Category Archives: Health

Lung Collapse

Lung Collapse occasionally takes place, most frequently after surgical operations, due to obstruction occurring in a bronchus. The air in the portion of lung on the far side of this is absorbed, and the lung simply collapses. It tends to occur chiefly in the right lower lobe, and it may come on one to four days after surgery.

Lung Collapse Symptoms

If the collapse is major, there is pain in the lower part of the chest behind the sternum (breastbone), accompanied by severe breathlessness, restlessness and a bluish tinge to the face. An increased rate of breathing, increased heart rate and fever may follow. This may be followed by considerable infection in the affected part. Unless relief is forthcoming soon, it is possible for permanent bronchiectasis to develop in the affected portion of lung.

Lung Collapse Treatment

In patients intending to undergo surgery, lung collapse can often be prevented by sensible measures taken beforehand. These include cessation of smoking, the doctor not operating on any patient with a chest infection, for there is a much higher risk of a mucus plug becoming lodged in an air passageway during or after the anesthetic. The patient should be encouraged to move about and cough as soon as possible after the operation, to dislodge any impending obstruction, such as mucus in the airways.

If collapse does occur, physiotherapy by a skilled practitioner may assist. Otherwise, investigation with the bronchoscope is essential. Antibiotics are needed if there is any delay in initiating therapy.

Loss of Consciousness

Unconsciousness occurs when the oxygen supply to the brain becomes inadequate. There is not enough oxygen for the nervous system to control normal activities. So there may be a slow or gradual dulling of senses, often precipitated by a slowing of movements, general vagueness and finally dizziness, maybe drowsiness and finally a total lack of consciousness. Often this may be simple, due to fainting, where a momentary lack of oxygen occurs, and recovery is usually quick. However, there may be other serious underlying causes present as well. The patient may be a diabetic suffering from excessively high sugar levels (diabetic coma) that require urgent treatment to prevent death. Or there may be too much insulin as a result of treatment undertaken when the patient may have missed meals or over exercised, or some other condition.

Epilepsy is a well-known cause of unconsciousness, and the patient may have a series of convulsions prior to lapsing into the unconscious state. The situation may have occurred as a result of accident, in which case there is usually some other indication at the same time. It may have been due to trauma to the brain.

Many drugs and poisons may produce unconsciousness, and this includes alcoholic excesses. There may be evidence of these about the patient. A heart attack may have occurred, or the patient may have been electrocuted, in which case there is usually some obvious evidence.

When first confronted with an unconscious patient, they will have little knowledge of what has taken place. Therefore, a quick, preliminary assessment is essential.

After this, attention to general principles of treatment is urgently needed. The brain is unable to withstand oxygen deprivation from vital cells very long, and unless this is restored within a few minutes, irreversible brain damage is likely. If the heart has stopped beating, and breathing is diminishing or has also ceased, immediate steps at resuscitation are vital. Unless these two centers commence operating again, so allowing the blood flow to recommence and the blood to become reoxygenated, then the patient’s life is in grave peril.

Every first aider must have an intimate knowledge of the simple, effective methods of resuscitation and know how to commence these in a few moments. The first alder must know when they are needed, then how to carry them out. As these are fairly tiring, it is always advisable to have an assistant also conversant with the methods available to take over, so allowing periods of rest.

Loss of Consciousness Causes

It is always worth checking in the patient’s pockets, briefcase or handbag to see if there are any clues relating to possible disabilities. Sometimes patients with known chronic diseases (particularly diabetics, epileptics, heart cases) carry notification cards:

  • Stating their disease, with phone numbers and instructions regarding emergency care or medical warning medallions or bracelets. These may be vital, so always check.
  • Some cars have stickers with similar information, and glove boxes of cars may carry records.

Sometimes bystanders may be able to offer some indication of what occurred prior to the attack, and this may assist, such as in epileptics who may throw convulsions before lapsing into unconsciousness. See the sections on head injuries, stroke, fainting, epileptic fits, drunkenness, diabetic coma and hypoglycemic coma for some of the probable causes of unconsciousness. The treatment will be basically the same in each case but in some instances further treatment may be available

There are many causes of unconsciousness, but the immediate emergency treatment is the same. As soon as this has been carried out, the basic cause may be found, and sonic further treatment offered.

In any case, the sooner the patient is taken to expert medical attention (such as the emergency centre of a large hospital) the better. Many causes of unconsciousness are serious, necessitating urgent treatment.

Loss of Consciousness Symptoms

  1. The patient’s unconscious, and does not respond to normal stimulation, such as when spoken to or touched.
  2. There may be obvious causes present, such as hemorrhaging, vomiting, fluid loss from burns, diarrhea, or the obvious result from an accident.
  3. There may be eyewitness accounts of fits preceding the loss of consciousness. The patient may be a known diabetic, epileptic or heart patient. He or she may be an alcoholic.
  4. There may be evidence of what has caused the problem: sleeping-pill bottles, other medication containers, poison, drugs, bottles of alcohol, knives, guns etc.

What to Do in the Case of Unconsciousness

  1. Act promptly but remain calm and efficient. If you are scared and feel incompetent, call for immediate assistance. In any case, summon an ambulance for transport to hospital.
  2. Remove patient from the cause if further danger is imminent (e.g. electrical accidents).
  3. Turn patient on side. Make certain air passages are not blocked. If they are, remove any debris as a matter of urgency. Check for breathing and commence expired air resuscitation if necessary.
  4. Feel for pulse at neck if not present, immediate external cardiac compression is essential.
  5. If breathing and pulse are present, place the patient in the stable side position. This excellent position allows unwanted secretions (such as blood, vomitus, mucus or food) to drain from the body and reduces the risk of breathing obstruction.
  6. Check for bleeding and other injuries. Manage these.
  7. Under no circumstance give anything by mouth. This applies to fluid or alcoholic beverages. Oral administration could choke.
  8. Watch the patient’s color. A bluish color means inadequate oxygenation. A normal pink color means the patient is getting adequate amounts, and is in a far better position.
  9. Never leave the patient unless under adequate supervision of somebody with first aid or professional skill.
  10. Get medical aid as promptly as possible. Often, in serious cases, the emergency ward of a hospital is imperative. At this stage you do not know the cause, so plan for transportation promptly.
  11. Check in pockets, handbags or glove boxes for any identification of disease, as many chronics carry identification cards (or some other medical-warning device) setting out their disease, plus measures to be used in an emergency. These are often valuable.

Allergic Rhinitis

What is Allergic Rhinitis?

Allergic rhinitis refers to allergy of the nose. Allergies are basically caused by the interaction between the body’s immune system and irritants or agents referred to as allergens within the external world. Allergic reactions occur when the immune system sees a simple agent as a harmful intruder and reacts with chemical processes that are inappropriate hence they negatively affect the body. Symptoms of allergies are varied and can be mild or severe, some even being fatal.

Allergic rhinitis is among the most prevalent forms of atopic (skin) disorders. It is assumed that its prevalence is due to the nose’s constant exposure to airborne allergens, oftentimes being the initial point of contact between the body and these external stimuli. Airborne allergens are among the most common triggers of allergic reactions. The condition is impartial to gender with both males and females experiencing equal incidence rates.

Symptoms of allergic Rhinitis

Symptoms of this kind of allergy include runny nose and stuffiness, redness of the lower eyelid, sneezing, nasal congestion and other cold-like symptoms, snoring, heavy mouth breathing, the constant clearing of the throat, allergic creases (lines across the nose caused by frequent wiping of the nose in upward swipes made by the index finger often referred to an “allergic salutes”), headaches, nose bleeds or secretions that are tinted with blood, earaches and dark circles under the eyes.

Types of allergic Rhinitis

Allergies of the nose fall under two main categories; these are “perennial’ and “seasonal”. Perennial allergies tend to get worse during the winter months especially for children but are experienced year round. Winter months are associated with increases in allergic reactions in children because they tend to spend more time indoors hence exposures to airborne irritants around the house are more frequent and prolonged.

Seasonal allergic rhinitis results mainly from exposure to plant pollen being circulated by winds. Different irritants exist in different regions since plant life will vary based on natural habitat. The season of attack will differ as well based on the location of those affected. On average, trees produce common allergens during late winter going into early spring months, while grass is a leading cause through-out the rest of spring and the early summer period. Weeds (mainly ragweed) dominate late summer. Mold can trigger allergic rhinitis, so too can perfume and strong fragrances, pollution (unclear air), weather changes, humidity, tobacco smoke, dry air and cosmetics.

Treatment of allergic Rhinitis

Treatments include antihistamines, decongestants (in solid, liquid and nasal sprays), Immunotherapy (also called hyposensitization or more commonly know as allergy shots) and Cromolyn or steroid nasal spray. Strength, type, frequency and duration of treatment will vary based on the condition, allergen and severity of each attack although preventative measures are best. Airborne allergens can be avoided for the most part especially those that are found around the home. For those that cannot be avoided, reducing exposure should be attempted.

Reactions that are persistent or affect natural functions (like breathing or swallowing) should be brought to the attention of a doctor. Mild cases can be treated at home with drugs that can be obtained from local pharmacies without a prescription.


What is Leukemia?

Leukemia means malignant disease, or cancer, of the blood-cell-producing areas in the bone marrow. When we think about cancer, it usually involves one of the organs of the body. Instead of the abnormal cells concentrated in one area, they are scattered irregularly throughout the bloodstream. But rather than the cells of the blood being the prime source, they are the aftermath. The disease commences in the manufacturing centres of the white cells. The main place is the bone marrow. There are various kinds, but most are the so-called “acute forms” in childhood, and the age between two and five years is the most probable.

There is an enormous increase in the number of white cells produced, and because of this overproduction, very young, immature cells termed blast cells are present in large numbers, and these are poured out into the general circulation. Although the cause of cancer in general is still an enigma, at least son-le of the causes of leukaemia has become well-established. It is well-known that in many animals leukaemia is transmitted by a virus, although this has not yet been proved conclusively in humans.

In humans, however, there is a distinct relationship with irradiation. Evidence has now been available for some years of the massive increase in leukaemia in victims following the atomic bomb explosions in Japan.

Patients who were treated for severe back pain (due to ankylosing spondylitis) with radiotherapy have since shown a greatly increased incidence of leukaemia in later life.

It is also well-known that pregnant women who undergo X-ray examinations give birth to children who run a higher-than-average risk of later developing leukaemia. Even prenatally the X-rays are able to disrupt the sensitive cellular mechanism later to produce severe disease. For this reason doctors are strong in advising pregnant women to defer, if possible, any form of X-ray during pregnancy.

It is known that leukaemia is more common in children with Down’s syndrome (mongolism). It is also significant that the chromosomal anomaly occurs on the same chromosome as does the Down’s syndrome aberration.

Exposure to certain chemicals, particularly benzene, may also be a cause. It seems that the disease is increasing in frequency. Figures for Great Britain showed that 722 died from it in 1949, 939 in 1957, and 1495 in 1967. No doubt improved methods of diagnosis accounted for some, but certainly not all of these increases.

There are various forms of acute leukaemia. Some affect chiefly children, others afflict adults more commonly. There seems to be a preponderance of males to females, the ratio being about three to two.

Leukemia Symptoms

From a practical point of view the most probable combination of symptoms from the start are anaemia haemorrhage and infections. Often it starts off with symptoms similar to a child with ordinary red cell anaemia. In fact, there is often anaemia present. There may be a mild fever, weakness, pains in the bones and perhaps pains in the joints. There may be abnormal bleeding, such as from the gums, 108 nose or into the bladder. This may be the first indication that all is not right. The child may have a tendency to bruise easily. Sometimes there is an enlargement of the lymph glands in various parts of the body, or the liver or spleen (in the upper part of the abdominal cavity) may enlarge, but this is not always the case. They all vary. It seems that children with Down’s syndrome are more likely to develop the disorder. How does the doctor diagnose it? The doctor can call on many special tests. Initially the blood count will be checked, and this may show too many white cells – sometimes there are abnormally low numbers. But their shape and type is highly abnormal. It indicates that many are being formed. Often there is red cell anaemia also, and the platelets, the clotting factor, may be deficient.

In more detail, the symptoms will be a collection of these. Often when first seen the patient will be pale, quite ill and be running an elevated temperature from an underlying infection that may or may not be obvious. It may be a simple sore throat, a bout of bronchitis, tonsillitis, pleurisy or pneumonia or something else. There may be obvious bruising of the skin or mucous membranes, or frank bleeding from the gums or lower part of the intestinal system. The spleen may be enlarged, and it may be possible to feel it jutting from below the rib margin on the upper left-hand side of the abdomen. In some cases there may be enlargement of the lymph glands in the neck, under the arms and in the groin.

Blood tests and tests of bone marrow show the telltale story. There is the presence of typical leukaemic cells in profusion. As the disease advances it may infiltrate many other organs of the body. The central nervous system seems particularly vulnerable, and involvement may occur early, producing signs of meningitis and infiltration of the nerves of the head or extremities. The skin, testes, pelvic organs, kidneys, liver and intestine may also be attacked, and symptoms may occur as a result of this.

The triad of anaemia, haemorrhage and infection immediately arouses suspicion of leukaemia, and indicates that blood tests should be carried out to establish the diagnosis.

The normal white-cell count of the blood, usually between 4.0 and 11.0 thousand million cells per litre (written as 4.0 – 10.0 x 109/L), can rise dramatically to figures of 50.0 or more. Many primitive blast cells may be in evidence. However, in certain so-called leukemic forms, there may be a dramatic reduction in the white cell count to 1.0 or less. The precise type of leukemia usually depends on the nature of the white cells in greatest evidence (and so the profusion of names in this disease).

Leukemia Treatment

With the development of specialised units in many large hospitals, usually located in key capital cities, intensive therapy is now available. This usually encompasses powerful, relatively new drugs, and parents will soon become familiar with names such as prednisone, vincristine, mercaptopurine, methotrexate, cyclophosphamide and various others. Also, in more recent years, marrow transplants have become popular and dramatically successful. Cells taken from the bone marrow of a suitable person (ideally a twin of the patient) can often take hold and produce normal white cells. National bone marrow registers are being set up in Australia to quickly match suitable donors with patients. This will again enhance the chances of successful treatment. Collectively, this has made the outlook for the leukaemia patient much better than at any previous time in history. Now many centres claim “cures” for their youthful patients. Of course, only the future will prove if this will last a lifetime, but the current evidence seems to indicate that, in many cases, it probably will. What is the important message here? Parents must be alert to the possible symptoms of leukaemia, and report any untoward symptoms – the kind we have talked about – to the doctor immediately. Even simple recurring nosebleeds or bleeding gums warrant investigation. This can easily be arranged. If by some misfortune leukaemia is present, the sooner this is treated, the better. Becoming associated with a major centre is the ideal. Acute cases are not treated at home, and there is no place for do-it-yourself remedies. Specialised instruction and care is mandatory. Unfortunately, there are still a few misguided parents around who think that natural remedies and good food may cure their child. This is not so. Please be cautioned. We certainly condone do-it-yourself remedies whenever practical, but this disease is not one of them.

Acute lymphoblastic leukaemia responds dramatically to treatment, and instead of being a death sentence, a cure seems possible. To quote from one eminent authority: “One of the most remarkable events in malignant disease is that a complete remission is now possible in about 95 per cent of children with lymphoblastic leukaemia.” A “complete remission” means “a complete return to normal of the blood and bone marrow, no abnormal signs such as an enlarged spleen, and no evidence of the disease elsewhere.” To achieve this situation with a malignant disease certainly gives reason for optimism. This has occurred only in the past few years, and is a result of the research and aggressive approach that has recently been made in therapy.

Gaining complete remission is the start. After this, vigorous follow-up treatment is needed to retain this situation and prevent recurrences.

Various forms of drug therapy are now in wide use. These will vary in form from centre to centre, and from patient to patient. In fact, the pattern is changing rapidly.

Generally speaking, therapy entails the use of the so-called cytotoxic drugs, including vincristine and prednisone. Also in use are cytosine arabinoside, daunorubicin, asparaginase and BCNU. When remissions have taken place, other drugs are introduced to maintain the good work. Drug names such as 6-mercaptopurine, methotrexate and cyclophosphamide are well-established.

When the remission has settled down, maintenance treatment with combinations of these drugs is kept up. Marrow transplants also form an important and often successful form of treatment.

The treatment of leukaemia is in a specialised unit in a major hospital where doctors who expert in this particular specialty are in charge.

Therapy is intensive, and there is often accompanying toxicity due to medication, which is quite separate from the symptoms invoked by the disease itself. “However, the aggressive approach to the treatment of acute leukaemia is justified by the results,” one investigator says, and gives the results of Burchenal who collected the results of 157 cases of proven leukaemia of all types from around the world who were still alive after five years, and of whom 103 are free from disease five to 17 years later. Subsequent journal reports are giving progressively more satisfactory results each year.

Once, the outlook for children with acute leukaemia was less than five months. Now, with intensive combination therapy, it is more than three years, and in many cases it seems curable. Today’s aim is to cure the disease totally although this may rarely be the case, the outlook is increasingly promising.

Leukemia requires prompt attention from the doctor. The sooner a definitive diagnosis is made, the quicker modern treatment can be started and the greater is the chance of a cure or at least a greatly enhanced life span compared to yesteryear.


What is Psoriasis?

While still talking about skin inflammations in general, let’s consider that nasty chronic disorder called psoriasis. Fortunately it’s uncommon in children before the age of three years, and is still not common under the age of ten years. It is a disease of the skin, and affects 1-2 per cent of the white population. It is characterised by clearly demarcated areas called papules that coalesce into larger areas called plaques. Generally, these are not itchy but form silvery scales. When these are removed, it leaves minute bleeding points. Once it begins; it often becomes chronic, and persists for many years, probably for the rest of one’s life. It is common, and about 5 per cent of the community suffer from it. Many claim the true figure is much higher.

Although Psoriasis is a chronic skin disorder that occurs infrequently in young children. the name comes from the Greek word psora meaning itch, the lesions are usually not very irritable. Typically it involves the scalp, the ears (externally), the elbows, knees and trunk (about 75 per cent of cases). It varies, and may involve chiefly the scalp, area behind the cars, armpits, and “anogenital region” (i.e. area about the external genitals extending around to the anus). Due to its appearance, and the disfigurement it can produce, it is among the “socially disabling” diseases. If the palms of the hands or soles of the feet are involved, and this is common, deep fissuring can take place. This can be painful and highly irritable, and may interfere with normal working duties.

Sometimes arthritis accompanies it, flaring up if the rash worsens. Most psoriasis patients are reasonably healthy, apart from the joint pains. Sometimes minor illnesses can aggravate the rash. It is often worse during cold weather, and when sunshine is prevented from gaining access to the lesions. In about 30 per cent of cases, there is a family history of psoriasis, and several members of the one family may have the disorder.

Frequently, the nails are affected, and sometimes this is a dominant feature, with characteristic pitting. The cause of psoriasis is unknown, but many doctors now believe that there could be a psychosomatic factor.

Psoriasis Treatment

Innumerable routines have been suggested over the years for this very difficult skin disorder. The fact that there are so many suggests that no single cure is at present available. Many can be tried at home. Some of them offer temporary (and sometimes long-standing) relief. They are worth a trial, for they will do no harm, and could be beneficial. A “spontaneous cure” is unlikely. Cleanse daily, scrubbing the affected areas with soap arid water and a soft brush often helps. It removes surplus scales. “Pinctarsol” may help.


Many ointments have been used. Dithranol has been used with reasonable success for many years. It is still widely prescribed in 1-2 per cent creams. Ammoniated mercury ointment 5 per cent applied morning and night, or Anthralin 0.25 per cent may be applied once daily (NB avoid contact with the eyes as it is very irritating). Coal tar ointment 2 per cent smeared on at night and moved next day with liquid paraffin ten assists.

Sebitar is good for the scalp. More acute cases should use applications, such as calamine lotion containing 5 per cent detergent solution coal tar. Lecithin, is claimed by some to give favourable results when taken over a period of time, maybe many months. Ten il7E1MS of the powdered form is sprinkled on the breakfast cereal each morning. This is available from health food shops.

Ascorbic acid

Given in daily doses of 2,000 mg for an extended period of time (months), this may bring relief to some sufferers and is worth a trial. (It is also known as vitamin C.)

Ultra-violet light

Lesions often respond favourably to ultraviolet light. The cheapest and most readily available source is sunshine. Lamps are sometimes ordered and must be used under proper medical supervision.

Other Treatment

See the doctor if the simple remedies do not help. Recent research has made new treatment available that is often curative:

The Psoralens

This family of preparations is available, and is often effective. It is given in the form of trioxsalen or methoxsalen. By concentrating on the five points in life, attention may be diverted from the skin problems to more important facets of life. This is at present debatable. Many different forms of therapy have been tried, and the condition tends to wax and wane, treated or not. Often daily scrubbing with soapy water and a nailbrush will get rid of scales. It helps, so does plenty of sunshine and bathing in the salty water at the beach.

Ointments containing tar are used, salicylic acid, dithralin are popular. Severe cases are treated by the doctor with the corticosteroid family of drugs, but medical supervision is essential. There are some other forms of treatment for severe cases which is the so-called PUVA therapy. A family of drugs called the psoralens (taken by mouth), followed by exposure to the sunlight, or to a special light called ultraviolet (or “black”) light is claimed to effect a cure in certain cases. This again is the field of the skin specialist, for adverse side effects can occur, but many successes have been recorded in the medical journals. Fish oil capsules are also claimed to clear the skin in some people.


What is Cretinism?

This occurs when the infant has been deprived of thyroid hormone either during prenatal life or babyhood. Developmental retardation, particularly of the bones and brain, is marked. The condition is common in regions where there is a severe iodine lack and endemic goitre is widespread. It is most likely that the mother of the affected child had goitre, and suffered from thyroid deficiency.

In some cases there is a congenital absence of the thyroid gland in the child. In some instances the infant may have been born to a parent who was under treatment for thyroid disease. The mother may have taken doses of thyroid-suppressing drugs in excess of her needs, and this has crossed into the womb during pregnancy, having a similar suppressing effect on the developing infant.

Cretinism Symptoms

Typically the infant is drowsy, tends to go to sleep while feeding does not put on weight and show the normal rate of development and has a tendency to constipation. This may become evident in the first two or three months of life.

The abdomen tends to protrude, and often there is a swelling at the navel (umbilical hernia). The face shows a typical appearance, with a flattened nose, broad, puffy face, thick nostrils and lips and a tongue that protrudes. The skin is pale and dry. Pads of fat occur around the base of the neck, giving it a shortened look. The fontanelle (hole in the skull where the bones meet) tends to close later than normal, and the general bony development is much below normal. Mentally the infant is retarded, teeth are late in appearing, temperature is often below normal, hair is usually dark and the infant usually has a hoarse cry.

Cretinism Treatment

In areas where goitre is endemic, it is essential for the mother to take iodine as a prophylactic measure, otherwise there is a definite risk to her infant. After birth the child’s condition must be diagnosed early and accurately, and treatment started at once to avoid permanent mental and physical damage. However, if there has been a marked prenatal deficiency, by the time of birth adverse changes may have developed to the point of no return, and may be permanent despite any further treatment. In any event treatment is by the administration of thyroxine, and this will be worked out for the needs of the individual patient. The outlook will vary according to the degree of mental impairment that has occurred up to the time treatment is started.

Often no improvement will take place, and the child is an established cretin. The outlook then is extremely poor. In America hospitals now routinely screen newborn babies for thyroid deficiency. This enables very early diagnosis. Treatment is also started at once. About one baby in 4000 suffers from this problem.

It is likely that they will be diagnosed and best treated in the large endocrine clinics of major hospitals that have full facilities both for diagnosis and treatment.

Red Splotches

Red Splotches seems to happen in adults as well as with children. This is called a sub-conjunctival haemorrhage. It means that a microscopic blood vessel in the white of the eye has ruptured, and blood oozes out in the space immediately below the surface. It may be quite extensive and can look alarming, especially if large.

In most cases this condition will clear itself up with no therapy. After a few days it will tend to darken into a brown colour. This will fade into a yellow and finally disappear as nature resolves it entirely.

Any recurrence should receive medical attention. In some instances, albeit rarely, important underlying conditions may be the cause. This is usually unlikely – but I don’t believe in taking undue risks, and like to double-check most things, as you know.

Kidney Tumor

The two most common forms of kidney tumor are so called adenocarcinomas (cancers) of the kidney (also known as Grawitz’s tumor), which occur in men in 80 percent of cases, and the Wilms’ tumor, which occurs almost exclusively in children under the age of six years. About 30 percent of children with Wilms’ tumor may be cured, provided they are young enough and surgery is performed before the cancer cells have spread to other tissues. Symptoms include painless bleeding, sometimes profuse, and this is often the first and only presenting symptom with renal cancers. Sometimes a mass in the abdomen that feels firm and may be nodular will cause the patient to first seek medical advice.

Kidney Tumor Symptoms

As with the symptoms of bladder cancer, immediate investigation by the urologist is mandatory, probably carried out in the urology unit of a large hospital where full facilities are available. A cystoscopy is the usual starting point. This will indicate if the bleeding is coming from a bladder tumor. Sometimes blood can be seen oozing from the left or right orifice where the ureter leads into the bladder, suggesting which kidney may be affected.

Kidney Tumor Treatment

X-ray, CT or ultrasound examinations may be carried out and show filling defects, which may assist the diagnosis. Treatment is surgical if metastases (spread to other areas) have not taken place. Nephrectomy, which means complete removal of the kidney, is carried out. “About 25 per cent of patients are alive five years after nephrectomy,” Smith says. However, it seems to depend on the nature of the cancer, for others do much better. “In a well-encapsulated tumor that has not metastasized, survival up to 10 years may occur,” Wilson states. Although the cancer is relatively resistant to radiation, this is often used, for it seems to help reduce local recurrences and cell nests that have formed in bones in other parts.

Tumors of the Renal Pelvis

About 10 per cent of renal cancers occur in the pelvis, the cavity of the kidney. Once again, hematuria is the cardinal symptom. They resemble cancers of the bladder. Treatment is similar to that for cancer of the kidney, with surgical removal of the organ. With well-encapsulated ones, the outlook is relatively good, but others grow alarmingly and spread early, and the outlook is grave. This will be known only at the time of surgery when a pathological examination will reveal the nature of the cancer.

Primary Amenorrhoea

Primary Amenotthoea means that menstruation has failed to occur at or after puberty. In some women there is a familial tendency for menstruation to commence late, sometimes delayed up to the age of 16 years or even later. With the social implications of early sexual development in today’s society, it is common for doctors to see girls early who have not started to menstruate. Figures for the Western world show that there is a general trend with modern living for sexual development and menstruation to occur at younger ages. Frequently girls aged 10 or even nine have started. There are many reasons why menstruation does not occur when it should.

Sometimes an imperforate hymen may prevent the escape of blood. This is an obvious and readily curable cause; acute or chronic pelvic disorders may be another. Often psychological reasons may check release of gonadotrophins by the pituitary, so delaying the menses.

It may also be due to a symptom of a general lack of development of the pituitary or the thyroid, or a symptom of juvenile myxoedema. In some, other indications of endocrine deficiencies may be in evidence, such as dwarfism. About 25 per cent of patients with the symptom have a genetic anomaly, having inherited an extra chromosome. This is called Turner’s syndrome. In other cases there is simply no explanation, and the lack of menstruation together with a lack of sexual development simply occurs for reasons unknown.

Primary Amenorrhoea Symptoms

Symptoms are usually obvious. Ovulation does not take place, so normal hormones fail to be produced, and usual menstrual cycle simply does not eventuate. Secondary sexual characteristics do not develop either. Breasts, vulva, vagina and uterus remain rudimentary. Often the mental outlook is immature. The bones may show stunted growth, and dwarfism may occur. If it occurs in conjunction with other hormonal disorders, symptoms due to the primary cause may also be in evidence.

Primary Amenorrhoea Treatment

In most cases there is no correctable underlying cause. Giving sex hormones may at least produce mental and physical development, which many of these girls seek. It can also establish artificial menstruation, which is satisfactory to many. Pregnancy of course will not occur unless ovulation is taking place. The hormones contained in the contraceptive pill, usually a progestogen and an oestrogen, are available. These may be continued long-term.

If the basic cause is a thyroid disorder that may be corrected, then this may respond by allowing ovulation to proceed. The outlook is then good in terms of ovulation and fertility. If merely a late-occurring normal puberty was the reason, the outlook is likewise generally good, and after a few normal cycles, discontinuation of medication may be followed by the regular normal cycles. However, in many, infertility will continue if the cause is a not correctable one, and substitution therapy will be necessary until the change of life and parents.

The average baby will develop normally and naturally, irrespective of what you do to try to hasten this along. After all, baby humans are just another facet of nature. Cows and horses, dogs and cats manage to do quite well and generally develop in a normal healthy way without the need of textbooks and specialists or oral advice. Babies (with two legs) are not much different. Do not expect too much too soon.

There are enormous variables; one child will start to teethe early while another will start months later. The end point is identical. Maybe the late teether will have better teeth in the long run. Trying to force baby along these channels can breed problems, both for you and your child, take it gently. If there are any obvious problems looming, consult your doctor. If there is any major query, seek the expert opinion of a paediatrician.


In the past several decades, a number of individuals proposed that sugar, dairy products, preservatives, artificial colors and flavors in foods trigger or aggravate ADHD symptoms. The most widely publicized has been from pediatric allergist Dr. Feingold, who claimed in the mid-1970s that hyperactive behavior was caused by artificial colors and flavors. The Feingold diet thus involved scrupulous avoidance of these items. Based on some excess in individual cases, Dr. Feingold took his theory the public, and his diet became the nutritional bulk for thousands of parents of ADHD children. But frequent controversy studies shows that in larger numbers of children it failed to support his claims. Similarly, a common problem of that eating refined sugar triggers hyperactive behavior has not held up in large-scale studies.

It is quite possible that some children show a deterioration of behavior when they eat certain foods. If this happens consistently, those foods should be avoided. To prove cause-and-effect relationships can be very difficult, and some caution and skepticism are in order to prevent a child from becoming a “food cripple” who isn’t allowed to eat anything but a handful of “safe” items.

Because a child with ADHD can create such havoc in a family, the desire for a magic formula to make the problem go away can become overwhelming. Several types of therapies (e.g., the use of mega vitamins) have made parents desperate for a cure, but the likelihood that these therapies will create lasting success without other measures being taken is remote.