Author Archives: Paula.KGS

Purpura

What is Purpura?

Purpura means there is a tendency for the skin to bruise. It’s more likely in children under the age of six years, and often there may have been a tendency to bruise easily with simple knocks. A large number of purpuras exist, and they have a strange variety of names. Basically, the cause is a fault with the clotting mechanism of the blood. This usually involves tiny particles called platelets, which are part of the solid phase of the blood. There may be too few, or the place where they are produced, in the bone marrow, may be diseased.

Sometimes the condition follows a few weeks after a simple infection, often a viral one, or germs collecting in the urinary tract or teeth. There may be bleeding into the skin causing bruising. It may come from the nose, gums or urinary system these are the most common areas. Sometimes bleeding may occur into the bowel or pints or even into the nervous system, hit these are more unlikely. The child may run a fever, appear pale, but this varies. When the blood is examined, there is usually a reduced number of platelets.

Purpura Treatment

It can be a worrying time, and treatment may be needed for many months, often up to six or eight. Blood transfusions are given to restore the platelet count to normal, and these may be repeated depending on the child’s reaction.

Any infection is treated. The child is given a nutritious diet, probably with added vitamins, and the steroid drugs are sometimes used. Every effort is made to avoid injuring the body, for this will aggravate the bruising and bleeding. Certain of the newer drugs may also be used. It depends on the case, and the opinion of the doctors treating it. In continuing cases despite treatment (probably after six to twelve months of active therapy), the spleen, the large organ in the upper abdomen is sometimes surgically removed.

In most cases the results are favourable often with or without treatment, the vast majority of people recover within six months, but some may take longer and cases have continued for three years or more. Occasionally a purpura is fatal, but usually not.

Lyme disease

Lyme disease is the most commonly known disease caused by tick bites in the Northern Hemisphere. Approximately 70,000 cases are reported in the United States on an annual basis. Also called Lyme Borreliosis, the condition is thought to be caused by at least three members of the Borrelia family (a family of bacteria with over 36 types that are transmitted mainly by the bites of infected ticks and some species of lice). The disease received it name from Lyme, Connecticut in the US after the discovery of multiply cases (in children) in 1975.

Symptoms Lyme disease

Early symptoms of Lyme disease include fever, fatigue, depression, headaches and circular rashes on the skin called erythema migrans. The rashes can appear anywhere between one day to a month after being bitten by an infected insect. Contrary to popular beliefs, the rash is not indicative of an allergic reaction but a bacterial infection. In the absence of treatment, symptoms could progress to complications of the joints, central nervous system and the heart.

If left untreated or treated at a late stage, more severe symptoms can develop that are not only hard to treat but can also be disabling. In some instances, arthritis caused by Lyme disease as well as some after symptoms may remain after treatment suggesting that Borrelia can lead to autoimmunity (a condition in which the body recognizes parts of itself as harmful, causing the immune system to fight the cells or tissues thought to be foreign agents).

Stage two of Lyme disease is characterized by paralysis of the facial nerves, stiffness of the neck, abnormal heart rhythm, numbness of the extremities and weakness. The incubation period for the final stage of the disease is 6 week to 2 years after the infected bite or bites.

It is possible for Lyme disease to go untreated because the symptoms are similar to many other conditions, the most obvious sign is the rash resulting from the bite which can appear within the first 48 hours after infection takes place. However, since the range of time runs for 24 hours to 1 month, this telltale sign can also appear at a late stage in the infection. Rashes can still be misinterpreted even if they appear early since many people will mistake them for allergic reactions.

The vagueness of the symptoms that characterize Lyme disease is not the only problem when diagnosing the infection. The disease is one that can prove rather evasive during testing. Unlike most viral infections, this condition cannot be easily spotted using tissue cultures and blood tests are only successful if certain antibodies are produced. Even in these cases, the antibodies may be undetectable or show up late in the disease’s development. It often takes an evaluation of a person’s medical history, symptoms and test results for Lyme disease to be suspected.

Treating Lyme disease

2 to 3 weeks of antibiotics like Amoxicillin or Tetracycline is often sufficient to treat early stages of the disease while a long period and more intense treatment is needed for advance stages.

Lawn Weed Control

The only place where weeds are acceptable is in a wildlife corner, although some people find daisies in the lawn a very attractive feature. Generally, however, weeds have to be controlled.
Any perennials that arise from small pieces of root left in the soil should be dug out, as should any suckers, and any seedlings should be hoed off.

It is inevitable that there will be some annual weeds appearing from time to time around plants, such as climbers, but, if these are removed before they set their seed, their numbers will gradually drop as the reserve of seed in the soil is used up.

There are two main weapons if you want to cut down on weeding: mulching, which uses no chemicals, and herbicides.

Killing weeds in beds and borders

Although there are herbicides that will kill some problem grasses growing among broad-leaved plants, generally you can’t use selective weed killers in beds and borders. Most herbicides will kill or damage whatever they come into contact with, but there are ways in which you can use herbicides around ornamental plants to minimize the amount of hand weeding necessary.

You may be able to treat areas in a shrub border with a watered-on weed-killer simply by shielding the cultivated plants. If deep-rooted perennials are not a problem you can use a contact weed killer that will act rather like a chemical hoe (a real hoe may be an easier alternative to mixing and applying a weed-killer if the area is small enough).

Deep-rooted perennial ‘problem’ weeds, such as bindweed, are best treated by painting on a trans-located weed-killer such as one based on glyphosate. Ordinary contact weed-killers may not kill all the roots, but this chemical is moved by the plant to all parts. Even so, you may have to treat really difficult weeds a number of times for long term eradication. Use a gel formulation to paint on where watering on the weed-killers may cause damage to adjacent ornamentals.

Mulching

Once the soil is clean, applying a mulch will do a great deal to help to keep weeds under control. It will not prevent perennial weeds that are already established from coming up but it will prevent any further germination from the seed in the soil. It will also reduce the amount of moisture lost to evaporation. A wide variety of materials can be used.
The main advantages of loose organic mulches are that they look attractive, can often be homemade (and are therefore inexpensive), and are gradually incorporated into the soil by the activity of worms, adding to the organic-matter content. It is important to top them up every year if they are to remain effective.

Inorganic mulches, such as black plastic and woven membranes, are less pleasing to the eye but provide a much more effective barrier against weeds. They are most useful in shrub beds that can be left undisturbed for some years, and are best used when the bed or border is newly planted. When using inorganic mulches, always prepare the ground as thoroughly as you would if not using a mulching sheet.
It is possible to use a combination of both types of mulch. Lay the artificial material, then cover it with an even layer of bark or gravel. This creates the best of both worlds, providing good protection against weeds and a pleasing appearance in the garden.

Weeds in lawns are best controlled by a selective hormone weed-killer, ideally applied in mid- or late spring. These are usually applied as a liquid, using a dribble bar attached to a watering-can. To ensure even application you should mark out lines with string, spacing them the width of the dribble bar apart.

Always mix and apply the weed-killer as recommended by the manufacturer. There are a number of different plant hormones used in those products, some killing certain weeds better than others, so always check that it is recommended for the weeds you most want to control. If your lawn also needs feeding, you can save time by using a combined weed and feed. The most efficient way to apply these — which are likely to be granular rather than liquid— is with a fertilizer spreader. Check with your local nursery, if unsure.
If you have just a few troublesome weeds in a small area, it is a waste of time and money treating the whole lawn. For this job, a spot weeder that you dab or wipe onto the offending weed will work well.

Mulching with grass cuttings

Grass cuttings are readily available in most gardens. They are not the most attractive form of mulch but can be used effectively at the back of borders, where they are not easily seen. Do not heap them on thicker than 5 cm/2 in or they may heat up too much as they decompose, harming the plant. Do not use cuttings from lawns that have recently been treated with a lawn herbicide which might harm the plant

WEEDING BY HAND

  1. The advantage of hand-weeding is that you can thoroughly check which weeds are present and can take more rigorous action if perennials are spotted. At the same time, it also enables you to spot any seedlings produced by plants that you may want to transplant or pot up.
  2. Hoeing is quicker than hand weeding and allows you to get round more frequently. It is very effective against annual weeds but chopping the top off a perennial does not kill it and it will soon re-emerge. Do not dig too deeply with the hoe or you may disturb the plant’s roots.

USING A LOOSE MULCH

First, prepare the ground thoroughly, digging it over and working in plenty of organic material such as rotted manure or garden compost if the soil is impoverished. Dig up deep-rooted perennial weeds, otherwise they could grow through.

Then water the ground thoroughly. Do not apply a mulch to dry ground. Finally, spread the mulch, such as the hark mulch shown here, thickly over the ground.

INSTALLING A SHEET MULCH

  1. Make a slit around the edge of the bed with a spade, and push the sheet into this. For a vegetable plot you can use special plastic pegs, but these are too conspicuous for an ornamental position.
  2. Make cross-shaped planting slits in the sheet with a knife or scissors. If planting a shrub you will probably have to make slits large enough to take a spade for planting. This won’t matter as the sheet can be folded back into place.
  3. Small plants can be planted with a trowel, but for shrubs you will need to use a spade. Provided the ground has been well prepared before the sheet was laid, it should be easy to dig out the planting hole.
  4. Although most of the sheer mulch will be hidden as the plants grow, it will be very conspicuous initially. A layer of a decorative mulch such as chipped-bark or gravel will make it much more acceptable.

Piles

What is Pile?

Piles are a common condition involving the rectum and adjacent tissues. However are several conditions involving the anus, the final part of the intestinal system, will be dealt with collectively, the first of these being hemorrhoids. These are common, and represent varicosity of the veins (i.e. varicose veins) in the lower bowel. Often there is an itch, irritation, burning or a discharge. Frequently they bleed, and this is often what prompts medical advice.

Large hemorrhoids may prolapse following a bowel action, and must be replaced manually into the bowel. They are common during pregnancy, but after the confinement most subside and give little further trouble. Sometimes a blood vessel actually ruptures and then clots, forming a very painful, acutely tender, swollen pile. This is often felt at the anal margin. Constipation and having to strain when undertaking a bowel action as well as prolonged sitting and anal infection are believed to aggravate them.

Piles can often be prevented by keeping the bowel actions regular and soft, and the current recommendation of a high-fiber diet (adding unprocessed bran and fiber to the daily diet) is often very effective. Many claim this may cause piles to subside and may reduce the need for surgery, even in severe cases.

Many types of treatment have been tried. Smaller piles that are producing symptoms are often injected with a sclerosing fluid that makes them shrink. Recently, anal dilation (Lord’s method) has been shown to be very effective without any cutting. Rubber-band ligation can be successful and done on an outpatient basis. A ligature is placed around the hemorrhoid at its base, and the pile gradually reduces in size.

Cryosurgery is also used, which involves the application of a frozen point. This may be used in conjunction with other methods. A thrombosed (clotted) external pile is usually treated by excision and removal of the clotted contents. This often affords remarkably prompt relief. Advanced hemorrhoids are frequently surgically removed, although the operation is far from pleasant. It takes quite a few days for the raw area to heal over and freedom from pain to be experienced once more.

Piles Treatment

It is completely wrong to imagine that any bleeding from the anus is due to hemorrhoids, unless proven by an adequate examination by the doctor. It is sometimes believed piles are the cause, when in fact it may be a more deep-seated cancer of the rectum. Any bleeding from the bowel must immediately be checked by the doctor and a proper bowel examination carried out, mainly to exclude the possibility of cancer.

Fissures occur when a break in the lining of the anal region takes place. It is common during constipation, when a small anal tear happens. Chronic fissures might develop and remain for some time, causing acute pain during a bowel action. There may be some spotting after an action as well as there may be a tendency to constipate from fear of the discomfort of bowel movement. A solitary pile (called a sentinel pile) may develop.

Correction of constipation is essential. Attention to diet, adding more roughage and fluid to the diet, and ideally using unprocessed bran each day will often assist both in recovery and checking recurrences. The local use of anesthetic creams and ointments often provides relief during normal, natural healing, but this should be purely temporary.

Fistulas, or abscesses, form about the anal entry, and a permanent narrow canal may form between the rectum and the area just near the anal opening. This may fill with pus and debris that discharges onto the skin, causing discomfort, itch and tenderness about the anus. Abscesses may recur regularly. Treatment and a final cure may be gained from surgery.

Pruritus Ani (Itching) is common, and many conditions may produce the persistent desire to scratch and rub the anus. Infections from organisms, worms, fungi; skin irritations from local applications or drugs, and many other causes abound. Medical attention is often necessary, first to pinpoint the cause if possible, and then treat whatever this happens to be. Often cold compresses give good symptomatic relief. Carefully cleansing the area completely and regularly is essential. Liquid paraffin cleansing is soothing and effective. Also the fluorinated steroid creams and ointments give excellent and prompt relief’. Anesthetic agents are frequently frowned upon, for they may aggravate the condition afterwards by producing added hypersensitive reactions.

Asthma

The term Asthma refers to a chronic inflammatory condition or disease affecting the airways. Symptoms of asthma include coughing, chest tightening and shortness of breath. Symptoms are often recurring and can vary. Besides those already listed, asthma is also characterized by airway obstruction and bronchospasms (constriction of the muscles in the bronchioles). The condition is also called Reactive Airway Disease. A part of the danger of the disease lies in the fact that it is impartial and can affect both large and small airways.

For an attack or episode to occur, the airways affected are forced to contract causing coughing or wheezing. It is not uncommon for both to occur. Persons affected by asthma can merely experience occasional annoyance while the condition can be disruptive for some. It can be frightening because symptoms may be severe enough to be life-threatening.

An approximated 10 percent of girls and 15 percent of boys will be affected at some stage in their lives. The disease is documented as the most common cause of hospitalization in children in the US annually. Children with asthma are likely to experience their first attack by the age of 1. Almost 90 percent will experience this by age five.

It is noted that in most instances a child who develops persistent or sever symptoms has a family history of either asthma or allergies. In these cases, signs of the disease may present themselves within the first year of the child’s life. It is possible to outgrow the condition. In fact, approximately half of all asthma patients will eventually stop exhibiting or suffering from their symptoms. This happens mainly because airways tend to get larger as children grow.

The dark side to asthma is that despite advances in the field of study, asthma-related deaths have increased over the years. This being the case, it is important to keep monitoring symptoms, noting any and all changes and act swiftly in the event that an attack or episode takes place. Patients may also suffer from other conditions like sinusitis and bronchitis, both of which can trigger wheezing. Other triggers include common allergens like dust, animal dander, pollen, air pollution, cockroaches and some food kinds.

Drastic changes in emotions and exercise (light or heavy depending on the severity of condition) can also trigger asthma attacks. It has also been discovered that some girls experience wheezing shortly before the onset on their menstrual period and some drugs; aspirin for example, can trigger wheezing so check with a doctor before taking any medication.

The airway constriction caused by asthma is reversible over time and with proper treatment. Rescue inhalers (some which contain steroids) are used during attacks to keep airways open. Treatment can be used outside of attacks to help prevent them. There are many types of inhalers and alternatives to inhalers so a physician should be able to find a suitable match.

Since inflammation and swelling may still exist even in the absence of the listed symptoms, the treatment chosen should address these since treating the manifested symptoms will only provide temporary relief.

Reproduction Cells

A point of major interest is that during manufacture, both the egg and the sperms undergo a special internal division. In this way, their genetic characteristics are affected.

Each cell normally contains 44 special bodies, called chromosomes, plus another special two called the sex chromosomes. These arc named either X or Y chromosomes. In the female, the sex chromosomes have an XX pattern. In the male, they have an XY pattern.

Just before their release, the reproductive cells split, and each then contains 22 chromosomes plus either an X or a Y sex one. When the sperm and ovum unite at conception, the numbers are once more made up to 44 plus two sex chromosomes. If the union produces an XX pattern, a female infant will be born. If it is an XY pattern, a male infant will be the result.

Along the length of the chromosomes are small bodies called gems. These are the heredity factors. Thus there will be a union of characteristics coming from both the male and female partner. The forthcoming infant will bear characteristics common to both parents.

The interesting fact is that all this is determined at the instant that conception occurs. Right at that climactic moment, the future of the infant is scaled forever. It is a momentous occasion, and one that will have far-reaching effects.

Much research on genetics has been done on a worldwide level. More will be done in the years immediately ahead. The tremendous significance of the chromosomes, genes, and inherited possibilities boggles the mind and imagination even of the researchers.

Now that you have briefly reviewed the normal pattern of anatomy and physiology (and looked at some of the illustrations that make it all so much simpler and easier to follow), it is time to investigate some of the ways in which all this happy picture can get off the correct track and produce problems.

That, really, is the crux of the study of gynaecology. But just as important, besides finding out what can go wrong, the key factor is to discover how to make it all right again.

This is really the way to make living happier and healthier, and give every woman the ultimate benefit and maximum enjoyment.

Last Day Before Holiday

Taking a holiday is all about relaxing, not about worrying that you have left the oven on, the door open or have forgotten to take out insurance cover.

Moving home, on the other hand, is considered to be one of the most stressful and exhausting experiences that we have to face. You can, however, make it less of an ordeal by ensuring that you are well-prepared before the day itself, to minimize the risk of anything going wrong.

Holiday preparations

Whether you will be travelling by air, sea or car, choose the best luggage that you can afford, as cheap suitcases will soon weaken. Tie round a coloured tape or buy straps with your name woven on them to help you to identify your luggage quickly at an airport. Never write your name and home address on luggage labels where they can easily be seen – anyone dishonest will instantly know where their next ‘job’ is to be.

Several weeks before you are due to travel, check that all passports are up to date and will not expire while you are away. You will also need to find out well in advance whether you need visas for the countries to which you will be travelling, and, if so, to organize them with the relevant authorities, which can take some time.
Take out holiday insurance and make sure that, in the event of having to cancel at the last moment, you will be given a refund.

Holidays in which sports are involved may require additional cover. Always check that, in the case of an accident, you will be flown back home: for long or specialist treatment. Check with your doctor whether any vaccinations or a course of tablets are required for the country or countries that you will be visiting.

Order some currency and arrange traveller’s cheques for the remainder of the money – this is both safer in case of loss or theft, and more convenient.

Lock ladders to a garage or shed wall so that would-be burglars cannot use them to gain entry to your home.

Mark all your valuables with an engraver and stencil or ultra-violet pen so that, in the event of a burglary while you are on holiday, the items can be identified should they be recovered. Many stolen items such as hi-fi (stereo) equipment are found by the police, but cannot be returned because of lack of identification.

Home security

Giving a little thought to security before you go on holiday will greatly reduce the chances of a burglary while you are away. Some of these suggestions may seem obvious, but it is surprising how often they are forgotten.

Ask a neighbour to call in every day to remove flyers and letters from the mat, as a pile of these is a good indication that you are away. Cancel milk and paper deliveries, as these can alert any passerby to the fact that no one is at home, if they are stacked upon the doorstep. Keeping house plants watered is also a good way of ensuring that the house looks occupied.

Fit door and window locks if you have not already done so (this may be a requirement of your insurance policy in any case, so you must do this or your policy could be invalidated in the event of a burglary). Padlock ladders to a wall and lock up the garden shed if you have one so that tools cannot be used by burglars to gain entry. Buy time switches to operate the television and some lights to give the impression that people are in the house.
Leaving washing up on the drainer and a couple of magazines scattered around will also make it look as if the house is occupied.

Travelling with children

Stop boredom from setting in by taking a selection of games and toys with you. Guessing games and stories also help to pass the time enjoyably. Acupressure wristbands and travel-sickness tablets are useful for long journeys. Another remedy is to eat crystallized (preserved) ginger, which prevents nausea.

TRAVEL KIT

This should include the following:

  • Sun-screen lotion.
  • After-Sun lotion.
  • Insect repellent.
  • Antiseptic wipes.
  • Sticking plasters and bandages.
  • Upset-stomach tablets or medicine.
  • Tweezers.
  • Thermometer.
  • Paracetamol or other pain-relief tablets for adults and children.
  • Dehydration packs for diarrhoea.

Calluses

What is Calluses?

Also called Callosity, a Callus is a piece of skin that has hardened due to repeated friction, contact, pressure or any irritation suffered by the area that becomes toughened. In humans, the condition commonly affects the feet because the source of irritation must be constant and often times the only thing on the human body that can facilitate this environment are shoes.

For friction that is excessively forceful or frequent, blisters are more likely to be formed. Generally, calluses are harmless causing only discomfort especially if the condition that fostered their development does not change (for example, continuing to wear the shoes that resulted in them). However, it is possible for them to lead to problems like infections and skin ulcerations. Often the term is paired with the word “Corn” because they tend to be yellow or of a yellowish color.

It is possible to develop calluses in the palms due to excessive use of instruments that squeeze or rub against them repeatedly. Persons in some professions are prone to calluses of the hands; musicians, athletes, chefs, cooks and persons who do excessive manual labor fall on that list. Calluses can appear anywhere on the body as long as the friction needed to thicken the skin is present.

Incorrect sizing of footwear as well as footwear made from hard material are the most common causes of calluses to the feet while tight or rough clothing can cause calluses on the body. Choosing the right footwear for daily activities and clothes that fit well and are not abrasive to the skin are key to avoiding these lesions.

Even when harmless, the condition can cause excruciating pain and discomfort. Also, ones daily life could be disrupted since difficulty walking or holding things may result from extreme cases. Besides pain, a burning sensation may be experienced.

Removing Calluses

To remove calluses, pare away the hardened layers (many people use razors), be careful when doing so since these can still bleed. It is recommended that calluses are soaked in warm water before paring to make the process easier and safer. Cuts to calluses can result in infections worsening both the condition and discomfort.

There are solutions made to soften or remove calluses that work to varying degrees (some do not work). Keratolytic Therapy can be used as well. These treatments thin the hardened skin and work best when applied both on and around the area. The outer layer then sheds as it loosens. Salicylic Acid is commonly used. As a home remedy, try 4 parts acetone with (up to) 15 parts collodion. Apply solution nightly and cover with an adhesive strip. Continue until callus disappears.

For a more organic approach, thoroughly wash then soak areas in warm water with 3 to 4 tablespoons of baking soda. After 30 minutes the dead skin should be removed or dissolved. Areas should be dried completely. Apply cornstarch to the area to keep it uninfected as well as dry. Tape a piece of vinegar-soaked cloth around the area before bed. Any dead skin present in the morning can be removed with a pumice stone.

Pituitary Disorders

It is possible for hormonal production of the pituitary gland to become abnormal. The main reason for this is when tumors (growths) commence to grow either in the gland or close by. These may produce two sets of irregularities. One will be an increased or decreased amount of hormones coming from the gland. The other will be mechanical disorders associated with a growing tumor pressing on surrounding structures. The most notable is the effect on vision, for the gland is very close to the optic nerves, and frequently visual disturbances are the first symptom the patient notices.

Tumors may be benign (noncancerous) or malignant (cancerous). The most common tumor found growing in the pituitary is called a Nonsecretory Chromophobe Adenoma. There is no need to try to remember the names, for these are mainly of academic importance. It is a noncancerous growth.

Other growths that may occur are those that can themselves secrete hormones. These include Eosinophil Adenomas (that may manufacture growth hormone), and others that may secrete ACTH. Other tumors may occur in this region, and some may be cancerous, most frequently being “secondary” deposits from a primary source in some other part of the body.

The significance of this is that the patient may notice some abnormal symptom, leading to a request for medical advice. The symptoms may be of a local nature, or may indicate that an abnormal amount of hormone is circulating in the bloodstream. Quite often, discovering the growth may be an accidental finding when X-rays. CTs or MRI examinations of the skull are taken for other purposes. This is much the same, in principle, as discovering a person has high blood pressure or diabetes when routine examinations are being carried out, such as for life-insurance purposes.

A survey in a large London endocrine clinic recently showed that of every hundred patients coming along, forty percent had local symptoms. Fifty-seven percent had endocrine symptoms, and in three percent of cases, the discovery was accidental.

The local symptom most common is a headache. Another frequent complaint involved visual defects. The tumor had pressed on the “optic chiasma” (part of the optic nerve pathway), and this had obliterated a significant section of the patient’s normal visual field. The patient may have been bumping into people on the pavement, simply through failure to see them, which is a very unusual situation, and one calling for immediate investigation. Others noted the development of a squint (becoming cross-eyed) for no obvious reason. Usually the symptoms came on over a period of time. Seldom do they develop rapidly and dramatically, and for this reason may have existed for some time before being noticed.

Endocrine symptoms occur as the most common type of tumor, the chromophobe adenoma, increases in size, as it does so it tends to compress the pituitary gland, and simultaneously the production of the hormones is gradually reduced. However, this happens at an irregular rate. Gonadotrophin is the first to be lost. This is followed by the growth hormone, then TSH, while ACTH is the last one to be affected.

Different tumors can have varying effects, and it may depend on their location as to the order of interference with hormonal production and release. For instance, lesions above the pituitary may interfere with the antidiuretic-hormone (ADH) releasing mechanism, so permitting the onset of the disease known as diabetes insipidus, which is characterized by excessive water loss.

If gonadotrophin secretion fails before puberty, the result will be lack of commencement of menstrual periods in females, and delayed sexual development in males. In older women, a sudden cessation of menstruation may take place. Sometimes, a male may complain of the onset of impotence and loss of sexual libido. Growth hormone deficiency is most apparent in children where stunted growth is noticed.

A deficiency in TSH will give a clinical picture of an underactive thyroid gland. Fortunately, in the total picture the occurrence of pituitary tumor is rare, but it must be considered in cases of apparent hormonal disturbances. Today the diagnosis is still often difficult, but the availability of accurate tests (essentially radioimmunoassay and others) is making it simpler, quicker and much more reliable.

Unrelated hormonal production in other areas, a strange situation, may occur, giving rise to endocrine anomalies unrelated to the actual endocrine gland itself. This may arise when certain tumors develop in the system and commence producing hormones themselves. They are nearly always malignant (cancerous).

They may arise in a wide variety of organs. These include the bronchi of the lungs, the thymus gland in the lower part of the neck; in breast tissue; the thyroid gland; pancreas; kidney; trachea; ovary and uterus, as well as other tissues.

Sometimes more than one hormone is manufactured. Generally, the hormone produced will be the one usually manufactured by that organ, but this is not always the case. Often the hormones produced have an identical physiological function as the hormones naturally and normally produced by the endocrine gland itself.

ACTH hormone may be produced with oat-cell cancer of the bronchus, as well as in other sites. It tends to complicate an already overcomplicated picture, and can test the ingenuity of physicians dealing in this area. This is why many patients with symptoms suggesting endocrine anomalies are best treated in major hospital centers fully equipped with facilities to diagnose accurately and treat whatever abnormality happens to be present. Generally speaking this is the best place, and symptoms suggesting endocrine imbalances should receive prompt, specialized medical attention.

Kitchen Organize Tips

Successful meal preparation is as much dependent on a good working environment and organization as on culinary skills. It is worth spending some time ensuring your kitchen is arranged and equipped for convenient and safe movement and access between all the key areas. Once it is arranged to your satisfaction, you will be able to undertake the daily tasks of planning and cooking in the minimum of time.

Decide how the various contents of your kitchen can be grouped and where they should be stored in relation to how you use them. Roasting and cake tins (pans), saucepans, cooking utensils, china and glassware, cutlery, fresh and packaged food all need to be sited nearest to where they will be used.

Make sure that equipment is always stored in its allotted place so that it is easily found whenever required. In cupboards (cabinets), plan shelving so that everything is accessible; don’t put items that are in daily use in difficult to reach corners. You may prefer to keep items that are used everyday readily accessible, either on racks, open shelves or standing in large pots. But remember, they will be on display and so may create cluttered look or get in the way. Where open shelving is used to display items such as jars and pots decoratively, it will attract dust and grease so increasing your cleaning load.

Work surfaces need to he kept as clear of clutter as possible so that you can work on them at any time without having to make space first. Wash utensils immediately after use and put them away. Clear and wipe work surfaces down after every activity to keep them spotless and ready for use.

Site large appliances such as the cooker (stove) and refrigerator in relation to the sink area and work surfaces to minimize time-consuming travel in the kitchen. Keep appliances clean and in good working order – wiping them down or washing them after each use and before storing them away.

Always read and follow the manufacturer’s instructions for any kitchen appliance; misusing an appliance may lead to damage and may nullify any guarantees. Keep instruction booklets together with the phone numbers or addresses of service agents.

Lighting

Good lighting is essential in any working environment and the kitchen, where sharp knives and scalding hot pans are handled, is no different. Shadow-free general lighting needs to be supplemented by focused lighting for areas of more intense activity , that is the sink, the cooker (stove), the refrigerator and all preparation surfaces.

Avoid a central fluorescent strip as it can be harsh and gives poor colour rendering (when preparing food it is important to be able to see that your ingredients are fresh). However, consider fixing concealed fluorescent strips on top of wall-mounted units (cabinets), against the wall at the back; these will cast light upwards which, if reflected by a white ceiling, can create a pleasing glow. Strip lights can also be fixed to the underside of a unit, behind a baffle, deflecting the light, to cast an even light on the work surface below.

Spotlights or down-lighters can be used to create pools of general light. Down-lighters are a useful solution to kitchen lighting because, being recessed they attract less dirt and grease and so require less cleaning. They can be placed to shed light in specific areas. Wall-mounted adjustable spotlights can be angled to shine light wherever you want.

A well-lit kitchen is essential. Natural lighting is always best, but wall mounted units can provide focused lighting in work areas.

Safety

Kitchen safety is paramount. Not only for the cook, but for anyone else visiting the kitchen, especially children and even pets, both of which should probably be discouraged from being there. Being closer to the ground, both could trip you up when you are carrying a pan of hot water or a knife.

The oven door gets hot when the oven is on and so can burn the unwary visitors. Pan handles protruding over the edge of the hob (burner) can tempt small hands with disastrous results. Adults, too, can knock into them, so always get into the habit of turning handles inwards.

Install a fire blanket, available in neat packs and designed for kitchen use, next to the hob (burner). In case of a far fire, this can be released and thrown over the flames to put them out. A kitchen fire extinguisher is also a good idea.

Kitchen knives need to be kept sharp if they are to be of any use in the kitchen, so store them carefully. This will help to preserve their edges and to avoid the risk of getting cut. Either keep them in a knife block or use a magnetic holder; never leave them loose in a drawer.

Hygiene

A regular programme of cleaning and disinfecting will ensure that all the work surfaces and sink are kept clear of germs. Wash up as soon as you have used items; not only do piles of dirty dishes look unsightly but the warm atmosphere of a kitchen encourages germs to breed.

The refrigerator is probably one of the most overlooked areas when it comes to kitchen hygiene. Check all the contents regularly so that you can discard food that is past its best and before it starts to rot or go mouldy. Wipe down all the surfaces with a clean cloth. If you disinfect, wipe the surfaces with clean water to remove the smell. For more information on how to store fresh foods in the refrigerator, see Getting the Most From Fresh Ingredients.

Planning a meal

Successful meal preparation is as much dependent on organization as on culinary skills. Try to include a good range of flavours, colours and textures, as well as a balance in protein, fat, fibre and other healthy considerations. Consider what you can prepare ahead, and what remains to be done at the last minute so that all is ready together.
Clean, uncluttered work surfaces not only are more hygienic, they are also pleasing to the eye.

The first step is to read all the recipes before making a final choice. The main dish, with simple accompaniments such as a salad and bread, is a good starting point. Serve that with a cold starter (if there is to be one) and a cold dessert that can he made ahead of time. This way you can concentrate your efforts.

If you do choose two or more hot dishes, consider their cooking times and oven temperatures. If you have only one oven, and the temperatures required for the two dishes are different, this will present difficulties.

Next, make a shopping list and check that you have all the equipment you require. Read each recipe through again so you know what lies ahead, and try to estimate how long each preparation stage will take. Review techniques in the preparation that are unfamiliar. Set the time you want to serve the meal, and work back from there so you know when to start the preparation.

If you are serving a starter, you’ll need to plan what can be cooked unattended while you are at the table. If your chosen dessert is frozen, it may need some time out of the freezer before serving, so decide when to do that.

Remember to allow time for the final draining of vegetables, or carving of meat, or seasoning of a sauce. It is usually the case that all of these need to be done at the same time — but you only have one pair of hands. So decide what can wait and what will keep hot.
If any recipe requires the oven to be preheated or tins to be prepared, do this first. Pots of boiling salted water for cooking vegetables or pasta can be brought to the boil while you are doing the chopping and slicing. Set out all the ingredients required and prepare them as specified in the recipe. If more than one dish calls for the same ingredients, say chopped onion, you can prepare the total amount at the same time.