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Endometriosis affected regularly menstruating women before Homo sapiens discovered how to control tire or chip a block of stone into a working wheel. Though we have no way of knowing how earliest woman coped with menstrually related distress. We might guess that she believed the cause was cosmologies and out of her control. The early Egyptians, who created one of the most advanced cultures four and five thousand years ago, were diligent recorders of history, astronomy, and science. It was they who for the first time made reference to a “painful disorder of her menstruation,” duly noted on the Papyrus Ebers from the year 1600 B.C.

We are without further medical identification of the disorder until 1696, when the French surgeon Saviard noted the presence of endometrial tissue outside the uterus. Then in 1835 another French doctor, Jean Cruveilhier, described uterine cysts. Twenty-five years later. Dr. K. von Rokitansky, a German doctor, published the first paper on the disease, referring to it as an “adenomyoma,” now called adenomyosis, or endometriosis confined entirely to the muscle wall of the uterus. At the turn of the century, two American doctors further described degrees of the disease, but it was not until 1921 that Dr. Sampson, as noted earlier, recorded his theory of how endometrial tissue implants on internal organs.

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Comments (0) May 08 2009

Acne is a very common inflammatory disorder of the oil glands, or pilosebaceous follicles. The majority of these glands are confined to the face, chest and back, and they are most active during adolescence. The course of the disorder is variable, as is the age of onset. Usually it appears a little earlier in girls, but in either sex it is very uncommon before the age of 10. The duration of acne is as variable as the severity. In mild cases the condition may resolve itself spontaneously within a few months, but typically it will last for a year or two. If severe or if chronic, the condition warrants active treatment.

The precise reason why some people develop acne yet others do not, is unknown. However, hormonal factors appear to set the stage for the development of the condition. Except for in the first few months of life, the disease does not develop before puberty, nor does it occur in eunuchs unless they are treated with male hormones. Acne is aggravated by the administration of male hormones, and of course pre-menstrual exacerbations are common in women. Without the natural oils secreted in the skin, known as sebum, there would be no acne. Without male hormones there is little if any sebum. Genetic factors, however, have a definite influence, as do bacteria, which are involved in the development of inflammation. Dietary and emotional factors are sometimes implicated, but have not been completely proven.

The pathology in acne is that the sebaceous duct leading from the gland which produces the sebum becomes blocked. This blockage, if below the skin surface, is called a whitehead, or if above the surface, a blackhead. Following blockage of the duct, at whichever level, the duct, at whichever level, the duct or the gland may rupture, and the sebum escape underneath the skin, setting up an inflammatory reaction. This may be aggravated by the normal bacteria present on the skin.

Looked at objectively, it will be seen that the methods of treatment could include unblocking the duct; decreasing the amount of sebum secreted; changing its composition to make it less irritating; and reducing the amount of bacteria on the skin surface.

Acne occurs at an age when the adolescent is adjusting, sometimes with difficulty, to a major physical and emotional transition. The teenager is often self-conscious, and unduly embarrassed by even minor grades of the disease. To dismiss acne as unimportant demonstrates a considerable lack of understanding, particularly as the disease can be satisfactorily suppressed in the majority of patients, and scarring prevented or minimized.

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Comments (0) May 08 2009

1. A reduction in dietary fat will be the prime objective of any fat loss eating plan.

2. Calorie counting should be avoided in favour of a low-fat eating plan.

3. Fat reduction should be recommended only in the context of a balanced diet.

4. Although some fats may have better health value than others, it is currently prudent to recommend a decrease in all dietary fets for body fat reduction.

5. A ‘user-friendly’ rule is to try to reduce total daily fat intake to below 40g. Even so, any reduction will be moving in the right direction.

6. Clients can identify sources of dietary fat using the Short Fat Questionnaire.

7. A ‘fat count’ may be a useful exercise to identify more specific sources of dietary fat.

8. Clients should be taught to read food labels, nutrition information panels and ingredient lists to assist the appropriate selection of foods. 9 Clients should be encouraged to eat regular servings of low-fat foods.

10. Spreads such as butter and margarine may be easily minimised or eliminated.

11. The use of oils should be minimised.

12. Clients should be taught low-fat cooking and food preparation procedures.

13- Help clients to determine which food sources of fat they are willing to exclude and which ones they are willing to limit in quantity.

14. Any low-fat eating plan prescribed for fat loss must be one that can be comfortably adhered to for a lifetime.

15. Although of secondary importance to dietary fat reduction, total energy input may need to be reduced if desired fat loss is not achieved with dietary fat reduction alone.

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Comments (0) May 08 2009

Luteinised unruptured follicle syndrome, usually known as LUF syndrome, occurs when the ovarian follicle matures and prepares itself for ovulation but at the time of ovulation the follicle fails to rupture and release the ovum.

LUF syndrome is very hard to detect because the usual methods of determining whether or not ovulation has taken place, such as basal body temperature charts and measuring progesterone levels in the second half of the cycle, all indicate that ovulation has occurred. It can only be reliably detected by inspecting the follicle during a laparoscopy or by measuring the size of the follicle during repeated ultrasound scans. In the past many researchers thought that the LUF syndrome was a major cause of infertility in women with endometriosis. However, now many researchers believe that it does not play a significant role and some believe that the LUF syndrome is probably just a random event which occurs in most women from time to time.

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Comments (0) May 08 2009

In the past it was often claimed that endometriosis could be prevented if women had frequent pregnancies early in their reproductive life. But it is now well documented that early and frequent childbearing does not necessarily protect a woman from developing endometriosis as many women have been diagnosed after they have had their children.

So far, gynaecologists and researchers have not been able to find a way of preventing endometriosis because no one knows precisely the causes or what factors influence its development or who it affects.

There is a considerable amount of research being carried out which is attempting to identify the possible factors that may increase or decrease a woman’s risk of developing endometriosis. To-date, none of the results have been sufficiently consistent for any conclusions to be made. In the future it may be possible to identify those women and girls who are most likely to develop endometriosis and to offer them advice regarding the things that they could do to reduce their risk of developing the condition.

Eventually, when more is known about what determines how — and why — the misplaced endometrium implants in some women and not others, it may also be possible to find ways to prevent endometriosis from occurring altogether or at least to prevent recurrences of the condition. For example, it may be possible to develop a vaccine against the condition or to develop drugs which cure the condition permanently.

Lyn’s story

It came as something of a shock when I was told in December 1986 that I had endometriosis — a shock because I had never heard of ‘endometriosis’.

Coming from a family of eight children I suppose I just assumed fertility would never be a problem.

Thinking back now, I am sure I developed endometriosis when I was about 16 — about two years after I started menstruating. I would get severe cramps on the first two days of my period, usually requiring me to stay home from school tucked up in bed with my faithful hot waterbottle.

I remember waking one night in such severe pain I could hardly walk. I staggered to the bathroom, thinking I had a severe bout of diarrhoea. For two hours I suffered hot flushes and pain which, although I have never experienced childbirth, came with the irregularity of labour pains. I remember staggering out of the bathroom and fainting much to the horror of my father.

You see, he was a jockey and his small five foot frame was no match for my larger, heavier and limp body. Much to his credit, he was able to carry me to bed!

The next morning my mother took me to our local doctor. After describing the symptoms, he told us I had probably experienced a twisted bowel which had ‘corrected itself. His solution for my painful periods was to put me on the pill.

For the next 10 years I went on and off the pill. I didn’t think it was too healthy to stay on the pill for such a long stretch but each time I took a break, the cramping periods would be back as bad as ever. It was easier to stay on the pill and enjoy a relatively painless cycle.

In 1985 my husband and I decided it was time to start a family. I just presumed that the first month off the pill would result in the expected pregnancy.

When this didn’t eventuate, I was given the usual advice: ‘Try not to think about it dear’, ‘Your job is too stressful’, ‘Just relax!’.

Six months later I had another attack of what I thought was a twisted bowel. Again I went to a doctor and again he confirmed that it was a twisted bowel which had corrected itself. I mentioned to him that I was having difficulty becoming pregnant. His answer was that as I was only 25,1 shouldn’t worry. He said he would not recommend seeing a specialist for another two years.

Neither my husband nor I were happy with that suggestion and we decided to see another doctor. As luck would have it, a girl I went to school with was working as a GP near our home. I went to her, told her my symptoms and had an appointment with a gynaecologist two weeks later. That’s when the fun really started. On my first visit, he did an internal examination and told me I was very tender on my right side. Who wouldn’t be tender when someone is tugging at your ovaries!

He suspected an ectopic pregnancy and sent me to have blood tests and an ultra-sound, both of which confirmed I was not pregnant. I was then booked in to have a laparoscopy and this revealed I had severe endometriosis.

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Comments (0) May 08 2009