Minimally Invasive treatment to dissolves blood clots in brain tissue

ScienceDaily (2011-05-28) -- A new treatment that treats a subset of stroke patients by combining minimally invasive surgery, an imaging technique likened to "GPS for the brain," and the clot-busting drug t-PA (Tissue Plasminogen Activator) appears to be safe and effective, according to new research.
Surgeons drilled hole in the skull over the clot using high-tech neuro-navigational software that provides detailed brain images, the physicians put catheters through the holes into the clots. They used these catheters to drip t-PA into the clot for up to three days at one of two doses, either 0.3 mg or 1 mg, every eight hours.
They found the minimally invasive treatment group did better than the group on supportive treatment only.

Related articles

• New treatment dissolves blood clots in brain tissue (sciencedaily.com)

Mushroom Helpful in Prostate Cancer

Mushroom compound suppresses prostate tumors

A mushroom used in Asia for its medicinal benefits has been found to be 100 per cent effective in suppressing prostate tumour development in mice during early trials, new Queensland University of Technology (QUT) research shows.
The compound is polysaccharopeptide (PSP), found to act on prostate cancer stem cells and suppress tumour formation in mice.
The health benefits may not be available by simply eating those the researchers concluded. 

What is Anorexia and Loss of Appetite

Image by bettyx1138 via Flickr
Anorexia is not same as loss of appetite. Loss of appetite means there is no hunger for food, whereas anorexia means there is hunger but the person does not like to eat.
Anorexia is typically seen in patients suffering from anorexia nervosa and usually are adolescent girls. They are very much concerned about lean appearance and are afraid of taking food.
Loss of of appetite generally seen in people suffering from any disease starting from common cold to very serious diseases like cancer.
Anorexia nervosa may be due to hormonal disturbances. Now, it has been seen that a feel good hormone, dopamine acts differently in these patients.
Normally, taking food increases dopamine release in the brain, which acts on the reward centre to give good feeling. But, in anorexia nervosa it acts on the part of brain that gives anxious feeling.
This has been substantiated by researcher Walter Kaye, professor of psychiatry at the University of California, San Diego School of Medicine, used a brain imaging technology called positron emission tomography (PET), which permits visualization of dopamine function in the brain.
 Imageof Dopamine and  Serotonin Pathway
They injected amphetamine, a drug that releases dopamine in the brain; women without eating disorder felt well as released dopamine acted on the reward centre of brain, where as patients of anorexia nervosa felt anxious, and the part of the brain that was activated was, instead, one that worries about consequences.

Related articles

• Why the very sight of food makes people with anorexia nervosa restless (news.bioscholar.com)

Sleeplessness at Night may Cause Frequency of Urination

Insomnia Sleeplessness or insomnia may be associated with frequency of urination at night called nocturia in men and women. More than two urinations after falling asleep is termed as nocturia and insomnia is less than 5 hours of one night's sleep.
Insomnia and nocturia go hand in hand. Nocturia as seen in prostatic hyperplasia in men, often leads to insomnia.
Nocturia often affects the quality of life, from irritability, day time sleepiness, attention disturbances or cognitive dysfunction, accident proneness while driving, type II diabetes mellitus, obesity and cardiovascular disease; to shorter life span.
Insomnia many times precedes nocturia for about 5 years. There are various causes of insomnia; which needs to be addressed.
This nocturia and insomnia may be the result of hormonal disturbance that results from disturbed circadian rhythm.

Related articles

• Nighttime Incontinence (OAB): Tips for Restful Sleep (webmd.com)

Acetaminophen Use and Abuse in Children and Adult

Image Paracetamol FDA panel backs infant doses for kids' Tylenol

(AP) -- Federal health experts say dosing instructions for children younger than 2 years old should be added to Children's Tylenol and similar products containing acetaminophen, the popular pain reliever and fever reducer.
Prolonged and over use of Acetaminophen has been linked to serious side effects like liver problem and initiating certain blood cancers ; in addition to common side effects of gastrointestinal upset.

Related articles

• FDA panel backs infant doses for kids' Tylenol (seattlepi.com)
• FDA panel recommends dosing instructions for Children's Tylenol, Triaminic (oregonlive.com)
• How much acetaminophen is safe for a single dose? (zocdoc.com)

Vocal Cord Ulcer Following Reflux Oesophagitis

Acid peptic disease may present with duodenal ulcer, oesophagitis and laryngeal ulcer or congestion in larynx. In this patient who presented with hoarseness of voice for some 15 days along with a previous history of duodenal ulcer; a left vocal cord ulcer, oesophagitis and duodenal ulcer were found by upper GI endoscopy.

Related articles

• Vocal Nodules or Vocal Cord Polyps (Singer's Nodules) (healthhype.com)

Urinary Stone Diagnosis Tips

Kidney stones usually form within the kidneys and descend down the urinary tract to cause symptoms. They usually follows an infection, stagnation or abnormality in the urinary tract, and can also occur due to excessive calcium intake, hyperparathyroidism, blood disorders like sickle cell disease, or gout. Kidney stones may be found in the renal pelvis, ureter, urinary bladder or in the urethra.
The most common variety are composed of a phosphate salt of calcium and /or magnesium. Around 40 to 50 percent of stones show as a shadow in x-rays of the abdomen and pelvis.
As with any disease, a complete medical history is the most important part of diagnosing this condition. Any history of other diseases like sickle cell disease, gout or hyperparathyroidism may give a clue to the diagnosis.

• Some of the symptoms include, haematuria, blood in urine. and severe pain in the abdomen with location depending upon site of the stone, which can cause nausea and vomiting. The pain may be a dull aching or a severe colicky pain, which is not relieved by any change in the patient's position, and often radiates into the groin. A fever may be present, if there is a secondary infection.

On examination;

• Abdomen is usually soft without any distension and may have some pain on pressure over the site of impaction of stone.
• There may or may not be any true muscular guarding in abdomen or rebound tenderness i.e. pain after release of pressure.

Its diagnosis is both easy and difficult. When pain is felt in the upper abdomen due to stone in the kidney most often simulates acid peptic disease, cholecystitis or pancreatitis. Pain in right lower abdomen may confuse with appendicitis.
Common investigations usually required are;

• A plain x-rays examination will often show the stone as a radiopaque shadow, taking the shape of the site in urinary tract where it is impacted. In renal pelvis, it typically takes shape of stag horn. In ureter, it may be round or elliptical. In bladder it is usually round in shape.
• Ultrasonogram is an invaluable tool in the diagnosis of urinary stone.
• Blood in urine is a corroboratory finding.

Tips for correct diagnosis:

• The nature of pain; i.e. patient does not get comfort in any position; either lying or sitting is very typical of stone in ureter.
• Radiating pain from loin to groin.
• Lack of true guarding in abdomen and rebound tenderness differentiate it from appendicitis and some other GI diseases giving rise to pain in abdomen.
• Associated painful haematuria.
• Plain X-rays examination of abdomen and pelvis.
• Ultrasonogram

With the proper history taking, a careful examination and common investigations diagnosis of a stone in the urinary tract is possible with reasonable accuracy. However, more investigations like intravenous urogram (IVU), retrograde urogram (RGU), CT and some other blood tests may be required for proper evaluation and treatment of a patient.

First Published in Technorati

Potential for solution to baldness? Surprising clues about communication in hair stem cell populations

ScienceDaily (2008-01-19) -- Researchers have identified a novel cyclic signaling in the dermis that coordinates stem cell activity and regulates regeneration in large populations of hairs in animal models. The 'dermal clock' signaling coordinates stem cell activity in a population of hair follicles.

Safe Urinary Catheterization of a Patient

My professor once said; "Urethra is just like a glass, handle with care." A little carelessness in catheterization of urethra may land the patient in a lifelong problem or may sometimes cost his/her life. Catheterization of urethra means; putting a small caliber silicon or rubber tube through the urethra into the urinary bladder to get the urine collected to an attached bag. The idea is to relieve any retained urine in the bladder or collect the urine safely to a bag without soiling the bed as in case of incontinence.
Indications could be:
(A) Bladder neck obstruction due to 1) an enlarged prostate, 2) a fibrosed prostate 3) narrowing of bladder neck.
(B) Incontinence of urine due to 1) nerve injury 2) comatose patient 3) as a pre-operative preparation for pelvic surgery 4) some cases of multiple sclerosis.
( C ) Autonomous bladder.
Requirements: 1) 5 % providone iodine lotion as antiseptic, 2) Sterile gauze and cotton, 3)Sterile gloves, 4) Sterile towel, 5 ) Sterile 5% Lignocaine jelly, 6) Foley's catheter of 14 F size and 7) Distilled water.

First of all the patient is to be placed in a comfortable bed and privacy maintained. Gentamicin in the required dose e.g. for adults 80 mgs is to be injected as a precautionary measure for probable bacterial migration upwards from urethra and spread of infection. Gloves are to be put on by the person who will catheterize the patient in an aseptic way.

The foreskin of penis is to be retracted and area surrounding the body of penis is to be cleaned; and providone iodine lotion applied. A towel is to be put around the penis, so that no equipment will become unsterile during the procedure. A full tube of lignocaine jelly is to be put into the urethra and urethra held tightly, at least for 5 minutes so that no jelly could escape out. The urethra will get anaesthetized in the meanwhile. The catheter will be taken out of the container and gradually introduced into the urethral opening; and progressed with very gentle push till it reaches the bifurcation. Now, if the catheter is in the urinary bladder, urine will be seen coming out. At this point 20 ml of distilled water is to be put into the channel with the valve by a 20 ml syringe. The water will distend the balloon present in the tip of the catheter which is inside the bladder now and the catheter will be seen retained.

The collecting bag will now be connected to the channel of catheter. Urine will be seen passing to the bag. A little providone iodine ointment is to be put around the catheter where it enters the urethra. The prepuce if present will be returned to original position. That will conclude the procedure.
Tips & Warnings

• Precautionary Injection of gentamicin will prevent infection that is likely to enter the urinary bladder along with the passage of catheter in urethra.
• Rubber catheters need not be used, instead silicone should be preferred in fear of subsequent urethral infection.
• Fully aseptic method is to be followed or else an urinary tract infection may be the outcome.
• Full tube of lignocaine jelly is to be put or else the urethra will not be fully lubricated and anaesthetized.
• The catheter will not be introduced with force against resistance is felt that may injure the urethra; which may be the cause of a future stricture formation in urethra.
• Catheter should be introduced up to the end till its bifurcation, so that there will be no chance of balloon present in the tip of urethra remaining in the urethra and the inadvertent inflation of it in the urethra itself; which will rapture the urethra and bleeding from urethra.
• Before putting distilled water make sure to see urine coming out that will ensure the tip of catheter is inside the urinary bladder, and balloon is inflated in the right place.
• Always distilled water is to be used, if, instead saline or dextrose solution is used, that may precipitate inside the narrow channel, so that while removing the catheter the water cannot be drained out resulting in non-deflation of and a retained catheter.
• Risks;

1. Spread of infection,
2. Rapture of urethra,
3. False passage creation,
4. Injury to urethra and
5. Bleeding from urethra.

• When to abandon the procedure;

1. At any time, if blood is seen coming out signifying injury to urethra.
2. If good deal of resistance to introduction of catheter is encountered signifying impassable obstruction in urethra.

At last, I once again repeat, "Urethra is just like a glass, handle with care".
Article Source: http://www.articlesbase.com/diseases-and-conditions-articles/how-to-catheterize-a-patient-safely-4743116.html

How to See Peptic Ulcer in Endoscopy

Ulcers in the duodenum, stomach and oesophagus; also other tumours in the gastrointestinal tract can be visualized nicely through an endoscope. Thereby correct treatment can be instituted.
Patient should be made comfortable in a bed in am ambient temperature. He should be made to understand the procedure going to be performed on him/her. An informed consent should be taken. Lignocaine viscous is to be put to the mouth of the patient and allowed to be kept in throat for at least 5 minutes. By that time throat will get anesthetized. So that while negotiating the scope patient will not feel discomfort in throat.

Endoscope is to be set. The scope should be lubricated with lignocaine jelly. After the throat of the patient gets anesthetized, scope is to be put to the mouth; and gradually advanced under vision into the esophagus, then to stomach and duodenum in upper GI endoscopy..

                                                             It will then be gradually withdrawn from the duodenum and any pathology will be visualized while withdrawing the scope. Any fluid and/or mucous in should be washed and sucked out to see clear view of the mucosa of esophagus, stomach and duodenum. In this way the whole area from oesophagus to duodenum in upper GI endoscope can be thoroughly checked and a report prepared.
Tips & Warnings                                               
•    Anesthetize throat of patient fully.             
•    Lubricate scope nicely.
•    Forward the scope in gastrointestinal tract carefully.    
•    Do not blindly push the scope.                                                        
•    See while withdrawing the scope.
•    Keep the face of patient turned to one side, that will drain saliva outside if any and not choke the respiratory tract
•    Be careful not to perforate the gastrointestinal tract.
•    Too much of gas should not be left behind in the stomach, which may give rise to discomfort/bloating sensation in abdomen.
•    Be careful not to put scope into the respiratory tract.
•    Do not flush the scope near the larynx

Polyphenol from Grapes may be Used for Drug-Eluding Stents

It is said that the consumption of red wine in prescribed amounts may be good for heart due to the polyphenols, resveratrol and quercetin content. Now, researchers say that stents used in angioplasty can be coated with it to produce what is called as drug-eluding stent. These molecules basically act as antioxidants

Those can have several benefits as seen by the researchers from rat model; "red-wine" polyphenol-eluting stent reduced neointimal hyperplasia and promoted reendothelialization in diseased heart arteries after angioplasty.

At present bioresorbable everolimus drug-eluding stents from polylactic acid found in corn, magnetized stents with nanoparticle(iron) containing endothelial cells, platinum-chromium paclitaxel coated drug-eluding stents and conventional stents are available.

The main concern after angioplasty is re-stenosis, thrombus formation and healing problem at the site of injury after angioplasty.

It is seen in the animal models that "red wine" polyphenol eluding stents reduced restenosis, accelerated reendothelialization, and reduced inflammatory cell activation. Earlier studies have also shown that quercetin, also found in wine grapes, is a strong antioxidant that inhibits platelet activation and vascular smooth-muscle-cell proliferation.

Let us expect for a biodegradable drug-eluding stent for better result after a coronary angioplasty.