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Retroversion

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Because of the mobility of the pelvic organs, and the fact that they are subjected to pressure from above during such actions as sneezing, coughing, straining, or even breathing, certain mechanical results can take place that are peculiar to this particular area. This is accentuated by the presence of the vaginal canal, which really represents an opening in the pelvic floor.

Some doctors liken this situation to other parts of the body where apertures exist and internal contents can be forced through the lightly covered orifices. This is the basic pathology of hernias, whether they be about the navel region (as in babies), or lower down in the inguinal (groin) region in adults.

The more common uterine displacements will be discussed. After this, a short word will be given over to the urinary tract that forms part of the pelvic cavity, for this is very significant, and is a well-known cause of trouble to many women.

The uterus is normally positioned pointing upwards and forwards. The cervical (neck) portion forms the upper part of the vaginal canal. From here, the body of the womb wells up into the pelvic cavity, tilting toward the front of the body. This is referred to as the normal anteverted position.

It is held in this position by a variety of anatomical bands and ligaments. It tends to remain in this position throughout life.

It is often believed that this position is significant. Under conditions of normal copulation, with the female partner lying on her back, and with the male uppermost. the seminal pool following ejaculation will be placed automatically in such a way that the cervix is bathed in it while the female remains in this position. It is essential that the sperms have ready and prompt access to the cervical canal. The entire mechanics of a uterus located in the way described will ensure maximum possibility for a pregnancy to result, provided the timing of the menstrual cycle is correct.

In some cases of infertility, the uterus is in the opposite position. It tilts backwards, and is described as being retroverted. At this time, if a similar position is used during intercourse, the cervical canal could be some distance away from the vital seminal pool. Fertilisation may thus become difficult or even impossible.

This of course assumes that the male uppermost position is being used. If other positions are utilised at a time when pregnancy is desired, then other mechanical problems may arise.

In recent times, many gynaecologists have studied the problem of retroversion. Once it was claimed to play a significant part not only in infertility, but was blamed for many other gynaecological symptoms. These ranged from backache, and pelvic pain, to abortion.

Many now believe that the uterus is a very mobile organ, and rarely plays much part in producing symptoms. However, fairly simple tests can be carried out to see if the apparent misplacement is really producing the symptoms claimed. It may be necessary to make further investigations.

In years past, innumerable surgical operations were carried out to correct retroversion. Many complex arrangements were entered into. The uterus was dragged from its backward tilt and forced to point forwards. In retrospect, it is not known just how much good these operations accomplished. Undoubtedly they had their part and assisted many women. But, some modern-thinking gynaecologists now claim that the effect was probably more in their minds (both the patients’ as well as the doctors’) than in the pelvis.

Be that as it may, it still holds a place in gynaecological practice. Often when there is not much else to do, it seems to be a potent factor in assisting couples with infertility problems.

Cogenital Abnormality

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Blanket advice is now given to women: No drugs of any description should be taken during the first three months of pregnancy unless on the specific instructions of the doctor. This includes everything, even simple aspirin. Drugs can have a very adverse effect on the developing infant at the time when the vital organs are being formed, which is during the first 12 weeks. Intending mothers must adhere to this advice to avoid problems later on.

However, there are many other things that can produce anomalies during pregnancy. It is well-known that rubella (German measles) can produce outstanding fetal disorders of development. Therefore, any pregnant woman contacting or contracting rubella must seek immediate professional advice.

Tests will show if she is safe or vulnerable. Today, legal termination of pregnancy is often recommended if the baby is obviously at risk.

Other viral infections in early pregnancy are possible producers of fetal problems. The mother-to-be should make every attempt to keep free from infections during the vital early weeks. Smoking in pregnancy is well-known to produce problems in the newborn.

Smoking should be given up entirely during pregnancy and preferably in the months following confinement. Best of all, give it up altogether.

Alcohol is also a severe cause of congenital abnormalities and should not be taken during pregnancy. The fetal alcohol syndrome (FAS) is a potent cause of mental retardation, physical defects and premature death.

If abnormalities still occur and a child is born with some disability, much can now be offered in the expert centers in the major capital cities. The family doctor is a valuable guide in these cases.

Foreign Bodies in the Nose

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Any chronically discharging or unpleasant-smelling nose should be carefully inspected (ideally by the doctor) for a deeply placed foreign body. It’s a fairly common childhood problem. The symptoms may mimic a common cold, but it usually persists.

One investigation not long ago indicated children had stuffed bits of tightly rolled-up cotton into their noses, causing a persisting, vile, pus-filled discharge. Removal of the debris rapidly resulted in a magical cure.

Foreign Bodies in the Nose Treatment

Any persisting nasal discharge requires a proper examination, both from the front, as well as from the far end of the nasal passages. Often this is in the realm of the specialist who has the equipment for such examinations. It also needs special devices to remove. Sometimes hospital and a general anesthetic may be necessary, particularly with deeply placed debris.

Children are the worst offenders, and it is amazing the nature and variety of objects they will poke into the nasal canals. Pieces of gravel, bits of plastic toys, peanuts, peas and beans, bits of Indian-rubber, they have all found their way there.

When practicing in a country town some years ago, a patient complained of a “big white worm” in his nose. This moved with breathing or any facial movement. It proved to be several grains of wheat poked into the nostril several days beforehand. These had subsequently absorbed moisture and germinated. The “worm” was the growing wheat grain, which naturally started to protrude from the nostril and moved along with normal facial movements.

The prompt removal of the foreign body brought great relief to the patient and his parents who believed lie was being internally devoured by some foul monster.

Foreign Bodies in the Nose Symptoms

These usually include nasal obstruction on one side, together with a foul-smelling discharge that often contains pus. There may be a known history of having inserted a foreign body, but children may be afraid to admit this.

In adults, the symptoms are the same but there may also be a history of previous nasal difficulties, such as nosebleed and nasal gauze packing. It is possible for bits of gauze to have remained, and slowly become calcified forming larger bodies (rhinoliths) that suddenly produce obstruction.

Glands

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Located at the base of the brain in a little bony cavity is the pituitary gland. It’s connected to the brain by a stalk called the hypothalamus. Collectively these organs produce many vital chemicals. They in turn influence the activity of all the other hormones in the body and for this reason have often been referred to as “the captain of the ship.”

In the neck, near the prominence in adults called the “Adam’s apple,” is the thyroid gland. This consists of two largish lobes, one on either side of the trachea or windpipe. These are joined at the front by a narrow band of tissue called the isthmus

It also produces a potent hormone called thyroxin. Too little or too much can, once again produce extremely important symptoms. Sometimes it goes crazy, swells up and forms a major lump in the neck called a goiter. You’ve often heard and probably seen these weird swellings. They appear quite unattractive.

A largish gland in the lower part of the neck is called the thymus. This plays an important part in children, but with increasing age it reduces in size and by adulthood has often almost entirely vanished. It, too, produces various vital elements, usually of major importance to the growing child.

Pancreas is located snugly sitting in the abdominal cavity. Its main claim to fame is diabetes if the cells are underactive. A great number of people suffer from this disorder, so the gland may play a vital part in the lifestyle of the patient for an entire lifetime.

They are called the adrenals, and there is one sitting atop each kidney. If disease occurs here, it may be very serious. Fortunately these are rare.

Of course in the pelvic region we have the sex glands. These are naturally different in boys and girls.

That’s right. The ovaries are the sex organs of the female; the testes the male counterpart. Each plays a highly significant role in both development and the life of the individual.

Actually it is an inherited disorder of metabolism. A baby may be born with this defect. If it’s not diagnosed early and adequate therapy undertaken, baby may develop into a mental defective, with terribly adverse and sad results. But fortunately, amazing steps have been taken in Australia. Nearly every PKU baby receives adequate treatment starting soon after birth, so serious effects are now very uncommon.

Below the ears on each side are the large parotid glands. These, together with the submaxillary glands located under the jaw, produce saliva. At times they may become inflamed from viral or bacterial invasions. Excessive salivation may occur. On rare occasions the ducts conveying the saliva into the oral cavity may become blocked.

One of the most common sites for viral invasion is the parotid glands (and less commonly the submaxillary glands). The virus producing mumps has a predilection for these glands, and it is a common childhood infection.

There are many lymphatic glands located under the jaw, and around the head and neck. They are all part of the body’s general lymphatic system. They are protective in nature, and help produce cells and antibodies aimed at quelling infective forces that enter the system.

For this reason they often swell and become palpable and tender, particularly when any infection sets in. Thus, sore throats, upper respiratory tract infections (URTI) and ulcers are notorious for producing discomfort in these important glands.

However, never forget that the reaction is a protective one, and this will help you bear them more philosophically. Generally they subside some days after the infection has settled and been overcome.

Gland Disorders Symptoms

There is no do-it-yourself home doctoring in the diagnosis and initial treatment of these endocrine disorders. We mention symptoms merely to alert the mother that all is not well, and that medical attention is necessary.

In the first instance she should take the child to her own family doctor for a check. If the doctor feels there is some anomaly, the child may be referred to an endocrine specialist, or one of the large endocrine units at a major public hospital where they have the full facilities to diagnose and treat such cases. Some are rare and hard to diagnose. Others are easier, and treatment is straightforward, and may often be carried out at home by the parent.


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