Showing posts from November, 2017

Benign Prostatic Hypertrophy

The prostate gland is located in the midline at the junction of the urinary bladder and urinary passage in the penis. It is present only in men and is about 20 gms in weight at 20 yrs of age, but increases in size to about 50 gms by the age of 80 yrs. It surrounds the urinary passage on all sides just below the bladder and this part of the urinary passage is called prostatic urethra. The prostate gland is a chemical factory. It produces secretions which act as lubricants, produces chemicals which can increase or decrease blood pressure. It also produces a substance called prostacyclin which reduces blood clotting by stopping platelets from adhering to each other. As the prostate enlarges over the age, in about 20% of men, it can produce symptoms or obstruction. The incidence of obstruction rises with advancing age. The symptoms of prostatic enlargement are often referred as LUTS (men) or lower urinary tract symptoms. SymptomsUrgency or inability to hold urine for adequately long timePr…

Tuberculosis (TB)

Part I (Lung TB)Tuberculosis is a worldwide disease. It was equally found in the western developed world until a century back. Better treatment, hygiene, case detection, prevention has decreased the incidence in the developed world. It is a common cause of prolonged illness and fatalities in the 3rd world. HIV had caused spread and increase in no of TB patients which are now declining. It is caused by a bacteria (Mycobacterium) which grows better in tissues with high Oxygen levels. Since oxygen levels are high in the upper portion of lungs, the commonest form of TB involves upper lungs. It is spread by droplet infection. Droplets are small drops of body fluid sent out of the body during coughing and sneezing. The TB bacteria are present in the phlegm of patients and is spread in patients vicinity when they cough. Once it is inhaled by susceptible people, the infection may occur. Susceptible persons are ones with decreased or low immunity. These include young children, elderly patients…

Our Kidneys

Our KidneysCommon QuestionsAre both my kidneys affected? Ans:  Most diseases involve both kidney diseases simultaneously. Exceptions are obstructions in one kidney or ureter, the tumor of one kidney, injury to one kidney or ureter, infections confined to one kidney etc. However, some people may be born with only one kidney! Have both my kidneys failed? Ans:      If the urea and creatinine are high, it means both kidneys are functioning less. If one kidney function is normal, urea and creatinine are usually not elevated. Will the kidney function recover with dialysis? Ans:     Dialysis does not improve kidney function. It is a substitute for some of the kidney functions. In acute kidney injuries, dialysis may buy time and allow the kidneys to start functioning again. In Chronic kidney disease, unless there are some reversible elements, the kidney function will not only not recover but the residual function will also decrease with time. Do kidney donors lead a normal life? Can they do heav…

Stone Disease of the Kidneys

Stone Disease of the KidneysStone formation in the kidneys is a common disease. About 1 in 8 men and 1 in 20 women suffer from the symptomatic stone disease. Stone formation without symptoms is even more common. About ¾ of the stones contain calcium and 10% have uric acid. Rest are due to combinations and rare diseases. Calcium Stones These contain calcium oxalate or calcium phosphate. Former is more common. The risk factors for stone formation are In Urine  Low volume, High calcium in urine, High acid concentration and Low citrate levels. In Diet Water and fluid intake is low, fruits are seldom eaten, food has high oxalate level or if calcium content of the diet is on the lower side. Other diseases with high risk for stone formation are overweight, gout, diabetes, recurrent urinary tract infection etc. Bariatric surgery is a very significant risk factor. If kidneys have certain diseases like the inability to excrete acid, a stone formation may occur. Symptoms: Stones if they are on the …

Prevent Swine Flu

How to Prevent Swine Flu ~Take vaccines. These vaccines keep undergoing changes depending on the current viruses. Since it takes 6 months to produce a vaccine, the vaccine available now is based on the likely viral types as seems most likely from last influenza season. Children > 6 months of age, older adults >65 yrs, pregnant woman, asthmatics, Chronic liver, heart and kidney disease patients, those suffering from neurological illnesses should certainly take vaccines. Treatment with antiviral drugs are recommended in all these cases as they suffer more complications. Health care workers are more likely to come in contact with flu patients and should be vaccinated. Personal protective measures: Stay away from people suffering from infectious respiratory illness. Wash hands often with soap and water or if not available alcohol-based solutions. Do not touch eyes, mouth or nose often. Use a handkerchief or tissue during sneezing or coughing. Disposable tissues are better. After an e…

Scrub Typhus

Scrub TyphusThe disease is caused by a very small parasite of Rickettsia group called Orientiasis tsutsugamushi. It is spread by the bite of a mite (chiggers) technically called trombiculid mite of genus Leptotrombidia. The mite remains in small bushes. A mite can transmit the disease causing organism to its offsprings by transovarian route. The bite occurs during visit to infected areas (mite islands). In India this may occur during the clearing of fields for agriculture, or during a visit to these areas where toilets are not available. It can also infect soldiers training or staying in bushy jungle areas. Signs and Symptoms: The incubation period is usually 7 to 10 days. The illness starts with fever and chills, muscle pains, decreased appetite, vomiting, sometimes diarrhoea, cough and tiredness. Untreated with antibiotics it may last for about 3 weeks before recovery. Clinical Signs: On clinical examination, at the site of bite, a small dark (few mms to 1 cm) area may be present. Th…