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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Leg toning exercises for womenFor those women who will leave 'no stone unturned', here are a few great exercises which work superbly on the legs and whole body. For those who have always wanted a great pair of legs, don't change your jeans brand. Just change your brand of exercise. Here are great leg toning exercises that can make your legs attention grabbers. Well-shaped legs are what every woman desires especially as it signifies 'movement', 'mobility' and 'strength'. When we say legs we mainly mean the thighs, the calves and the feet. To get more precise the quadriceps of the thighs the hamstrings and the hip adductors are the prime targets of most exercises. A complete leg work out would also include the 'Tibialis Anteriors' or the shin muscles. Exercising the legs can be quite a frustrating thing especially if the leg muscles don't show any cosmetic improvement. Here is an exercise regimen which will ensure that you will get those attention-grabbing legs along with the strength, flexibility and tone which you have always desired. The stand This is probably the most undermined exercise of them all since it doesn't involve lugging heavy weights around or running for miles or squatting! It is a foundation exercise for the legs.  Choose your favorite spot on the floor and just stand erect with both feet together and toes pointing forward. Hold the hands straight at the elbows and keep the shoulders square. Tuck the chin in and do not bend your knees. Feel the ground under the feet. Now flex your thigh muscles and keep your feet firmly on the ground. Direct your attention towards the back of your thighs and keep your knees taut. Stand firm for about 3-5 minutes initially and gradually extend to five minutes or more. This exercise is simpler than it actually is as it keeps the thighs taut and firm. The entire leg gets a marvelous stretch and any faulty standing or postural habits create unnecessary tension and uneven hip alignment. The standing pose will be your first step towards trim and well-sculpted legs. The One Leg Extension After you perfect the stand, here is another great leg exerciser - The one leg extension Perform a stand as in the previous exercise for about 30 seconds. Once you get your grounding and feel your foundations beneath the feet, take a deep breath. Now flex your thigh muscles and keep the kneecaps taut without feeling any strain. Bend the left leg at the knee and raise it without bending at the right leg. Now catch hold of the big toe with the left hand and hold the pose for a few breaths. You will initially struggle for balance as you have to keep the other leg straight. Now that you have caught the big toe of the flexed leg gradually straighten the leg out without letting go of your grip. This is a challenging pose especially for the hamstrings, the hip flexors and the calves since the leg muscles are going to be a little tight especially around the hips and the hamstrings. With regular practice, the pain will ease and then you can even try and take the toe towards as high as you can with the aid of your left hand. Repeat with other leg following the same sequence. One Legged Squat The one legged squat is a superior exercise to the two legged variety is that it doesn't require many repetitions as it is quite a strenuous exercise even for advanced exercisers. Stand with the back of a chair within easy reach initially. Extend the right leg out first and squat down to your heel with your left. Once you have reached the end of the squat try not to touch extended leg as there comes the difficult part - getting up to standing position without touching the floor with your hands for support. Raise yourself to standing position and repeat with other leg. You can do about 3-4 sets with the same leg or alternate legs using the back of a chair for hand support as you squat deeply. The single legged squat exercises the gluteus, the knees and the entire hip joint and also gives lower back strength. Initially your knees might hurt so don't try this without support of a chair or a partner. Stop in case of intense pain. Step Training If plain jogging doesn't do the trick for shapely legs for you, try using stadium stairs or any gradient which is at 30 degrees and comprises even steps. Your regular apartment stairwell or even a pedestrian over bridge can do the trick. First set only walk up one step at a time. Second set do alternate stairs. For the third set you can sprint up as fast as you can the entire flight of stairs or halt for exactly ten seconds when tired and start again. You have the option of stopping as many times you wish as long as you start again after ten seconds. This can work up quite a sweat and regular step training works out and touches muscle groups that even normal running or squats cannot reach.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Afraid of the dark? understand your fear and cure it!Scotophobia, more commonly known as Nycotophobia, is a psychological illness, where the patient is afraid of the dark. Children are more prone to this fear, though it does affect quite a few adults as well. The dark often represents insecurity and uncertainty to children, and it symbolizes their entrance into an unknown territory. If the children are alone during their first few encounters with darkness, the absence of parents (who exemplify safety), tends to amplify this crippling fear. While most of us do actually possess this fear in relatively small amounts, as we grow up the fear diminishes. However, there are those of us who might carry this fear of the dark into their adulthood and in such cases, the fear is usually accompanied by quite a few intricate issues. People often tend to externalize a set of conflicting feelings about a certain situation, towards something else. For instance, you might be worried about your children; but your mind may externalize this fear, via your inefficiency at work. This process is called externalization. So, when it comes to the root of your fear of darkness, it is possible that at some point in your past, you experienced something untoward, which through externalization, inculcated this fear of darkness, deep into your psyche. Evolutionary Ties to Darkness: Many scientists have pointed out that this phobia might be linked to the process of evolution. Since predators hunt for their prey at night, we might have inherited this fear of darkness from our ancestors, who believed that darkness was a space where they could be attacked by wild animals. However, recent studies have shown that  Scotophobia begins at approximately the age of two in children, and thus, it cannot be said to be innate to us. In a study done by Ryerson University involving over 90 students, it was found that people who are afraid of the dark, are more likely to be poor sleepers, than those who are not afraid of it. More interestingly, it was discovered that any kind of noise made while the people with this phobia were asleep, frightened them the most.. Symptoms of Scotophobia: The first symptoms of this fear are the resistance to visit dark places and the yearning for company when such situations arise. However, many a times adults who are suffering from this fear, do not reveal it due to the added fear of embarrassment and this, sometimes, results in outbursts of rage when they are forced to go out for an event at night, or to confront the dark under any such circumstances. A person battling this fear may experience panic attacks, sweating and trembling prior to, or while staying in the dark. The blood pressure also rises, accompanied by chest pain and lastly, a difficulty in breathing. Diagnosis of Scotophobia: In children, this fear can be easily verified by their behaviour. However, adults might require further assistance, due to their natural resistance to openly admit to such a fear. Scotophobia can be diagnosed through a comprehensive psychiatric evaluation. Following this, your psychologist would be able to give you an idea of the source of your fear as well. Pursue a course of treatment immediately after the discovery of the phobia, which will ensure a faster and more effective recovery. Treatment of Scotophobia: The process of 'desensitization' is most commonly used to help with such a phobia. In this form of treatment, the patient is slowly exposed to the object of fear, in a situation where she/he will not feel vulnerable. This is done by asking the patient to confront the dark along with another individual who symbolizes safety for him/her. This could be a parent or a friend. Night lights can also be installed to gradually reduce the fear. You may try certain breathing exercises, which will reduce the panic attacks that accompany this fear. Hypnosis has also been said to be very effective in dealing with this phobia. If your psychologist sees fit, you might be also prescribed some medicines; antidepressants are given in some cases. Joining a self-help group is also a good option, in addition to your psychological treatment.  
Lost in wonderland? - Absentmindedness!The Daily Telegraph reports that on an average every adult in UK forgets three things per day. Forgetfulness is a human tendency. If this absentmindedness or forgetfulness is limited to forgetting three to five things per day, then it can be left unattended. However, if you or a near one is facing a lot of trouble in your daily life due to this habit or problem, you should immediately have a consultation with your doctor. Mystery behind Absentmindedness According to Maria Jonsdottir, an investigating neuropsychologist from Iceland, absentmindedness is the mental lapses that usually happen in connection with the actions that are routine or well-rehearsed. You can perform these actions without any need to be careful. This includes regular actions such as squeezing out toothpaste or moisturizer from the tube. These action slips are very common and if you observe carefully, you do forget some such regular things every day unknowingly. Psychologists believe that an individual makes such mental lapses around 30 times in every week. On an average, the nervous system of a human brain runs quite efficiently. However, sometimes temporary fault may develop that may make you use incorrect word or slip to your native tongue while conversing. This does not mean however, that something is wrong with your brain. When the team of Jonsdottir surveyed around 200 people, they found out that on an average the slips are 6.4 per week although the number also greatly depends upon the gender, intelligence level, and age. One startling fact that was discovered is that most of the events of forgetfulness occurred before 8 p.m. that means people tend to forget more during the daytime than in the evening. Apart from a momentary lapse in the functioning of brain efficiency, other reasons that can lead to increase in the incidents of forgetfulness are high stress levels, mobile phones, e-mails, and busy lifestyles. Today, people are pressed for time and they have more work at hand than time and that has increased the occurrence of forgetfulness. Types of Absentmindedness A team of neuropsychologists has divided these mental lapses into five categories. The most common are the storage failures in which people cannot recall what they had planned for a particular occasion or they can recall the action, but cannot remember for whom it was meant. Another category is test failures in which people come back home to check whether they have turned the light off and find out that they have already done so. Discrimination failure is another category of absentmindedness wherein you for a moment fail to identify the difference between your things and others'. During the study, a male participant accepted that he picked up the jacket of his female partner thinking it to be his own. Sometimes you put books in the dustbin and the trash on the shelf and laugh at your behavior a moment later when you find out what you have done. This is discrimination failure. Another mix-up includes program assembly failure wherein you put salt in the tea instead of sugar or you just do not keep the right things at the right place. The fifth one is the sub-routine failure wherein you go to the market to buy tea and instead come back home with coffee. The research proves one thing that if you are absentminded, it does not mean that you have a bad memory or can suffer from dementia as is widely publicized in the media. It is perfectly all right to forget or being an absentminded person. Sometimes the incidences of absentmindedness can increase due to fatigue. A good sleep and rest can fix the problem easily.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
Top 10 tips for weight maintenanceTIP 1: Stay Calm and PlanDon't worry about your weight excessively. This will only result in stress which can be counter-productive to your pursuit. Remember that you have reached the goal you had to and you are strong enough to sustain it. Take one day at a time. Do not think about how you are going to keep it forever. Just focus on the next day. TIP 2: Health JournalKeep a journal where you note down your eating and exercising patterns. Write down what you eat, plan your meals, drink adequate water, and form an exercise regime. Did you know that you can include an activity within your life as a habit by performing it for 21 days? Do these things not because you have to but because they are good for your health. Slowly, they will become a part of who you are. TIP 3: Being Healthy Is A Lifetime DealOne of the greatest mistakes that people do is to think that once they have lost weight, they can return to their early eating habits. Remember that your health is with you for life. Shift your perspective from 'I have to become thin' to 'I have to be healthy.' Once you do this, you will find it easier to stay healthy for the well-being of your body. TIP 4: Be RealisticWhen you are planning your lifestyle, don't take up unrealistic goals. This is one of the reasons why weight-trainers say that the best way to reduce and sustain right weight is to make it 'your life.' Eat right, sleep well, and drink lots of water. These three, if done properly, can help you to have the right body weight. If you have any rules like 'don't eat cake or pastries ever,' 'quit drinking,' then rethink about them. Are you going to be able to never eat sweets? The primary goal is to make a balance, choose the middle path. TIP 5: Get An Idea Of Your Weight-PatternMany people stop weighing their body once they have reached the ideal weight. They think that the scales are only for the fat ones. A person with such a perspective is only looking for slim bodies and not healthy ones. Remember that your weight is not a judgment of your appearance, but a barometer of your health. So do not stop doing the weekly weight checks. Keep a report of your weight every week and check out the causes for any abnormal changes. TIP 6: Accept Your Limitations And Learn From ThemEveryone has their ups and downs. Don't get discouraged and be angry at yourself if you binged on a donut on a cloudy day. Everyone makes mistakes. It is not the end of your weight maintenance. It is simply a blip. Learn from it. Know what the causes are for it and work on making sure you react to the cause differently next time. TIP 7: Thirst And HungerYour body could confuse your thirst for hunger. So, if you are feeling hungry really soon after your previous meal, then start by drinking a glass of water and check if you feel better. If you do not, then it is time for a light healthy snack. TIP 8: Inspire YourselfWeight maintenance is primarily a psychological task. Till the time you were reaching the ideal weight, you learn everything you had to about being healthy. Now, you have to make sure you don't let obstructions stop you from sustaining this healthy lifestyle. So, join other people who are only in the process of maintaining their weight. Become part of the running blub or catch up with a health conscious friend regularly. TIP 9: Mind Over MatterBalance your eating patterns. If you think that you will be going out for lunch, then have a healthy breakfast and cut down on the dinner. You might be craving for a dessert, so you can have salad for the main course and treat your sweet tooth. Talk to yourself about what you are going to eat. Ask yourself if you really want to eat it because you are hungry or are there any other reasons for it. How would you feel about it after you are done eating? TIP 10: Celebrate Your AchievementsLastly, be proud of your weight maintenance program. Celebrate the fact that you worked hard towards making sure you have a healthy body and invite people who were part of your pursuit. Embrace your body and toast to the next year of a healthy lifestyle.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
How to communicate with a patient who has a strokeThe first and the most important thing to communicate with the patient, is to give undivided attention. Give attention to his activities, gestures, his facial expressions through which he may try to communicate so his feelings could be understood. Eye contact is also important but the patient having stroke may look at you square in the eyes but he may not respond to your conversation. While communicating with the patient you should always stand in front and tune out all the other sights and sounds in the room. Maintain full silence around the patient in the room, turn down the volume of the television, radio and ask other people in the room to be silent. You may communicate with the patient by making contact by touching the hand, chin, cheek or areas which are not affected by stroke. As the side which is affected by stroke, does not have any sensations. You may communicate with the patient through his family member by telling the family member to communicate with patient by saying, "Look at my face"; through this we can gain the patient's concentration. You should always speak clearly with the patient in a normal soft volume. Express your ideas in simple terms, form simple sentences, do not use complex words. You may repeat the sentences or an important term again. For example to ask if the patient wants tea, repeat the word 'tea'. More complex thoughts can also be similarly conveyed and repeated. You may also use hand gestures with clarification like doing Hello by waving your hand or through your hand action, you may ask questions like, How are you? Are you ok? What do you want? Through this both caregiver and stroke patient can benefit. You may ask your patient to point out whatever he wants or if he needs anything. And gradually he will develop the habit of pointing the daily items like television, newspaper, remote, eyeglasses radio, drapes an uncomfortable foot, the patient can indicate any pain or headache. Through this communication we can make the patient learn, use mechanical lifts to get in and out of the bed, and with the help of the attendant by demonstrating the patient how to use it. Sometimes when the communication does not work, take a break, give it time and try again, do not get frustrated and reassure the patient that yes, he or she can do it. Good communication with the patient is very important as they cannot speak their basic wants and needs clearly. The patients suffered a stroke also have slurred speech. There is a deviation of the angle of mouth. They are mostly bed ridden and could not carry out the routine activities.
Psychological impotenceSex is not just physical but just as equally mentally involved. Mental stimulation and response are responsible for arousal and overall enjoyment; and therefore any sort of psychological disturbance or mental issues like stress, tension, or anxiety can lead to psychological impotence. Stress or exhaustion are most possible explanations for psychological impotence. Depression and post-traumatic stress disorder also may result in impotence. A mental trauma of sexual or physical abuse, guilt due to sexual relationship, problems amongst partners contribute too. Confusion over one's sexual identity is also a major cause for impotence. Impotence results from underlying physical disorders, especially if the people choose to stay unaware of it. Absence of knowledge of this disorder leads to anxiety and stress building up over a period of time.  So when determining factors rule out physical causes first and then go for identifying mental causes. Psychological impotence can be sometimes situational or only with a particular partner and the treatment approach differs with the cause. Counseling works wonders in the case of psychological impotence. For example, depression or anxiety may require treatment to improve condition. Post-traumatic stress disorder or abuse needs therapy on coping skills. Sometimes simply explaining underlying cause of physical condition resulting in impotence and comfort and reassurance are sufficient. So don't hold back, share to get your mojo back!!
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