All about diseases


Sunday, June 24, 2012

Benign Prostate Hyperplasia


What is a prostate ?

The prostate is a walnut-sized gland located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.

The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen.
The vasa deferentia (singular: vas deferens) bring sperm from the testes to the seminal vesicles. The seminal vesicles contribute fluid to semen during ejaculation.

What is benign prostat hyperplasia(BPH)

BPH is a non-cancerous increase in the size and number of cells that make up the prostate.BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.

As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so some of the urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Many people feel uncomfortable talking about the prostate, since the gland plays a role in both sex and urination. Still, prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH. In the United States in 2000, there were 4.5 million visits to physicians for BPH.

Why BPH occurs

BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.

As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so some of the urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Many people feel uncomfortable talking about the prostate, since the gland plays a role in both sex and urination. Still, prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH. In the United States in 2000, there were 4.5 million visits to physicians for BPH.

Sign and symtoms

When the prostate gland enlarges, it may begin to obstruct the flow of urine through the urethra. It may also push up against the bladder causing some irritation. The most typical symptoms of BPH include:
  • A slow urinary stream
  • An interrupted stream—one that starts and stops
  • Having to strain to urinate
  • Hesitancy-having to wait before the stream will start
  • Feeling that the bladder doesn’t empty all the way
  • Urgency—having to urinate more often then when you were younger
  • Having to get up at night to urinate
These symptoms will almost always be worse at night time. In the early stages for instance, men will have hesitancy and a slow, interrupted stream at night, but after being up for a few minutes in the morning, they will urinate perfectly fine the rest of the day.
As symptoms progress, you may develop:
  • Bladder stones
  • Bladder infection
  • Blood in your urine
  • Damage to your kidneys from back pressure caused by retaining large amounts of extra urine in the bladder
  • Sudden blockage of the urinary tube, making urination impossible
How to diagnose BPH

The doctor will do digital rectal examination.Because the prostate gland is in front of the rectum, the doctor can feel if the back of the gland has any abnormalities during this examination.
Several studies may be done to help diagnose your condition:
  • A urine test called a urinalysis.
  • A seven-question BPH Symptom Score Index survey to evaluate the severity of your symptoms.
  • A flow study to measure how slow the urinary stream is compared with normal flow(uroflometry)
  • A study to detect how much urine is left in the bladder after urination is done.
  • Ultrasound abdomen pelvis
Treatment for BPH

Medication. Proscar was one of the first drugs used to treat BPH. Avodart is another similar drug that can be used. They both work by inhibiting the conversion of testosterone to the hormone dihydrotestosterone (DHT), which affects the growth of the prostate gland.

Surgery. A number of surgery types can remove the prostate tissue blocking the flow of urine. The most common is called transurethral resection of the prostate, or TURP. It involves removing the tissue blocking the urethra (urine tube) with a special instrument.

Minimally Invasive Treatments. Newer treatments can effectively reduce the size of the prostate and relieve urinary obstruction, but are less invasive and damaging to healthy tissue than surgery.

Minimally invasive treatments include:
  • ·         Transurethral Microwave Thermotherapy (TUMT).
  • ·         Interstitial Laser Coagulation.
  • ·         Transurethral Needle Ablation (TUNA).
  • ·         Transurethral Electrovaporization
  • ·         Intraurethral Stents. Stents (wire devices shaped like springs or coils) are placed within the prostate channel (where the urethra runs through the gland) to help keep the channel from tightening around the urethra.

Bronchial asthma


So many patient they came to hospital with complaint of breathing difficulty.when they are coming with that complaint usually because of history of bronchial asthma,in this article you can get some information about ,definition,sign and symptom and management treatment for bronchial asthma.

What is bronchial asthma?

A condition of the lungs in which there is widespread narrowing of airways, varying over short periods of time either spontaneously or as a result of treatment, due in varying degrees to contraction (spasm) of smooth muscle, oedema of the mucosa, and mucus in the lumen of the bronchi and bronchioles; these changes are caused by the local release of spasmogens and vasoactive substances (e.g., histamine, or certain leukotrienes or prostaglandins) in the course of an allergic process.

Signs & Symptoms of Bronchial Asthma

Bronchial asthma is a longer name for what is generally referred to as asthma, or a chronic inflammation of the airways. The Centers for Disease Control estimates that approximately 22 million Americans are inflicted with asthma. Bronchial asthma is very common and in most cases can be controlled with medication from your doctor. There are a number of signs and symptoms that point to asthma.

·         Shortness of Breath
According to the National Institutes of Health, shortness of breath is one of the most common signs of bronchial asthma, in addition to coughing and wheezing. Shortness of breath may be most noticeable in bronchial asthma sufferers during exercise or other strenuous activity.

·         Coughing & Wheezing
Repeated coughing and wheezing is also another common symptom of Bronchial asthma. The National Institutes of Health finds that wheezing in asthma sufferers is likely be at its worst early in the morning or late at night, and will usually occur without warning before it goes away on its own or is relieved by an inhaler.

·         Chest Tightness
A tight feeling in the chest can be caused by asthma and is usually associated with shortness of breath.

·         Emergency Symptoms
Bronchial asthma attacks can cause an emergency situation if they are severe and not treated right away. If you or someone you know seems to be having trouble breathing and cannot speak, is sweating or is turning blue, go to the emergency room immediately

Causes of Bronchial Asthma

Family History

According to the National Heart, Lung and Blood Institute, asthma may be heritable. Individuals with a parent or parents, with the disease are more likely to also have asthma.

Allergies

According to the National Heart, Lung and Blood Institute, individuals who come into contact with airborne allergens or chemicals when they are young could develop asthma. Examples of allergens and chemicals include dust, mold, pets and disease-carrying bugs.

Respiratory Infections

Children that suffer viral infections, like a cold, when they are very young could be more prone to developing bronchial asthma. Increases in the number of asthma cases in modern society have led some scientists to hypothesize that the modern environment may have altered the development of the immune system in children. Because of improvements in sanitation, for example, children are not infected by certain viruses and bacteria that may have boosted immunity and prevented asthma disease in the past.

Treatment and management for bronchial asthma

In the clinical picture, asthma consists of the acute attacks (gasping for air) and periods between them. Acute attacks require hospitalization and intensive treatment. After coping with acute exacerbation, the patient is prescribed therapeutic exercise in complex with breathing exercises.
Breathing technique using the Frolov’s Respiration Training Device includes the key elements necessary for bronchial asthma rehabilitation: long smooth exhale, voluntary control of breathing, establishing a normal breathing rhythm and lungs extra air removal.
Positive effects of breath therapy with the Frolov’s Respiration Training Device in patients with asthma:
  1. Reduced respiratory muscles fatigue.
  2. Improvement of the ventilation and gas exchange during regular breath exercises.
  3. Immune and autonomic systems improvement.
  4. Reduced inflammatory condition.
  5. Elimination of the shortness of breath.
  6. Increased reserve capacity of the respiratory system.
  7. Less medications required.
  8. Life quality improvement.
Important rules for breathing technique with Frolov’s Respiration Training Device in asthma treatment:
  • Begin the breath therapy without the device — inhale through your nose.
  • The period of adaptation takes 1-1,5 months, after which the device can be used for inhaling and exhaling. The duration of the exhale should be increased slowly. It is important that the body is relaxed during the exercising. If necessary, the evening exercises can be used in complex with inhalation during the day or additional morning exercises.
Another benefit of using the Device is its suitability for pre-school children, pregnant women and patients with concomitant diseases (such as angina, hypertension, hormonal disorders and other diseases).

Bronchial asthma medication

Treatment with asthma medication focuses on:
  • Taking asthma medication that controls inflammation and prevents chronic symptoms such as coughing or breathlessness at night, in the early morning, or after exertion (long-term control medications)
  • Providing asthma medication to treat asthma attacks when they occur (quick-relief asthma medication)
  • Avoiding asthma triggers
  • Monitoring daily asthma symptoms in an asthma diary
  • Monitoring peak flows with daily asthma tests
There are two general types of asthma medication which can give you long-term control or quick relief of symptoms.
  • Anti-inflammatory drugs. This is the most important type of therapy for most people with asthma because these asthma medications prevent asthma attacks on an ongoing basis. Steroids, also called "corticosteroids" are an important type of anti-inflammatory medication for people suffering from asthma.
  •  Bronchodilators. These asthma medications relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways. This action rapidly opens the airways, letting more air come in and out of the lungs. As a result, breathing improves. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily.

Long-Term Control Asthma Medications


The most effective long-term control asthma medications are those that stop airway inflammation (anti-inflammatory drugs), but there are others that are often used along with anti-inflammatory drugs to enhance their effect.
Long-term control asthma medications include:
  • Corticosteroids (The inhaled form is the anti-inflammatory drug of choice for persistent asthma.)
  • Mast cell stabilizers (anti-inflammatory drugs)
  • Long acting beta-agonists (bronchodilators often used along with an anti-inflammatory drug)
  • Theophylline (a bronchodilator used along with an anti-inflammatory drug to prevent nighttime symptoms)
  • Leukotriene modifiers (an alternative to steroids and mast cell stabilizers)
  • Xolair (an injectable asthma medication used when inhaled steroids for asthma failed to control asthma symptoms in people with moderate to severe asthma who also have allergies)