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Pseudotumor Cerebri

Tuesday, 28 December 2010

Pseudotumor Cerebri, also called benign intracranial hypertension or idiopathic intracranial hypertension, is a condition in which the pressure inside the skull increases without any obvious reason. Most commonly, it affects obese women of childbearing age.

Most of the symptoms are related to:
1. Increased intracranial pressure.
2. Papilledema: a swelling around the optic disc (the site of entry of the optic nerve to the eyeball). It occurs due to increase in the intracranial pressure.

Symptoms of pseudotumor cerebri include: 
  • Symptoms due to increased intracranial pressure:
    1. Headache, ranging from moderate to severe, that originates deep to the eye and that worsen with eye movements.
    2. Pulsatile tinnitus: ringing sound in the ears which are synchronous with the pulse.
    3. Double vision.
    4. Nausea and vomiting.
  • Symptoms due to papilledema:
    1. Dimming or black-out of vision in either eyes or both that lasts for seconds (visual obscurations).
    2. Blurring of vision.
    3. Having a difficulty to look to the sides.

How is pseudotumor cerebri diagnosed ?
- Fundus examination: a doctor will examine the patient's eye to confirm the presence of papilledema.

First aid measures for nosebleeds (epistaxis)

Sunday, 26 December 2010

Epistaxis or nosebleeds is defined as the bleeding from the nose and is classified as either anterior or posterior.
Anterior nosebleeds occur when the source of bleeding originates from Kiesselbach's plexus (Little's area) which is present in the anterior part of the nasal canal. Anterior epistaxis usually occurs in children and young adults.

(From Fleisher GR, Ludwig S: Textbook of Pediatric Emergency Medicine. Philadelphia, Lippincott, Williams & Wilkins, 1999.) 

However, posterior nosebleeds originates from the sphenopalatine artery which is present in the posterior part of the nasal canal. Posterior epistaxis usually presents in old individuals.

First aid measures for controlling epistaxis:
In most cases, the bleeding will be from Little's area. You must sit down and lean slightly forwards. You must breath through your mouth.
Pinch the nose so that the nostrils are closed between your thumb and forefinger for 10 minutes. Apply cold compresses to the bridge of the nose, if possible. Besides, you can suck on ice to achieve the same result. 
This is done so that vasoconstriction of vessels is obtained which will reduce the amount of blood supplying the nose.

10 easy effective tips for GERD (or heartburn) relief

Tuesday, 21 December 2010

Gastroesophageal reflux disease (GERD) is defined as the reflux of the gastroduodenal contents into the esophagus, larynx or lungs with or without resultant oesophageal inflammation. In other words, the stomach acid and/or bile flows, in the reverse direction, into the esophagus causing heartburn.

Here are 10 effective tips for treatment of GERD or heartburn:
  • Avoid foods that increase GERD symptoms as chocolate, peppermint, citrus, onions, spicy foods and fatty foods.
  • Avoid alcohol and caffeine.

Surgeries done in breast cancer management

Sunday, 19 December 2010

Breast cancer can be treated especially when discovered early. Mammogram is a very helpful imaging investigation that helps in the diagnosis of breast cancer.
The findings in mammography that are suggestive of malignancy include the presence of clustered micro-calcification and star shaped mass. The following mammogram belongs to a woman diagnosed with breast cancer:

Surgery has a great role in the management of breast cancer. Surgery can be done with or without radiotherapy. Early treatment can lead to cure. Besides, it helps in controlling the local malignancy and preventing the occurrence of metastatic lesions.

What are the surgeries done for treatment or management of breast cancer ?

  • Lumpectomy: as its name suggests, the surgeon removes only the malignant lump and a small portion of the surrounding tissues.

Mechanism and treatment of herniated disc (lumbar disc prolapse)

Saturday, 18 December 2010

Herniated disc can be the cause of intolerable back pain. Let's first clearly summarize the basic anatomy of the vertebral column. The vertebral column is made up of vertebrae (bones) that are separated by intervertebral discs. Here is a normal spine:

A normal intervertebral disc is shown below (seen from above).
The disc consists of a central soft area known as nucleus pulposus and a tough outer ring known as annulus fibrosus. Factors as trauma and degeneration may cause a tear in the annulus fibrosus which will lead to herniation of the nucleus pulposus outwards. This is simply the mechanism of a herniated (slipped) disc. 
The herniated disc will start to compress the nearby nerves causing back pain which is accompanied with a sharp lancinating leg pain (known as sciatica and femoralgia).

Causes and the treatment of bad breath (halitosis)

Friday, 17 December 2010

Foetor oris or halitosis are the medical terms that refer to bad breath. This can be an embarrassing problem that may lead to social problems. It is a common condition but many avoid to admit having it.

The causes of bad breath are:
  • Eating certain foods as garlic and onions.
  • Hunger and fasting for a prolonged period of time.
  • Tooth decay or dental caries.
  • Poor oral hygiene.
  • Gum disease as periodontitis.
  • Smoking, as it can cause periodontitis.
  • Unusual dryness of the mouth, which is known as xerostomia. This can normally occur during sleep. Some medications can cause dry mouth as antihistaminics, decongestants, high blood pressure medications, Parkinson's disease medications.

Symptoms of appendicitis

Friday, 10 December 2010

Acute appendicitis is defined as the acute inflammation of the appendix. It is the most common surgical emergency. Acute appendicitis can affect all age groups but the majority of cases occur between ages 11 and 20. 

Symptoms of acute appendicitis:
It starts with pain around the umbilicus or below the xiphisternum (the lowest part of the sternum) which is called the epigastrium. In the next 4-18 hours, the pain will migrate to the lower right quadrant of the abdomen. Pain can be present in back or the right flank. Pain of acute appendicitis increases in intensity with passage of time.

Vomiting and anorexia can occur after the feeling of pain. Besides, an elevated body temperature is a sign of an ongoing inflammation in the body. 

Causes of acute appendicitis:
The appendix contains a lumen in it. Anything that causes obstruction of the lumen will cause appendicitis. In adults, the lumen is commonly obstructed by fecaliths. Fecalith means hard fecal matter.

In teens and children, the lumen can be obstructed due to inflammation (submucosal lymphoid hyperplasia).

If symptoms are present, then the next step is to immediately go the nearest emergency room. The doctor will examine the patient and will order blood tests to check the white blood cells count. Besides, a CT scan can be done to confirm the diagnosis.

What is the treatment of acute appendicitis ?
Urgent appendectomy is the cure. It can be done either laparoscopic or open. This choice will be taken by the surgeon according to the general condition of the patient and the degree of inflammation.

Metabolic syndrome: diagnosis and prevention

Thursday, 9 December 2010

Let's start by defining metabolic syndrome. It is a common condition in which obesity, high blood glucose, high blood pressure and an abnormal cholesterol (lipid) profile cluster in one person.

How common is metabolic syndrome ?
Some researchers suspect that 35% of American adults have metabolic syndrome. 

What is the mechanism behind metabolic syndrome ?
There is no confirmed mechanism till now but many researchers think that any obese individual is liable to get insulin resistance. When the body is resistant to its own insulin, a lesser amount of glucose is taken by the body cells. This stimulates the pancreas to increase more and more insulin. This leads to high glucose levels and hyperinsulinemia and will also cause a high triglycerides and cholesterol levels.

What are the criteria needed for the diagnosis of metabolic syndrome ?
To be diagnosed as having metabolic syndrome, an adult must have three or more of the following:
  • Waist measurement of 40 inches or more in men and or 35 inches or more in women.
  • High triglycerides level (greater than or equal to 150 mg/dl) or being treated for high levels of triglycerides.
  • Low level of HDL (good cholesterol). In males, a low level means less than 40 mg/dl. In females, a low level means less than 50 mg/dl.
  • High blood pressure or being treated for hypertension.
  • High level of blood sugar when measured after fasting for about 8 hours.

What are the complications of metabolic syndrome ?
Metabolic syndrome increases the risk of having diabetes and cardiac diseases.

Can metabolic syndrome be prevented ?
Yes. Metabolic syndrome can be prevented by following these instructions:
  • Eat a well balanced diet. Avoid foods that contain a high amount of saturated fats. Eat more foods that are rich in fibres as green vegetables.
  • Maintain a normal body weight. As mentioned earlier that obesity plays a great role in the mechanism of metabolic syndrome.
  • Exercise regularly for at least 30 minutes daily.
  • Avoid alcohol intake. If you are a smoker, quit smoking.
  • Go for regular medical check-ups. You must regularly check your blood glucose level, blood pressure and cholesterol level. 

I hope you benefited from this article. Thank you for reading.

What are the banned drugs for athletes?

Wednesday, 8 December 2010

In sports, fair play involves treating all competitors equally and fairly. According to the International Olympic Committee, a list of drugs should not be used by athletes.

These drugs include:
  • Stimulants: as caffeine, ephedrine, amphetamines. These drugs will speed up and stimulate some areas in the brain which will make the athletes' reflexes faster.
  • B2-agonists: these are similar to stimulants in its action. Besides, these drugs have significant anabolic effects.
  • Anabolic steroids: as testosterone. They increase the muscles strength and weight. Besides, they improve an athlete's overall performance and acceleration.
  • Diuretics: as furosemide and mannitol. These drugs help in reducing the body weight by excreting more water out of the body. And this can have a positive effect on the athlete's performance.
  • Narcotics: as morphine and pethidine. They increase the pain threshold so the athlete will feel pain after a longer period of time. This is beneficial in sports in which aggression is required.
  • Hormones: as erythropoietin. Erythropoietin is secreted normally by the body. But it can be taken from external sources. It stimulates the bone marrow to produce more red blood cells. In turn, the athlete's blood will have a greater content of hemoglobin. 

All the above drugs can lead to the manipulation of a fair game. That's why all athletes are advised to avoid taking them because if the drug test came back positive, then this will have a negative effect on the athlete's reputation.

How can you prevent osteoporosis ?

Sunday, 5 December 2010

Osteoporosis is defined as the progressive decrease in the bone mass that results in increased bone fragility and a higher risk of a bone fracture from even a minor fall or with no trauma at all. Osteoporosis literally means "porous bone". 

Ways of preventing osteoporosis:

    • Diet: should contain the adequate amount of proteins, total calories, vitamin D and calcium. Daily intake of 700 -1000 mg of calcium is adequate. Adolescents, pregnant or breast-feeding women, post-menopausal women and adults over age of 65 are advised to have 1500 mg of calcium daily. Sources of calcium include milk, cheese, yogurt, green leafy vegetables,

      Brazil nuts, sardines and almonds. Daily intake of about 800 IU of vitamin D is recommended.       
    • Exercise: high-impact physical activity (as jogging) significantly increases the bone density in men and women. Gentle exercise in the elderly may reduce the risk of falls and improves the protective responses to falling.
    • Avoid smoking because smoking promotes bone loss.
    • Avoid alcohol intake.
    • Pharmacologic corticosteroid doses should be reduced or discontinued if possible.
    • For menopausal women: it is recommended that these women will take medications that promote bone growth and prevent bone loss. Bisphosphonates (as alendronate and risedronate) is a group of drug that inhibits bone loss.Besides, Raloxifene is used in the prevention and treatment of osteoporosis.
      Phytoestrogens are plant substances that are found in food, as soya, are helpful in preventing osteoporosis. 

    Systemic lupus erythematosus (SLE)

    Friday, 3 December 2010

    SLE is a chronic disease that causes inflammation of connective tissue. It is a multisystem autoimmune inflammatory disease. SLE is the commonest and the most serious type of lupus. 

    What causes SLE ?
    SLE is believed to be an autoimmune disease, which means that the body's immune system produce antibodies that attacks the own body's healthy organs. Besides, genetic predisposition can be one of the causes. 

    What are the risk factors for SLE ?
    Females are more likely to get SLE than males. Usually the age of the patient lies between 15-45 years old. SLE is more common in dark races. Besides certain drugs can trigger lupus.

    What are the drugs that are associated with lupus ?
    The following drugs had been associated with lupus only after long-term use. They are:
    Chlorpromazine, Hydralazine, Isoniazid, Methyldopa, Procainamide, Quinidine. 

    What are the symptoms of systemic lupus erythematosus (SLE) ?
    90% of patients will complain of joint symptoms and arthritis. This can be the earliest manifestation of the disease. Many patients will experience malar (butterfly-shaped) rash like this one:

    Eye affection can occur in the form of conjunctivitis, photophobia and blurring of vision. Systemic symptoms like fever, malaise, anorexia and weight loss/gain are usually present. Symptoms include:
    Shortness of breath, chest pains, mouth sores, kidney functions affection that can lead to renal failure. 

    How is SLE diagnosed ?

    To be diagnosed as having SLE, you must have at least 4  of the following 11 items:

    1. Malar rash
    2. Discoid rash
    3. Oral ulcers
    4. Photosensitivity
    5. Serositis
    6. Arthritis
    7. Neurologic disease
    8. Kidney disease
    9. Hematological abnormalities
    10. Immunologic abnormalities
    11. Positive antinuclear antibodies  

    What is the treatment of systemic lupus erythematosus ?
    There is no definitive cure for lupus till now. Drugs as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are used to reduce the pain and inflammation. Anti-malarial drugs, as Hydroxychloroquine, had proved to control the symptoms and signs of the disease and can prevent flares. 
    Immunosuppressive drugs, as cyclophosphamide, can be used especially when there is kidney affection. This group of drugs must be taken with extreme caution.
    A lot of clinical research is being conducted by the use of new emerging drugs that can help treat SLE. Epratuzumab, a humanised IgG1 monoclonal antibody, entered phase III trials after promising results in a smaller study. 

    General guidelines for SLE patients:
    - Avoid excessive exposure to sun by using sunscreens.
    - Exercise regularly.
    - Quit smoking and alcohol intake.
    - Avoid sulphonamide-containing antibiotics.
    - If you are taking immunosuppressive drug, then you must not take a live vaccine.
    - At any time, if you experience severe acute symptoms or fever or anginal pains or shortness of breath, immediately call your doctor.

    I hope this article was beneficial to you. And i hope you stay healthy and happy forever.Thank you for reading.


    Is it a urinary tract infection ?

    Tuesday, 30 November 2010

    Urinary tract infections are common and they frequently affect both males and females. UTI is commoner in females than males due to anatomical reasons.
    By definition, urinary tract infection is an infection that affects the urethra, bladder, ureters or kidneys. The infection can involve any of these structures.

    Do i have a urinary tract infection ? A question that arises when the symptoms are urinary in origin.

    For women:

    If you have a burning sensation when urinating, pain during urination, sensation of a need to urinate (urgency), low back pain, blood in urine or have frequent urination, then it can be a UTI.

    For men:
    If you have a sensation of need to urinate (urgency), pain during urination, low back pain, slow urinary flow or blood in urine, then it can be a UTI.

    Remember that if the infection had affected the kidneys, chills and fever can be present. A condition called pyelonephritis.

    What should i do to check if i am having a urinary tract infection ?

    First of all, consult a doctor (nephrologist). Your doctor will examine you and will ask for a urine sample for dipsticks urinalysis, urine analysis +/- urine culture.
    If the urine proved positive, then you will be given antibiotics to clear out the infection. It is important that you take your medication on time and as instructed by your doctor.

    If you have a urinary tract infection, drink excess water + fluids and maintain a good hygiene. Both men and women must avoid sexual intercourse during treatment. 

    UTI is easy to treat. However if left untreated can lead to serious complications so please pay attention to any of the above symptoms.

    How to get rid of carpal tunnel syndrome ?

    Monday, 29 November 2010

    Carpal tunnel syndrome is the most common cause of peripheral nerve compression. It occurs when the median nerve is compressed during its passage in the carpal tunnel which is present at the wrist.
    Here is a diagram of the anatomy of the wrist:

    Who are more liable to have carpal tunnel syndrome ?

    - Computer users.
    - Pregnant women (especially those who are in the third trimester).
    - Obese individuals.
    - Musicians.
    - Females are more liable than males.
    - Women who are taking oral contraceptive pills.
    - Menopausal women.

    What are the symptoms of carpal tunnel syndrome ?

    Symptoms include tingling and pain in the hand and/or forearm. The pain of carpal tunnel syndrome does NOT affect the little finger.
    Feeling of weakness in the hands can occur.

    How to get rid of carpal tunnel syndrome ?
    Non-surgical ways:
    Application of cold packs can relief the swelling. Splinting of the wrist in extension while sleeping can relief the symptoms.
    Besides, the doctor can inject corticosteroids into the carpal tunnel.

    Surgical ways:
    Surgical decompression of the carpal tunnel is the definitive treatment. It is usually done as an outpatient procedure under local anesthesia. 

    Note: Pregnant women having carpal tunnel syndrome are usually relieved after childbirth.

    How to quit smoking ?

    Thursday, 18 November 2010

    Quitting smoking can be a pretty hard. Smoking is a habit easy-to-do but hard-to-leave. Many are struggling to quit and they fail to do so. 

    Usually it takes more than one try so that a person can quit completely. Lets talk first about the dangers to smoking then we will discuss ways for quitting. 

    Why do you need to quit smoking ?
    Because it increases your risk of getting coronary artery diseases, heart attacks and atherosclerosis. Smoking can kill. Besides it is carcinogenic and can help in occurrence of certain cancers as lung cancer.
    When you quit for a year, the increased risk of coronary artery diseases gets reduced by half. And after 15 years, the risk falls to be same as a non-smoker.

    Quitting smoking is an easy job only if you follow these points with the same order:

    • Admit the benefits of quitting and make sure that you are convinced that your life and health will be better when you do so. 
    • Throw away your cigarettes, lighters and ashtrays.
    • Avoid any contact with friends who smoke or encourage you to do so.
    • Tell everybody about it. Tell your family, friends and colleagues that you are quitting.
    • Be well determined. It is normal that you wont be able to quit from the first try so it may need a few chances and you must have the determination for it.
    • Exercise your favourite sport.

    • Choose a quitting strategy:
     You may need to use a nicotine replacement therapy so that your body gets its daily needs of nicotine. The methods include nicotine patch, gums or spray.However i recommend that you stop it gradually.
    • It will be better to try chewing sugarless gums as it can help reduce the urge to smoke or use tobacco.
    • If you fail to quit, seek help from a doctor. Drugs as Bupropion and Varenicline can help a lot people who smoke more than 10 cigarettes per day.
    Remember that you will feel different after you quit. And you will feel the results soon. 

    Encourage others to quit and seek help from doctors if they can't do that by themselves because smoking kills.
    I hope you benefited from this article. If you are a smoker, good luck with your quitting plan. And if you are a non-smoker, keep it up.

    Helicobacter Pylori infection

    Saturday, 13 November 2010

    H. pylori infection is present in many individuals but it doesn't cause any signs or symptoms. H. pylori is a bacterium that infects the stomach or the duodenum. In some people, it can cause serious complications as gastric ulcer or cancer.
    Infection is usually acquired during childhood. The exact route is unknown but it can be transmitted by oral-oral or kissing. 
    Once you are infected, it will persist for life unless it is treated. This bacteria can survive in the acidity of the stomach as it produces an enzyme to create an adequate pH for its survival.

    In many cases, it is asymptomatic (causing no symptoms). In some cases, it can cause the following symptoms:
    • Burning pain in the abdomen.
    • Nausea
    • Vomiting
    • Weight loss
    If you are unaware of this infection, it can lead to a peptic ulcer or gastric cancer. 

    Peptic ulcer:
    H.pylori is the major cause of peptic ulcer.

    Symptoms of a peptic ulcer include:
    - Burning epigastric pain: an individual who can point using a single finger to the epigastric pain, is highly suggestive of a peptic ulcer. The charcteristics of pain is that it is worse when hungry.
    - Back pain
    - Nausea
    - Anorexia

    Gastric cancer:
    Can H.pylori infection cause gastric cancer ? 
    Yes, chronic H.pylori gastritis can cause gastric cancer. 
    Clinical presentation: 
    - Presence of an epigastric or abdominal mass + epigastric pain
    - Hard nodular liver
    - Ascites
    - Lymphadenopathy

    What are the investigations that are done to detect H. pylori infection ?
    - Serological tests to detect the presence of IgG antibodies.
    - Breath test: a quick and reliable method. It is used as a screening test. 
    - Endoscopy: a sample is taken from the stomach and duodenum and checked for the presence of the bacterium.

    Treatment of H.pylori infection: 
    H. pylori should be eradicated by the use of triple therapy. It consists of: 
    - Tetracycline/ amoxicillin
    - Colloidal bismuth
    - Metronidazole

    If there is a peptic ulcer, your doctor will prescribe an H2-receptor blocker or a proton pump inhibitor.Besides you should follow these instructions:
    - Have small frequent meals. Avoid heavy meals
    - Avoid smoking
    - Avoid alcohol
    - Avoid non-steroidal anti-inflammatory drugs as aspirin, ibuprofen, ketoprofen
    - Avoid coffee and tea
    - Avoid any spicy diet

    Surgery can be done in cases of perforation or severe hemorrhage 

    We hope this article was interesting to you. Thank you for reading it. 

    Depression: Symptoms - Causes - Treatment

    Thursday, 11 November 2010

    Depression is one of the commonest psychological conditions nowadays. It is defined as chronic and recurrent mood disorder. 

    Clinical depression refers to the persistence of the symptoms for a long period of time which result in affection of everyday life. 

    What are the causes of depression ?

    • Most commonly it is related to life events. 
    • Depression can be caused by hormonal changes. Thyroid problems and menopause can cause hormonal changes which can lead to depression.
    • Traumatic events during childhood can leave a permanent effect in the brain.
    • Changes in neurotransmitters in the brain.

    Symptoms of depression can include any of the following: 
    - Persistent sad mood
    - Loss of interest in activities that were once enjoyed
    - Feeling guilty
    - Feeling hopeless
    - Insomnia or excessive sleeping
    - Decreased appetite and weight loss
    - Fatique and loss of energy
    - Crying spells for no apparent reason
    - Unexplained physical problems as headache and back pains

    In children, symptoms of depression include poor school performance, lack of playfulness, suicidal actions.

    What should be done to treat depressive disorders ?   

    • Stop depressing drugs as steroids and alcohol.
    • Regular exercise (at least a 30 minutes walk daily)
    • Your doctor can put you on an antidepressant if depression persists. 
    • If antidepressants didn't work, an adjunctive drug (as lithium) can be used.
    • The use of cognitive behaviour therapy can be of great help in depression. 
    • Get plenty of sleep.

    The most effective treatment is a mixture of cognitive behaviour therapy and an antidepressant.
    The commonest two types of antidepressants are tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI).

    Bottomline (if possible) try to avoid any cause of depression and if you feel that you need help, please do not hesitate to seek help from a psychologist whenever you feel that you are going through a psychological problem.

    Non - Hodgkin's lymphoma

    Wednesday, 10 November 2010

    Non-Hodgkin's lymphoma is a malignant tumour that originates from the lymphatic system. 
    Let's give a brief introduction about the lymphatic system:
    It consists of lymphoid organs (as bone marrow, thymus, lymph nodes) and lymph vessels. When a malignant tumour arises from the lymphatic system, it is called Lymphoma. 
    There are two forms: Hodgkin's lymphoma and Non-Hodgkin's lymphoma.
    Today we will talk about Non-Hodgkin's lymphoma as it is much common than Hodgkin's lymphoma.
    What are the causes of Non-Hodgkin's lymphoma ?
    The definite cause is unknown but it has been linked to some viruses and toxins as benzene and pesticides.

    Now let's talk about a general simplified view of the mechanism of this cancer.
    This cancer causes production of lots of abnormal lymphocytes. A normal lymphocyte has a life span but the abnormal one doesn't. These lymphocytes continue to grow and divide until they cause crowding of the lymph nodes. As a result, lymph nodes get enlarged.

    Symptoms of Non-Hodgkin's lymphoma include:
    - Painless enlarged lymph nodes (usually cervical or supra-clavicular nodes). 
    Normally, lymph nodes are not felt. If you feel them, then they are enlarged.
    (Here is an illustration of the sites of lymph nodes)
    - Systemic symptoms as fever, night sweats and weight loss.
    - Abdominal pain or swelling.

     Posterior auricular and posterior cervical adenopathy.
    (From Swartz MH: Textbook of Physical Diagnosis, 5th ed. Philadelphia, WB Saunders, 2006.)

    What are the risk factors ?
    Individuals who are old aged or taking immunosuppressive drugs or using insecticides are at a higher risk of developing Non-Hodgkin's lymphoma.
    Non-Hodgkin's lymphoma is classified according to "The Working Formulation" into:
    - Low grade lymphoma
    - Intermediate grade lymphoma
    - High grade lymphoma
    The treatment depends on the histological findings. In general, it may include radiation therapy, chemotherapy, total neck irradiation.

    Please note that not all enlarged lymph nodes are of malignant cause as there are other causes of lymph nodes enlargement. If you feel any lymph node in your body, let a doctor check it as early as possible.

    Thank you for reading this article. We hope you benefited from it. 
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    Last edited: 20/2/2012 

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