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Tuesday, 8 November 2016

Intrauterine device/system, something to ponder

INTRAUTERINE DEVICE
  • An IUD is a small, T-shaped plastic device that is wrapped in copper or contains hormones. The IUD is inserted into your uterus by your doctor. A plastic string tied to the end of the IUD hangs down through the cervixinto the vagina. 
  • Hormonal IUD. The hormonal IUD releases levonorgestrel, which is a form of the hormone progestin. The hormonal IUD appears to be slightly more effective at preventing pregnancy than the copper IUD. Hormonal IUDs prevent pregnancy for 3 to 5 years, depending on which IUD is used.
  • Copper IUD. The most commonly used IUD is the copper IUD. Copper wire is wound around the stem of the T-shaped IUD. The copper IUD can stay in place for up to 10 years and is a highly effective form of contraception.
  • Hormonal IUD. This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can't get through to the uterus. It also keeps the lining of the uterus (endometrium) from growing very thick.1 This makes the lining a poor place for a fertilized egg to implant and grow. The hormones in this IUD also reduce menstrual bleeding and cramping.
  • Copper IUD. Copper is toxic to sperm. It makes the uterus and fallopian tubes produce fluid that kills sperm. This fluid containswhite blood cells, copper ions, enzymes, and prostaglandins.
  • You can have an IUD inserted at any time, as long as you are not pregnant and you don't have a pelvic infection. An IUD is inserted into your uterus by your doctor. The insertion procedure takes only a few minutes and can be done in a doctor's office. Sometimes a local anesthetic is injected into the area around the cervix, but this is not always needed.
  • Do not have sex, use tampons, or put anything in your vagina for the first 24 hours after you have an IUD inserted.
IUD use is safe in women with the following conditions:

Absolute contraindications for IUD use include the following:
  • Pregnancy
  • Significantly distorted uterine anatomy
  • Unexplained vaginal bleeding concerning for pregnancy or pelvic malignancy
  • Gestational trophoblastic disease with persistently elevated beta-human chorionic gonadotropin levels
  • Ongoing pelvic infection

video


Levonorgestrel-Releasing Intrauterine System (Mirena and Skyla) Insertion
The packaging is opened by an assistant, taking care to maintain the sterility of the package contents. Care is taken to ensure the arms of the IUD are in a horizontal position (see the image below).
Ensuring horizontal positioning of IUD arms. Ensuring horizontal positioning of IUD arms.
The threads on the handle of the IUD insertion device are then released from the groove in the handle of the insertion device. While pushing the slider toward the insertion tubing, the strings at the base of the IUD handle should be pulled, which will retract the IUD arms into the insertion tubing. See the image below.
Loading the levonorgestrel-releasing intrauterine
Loading the levonorgestrel-releasing intrauterine system into insertion tubing with correct orientation of knobs at the end of the arms.
The threads are then secured in the thread cleft, as shown in the image below.
Securing threads on the handle of the insertion de
Securing threads on the handle of the insertion device.
The flange on the insertion device is then set at the level to which the uterus sounds. This is accomplished by sliding the flange over the marked increments on the IUD insertion tube, as shown in the image below.
Set the flange at the level to which the uterus soSet the flange at the level to which the uterus sounds.
One hand is then used to provide gentle downward traction on the tenaculum. While continued upward pressure is applied to the green slider on the IUD handle, the insertion tubing is placed into the vagina at the level of the external cervical os. The insertion tubing is then gently advanced until the flange is approximately 1.5-2 cm from the external cervical os. See the image below.
Advancing the insertion tubing to 1.5 cm from the Advancing the insertion tubing to 1.5 cm from the external cervical os.
Next, the slider on the handle is pulled backward to the level of the raised mark on the insertion handle, expelling the IUD arms from the insertion tubing (see the image below), and wait 10 seconds to allow the arms to open completely.
Retracting slider and expelling the IUD from inserRetracting slider and expelling the IUD from insertion device.
The insertion tubing is then advanced until the flange is at the external cervical os, thereby advancing the IUD to the level of the uterine fundus (see the image below).
Advancing the insertion tubing until the flange isAdvancing the insertion tubing until the flange is at the level of the external os.
While holding the insertion device steady, the slider is pulled all the way down to release the IUD. The IUD handle and insertion tubing are then gently retracted from the uterus and cervix. The strings will remain in place. See the image below.
Pulling the slider down completely to release the Pulling the slider down completely to release the IUD.
Following removal of the insertion device, the IUD strings will be readily visualized in vagina. Using long-handled scissor, the strings are then trimmed so that approximately 3 cm are visible, extending from the external cervical os.[52] See the image below.
Trimming the IUD strings to 3-4 cm. Trimming the IUD strings to 3-4 cm.



Copper T380A IUD (Paraguard) Insertion
The copper T380A packaging is opened by an assistant, taking care to maintain the sterility of the package contents.
Load the IUD into the insertion tubing. This is accomplished by slightly withdrawing the insertion tubing and folding the horizontal arms of the IUD down along the vertical arm using your thumb and index finger. The insertion tubing is then advanced so that the horizontal arms sit securely within the insertion tubing. See the images below.
Loading the copper T380A IUD into the insertion tuLoading the copper T380A IUD into the insertion tubing.
Loading the copper T380A IUD into the insertion tuLoading the copper T380A IUD into the insertion tubing.
Next, the solid white rod is introduced into the bottom of the insertion tubing and advanced to the point that it touches the bottom of the IUD (see the image below).
Placing the insertion tubing containing the copperPlacing the insertion tubing containing the copper T380A IUD.
The insertion tube is grasped at the open end and the blue flange is set to the level to which the uterus sounds. The insertion tubing is then rotated so that the horizontal arms of the IUD are parallel to the long axis of the blue flange. See the image below.
Releasing the arms of the copper T380A IUD. Releasing the arms of the copper T380A IUD.
The loaded insertion tube is passed through the cervical canal until resistance is met at the uterine fundus and the blue flange should be at the external cervical os, as shown in the image below.
Advancing the insertion tubing to the fundus, wherAdvancing the insertion tubing to the fundus, where slight resistance is felt.
With the solid white rod steady, the insertion tubing is withdrawn approximately 1 cm, releasing the IUD.
The insertion tube is then gently moved up to the fundus of the uterus, ensuring placement of the IUD at the level of the fundus. Holding the insertion tubing steady, withdraw the white rod. Then, gently withdraw the insertion tubing. See the image below.
Holding the insertion tube steady and withdrawing Holding the insertion tube steady and withdrawing the white rod.
Following removal of insertion device, the IUD strings will be readily visualized in vagina. Using long-handled scissors, the strings are then trimmed so that approximately 3 cm are visible extending, from the external cervical os.[53] See the image below.
Trimming the IUD strings. Trimming the IUD strings.


Referral http://emedicine.medscape.com/article/1998022-overview#a3

Saturday, 10 January 2015

ALERT!!! Colon Cancer on rise


"The overall age-adjusted CRC incidence rate decreased by 0.92% (95% CI, −1.14 to −0.70) between 1975 and 2010. There has been a steady decline in the incidence of CRC in patients age 50 years or older, but the opposite trend has been observed for young adults. For patients 20 to 34 years, the incidence rates of localized, regional, and distant colon and rectal cancers have increased. An increasing incidence rate was also observed for patients with rectal cancer aged 35 to 49 years. Based on current trends, in 2030, the incidence rates for colon and rectal cancers will increase by 90.0% and 124.2%, respectively, for patients 20 to 34 years and by 27.7% and 46.0%, respectively, for patients 35 to 49 years."

Above is the result of a study which shows a concerning figure. It tells us that more and more of young people are getting colon carcinoma. 

Friday, 14 November 2014

MUST KNOW!!!! Heart cancer as we never heard of it..




The Reason We Don’t Get Heart Cancer As you likely know, we receive half our genes from our mothers, half from our fathers. While it would seem our genetic fate is sealed, “nothing could be further from the truth,” said Gaynor, whose new book on the subject, The Gene Therapy Plan, will be available in 2015. “We understand now how gene expression can be modified throughout your life… and that can create cancer,” he said. In fact, our environment affects which genes become expressed (activated) as well as how frequently they become activated. And carcinogens coming from our food and environment are one of the many factors that influence which genes are activated or not. “A lot of toxins are found in breast tissue, because there are a lot of fat cells there,” Gaynor explained. “And toxins are found wherever there is the most fat.”


 While our bodies have some defenses against these contaminants, in the form of detoxifying enzymes, and while our bodies are supported by micronutrients which turn on tumor suppressor genes, dangerous toxins found in our fat tissue still modify our genes, which can result in cancers forming in the organs of our bodies, especially those containing fatty tissue. 

This, then, is why the heart is so exceptional: “There’s not a lot of fatty tissue [in the heart],” Gaynor said. Even more, “the heart’s enclosed in a membrane,” he explained. Known as the pericardium, this fluid-filled sac may itself become engulfed by cancer, with tumors metastasizing to the outside of it, but still it does its job of protecting our precious hearts. So, even though cancer can happen anywhere there are cells, your heart remains virtually immune due to its muscular nature and the assistance of the pericardium. Smart heart.



Read more at: http://forum.facmedicine.com/threads/why-do-we-never-hear-about-heart-cancer.19966/

Saturday, 1 November 2014

Vaccination.

video




Measles is one of the most contagious of the vaccine-preventable diseases, with reproduction rates (R 0) estimated at 12 to 18 — meaning that the average person with measles would be capable of infecting 12 to 18 other people if all his or her contacts were susceptible. The herd-immunity threshold (the population immunity level needed to interrupt transmission) is usually calculated as (R 0−1)÷R 0; for measles, this threshold is on the order of 92 to 94% to prevent sustained spread of the virus — higher than the thresholds for almost all other vaccine-preventable diseases.




From statistic of the measles prevalence in US, the resurgent of the case is somewhat closely related to the increasing number of parents in this country which are hesitant to have their children vaccinated, and such hesitancy has resulted in an accumulation of unvaccinated populations who can become infected and maintain transmission.

The licensure of the first live attenuated measles vaccine in 1963 offered the opportunity to prevent this health burden. Current vaccines are highly effective — about 94% for a single dose, if it's administered in the second year of life. With two doses administered on or after the first birthday and at least 1 month apart, almost all immunocompetent children are protected against measles for life. But vaccines don't save lives — vaccinations do. Vaccines that remain in the vial are completely ineffective.


To prevent measles from being reestablished as an endemic disease in the United States, we must first do better in vaccinating our at-risk population. That means ensuring that vaccine is accessible to all who need it — especially to people traveling outside the Western Hemisphere and those traveling to the United States from countries with circulating disease — and convincing hesitant families both that the vaccine is safe and effective and that measles is not trivial and can result in serious illness.



Taken from article entitles:

Mounting a Good Offense against Measles

Walter Orenstein, M.D., and Katherine Seib, M.S.P.H.
N Engl J Med 2014; 371:1661-1663October 30, 2014DOI: 10.1056/NEJMp1408696

Monday, 20 October 2014

life support....!! how to do cpr...

If happen in front of you, someone just fall down unawake.. What will you do besides panicking??
at least you can make yourself usefull sometimes right...  so enjoy these videos...

adult cpr




cpr with 2 rescuers




with AED


MUST SEE!!! squatting is the best!!!



Seven Advantages of Squatting

  1. Makes elimination faster, easier and more complete. This helps prevent "fecal stagnation," a prime factor in colon cancerappendicitisand inflammatory bowel disease.
  2. Protects the nerves that control the prostatebladder and uterus from becoming stretched and damaged.
  3. Securely seals the ileocecal valve, between the colon and the small intestine. In the conventional sitting position, this valve is unsupported and often leaks during evacuation, contaminating the small intestine.
  4. Relaxes the puborectalis muscle which normally chokes the rectum in order to maintain continence.
  5. Uses the thighs to support the colon and prevent straining. Chronic straining on the toilet can cause hernias, diverticulosis, and pelvic organ prolapse.
  6. A highly effective, non-invasive treatment for hemorrhoids, as shown by published clinical research.
  7. For pregnant women, squatting avoids pressure on the uterus when using the toilet. Daily squatting helps prepare one for a more natural delivery.




DigitalMimbar (khalifahklothing)


Toilets from Ancient Times

Ancient Public Toilets
Pictures of ancient public toilets tend to confuse westerners, who assume that they were used in the sitting position. This impression is often reinforced by the pose of a comical tourist.
But, in reality, these are squattoilets.

Ancient Public Toilets

They are elevated, not for sitting, but because there is an open sewer underneath. The cutouts in the vertical wall allow people to clean themselves with water, which is done from the front when squatting.

The ancient Romans used the posture shown below on the left. (Togas were more convenient than trousers, and provided some degree of privacy.)
 
The tourists shown below might be surprised to learn that, except for royalty and the disabled, everyone used the squatting position until the second half of the 19th century.22




Note: The Sulabh International Museum of Toilets website claims that archeologists have found "sitting-type" toilets at ancient sites, thousands of years old. The author of the site, Dr. Bindeswar Pathak, was asked for his evidence that these toilets were used in the sitting position. He replied that he actually has no evidence, but was simply repeating the assumptions of western archeologists. 






A Clinical Study of Sitting versus Squatting

In April, 2002, an Iranian radiologist, Dr. Saeed Rad, published a study which compared the effectiveness of sitting versus squatting for evacuation.24    One of his conclusions relates to the cause of a type of hernia known as "rectocele," which is a bulge of the front wall of the rectum into the vagina.
Thirty subjects participated in the study – 21 male, 9 female – ranging in age from 11 to 75 years. Each patient received a barium enema so the internal mechanics of evacuation could be recorded on an X-Ray image. Each patient was studied in both the squatting and the sitting positions.
Using these images, Dr. Rad measured the angle where the end of the rectum joins the anal canal. At this junction point, the puborectalis muscle creates a kink to prevent incontinence. Dr. Rad found that when the subjects used sitting toilets the average angle of this bend was 92 degrees, forcing the subjects to strain. When they used squat toilets, the angle opened to an average of 132 degrees. At times it reached 180 degrees, making the pathway perfectly straight.
Using squat toilets, all the subjects reported "complete" evacuation. "Puborectalis relaxation occurred easily and straightening of the rectum and anal canal facilitated evacuation. The anal canal became wide open and no folding was noticed in the terminal rectum."
In the sitting position, "a remarkable folding was created in the terminal rectum predisposing it to rectocele formation, and puborectalis relaxation was incomplete." All the subjects reported that elimination felt "incomplete" in the sitting position.
Dr. Rad also measured the distance from the pelvic floor to the perineum. In the sitting position he found that the pelvic floor was pushed downwards to a significant degree. (A detailed discussion of the connection between sitting toilets and pelvic organ prolapse – including rectoceles – can be found in thegynecological disorders section.)
Dr. Rad concluded that the use of the squat toilet "is a more comfortable and efficient method of bowel evacuation" than the sitting toilet.


 
Different types of squat toilets





Conclusion

For 150 years, the people of the Western World have been the unwitting subjects of an experiment. By an accident of Fate, they were forced to adopt sitting toilets, while the other two-thirds of the world (the "control group") continued to use the natural squatting position.22




 

Photo courtesy of Lon&Queta at flickriver.com


The results of this experiment have been clear and unequivocal. The experimental group has suffered dramatically higher rates of intestinal and urological disorders. The following diseases are almost exclusively confined to the Western World: appendicitis, colon cancer, prostate disorders, diverticulosis, bladder incontinence, hemorrhoids, and inflammatory bowel disease.
But the results have been misinterpreted by researchers who were unaware that the experiment was even taking place. Western doctors have tried to blame these diseases on the "highly refined" western diet. Their attempts have consistently failed to show that diet is a significant factor. Conventional medical websites all tell the same story:
This is a disease of the Western World. We don't know what causes it, or why the developing world seems so strangely immune.
Medical researchers have been working diligently to solve these deadly mysteries, but they have made little progress. Due to their habit of studying diseases in isolation, they failed to notice a remarkable coincidence:   Many different bowel, bladder and pelvic diseases – previously rare or unknown – suddenly became commonplace in the last half of the 19th century.
This simple observation would have alerted them to the presence of a common underlying factor. It would have prompted the obvious question:  What suddenly changed in the daily habits of the population?
The obvious answer: They abandoned the squatting posture for bodily functions (including childbirth.) For each disease, the anatomical relevance of this change has been explained above. The relevance is confirmed by the absence of these disorders among squatting populations.

In conclusion, the porcelain throne has caused enormous amounts of needless suffering, and the annual waste of billions of dollars in health-care costs. Clearly, the time has come to reacquaint Western Man with his natural habits – and put this unfortunate experiment to an end. 






REFERENCES

  1. Causes, Symptoms and Diagnosis of Diverticulosis and Diverticulitis: http://digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/
  2. Welles, William, "The Importance of Squatting" chapter in Tissue Cleansing Through Bowel Management, Bernard Jensen Publisher; 10th edition (June 1981).
  3. Jacobs E J, White E., Constipation, laxative use, and colon cancer among middle-aged adults. Epidemiology, 1998 Jul, 9 (4): 385-91.
  4. Tagart REB. The Anal Canal and Rectum: Their Varying Relationship and Its Effect on Anal Continence, Diseases of the Colon and Rectum 1966: 9, 449-452.
  5. Hornibrook, F.A., The Culture of the Abdomen, (Garden City, N.Y.: Doubleday, Doran & Co., Inc., 1933), pp. 75-78
  6. Aaron, H., Our Common Ailment, (New York: Dodge Publishing Co., 1938), p. 39.
  7. Sikirov BA. Management of Hemorrhoids: A New Approach, Israel Journal of Medical Sciences, 1987: 23, 284-286.
  8. Dimmer, Christine; Martin, Brian; et al. "Squatting for the Prevention of Hemorrhoids? ", Department of Science and Technology Studies, University of Wollongong, NSW 2522, Australia, published in the Townsend Letter for Doctors & Patients, Issue No. 159, October 1996, pp. 66-70 (available online at http://www.uow.edu.au/~bmartin/pubs/96tldp.html)
  9. Sikirov BA, Etiology and pathogenesis of diverticulosis coli: a new approach, Medical Hypotheses, 1988 May;26(1):17-20.
  10. Sikirov BA, Cardio-vascular events at defecation: are they unavoidable?, Medical Hypotheses, 1990 Jul;32(3):231-3.
  11. Bockus, H.L., Gastro-Enterology, (Philadelphia: W.B. Saunders Co., 1944), Vol. 2, p. 469
  12. Kira A. The Bathroom. Harmondsworth: Penguin, 1976, revised edition, pp.115,116.
  13. Tobin, Andrew.. Prostate Disorder – Causes and Cure, National Direct Publishing, Bowden, Australia, 1996, (Chapter 12, by Wallace Bowles, entitled "Refining an Everyday Activity"),p.132
  14. Ibid., p. 138.
  15. Cleary, Margaret, "My Child, My Teacher", New Vegetarian and Natural Health, Australian Vegetarian Society, Spring Edition, 1998.
  16. Henry, Dr. M.M. and Swash, Dr.M., Coloproctology and the Pelvic Floor, Butterworths London, 1985, p. 145,147,301.
  17. Bowles, Wallace, The Importance of Squatting for Defecation, unpublished article, January, 1992.
  18. The role of Reginald Heber Fitz in explaining appendicitis: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2601730/
  19. Walker AR, Segal I., Epidemiology of noninfective intestinal diseases in various ethnic groups in South Africa. Israel Journal of Medical Science, 1979 Apr;15(4):309-13. (online atPubMed.)
  20. Appendicitis and King Edward VII: www.users.bigpond.com/billmastermind/moments53.htm
  21. Montgomery Scott M , Pounder Roy E , Wakefield Andrew J, Infant mortality and the incidence of inflammatory bowel disease,The Lancet Volume 349, Number 9050 DATUM: 1997-02-15.
  22. A History of Technology, Vol.IV: The Industrial Revolution, 1750-1850. (C. Singer, E Holmyard, A Hall, T. Williams eds) Oxford Clarendon Press, pps. 507-508, 1958
  23. King, John E.(Editor in Chief), Mayo Clinic on Digestive Health, Mayo Clinic, Rochester, MN, 2000, p.128
  24. Rad, Saeed, "Impact of Ethnic Habits on Defecographic Measurements", Archives of Iranian Medicine, Vol 5, No. 2, April 2002, p.115-117.
  25. Russell JGB. Moulding of the pelvic outlet. J Obstet Gynaec Brit Cwlth 1969;76:817-20 (cited at http://home1.gte.net/gastaldo/part2ftc.html)
  26. Information on cost of hysterectomies at the Hudson's FTM Resource Guide website
  27. Historical Perspectives in Surgery, Medscape Surgery 4(1), 2002, "Famous Patients, Famous Operations, 2002 - Part 2: The Case of a Royal Pain in the Abdomen"
  28. Kirsner, Joseph B., Historical origins of current IBD concepts,World J Gastroenterol,2001; April 7(2):175-184. The relevant excerpt, regarding Inflammatory Bowel Disease: "Appearing initially as isolated cases in Great Britain and northern Europe during the 19th and early 20th centuries, they have steadily increased numerically and geographically and today are recognized worldwide."
  29. Roberts RO, Lieber MM, Bostwick DG, Jacobsen SJ: A review of clinical and pathological prostatitis syndromes. Urology 49: 809-821, 1997
  30. Latest trends in dealing with appendicitis: http://www.mja.com.au/public/issues/175_01_020701/hugh/hugh.html
  31. Burkitt DP. Appendicitis. London: Norgine Ltd, 1980.
  32. History of Hysterectomies: http://www.qis.net/~pvietz/history.htm
  33. Prostate cancer timeline: http://www.psa-rising.com/timeline/
  34. Primary Surgery, Volume One: Non-trauma, Prolapse of the Uterus (online at http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x6935.html)
  35. Schulz, J.A. (2001). Assessing and treating pelvic organ prolapse. Ostomy Wound Management, 4 (5), 54-56, 58-60.
  36. McIntosh, Louise. The Role of the Nurse in the Use of Vaginal Pessaries to Treat Pelvic Organ Prolapse and/or Urinary Incontinence: A Literature Review, Urologic Nursing, 2005; 25 (1): 41-48.
    (online at http://www.medscape.com/viewarticle/499503_3)
  37. Information on C-Sections at International Cesarean Awareness Network.
  38. Transcript of Mrs. Kotarinos' talk at Interstitial Cystitis Network.
  39. Department of Urology | Addenbrooke's Hospital, History of Urology: http://www.camurology.org.uk/about/history_of_urology.php
  40. Temple NJ, Burkitt, DP, The war on cancer--failure of therapy and research: discussion paper., J R Soc Med. 1991 February; 84(2): 95–98.
  41. Burkitt, DP, Hiatus hernia: is it preventable?, Am. J. Clinical Nutrition, Mar 1981; 34: 428 - 431.
  42. Sontag, SJ, Defining GERD, Yale J Biol Med. 1999 Mar-Jun; 72(2-3): 69-80.