and increasing the strength and endurance of your neck muscles.
• Transcutaneous electrical nerve stimulation (TENS).Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
• Injections of medication. Injections of medications into your neck may help relieve pain. Your doctor may inject corticosteroid medications near the nerve roots, near the small neck joints or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to numb your neck pain.
• Pain medications. Your doctor may prescribe stronger pain medicine than what you can get over-the-counter. Opioid analgesics are sometimes used briefly to treat acute neck pain. Muscle relaxants, tramadol (Ultram) or tricyclic antidepressant medications used for pain also may be prescribed.
• Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation. Relief may last for hours or even days.
• Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck.
• Surgery. Surgery is rarely needed for neck pain. However, it may be an option for relieving nerve root or spinal cord compression.

Prevention

Most neck pain is associated with poor posture on top of age-related wear and tear. To help prevent neck pain, keep your head centered over your spine, so gravity works with your neck instead of against it. Some simple changes in your daily routine may help. Consider trying to:

• Take frequent breaks if you drive long distances or work long hours at your computer. Keep your head back, over your spine, to reduce neck strain. Try to avoid clenching your teeth.
• Adjust your desk, chair and computer so the monitor is at eye level. Knees should be slightly lower than hips. Use your chair’s armrests.
• Avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot, get a headset.
• Stretch frequently if you work at a desk. Shrug your shoulders up and down. Pull your shoulder blades together and then relax. Pull your shoulders down while leaning your head to each side to stretch your neck muscles.
• Balance your base. Stretching the front chest wall muscles and strengthening the muscles around the shoulder blade and back of the shoulder can promote a balanced base of support for the neck.
• Avoid sleeping on your stomach. This position puts stress on your neck. Choose a pillow that supports the natural curve of your neck.

Alternative medicine

Talk to your doctor if you’re interested in trying complementary and alternative neck pain treatments. Your doctor can discuss the benefits and risks of various alternative neck pain treatments.

Alternative neck pain treatments include:

• Acupuncture. Acupuncture involves the insertion of thin needles into various points on your body. Studies have found that acupuncture may be helpful for many types of pain. But studies in neck pain have been mixed. For results, you may need to undergo several acupuncture sessions. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. But don’t undergo acupuncture treatment if you’re taking blood thinners.
• Massage. During a massage, a trained practitioner manipulates the muscles in your neck. Little scientific evidence exists to support massage in people with neck pain, though it may provide relief when combined with your doctor’s recommended treatments. Massage is generally safe for most people with minor neck strains, as long as it’s performed by a trained massage therapist. If you have chronic neck pain or neck pain that’s caused by injury or arthritis, ask your doctor if massage would be safe for you.

Article from: http://www.mayoclinic.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.

For more information on bone health and osteoporosis please visit the National Osteoporosis Foundation.

Peak Bone Mass

Peak bone mass refers to the genetic potential for bone density. By the age of 20, the average woman has acquired most of her skeletal mass. A large decline in bone mass occurs in older adults, increasing the risk of osteoporosis. For women this occurs around the time of menopause.

It is important for young girls to reach their peak bone mass in order to maintain bone health throughout life. A person with high bone mass as a young adult will be more likely to have a higher bone mass later in life. Inadequate calcium consumption and physical activity early on could result in a failure to achieve peak bone mass in adulthood.

Osteoporosis

Osteoporosis or “porous bone” is a disease of the skeletal system characterized by low bone mass and deterioration of bone tissue. Osteoporosis leads to an increase risk of bone fractures typically in the wrist, hip, and spine.

While men and women of all ages and ethnicities can develop osteoporosis, some of the risk factors for osteoporosis include those who are

• Female
• White/Caucasian
• Post menopausal women
• Older adults
• Small in body size
• Eating a diet low in calcium
• Physically inactive

To find out more about the prevalence and risk factors associated with osteoporosis, please visit the National Osteoporosis Foundation.*

Calcium

Calcium is a mineral needed by the body for healthy bones, teeth, and proper function of the heart, muscles, and nerves. The body cannot produce calcium; therefore, it must be absorbed through food. Good sources of calcium include

• Dairy products—low fat or nonfat milk, cheese, and yogurt
• Dark green leafy vegetables—bok choy and broccoli
• Calcium fortified foods—orange juice, cereal, bread, soy beverages, and tofu products
• Nuts—almonds

Recommended amount of calcium vary for individuals. Below is a table of adequate intakes as outlined by the National Academy of Science.

Recommended Calcium Intakes

Source: Dietary Reference Intakes for Calcium, National Academy of Sciences, 1997

Vitamin D also plays an important role in healthy bone development. Vitamin D helps in the absorption of calcium (this is why milk is fortified with vitamin D).

For more information on calcium and children visit the National Institute of Child Health and Human Development (NICHD).

Weight-Bearing Physical Activity

Regular physical activity has been associated with many positive health benefits including strong bones. Like proper calcium consumption, adequate weight-bearing physical activity early in life is important in reaching peak bone mass. Weight-bearing physical activities cause muscles and bones to work against gravity. Some examples of weight bearing physical activities include

• Walking, Jogging, or running
• Tennis or Racquetball
• Field Hockey
• Stair climbing
• Jumping rope
• Basketball
• Dancing
• Hiking
• Soccer
• Weight lifting

Incorporating weight-bearing physical activity into an exercise plan is a great way to keep bones healthy and meet physical activity recommendations set forth in the Dietary Guidelines for Americans.

Adults: Engage in at least 30 minutes of moderate physical activity [on] most, preferably all, days of the week

Children: Engage in at least 60 minutes of moderate physical activity [on] most, preferably all, days of the week

Article from: http://www.cdc.gov/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

 Article from: http://www.webmd.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

What is chlamydia?

Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman’s reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur “silently” before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.

How common is chlamydia?

Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2006, 1,030,911 chlamydial infections were reported to CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. Also, testing is not often done if patients are treated for their symptoms. An estimated 2,291,000 non-institutionalized U.S. civilians ages 14-39 are infected with Chlamydia based on the U.S. National Health and Nutrition Examination Survey.  Women are frequently re-infected if their sex partners are not treated.

How do people get chlamydia?

Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

Any sexually active person can be infected with chlamydia. The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is probably more susceptible to infection, they are at particularly high risk for infection if sexually active. Since chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection.

What are the symptoms of chlamydia?

Chlamydia is known as a “silent” disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.

Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

What complications can result from untreated chlamydia?

If untreated, chlamydial infections can progress to serious reproductive and other health problems with both short-term and long-term consequences. Like the disease itself, the damage that chlamydia causes is often “silent.”

In women, untreated infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.

To help prevent the serious consequences of chlamydia, screening at least annually for chlamydia is recommended for all sexually active women age 25 years and younger. An annual screening test also is recommended for older women with risk factors for chlamydia (a new sex partner or multiple sex partners). All pregnant women should have a screening test for chlamydia.

Complications among men are rare. Infection sometimes spreads to the epididymis (the tube that carries sperm from the testis), causing pain, fever, and, rarely, sterility.

Rarely, genital chlamydial infection can cause arthritis that can be accompanied by skin lesions and inflammation of the eye and urethra (Reiter’s syndrome).

How does chlamydia affect a pregnant woman and her baby?

In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery. Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns.

How is chlamydia diagnosed?

There are laboratory tests to diagnose chlamydia. Some can be performed on urine, other tests require that a specimen be collected from a site such as the penis or cervix.

What is the treatment for chlamydia?

Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible.

Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple infections increases a woman’s risk of serious reproductive health complications, including infertility. Retesting should be encouraged for women three to four months after treatment. This is especially true if a woman does not know if her sex partner received treatment.

How can chlamydia be prevented?

The surest way to avoid transmission of STDs is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.

CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STD infection. If a woman has any of these symptoms, she should stop having sex and consult a health care provider immediately. Treating STDs early can prevent PID. Women who are told they have an STD and are treated for it should notify all of their recent sex partners (sex partners within the preceding 60 days) so they can see a health care provider and be evaluated for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary, treated.

Article from: http://www.cdc.gov/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com

By Tracee Cornforth, About.com

Article from: http://womenshealth.about.com/

>>> Consult online with doctors this issue or
any other healthcare issue at Wortix.com