Useful things to buy during medical school

The following is a brief list of some of the things I think have been useful and worth their money in my first two years of med school:

1. Large, widescreen computer monitor. The volume of information required to internalize during the preclinical years of medical school can’t be compiled and organized on paper. You would end up with bookshelves filled with those gigantic 4″ binders. Therefore, almost everything happens on a laptop. Of course, the advantages of portability afforded by laptops are offset by the tiny screen size. Plugging into an external, gigantic screen when at home is a huge advantage. You can actually see what you need to be looking at. It’s brighter and generally has better resolution. More important, the additional real estate allows you to have multiple windows open side-by-side so you can take notes in one and look at material or watch videos in the other.
2. Robbins Pathologic Basis of Disease. One of our professors once said, “You could lock a med student in a basement for two years with a copy of Robbins and they would come out and not miss a question on Step 1.” A single textbook doesn’t exist for medical school, but this one pretty much covers everything you need to know in the first two years. Unfortunately, Robbins often goes into too much detail, but it is the best reference book for anything during the preclinical years. This is a required book for any med student.

3. Smartphone. If for nothing else, to keep track of your email and schedule. I don’t know exactly how much email I get in a given day, but it’s a lot. Being able to check these emails anytime without sitting down at a computer is a huge advantage. The other thing smartphones are getting better and better at is on-the-go studying. I can pull up a set of anatomy flashcards while I’m waiting for a meeting to start and quickly hit high-yield information. You can also use it for quick reference while in the clinics — either to teach yourself about a condition/medication relating to a patient or help out your preceptor/attending (be careful with this one, though, they might not appreciate your help).

4. A decent stethoscope. The key word here is “decent.” Get one better than the base model, but don’t go out and drop $500 on an electronic cardiology stethoscope — (1) you’ll look like an idiot, (2) it’s not worth it at this point and (3) you’ll probably lose it at some point. A good quality stethoscope will help tremendously, both in terms of hearing what you’re supposed to be hearing and comfort.

5. A good bed. You may not get a lot of sleep, so what you do get you want to be very good.

6. Question and review books. Hundreds of question and review books exist. Some advise med students against getting any of these until they are actually preparing for Step 1. The fear is two-fold:

1. Students will use review books as a primary source for studying and miss out on some of the nuance provided by studying actual textbooks or materials from professors.
2. Students will become too focused on prep Step 1 and look past the fact that they need to focus on their current courses and pass them.

Both risks are very real for students. However, review books and question books can effectively be incorporated into normal test prep during coursework in Year 1 and 2. The benefit of using these tools in your preparation for regular course tests is that you become familiar with these materials before you begin your arduous Step 1 preparation. Also, many of the review books contain very helpful mnemonics and tools for memorizing complicated pathways or concepts. Instead of wasting time coming up with your own, often inferior, memorization tools you can use some of the most effective ones from previous students. But don’t fall into the aforementioned traps — study primary materials first and only use these as your last bit of review/self-testing before an exam.

7. A good anatomy atlas. I think it’s important to have a true anatomy atlas, meaning one that is simply labeled pictures/diagrams. Several anatomy texts exist that are a combination textbook and atlas. I generally don’t like these because I find the text only functions to make the book thicker and makes finding the diagram you want difficult.

8 . Not over-paying for med school. A recent study in the Archives of Internal Medicine showed physicians who went to med school at US News & World Report Top 10 research or primary care medical schools did not perform any better on quality measures than their peers who went to less prestigious institutions. Med school debt is bad enough, don’t exacerbate the problem.

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101 Things You Wish You Knew Before Starting Medical School

Simple enough, here are 101 things you wish you knew before starting medical school.

1. If I had known what it was going to be like, I would never have done it.
2. You’ll study more than you ever have in your life.
3. Only half of your class will be in the top 50%. You have a 50% chance of being in the top half of your class. Get used to it now.
4. You don’t need to know anatomy before school starts. Or pathology. Or physiology.
5. Third year rotations will suck the life out you.
6. Several people from your class will have sex with each other. You might be one of the lucky participants.
7. You may discover early on that medicine isn’t for you.
8. You don’t have to be AOA or have impeccable board scores to match somewhere – only if you’re matching into radiology.
9. Your social life may suffer some.
10. Pelvic exams are teh suck.
11. You won’t be a medical student on the surgery service. You’ll be the retractor bitch.
12. Residents will probably ask you to retrieve some type of nourishment for them.
13. Most of your time on rotations will be wasted. Thrown away. Down the drain.
14. You’ll work with at least one attending physician who you’ll want to beat the shit out of.
15. You’ll work with at least three residents who you’ll want to beat the shit out of.
16. You’ll ask a stranger about the quality of their stools.
17. You’ll ask post-op patients if they’ve farted within the last 24 hours.
18. At some point during your stay, a stranger’s bodily fluids will most likely come into contact with your exposed skin.
19. Somebody in your class will flunk out of medical school.
20. You’ll work 14 days straight without a single day off. Probably multiple times.
21. A student in your class will have sex with an attending or resident.
22. After the first two years are over, your summer breaks will no longer exist. Enjoy them as much as you can.
23. You’ll be sleep deprived.
24. There will be times on certain rotations where you won’t be allowed to eat.
25. You will be pimped.
26. You’ll wake up one day and ask yourself is this really what you want out of life.
27. You’ll party a lot during the first two years, but then that pretty much ends at the beginning of your junior year.
28. You’ll probably change your specialty of choice at least 4 times.
29. You’ll spend a good deal of your time playing social worker.
30. You’ll learn that medical insurance reimbursement is a huge problem, particularly for primary care physicians.
31. Nurses will treat you badly, simply because you are a medical student.
32. There will be times when you’ll be ignored by your attending or resident.
33. You will develop a thick skin. If you fail to do this, you’ll cry often.
34. Public humiliation is very commonplace in medical training.
35. Surgeons are assholes. Take my word for it now.
36. OB/GYN residents are treated like shit, and that shit runs downhill. Be ready to pick it up and sleep with it.
37. It’s always the medical student’s fault.
38. Gunner is a derogatory word. It’s almost as bad as racial slurs.
39. You’ll look forward to the weekend, not so you can relax and have a good time but so you can catch up on studying for the week.
40. Your house might go uncleaned for two weeks during an intensive exam block.
41. As a medical student on rotations, you don’t matter. In fact, you get in the way and impede productivity.
42. There’s a fair chance that you will be physically struck by a nurse, resident, or attending physician. This may include slapped on the hand or kicked on the shin in order to instruct you to “move” or “get out of the way.”
43. Any really bad procedures will be done by you. The residents don’t want to do them, and you’re the low man on the totem pole. This includes rectal examinations and digital disimpactions.
44. You’ll be competing against the best of the best, the cream of the crop. This isn’t college where half of your classmates are idiots. Everybody in medical school is smart.
45. Don’t think that you own the world because you just got accepted into medical school. That kind of attitude will humble you faster than anything else.
46. If you’re in it for the money, there are much better, more efficient ways to make a living. Medicine is not one of them.
47. Anatomy sucks. All of the bone names sound the same.
48. If there is anything at all that you’d rather do in life, do not go into medicine.
49. The competition doesn’t end after getting accepted to medical school. You’ll have to compete for class rank, awards, and residency. If you want to do a fellowship, you’ll have to compete for that too.
50. You’ll never look at weekends the same again.
51. VA hospitals suck. Most of them are old, but the medical records system is good.
52. Your fourth year in medical school will be like a vacation compared to the first three years. It’s a good thing too, because you’ll need one.
53. Somebody in your class will be known as the “highlighter whore.” Most often a female, she’ll carry around a backpack full of every highlighter color known to man. She’ll actually use them, too.
54. Rumors surrounding members of your class will spread faster than they did in high school.
55. You’ll meet a lot of cool people, many new friends, and maybe your husband or wife.
56. No matter how bad your medical school experience was at times, you’ll still be able to think about the good times. Kind of like how I am doing right now.
57. Your first class get-together will be the most memorable. Cherish those times.
58. Long after medical school is over, you’ll still keep in contact with the friends you made. I do nearly every day.
59. Gunners always sit in the front row. This rule never fails. However, not everyone who sits in the front row is a gunner.
60. There will be one person in your class who’s the coolest, most laid back person you’ve ever met. This guy will sit in the back row and throw paper airplanes during class, and then blow up with 260+ Step I’s after second year. True story.
61. At the beginning of first year, everyone will talk about how cool it’s going to be to help patients. At the end of third year, everybody will talk about how cool it’s going to be to make a lot of money.
62. Students who start medical school wanting to do primary care end up in dermatology. Those students who start medical school wanting to do dermatology end up in family medicine.
63. Telling local girls at the bar that you’re a medical student doesn’t mean shit. They’ve been hearing that for years. Be more unique.
64. The money isn’t really that good in medicine. Not if you look at it in terms of hours worked.
65. Don’t wear your white coat into the gas station, or any other business that has nothing to do with you wearing a white coat. You look like an ass, and people do make fun of you.
66. Don’t round on patients that aren’t yours. If you round on another student’s patients, that will spread around your class like fire after a 10 year drought. Your team will think you’re an idiot too.
67. If you are on a rotation with other students, don’t bring in journal articles to share with the team “on the fly” without letting the other students know. This makes you look like a gunner, and nobody likes a gunner. Do it once, and you might as well bring in a new topic daily. Rest assured that your fellow students will just to show you up.
68. If you piss off your intern, he or she can make your life hell.
69. If your intern pisses you off, you can make his or her life hell.
70. Don’t try to work during medical school. Live life and enjoy the first two years.
71. Not participating in tons of ECs doesn’t hurt your chances for residency. Forget the weekend free clinic and play some Frisbee golf instead.
72. Don’t rent an apartment. If you can afford to, buy a small home instead. I saved $200 per month and had roughly $30,000 in equity by choosing to buy versus rent.
73. Your family members will ask you for medical advice, even after your first week of first year.
74. Many of your friends will go onto great jobs and fantastic lifestyles. You’ll be faced with 4 more years of debt and then at least 3 years of residency before you’ll see any real earning potential.
75. Pick a specialty based around what you like to do.
76. At least once during your 4 year stay, you’ll wonder if you should quit.
77. It’s amazing how fast time flies on your days off. It’s equally amazing at how slow the days are on a rotation you hate.
78. You’ll learn to be scared of asking for time off.
79. No matter what specialty you want to do, somebody on an unrelated rotation will hold it against you.
80. A great way to piss of attendings and residents are to tell them that you don’t plan to complete a residency.
81. Many of your rotations will require you to be the “vitals bitch.” On surgery, you’ll be the “retractor bitch.”
82. Sitting around in a group and talking about ethical issues involving patients is not fun.
83. If an attending or resident treats you badly, call them out on it. You can get away with far more than you think.
84. Going to class is generally a waste of time. Make your own schedule and enjoy the added free time.
85. Find new ways to study. The methods you used in college may or may not work. If something doesn’t work, adapt.
86. Hospitals smell bad.
87. Subjective evaluations are just that – subjective. They aren’t your end all, be all so don’t dwell on a poor evaluation. The person giving it was probably an asshole, anyway.
88. Some physicians will tell you it’s better than it really is. Take what you hear (both positive and negative) with a grain of salt.
89. 90% of surgeons are assholes, and 63% of statistics are made up. The former falls in the lucky 37%.
90. The best time of your entire medical school career is between the times when you first get your acceptance letter and when you start school.
91. During the summer before medical school starts, do not attempt to study or read anything remotely related to medicine. Take this time to travel and do things for you.
92. The residents and faculty in OB/GYN will be some of the most malignant personalities you’ve ever come into contact with.
93. Vaginal deliveries are messy. So are c-sections. It’s just an all-around blood fest if you like that sort of thing.
94. Despite what the faculty tell you, you don’t need all of the fancy equipment that they suggest for you to buy. All you need is a stethoscope. The other equipment they say you “need” is standard in all clinic and hospital exam rooms. If it’s not standard, your training hospital and clinics suck.
95. If your school has a note taking service, it’s a good idea to pony up the cash for it. It saves time and gives you the option of not attending lecture.
96. Medicine is better than being a janitor, but there were times when I envied the people cleaning the hospital trash cans.
97. Avoid surgery like the plague.
98. See above and then apply it to OB/GYN as well.
99. The money is good in medicine, but it’s not all that great especially considering the amount of time that you’ll have to work.
100. One time an HIV+ patient ripped out his IV and then “slung” his blood at the staff in the room. Go, go infectious disease.
101. Read Med School Hell now, throughout medical school, and then after you’re done. Then come back and tell me how right I am.

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Understand "What USMLE Is"

The United States Medical Licensure Examination (USMLE) is a series of examination which a medical student has to take in order obtain license in United State. The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners (NBME).

The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

Step 1 and Step 2 CK are given around the world at Prometric Test Centers (PTCs).

Step 3 is given at PTCs in the United States and its territories only. Once the passing score for step1 or step 2CK is achieved, one cannot retake the exam in order to achieve a higher score, therefore it is important to be prepared to achieve high score.

USMLE Test Format


Step 1 has approximately 336 multiple-choice test items, divided into seven 60-minute blocks, administered in one eight-hour testing session.


Step 2 CK has approximately 352 multiple-choice test items, divided into eight 60-minute blocks, administered in one nine-hour testing session.


Step 2 CS has 12 patient cases. You will have 15 minutes for each patient encounter and 10 minutes to record each patient note. If you do not use the entire 15 minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note. The testing session is approximately eight hours.


Step 3 has approximately 480 multiple-choice test items, divided into blocks of 35 to 50 items. You will have 45 to 60 minutes to complete each of these blocks. There are approximately nine computer-based case simulations, with one case in each block. You will have a maximum of 25 minutes to complete each of these blocks. Step 3 is administered in two eight-hour testing sessions.



USMLE Score Format


Once Steps 1, 2, or 3 of the USMLE is complete the scores are electronically transmitted to the NBME for scoring.


The first step of the scoring process is to convert the number of correct answers into two equivalent scores. The first score is a three-digit scaled score and the second is a two-digit scaled score. Three-digit scores will fall between 140 and 260 with the mean score being between 210 and 230. Two-digit scores are based on the three-digit score.


The two-digit score is calculated in such a way that a score of 75 always corresponds to the minimum passing score. This scoring method applies to all parts of the USMLE except for Step 2 CS. Step 2 of the USMLE contains two parts: Step 2 CK and Step 2 CS. Step 2 CS is assessed as either a pass or fail score. There is no numerical value assigned to this part of the test.

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Posted in: Medical Slides,USMLE

Pica (Eating Disorder)

Pica is an eating disorder typically defined as the persistent ingestion of nonnutritive substances for a period of at least 1 month at an age at which this behavior is developmentally inappropriate (eg, >18-24 mo).

The definition is occasionally broadened to include the mouthing of nonnutritive substances.

Individuals who present with pica have been reported to mouth and/or ingest a wide variety of nonfood substances, including, but not limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, cigarette butts, wire, and burnt matches.

Although pica is observed most frequently in children, it is the most common eating disorder in individuals with developmental disabilities.

In some societies, pica is a culturally sanctioned practice and is not considered to be pathologic. Pica may be benign, or it may have life-threatening consequences.

In children aged 18 months to 2 years, the ingestion and mouthing of nonnutritive substances is common and is not considered to be pathologic. Consider pica when the behavior is inappropriate to the developmental level of the individual, is not part of a culturally sanctioned practice, and does not occur exclusively during the course of another mental disorder (eg, schizophrenia).

If pica is associated with mental retardation or pervasive developmental disorder, it must be sufficiently severe to warrant independent clinical attention. In such patients, pica is typically considered to be a secondary diagnosis. Furthermore, the pica must last for a period of at least 1 month.

Pica is a serious behavioral problem because it can result in significant medical sequelae. The nature and amount of the ingested substance determine the medical sequelae.

Pica has been shown to be a predisposing factor in accidental ingestion of poisons, particularly in lead poisoning. The ingestion of bizarre or unusual substances has also resulted in other potentially life-threatening toxicities, such as hyperkalemia following cautopyreiophagia (ingestion of burnt match heads).

Exposure to infectious agents via ingestion of contaminated substances is another potential health hazard associated with pica, the nature of which varies with the content of the ingested material.

In particular, geophagia (soil or clay ingestion) has been associated with soil-borne parasitic infections, such as toxoplasmosis and toxocariasis.

Gastrointestinal (GI) tract complications, including mechanical bowel problems, constipation, ulcerations, perforations, and intestinal obstructions, have resulted from pica.

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Gold Standard - Step One (55 cds) for usmle step 1 review

i cant add download links here but you will find download links in this arabic topic

Gold Standard - Step One (55 cds) for usmle step 1 review - .:

enjoy

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Top 10 Most Controversial Health Stories of 2011

If there's one thing you can say about 2011 from a health point of view, it's that it wasn't boring!
From killer vitamins to scientists flip-flopping on the dangers of cell phones and salt, our heads are spinning as we sort through the headlines.
Here are our picks for the year's most buzz-worthy stories.


1. Are Mammograms and Breast Self-Exams Worth It?

In 2009, the U.S. Preventive Services Task Force said most women don’t need mammograms until age 50. But a pair of studies released in April supported the idea that women in their 40s, especially minority women, should get annual mammograms. The tables turned again in July, when it was revealed that mammograms analyzed with a technology called computer-aided detection aren’t helpful in detecting cancers—only in producing false positives and causing unnecessary biopsies. But in September, researchers announced that both mammograms and breast self-exams are indeed useful for detecting breast cancer, including in younger women. The bottom line? Talk to your doctor.



2. Is Your Multivitamin Killing You?

Mom may have told you to take your vitamins, but a study published in October found that older women who took multivitamins and other dietary supplements—such as iron, folic acid, vitamin B, and zinc—actually had a higher risk of dying earlier. The study showed only an association—not cause and effect—and it didn’t ask the women about underlying health conditions for which they may have been taking the supplements.


3. K2 Synthetic Marijuana Sending Kids to ER

Just because it’s legal doesn’t mean it’s safe. That’s the message doctors hope to send to teenagers smoking K2, a synthetic form of marijuana. In November, the American Association of Poison Control Centers revealed that, since the beginning of 2010, it had received nearly 2,000 reports of people becoming ill (sometimes with life-threatening symptoms) after smoking the herb, which also goes by the names Spice, Yucatan Fire, Genie, and Fire and Ice. Many users are sent to the emergency room with racing hearts, extreme anxiety, and hallucinations.


3. Pregnant Woman Runs Marathon, Gives Birth Hours Later

Race-day spectators watched in awe as Amber Miller crossed the finish line at the Chicago Marathon in October—and proceeded to go into labor. When she gave birth to a healthy baby hours later, the question on everyone’s mind was, “Was that safe!?” Experts have long recommended exercise during pregnancy, but this takes it to an extreme. (And here’s perhaps the biggest news of all: She still finished before her husband!)


4. Turn Brown Eyes Blue With New Laser

For when colored contacts just aren’t permanent enough, a California company claims its new laser technology can change brown eyes blue. The technology won’t be available in the United States for at least three years, but it’s already sparking questions about genetic identity and family ties. (Eye color is one of the inevitable traits passed down from parents to children.) In November, “Time”’s Healthland blog published a story on why the idea feels “off-color."


5. Barefoot Running Shoes Are Hot

They’ve been hailed as the “real” way to run, to prevent injury and to reverse the harm that regular running shoes with lots of padding under the heel cause to our natural gait. But as more people have jumped on the barefoot-running wagon, researchers have begun to caution about potential injuries caused by switching shoe styles too quickly. These minimalist shoes, which contain little if any padding and encourage runners to land on their mid-foot or forefoot, lack the support and cushioning many runners need, especially if they continue to land on their heels in their new shoes.


6. No TV Before Age 2, Say Pediatricians

The recommendation has been around for a few years, but in October the American Academy of Pediatrics made it official: No television is the best television for children under the 2. Kids instead should be encouraged to think creatively during periods of unstructured “free play,” they said. The announcement was a blow to companies that market educational videos for babies—as well as any parents enjoying a rare moment of peace and quiet!


7. High-Salt Diets Might Kill You—but Low-Salt Diets Might Too

We’ve always been told that too much sodium raises your blood pressure, but a report published in May found that death from cardiovascular problems was 56 percent higher for men who ate the least amount of sodium. Although some people with hypertension should lower their salt intake, experts say, reducing sodium isn’t necessarily good for everyone. To make matters more confusing, a large, 15-year study published in July found that people who eat more sodium and less potassium die sooner of heart problems than those who consume the opposite.


8. Baby Shampoo May Be Toxic

It’s known as the no-tears formula, but Johnson & Johnson’s baby shampoo should perhaps be recognized for something else: toxic chemicals that are still lurking in some formulas, says the Campaign for Safe Cosmetics. In November, the watchdog group sent the company a letter urging it to stop using formaldehyde-releasing substances in its popular shampoo brand. Johnson & Johnson responded by saying that it is gradually phasing out such harmful chemicals, but did not comment on this specific product.


9. Cellphones May or May Not Cause Cancer

The world breathed a collective sigh of relief in February when a British study found no link between cell phones and brain tumors. But before you can say “OMG”, cancer experts told the World Health Organization in May that cell phones may actually still cause brain cancer. The most recent study on the topic, released in July, found that cell phones don’t seem to pose a cancer risk to kids who use them regularly—but the researchers cautioned that more research is needed.


10. Speech-Slurring Emmy Anchor: Stroke, Drunk, or Migraine?

Reporter Serene Branson’s bizarre telecast live from the Emmys in February made headlines for what she didn’t say: Fumbling her words and uttering nonsensical syllables, she caused news outlets to wonder whether she’d had a stroke on air. Some even questioned whether she was drunk or on drugs. Medical professionals examined Branson after the incident, and doctors revealed in the following days that she had actually suffered a short-term complex migraine.

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anti-aging foods

HE suddenly saw himself in the mirror and start crying after he discovered his first gray hair (gasp!) THIS IS some anti-aging foods :

Berries:
All black and blue berries such as blackberries, blueberries, blackcurrants and black grapes contain phytochemicals known as flavonoids-powerful antioxidants which help to protect the body against damage caused by free radicals and aging.

Ginger:
This spicy root can boost the digestive and circulatory systems, which can be useful for older people. Ginger may also help to alleviate rheumatic aches and pains

Nuts:
Most varieties of nuts are good sources of minerals, particularly walnuts and brazi nuts. Walnuts, although high in calories, are rich in potassium, magnesium, iron, zinc, copper and selenium. Adding nuts to your diet (sprinkle them on salads and desserts) can enhance the functioning of your digestive and immune systems, improve your skin help control prevent cancer. Nuts may also help control cholesterol levels. Never eat rancid nuts, however, as they have been linked to a high incidence of free radicals.

Soya:
Menopausal women might find that soya helps to maintain oestrogen levels. Soya may alleviate menopausal hot flush and protect against Alzheimer's disease, osteoporosis and heart disease. Look out for fermented soya products, which are more easily digested, therefore more nutritional, and do not generally cause food intolerances. You may want to check that soya products have not been genetically modified. Soya should not be confused with soya sauce, which is full of salt and should be used sparingly, if at all.

Whole meal pasta and rice:
Complex carbohydrates provide a consistent supply of energy throughout the day and should make up the bulk of your diet. Wholemeal pasta is an excellent complex carbohydrate. It is high in fibre and contains twice the amount of iron as normal pasta. Brown rice is another recommended complex carbohydrate, which is high in fibre and B vitamins.

Watermelon:
Both the flesh and seeds of the watermelon are nutritious so try blending them together in a food processor and drinking as a juice. The flesh contain vitamin A, B and C ; the seeds contain selenium, essential fats, zinc and vitamin E, all of which help against free radical damage and aging.

Water:
Drink at least 8 glasses of water every day in order to remain healthy. Water helps us to get rid of the toxins and unwanted waste materials from your body.
Don't rely on thirst; this sensation diminishes with age. Drink often and choose from nutritious liquids, including 100% fruit and vegetable juices, skim or low fat milk, broths, sparkling water, and teas. You can also get fluids from foods, especially those that are liquid at room temperature. Try gelatin, frozen yogurt, soups, watermelon, pickles, oranges, lettuce, tomatoes, etc.

Avocado:
This fruit, which is usually eaten as a vegetable, is a good source of healthy monounsaturated fat that may help to reduce level of a bad type of cholesterol in body. Avocado is a good source of vitamin E and can help to maintain healthy skin and prevent skin aging (vitamin E may also help alleviate menopausal hot flushes). It is rich in potassium which helps prevent fluid retention and high blood pressure.

Fish:
Thirty years ago, researchers began to study why the native Inuits of Alaska were remarkably free of heart disease. The reason, scientists now think, is the extraordinary amount of fish they consume. Fish is an abundant source of omega-3 fats, which help prevent cholesterol buildup in arteries and protect against abnormal heart rhythms. Eat some tonight with a healthy fish recipe.

Olive Oil:
Four decades ago, researchers from the Seven Countries Study concluded that the monounsaturated fats in olive oil were largely responsible for the low rates of heart disease and cancer on the Greek island of Crete. Now we know that olive oil also contains polyphenols, powerful antioxidants that may help prevent age-related diseases.

Yogurt:
In the 1970s, Soviet Georgia was rumored to have more centenarians per capita than any other country. Reports at the time claimed that the secret of their long lives was yogurt, a food ubiquitous in their diets. While the age-defying powers of yogurt never have been proved directly, yogurt is rich in calcium, which helps stave off osteoporosis and contains “good bacteria” that help maintain gut health and diminish the incidence of age-related intestinal illness.

Cruciferous vegetables:

The family of Cruciferous vegetables includes cabbage, cauliflower, broccoli, kale, turnip, brussels sprouts, radish and watercress. Cruciferous vegetables assist the body in its fight against toxins and cancer. You should try to consume at least 115g/40z(of any one or a combination) of these vegetables on a daily basis. If possible, eat them row or very lightly cooked so that the important enzymes remain intact

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Food to calm your nerves

Are you feeling stressed ? Don't worry, here is some helpful food for you to calm your nerves. Try eating carbohydrates. The effect that carbohydrates have is their ability to produce serotonin. Serotonin gives you a calm and relaxed feeling.

It is also important to have vitamin B6 as it ensures the production of serotonin. When the blood sugar runs dry ,it depends upon glycogen in the liver. Therefore it is very important for the liver to function well in order to ensure a good functioning of the nerves. The following foods have been found to be beneficial for the nerves.

Carbohydrate rich food like pop corn, oatmeal, dry cereal without milk, berries which help in fighting cortisol which is a stress hormone in the body.

Vitamin B rich foods like potatoes, raisins , bananas ,avocados and mixed nuts.

Flax- seeds and nuts are rich sources of omega 3 fatty acids.

Tea rich in anti oxidants like chamomile tea is better than coffee.

Carrots, apricots, parsley juice and turnip greens are a rich source of food for eyes (optic nerve).

Eating regular meals helps in feeding the brain and improves concentration.

Foods to avoid include refined sugar, hot pepper , alcohol and mineral oil (laxatives).

Magnesium is very important to maintain the nerves and muscles, improve circulation in the blood and maintain good bone health. Sources of magnesium include spinach, cucumber, celery, broccoli, turnip

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Lets Distinguish Between Low and High Cholesterol Foods

Although cholesterol has gotten a bad rap, it isn't quite the culprit it's made out to be. Your body actually needs cholesterol, and your liver makes about 1,000 mg of the stuff every day.

In addition to cholesterol produced by the body, we also get cholesterol from animal products. For example, dairy products, meat, fish and egg yolks contain cholesterol. Foods derived entirely from plants, such as vegetables, fruits and grains, do not contain cholesterol.

It is recommended that less than 300 mg of cholesterol should be consumed per day. According to the American Heart Association, men typically ingest about 337 mg of cholesterol daily, and women ingest about 217 mg.

Reading Food Labels

Physicians most often recommend cholesterol-restricted diets for patients with significantly elevated cholesterol levels and known heart disease and sometimes for those with a high risk of cardiovascular disease. To follow such a diet, it's important to read the nutrition labels on foods before consuming.

Each food label should include milligrams of cholesterol per serving. Don't forget to look at the serving size as well. Sometimes products can seem low in cholesterol, but if you eat more than the recommended servings at one sitting, then you can end up consuming a lot more cholesterol than you intended.

You may be confused by the percentages included on the label, marked as "% of daily value." The daily value -- or daily reference value -- is the USDA's term for daily nutritional requirements, based on a 2,000-calorie diet. But when counting cholesterol, it's best to overlook these percentages and focus on limiting your daily consumption to 300 mg or less.

Foods Without Labels

When shopping in certain areas of the grocery store many foods do not have labels, such as fruits, vegetables and other plant products, but remember that these foods don't have any cholesterol. For other products, the USDA maintains a searchable nutrient database. This database provides cholesterol contents for many different foods. All you have to do is use a keyword, like "turkey," and scroll down until you find the turkey bacon that you ordered.

You must also be careful when you eat out, although many restaurants now offer healthy choices. You may want to ask the restaurant's staff for more information about their menu choices.

What About Fats?

In addition to watching the cholesterol content of your foods, you'll probably want to keep tabs on saturated fat and trans fats.

According to the USDA, saturated fats can raise "bad cholesterol" or the low-density lipoproteins (LDL); this is the artery-clogging stuff that can lead to heart attacks or strokes.

Trans fats have also been linked to increased LDL levels. The USDA recommends limiting saturated and trans fats as much as possible.

Unsaturated fats, however, can be good for the body. According to the USDA, most of the fat in your diet should come from unsaturated fats. Seeds, nuts and fish are all good sources of these healthy, unsaturated fats.

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10 Tips to Reduce Stomach Fat

1. Short of surgery, there is no simple process to quickly remove the fat. Reducing it requires time, patience and work.


2. When you exercise, make sure your movements are smooth and controlled.


3. Do your best to not arch your back during your abdominal workout. Arching your back can strain the muscles in your lower back and increase the length of time it will take to lose the fat.


4. Lots of people think that, in order for exercise to be effective, exercise must be done until the person feels out of breath and physically tapped. This couldn't be farther from the truth. Exercise until it feels uncomfortable and then cool down. As time goes on, you'll find that the time it takes to feel winded or uncomfortable gets longer and longer.


5. Sit ups, when not paired with a full body workout do not actually flatten your stomach. In fact, unless you are working your entire abdominal region (and the rest of your body), sit ups will tone your abdominal muscles, making them more pronounced behind the layer of fat--making your stomach fat even more obvious!


6. Do some crunches when you would normally be lying around and doing something passive (like watching television or listening to music). Crunches are one of the best exercises you can do to work your abdominal muscle area.


7. Keep your workout routine varied. The more you do an exercise, the more your muscles will become used to it and the less effect it will have on your muscle tone and it will make it harder for you to get into shape.


8. Make sure that you are eating a healthy diet. All of the exercise in the world won't do you any good if you aren't eating healthy as well. Healthy foods have fewer calories and are easier for your body to digest.


9. Stay away from saturated fats and foods containing high fructose corn syrup. Saturated fat and high fructose corn syrup are two of the leading reasons why people have problems with belly fat in the first place.


10. Maintain proper posture. By sitting up straight you will be able to reduce the appearance of your stomach fat. Proper posture will also help you when you work out and you'll find that you have less muscle aches!

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Managment Of Cardiac Hypertrophy Flow chart

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Posted in: Medical Slides

Assessing Pain in Loved Ones with Dementia

Persistent pain is common among older persons, who are more likely to suffer from problems such as arthritis and other chronic conditions. The person with dementia often has trouble communicating his or her feelings or thoughts—and this can mean the inability to tell you if a physical problem, such as pain, exists.
If your loved one has dementia, determining if he or she is experiencing pain may be up to you. Careful observation can reveal important clues to let you know that he or she is experiencing pain.

These clues can include:

• Facial expressions: frowning, looking frightened, grimacing, wrinkling his or her brow, keeping eyes closed tightly, blinking rapidly, or exhibiting any distorted expression.
• Verbalizations/vocalizations: moaning, groaning, sighing, grunting/chanting/calling out, breathing noisily, asking for help or becoming verbally abusive.
• Body movements: rigid or tense posture, fidgeting, pacing or rocking back and forth; restricted movement, gait or mobility changes.
• Behavioral changes: refusing food or showing any appetite change; change in sleep/rest periods; wandering; stopping common routines.
• Mental status changes: crying, showing increased confusion or irritability, acting distressed.

When does the pain occur?

• During movement: Signs could be grimacing or groaning during personal care (such as bathing), walking, or transferring (from bed to chair, for example).
• Without movement: Does your loved one appear agitated or have other behavioral changes, such as trouble sleeping, loss of appetite, or reclusiveness?

If you see any of these signs, talk to your healthcare provider as soon as possible, telling him or her what you have noticed and giving examples. Focus on when the pain occurs, and how it seems to be experienced (burning? aching? stabbing?) and whether it occurs with or without movement. Tell your healthcare provider what, if anything, relieves the pain. It is important to provide your healthcare professional with a history of all prescription and over-the-counter medicines your loved one now takes and has taken in the past, writing down all medications and dosages.

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Pain in the Elderly: When Someone You Love Is in Pain

While arthritis is the most common cause of pain for people over age 65, circulatory problems, shingles, certain bowel diseases and cancer are other common reasons for pain in older people. Nerve damage can also cause severe and constant pain.
Some people think that pain is natural with old age or that when older people are not clear in explaining the cause of their pain they are just complaining. Both of these views are wrong. There is almost always a real problem behind the aches and pains.
Pain can lead to other problems. People with pain may lose the ability to move around and do everyday activities. They may have trouble sleeping, experience bad moods and have a poor self-image. People with pain also often have anxiety or depression. They may be at greater risk for falls, weight loss, poor concentration and difficulties with relationships.
Most pain can be controlled, usually through a combination of drug and non-drug strategies, which should be discussed with a healthcare provider.

Caring for someone in pain or at risk for pain is often an ongoing process. As various strategies are tried, it may help to keep in mind two basic principles:

• Believe the person you are caring for. People with pain are the only ones who know how much pain they are feeling. Pain is whatever the older person says it is and exists whenever he or she says it does. If people with pain feel that others do not believe them, they become upset and may stop reporting their pain accurately. This makes controlling the pain more difficult.
• Every person has the right to good pain control. Your job as a caregiver is to make sure that good pain control is provided. Tell health professionals if pain does not improve with treatment and ask them to try new treatments until the pain is controlled. Your goals are to help evaluate and relieve pain and to keep health professionals informed about pain levels and responses to pain treatments.

What You Can Do to Help
Evaluate pain:

• Ask about the pain. No medical test can tell you whether or not a person is in pain. The best way to find out if a person is in pain is to ask. A good way of asking is to say, “How bad is your pain right now on a scale from 0 to 10, with 0 being no pain and 10 being the worst pain you ever had?” Don't contradict or argue about these ratings.
• Listen for words other than "pain." Older people may use different words to describe their pain, such as “discomfort,” “soreness” or “ache.”
• Look for behavior or body language that could be a response to pain. The older person may be unwilling to report pain or be unable to communicate about pain in words. Behaviors to look for include facial expressions or groaning when moved

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Sinusitis: Acute or Chronic?

What is Sinusitis?
If you've never given your sinuses much thought, a bout of sinusitis can make you think about nothing else. Sinusitis is used to describe any condition where the sinuses become inflamed. Sinuses are the four pairs of air-filled pockets located around the nose and eyes. They are designed to strengthen your skull, filter the air that comes through your nose, add resonance to your voice and help remove mucus from the body. If they become blocked, mucus can't drain properly and air pressure can build up in the sinuses, resulting in the familiar headache and congestion.
Although "sinusitis" and "sinus infection" are often used interchangeably, an infection is only one of many possible causes. The sinuses can also become inflamed by allergens or other environmental irritants, or if you have structural abnormalities in your nose that interfere with sinus functioning.
Your doctor might suspect sinusitis if you show up complaining of a headache, especially one that gets worse when you lower your head, tenderness around the eyes and nose, and thick greenish-yellow nasal discharge. However, not all cases of sinusitis are created equal. One of the major distinctions that physicians use when diagnosing sinusitis is whether it's an acute or a chronic problem.
Acute Sinusitis
An acute infection is one that crops up seemingly out of nowhere. You could be breathing free and easy one day and then struck with an unbearable sinus headache the next.
In most cases, acute sinusitis occurs after a particularly nasty cold. The cold virus causes the mucous membranes in your sinuses to swell and become less effective at draining mucus. The mucus and other material sitting around in your sinuses becomes perfect food for bacteria, leading to a bacterial infection in the sinuses.

Although a bacterial infection following the cold is the most common cause of acute sinusitis, it can also be caused by allergies or viral and fungal infections.
If you have symptoms of sinusitis, your doctor will probably examine you and use a long swab to take samples from your nasal passages and sinuses. These samples can then be analyzed for signs of bacterial or fungal infection. Nasal swabbing doesn't usually hurt, but it can be uncomfortable, especially if you have structural abnormalities like a deviated septum.
Acute sinusitis is usually easy to treat. In some cases, it clears up on its own, but anti-inflammatory painkillers such as ibuprofen and aspirin can help alleviate most symptoms. Your physician might also prescribe antibiotics or allergy medication, depending on the cause of your sinusitis. Washing the sinuses out with saline solution (using a saline nasal spray, a sinus cleansing kit or neti-pot) can also help to alleviate the symptoms of acute sinusitis.
Chronic Sinusitis
If you have sinus headaches and congestion that never seem to go away, or that go away and come back repeatedly, you could be experiencing chronic sinusitis. You have sinus passages that are constantly inflamed, and this causes chronic headaches, difficulty breathing and postnasal drip into the throat.
Unfortunately, in many cases the cause of chronic sinusitis is unknown. Allergies may be a factor, in addition to tiny nasal polyps that can aggravate the sinuses and cause chronic sinusitis.
Chronic sinusitis can be tough to treat because it can be difficult to figure out what's causing it. Acute flare-ups can usually be treated with painkillers, although this won't fix the underlying problem. Your physician might suggest that you wash your sinuses out regularly with saline solution to remove some of the mucus and keep your sinuses from drying out. In extreme circumstances, surgery to remove polyps or enlarge the sinus passages may be recommended.
Whichever type of sinusitis you have, do your best to treat it. A nasty little sinus infection can quickly turn into a more severe one that can spread throughout your body. So, if you find yourself complaining of a sinus headache and congestion for more than a couple of days, visit your doctor to discuss treatment options.

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Sickle Cell Anemia

Sickle cell anemia is a painful, inherited condition in which the red blood cells become abnormally shaped. It may lead to pain or a number of other serious complications including stroke, life–threatening infection or end-organ damage.

Red blood cells transport vital oxygen to the limbs and organs. These cells are normally disc–shaped. In people with sickle cell anemia, a large number of these red blood cells become sickle- or crescent–shaped.
Hemoglobin, a protein molecule present in all red blood cells, is responsible for transporting oxygen from the lungs to the tissues around the body. However, in people with sickle cell anemia, a sickle–shaped red blood cell develops as a result of the presence of an abnormal hemoglobin called hemoglobin S. Normally red blood cells contain hemoglobin A. But with hemoglobin S, there is a reduction in the amount of oxygen transported in the red blood cells.
As a result of this reduced oxygen, the cells change shape. These sickle-shaped cells are harmful because they often get stuck in small blood vessels, obstructing the flow of blood. This can lead to a number of complications, including recurrent episodes of pain known as asvaso-occlusive sickle cell crises.

These structurally abnormal cells also become very fragile and begin to be broken down prematurely, at a rate faster than the body can replace them. As a result, patients with sickle cell anemia often have a lower-than-normal number of red blood cells in their blood, condition called anemia. This can lead to a number of symptoms including fatigue, jaundice (yellowing of skin and eyes) and shortness of breath.
Sickle cell anemia can affect only someone who has inherited hemoglobin S from both parents. A person who inherits hemoglobin S from only one parent can have sickle cell trait (AS). Known as carriers, these people with sickle cell trait usually have no symptoms. They can, however, pass the trait onto their children.
To determine if a person has sickle cell anemia or sickle cell trait, physicians may order a number of blood tests (e.g., hemoglobin electrophoresis, sickle cell test). Newborns are routinely screened for the abnormal gene in many states. Adults, older children and fetuses can also be screened.
According to the Sickle Cell Disease Association of America, there are approximately 70,000 people living with the sickle cell anemia in the United States. Most of these patients are African American and Hispanic.
Currently, bone marrow transplant is the only cure for sickle cell anemia. The procedure, however, is risky, and it is often difficult to find a suitable donor. When a bone marrow transplant is not an option, the focus of treatment is on relieving pain and preventing crises and other complications

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Scoliosis

Scoliosis is an abnormal sideways curvature of the spine that is usually painless, but can result in chronic back pain if left untreated. Severe cases in young children can cause deformities, impair development and be life-threatening.

Scoliosis is most often found in patients between 10 and 14 years old, though the condition can also affect infants. In infancy, boys are at higher risk for scoliosis than girls, but girls are at much higher risk for developing scoliosis after age 3. Regular checkups by the primary care physician are necessary to notice this problem at an early phase, with early treatment intervention.
In most people, the spine appears straight when viewed from behind. However, patients with scoliosis have one or more side–to–side spinal curvatures. Scoliosis is diagnosed when a patient has a spinal curvature greater than 10 degrees.
Scoliosis patients who wear a back brace over an extended period of time can usually prevent further curvature of the spine. Left untreated, scoliosis can become more severe, resulting in ongoing back pain and breathing difficulties. In severe cases of scoliosis, surgery may be necessary to restore the spine.

About scoliosis

Scoliosis is an abnormal sideways curvature of the spine that is typically found in children and adolescents. In most cases, scoliosis is painless. However, it can become gradually more severe if left untreated, resulting in chronic back pain. In young children, severe cases can cause deformities, impair development and be life-threatening.
In most people, the spine appears straight when viewed from behind, with the lower back bending slightly inward and the upper back bowing a little outward. However, scoliosis patients have one or more side–to–side spinal curvatures that can appear in the shape of an “s” or a “c.” Though this curve is not always visible, it can be seen from behind in many patients. This is especially true in severe cases.
Scoliosis, which comes from the Greek word for “crooked,” is usually diagnosed when a patient has a spinal curvature greater than 10 degrees. It is most often found in patients between 10 and 14 years old, although it can be present in infancy. Infant boys are at higher risk for scoliosis than girls, but girls are at much higher risk for developing scoliosis after age 3.
The cause of about 80 to 85 percent of all scoliosis cases is unknown (idiopathic), according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The most common form of scoliosis is known as adolescent idiopathic scoliosis, which occurs when a patient is 10 years old or older. Other forms of scoliosis include infantile idiopathic scoliosis (birth to 3 years) and juvenile idiopathic scoliosis (ages 3 to 10 years). Scoliosis is less common in adults.

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Ionic toothbrush

The Ionic toothbrush works on the principle that every element in nature has a positive or negative charge. This is called polarity. When the polarities are opposite, the two elements cling together. That's why dust sticks to your coffee table and why plaque, which has a positive charge (+), clings stubbornly to your negatively charged (-) teeth.

Ionic Action toothbrush temporarily reverses polarity of the tooth surface from negative (-) to positive (+), drawing plaque towards the negatively charged toothbrush head.

When you brush with a ionic toothbrush, a constant flow of positive ions (+) from the lithium power source temporarily reverses your teeth's polarity. This makes your teeth reject plaque, even in areas that aren't touched by ionic tooth brush bristles.

The IONIC toothbrush handle is only slightly larger in size than a manual toothbrush, and has been specially designed with specialized brush heads head to reach hard-to-clean areas of teeth. The toothbrush handle contains the power source responsible for the ionization, because people are used to slim handled toothbrushes, the ionic tooth brush handle is ergonomically designed.

When the ionic toothbrush is held in your hand and the bristles of the brush head touch your teeth in the presence of saliva or water, an imperceptible electronic circuit is created. The power source for the circuit is encased in the handle section, and covered with a metal pad. When brushing, the user must simply keep a finger or part of the palm in contact with the pad, perferably wet, and brush as usual. The electron flow attracts plaque to the negative bristles for removal. This process is safe, simple and effective.

Additional features of the IONIC toothbrush make it a sensible and efficient oral hygiene tool. It includes an electronic handle, 5 interchangeable brush heads, a power source tester, and a snap on sanitary travel cap. Super Soft bristles are also available in junior size heads for children, or users with sensitive gums.

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Stop Smoking Otherwise

There are many different ways to stop smoking and I'll describe a sampling of the most effective ones below. But remember that there are many different approaches and the best method for one person may not be the best method for another. Also, it's common for people to make several "quit attempts" before they finally succeed. So if you try one approach and it doesn't work for you -- don't give up! Try again using another approach instead of, or in addition to, the one you tried.

Cigarette smoking involves both a physical addiction to nicotine and a psychosocial habit, so effective interventions typically include components that address BOTH of these factors.

Physical addiction: Many people can successfully quit by going "cold turkey." But those who are more physically dependent on nicotine (generally those who smoke within 30 minutes of waking up and/or who smoke more than 20 cigarettes per day) are more likely to succeed if they gradually "wean" themselves off of nicotine before trying to quit altogether. This makes it easier by decreasing their experience of unpleasant withdrawal symptoms when they quit.

One effective way to wean yourself is by using nicotine replacement products, such as nicotine patches or nicotine gum. There are advantages and disadvantages to each of these methods (e.g., the patches are much easier to use, but the gum can provide a nicotine "hit" on demand), but a full discussion of these is beyond the scope of this column -- talk to a professional about this further if you are interested in using nicotine replacement (see the resources section below).

Both nicotine gum and nicotine patches are now available "over-the-counter,". But remember that they are a little pricey and they are not "magic pills" -- studies have found that quit rates are much higher when nicotine replacement products are used in combination with "cognitive-behavioral" approaches that also address your smoking habit.

Another effective approach for weaning yourself off of nicotine is called "nicotine fading." It involves progressively switching to cigarette brands with lower and lower nicotine levels before quitting altogether -- a typical schedule is to switch once a week for 3 weeks to brands with 30%, 60%, and then 90% less nicotine than you started with.

One potential problem with this approach is that some smokers "compensate" for lower nicotine levels by smoking more cigarettes, taking more puffs off of each cigarette, and/or puffing more deeply and this can lessen the effectiveness of nicotine fading.

But there are things you can do to decrease the compensation problem -- you can be aware of it and minimize these behaviors, and you can delay a brand switch for a few days if you notice that you're compensating (some people's bodies take a little longer to adjust and they will naturally stop compensating after a few extra days). Besides being inexpensive, this approach to "weaning" can also help you develop confidence in your ability to exercise some control over your smoking habit before you stop smoking altogether.

Smoking habit: One effective approach for addressing your smoking habit is called "relapse prevention." This involves identifying your personal "triggers," "cues," or "high-risk situations" for smoking, and then developing "tools" or "coping skills" for dealing with them. Triggers can be a wide variety of things -- people, places, events, emotions. Do you smoke after meals, at parties, when you're angry or anxious or bored, or in your car?

Once you've identified the situations that are likely to put you at risk for relapsing after you've quit, you can develop ways to cope with them. If you smoke when you're anxious, learn a deep breathing skill or work on some calming thoughts you can say to yourself when you're nervous (e.g., "Calm," "Relax").

If you smoke, when you're bored, make a list of 10 things you can do instead of smoke and keep it handy for after you've quit. If you smoke after dinner, plan to go for a walk each night after dinner instead. In other words, plan ahead and develop ways to avoid, escape from, or cope with the things that might trigger you to return to smoking after you've quit.

Continue to identify difficult situations after you quit and continue to work on improving your coping skills so that you can stay smoke free. If you slip, don't give up! -- examine the situation to identify hidden or new triggers, develop some new coping skills or strengthen your existing ones, then set another quit date, and try again.

Another effective approach for addressing your smoking habit is to develop a quit smoking contract with yourself -- plan to give yourself small rewards for each day, and progressively larger rewards for increasingly longer periods of time, that you stay smoke free.

Yet another effective approach is to develop a support system for quitting -- ask a non-smoking friend or family member to be your "buddy," someone you can call to help you through tough times and someone who can help reward you for time smoke free (by doing one of your household chores for you for a full day smoke free, by taking you to lunch for being smoke free for a whole week).

Remember, combining approaches that address both your physical addiction and your smoking habit is most likely to be effective...and, as the old adage says, "If at first you don't succeed -- Try, Try again!"

Resources:

Luckily, there are many excellent resources available to help you quit smoking. Nonprofit groups can be found in communities throughout the country:

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Tonsillitis

Tonsils are 2 balls of lymphatic tissue on both sides of the throat, above and behind the tongue. They are part of the immune system, which helps the body fight infection. However, the basic roles of the tonsils in immunity is not clear yet! 

:Causes 

tonsillitis is caused by a virus, and this is the most frequent.But may occur as a result of the same bacteria that cause sore throat, and in other rare cases where the general health situation is not good ,the cause may be fungal infection or a parasite! 

Viral infections are more common than bacterial infections in all seasons, but bacterial infections are usually most common during the winter 

Although there is no evidence that exposure to cigarette smoke can cause tonsillitis, but the children of smokers are conducting a tonsillectomy more than others. 

The modes of transmission of this infection is the exposure to the infected persons' droplets, either directly or indirectly via any tool or surface that received the droplets. 

:Symptoms 

The most common symptom is sore throat . 

Redness and swelling of the tonsils, with patches or completely covered by pus 

High temperature. 

headache. 

Malaise. 

* Viral symptoms are similar to the symptoms of common cold: runny nose, sneezing, cough and sore throat. 

* Bacterial symptoms: sore throat and high "sudden" elevated temperature, swollen tonsils with no symptoms of common cold. 

The attack resolves on it's own in 4-10 days and longer in the bacterial cases. 

Tonsillitis occurs mostly in the childern equally in both female&male.May occur in the adults who didn't do tonsillectomy in their childhood.But doing this operation for the elderly has alot of risks for bleedin and pain. 

:Complications 

* Frequent throat infections. 

* Inflammation of the tonsils caused by bacteria and not treated, lead to complications, such as ear infections and sinus or abscess outside the tonsils. 

More serious complications may occur, such as rheumatic fever, especially with the lack of commitment to the treatment and antibiotics. 

* Chronic inflammation, which leads to upper airway obstruction, and other problems, such as snoring, nasal congestion, and breathing through the mouth. 

:Surgery 

Tonsillectomy is an operation common for children, but it's not commonly operated as it was before. 

The operation reduces the exposure of your child to throat infections caused by inflammation of the tonsils, but these infections get lesser to occur to the child by getting older,even without surgery. 

It's preferred for children who have serious complications with recurrent resistant infections that do not respond to other treatments, especially when they affect the daily life, such as frequent absenteeism from school or because of problems with sleep.Taking the decisions should be after careful consideration for the child health. 

However,it's not believed to be the most suitable solution,this operation may be the ideal solution for some cases like: 

* Episodes of inflammation occur 5 times or more during the year 

* Episodes of inflammation of a 3 or 4 times during the year for several consecutive years. 

* Inflammation continued for 3 months despite treatment. 

*Obstructed air passages. 

* Difficulty in swallowing. 

* Difficulty in speaking. 

* Bleeding tonsils 

The child will be subjected to general anesthesia, discharged from the hospital in 1 day and may remain for one night only. The child, after this surgery should receive care for rest and food. 

Tiredness for several days is normal, but he slowly regains his activity,and supposed to return to school in one week and return to full daily activities within two weeks. 

* It's preferred the child not to be very young. 

:Risk of surgery 

Bleeding after the operation is simple and common, especially with the fall of the crust over the wound. 

Other complications, but much less common, including bleeding and problems with anesthesia, and these occur during the operation. 

:Prevention and treatment 

*Prevention 

The best prevention is to follow basic health precautions, hygiene, and the following steps are useful, especially for children: 

* Avoid close contact with others who are suffering from the disease if possible, keep your child away from the infected children. 

* Remind your child repeatedly the importance of washing hands, and do not share toothbrushes or eating utensils with other children. 

Washing and disinfection of surfaces and toys .* 

* Do not smoke near your child. 

*Treatment 

*Viral infections 

Usually go away on its own. Antibiotics are not effective in the treatment. 

May be useful home remedies such as gargling with salt water, drinking warm tea. 

Analgesics such as ibuprofen 

Do not give aspirin to those who are without the century! This general advice is not specific only for tonsilitis. 

*Bacterial infections 

Doctor prescribes antibiotics, and full commitment to take the full dose is a must, even if the symptoms disappeared and the state of health improved ! Otherwise, the bacteria will become resistant and these antibiotics are not effective, so it becomes more dangerous bacteria, causing health problems, for example, rheumatic fever in the heart. 

By:Dr. Rokaya Almehdawy

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Facts about Botox

Facts about Botox 

Botox is the brand name of a toxin produced by a bacterium called Clostridium botulinum. In large amounts, this toxin can cause food poisoning. Despite that one of the most serious complications of botulism is paralysis; scientists have discovered a way to use it to human advantage. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles.

The FDA approved in 1980s to use Botox in treatment of uncontrolled blinking and lazy eye. Doctors are using Botox for years now to treat wrinkles. In April 2002, FDA approved to use Botox for treatment of wrinkles between the eyebrows, and it is often used for other areas of the face as well.

How Does Botox Work?
Botox blocks signals from the nerves to the muscles. The injected muscles can no longer contract, which causes the wrinkles to relax and soften.

It is most often used on forehead lines, lines around the eye and frown lines. BUT Wrinkles caused by sun damage and gravity will not respond to Botox.

How Is a Botox Procedure Performed?
Getting Botox takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes 3 to 7 days to take full effect and it is best to avoid alcohol at least one week before the injection. Aspirin and anti-inflammatory medications should be stopped 2 weeks before treatment to reduce bruising "bluish coloration around injection site".

How Long Does a Botox Injection Last?
The effects of Botox will last 4 to 6 months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.

What Are the Side Effects of Botox?
· Temporary bruising is the most common side effect of Botox.

· Headaches, which disappear in 24-48 hours, but this is rare.

· A small percentage of patients may develop eyelid drooping. Whish usually resolves in three weeks. This usually happens when the Botox moves around so you shouldn't rub the treated area for 12 hours after injection or lay down for three to four hours.

Who Should Not Receive Botox?
· Pregnant women.

· Breastfeeding.

· Or those who have a neurological disease.

 Since Botox doesn't work for all wrinkles, a consultation with a doctor is recommended.

Take Care 

Dr: Nada Seliem

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