OBESITY

OBESITY?
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may
have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Body mass index (BMI), a measurement which compares weight and height, defines people as overweight (pre-obese) when their BMI is between 25 kg/m2 and 30 kg/m2, and obese when it is greater than 30 kg/m2.Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, breathing difficulties during sleep, certain types of cancer, and osteoarthritis. Obesity is most commonly caused by a combination of excessive dietary calories, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.
The primary treatment for obesity is dieting and physical exercise. To supplement this, or in case of failure, anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption. In severe cases, surgery is performed or an intragastric balloon is placed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.
THE CAUSES

At an individual level, a combination of excessive caloric intake and a lack of physical activity is thought to explain most cases of obesity.A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness.In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.A 2006 review identified ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children), (8) epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10) assortative mating leading to increased concentration of obesity risk factors (this would not necessarily increase the number of obese people, but would increase the average population weight)
THE MANAGEMENY FOR OBESITY

The main treatment for obesity consists of dieting and physical exercise.Diet programs may produce weight loss over the short term,but keeping this weight off can be a problem and often requires making exercise and a lower calorie diet a permanent part of a person's lifestyle.Success rates of long-term weight loss maintenance are low and range from 2–20%.In a more structured setting, however, 67% of people who lost greater than 10% of their body mass maintained or continued to lose weight one year later.An average maintained weight loss of more than 3 kg (6.6 lb) or 3% of total body mass could be sustained for five years.Some studies have found significant benefits in mortality in certain populations with weight loss. In a prospective study of obese women with weight related diseases, intentional weight loss of any amount was associated with a 20% reduction in mortality. In obese women without obesity related illnesses a weight loss of greater than 9 kg (20 lb) was associated with a 25% reduction in mortality. A recent review concluded that certain subgroups such as those with type 2 diabetes and women show long term benefits in all cause mortality, while outcomes for men do not seem to be improved with weight loss.A subsequent study has found benefits in mortality from intentional weight loss in those who have severe obesity.The most effective treatment for obesity is bariatric surgery; however, due to its cost and the risk of complications, researchers are searching for other effective yet less invasive treatments.

Easy for English!

Nowdays, students sometime have problem in deciding which universities they want to apply. After finishing the secondary school , many students have the same problems such as problem to decide any universities. Based on the above , students may condsider courses offered , facilities and fees.

         The first factor , students having problem in courses offered because in the secondary school they already om the science base , accounting and so on. Thus , in  certain courses they did not have base on that so it quite difficult for student to apply for it. The courses offered is one of the factor why there are a lot of student facing problem in choosing a place in universities.

        Beside that, other factor is facilities that given by the institution itself. Some of the campus has provide with a lot of facilities for student such as wifi , pool , field and others but not all campus can provide with all facilities. This is due to some campus had limited space to build field , pool , and others. Facilities also are the reason why students are realy consern about choosing place to futher their studies.

       In the other hand , fees also is one of the factor why students are always having problem in choosing place for study. The amount of the fees is sometimes make parents and student think back either they want to enter the institutions or not due to the fees are very expensive. As we know , not all people can effort to pay for that expensive fees. So that, fees aalso is the factor that contributing in choosing a place for futher their studies.

       The conclusion is actually there are alot of problem and factors in choosing which universities that realy suitable for us to go. So we as a student should think carefully and make a good decision because once we have choose there are no way to turn back.

HEADACHE

WHAT IS HEADACHE?
A headache or cephalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck.The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Several areas of the head and neck have these pain-sensitive structures, which are divided in two categories: within the cranium (blood vessels, meninges, and the cranial nerves) and outside the cranium (the periosteum of the skull, muscles, nerves, arteries and veins, subcutaneous tissues, eyes, ears, sinuses and mucous membranes).There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society. Treatment of a headache depends on the underlying etiology or cause, but commonly involves analgesics.
WHAT THE CAUSES OF HEADACHE?
Typical causes

The commonest types of headache are the "primary headache disorders", such tension-type headache and migraine. They have typical features; migraine, for example, tends to be pulsating in character, affecting one side of the head, associated with nausea, disabling in severity, and usually lasts between 3 hours and 3 days. Rarer primary headache disorders are trigeminal neuralgia (a shooting face pain), cluster headache (severe pains that occur together in bouts), and hemicrania continua (a continuous headache on one side of the head).
Secondary causes
Headaches may be caused by problems elsewhere in the head or neck. Some of these are not harmful, such as cervicogenic headache (pain arising from the neck muscles). Medication overuse headache may occur in those using excessive painkillers for headaches, parodoxically causing worsening headaches.
A number of characteristics make it more likely that the headache is due to potentially dangerous secondary causes; some of these may be life-threatening or cause long-term damage. A number of "red flag" symptoms therefore means that a headache warrants further investigations, usually by a specialist. The red flag symptoms are a new or different headache in someone over 50 years old, headache that develops within minutes (thunderclap headache), inability to move a limb or abnormalities on neurological examination, mental confusion, being woken by headache, headache that worsens with changing posture, headache worsened by exertion or Valsalva manoeuvre (coughing, straining), visual loss or visual abnormalities, jaw claudication (jaw pain on chewing that resolves afterwards), neck stiffness, fever, and headaches in people with HIV, cancer or risk factors for thrombosis."Thunderclap headache" may be the only symptom of subarachnoid hemorrhage, a form of stroke in which blood accumulates around the brain, often from a ruptured brain aneurysm. Headache with fever may be caused by meningitis, particularly if there is meningism (inability to flex the neck forward due to stiffness), and confusion may be indicative of encephalitis (inflammation of the brain, usually due to particular viruses). Headache that is worsened by straining or a change in position may be caused by increased pressure in the skull; this is often worse in the morning and associated with vomiting. Raised intracranial pressure may be due to brain tumors, idiopathic intracranial hypertension (IIH, more common in younger overweight women) and occasionally cerebral venous sinus thrombosis. Headache together with weakness in part of the body may indicate a stroke (particularly intracranial hemorrhage or subdural hematoma) or brain tumor. Headache in older people, particularly when associated with visual symptoms or jaw claudication, may indicate giant cell arteritis (GCA), in which the blood vessel wall is inflamed and obstructs blood flow. Carbon monoxide poisoning may lead to headaches as well as nausea, vomiting, dizziness, muscle weakness and blurred vision. Angle closure glaucoma (acute raised pressure in the eyeball) may lead to headache, particularly around the eye, as well as visual abnormalities, nausea, vomiting and a red eye with a dilated pupil.
WHAT TREATMENT WITH BPATIENT HEADACHE?
Acute headaches:Not all headaches require medical attention, and most respond with simple analgesia (painkillers) such as paracetamol/acetaminophen or non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, or diclofenac.[citation needed] Chronic headaches:In recurrent unexplained headaches keeping a "headache diary" with entries on type of headache, associated symptoms, precipitating and aggravating factors may be helpful. This may reveal specific patterns, such as an association with medication, menstruation or absenteeism or with certain foods. It was reported in March 2007 by two separate teams of researchers that stimulating the brain with implanted electrodes appears to help ease the pain of cluster headaches.Acupuncture has been found to be beneficial in chronic headaches of both tension type and migraine type. Whether or not there is a difference between true acupuncture and sham acupuncture however is yet to be determined.One type of treatment, however, is usually not sufficient for chronic sufferers and they may have to find a variety of different ways of managing, living with, and seeking treatment of chronic daily headache pains. There are however two types of treatment for chronic headaches meaning acute abortive treatment and preventive treatment. Whereas the first is aimed to relieve the symptoms immediately, the latter is focused on controlling the headaches that are chronic. From this reason, the acute treatment is commonly and effectively used in treating migraines and the preventive treatment is the usual approach in managing chronic headaches. The primary goal of preventive treatment is to reduce the frequency, severity, and duration of headaches. This type of treatment involves taking medication on a daily basis for at least 3 months and in some cases, for over 6 months. The medication used in preventive treatment is normally chosen based on the other conditions that the patient is suffering from. Generally, medication in preventive treatment starts at the minimum dosage which increases gradually until the pain is relieved and the goal achieved or until side effects appear.To date, only amitriptyline, fluoxetine, gabapentin, tizanidine, topiramate, and botulinum toxin type A (BoNTA) have been evaluated as "prophylactic treatment of chronic daily headache in randomized, double-blind, placebo-controlled or active comparator-controlled trials. Antiepileptics can be used as preventative treatment of chronic daily headache and includes Valproate. Psychological treatments are usually considered in comorbid patients or in those who are unresponsive to the medication.

MORE POWER IN GARLIC

From treating colds to acne, garlic has now been discovered as a potential drug to fight cancer and heart disease.IT’S so pungent that it’s said to ward off vampires. But the humble garlic certainly keeps diseases at bay. Garlic is a pharmaceutical goldmine. It has countless sulfur compounds that can do magical things when they reach targets in the tissues and organs. Now, let us understand garlic a little.


Recognised for its healing powers in ancient times, garlic is now being rediscovered by scientists, who have new evidence of its efficacy against cancer and heart disease. Dr Richard Rivlin of New York-Presbyterian Hospital/Weill Cornell Medical Center, is guest co-editor of a special March peer-reviewed supplemental issue of The Journal of Nutrition. It has 35 articles representing the latest research on garlic — findings that were first presented at a symposium held last year at Georgetown University.


    “Medical texts from China, India, Egypt, Greece and Italy mention medical applications of garlic,” says Dr Rivlin, professor of medicine at Weill Cornell Medical College, attending physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, and director of the Nutrition Center at the Strang Cancer Prevention Laboratory. “Cultures that developed independently came to the same general conclusions, namely, that garlic could be administered to provide strength and to increase work capacity. Hippocrates, considered the Father of Medicine, used garlic as an essential component of one of his therapies.”



Complementary medicine.Rivlin believes that while much promising research has been made pointing to the disease-preventive and therapeutic effects of garlic, it should be considered complementary medicine, not alternative therapy. “The rapid advances in garlic research provides evidence that garlic has significant potential as a complement to established therapies.”



The health benefits and medicinal properties of garlic have long been known. It has long been considered a herbal “wonder drug”, with a reputation in folklore for preventing everything from the common cold and flu to the feared plague. Garlic has also been used extensively in herbal medicine. Raw garlic is used by some to treat the symptoms of acne, fungal infection and there is evidence that it can assist in managing high cholesterol levels.



New compounds.
Recently, exciting compounds in garlic have been shown to have powerful effects on the prevention of cardiovascular disease linked to the metabolic syndrome or better known as Syndrome X. These compounds are vinyldithiins and sulfides. These vinyldithiins sulfides (particularly dillyldisulfide and triallytrisulfide) have a powerful effect in inhibiting the enzyme HMG-CoA reductase — the enzyme implicated in cholesterol synthesis. Indeed, many major cholesterol lowering drugs work by also inhibiting this same enzyme. Vinyldithiins, in particular, have strong potential as anti-thrombotic (anti-clot forming agents).



In the field of molecular biology, the peroxisome proliferator-activated receptors (PPARs) are a group of nuclear receptor proteins that function as transcription factors regulating the expression of genes. PPARs play essential roles in the regulation of cellular differentiation, development, and metabolism (carbohydrate, lipid, protein), and tumorigenesis of higher organisms. PPARs have a powerful indirection on insulin and inflammation. Vinyldithiins have the ability to affect PPARs in the liver by up to 40 per cent. Ultimately, this affects the deposit of fats in the cells and in critical organs. It may also help quell inflammation and improve the overall symptoms of Syndrome X.



Belgian research
Research on these valuable compounds found in garlic is making great progress in the heart of Europe. Belgian scientists have recently developed superior high-yielding varieties of garlic. These new varieties yield higher actives of garlic like vinyldithiins and sulfides. Again, these compounds which are also pungent are easily lost as they are volatile. This is especially so when they are subjected to higher heat and pressures that typical extraction protocols would expect.



As such, the garlic mixture is extracted using super critical fluid extraction technology. Extraction happens at very low temperatures using liquid carbon dioxide and nitrogen. At these extremely low temperatures, where nitrogen and carbon dioxide are liquid, they are mixed with the pulverised garlic and “extracted”. As the temperature warms, the liquid nitrogen or carbon dioxide basically move from liquid to gas phase. The extracted high value garlic compounds remain. This extract is naturally rich in vinyldithiins and sulfides.



On the shelf
The unique vinyldithiins and sulfides are now available in pharmacies. These compounds are not found in most garlic supplements. If they are, they are usually in small quantities when you actually need to consume more than 280mg. Look for supplements from unique high-yielding garlic species. Also, look for garlic supplements that are super critically extracted. Look for actual label claims for vinyldithiins and sulfides. Garlic is more than just food, spice and herb. The way things are, it may end up as a pharmaceutical drug.

EDEMA

WHAT IS EDEMA?
Edema (American English) or oedema (British English; both words from the Greek οἴδημα, oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body. Generally, the amount of interstitial fluid is determined by the balance of fluid homeostasis, and increased secretion of fluid into the interstitium or impaired removal of this fluid may cause edema
CLASSIFICATION

Generalized
A rise in hydrostatic pressure occurs in cardiac failure. A fall in osmotic pressure occurs in nephrotic syndrome and liver failure. It is commonly thought that these facts explain the occurrence of edema in these conditions. However, it has been known since the 1950s that the situation is more complex and it is still far from completely understood.Causes of edema which are generalized to the whole body can cause edema in multiple organs and peripherally. For example, severe heart failure can cause pulmonary edema, pleural effusions, ascites and peripheral edema.Although a low plasma oncotic pressure is widely cited for the edema of nephrotic syndrome, most physicians note that the edema may occur before there is any significant protein in the urine (proteinuria) or fall in plasma protein level. Fortunately there is another explanation available. Most forms of nephrotic syndrome are due to biochemical and structural changes in the basement membrane of capillaries in the kidney glomerulae, and these changes occur, if to a lesser degree, in the vessels of most other tissues of the body. Thus the resulting increase in permeability that leads to protein in the urine can explain the edema if all other vessels are more permeable as well.
 WHAT THE ORGAN SPECIFIC WILL INVOLVE?
Edema will occur in specific organs as part of inflammation, as in pharyngitis, tendonitis or pancreatitis, for instance. Certain organs develop edema through tissue specific mechanisms.
Examples of edema in specific organs:Cerebral edema is extracellular fluid accumulation in the brain. It can occur in toxic or abnormal metabolic states and conditions such as systemic lupus. It causes drowsiness or loss of consciousness.Pulmonary edema occurs when the pressure in blood vessels in the lung is raised because of obstruction to removal of blood via the pulmonary veins. This is usually due to failure of the left ventricle of the heart. It can also occur in altitude sickness or on inhalation of toxic chemicals. Pulmonary edema produces shortness of breath. Pleural effusions may occur when fluid also accumulates in the pleural cavity.Edema may also be found in the cornea of the eye with glaucoma, severe conjunctivitis or keratitis or after surgery. It may produce coloured haloes around bright lights.
Edema surrounding the eyes is called periorbital edema or eye puffiness. The periorbital tissues are most noticeably swollen immediately after waking, perhaps due to the gravitational redistribution of fluid in the horizontal position.Common appearances of cutaneous edema are observed with mosquito bites, spider bites, bee stings (wheal and flare), and skin contact with certain plants such as Poison Ivy or Western Poison Oak,[2] the latter of which are termed contact dermatitis.Another cutaneous form of edema is myxedema, which is caused by increased deposition of connective tissue. In myxedema (and a variety of other rarer conditions) edema is due to an increased tendency of the tissue to hold water within its extracellular space. In myxedema this is because of an increase in hydrophilic carbohydrate-rich molecules (perhaps mostly hyaluronan) deposited in the tissue matrix. Edema forms more easily in dependent areas in the elderly (sitting in chairs at home or on aeroplanes) and this is not well understood. Estrogens alter body weight in part through changes in tissue water content. There may be a variety of poorly understood situations in which transfer of water from tissue matrix to lymphatics is impaired because of changes in the hydrophilicity of the tissue or failure of the 'wicking' function of terminal lymphatic capillaries.In lymphedema abnormal removal of interstitial fluid is caused by failure of the lymphatic system. This may be due to obstruction from, for example, pressure from a cancer or enlarged lymph nodes, destruction of lymph vessels by radiotherapy, or infiltration of the lymphatics by infection (such as elephantiasis). It is most commonly due to a failure of the pumping action of muscles due to immobility, most strikingly in conditions such as multiple sclerosis, or paraplegia. Lymphatic return of fluid is also dependent on a pumping action of structures known as lymph hearts. It has been suggested that the edema that occurs in some people following use of aspirin-like cyclo-oxygenase inhibitors such as ibuprofen or indomethacin may be due to inhibition of lymph heart action.
Six factors can contribute to the formation of edema:

1.It may be facilitated by increased hydrostatic pressure or,
2.reduced oncotic pressure within blood vessels;
3.increased tissue oncotic pressure
4.by increased blood vessel wall permeability as in inflammation;
5.by obstruction of fluid clearance via the lymphatic system; or,
6.by changes in the water retaining properties of the tissues themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidney.[3]

Hemorrhoids

Hemorrhoids are part of the human anatomy of the anal canal. They become pathological or piles when swollen or inflamed. In their physiological state they act as cushions composed of arterio-venous channels and connective tissue that aid the passage of stool. The symptoms of pathological hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids present with pain in the area of the anus.Recommended treatment consists of increasing fiber intake, oral fluids to maintain hydration, NSAID analgesics, sitz baths, and rest. Surgery is reserved for those who fail to improve following these measures.
Classification
Direct view of a hemorrhoid as seen by sigmoidoscopyThere are two types of hemorrhoids external and internal which are differentiated via their position with respect to the dentate line.
 External
External hemorrhoids are those that occur outside the anal verge (the distal end of the anal canal). Specifically they are varicosities of the veins draining the territory of the inferior rectal arteries, which are branches of the internal pudendal artery. They are sometimes painful, and often accompanied by swelling and irritation. Itching, although often thought to be a symptom of external hemorrhoids, is more commonly due to skin irritation. External hemorrhoids are prone to thrombosis: if the vein ruptures and/or a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid.
Internal
Internal hemorrhoids are those that occur inside the rectum. Specifically they are varicosities of veins draining the territory of branches of the superior rectal arteries. As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated. Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids. Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside the anus. If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid.
Internal hemorrhoids can be further graded by the degree of prolapse.
Grade I: No prolapse.
Grade II: Prolapse upon defecation but spontaneously reduce.
Grade III: Prolapse upon defecation, but must be manually reduced.
Grade IV: Prolapsed and cannot be manually reduced.
 Signs and symptoms
Classical appearance of an external hemorrhoid.Hemorrhoids are usually benign. In most cases, symptoms will resolve within a few days. External hemorrhoids are painful while internal hemorrhoids usually are not.
The most common symptom of internal hemorrhoids is bright red blood covering the stool, a condition known as hematochezia, on toilet paper, or in the toilet bowl. They may protrude through the anus. Symptoms of external hemorrhoids include painful swelling or lump around the anus.
Causes
A number of factors may lead to the formations of hemorrhoids including irregular bowel habits (constipation or diarrhea), exercise, gravity, nutrition (low-fiber diet), increased intra-abdominal pressure (prolonged straining), pregnancy, genetics, absence of valves within the hemorrhoidal veins, and aging.Other factors that can increase the rectal vein pressure resulting in hemorrhoids include obesity, and sitting for long periods of time.During pregnancy, pressure from the fetus on the abdomen and hormonal changes cause the hemorrhoidal vessels to enlarge. Delivery also leads to increase intra abdominal pressures.Surgical treatment is rarely needed as symptoms usually resolve post delivery.
Pathophysiology
This section requires expansion. Hemorrhoid cushions are a part of normal human anatomy and only become a pathological disease when they experience abnormal changes. There are three cushions present in the normal anal canal.These cushions support distal anastomoses between the superior rectal arteries and the superior, middle, and inferior rectal veins. They also contain a subepithelial smooth muscle layer, contributing to the bulk of the cushions. Normal hemorrhoidal tissue accounts for approximately 15-20% of resting anal pressure and provides important sensory information, enabling the differentiation between solid, liquid, and gas.Most people contain 3 of these cushions. Although classically described as lying in the right posterior (most common), right anterior, and left lateral positions, this combination is found in only 19% of patients. Hemorrhoids can be found at any position within the rectum.
 Prevention
The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Exercise, including walking, and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass. Spending less time attempting to defecate and avoiding reading while on the toilet have been recommended.
 Diagnosis
Endoscopic image of internal hemorrhoids seen on retroflexion of the flexible sigmoidoscope at the ano-rectal junctionA visual examination of the anus and surrounding area may be able to diagnose external or prolapsed hemorrhoids. A rectal exam may be performed to detect possible rectal tumors, polyps, an enlarged prostate, or abscesses. This examination may not be possible without appropriate sedation due to pain.Visual confirmation of internal hemorrhoids is via anoscopy. This device is basically a hollow tube with a light attached at one end that allows one to see the internal hemorrhoids, as well possible polyps in the rectum.
 Differential
Many anorectal problems, including fissures, fistulae, abscesses, colorectal cancer, rectal varices and itching,diverticulosis,polyps have similar symptoms and may be incorrectly referred to as hemorrhoids.
Treatments
Conservative treatment typically consists of increasing dietary fiber, oral fluids to maintain hydration, non-steroidal anti-inflammatory drugs (NSAID)s, sitz baths, and rest. Increased fiber intake has been shown to improve outcomes and may be achieved by dietary alterations or the consumption of fibre supplements .While many topical agents and suppositories are available for the treatment of hemorrhoids there is little evidence to support their use. Preparation H may improve local symptoms but does not improve the underlying disorder and long term use is discouraged due to local irritation of the skin.
 Procedures
Rubber band ligation is a procedure in which elastic bands are applied onto an internal hemorrhoid at least 1 cm above the dentate line to cut off its blood supply.Within 5–7 days, the withered hemorrhoid falls off. If the band is placed too close to the dentate line intense pain results immediately afterwards. Cure rate has been found to be about 87%.Sclerotherapy involves the injection of a sclerosing agent (such as phenol) into the hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up. The success rate at four years is 70%.A number of cautery methods have been shown to be effective for hemorrhoids. This can be done using electrocautery, infrared radiation, or cryosurgery.
A number of surgical techniques may be used if conservative medical management fails. All are associated with some degree of complications including urinary retention, due to the close proximity to the rectum of the nerves that supply the bladder, bleeding, infection, and anal strictures.
Hemorrhoidectomy is a surgical excision of the hemorrhoid used primary only in severe cases. It is associated with significant post operative pain and usually requires 2–4 weeks for recovery.
Doppler guided transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then “tied off” and the prolapsed tissue is sutured back to its normal position. It has a slightly higher recurrence rate however has less complications compared to a hemorrhoidectomy.Stapled hemorrhoidectomy is a procedure that involves resection of soft tissue proximal to the dentate line, disrupting the blood flow to the hemorrhoids. It is generally less painful than complete removal of hemorrhoids and was associated with faster healing

HEART ATTACK

What Is a Heart Attack?


A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.


What is heart attack?
Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9–1–1 right away.
How its happen?
Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque (plak) builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery. Heart With Muscle Damage and a Blocked Artery.During a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.



Get Help Quickly

Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms.
The most common heart attack signs and symptoms are:
Chest discomfort or pain—uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.
Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath may occur with or before chest discomfort.
Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat.