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Cancer (General)
What is Cancer?
Our bodies are made up of billions of cells. Normal healthy cells grow and multiply in an orderly, controlled manner.
Cancer cells on the other hand multiply uncontrollably. They do not function normally and instead form a growth or tumour.
These cancerous tumours can spread to nearby tissues and organs as well as to other parts of the body. Cancer kills by:
- Destroying important organs.
- Disturbing normal body functions.
- Blocking important blood vessels or air passages.
Cancer can be prevented!
Cancer is not contagious like the flu or chickenpox. You cannot catch cancer from someone who has it. Many
cancers develop because of lifestyle habits such as smoking, excessive drinking of alcohol or eating too much
fat (especially animal fat).
Others are caused by factors in the environment such as sunlight, radiation and some industrial chemicals.
By leading a healthy lifestyle and avoiding certain risk factors, about one-third of all cancers can be
prevented from occurring.
Cancer can be cured!
Many people are afraid of cancer because they think it is incurable. In fact, about one-third of all cancers
can be cured if they are detected and treated early enough. Recognising the early warning signs and going for
regular check-ups can save your life if cancer strikes.
How can you prevent yourself from cancer?
Lower your risk of cancer by leading a healthy lifestyle:
- Stay away from cigarettes and cigarette smoke.
- Take more fresh fruits and vegetables.
- Overweight? Exercise regularly and eat less fatty foods.
- Prevent sunburn and avoid overexposure to the sun.
- Comply with safety regulations if you are exposed to cancer-causing substances at work.
- Avoid excessive alcohol if you drink.
- Look out for these early warning signs.
- Pay attention to Constant cough, hoarseness, indigestion, weight loss, diarrhoea or constipation.
Bladder Cancer
What is Bladder Cancer?
Bladder cancer is a growth of abnormal cells forming a malignant tumour in the bladder.
Most bladder cancers start in the inner lining of the bladder. They come in a wide range
of forms and can behave in very different ways. For example, they may occur as small,
wart-like growths on the inside of the bladder, which can be removed in a simple operation
and will never recur, or they can form a large growth in the muscle wall of the bladder,
which requires major surgery to remove.
Some bladder cancers form mushroom-like growths on the inside lining of the bladder.
These are called papillary cancers. They have a short stem attached to the lining of
the bladder and can go on to spread into the wall of the bladder.
If bladder cancer is contained on the inner lining of the bladder, it is known as a
superficial cancer. If it has spread into the muscle wall of the bladder, it is called
an invasive cancer. Treatment is different for these two types of bladder cancer.
What can cause bladder cancer?
Research has shown that a few factors increase the risk of contracting bladder cancer:
Smoking: Some chemicals in a cigarette have been found to contribute to bladder cancer.
The more cigarettes smoked, the greater the risk.
Exposure to harmful, cancer-causing chemicals: Workers exposed to certain chemicals at the
workplace, for example, those used in dye factories, rubber, gasworks, plastics and other chemical
industries, have a higher risk of contracting bladder cancer. While these chemicals may have been
banned in some countries, it can take about 25 years after exposure to these chemicals before bladder
cancer starts to develop.
Frequent bouts of cystitis: These refer to cystitis caused by repeated bacterial infections and
bladder stones. They can lead to the development of bladder cancer.
Age and Gender: Bladder cancer occurs most commonly among people aged between 50 and 70 years old,
and is twice as common in men as in women. However, it is rare in people below age 40.
What are the symptoms of bladder cancer?
The most common symptom is blood in the urine (haematuria) which appears red. This usually occurs
suddenly and is generally not painful. The blood may not be present constantly but eventually it does
reappear. Sometimes blood clots can form and these may cause painful muscle spasms in the bladder.
The amount of blood present is however not related to the extent of the cancer.
Some people may also have a burning feeling when they pass urine, and they feel the need to do
so often. While these are also symptoms of bladder irritation, further tests would be necessary
if they persist and do not clear with antibiotics.
How can bladder cancer be treated?
The treatment for bladder cancer depends on the type of cancer , the stage and grade. The first main
distinction is between those cancers that are only in the lining of the bladder (superficial) and
those that have spread into the muscle wall of the bladder (invasive).
Superficial cancers, which can be single or multiple, are usually removed using a cystoscope.
Anti-cancer drugs (chemotherapy or immunotherapy) may be instilled into the bladder to try to
prevent the cancer recurring. For invasive cancers, the options are as follows:
Surgery: One of the most common treatment methods is surgery to remove a part of the bladder.
A new bladder is sometimes constructed if it has to be removed.
Radiotherapy: Radiotherapy may be used instead of surgery to avoid removal of the bladder.
Radiotherapy may also be used before surgery in cases of large tumours to facilitate the tumour
removal or after surgery if there is a high risk of cancer cells left behind.
Chemotherapy: In some circumstances, chemotherapy is given before surgery or radiotherapy
to shrink the tumour so that it can be treated more effectively. Chemotherapy is also applied
after surgery to reduce the risk of recurrence of the tumour.
What happens if bladder has to be removed?
Only a small proportion of people with bladder cancer will need to completely remove the bladder.
When a bladder is removed, doctors will give the patients an urostomy - an artificial opening from
the urinary tract.
Before your operation, the doctor will carefully plan the position of your opening (or stoma)
so that your bag will stay in place whether you are sitting, standing or moving about. The opening
is usually formed on the abdomen, to the right of the navel, but there are many considerations that
must be taken into account when planning the position. Wrinkles, scars and prominent underlying bones
must be avoided, as placing the opening near them may cause problems with leakage later on.
What should be noted of the urostomy?
Ensure that the bag is emptied and changed as often as necessary. Initially, the opening will be
slightly swollen and it may take several weeks for it to reduce to its normal size. There may also
be mucus (a thick white substance) from the opening. The amount of mucus will gradually lessen over
time but will never disappear completely.
Most people with an urostomy live a normal life. Many return to their jobs and take up their
favourite pastimes again, including swimming. Learning to look after a urostomy, however, takes
time and patience but it definitely gets easier with practice.
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Blood Cancer
The major forms of blood cancer are lymphoma, leukaemia and multiple myeloma. These cancers
are formed either in the bone marrow or the lymphatic tissues of the body. They affect the
way our body makes blood and provides immunity against other diseases. The three types of
blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone
marrow.
Since the risk of developing blood cancers increases with age, adults are more prone to blood cancer than children.
Lymphoma: Lymphoma is a cancer of the lymphoid tissues. Lymphoid tissues are composed of several types of immune-system
cells that work together to fight infections. Although lymphoma usually begins in a lymph node, it can also originate in
the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Leukaemia: Leukaemia is a cancer that affects the blood-forming system of the body, including the lymphatic system
and the bone marrow. Leukaemia can be classified as either acute or chronic. The former tends to affect children while
the latter is more common in adults but anyone can develop any kind of leukaemia.
Multiple Myeloma: Multiple myeloma is cancer of the bone marrow, which results from uncontrolled growth of plasma cells,
a form of immune-protective white blood cells. Under normal circumstances, plasma cells make antibodies to fight infections.
In multiple myeloma, there is a malignant proliferation of plasma cells. Age is an important risk factor for the illness,
with an average onset at age 60.
Symptoms:
All the three blood cancers have similar symptoms. Among the common signs are weight loss, constant infections
such as flu and diarrhoea, bleeding of gums or nose and slow healing cuts or frequent bruises are just some of
the warning signs of blood cancer.
In addition to the above, severe kidney problems, pain in the bones and a general numbness of the skin may
indicate the existence of multiple myeloma as the disease progresses. The pain can stretch to the back, ribs
and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone
is being destroyed.
On the other hand, one of the evident signs of lymphoma is the swelling of lymph nodes in the neck,
the armpits or in the groin among the other symptoms already highlighted.
Causes:
Exposure to excessive radiation and hazardous chemicals like benzene, asbestos, herbicides and pesticides are
known to be the primary causes of blood cancer. Therefore, contact with these harmful materials should be kept
to a minimum, wherever possible.
On top of that, certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular
chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms
of leukaemia. However, the possibility of a definite inherited risk for leukaemia is still being investigated.
Treatment:
Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.
Apart from these two, bone-marrow transplants also give patients and their families another option for a cure.
However, unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer,
bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only and tend to be more successful
for younger patients and when the disease is in the early stage.
Still, patients have to be made aware of the great dangers and side effects of bone-marrow transplants. In extreme
cases, the transplant may fail, thus resulting in death.
Prevention:
Should your job require you to be exposed to dangerous chemicals and radiation, take extra precautions by wearing
protective and appropriate clothing. The threat of contracting lymphoma can be reduced by avoiding the risk of HIV.
Patients infected with HIV are known to have a higher rate of lymphoma since they lack immune-system cells to fight
infections.
As for leukaemia, if you have/had a family member who is/was known to be suffering from the disease, go for genetic
testing and regular check-ups to spot the symptoms early.
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Liver Cancer
The liver is the largest organ in the body and is located in the right upper portion of the abdomen.
The liver performs many crucial functions. It is responsible for the removal of toxins from the human body,
regulation of metabolic functions such as fat digestion, storage of glucose as glycogen, protein synthesis or
breakdown, storage of blood, iron and some vitamins and many others.
In liver cancer, it is usually the cells of the liver that become cancerous. Liver cancer, or hepatoma,
affects males more than females and is a common disease in Asian countries. Statistics have reported that
the average age of an Asian patient with liver cancer is about 40 to 50 years.
Symptoms:
Most victims do not have any symptom. However some symptoms pertaining to the cancer are
apparent eventually. The most common are abdominal pain, unexplainable weight loss, loss
of appetite, tiredness, weakness and frequent fever.
In more advanced and grave cases, symptoms of jaundice may also appear. Jaundice is a
yellowing discolouration of the skin and eyes.
Causes:
Experts have reported that Hepatitis B carriers have a much higher risk of developing
liver cancer than non-carriers. The Hepatitis B virus can be transmitted either from an
expectant mother to her child or through sexual relations with an infected partner.
Finally, ingestion of foodstuff containing aflatoxins could also lead to liver cancer.
Aflatoxins are toxins which come from a mould which grow on grains and cereals in hot humid
conditions, especially when stored in wet areas.
Treatment:
Early diagnosis in liver cancer has a direct impact on prognosis which end stage liver
cancer patients usually succumb in 3-4 months; treated patients may live 6 to 18 months.
Some of the treatment options of the cancer are discussed below:
Surgery (Surgical resection): Surgery depends on the size and location of the liver cancer, and the
viability of the remaining portion of the liver. Since liver cancer normally arises on the background of
prior Hepatitis B infection and alcohol-related liver damage, sometimes surgery is not possible even if
the cancer is small and operable. This is because removal of the part of the liver bearing the cancer
leaves too little functional liver to maintain life.
Ethanol Injection: Ethanol is injected into the centre of the tumour through the skin. The
alcohol causes cells to dry out and cellular protein to break up, resulting in the death of the tumour cells.
This method can be beneficial as it is highly toxic to liver tumours and has been proven to increase the chance
of survival of up to 70%. This treatment is highly recommended to patients who refuse surgery or who have severe
liver disease that prevents them from having liver surgery.
Chemotherapy and Radiotherapy: Although these two modalities of treatment act as options in managing liver
cancer, they both have proven to be less effective. Moreover, the side effects further weaken the patient.
Liver Transplantation: This treatment may at times not be a guaranteed cure for patients as past cases
have shown that chances of a recurrence are substantially high. However, liver transplantation has been proven
to be a more effective treatment in patients with small hepatocellular cancers.
Prevention:
Regular check-ups and screening for Hepatitis B virus are crucial. Certain anti-viral drugs are known to be
effective in reducing the amount of virus in the carrier and possibly reducing the chance of developing liver
cancer.
Positive Hepatitis B carriers should also refrain from donating blood. Immunisation against Hepatitis B is a
valuable preventive tool. This involves 3 injections over a 6 month period and provides immunity for at least
5 years.
Alcohol consumption should be taken in moderation in order to reduce the likelihood of liver cancer.
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Lymphoma
Lymphoma is a cancer of the immune system that includes tumour of a type of white blood cell called
lymphocyte and Hodgkin's disease. Lymphoid tissues are important because they are composed of several
types of immune-system cells that work together to resist infections and diseases. Once when these
individual cells come together to form a bigger group of cells in a gland, it is called lymph node.
Although lymphomas usually begin in a lymph node, it also can originate in the stomach, intestines,
skin or any other organ that contains lymphoid tissue. Lymph nodes are found anywhere in the body,
particularly in the neck, armpits, groin, above the heart and around the big blood vessels inside
the abdomen.
It has been proven that men are at a higher risk of getting lymphomas. The disease is uncommon
among younger men and is often developed after the age of 50.
There are two main types of lymphoma. They are Hodgkin's disease and non-Hodgkin's lymphoma.
Hodgkin's Disease: Hodgkin's disease is characterised by a specific type of abnormal cell called
the Reed-Sternberg cell. This type of cancer can spread throughout the lymphatic system, affecting any
organ or lymph tissue in the body. Hodgkin's disease commonly affects people in their late 20s or older
than 50.
Non-Hodgkin's Lymphoma: Most blood cancers are non-Hodgkin's lymphomas. There are many types of
non-Hodgkin's lymphomas. Non-Hodgkin's lymphomas are more common in the age group of 60 - 70.
Different types of lymphoma occur in different age groups:
In adulthood: Adult non-Hodgkin's lymphoma is classified by the size, shape and arrangement
of the cancer cells in the lymph node. The appearance will determine the type of non-Hodgkin's lymphoma.
The degree or seriousness of the disease is broken into three types (grades) - low-grade (slower-growing),
intermediate grade and high-grade (aggressive). These grades are crucial in determining the treatment
options to treat the cancer.
In childhood: Childhood non-Hodgkin's lymphomas include lymphoblastic lymphoma, large cell lymphoma
and small non-cleaved cell lymphoma (including Burkitt's and non-Burkitt's lymphomas).
Symptoms:
The most common symptom that is often associated with lymphoma is lymph node swelling. A painless swelling
initially surfaces in the early stages of the cancer. This swelling may persist or increase in size. The most
common affected areas would be the neck, armpits or groin.
Apart from lumps and swellings, constant fever, sudden weight loss, itchy skin or rashes, night sweats
and abdominal pain are also indications of the disease.
There is no specific cause for lymphomas. However, it has been closely linked to several factors - 1)
environmental influences, 2) genetic factors and 3) viral infections.
Environmental influences may take the form of extreme exposure to certain chemicals like herbicides and
insecticides. Certain inherited immune-deficiency disorders that may be present from birth such as Wiskott-Aldrich
syndrome have been blamed for the cause of genetic factors that result in lymphomas.
On the other hand, viral infections such as the Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV)
have been associated with lymphomas.
Treatment:
Hodgkin's Disease can only be treated with radiation therapy using high-energy X-rays to kill lymphoma cells
in the affected area(s). This procedure may also be combined with chemotherapy.
Treatment for non-Hodgkin's lymphoma, can vary. The treatment is based on the degree of grade of the disease.
Early stage and low-grade (slow-growing) lymphoma can be treated with radiation therapy and sometimes just simple
observation is enough.
In contrast, intermediate-grade lymphoma may be treated with chemotherapy. The drugs are either injected directly
into the bloodstream or swallowed as pills. Each course of treatment is given at regulated intervals to kill cancer
cells and allow the body to recover. The drugs circulate throughout the body and will reach cancer cells even when
they are widespread.
Patients who are suffering from the more advanced stages and high-grade (aggressive) lymphomas will require a higher
dosage of chemotherapy. However, the high dosage has its own side effects. Too much of it may kill healthy bone marrow
that produces white and red blood cells and platelets (cells that prevent bleeding).
Therefore, to assist patients tolerate the high dosage of chemotherapy treatment, stem cells or bone marrow from the
patient or donor are collected beforehand. After a patient has received the chemotherapy, the stem cells or bone marrow
are returned to the patient through a drip in a vein.
In addition to the above treatment methods, another option for treating lymphomas would be biological therapy.
This procedure uses products such as immunoglobulin that boost the body's own immune system to fight cancer.
This therapy may be used alone or combined with chemotherapy.
In conclusion, the type of treatment sought or used depends very much on the stage, and grade of the lymphoma
when diagnosed and the age and health of the patient. Usually, doctors will advise their patients on the various
treatment options that are the most beneficial and appropriate whilst considering the factors mentioned above.
Prevention:
In some occupations where exposure to some toxins and chemicals which are known to cause lymphomas are possible,
one should be properly attired and guarded from these chemicals, so as to decrease the risk of developing the disease.
Since HIV / AIDS carriers are also related to lymphomas, one should be aware of the importance of safe sex and should
stay away from drugs, as far as possible. Since HIV / AIDS carriers are also related to lymphomas, one should be aware
of the importance of safe sex and should stay away from drugs, as far as possible.
Lastly, regular visits to the family doctor helps in detecting any sign or symptom that may eventually lead to the cancer.
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Ovarian Cancers
There are several types of ovarian cancers. The most common type, the epithelial carcinoma that begins from the
surface of the ovary is discussed here.
Are you at risk?
The cause of cancer of the ovary is unknown. However, studies show that certain factors may increase
the chance of developing this disease.
- If you have first degree relatives (mother, daughter, sister) who have had ovarian cancer.
- The risk of developing ovarian cancer increases with age with highest incidence in those over 60.
- If you have never had children. The more children you have, the lesser your risk is.
- If you have had a history of cancer of the breast or colon.
There are also some studies that suggest that you may also be at increased risk if you have
used fertility drugs, used talc in genital areas for many years or use Hormone Replacement
Therapy (HRT).
Symptoms:
Ovarian cancer is the most lethal of gynaecological cancers because it is often silent and
difficult to detect. There is no early detection method, so you must be vigilant and take note
of persistent warning signs seriously. If you are having some of the following symptoms persisting
for more than a week or so, see your doctor.
- Loss of appetite/loss of weight.
- Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling.
- Swelling in the abdomen, unexplained weight gain.
- Pelvic or abdominal pain or discomfort, and/or feeling of fullness.
- Backache.
- Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection.
- Unexplained or changes in bowel habits.
- Abnormal vaginal bleeding, although this is rare.
If you do have any of the above symptoms you must have them checked by your doctor.
Remember, they are common to many other conditions and most women with these symptoms
will not have cancer.
Diagnosis: How does the doctor make the diagnosis?
If you are at risk of ovarian cancer, see your gynaecologist regularly. A recto-vaginal bimanual
pelvic exam, Pap smear, blood test for CA-125 and a transvaginal ultrasound will be done. Otherwise,
see your family doctor (general practitioner) who will evaluate your medical history, examine you and
arrange for you to have any further tests (usually ultrasound scans and/or blood tests). Your general
practitioner may need to refer you to the hospital for these tests and for specialist advice and treatment.
Treatment: What types of treatment are used?
Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease)
and the general health of the patient. Surgery, chemotherapy and various types of radiotherapy may be used alone,
or in combination to treat ovarian cancer.
Surgery: Surgery is normally the first treatment for ovarian cancer, and may sometimes also be needed to
make the diagnosis. If the cancer detected is in the early stages, surgery is all the treatment that may be required.
The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum (thin tissue covering the stomach
and intestines) and lymph nodes (small organs located along the channels of the lymphatic system) in the abdomen are
often removed too. If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be
applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.
Chemotherapy: Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery,
to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be
applied before surgery is carried out.
Radiotherapy: Radiotherapy is less commonly used in ovarian cancer but may sometimes be used to treat individual
spots of cancer that have recurred after surgery and chemotherapy.
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Cataract: What is a cataract?
A cataract is a clouding of the lens of the eye. The lens is located behind the pupil in the centre of the eye.
The lens focuses light onto the retina at the back of the eye, much like a camera lens focusses light onto a film.
If the lens becomes cloudy, light to the retina is reduced, hence causing vision to be blurred.
What causes cataracts?
Research has shown that a few factors may lead to the formation of cataracts. They include:
- Age: Most cataracts are related to ageing. This is the most common cause and it is part
of the natural ageing process, although not everyone will develop cataracts.
- Congenital factors: Some babies are born with cataracts or develop them in childhood, often in
both eyes. These cataracts may not affect vision. If they do, they may need to be removed.
- Health problems: Cataracts are more likely to develop in people who have certain health problems,
such as diabetes. Cataracts are sometimes also linked to steroid use.
- Eye injury: Cataracts can develop soon after an eye injury, or several years later.
What are the signs and symptoms of cataracts?
The most common symptoms of a cataract are:
- Cloudy or blurry vision.
- Problems with light. These can include headlights that seem too bright at night; glare
from lamps or very bright sunlight, or a halo around lights.
- Colours that seem faded.
- Poor night vision.
- Double or multiple vision, although this symptom often goes away as the cataract grows.
- Frequent changes in your eyeglasses or contact lenses.
When a cataract is small, you may not notice any change in your vision. Cataracts tend to grow slowly,
so vision worsens gradually. To detect a cataract, an eye care professional has to examine the lens.
A comprehensive eye examination usually includes the following:
Visual acuity test: This eye chart test measures how well you see at various distances.
Pupil dilation: The pupil is widened with eye-drops to allow your eye care professional to see more
of the lens and retina and look for other eye problems.
Tonometry: This is a test to measure fluid pressure inside the eye. Increased pressure may be a sign of
glaucoma. Your eye care professional may also do other tests to learn more about the structure and health of your eye.
How can cataracts be treated?
In the early stages of cataract, vision may be improved using eyeglasses, magnifying lenses, or stronger lighting.
If these measures do not help, surgery is the only effective treatment. Surgery involves the removal of the cloudy
lens and replacing it with a substitute lens.
A cataract needs to be removed only when vision loss interferes with everyday activities, such as driving, reading,
or watching TV. An eye care professional would be able to advise if a removal is necessary based on the seriousness
of the cataract.
How are cataracts removed?
Cataracts can be removed in two ways, depending on the advice of the eye professional:
Small Incision Cataract Surgery or Phacoemulsification: A small slit is made on the side of the cornea,
which is the clear, dome-shaped surface that covers the front of the eye. A tiny probe is then inserted into
the eye. This device gives out ultrasound waves that soften and break up the cloudy centre of the lens so it
can be removed by suction. This method is one of the most commonly used surgeries.
Extracapsular surgery: A slightly longer incision is made on the side of the cornea to remove the hard
centre of the lens. The remainder of the lens is then removed by suction. In most cataract surgeries, the
removed lens is replaced by an intraocular lens (IOL).
An IOL is a clear, artificial lens and becomes a permanent part of your eye. With an IOL, your vision will
improve because light will be able to pass through it to the retina. People who may have problems during
surgery or who have other eye diseases cannot have an IOL. They may be given soft contact lens or glasses
to provide powerful magnification instead.
Can cataracts be prevented?
There is no sure way to prevent the formation of cataracts. However, since people aged 60 and above are at
risk for many vision problems, regular eye examinations through dilated pupils conducted at least once every
two years should help to detect early signs of age-related macular degeneration, glaucoma, cataracts, and other
vision disorders.
Can cataracts be prevented?
Sometimes part of the natural lens that is not removed during cataract surgery becomes cloudy and may blur
your vision. This is called an after-cataract. An after-cataract can develop several months or several years
later. Unlike a cataract, an after-cataract is treated with a laser. Using a technique called YAG laser capsulotomy,
a laser beam is used to make a tiny hole in the lens to let light pass through. This is a painless outpatient procedure.
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Cerebral Palsy
A group of disorders characterised by loss of motor functions or any other nerve functions. These disorders are caused
by brain damage that occurs during foetal development or near the time of birth.
Symptoms:
The symptoms of CP vary from just mild clumsiness to extensive uncontrolled muscle spasticity. Many with cerebral palsy
have other disabilities as well, such as seizures, an inability to see, hear, speak or learn as others do, or psychological
or behavioural problems. Not everyone with CP is retarded, some are of average intelligence. While some people with CP have
learning disabilities many others with CP do not.
Early signs would appear before the age of 3. Babies with CP are usually slow to reach developmental milestones. Abilities
like learning to roll over, sit, crawl, smile or walk are not well developed. The motor abilities will often seem unusual
and strange. There are four types of CP:
- Spastic CP, the most common type, is a disorder in which certain muscles are stiff and weak.
- Athetoid (dyskinetic, hypotonic, dystonia) CP involuntary movements are present.
- Ataxic CP occurs when the Cerebellum has been damaged, thus causing lack of coordination and jerky movements.
This form of CP have staggered or fragmented movements often involving tremors or exaggerated posturing (athetosis)
and bizarre twisting motions.
- Mixed CP is when two or more types of CP are present in the same person.
Treatment:
CP is a lifelong condition that cannot be cured. The treatment is aimed at maintaining or improving the quality of
life, providing the sufferer with tools to enjoy a near-normal life. There are basically three types of treatment
for Cerebral Palsy:
Surgery can be used to correct muscle contractures - removal of tight contractures that inhibits proper
movement of the limbs.
Drugs such as clonazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic
medications can help to control abnormal movements. Alcohol or botulinum toxin type A (Botox) injections into
muscle may be used to reduce spasticity for a short time so health care providers can work to lengthen a muscle.
An IOL is a clear, artificial lens and becomes a permanent part of your eye. With an IOL, your vision will improve because
light will be able to pass through it to the retina. People who may have problems during surgery or who have other eye
diseases cannot have an IOL. They may be given soft contact lens or glasses to provide powerful magnification instead.
Adjunctive therapies include:
- Physical Therapy, the most common treatment for cerebral palsy, consists of special exercises designed to
increase and improve the range of movement and strength of the muscle groups, is aimed at strengthening and
stretching muscles and preventing spasticity as well as increasing muscle control.
- Occupational therapy is designed to help the child develop the fine motor skills needed to function day-to-day at home and school.
- Speech therapy will also help the child develop communication skills.
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Chickenpox
Chickenpox is a highly infectious disease caused by the Varicella virus, a member of the herpes virus family.
It is one of the most commonly reported childhood diseases, characterised by raised body temperature and red,
itchy spots on body and face.
What are the signs and symptoms of chickenpox?
An infected person usually has a slightly raised temperature, together with red spots, mainly on the body and face.
The spots appear over a few days and progress from being red spots to blisters which eventually burst, dry and crusty
before healing. These spots usually cause itch and will leave scars when scratched.
Other symptoms:
- Signs of skin infection such as sores becoming more red, swollen, or tender, pus or red streaks around a sore.
- Signs of dehydration such as decreasing urination, increasing drowsiness, dry mouth and lips, and/or excessive thirst.
- Behaviour changes such as confusion, irritability, excessive drowsiness, difficulty waking a child up, hallucinations.
- Severe headache, stiff neck, and/or back pain.
- Frequent vomiting.
- Refusal to drink fluids.
- Breathing difficulty, fast breathing, chest pain, wheezing, worsening cough.
- Fever lasting more than four days.
- Redness of the eye, pain in eye, or change in vision.
While chickenpox is common and harmless to most people, it may have adverse impact on those whose immune systems
are impaired (e.g. newborns and persons who are on chemotherapy for cancer, persons with AIDS, or persons who take
steroids like cortisone or prednisone). People with impaired immune systems may experience severe disease or even
death.
Chickenpox can also cause more severe health problems in pregnant women, causing stillbirths or birth defects, and
can spread to their babies during childbirth. Occasionally chickenpox can cause serious, life-threatening illnesses,
such as encephalitis or pneumonia, especially in adults.
How does one get infected by chickenpox?
Chickenpox is highly contagious and it spreads from person to person by direct contact, or by droplet or airborne
discharges from an infected person's nose and throat or indirectly through articles freshly soiled by discharges from
the infected person's cuts. The scabs themselves are not considered infectious.
One can get chickenpox within 10 to 21 days after contact with an infected person. An infected person is usually
infectious one or two days before the rash appears till about a week later when the spots have stopped forming and are
dried, and when the body temperature has fallen back to normal.
Once you have had chickenpox, you are immune to the disease and are very unlikely to catch it again. The virus particles
remain dormant in your nervous system, however, and can, at a later stage, cause shingles.
How can chickenpox be treated?
In healthy children, chickenpox is usually a mild disease. Treatment is directed at reducing the itch and discomfort.
Children with chickenpox should not receive aspirin because of the possibility of causing a complication called Reye syndrome,
an acute brain disease and fatty infiltration of the liver.
Can chickenpox be prevented?
Chickenpox can be prevented through the use of vaccination. Varicella vaccine is highly effective in protecting against
severe chickenpox. It is recommended that all children be routinely vaccinated at 12-18 months of age and that all susceptible
children receive the vaccine before their 13th birthday.
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Cholera
Cholera is caused by the bacteria Vibrio cholerae. It is a severe form of watery diarrhoea. The dehydration it causes
has been fatal for many people living in poor hygienic conditions. The poor sanitation allows the bacteria to thrive
and spread rapidly, contaminating water supplies and causing epidemics.
Symptoms:
Symptoms include:
- A sudden onset of watery diarrhoea, up to 1 litre per hour.
The diarrhoea has a "rice water" appearance and a "fishy" odour.
- Dehydration.
- Lethargy.
- Unusual sleepiness or tiredness.
- Low urine output.
- Sunken "soft spots" (fontanelles) of the skull in infants.
- Rapid pulse.
- Dry skin.
- Dry mucus membranes or dry mouth.
- Excessive thirst.
- "Glassy" and sunken eyes.
- No tears.
- Abdominal cramps
- Nausea and vomiting.
Treatment:
The aim of the treatment is to replace the lost fluids quickly and adequately. Rehydration therapy consists
of a special rehydration formula. The drinks include rice or other grains as their base and are fortified with
oral-rehydration salts, such as sodium, potassium and other nutrients.
Intravenous fluid replacements may be necessary for ill or unconscious patients. Antibiotics may be prescribed
to combat the bacteria growth. Such antibiotics include tetracycline, doxycycline or ciprofloxacin.
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Cold
One of the most common infections contracted by humans; it is characterised by inflammation of the
mucous membranes, with sneezing, sore throat, and coughing.
Colds are typically viral infections of the upper respiratory tract. Over 200 different viruses can
cause a cold. Some of the common viruses include: rhinovirus, respiratory syncytial virus (RSV), corona
virus, para-influenza and influenza.
Symptoms:
Symptoms include:
- Muscle aches.
- Headache.
- Fever low grade.
- Runny nose.
- Cough.
- Nasal congestion.
- Sneezing.
- Sore throat.
Note: Symptoms usually last less than two weeks.
Treatment:
A cold usually runs its course without complications in one to two weeks. Because there is no cure,
treatment is aim at relieving symptoms. The aim is to allow the body to rest adequately for quicker
recovery.
In addition, there must be increased fluid intake to keep the mucus membranes moist to allow infected
mucus to flow better. With a fever, aches and pains, paracetamol can be given to relieve symptoms. Decongestant
sprays can relieve block nose temporarily, but should not be used for more than three days.
Longer use can lead to rebound congestion with more symptoms of congestion. Oral (tablet or syrup) decongestants
may also relieve nasal symptoms. Antihistamines may be of some benefit in reducing mucus production. Antibiotics
and vitamin C are not helpful in relieving symptoms of the common cold.
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Conjunctivitis
Conjunctivitis is an inflammation of conjunctiva - the membrane that covers the eye and lines the inner surface of
the eyelid. The three most common types of conjunctivitis are: viral, allergic, and bacterial. Each requires different
treatments. Other than the allergic type, conjunctivitis is typically contagious.
What are the signs and symptoms of conjunctivitis?
Various combinations of the following symptoms may be present in cases of conjunctivitis:
- Itching eye.
- Redness in eye.
- Photophobia (sensitivity to light).
- Swelling of the lids and/or discharge from the eyes.
The consistency of possible discharge may range from watery
to purulent (pus-like), depending on the specific cause of the
conjunctivitis.
What causes conjunctivitis?
Conjunctivitis is often caused by viruses. It can also be caused by bacterial infections, allergies, chemicals,
irritation from contact lenses or pollutants, as well as eye injury. Viral and bacterial conjunctivitis are
very contagious.
Bacterial or viral infections: These may occur when micro organisms are introduced or transmitted into the
eye through contaminated hands, the use of washcloths or towels, cosmetics, use of false eyelashes or through
the extended usage of contact lenses.
It is also quite common for a minor conjunctivitis to accompany a viral cold or flu. Although bacterial
infections and some of viral infections, particularly herpes, are not very common, they are potentially
serious. Both types of infection are contagious.
Treatment:
These are some of the steps you should take in the treatment of conjunctivitis:
- Apply a cool compress to the infected eye or eyes about three to four times a day for
10-15 minutes. Make sure you use a clean washcloth or towel each time. This should help
to reduce itching and swelling and alleviate some of the discomfort.
- Wash your hands frequently and be sure to keep them away from your eyes in order to
reduce or prevent recontamination.
- Avoid rubbing your eyes. This may contribute to the spread of the infection and increase
the irritation.
- Wear sunglasses if your eyes are sensitive to the light.
- Avoid exposure to the irritants that may be causing the conjunctivitis.
- Dispose of old eye makeup if the culture for bacteria, taken by the doctor, turns out to be positive.
- Change your pillowcase each night. Alternatively, you can change your pillowcase every other
day and turn it over nightly.
- Avoid wearing contact lenses while you are using medication on your eyes, or if you
feel discomfort in the eyes. Clean your contact lenses thoroughly before you begin
using them again.
Can conjunctivitis be prevented?
Although many kinds of conjunctivitis are hard to prevent, you can take some measures to decrease
the risk of recontamination or spreading it to someone else. Here are some measures you can take to
prevent recontamination :
- Do not share eye makeup or cosmetics of any kind with someone else.
- As far as possible, avoid sharing washcloths or towels.
- Wash your hands frequently and keep them away from the eyes.
- Wear protective goggles when you go swimming or when you have to work
in a place that is exposed to chemicals that may irritate the eyes.
- Do not use medication, such eye drops, ointment, etc., which have not been
prescribed for you. Someone else's prescription is not be suitable for you.
- Avoid swimming in stagnant lakes or ponds.
- Do not save remaining medication for future use. Dispose of expired medication.
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Constipation
Constipation is a relative term. There is wide variability in what is considered normal
patterns of bowel elimination. While some healthy people may have consistently soft or
near runny stools others may have consistently hard firm stools but no difficulty in
passing them.
When the stool is hard, infrequent, and requires significant effort to pass, the person
has constipation. Constipation may cause discomfort with passage of stools, and passage
of large calibre stools may tear the mucosal membrane of the anus, especially in children,
causing bleeding and the possibility of an anal fissure.
Constipation can be caused by changes in diet, decrease in physical activity, lack of
toilet facilities, behaviour and psychological problems, dehydration, diseases of the bowel,
neurological diseases, congenital diseases, medications, and many other causes.
Symptoms:
- Hard, compacted stools that are difficult or painful to pass.
- No bowel movements in three days for adults, four days for children.
What causes conjunctivitis?
Conjunctivitis is often caused by viruses. It can also be caused by bacterial
infections, allergies, chemicals, irritation from contact lenses or pollutants,
as well as eye injury. Viral and bacterial conjunctivitis are very contagious.
Treatment:
Treat underlying disease:
- Stop constipating drugs and strong laxatives.
- Encourage a high fibre diet and adequate fluid intake.
- Improve bowel habits i.e. do not delay the urge to pass motion.
- Encourage physical activities for the sedentary.
Diet:
Dietary measures such as increasing fibre intake from whole-wheat grains; fresh fruits, vegetables
and bran may help add bulk to the stool, thus promoting normal bowel movements. Special efforts
should be made toward increasing the daily intake of fluids.
Exercise:
Regular exercise is also very important in establishing regular bowel movements. People who are
confined to a wheelchair or bed should be taught to change position frequently and perform abdominal
contraction exercises and leg raises. A physical therapist can recommend a programme of appropriate
exercises.
Medications:
Stool softeners such as ducosate, may be recommended to aid in the passage of soft, formed stools.
Additionally, bulk laxatives, such as Metmucil, may be used to add fluid and bulk to the stool,
thus promoting soft, moist, formed stools. Suppositories or gentle laxatives may be used in conjunction
with a bowel-retraining program to establish a pattern of regular, bowel movements.
However, enemas or laxatives (such as milk of magnesia) should be reserved for severe cases only-laxatives
should not be used over a long period of time because laxative dependence may occur.
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