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Cervicitis and cervical erosion

March 28th, 2011
khurram akhtar asked:




red columnar epithelium. The lesion may be flat or thrown up into small papillary folds.

Treatment

See below.

Chronic cervicitis True cervical infection may persist after bacterial invasion at the time of delivery or abortion. In such cases mucopus is seen coming from the external os. Bacteriological examination is seldom helpful because so many cases show a very mixed flora by the time the patient is seen.

The symptoms hardly differ from those of cervical erosion, except that the discharge is more purulent; the same treatment is applied. Small vascular tags of proliferating cervical epithelium may project from the cervical canal in some of these cases. These tags are not of the same nature as cervical adenomatous polypi (see p. 162).

.The cervix may also be infected with Ozlamydia trachomatis during intercourse with a male with chlamydia! urethritis. No local symptoms may be noticed but the organism can spread upward to cause chronic salpingitis. Ozlamydia is difficult to culture by ordinary bacteriological techniques, but an immuno-fluorescent antibody test is available. If a male is found to have non-gonococcal urethritis the possibility of chlamydial infection of any sexual contact must be considered, and she should be treated with tetracycline 500 mg orally 6-hourly for 2 weeks.

Cervical ectropion Often the cervix is partly split during childbirth. The split may be on both sides of the cervix or on one side only. Such lacerations may be very small or so large that they extend right up to the vaginal fornix. When the tear is bilateral, eversion of the two lips of the cervix exposes the columnar epithelium of the cervical canal, and such a lesion is often wrongly diagnosed as an erosion.

A small ectropion does not cause symptoms, but there may be mucoid discharge from a large one. In a few cases, especially if abortion has occurred and cervical incompetence is thought to be the cause, trachelor- rhaphy is performed. The edges of the tears are excised, and the resulting raw surfaces are sutured together to reconstitute the cervical canal.

Treatment of cervical erosion or chronic cervicitis Erosions found on routine examination should not be treated unless they are causing troublesome discharge. A cervical smear must be taken in all cases, and if there is any doubt about the smear colposcopy and cervical biopsy should be undertaken.

If patients taking an oral contraceptive complain of discharge and are found to have an erosion, another contraceptive method may be advised. However, some patients will wish to continue with the pill. Sometimes it is worth treating the erosion (see below) but it may recur while the hormonal

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Risks Involved In Varicose Veins Operation

March 25th, 2011
bcured asked:




It is essential that your doctor have a complete knowledge of your medical history as well as medication used prior to treatment (this includes regular use of recreational drugs). This is important for treatment planning so that medications do not clash with proposed treatment or that your doctor makes the necessary changes, modifications and precautions.

Blood clots in the deep circulation (DVT) are very rare with treatment. Since patients are up and about almost immediately, your doctor does not expect this to be a problem. However if you have had a DVT or blood clot previously, it may be that your blood is prone to clotting (thrombophilia). A sizable percentage of some population groups have this tendency. Blood tests can be done to detect this problem.

Ulceration can be a complication of varicose vein treatment. It comes from a variety of potential causes including: inadvertent intra-dermal injection of sclerosant, closure of an arteriole in an AV malformation during sclerotherapy, following an infection, recurrence of an old ulcer shortly after treatment during the healing phase and so on.

All of the above are temporary and are readily treatable. In many cases this can be anticipated and prophylactic measures taken to avoid this complication. At worst this is merely the inconvenience of regular dressings and one or more episodes of sutures to minimize the cosmetic impact. All of this is managed by the practice.

Skin discoloration (hyper or hypo pigmentation): This is a potential side effect of any skin procedure/manipulation and is more a function of the skin type than the treatment. In other words you may be prone to this genetically. It is generally more common in the olive coloured mediteranean type skin and in park skin pigmentation. Adequate care in the post-op phase has almost eliminated this complication. However topical preparations are also available from us to speed up the return to normal. In exceptional cases pigmentation may persist for many months. However your doctor does not expect this to be permanent.

It’s anticipated that around 85% of abnormal treated vessels will respond after the first treatment. There are things that can be done to maximize the benefits of this first treatment. Nevertheless, your doctor asks you to expect some follow up treatment. If you present to the practice within the prescribed three months after the first treatment, your doctor may include a follow up treatment as part of the follow up evaluation. Depending on what needs to be done, and if you require intravenous sedation analgesia, you may be charged a nominal amount for materials used. Also be aware that this cosmetic touch up is not usually paid for by medical aid, and will therefore be for your account.

Not permanent result — recurrence. The very reason why you get varicose veins is genetically determined. Therefore, while treatment is very effective, I have to inform you that regrowth and new varicose and spider veins are inevitable with any treatment you are offered sometime in the future. It may take many years and indeed may in most cases not manifest through the course of a lifetime. Yet in others new growth may happen distressingly soon after treatment. This is individual and impossible to predict. For this reason, maintenance treatment may be needed.

Infection is a possibility, but is not common. In addition, allergies are possible to any and all preparations employed. Your doctor would require you to inform him/her before treatment of any known or suspected allergies or diseases present in the family. When you agree to undergo treatment by written and/or verbal consent you agree to the financial terms of the practice. Primarily, irrespective of any third party being involved in payment, you agree to remain solely responsible for the whole account.

VenousBalm-Rx and VenousDrops are new topical and oral remedies to treat varicose and spider veins. They are characterized by very strong and real pharmacological activities which unequivocally qualify them as “ethical drugs”. The effectiveness of these treatments is undisputed.

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True hermaphroditism

March 19th, 2011
khurram akhtar asked:




“found. The urine contains no oestrogens, but gonadotrophic hormones are )resent. In most cases of Turner’s syndrome there are 45 chromosomes; me X chromosome is missing, and the complement is written as 45 XO. Because there is only one X chromosome the nuclei will show no sex ~hromatin nodule.

True hermaphrodites, with an ovary on one side and a testis on the 0 are very rare indeed, and in such cases one or both of the gonads is aim invariably abnormal in structure and without function. Sometimes ferentiation of the gonad is incomplete, and is described as an ovote The chromosomal pattern may be 46 XY or a mosaic.

Another recognized type of intersex is so-called testicular feminizat’ This may occur in more than one member of a family. The patient has attractive female appearance, and usually presents with amenorrh The skin is smooth and hairless, and the voice is female. Although

hair is luxuriant there is often a lack of pubic and axillary hair. The bre are well formed. The vulva appears to be normal and, although the ute is usually absent, there is a vaginal pit and sexual activity may be no If the gonads, which may be situated in the abdomen or in the groin, examined they are found to be testes, with an excessive development the interstitial cells. The chromosomal structure is XV.

In this disorder the gonads produce testosterone, usually in no amounts. However, one of two deficiencies may be responsible for fail of the testosterone to bring about the normal changes seen in a male fe The nuclear receptor which binds testosterone and thus initiates activity the target cell may be missing. Alternatively, the enzyme which con testosterone into the active dihydrotestosterone may be deficient. In latter case some virilization does take place after birth, but in the ab of the specific nuclear receptor testosterone is totally ineffective.

Malignant disease (disgerminoma, see p. 205) may develop in abnormal testes, and it is therefore usual to remove these and to hormone replacement therapy.

Abnormal production of androgens by the cortex of the suprarenal will cause virilism in the female, and if the disorder arises in fetalliti will cause one form of pseudohermaphroditism. In these cases there functional disorder of the suprarenal cortex, which may be familial which the normal conversion of 17a-hydroxyprogesterone to cort’ blocked, most commonly because of a deficiency of the enzyme hydroxylase. Cortisol normally inhibits the production of adrenocor trophin, which stimulates the suprarenal cortex. The abnormal co cannot produce cortisol, and responds instead by producing an exce androgens, which appear in the urine as oxosteroids. There is no detect chromosomal abnormality, and the abnormal androgens will only pro structural changes in the female genital tract if they operate early in ~ life, at about the 11th to the 16th week.

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