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Health Bulletin


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  1. #2001
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    Re: Health Bulletin

    Incontinence strikes young adults

    Twenty-eight-year-old Sheetal gets at least a dozen bladder contractions a day. Even a small amount of urine can give her contractions, and going to the washroom doesn't always help.

    Overactive bladder (OAB) is a condition where patients experience urgent sensation to pass urine, frequent urination, and may leak urine before they are able to reach the washroom. These symptoms may appear singly or in combination, in the absence of identifiable causes such as bladder infections or tumours. Overactive bladder is also known as urge incontinence and is actually a form of urinary incontinence or an unintentional loss of urine.

    Urinary incontinence is often considered a problem of middle and old age. But childbirth, injuries and medical conditions can lead to bladder control issues in young adults, too.

    "The prevalence of OAB is similar in women and men. However, the prevalence of incontinence associated with OAB is higher in women as compared to men. The prevalence of OAB increases with age and in women it increases with body mass index (BMI). Its prevalence in young women is 20 per 1,000 female population. Frequent urinary tract infections, obesity, smoking and diabetes can also cause urinary incontinence at a young age," said consultant urologist R K Shimpi of the Ruby Hall Clinic.

    Shimpi said, "Women who urinate eight or more times a day or more than two times at night with or without urine leakage are part of this group. Many affected by this disorder never get the help they need. They are either embarrassed, hold an incorrect assumption that it is a natural part of aging, or just hope the problem will go away on its own. However, there are effective treatment options available."

    "Experiencing frequent urination problems and having an overactive bladder can be very difficult to deal with, and is embarrassing for many. Overactive bladder can wreak havoc by disrupting work, sleep and social outings," said consultant urologist Shirish Yande of Ratna Memorial hospital.

    Yande said, "Many women who suffer from bladder control problems often feel embarrassed and alone. Some women even shy away from daily activities including exercise, socialising and even sexual activity. Women need to know that there are many promising drugs and treatment options available to help them regain control over their bladder and their lives."

    Symptoms of overactive bladder can include, aside from urgency in urination, increased frequency in urination that is usually eight or more times in 24 hours, urge incontinence which is the involuntary leakage of urine immediately following an urgent need to urinate and needing to wake up two or more times in the night to urinate (nocturia).

    "Though, discussing the problem may be difficult because it is considered by many as a very private issue, it is very important that a doctor is consulted. This is especially true if there is urge incontinence or if the other symptoms of overactive bladder are beginning to cause disruption in social interactions, work schedules and daily activities," said Yande.

    There are times when people consider bladder problems as something that is a normal part of aging and simply go about wearing adult diapers and pads. However the symptoms of overactive bladder are not an inevitable part of aging and there are treatment options available. Also, it is crucial to speak with a doctor because urge incontinence or an overactive bladder may be a result of a serious issue like a tumor that could be cancerous, he added.

    There are some simple first steps people can make on their own. If these methods don't work, anti-muscarinics are mainstay of managing over active bladder symptoms besides many effective non-surgical and minimally invasive surgical treatment options that can offer significant and often dramatic relief from these symptoms. Some of the options include a new class of medication with far fewer side effects than prior medications, including pelvic floor rehabilitation and tibial nerve stimulation.

    "Patients with mild and early stage of incontinence are treated with medicines and Kegel exercises. In severe cases, surgical procedures like sling, tension free vaginal tape are conducted in women. Those who have urinary leak following prostate cancer surgery or radiotherapy are treated with male sling or artificial sphincter. Artificial sphincter are used in patients with extremely severe form of incontinence," said senior reconstructive urosurgeon Sanjay Kulkarni, director of the Kulkarni Reconstructive Urology Centre — a tertiary referral centre.


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  2. #2002
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    Re: Health Bulletin

    Pushing dengue under carpet won't send it away: Doctors


    Prominent private hospitals say the government's strategy to downplay dengue is not helping things in any way. In private, doctors say there's nothing ethical about the strategy.

    "The government is not projecting the exact number of dengue cases. There are many cases that test positive in private labs but samples are not being sent to the National Institute of Virology (NIV) unit in the city. As per 2010 guidelines, private hospitals should send only 5% positive cases and 5% negative cases to NIV for crossverification. But when there is a death, the government declines to accept it as a dengue death as the person's blood sample was not tested at the NIV. This is not right," said a doctor from a major private hospital.

    However, representatives from NIV present at Thursday's meeting said hospitals can send suspect samples every day. "Sometimes we get over 80 samples from one hospital in a day. Don't wait for the samples to accumulate. Don't send the samples with the patient's relatives. Send them through hospital personnel. We don't have backlog and test results will be out in 48 hours," said an officer with NIV.


  3. #2003
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    Re: Health Bulletin

    Marijuana can help treat fractures


    A component in marijuana can significantly help heal bone fractures, according to a new study that paves the way for future use of cannabinoid drugs to combat osteoporosis and other bone-related diseases.

    According to the research at Tel Aviv University and Hebrew University, the administration of the non-psychotropic component cannabinoid cannabidiol (CBD) helps heal bone fractures. The study, conducted on rats with mid-femoral fractures, found that CBD - even when isolated from tetrahydrocannabinol (THC), the major psychoactive component of cannabis - markedly enhanced the healing process of the femora after just eight weeks.

    This paves the way for the future use of cannabinoid drugs to combat osteoporosis and other bone-related ailments, the researchers said.

    The same team, in earlier research, discovered that cannabinoid receptors within our bodies stimulated bone formation and inhibited bone loss.

    "The clinical potential of cannabinoid-related compounds is simply undeniable at this point," said Dr Yankel Gabet of the Bone Research Laboratory at the Department of Anatomy at Tel Aviv University.

    "While there is still a lot of work to be done to develop appropriate therapies, it is clear that it is possible to detach a clinical therapy objective from the psychoactivity of cannabis. CBD, the principal agent in our study, is primarily anti-inflammatory and has no psychoactivity," said Gabet.

    According to Gabet, our bodies are equipped with a cannabinoid system, which regulates both vital and non-vital systems.

    "We only respond to cannabis because we are built with intrinsic compounds and receptors that can also be activated by compounds in the cannabis plant," he said.

    Researchers found that the skeleton itself is regulated by cannabinoids. Even the addition of a non-psychogenic compound acting outside of the brain can affect the skeleton.

    "We found that CBD alone makes bones stronger during healing, enhancing the maturation of the collagenous matrix, which provides the basis for new mineralisation of bone tissue," said Gabet.

    "After being treated with CBD, the healed bone will be harder to break in the future," said Gabet.

    The researchers injected one group of rats with CBD alone and another with a combination of CBD and THC.

    After evaluating the administration of THC and CBD together in the rats, they found CBD alone provided the necessary therapeutic stimulus.

    "We found CBD alone to be sufficiently effective in enhancing fracture healing," said Gabet.

    "Other studies have also shown CBD to be a safe agent, which leads us to believe we should continue this line of study in clinical trials to assess its usefulness in improving human fracture healing," Gabet added.

    The study was published in the Journal of Bone and Mineral Research.


  4. #2004
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    Re: Health Bulletin

    Human screams jolt brain's fear-response center


    If you feel like a human scream jolts the deep recesses of your brain, there's a good reason for it. That is precisely what is happening, scientists say.

    Researchers who explored how the brain handles a scream said on Thursday the loud, high-pitched sound targets a deep brain structure called the amygdala that plays a major role in danger processing and fear learning.

    "We knew pretty well what frequencies are used by speech signals and the brain regions involved in speech processing: the auditory cortex and higher order regions such as Broca's area, for instance," said University of Geneva neuroscientist Luc Arnal, whose research appears in the journal Current Biology.

    "But what makes screams so special and unpleasant and how the brain processes these sounds was not clear," Arnal said.


    The researchers said an acoustic quality called "roughness," the quick change in sound loudness, sets screams apart from other sounds.

    "Normal speech patterns only have slight differences in loudness, between 4 and 5 Hertz (sound wave cycles per second), but screams can modulate very fast, varying between 30 and 150 Hertz," Arnal said, explaining the "roughness" of screams.

    As part of the study, the researchers played recordings of screams from horror movies, YouTube videos and those made by volunteer screamers in a laboratory, and asked people to judge how frightening these were. Those with the highest "roughness" were found to be the most terrifying.

    To learn how these sounds were processed, the researchers monitored brain activity using a neuroimaging method called functional magnetic resonance while the study's subjects listened to screams.

    They found that the screams increased the activation of the fear response in the amygdala, an almond-shaped structure situated deep inside the brain's medial temporal lobe.

    "In terms of potential applications, our findings could be used to improve the way we design alarm sounds. The same way a bad smell is added to natural gas to make it easily detectable, adding roughness to alarm sounds may improve and accelerate their processing," Arnal said.

    Arnal said he is planning future research on infant screams to see if those have extra roughness.

    "I started being interested in screams when a friend of mine told me that the sound of his newborn's screams was literally hijacking his brain, and I wondered what makes screams so efficient as an alarm signal," Arnal said.


  5. #2005
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    Re: Health Bulletin

    Men at higher risks of thyroid dysfunction


    SRL Diagnostics, a diagnostic chain, recently conducted a three year long data mining survey (2012 - 2014) which revealed increasing number of urban men were diagnosed with thyroid disorders in the recent times.

    Thyroid disorders, which are most commonly associated with women, are affecting men as well with serious consequences leading to heart problems, mental health issues and infertility.

    B R Das, president (research and innovation) of SRL Diagnostics said, "There is a significant need for reaching out and making people aware of the causes, symptoms, treatment and importance of testing for thyroid problems. Our in-house data analysis on thyroid tests assesses the nationwide abnormalities in test results in men residing in various cities that represent diverse geographic origin, occupation, socio-economic status and food habits."

    A recent survey conducted by Indian Thyroid Society showed awareness about the disease ranked ninth as compared to other common ailments such as asthma, cholesterol problem, depression, diabetes, insomnia and heart problem .

    The symptoms of the disease are often confused with other disorders, thus making thyroid one of the most under-diagnosed with no permanent cure disorders in India. However, with medication and proper treatment, thyroid can be controlled thereby helping patients to lead normal lives.

    The study findings call for an emphasis on active screening of endocrine function among patients at greater risk along with regular monitoring of thyroid status and dose adjustments to provide effective therapy in patients with established diagnosis. Thyroid abnormalities are diagnosed by measuring the status of thyroid hormones - serum FT3, FT4 and thyroid stimulating hormone [TSH].

    Of the 14, 24,008 screened for the study by SRL, 22.68 per cent, of the total samples were found with abnormal TSH levels. The younger population within the age group of 31-45 years was at higher risk of thyroid dysfunction (30.33% of the samples) than the older population within the age group of 46-60 years (25.81% of the samples). The analysis showed the highest prevalence of the disease among men in the eastern zone of the country.


  6. #2006
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    Re: Health Bulletin

    Sugar trail may lead to early cancer detection


    In a breakthrough that could lead to a new protocol for cancer detection and treatment, scientists have identified a glucose delivery mechanism which helps cancer cells to survive and grow.

    The discovery can help in early detection of not only pancreatic and prostrate cancer but many others like cancer of the breast and colon.

    Announcing the findings, scientists from the University of California, Los Angeles(UCLA) also suggested the use of certain anti-diabetic drugs to reduce the growth of tumours. Experts and doctors say the findings can give a new protocol worldwide for cancer detection and treatment.

    Cancer cells require large amounts of glucose to survive and grow. So far, passive glucose transporters — membrane proteins known as GLUTS — were known to be the primary method used by the body to deliver glucose to tumours. However, through a n extensive three-year study, UCLA scientists have now identified a new pathway, revealed in an article published in leading American science journal, Proceedings of the National Academy of Sciences(PNAS).

    "We have identified a new mechanism to import glucose into pancreatic and prostate cancer cells, namely active glucose transport mediated by sodium-dependent glucose tran8s8porters (SGLTs)," researchers said.

    The researchers suggest probing the new pathway through specific radioactive imaging probe along with positron-emission tomography (PET) that can enable early detection of these cancers cells. Experts say this is the first promising evidence that PET imaging techniques and SGLT2 inhibitors could be used to better diagnose and treat pancreatic and prostate cancers.



    The findings also provide strong evidence that certain type-2 diabetic drugs, belonging to a new class known as SGLT2 inhibitors which are already approved by the US Food and Drug Administration and were recently launched in India, could potentially block glucose uptake and reduce tumour growth and increase survival among pancreatic and prostate cancer patients.

    Pancreatic cancer, estimated as the fourth leading cause of cancer-related deaths in the US behind only lung, colon and breast cancers, is also increasing significantly in India. In most cases, the tumour is detected at a very late stage, making it very difficult for doctors to remove it.



    Prostate cancer, though generally more treatable, is also witnessing a rapid increase in incidence in India as well as globally. While globally it is the second leading cause of cancer-related deaths in men, in India, the incidence of prostate cancer among men has increased by over 220% between 1900 and 2013.


    Researchers at UCLA will next begin a clinical study to further investigate the importance of sodium-dependent glucose transporters in glucose delivery. They hope that these findings will lead to the potential use of the existing anti-diabetic medicines to reduce the viability of pancreatic and prostate cancer cells and improve the survival rate in patients.


  7. #2007
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    Re: Health Bulletin

    Brain implant to help deliver drugs via remote control

    Researchers have developed a new wireless device the width of a human hair that can be implanted in the brain and activated by remote control to deliver drugs.

    The technology, demonstrated for the first time in mice, one day may be used to treat pain, depression, epilepsy and other neurological disorders in people by targeting therapies to specific brain circuits, said researchers at Washington University School of Medicine in St Louis and the University of Illinois at Urbana-Champaign. They added that with one of these devices imp8lanted, we could theoretically deliver a drug to a specific brain region and activate it with light. This approach could deliver therapies that are much more targeted but have fewer side effects.

    The new devices may help people with neurological disorders and other problems.

    "In the future, it should be possible to manufacture therapeutic drugs that could be activated with light," said co-principal investigator Michael R Bruchas, associate professor of anesthesiology and neurobiology at of Washington University. Previous attempts to deliver drugs or other agents to experimental animals have required the animals to be tethered to pumps and tubes that restricted their movement. But the new devices were built with four chambers to carry drugs directly into the brain. By activating brain cells with drugs and with light, the scientists are getting an unprecedented look at the inner workings of the brain.

    The new devices ultimately may help people with neurological disorders and other problems, according to co-first authors Jae-Woong Jeong, a former postdoctoral researcher at the University of Illinois and now assistant professor of electrical, computer and energy engineering at the University of Colorado, Boulder, and Jordan G McCall, a graduate student in the Bruchas lab.

    "Now, we literally can deliver drug therapy with the press of a button," McCall said.

    "We've designed it to exploit infrared technology, similar to that used in a TV remote. If we want to influence an animal's behaviour with light or with a particular drug, we can simply point the remote at the animal and press a button," he said.

    "The device embeds microfluid channels and microscale pumps, but it is soft like brain tissue and can remain in the brain and function for a long time without causing inflammation or neural damage," Jeong added.

    As part of the study, the researchers showed that by delivering a drug to one side of an animal's brain, they could stimulate neurons involved in movement, which caused the mouse to move in a circle.

    In other mice, shining a light directly onto brain cells expressing a light-sensitive protein prompted the release of dopamine, a neurotransmitter that rewarded the mice by making them feel good. The mice then returned to the same location in a maze to seek another reward.

    The study will be published in the journal Cell.


  8. #2008
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    Re: Health Bulletin

    Drug abuse reduces grey matter in women: study

    Stimulant drug abuse may have long-term effects on brain volume in women, a new study has warned.

    Brain structures involved in reward, learning and executive control showed vast changes even after a prolonged period of abstinence from drug use, researchers said.

    "We found that after an average of 13.5 months of abstinence, women who were previously dependent on stimulants had significantly less grey matter volume in several brain areas compared to healthy women," said senior author Jody Tanabe, Neuroradiology Section Chief at the University of Colorado Denver School of Medicine.

    "These brain areas are important for decision making, emotion, reward processing and habit formation," Tanabe said.

    For the study, the researchers sought to determine how the brains of people previously dependent on stimulants differed from the brains of healthy people.

    "We specifically wanted to determine how these brain effects differed by gender," Tanabe said.

    The researchers analysed structural brain magnetic resonance imaging (MRI) exams in 127 men and women, including 59 people (28 women and 31 men) who were previously dependent on cocaine, amphetamines, and/or methamphetamine for an average of 15.7 years, and 68 healthy people (28 women and 40 men) who were similar in age and gender.

    The MRI results showed that after an average of 13.5 months of abstinence, women who were previously dependent on stimulants had significantly less grey matter volume in frontal, limbic and temporal regions of the brain.

    "While the women previously dependent on stimulants demonstrated widespread brain differences when compared to their healthy control counterparts, the men demonstrated no significant brain differences," Tanabe said.

    The researchers also looked at how these brain volume differences were related to behaviours. They found that lower regional grey matter volumes correlated with behavioural tendencies to seek reward and novelty.

    "Lower grey matter volumes in women who had been stimulant dependent were associated with more impulsivity, greater behavioural approach to reward, and also more severe drug use," Tanabe said.

    "In contrast, all men and healthy women did not show such correlations," Tanabe said.

    According to Tanabe, the results may provide a clue to the biological processes underlying the clinical course of stimulant abuse in men and women.

    "Compared to men, women tend to begin cocaine or amphetamine use at an earlier age, show accelerated escalation of drug use, report more difficulty quitting and, upon seeking treatment, report using larger quantities of these drugs," she said.

    "We hope that our findings will lead to further investigation into gender differences in substance dependence and, thus, more effective treatments," Tanabe said

    The study was published in the journal Radiology.


  9. #2009
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    Re: Health Bulletin

    Overwork can lead to infertility, expert says


    Infertility rate in Tamil Nadu is higher than that in states like Bihar because people here spend more time on work, and it leads to physiological imbalances and ovulation disorders, said director of medical education Dr S Geethalakshmi on Sunday.

    Speaking at the fifth FERTICON, a national medical conference organised by Aakash Infertility Centre here, Geethalakshmi said the infertility rate in Tamil Nadu is at 20% while it is lower in states like Bihar and Orissa due to early marriages and lower literacy level.

    "As literacy rate increases and people get more ambitious, they end up spending a lot of time on work. It leads to physiological imbalances and ovulation disorders resulting in infertility," she said.

    She said around 70% of the infertility problems were curable while the rest could be managed with interventional procedures.

    Elaborating on the Tamil Nadu government's efforts to reduce infertility problems, she said a sum of Rs 15,000 had been sanctioned for interventional procedures under the chief minister's comprehensive health insurance scheme.

    "We already have the Dr Muthulakshmi Reddy Maternity Benefit Scheme and free drop in facility for women after delivery. More amendments will be made depending on the need," she said.

    She also urged gynaecologists and other specialists to upgrade their skills in advanced and complex procedures like uterine transplantation.


  10. #2010
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    Re: Health Bulletin

    Why HIV progresses slowly in some people

    Even in the absence of HIV therapy, some HIV-infected people may not suffer from AIDS for many years due to enhanced cholesterol metabolism in certain immune cells, which is an inherited trait, shows research.

    The findings may lead to potential development of new approaches to control HIV infection by regulating cellular cholesterol metabolism.

    "We have known for two decades that some people do not have the dramatic loss in their T cells and progression to AIDS that you would expect without drug therapy," said lead author Giovanna Rappocciolo, assistant professor at University of Pittsburgh in the US.

    T-cells are a type of white blood cells that play a very important role in human immunity by scanning for cellular infections.

    "Instead, the disease progresses more slowly and we believe altered cholesterol metabolism in certain immune cells may be a reason," Rappocciolo said.

    These people are known as "nonprogressors." This discovery was made possible by using 30 years of data and biologic specimens.

    Rappocciolo and her colleagues searched for patterns in gene expression, or the degree to which specific genes are turned on or off.

    "These results improve understanding of how nonprogressors control HIV without drug therapy and potentially may contribute to new approaches to manage HIV infection," Rappocciolo added.

    The findings were presented at the eighth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver, Canada.


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