Welcome ! I'm Dr. Ahmad and I will be pleased to offer help.. email me: ad_icare@yahoo.com أهلا و سهلا: يسعدنا إنضمامك لنا من خلال صفحتنا على الفيس بوك: استشارة صحية

Polycystic Ovary syndrome

Saturday, 26 June 2010

Please note that I will not be able to answer any questions concerning PCOS. Kindly consult your doctor. 

Polycystic ovary syndrome is our topic today.

It is a common disorder nowadays. And because it is common i decided to bring to you a summarized post about it.

What is polycystic ovary syndrome ? 
Poly-: means many
- Cystic: means cystic cavities

It is an endocrinological disorder characterized by multiple small ovarian cysts, signs of androgen excess, anovulation (no ovulation), menstrual disturbances (it ranges from lighter period to no period).

It was first described by Stein and Leventhal in 1935. Polycystic ovary syndrome is also known as the Stein Leventhal syndrome.

What causes Polycystic ovary syndrome ?
Till now, the exact cause is unknown. However several mechanisms and factors are involved in it. 

There is a genetic factor involved, which means that polycystic ovary syndrome may run in families especially in first degree relatives. Besides obesity is a common finding in patients having polycystic ovary syndrome.

One of these mechanisms are started by Insulin resistance (the female body become resistant to the action of her own insulin). Insulin resistance causes the body to produce more insulin to compensate the present resistance.
This is called Hyperinsulinemia (high insulin in blood). The high insulin level will eventually lead to more free androgens (testosterone).

At the end, you get more testosterone in the female body and this what brings the symptoms that will be mentioned next.

Symptoms of Polycystic ovary syndrome:
1. Menstrual dysfunction: the woman can present with less periods in the year or cessation of menstruation (amenorrhea).

2. Infertility: due to altered hormonal balance and due to increased testosterone level.

3. Hirsutism, hair growing on the face or acne: these effects are due to increased testosterone.

In some cases, there are no signs of increased testosterone and diagnosis is made by visualization of the polycystic ovary by ultrasound.

The diagnosis is the job of the doctor so we will leave that to him/her. 

However there are important advices to any woman having polycystic ovary syndrome:
1. Reduce your weight because this will make your body more responsive to the medications.(i know this is not easy but do your best). You can do that by:
  • Lowering the carbohydrates and increasing proteins in your diet.
  • Walk daily for at least 30 minutes.
  • If possible go to a gym and start exercising.
  • If these measures fail to reduce your weight, your doctor can prescribe Metformin to help you reduce your weight.
2. If you have excess hair, a medication can be prescribed. Besides you can use depilators as a temporary measure for the situation.
3. Be an active individual and don't get used to a sedentary life.
4. Try to increase the fruits and vegetables in your diet.
5. Try to share your daily activities with a friend and be more social.
6. If you are trying to get pregnant, discuss with your doctor having ovulation inducing drugs. These drugs include Clomid, HMG/HCG injections.

Lines of treatment in polycystic ovary syndrome:
There is medication and there is surgery.

Medication will include contraceptive pills , metformin, Clomid, anti-androgen drugs.

The surgery used in polycystic ovary syndrome is known as ovarian drilling done by laparoscopy. 
The benefits of medication and surgery varies from a woman to another. It depends on the woman's age and desire for pregnancy.

Congestive heart failure (simplified)

Monday, 21 June 2010

Today's topic will be about "Congestive heart failure"

But before going to our topic, i would like to give you a simplified view for the heart. This is a simplified diagram showing the direction of flow of blood in the cardio-vascular system:

The heart is the pump in our body. It receives deoxygenated blood (blood low in oxygen) from the body systems and then pumps it to the Lungs (where blood will be oxygenated).
From the lungs, oxygenated blood will return back to the heart to be pumped to all body tissues and systems

Here is a more complex diagram:

Now its time to get into our topic "Congestive heart failure"

What is congestive heart failure ?
It is the condition when the heart is unable to perform its pumping function due to a structural or a functional heart disorder

What causes congestive heart failure ?
The defect is either in the pump or in the vessels that carry oxygenated blood to the body 

What can affect the heart (pump) ?

1. Coronary artery diseases: will lead to decreased blood supply to the cardiac muscle. So the cardiac muscles weakens and gets affected

2. Cardiomyopathy: infections, chemotherapy and drugs can lead to damage to the cardiac muscle.

3. Damaged heart valves: this will lead to abnormal circulation inside the heart and therefore the function is impaired

What can happen in the vessels and lead to heart failure ?

Hypertension (increased blood pressure) will lead to an increased resistance against the flow of blood coming out of the heart. So the cardiac muscle gets overloaded and causes damage to it on the long run. 

The term "congestive" refers to the back up of blood in the lungs, liver, abdomen and legs. 

What are the symptoms of congestive heart failure ?
1. Related to the backup of blood in:
- Lungs --> shortness of breath, cough of blood tinged mucous
- Abdomen --> ascites and abdominal enlargement

2. Rapid heart rate (a compensatory mechanism)

3. Fatique and decreased alertness (due to decreased oxygen supply to the body muscles and brain respectively)

At last, this youtube video will summarize the topic in 3 minutes. Note that it may be inappropriate as it has a live pumping heart view. Click here to watch the video 

Facts about Vitamin D

Monday, 14 June 2010

Today i bring to you a post on vitamin D, one of the important vitamins needed for normal growth and development
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Vitamin D is a fat-soluble vitamin.It has two forms: D2 and D3

How do we get Vitamin D in our body ?
Sources of vitamin D are dietary and non dietary. The non dietary sources form the greater supply of vitamin D

Non dietary sources of vitamin D:

Is by ultraviolet radiation of the skin and exposure of the bare skin to sunlight. The process is complex, it's done by the skin, kidneys and liver

Dietary sources of vitamin D:

Oil rich salt-water fish (eg; salmon), liver, egg yolk and D-fortified foods

So, what are the benefits of vitamin D ?
It is needed for healthy bones and teeth, fighting infections, prevents osteoporosis (a disease affecting bones that causes decreased bone density) and may reduce the risk of developing cancer
This video describes it in more details:

How much vitamin D should we have per day ?
The recommended daily intake of vitamin D is 400 IU

What are the dangers of vitamin D deficiency ?
Deficiency can occur in cases of non-exposure of bare skin to sunlight, which can lead to:
1. Rickets (in children)
2. Osteoporosis and osteomalacia (in adults)

Who is at risk of vitamin D deficiency ? am i at risk ?
 1. Breastfed infants: the mother's milk cannot supply the daily requirements of vitamin D. So they can be exposed to sunlight or better have vitamin D supplements

2. Old adults: due to ineffective synthesis of vitamin D due to defective liver and kidneys

3. People with limited sun exposure

4. People with dark skin: the dark skin reduced the ability of the skin to produce vitamin D from exposure to sunlight

5. People who are obese or having fat malabsorption or undergone gastric bypass surgery

What if we have an excess of vitamin D ? is it dangerous ?
Vitamin D is a fat-soluble vitamin which means that if present in excess, it will be stored in the fat component of our body. Unlike the water-soluble vitamins, which if present in excess, it will be excreted with urine and won't cause toxicity.
Toxicity of vitamin D will be in the form of nausea, vomiting, poor appetite, weakness. Besides it can cause heart rhythm abnormalities and formation of kidney stones due to increased calcium

Now it's time to focus on the latest updates involving vitamin D:
1. A recent study showed that women aged 70 or older who recieved a single annual dose of vitamin D had a higher rate of falls and fractures. Researchers say that the dosing regimen rather than the total annual dose might determine the outcome

2. Researchers found that there is a higher risk of rheumatoid arthritis in the northern latitudes. This might be related to the fact that there is less sunlight in these areas, which results in vitamin D deficiency. That's how rheumatoid arthritis can be linked to vitamin D deficiency

3. Researchers said that low levels of vitamin D is associated with more asthma symptoms and greater medication use

Breast Cancer (to both women and men)

Thursday, 10 June 2010

A great active member , Tricia Connolly, had brought to my notice a list of important guidelines that you should be aware of.

Recent studies involving prevention and treatment of breast cancer are becoming more advanced. It came out with new guidelines for both men and women. 
"Ladies first":
Breast cancer is hard to be diagnosed in women less than 40 years old due to a greater breast mass when compared to that in older women. So all those under 40 years, if you feel a breast lump or have a bloody discharge from your nipple or there is a change in the skin of the breast like dimpling or observe a skin colour change,
then see your Gynecologist as soon as possible. 

The good news is that death rates from breast cancer is declining which is related to many factors like better awareness of women, better medical care and improved ways of treatment. 

And if you know a friend with breast cancer then better get her the following advices:

1. Reduce stress as much as possible. Studies proved that patients who have sessions with a psychologist (to learn how to reduce stress) lived longer with a better quality of life

2. Eat peaches and plums. Extracts used in laboratories where effective against most aggressive breast cancers cells. This benefit is said to be due to presence of two phenolic compounds (chlorogenic and neochlorogenic). They are present in most fruits but are present in a higher concentration in peaches and plums.

And for men:
Take care, because for every 100 women diagnosed with breast cancer there is 1 affected male with it. 

Note that breast cancer in men is much aggressive than women. This is because there is less breast tissue in men which will be easily infiltrated by cancer cells. That's why it is more fatal in men than in women. 

It is so important to self examine yourself regularly and thoroughly and check for any lumps or swelling in the skin of the breast.

Last but not least, i would like to thank Tricia Connolly for her helpful contribution.

Feel free to post any question you have 

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A dream come true (Breast Cancer Vaccine)

Wednesday, 2 June 2010

Prevention is better than cure. That's why researches are going on in the meantime for getting a Breast cancer vaccine available to all women.
At the department of immunology at the Lerner Research institute at the Cleveland clinic, the team of researches announced that they are in the phase of trial on humans. 

The vaccine acts by initiating the body's own immune response to attack the malignant cells. What is more amazing is that it will be effective on a single administration. 

On the other hand, there are some challenges that will be more clear to solve in the coming period of time. The vaccine proved to be effective when tried on mice. None of the vaccinated mice developed breast cancer, while all the other did. 

Caitlin Palframan, of charity Breakthrough Breast Cancer, said: "This research could have important implications for how we might prevent breast cancer in the future.
However, this is an early stage study, and we look forward to seeing the results of large-scale clinical trials to find out if this vaccine would be safe and effective in humans."

At last i would like to add that if this vaccine proved to be safe for human use then this will be a great advance in preventing breast cancer.

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