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South African Medical Directory

(Quick Reference)

Bach Flower Remedies: System of treatments akin to Homeopathy and Herbalism. Uses curative properties claimed to exist in certain plants

Bacteria: A group of organisms, some of which are harmless and some only harmful when they multioy too quickly.Certain bacetrial infections can be controlled by Antibiotics

Bacterial Vaginosis: This is a bacterial infection of the vagina that sometimes causes an abnormal discharge.Unprotected sex with multiple partners is a risk factor.Bacterial Vaginosis is caused by excess growth of some of the bacteria that normally live in the vagina,particularly Gardnerella Vaginitis and Mycoplasma Hominis.As a result,the natural balance of organisms in the vagina is altered.The reason for this excess growth is unknown,but the condition is more common in sexually transmitted disease

Symptoms: Bacterial Vaginosis often causes no symptoms.However some women may have a greyish-white vaginal discharge with a fishy or musty odour and vaginal or vulval itching.Rarely the disorder leads to pelvic inflammatory disease in which some of the reproductive organs become inflammed

Treatment: Your doctor may be able to diagnose Bacterial Vaginosis from your symptoms.Swabs of any discharge may be taken and tested to confirm the dianosis.Vaginiosis is usually treated with antibiotics either orally or as pessaries.Sexual partners should also be checked for infection and treated if necessary.Vaginosis usually clears up completely within two days of starting treatment,but the condition tends to recur

1. Syphilis: It is a bacterial infection caused by a bacterium Spirochacta Pallida.Infection initially affecting the genitals,but ,left untreated can damage numerous other parts of the bodyincluding the spine and brain.Once diagnosed,syphilis can be treated successfully with antibiotics by a specialist in genito-urinary infections

2. Gonorrhoea: Is a bacterial infection that causes genital inflammation and discharge.Once diagnosed it can usually be eradicated by antibiotics but, as strains are becoming resistant to conventional therapy,it is important to seek specialist help

Balanitis: Inflammation of the head of the male Penis (Glans) and the Foreskin.Causes:Boys are especially vulnerable to balanitis because of the condiation of Phimosis - tight foreskin in boys (over the age of 5) that has not been circumcized. The condition may also occur as a result of a bacterial or fungal (thrush-candidiasis) infection that can present as a discharge and rash Men with Diabetes Mellitus are more susceptible to the condition because their urine contains high levels of glucose,which can encourage the growth of micro-organisms.Excessive antibiotics can increase the risk of a fungal infection by temporarily lowering the body's defences against this type of infection.This leads to infection and inflammation at the opeing of the urethra.Another cause could be the sensitivity of the penis to certain chemicals such as found in some condoms,contraceptive creams,detergents and laundry soaps

Treatment:The treatment of Balanitis depends on the cause.If the head of the penis or your foreskin is inflamed,you should consult your doctor.The area will be examined and a swob taken to look for evidence of infection.The doctor may also test your urine to check for the presence of glucose.If you have a bacterial infection,antibiotics may be prescribed.If the infection is due to a tight foreskin - circumcision may be recommended to prevent balanitis from recurring.If the condition is the result of a sexually transmitted disease(STD), your partner should be checked for evidence of an infection and treated if necessary to prevent recurrence.If the cause seems to be sensitivity to a chemical, the irritant should be identified - if possible - so that you can avoid it.The inflammed area should be kept clean,dry and free of irritants.Most cases of balanitis clear up rapidly once the cause has been found and appropriate treatments has been start

Baldness: Alopecia or Hairloss.Common cause of hair loss in older children is the Fungal infection of the scalp knows as Ringworm.This produces circular patches of pink or grey, scaly baldness in the scalp and is extremely itchy.Another cause of temporary baldness in children is a condition known as Alopecia Areata - Round,bald patches appear suddenly and within a few months fine white hair break through into the bald area, followed by normal hair.Some children can actually inflict har loss on themselves with a nervous tic or mannerism, compulsive pulling,twisting and breaking their hair.This condition, which is called Trichotillomania and is often worse when the child is concentrating on something

Alopecia may be localized - in which hair is lost in patches - or generalized - in which there is thinning or total hair loss over the whole scalp.Hair loss can be temporary or permanent.Alopecia is not always associated with ill health - but may cause embarrassment.If your scalp has patchy scarring you may need a skin biopsy to idanose the underlying cause.Scarred areas may be treated with tppical corticosteroids or antifungal drugs,but if the damage is sevee and has affected the hair follicles it is unlikely that new hair will grow

Causes: The most common cause of Alopecia in men is oversensitivity to the hormone testosterone,producing a characterisitic pattern of hair loss (male-pattern baldness).This is an inherited condition and the most common form of Alopecia.The process starts when normal hair at the temples and crown is replaced by fine downy hair.The hair-line then gradually recedes.Only a trained Dermatologist can determine if the hair follicle - the pit in the skin from which the hair grows - is so badly damaged that hair loss is permanent.Patchy hair loss is usually due to Alopecia Areata - an autoimmune disorder that causes bald patches to appear on the scalp,surrounded by short,broken hairs.The hair will usually regrow within 6 months,but in rare cases Alopecia areata can cause permanent loss of all body hair - Alopecia Universalis.Hairstyles that pull on the scalp are a common cause of patchy hair loss.If the pulling is continuous, hair loss is permanent.Patchy hair loss may be the result of a rare psychological disorder in which the hair is compulsively pulled - Trichotillomania.Burns or skin disorders - such as ringworm,that scar the scalp may cause permanent patchy hair loss.Generalized thinning of the hair is noticeable after the menopause,and hair loss is normal in elderly people.Hair loss may occur temporarily after pregnancy for up to a period of 18 months.Hair loss is also a common side effect of Chemotherapy and Hypothyroidism.Other causes of thinning hair include acute illness,stress and malnutrition

Hair Loss in women: Estrogen receptors in hair follicles maintain the health of each hair,which is why problems can occur at the time of menopause if Estrogen levels are lwo.So it is possible that if you have a problem with hair loss - it may be due to a hormone imbalance and hormone replacement therapy (HRT) might help.Consult your doctor for advice about this.It is also possible you have an underactive thyroid as hair loss is one of the symptoms.A simple blood test can diagnose this.Iron-deficiency Anaemia can aslo cause haire loss.Women who suffer with heavy periods are often deficient in iron.Rapid weight loss and stress is also thought to affect the hair folicles by constricting the blood vessels that supply them and so limiting their supply of oxygen.General thinning of the hairi is common after pregnancy.The pregnancy hormones drive most of the scalp hair into a growing phase.Under normal circumstance, hairs are at different stages of resting and growing phases and therefore hair loss is gradual and imperceptibl.The dramatic hair loss associated with pregnancy is because great numbers of hairs come out of the resting phase at the same time and are lost simultaneously.This may go on for anything up to 18months or two years.Although very disturbing, it is no cause for alarm because it is self-limiting and reversible - although hair may take a long time to grow back,and straight hair may become curly and vice versa.Chronic scratching of the scalp - particularly at the back near the nape of the neck,is quite a common symptom of anxiety and can give rise to hair loss.However, this is rarely complete and always recovers when scratching stops.Hair pulling - Trichotillomania - can occasionally cause bald patches but it can always be diagnosed because hair loss is never complete and there are often broken hairs of different lengths present in the bald patches.Like chronic scratching,Trichotillomania nearly always has a psychological cause

Treatment: 1. The hair usually regrows once the underlying cause has been treate 2. Your doctor will probably be able to diagnose Alopecia areata by the appearance of your scalp.This condition does not usually require treatment,but corticosteroids injected into the hairless patches may be effective in promoting regrowth 3. In most cases of hair loss, the hair usually regrows once the underlying cause has been treated 4. If you scalp has patchy scarring - you may need a skin biopsy to diagnose the underlying cause.Scarred areas may be treated with topical corticosteroids or antifungal drugs,but if the damage is severe and has affected the hair follicles, it is unlikely that new hair will grow

Possibilities for Permanent Hair Loss: 1. Hairpieces: This is the safest and least painful way (health & money) to camouflage hair loss.Some can be permanently attached to the head, either by being tied to existing hairs or by being sewn onto the scalp.The latter can cause infection and are not recommended for that reason.The only other possible side effect is that occasionally people are sensitive to the adhesive that is sometimes used 2. Hair Implant: This is a quasi-surgical procedure where strips of hair are attached to the scalp - in the form of sugical threads implanted in the balding area.The implants are usually synthetic so a hairdryer mus not be used 3. Hair Transplants: This is a surgical procedure that generally results in permanent replacement of hair although even when well established, it is not as luxurious as the hair you have lost.Plugs of hair are cut from the remaining healthy hair on the sides and back of the head and implanted in bald spots.This hair normally falls out after transplant - but is replace by new hair.Quite a few follicles must be transplanted in the same session and the process needs to be repeated in the total baldd area is to be covered 4. Hairweaving: This is a non-surgical procedure that adds replacement hair to existing hair in order to cover bald patches.The new hair is braided strand by strand onto the edges of the hair in situ.Hair weaving requires maintenance and careful cleansing 5. Scalp Colorants: A spray available from pharmacies - covers the head in an organic dust to disguise any bald patches.Coloured creams can darken the scalp to camouflage pale,hairless skin 6. Medication: During research on adfrug to control high blood pressure, it was discovered that Minoxidil, promoted hair growth.It has to be applied to the scalp twice daily for a minimum of 4 months for any effect to be noticeable.Treatments has to be continued or hair loss will reoccur.The one thing that all thses treatmetns have in common, is the expense involved over a long period of time.It is sensible to seek advice before committing yourself to any particular form of treatment 7. Self-Help: If possible, try not to worry about your hair loss because anxiety makes the problem worse.Very often it is worth considering wearing a wig so that the psychological effect of the hair loss dos not take too great a toll

Barber's Rash: Sycosis Barbae / Folliculitis.Infectious Rash. Affecting the area where male facial grow

Barium Sulphate: Thick white fluid swolled in aid to examine the gullet by X-ray

Bartholin's Cyst /Abscess: Swelling of the two Lubrication Glands at the back of the Vulva, can form a cyst.This cyst may become infected and form an abscess

Bed Wetting: Enuresis.Bedwetting once a child has gained bladder control is nearly always a sign of increased Tension and Anxiety.Few children might have a physical reason or incontinence because of a Urinary Tract Infecion or some abnormality of the Urinary System.Accompanied by an increased Thirst and Frequent urination during the day - may be a symptom of Diabetes

Bell's Palsy: Inflammation of the Facial Nerve, causing the face to droop Also called Facial Palsy. In Facial palsy,there is weakness or paralysis of the facial muscles on one side of the face due to damage to the facial nerve.The problem usually clears up without treatment

Causes: The viral infection Herpes Zoster (Shingles) is a known cause of damage to the facial nerve and many other viruses,especially Herpes Simplex,also have the potential to cause facial palsy.The bacterial infection,Lyme disease, carried by ticks,is also a known cause.Inflammation of the facial nerve is somethimes due to a middle ear infection.Rarely,the facial nerve may be compressed by a tumour called an Acoustic Neuroma

Symptoms: 1.In some cases,the symptoms of facial palsy appear suddenly over about 24 hours 2.In other cases,including facial palsy caused by an acoustic neuroma, symptoms may develop slowly 3.The symptoms include partial or complete paralysis of the muscles on one side of the fac 4..Pain behind the ear on the affected side 5. Drooping of the corner of the mouth 6.sometimes associated with drooling 7 Inability to close the eyelid on the affected side and 8.watering of the eye 9.Impairment of taste.If facial palsy is very severe,you may have 10.difficulty speaking and eating. In a few cases 11.sounds seem unnaturally loud in the ear on the affected side 12.If the eyelid cannot be closed,the eye may become infected,possibly leading to ulceration of the cornea,the transparent front part of the eye 13.In facial palsy due to shingles, there is also a rash of crusting blisters on the face

Treatment: If your symptoms have appeared in the last 48H,your doctor may prescribe Corticoserioids for up to 2 weeks to reduce inflammation of the nerve.Analgesics will relieve pain. To prevent damage to the cornea,you may be given artificial tears and you will probably be advised to tape the affected eye shut when you go to sleep.Bell's palsy usually clears up without further treatment.If facial palsy has and underlying cause,it will be treated too. e.g If facial palsy is due to shingles,antiviral drugs such as acyclover will be prescribed.To be effective,treatment with acyclovir should begin as soon as the rash appears.If there is an acuositc neuroma,it will be removed surgically to relieve compression of the facial nerve.If muscle paralysis persist,plastic surgery may be used to re-route another nerve to the face.Facial exercise and massage may help maintian tone and facial symmetry.With appropriate treatment,facial palsy usually improves in about 2 weeks.However a full recovery may take up to 3 months.Some people are left with weakness in the affected area and facial palsy may occur

Bilharziasis: Schistosomises.Parasite Infestation of liver, bladder or intestines by the Bilharzia parasite

Biofeedback: A techinque in which a patient, using scientific measuring devices can monitor bodily responses of which he would otherwise be unaware e.g brain rhythms, skin & muscle tension

Biopsy: The procedure in which a sample of tissue is taken specially for testing is known as a biopsy.Biopsy may be done to confirm a diagnosis or to investigate a suspicious lump or a tumour.e.g If Cirrhosis is suspected, a biopsy of liver tissue may be done and if characteristic changes are found, the diagnosis is confirmed.It is not known whether a tumour is malignant (cancerous) or benign (non-cancerous) - a biopsy can provide tissue that can be tested for cancerous changes.Futher test are sometimes needed if tissue tests do not provide a definitive diagnosis

Biorhythms: Human behaviour is influenced by varius biological cycles within the body that affects a person's moods and energy levels.Also called Circadian Rhythms

Bird-Fancier's Lung: Allergic reaction to a protein in a bird's blood supply found in their droppings.Humans can get infected by inhaling heavy doses of the protein

Birthmark: Is a patch of Discoloration in the Skin, caused by a collection of small blood vessels or pigment just under the surface.May be flat or raised and present at birth or may appear in the first months of life.Brown birthmarks are circular and may have hair growing out of them.These are called MOLES and they are usually permanent and should not be interfered with by anyone but a Specialist. Storkbites are small, pink and spidery and appear on the back of the neck, the upper eyelids or the nose.The disapear within a few years.A Mongolian spot looks like a blue bruise in the skin and is usually found among dark-skinned people.It occurs most often on the lower back or buttocks.Strawberry Naevus is a raised red mark wth a bumpy surface which is sometimes shaped like a strawberry.Usually disappears by the time a child is five,But before it does, it enlrges alarmingly, growing darker or lighter, before gradually disappearing.Most common in girls and can bleed spontaneously.A Port Wine Stain looks exactly like its name, red patch of skin.Appearing over much of the face and forehead or the limbs, and is usually large.It does not disappear - though it can fade to a paler pink. More common among blond children

Blackwater Fever: A serious complication of Malignant Terian Malaria in which the red blood cells are destroyed

Bladder: Expandable bag in which liquid waste (Urine) is stored before being excreted

Blepharitis ridology: Inflammation or Irritation of the margins of the skin around the Eyelids.often accompanied by Dandruff and may be part of a condition called Seborrhoeic Eczema

Blister: Swelling formed by an accumulation of clear fluid (serum) under the skin, result of burns, friction or as a result of exposure to extremes of temperatures.Do not prick blister, beter to leave the skin to heal from within on its own.If blister is broken before healing has taken place, there is a risk of infection

Bloating: Bloating with abdominal swelling may be a problem during the menopausal years.It is usualy due to gas in the large intestine produced by fermentation in the bowel.As we age,small pockets of tissue may balloon out from the bowel,giving rise to the condition called Diverticulosis.Within these small pockets bacteria may accumulate,ferment carbohydrates and produce produce large amounts of gas.The intestine may end up coated with food remenants that form small centres of fermentation.It is quite common to wake in the morning with a flat stomach and for the abdomen to swell as the day progresses so that by bedtime the swelling resembles a 6-month pregnancy.During the night lack of food and sugar in the intestine allows fermentation to abate.After a breakfast that contains sugar and yeast,fermentation in the bowel flares up again

Treatment: Try to eat foods with yeast and sugar in the early part of the day only to see if that helps.A high-fibre diet,plenty of fluids and frequent exercise will keep the bowels normal.Try to eat a pot of 'live' yoghurt each day

Blood Poisoning: Septicaemia.Quite often we have bacteria in the blood - but they do not multiply.Septicaemia is a rare infection in which bacteria multiply in the bloodstream.It nearly always occurs when bacteria escape from a localized infection such as Peritonitis,Meningitis or an abscess and is more likely to occur in people with a compromised immune system.It is a complication of bacterial meningitis

Symptoms: 1. The symptoms of Septicaemia develop suddenly and include 2. high fever 3. chills 4 & violent shivering 5. If septicaemia is left untreated,the bacteria may produce toxins that damage blood vessels,causing a drop in blood pressure and widespread tissue damage.In this condition called Septic Shock,which is potentially life-threatening,symptoms include faintness,cold,pale hands and feet,restlessness and irritability,rapid,shallow breathign,rash,jaundice,in many cases,delirium and eventual loss of consciousness.In some people,bacteria may lodge on the heart valves,especially if the heart has previously been damaged by disease.This serious condition is called Infective Endocarditis.Rarely,septicaemia may result in a lack of blood cells involved in the blood clotting (thrombocytopaenia) which increases the risk of bleeding and produces a characteristic purpuric rash that does not blanch when a glass is pressed on the skin

Treatment: If your doctor suspects that you have septicaemia,you will be admitted to hospital for immediate treatment.Intravenous antibiotics are given without delay and blood tests are done to identify the bacterium causing the infection.Once the bacterium has been identified,specific antibiotics are given.With prompt treatment before the onset of Septic Shock,most people are able to make a complete recovery

Body Dysmorphic Disorder (BDD): People with Body Dysmorphic Disorder - have a distorted percetion of their own body shape,becoming preoccupied with an imagined defect or showing excessive concern about some minor anomaly.BDD sufferers typically try to hide thier 'affliction.We have known for some time that anorexics have a distorted perception of their bodies,no matter how thin they are they still see themselves like the Michelin man.And it is not restricted to women,men are increasingly perceiving themselves as too thin and becoming obsessive about weight training and body building,even to the extent of taking anabolic steroids.In the most severe cases people go to extraordinary lenghts to rid themselves of their ugly feature, in some cases amputating an unwanted limb

Causes: Body Dysmorphic Disorder shares features with several other psychiatric conditions,including Anorexia and obsessive-compulsive disorder (OCD).Like anorexics,BDD suferers see their body in a distorted way,but while anorexics flaunt their thinness and are proud of it,people with BDD regard their affliction as a terrible secret.Preoccupation with an imagined defect in appearance is the basis of this disorder.If a slight physical anomaly is present,the person's concern is marked excessive.BDD quite often starts in adolescence when teenagers are plague with insecurity and shyness.It wouldn't be uncommon to feel that everything about you was wrong - the size of your head,your hands,your height,your thinness,your fatness,your spots.You may resort to all sorts.There are normal adolescent anxiety blown up to monstrous proportions,so that eventually you may believe that if anyone even looks at you in the street they are condenmming you for living.Self-loating can be so intense that you repeatedly mutilate yourself.Life may become one complex ritual.You check your face in the mirror hundreds of times a day and it can take you 5 hours to get ready to go out.Just why someone tumbles into the BDD pit of self-loathing no one knowns.There is speculation about triggering events in childhood.Researchers have shown that anorexics have reduced blood flow to the part of the brain that controls vision,which might be linked with the distortion of their body image.Brain scans have revealed that several areas in the brain malfunction in cases of OBD (Obsessive Compulsive Disorder).It might be the same with those suffering of BDD. 60% of those effected,recover with therapy

Treatment: The recommended treatment for BDD's is - Cognitive Therapy.This involves being exposed to more and more challenging situations until you can begin to function in society again.Selective Serotonin Re-uptake Inhibitor (SSR) drugs can help too.Also self-help groups gives support and advice

Boil: One of the most common types of skin infections.It presents as a large tender red Lump that results when a Hair follicle becomes infected with bacteria,usually Staphylococci.Pus is formed.Boils can be large or small

The pus-filled lump gradually comes to a head and bursts after about 2-3 days.It may also heal on its own without bursting and slowly disappear.As the hair follicles are so close together,the bacteria can infect a wide area,causing more boils to occur.This is most likely to happen on the face,especially the shaving area and the back of the neck near the hairline where the hairs may grow back into the skin.Boils usually appear on areas where there are pressure points,such as where a collar rubs on or on the buttocks.ALrhough unsightly - a blil is not serious.However,it can be extremely painful,especially if it develops over a bony area - such as the jaw or forehead where the skin is stretched tight.Consult your doctor as soon as possible if a boil does not come to a head within 5 days, if the boil is causing a lot of pain or if you notice red streaks spreading out from the centre of the boil - which may mean that the infection is spreading

Treatment: Your doctor will examine the boil and the surrounding area.If he can feel pus under the skin,your doctor will probably lance the boil with a small scalpel, and drain the pus,thus reducing the pain immediately.If there is a spreading infection - or if you have had a number of boils, over the previous months, your doctor may prescribe and anati-infective cream to treat the skin's surface or antibiotic tablets to prevent the internal spread of the infection lower down into the skin.If there are crops of boils,your doctor may prescribe a special antiseptic to put in the bath water.If the boils are recurrent, you will be referred to a Dermatologist to find out if there is an underlying cause, such as diabetes mellitus

Self-Help: Do not scratch or touch the are around the boil.Wash the skin with surgical spirits or a solution of one teasoppon of salt in a glass of warm water to prevent infection from spreading.Do not squeeze the boil - even when it comes to a head.Squeezing will spread the infection to the surrounding area and make the problem much worse.Once the boil has burst,keep the area clean and covered with a dressing for a few days.Keep your towel and face cloth seperate from those of your family.If the boil is in a place where clothing might rub,put a thick pad over the dressing to prevent any friction

Bone Marrow Transplants: To perform a Bone Marrow Transplant, cells in the centre of certain bones are collected from a living Donor and are then transfused directly into one of the recipient's veins after his or her existing Bone Marrow has been destroyed.Alternatively, cells may be collected from the recipient's own Bone Marrow during a period when his/herunderlying disease is in remission and frozen for later use.The stored Bone Marrow may then be thawed and used to replace abnormal Bone Marrow in the recipient's body if disease recurs

Brain Stem: Medulla Oblongata.Controls the involuntary functions of the body such as Heartbeat,Breathing rate an Temperature regulations

Breast Bone: Sternum.The Central bone to which most of the Ribs are joined, so froming the rib cage

Breast Cancer: Understanding of Breast Cancer can can greatly improve your chances of avoiding it and defeating it.You can reduce the risk of ever getting breast ca by knowing how to prevent it.This includes making life choices such as having your first baby before 30 years old.Lifestyle changes, such as keeping your weight down adn your consumption of alcohol low, also helps.You should also eat at least 5 fresh fruits and vegetables every day.Early detection and diagnosis play an important role in the successful treatment of Breast Cancer and in the long-term outlook.It is important to know that, even when a diagnosis of Breast Cancer is made, there are different types.Not all cancers have the same degree of invasiveness or potential for spread - so not all, by any means have a poor outlook.A positive attitude is a real asset, possibly as vital as some medical treatments

Facts to consider: For every breast lump found to be cancerous - approx 8 others will prove to be benign and therefore harmless.If the lump is diagnosed and treated early, you will have a better chance of a successful outcome.Even with a cancerous lump 6 or 7 out of 10 will be treated without removing the breast.In post-menopausal women,deaths from Breast Cancer pale into insignificance when compared with the number of deaths caused by heart disease.Five times more women suffer from the disease than die from it.More than 70% of women who have operable disease will be alive and will 5 years after diagnosis.By the age of 50 - your chances of dying from Breast Cancer - compared to other causes of death such as heart disease, will have dropped dramatically from 1 in 12 - to 1 in 70 and the odds get better with every year you live afer that without developing it.By the time you are in your 60's - your chances of dying from breast cancer are probably less than half what they were when you were 50

HRT (Hormone Replacement Therapy: The risk of Breast Cancer increases slightly if you take HRT.The increase rises a little depending on the time you are on HRT.A women who stops HRT returns to the normal risk rate after 5 years.However teh risk of Breast Ca shoulc be weighed against the benefits of HRT.Four times as many women die from coronary artery disease and the consequences of osteoporosis,both of which HRT may help to guard against

Family History: About 5% of breast cancer may be due to genes inherited from your family.Women are at increased risk if their mother or sister develop breast cancer before the age of 40,if two of these relatives developed it before the age of 60 or if three relatives developed breast cancer at any age.Any woman who's worried should ask her doctor to refer her to a Cancer Family Clinic for advice

Tumour: The word tumour simply means a lump.Most breast tumours aren't cancerous.They are usually benign i.e. the growth of cells is confined to the area where the tumour starts.Tumours whose cells don't spread to other parts of the body aren't fatal.In contrast,the cells that make up cancerous tumours are invasive.They spread beyond their original location,not just into adjacent tissues but to other distant parts of the body and as they invade they destroy.The original tumour is known as a Primary.Tumurs that arise from cancerous cells that have spread elsewhere are called Secondaries or Metastases.To determine how aggressive cancer cells are , and how far they have spread,if at all, grading and staging tests are done - which are also a basis for deciding on treatment

Metastases / Spreading: Invasive cancers tend to spread first into the regional gland - the axillary lymph nodes in the armpits in the case of the breast - causing swellings.They may also spread to lymph nodes under the breastbone and above the collarbone.Spread via the bloodstream, through 'seeds' is probably more important in determining the long-term outlook.This is why modern treatments, such as hormonal therapy and chemotherapy are aimed at eradicating cancer cells from the body as a whole rather than just dealing with the tumour locally

Treatment Options: Women who have treatment for early breast cancer can expect to live a normal life span.For women who get local recurrences, radiotherapy can sometimes cure without the need for other treatment,While breast cancer is predominantly a disease of older women, many women lvie to die from causes other than their Breast Cancer

Surgery: MastectomY: the removal of a breast - is less common nowadays - or should be.Radical surgery is no longer the norm for breast cancer and there are currently several possible variations of mastectomy.More than 80 of breast cancer are localized and caught early enough to be suitable for lumpectomy - removal of the lump alone leaving the breast virtually intact

Lumpectomy: Also called breast conserving surgery - Is the removal of the lump alone leaving the breast virtually intact.Just the removal of the breast lump along with some surrounding normal tissue.If the procedure is done to remove a cancerous lump - some of the lymph nodes in the armpit are usually also removed.The procedure is done in hospital under either a local or, more usually - a general anaesthetic.Lumpectomy to remove a cancerous lump is usually followed by 3-5 weeks of radiotherapy to ensure that the cancer is eradicated

Chemotherapy: Several drugs are designed to target rapidly dividing cancer cells anywhere in the body,and the use of these drugs can increase the cure rate by 10%.Side effects including hair loss and nausea are unpleasant but usually only temporary.Other non-cancerous cells that are rapidly dividing - such as those in bone marrow,are susceptible to damage from chemotherapy

Hormonal drugs: Tamoxifen: A very promising hormanal drug can block tumour growth in certain patients and is used widely.Tamoxifen may even be given as a preventive measure in women who are at high risk of getting breast cancer.The latest UK figures show that Tamoxifen has cut the death rate from breast cancer by nearly 40%.Because ithas an anit-oestrogenic effect, Tamoxifen has side effects when taken for long periods,including menopausal symptoms.It slightly increased the risk of Uterine cancer

Radiotherapy: Radiation destroys or slows the development of cancerous cells.It's usually given after surgery, to kill any remaining cancerous cells,but may be used in place of surgery to reduce the size of breast tumours and thus to relieve symptoms.A certain percentage of women may be left with discomfort and stiffness in the shoulders and arms following radiotherapy - and you may lsoe some sensation in the treated breast.It may also be slightly swollen and feel different.If your breasts were an important source of sexual stimulation prior to surgery, counselling could help you to find other means of enhancing your enjoyment of lovemaking

Breast Reconstruction: Every women who has a mastectomy, has the right to a new reconstructed breast.It can be done at the same time as the mastectomy or at a later date.Most breast reconstruction involve a flap of skin, fat and muscle swung round from the back that's folded into a breast shape.An implant may be inserted too.New Nipples can be created by tissue grafting and tattooing.The new breast is often better than the breast that's left

Prostheses: Breast prostheses are very sophisticated now and feel like a natural breast.The can be fitted into a bra or swimsuit.Bras containing breast prostheses can also be obtained.Prostheses are designed to simulate the appearance and feel of a natural breast

Prognosis: Modern techniques mean that doctors can tailor treatment to the particular needs of each women,so you will be given every chance of a cure.Rigorous follow-up will be necessary to pick up any problems and to check for recurrence of cancer.After months of intensive medical attention you may feel alone and fearful and this is a time when a care worker / support group can be invaluable.It is important to know taht treatment for early breast cancer can expect to live a normal life span

Breast Cyst: A breast cyst is a firm,fluid-filled swelling within the breast tissue.Cysts are nearly always a variation of normal anatomy, not serious disease.Breast cysts are most commonly found in women in their 30's,40's & 50's, with the peak just prior to menopause.It's posible although rare, for cysts to occur in young women or in postmenopausal women.Your doctor will probably suggest Fine-Needle Aspiration Cytology (FNAC) or an ultrasound scan as the next step to confirm the diagnosis.With cysts, FNAC serves as both diagnosis and treatment in one.Aspirations can be done quickly, simply and painlessly as a routine procedure in the doctor's surgery or at the breast clinic.The whole procedure may be carried out under ultrasonic guidance, allowing you to watch as your doctor inserts the needle, aspirates the cyst and it disappears.Large cysts that are easily felt can be aspirated without the help of ultrasound.Cysts are rarely malignant, or not harmfully so.It is very important to check for an underlying lump after the cyst has been drained.If any evidence of cell growth is found in the cyst, your surgeon will operate and remove it

Breast Lumps: Breast Lumps are any masses or swelling in the breast tissuand can be benign or malignant.When you find a lump in your breast,doctors use many investigative techniques to arrive at as specific a diagnosis as possible

The initial test sequence varies, depending on whether you have found the lump yourself or it has been detected during routine mammogram screeining, in which case it may be too small to feel.In a all cases, however, a sample of cells or tissue will have to be examined under a microscope to determine whether the lump is malignant.If it is, futher tests will be done to asses the precise origin of the tumor and to see if it has spread.Your doctor will start the examination by looking at your breast while you sit with your hands by your sides and then with your arms raised above your head, so that asymmetry between the breasts, nipple retraction,difference in level between nipples or dimpling of the skin can easily be seen.You will then be asked to lie back with your arms above your head while the doctor examines your breasts carefully,feeling each quadrant of both breasts with the flat of the hand.The aim is to decide whether there is an obvious lump and if the breasts are just generally lumpy -and many breasts are.One of the three procedures in assessing a breast lump is through Fine Needle Aspiration Cytology (FNAC).It is used to sample cells from the lump.Under mammography or ultrasound guidance, a fine needle is inserted painlessly into your lump.If fluid is withdrawn, the lump is a cyst,the fluid can be drawn off and the cyst will disappear.If your lump is solid, a sample of cells is removed and spread on a glass slide for microscopic examination.Because FNAC yields only a tiny sample of cells from the breast tissue, it is impossible to be specific about where they are coming from.A core Needle Biopsy, provides a sample of cells from the lump that can be analyzed to make this distinction

Broken Bones: Fractures.Childrens bones are like young,bendy twigs.They do not snap as easily an the harder bones of adults. There are 4 types of bone fractures in children. 1. Greenstick Fracture 2. Simple Fracture 3. Compound Fracture 4. Open Fracture

Bronchiolitis: Inflammation of the Bronchioles -smallest parts of the air tubes.Usually caused by viruses.Can be serious because it can cause breathing difficulty

Bronchitis: Inflammation of the Bronchi -larger air passages leading to the lung.May be caused of viral or bacterial infection.There is a dry hacking cough, which produces phlegm after one or two days

Bronchodilator: A drug which widens Bronchial passages and is used in the treeatment of Asthma.The drug is taken either by Nasal Inhalation or Orally through a spray

Bruise: Is a Purplish-red stain in the Skin, usually the result form a blow or knock that Ruptures the Small Blood Vessels near the skin surfaces.It usually takes 10-14 days for a bruise to disappear completely.As it Fades, it changes colour to Maroon,then Green or Yellow as the blood pigments break down and are reabsorbed by the body.Bruises are rarely serious, but if a bruise appears without reason, this may relate to uncommon but SERIOUS conditions such as Leukaemia and Haemophillia

Brucellosi : Chiefly a disease of cattle, pigs and goats, which is sometimes caught by humans.Caused by a bacterium called Brucella Abortus

Buerger's Disease: Severe & progressive obliteration of the small Arteries mainly in the legs and feet and sometimes hands and arms

Bulimia: Eating Disorders like Bulimia & Anorexia Nervosa are abnormal ways of controlling weight,but neither is what is popularly described as the 'slimmers disease'.Both are expressions of deep inner turmoil of psychological problems that are too difficult for the person to cope with in any other way

Anorexia Nervosa: Diet is easy to be good at,you just have to starve yourself.But it is impossible for an Anorexic to believe it is the only thing she is good at,so thinness becomes an obsession.Anorexics judge themselves only according to how much they have eaten,the less they eat the more successful they judge themselves to be.All their self-worth becomes bound up in not eating and so starving becomes very difficult to give up.Anorexics have food and crave love.They remember the time when they felt secure in being loved and did not have to take any grownop responsibilities,so they may subconsciously try to remain a child.As a child they did not have to perform and they did not have to exxcel.By starving they fight against their developing body - they lose or don't develop breasts and do not menstruate

Bulimia: Bulmics go for several days with very little food and then become crazed with an uncontrollable desire to eat so that they gorge on almost anything ins sight that is edible.This may mena eating exraordinary mixtures of raw and cooked food,sweet and savoury mixed in huge quanities.Some women have died after a binge,because their stomachs have ruptured under the strain.Some women eat normally,but then force themselves to vimit immediately afterwards ortake huge quantities of laxatives to induce purging.This pattern of starving,bingeing,vomiting and purging is very had to break.It is also much more common than people think,but treatments can help

Causes of Eating Disorders: 1. The desire for control: Dieting can be very satisfying,especially for girls in their teens who feel that weight is the only part of their lives over which they have control.Not eating becomes and end in itself 2. Social pressure:In societies that don't value thinness,eating disorders are very rare.In surroundings such as ballet schools, or modeling schools,where people value thinness hightly,they are common 3. Cultural pressure: Generally in Western culture 'thin is beautiful'.The media are full of slim,attractive young men and women and there is a huge pressure to conform 4. Family: Some children and teenagers find saying no to food is the only way they can make their feelings felt and have influence in the family.Eating becomes an important social tool with which to exert pressure on parents 5. Not growing up: A girl with Anorexia may lose or not develop some of the physical traits of an adult woman,such as pubic hair breasts and monthly periods.As a result,she may look very young for her age.Not eating therefore can be seen as a way of putting off some of the demands of growing up,particularly the sexual ones 6. Depression: Many bulimics are depressed and binges may start off as a way of coping with unhappiness.A third of people with eating disorders are depressed and can be helped with the new generation of antidepressants 7. Upsets: For some people,Anorexia and Bulimia seem to be triggered off by an upsetting event,such as the break-up of a relationship.Sometimes it need not even be a bad event,just an important one,such as a marriage or leaving home

Consequences of Anorexia & Bulimia: 1. Starvation - leads to broken sleep,constipation,difficulty to concentrating or thinking straight,depression,feeling the cold,brittle bones that break easily,muscles becoming weaker - it becomes an effort to do anything,mensturation failing to start or stopping,inability to have a baby and even death 2. Vomiting - Stomach acid dissolves the enamel on teeth and swollen salivary glands leads to a puffy face,irregular heartbeat,muscle weakness,eventually to kidney damage and even epileptic fits 3. Laxative use - Causes persistent tummy pain,swollen fingers and damage to bowel muscles that may lead to long-term constipation 4. Bladder Problems - Become common.New research shows that women with Anorexia, are far more likely to have bladder problems than other women. Nearly two-thirds of women with Anorexia,at least three time more thannon-sufferers, had symptoms suggestive of an unstable bladder,with a sudden and overwhelming desire to go to the loo 8 x or more in 24 hours and sometimes actual incontinence.These symptoms usually start about a year after Anorexia began

Treatment of Eating Disorders: The sooner you ADMIT to having an eating disorder and ACCEPT HELP,the better the chance of a cure.Left untreated,Anorexia has one of the highest death rates of all psychiatric illnesses,though deaths can be prevented by proper treatment.No one form of treatments in 100% effective,what is effective for one person may not be effective for you.And despite best efforts,some people only partly recover.But there are lots of avenues to explore

1. Your GP - to help yourself,you have to be open and honest with your family doctor.You don't need to be ashamed of being Anorexic or Bulimic or reluctant to admit that you have a problem.You don't need to be frightened of the concequences of admitting that your have an eating disorder.You are entitled to complete confidentiality.It is your right to be referred for assessment by a specialist who has training in eating disorders and you should be seen as soon as possible so that delays and waiting lists can be avoided.You may get worse if you wait too long and then need 'in-patient' rather than 'day-patient' treatment

2. Self Help - self-help support groups can be a very useful addition to treatment but they are not an alternative.They are very helpful in getting patients and families to understand they are not alone with the illness

3. General Treatment - Treatments mus address the psychological aspects of Anorexia & Bulimia Nervosa as well as the abnormal eating pattern.All these treatments work,so don't be afraid to try them - Counselling,Psychotherapy,Cognitive Therapy, Group Therapy,Family Therapy,Day hospital programmes,In-patient treatment,Dietetic advice, Drugs can be of help in the short term,particularly to Bulimics who are depressed. Re-feeing is last resort,but may be necessary to save life. Alone,however,it is only successful in short-term weight-restoration,but usually is not effective in the long term

4. Counselling - For Anorexia,counselling is more effective during the early stages - when less than 25% of body weight has been lost.Research shows that cognitive behaviour therapy is especially effective for people with Bulimia

5. Specialist Treatment - You should be involved as much as possible in your treatment programme and care plan,so you should be able to see your case notes and be involved in setting target weights.Therapy should not be conditional on weight gain,and vegetarian menus and appropriate food for minority groups shoud be available

6. Hospital Treatment - Some severely underweight people with Anorexia Nervosa can be treated sucessfully as day-patients rather than in-patients.If you need in-patient treatment,you have the right to - a quite and safe environment,continuity or care from staff with an understanding of eating disorder,support during and after your meals,appropriate food,on-going counselling or psychotherapy,follow-up and support after in-patient care

7. Compulsory Admission - Out of people who had been admitted or detained against their wishes,50% said they thought it had been 'a good thing' in retrospect.So,in extreme circumstances,and when all other alternatives have failed,people may be detained under the Mental Health Act - in order to save life or reduce risk

8.Teamwork - Good treatment demand selfless teamwork with families,careres and friends all working together.The impact on the family of someone with an eating disorder can be enormous.Families also need support .They need advice on what they should and should not do to help a person's recovery

Bunions: A harmless swelling due to the collection of fluid in a pouch over the big toe joint
Burn: Is an injury to the Skin, following exposure to Heat from fires, hot liquids, chemicals, sun or electric current.Severity will depend on the situaltion and the cause.Superficial burn - may just be a reddened pach of skin or a fluid-filled Blister.Deep Burns - Layers of skin may actually be removed.Only small superficial burns must be treated at home. Do not pop the blisters !
Bursa: A Bursa is a sac containing a small amount of lubricating fluid that reduces friction where skin, a muscle or a tendon moves over bone
Bursitis: When the Bursa (sac) becomes inflammed and excess fluid forms in the sac and interferes with lubrication
Buttock Muscles: Gluteus Maximus.This muscle of the buttocks helps with standing and climbing

Family Health Guide & The Baby & Child Health Care Handbook - Dr.Miriam Stoppard