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South African Medical Directory

(Quick Reference)

Labyrinthitis: Inflammation of the Inner Ear - the Labyrinth that is responsible for mainting balance of the body

Lactose Intolerance: A person who is Lactose Intolerant is unable to digest lactose - a natural sugar found in milk and dairy products.Even small amounts of lactose can cause abdominal pain and diarrhoea.The problem is due to an enzyme deficiency.Intolerance to lactose usually develops from adolescence onwards.The permanent form rarely affects babies.An inability to digest lactose in the diet is particularly common among Afro-Caribbean,Asian and Jewish people

Causes: Normally,the enzyme LACTASE, breaks down lactose in the intestines to form the sugars glucose and galactose,which are easily absorbed through intestinal wall.If the enzyme is absent,the unabsorbed lactose ferments in the large intestine and produces painful symptoms.Alhough high levels of lactase are present at birth,in many racial groups the level can drop with increasing age and become very low by adolescene,so that milk can no longer be digested.In children and babies,lactose intolerance sometimes occurs temporarily following and attack of gastroenteritis that causes short-term damage to the lining of the intestine

Symptoms: The symptoms usually develop a few hours after eating or drinking products containing milk.They may include abdominal bloating and cramping,diarrhoea,vomiting.The severity of the symptoms depends on the degree of lactase deficiency.One person may experience symptoms only after drinking several glasses of milk,but another may feel discomfort after consuming only as small amount of dairy product.The symptoms are often initially mild,but can become more sevee with each subsequent episode

Treatment: Your doctor may be able to diagnose lactose intolerance from your medical history and symtoms.You will be asked to keep a diary of all the foods you eat and the symptoms that occur.You may then have a specialized test to confirm lactose intolerance.Alternatively your doctor may ask you to eliminate all diary products from your diet for a few days.If your symptoms improve but return when milk is reintroduced into your diet,the diagnosis of lactose intolerance is confirmed.It is important to NOT exclude diary products from your diet without consulting your doctor first

Prognosis: Lactose intolerance is usually permanent in adults.However,the symptoms, can be completely relieved by eliminating lactose from the diet.Hard cheese,butter and 'live' yoghurt contain very little lactose and are tolerated by most people.Milk products that have been specially treated by having lactose broken down are available over the counter.In addition,your doctor may suggest lactase supplements in the form of liquid or capsules.In babies who lactose intolerance is caused by Gastroenteritis milk,may be gradually re-introduced into the diet after a few weeks as the intestine recovers

Laparoscopy: Certain conditions can be diagnosed accurately only if the organs are directly seen.Laparoscopy is a a minor procedure done under a general anaesthetic , that enables the abdominal cavity to be examined.A viewing instument called a Laparoscope is inserted through a small cut in the abdomen that enables a doctor to see the inside of the abdominal cavity and organs such as the gallbladder, liver and uterus.The most common use of laparoscopy is in gynaecology,where it is commonly used for the following: tubal surgery,including sterilization,infertility investigations,ovarian cysts,fibroids,ectopic pregnancy,laparoscopic hysterectomy,bladder operations for stress incontinence

Procedure: A tiny cut is made in the abdomen,usually just below the navel so that no scar is visible afterwards.A needle is inserted into the abdomen and carbon dioxide gas is pumped into the abdominal cavity so that organs can be visualized.The laparoscope is passed in and the doctor can angle it to get a clear view.If other instruments are being used, these are inserted through a second incision above the pubic line.The procedure takes abvout 30-40min and you will have one or two stitches in the skin.After about 2hours depending on the reason for the laparascopy, you should be allow to go home.You may have a little discomfort from any gas that remains in your pelvic cavity and the incision site may be sore.However, laparoscopy is very safe and you should have few problems

Laryngectomy: Surgical removal of all or part of the Larynx.Usually in the case of cancer

Laryngitis: Inflammation of the Larynx (Voicebox).Producing hoarseness or sometimes loss of voice.Caused by minor viruses and occasionally bacteria or in some cases an underlying disease.Caution in young children when a swollen Larynx can obstruct the passage of air - causing breathing difficulties and Croup, which is a SERIOUS complication and needs URGENT treatment

Laser Treatment: Light from a laser beam can cut or destroy tissue or repair damaged tissue by fusing together torn edges.This allows lasers to be used in a number of surgical procedures in place of scalpels, scissors and stitches.Since laser beams can be focused precisely,small sections of tissue can be treated without causing damage to the surrounding tissue.Laser treatment is commonly used in gynaecological procedures.A laser beam can be directed into the body through an endoscope to remove scar tissue inside the fallopian tubes, which may be a cause of infertility

Lasers are also be used to remove cysts fat from in the pelvic area due to endometriosis and to destroy abnormal cells on the cervix which if untreated,may develop into cancer.Similar small tumours or pre-cancerous cells in other internal body areas, such as the larynx or inside the digestive tract,can be destroyed by laser beams directed through an endoscope.The technique can also be used to open arteries that have been narrowed by fatty deposits, in ophthalmic surgery - laser beams can be used to seal small tears in the retina,the light sensitive layer at the back of the eye.Laser treatment is also often used on the skin,especially on the face for reducing scar tissue and birthmarks,non-cancerous moles,tattoos or wrinkles.The results depend on the extent of the problem but in most cases scarring in minimal and the appearance of the skin is much improved.External laser treatment can also be used to treat conditions such as spider veins and to remove warts on the skin and on genital warts

Most forms of laser treatment are done under either local or general anaesthesia, depending on the type of sugery and the area to be treated.However for minor skin conditions.laser treatment causes liattle discomfort and may be performed without anaesthesia.There may be some swelling,redness and blistering, which usually disappear within a wek.Large areas of skin may have to be treated over serveral seasons

Legionnaire's Disease: Infectious disease caused by bacteria called Legionella Pneumophilia and that causes Pneumonia

Leishmaniasis: Infectious disease caused by a parasite and the infection is spread by th bite from sandflies

Lentigo: These are tiny falt dark spots, like freckles.Occur in varying number anywhere on the body of children and adults ,especially elderly people

Leukaemia: Bone Marrow Cancer.Abnormal or very immature white blood cells multiply rapidly and accumulate within the Bone Marrow, where all types of blood cells are normally produced.The usual production of normal white blood cells, normal red blood cells and platelets within the Bone Marrow is reduced by the invading cancerous white cells leading to symptoms of Anaemia & Purpura - bleeding under the skin that may appear as unprovoked bruising.Leukaemia may therefore show up as Anaemia.Other symptoms may include weight loss, fever, night sweats, excessive bleeding and recurrent infections.In most of the Leukaemias, the cancerous white blood cells spread, causing enlargement of the lymph nodes (glands),liver & spleen.The two main types of Leukaemia are Acute Leukaemia, in which the symptoms develop rapidly and Chronic Leukaemia, in whcih symptoms may take years to develop.Adults may develop either type, but children usually have the acute form.Acute Leukaemia can be divided into Acute Lymphoblastic and Acute Myeloid Leukaemia, depending on which type of white blood cells is involved.Quite often the first indication of Leukemia is the Anaemic condition of the child and his failure to recover quickly from an infectious illness.Also look out for pain in the limbs, if in the legs,perhaps seen as a LIMP.Chronic Leukaemia is also divided into two types: Chronic Lymphocytic Leukaemia & Chronic Myeloid Leukaemia.Leukaemia may be diagnosed from blood tests and examination of the Bone Marrow

Treatment: is tailored to each kind of Leukaemia and of ten to each individual case.Chemotherapy is usually given, often as combinations or 'cocktails' of several drugs.In some cases, radiotherapy is given.Blood transfusions are sometimes necessary.In some cases, a bone marrow transplant will be done, providded a suitable donor is found

Prognosis: varies depending on the type of Leukaemia and its severity.Chronic Lymphocytic Leukaemia may run a long,benighn course and need little radical treatment.Treatment of Leukaemia in children is a success story.Due to decades of intensive research into chemotherapeutic regimens, it's fair to say that the majority of children will be successfully treated

Lice: Contagious.Parasites which feed by sucking blood.Skin irritation which result from this is called Pediculosis.Head Lice are tiny insects which infests the hair on the human head.The adult louse lays its eggs (nits) at the root of the hair to which it become firmly attached.The eggs hatch after 2 weeks and the lice bite the scalp to get blood.Child's head will be itchy, especially after strenuous excercise , when he is hot.Lice infestation is considered a public health hazard, needs to be reported to schools

Lice are wingless insects that feed on human blood.There are 3 kins of Human Lice - Pubic lice (crabs),Body lice and Head lice

PUBIC LICE (CRABS): Pubic Lice need the bodily heat of a person to keep them alive - hence they do not live very long on a toilet seat - although they may survive on warm bed clothes or garments for a short time.Medical text books state that 'CRABS' are nearly always passed from one person to another during SEXUAL CONTACT,because they actually live on PUBIC HAIR and sometimes body hair - where they feed on blood and lay eggs called NITS.With crabs,the most commons symptom is itching in the pubic area and around the anus,especially at night.Some people have no symptoms and only realize that they are infested when they see the nits (eggs) or the tiny insects.Normal washing does not remove the nits,since they are firmly stuck to the pubic hair.If you think that your partner has pubic lice,you should consult your doctor or g o to a clinic specializing in Sexual Transmitted Disease(STD)

BODY LICE: They live on clothing and bed linen and are easily picked up by someone sharing a bed or garments.Body lice do occasionally stray to the pubic area and therefore can be confuse with pubic lice.Treatment:Your doctor will probably prescribe a preparation containing lindane or permethrin to apply to affected areas.A second application is needed about 10 days after the first to destroy freshly hatched lice.To prevent spread of lice,sexual partners should be checked and treated if necessary.The clothing and stheets used by an infested person should be machine washed in HOT WATER

HEAD LICE: Head lice affect all social classes and have absolutely nothing to do with personal hygiene.They like clean heads as much as they do dirty ones and there is nothing shameful about being infected.If you have a child there is a good chance you will come into contact with head lice at some stage.Head lice live and such blood from the scalp,leaving tiny red spots that cause intense itching.Adult lice can live for several weeks and the females lay a daily batch of tiny pale eggs (nits) close to the scalp.These hatch out after several days.Lice are spread through direct contact, but it does not necessarily have to be head-to-head.Treatment: The traditional treatment for an outbreak of head lice is the application of powerful lotions containing pesticides.The main advantage is that such lotions can penetrate the hard casing of the lice eggs and kill nits inside.However there are concern about using powerful chemicals that are expensive & unpleasant to use on children.Luckily there are effective alternatives

ALTERNATIVE TREATMENT FOR HEAD LICE: The first and most important weapon against head lice is the SMALL-FINE-TOOTHED COMB - also called the nit-comb - because the teeth are so close together it can remove the lice eggs.Plastic combs are recommended rather than metal because they are more flexible and therefore can get nearer to the scalp.They are also easier to clean and less likely to pull or snag hair.Use nit-cobms every time you wash your own and your children's hair.But do use plenty of conditioner after shampooing.Using conditioner makes the procedrue simple and painless (no tangles) and makes it possible to dislodge lice from slippery strands.Pay special attention to anyone with curly hair as it is harder to see the lice or pull the comb through and so they may be more vulnerable.The use of QUASSIAA CHIPS is an alternative remedy that is becoming popular with some parents.Quassia chips look like pieces of wood.They are cheap,natural and do not smell or leave greasy residue.To use place 25g of Quassia chips in a pot and pour 560ml of boiling water over them.This loosens the oil in the chips.Leave overnight and the next day bring to the boil and simmer for 10-15min.Let it cool and transfer to a spray bottle.Shampoo hair,rinse and apply conditioner.Comb through with the nit comb.Rinse off the conditioner and towel dry.Spray Quassia solution all over the hair.Leave to dry naturally.Spray again when dry.Spray again the following morning after brushing and repeat over the next couple of days.You can also use the Quassia solution as a preventive because it creates a bitter,hostile environment that lice do not like. BIZ NIZ is a blend of 5 essntial oil (citronella,geranium,eucalyptus.lavender and rosemary).It claims to get rid of lice and act as a repellent

Lichen Planus: Uncommon condition usually occuring on the front of the wrists and forearms and sometimes the trunk and lower legs.Very itchy, and not contagious

Limp: Limping for no apparent reason should always be treated SERIOUSLY in a child.It may be a rare form of Blood Cancer - Leukemia.If the limp is accompainied by a Swelling or Tendernesss of the Joints, it may be caused by Rheumatic fever,Arthritis or Osteomyelitis

Listeriosis: Is a rare infection transmitted through contaminated food.It mainly affects vulnerable people such as infants,the aged,pregnant wormen - can cause miscarriage and people with a compromised immune system. The bacteria that causes listeriosis,Listeria monocytogenes,is widespread in the soil and is present in most animal species.It can pass to humans through food products,particularly soft cheeses,milk, meat pastes and pre-packaged salads.Storing food incorrectly increases the risk.The bacteria multiply in the intestines and may spread in the blood and affect other organs

Symptoms: Vary from one person to another.The infection often goes unnoticed in healthy adults,although some people may develop flu-like symptoms such as fever,sore throat,headache and aching muscles In elderly people and people with HIV,or those taking immunosuppressant drugs,listeriosis can lead to meningitis,a potential fatal inflammation of the membranes covering the brain.In pregnant women,infection can pass to the fetus,causing miscarriage or stilbirth

Treatment: Listeriosis is usually diagnosed by a blood test.In otherwise healthy people,mild listeriosis clear up with treatment in a few days.People with serious infection,especially during pregnancy,need urgent treatment in hospital with intravenous antibiotics.Hygienic handling and storge of food reduces the risk of listeriosis

Liver Cancer: Liver cancer may be Primary - it arises in liver cells or Secondary(Metastases) - meaning it arises elsewhere and then spreads to the liver. Primary Liver Cancer is rare in the west,but Secondary Liver Cancer is comparatively common.By far the most common form of Liver Cancer is Secondary (Metastases) from elsewhere in the body,commonly cancers of lung,breast,colon,pancreas and stomach.Other types of cancer,such as Leukaemia and Lymphoma, may also spread to the liver separate from the original form when cancerous cells separate from the original cancer,circulate in the blood and settle in the liver,where they multiply and enlarge

Symptoms: People may already have symptoms due to the original cancer,but sometimes this cancer is not apparent.The symptoms of liver metastases may be the only warning of illness and they include - weight loss,reduced appetite,fever,pain in the upper right side of the abdomen,yellowing of the skin and whites of the eyes - jaundice.As the disease progresses,the abdomen may become swollen due to enlargement of the liver or fluid accumulation

Treatment: Anyone who has cancer will have tests - such as ultrasound,scanning,computerized tomography (CT) scanning and magnetic resonance imaging (MRI) to find out if the liver is affected.To confirm diagnosis,a piece of liver tissue (biopsy) may be removed for microscipic examination.Treatment aims to maintain liver function and relieve symptoms.You may be offered analgesics for pain and chemotherapy or radiation to reduce the size of metastases.Surgery may be considered if there is a single metastasis

Causes & Prognosis: Primary liver cancer is rare in the West,where most cases occur following long-standing cirrhosis due to long-term alcohol abuse.Another cause of liver cancer is contamination of food by carcinogens (cancer-causing agents) such as aflatoxin, a toxin produced by a fungus that grows on stored grain and peanuts.In developing countries - liver cancer is closely linked with Viral Hepatitis,especially that due to the Hepatitis B & C viruses,which account for approx 7 in 10 cases.Surgery offers the only chance of a cure.A liver transplant may be considered - but is rarely done because in many cases the cancer is likely to recur.More commonly,the aim is to slow the progress of the disease with treatments that include chemotherapy and blocking the blood supply to the tumour,causing it to shrink.The outlook for people with liver cancer is poor.Many people do not respond to treatment and suvive less than a year after diagnosis

Long Sightedness: Hypermetropia or Long Sightedness with middle age is know as Presbyopia.Difficulty in focusing on near objects while being able to see distant objects quite clearly

Lordosis: Hollow back.Excessive forward curvature of the Spine seen lonly in the region of th lower back, where a slight curve is normal.Sign of faulty posture caused by a heavy abdomen or weak abdominal muscles

Lumbago: Severe Pain in the Lower Back - Lumbar region, usually felt when lifting or stooping

Lumbar Puncture: The procedure for taking a sample of fluid from the base of the spine by inserting a needle. This is done under local anaesthetic. The fluid is analyzed in order to diagnose certain diseases, particurlarly those affecting the nervous system such as meningitis

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 The removal of a lump in the breast - leaving the breastvirtually intact *also see Breast Cancer*

Lyme Disease: This is an infection transmitted by ticks that causes a rask and flu-like symptoms,named after old Lyme,the town in the US - whre the disease was first recognized.Lyme disease is caused by a bactrium called Borrelia Burgdorferi

If a person is bitten by an infected tick that remains embedded in the skin,bacteria can enter the bloodstream and may then spread through the body.Most reports of Lyme disease have been documented in the northeastern coastal states of the US - but it can be picked up wherever ticks thrive and is prevalent in southwestern France.The disease also occurs in northern & western US states,in Europe and in Central Asia.People who go camping or walking in wooded areas during the summer months are most at risk of being bitten by a tick carrying the Lyme disease bacteria

Symptoms: A bit from an infected tick usually produce a red lump with a scab on the skin,although some people who have been bitten may not notice this initial sign.Within 2 days to 4 weeks after the bite - symptoms may develop 1. spreading circular rash at the site of the bite- that may clear in the centre 2. fatigue 3. flu-like chills & fever 4. headache 5. joint pains 6. If the infection is left untreated,these symptoms may persist for several weeks 7. In some people who have Lyme disease,dangerous complications may develop up to 2 years later that may affect the heart,nervous system & joints

Treatment: Your doctor may suspect from your symptoms that you have Lyme disease and may arrange for a blood test to confirm the diagnosis.You will be given prompt treatment with antibiotics - most people make a complete recovery.Non-steroidal anti-inflammatory drugs (NSAIDS) can relieve joint pains.Vaccines are available that offer 70% protection against Lyme disease

Precaution: For continued protection,vaccination needs to be repeated every 2 years.In regions known to be tick-infested,you should cover your arms & legs to reduce the risk of bites and promptly remove any ticks that you find on your skin.Complications are extremely rare

Lymphangitis: This develops when bacteria spread into lymphatic vessels close to the site of an infection,possibly as a result of injury.The condition usually affects lymphatic vessels in an arm or leg.The infected vessels become inflamed and tender and hot red streaks may appear on the skin over the inflamed vessels.Lymph nodes near to the affected area sometimes become swollen.If you develop any of these symptoms following an injury,you should consult your doctor immediately.You will need antibiotic treatment to prevent futher spread

Lymphoedema: This is a localized accumulation of fluid in the lymphatic vessels,causing painless swelling of a limb.It results from disruption of the normal drainage of lymph due to local blockage,damage or removal of lymph vessels.Most commonly,lymphoedema is caused by damage of the lymphatic vessel following surgery or radiotheapy e.g the arm in the treatment of breast ca or the leg after the treatment of ovarian ca.The skin over the affected limb often becomes rough and thickened.You should contact your doctor immediately if you injure a limb affected by lymphoedema, even if it only seems trivial,because lymphangitis may ensue.However,ti is also a condition where often there is no known cause and for reasons unknown,it affects twice as many women as men

Treatment: In most cases, Lymphoedema is a life-long disorder and treatment is aimed at relieving symptoms.You can reduce swelling by keeping the affected limb elevated.Wearing and elastic stocking or sleeve can prevent further swelling.There is no cure as such and treatment consists of taking diuretic drugs,massage,wearing an elastic bandage or compression sleeve,and performing exerecises with the affected limb elevated.Surgery is possible in the most severe cases and this involves removing the swollen tissues and some of the overlying skin Lymphatic Drainage: can bring relief in some cases although again,this is not a cure and will only bring temporary respite.It is done through massage,which encourages the tissues to expel the excess fluid back into the blood vessels and so out of the body.Qualified practitioners will do this massage for you and most aromatherapists are trained to carry out lymphatic drainage

Lymphoma: The word Lymphoma strikes fear into many people because it is ill-understood.Lymphomas are cancers of the glands (lymph glands or nodes) affecting both adults and children.It is important to know that the outlook for cancers of this type is better than most other cancers

Cancer are simply cells whose growth has got out of hand.They invade healthy organs with differing degrees of aggressiveness according to how malignant they are .There are 2 typs of Lymphoma.Hodgkins Disease (HD) & non-Hodkins' Lymphoma (NHL) - which differ in their behaviour and treatment

Symptoms:The first symptom may be a painless lump in the neck,armpits or groin.Tiredness,weight loss,fever,night sweats and itching can be prominent symptoms too

Diagnosis: Your doctor will ask you many questions and examine you to see if the glands in your neck,armpit or abdomen are enlarged.After a biopsy to remove one of the glands,the gland will be examined under a microscope.This enables an accurate diagnosis to be made and with the results of other tests (X-rays,blood tests & scans) helps to decide the best form of treatment

Treatment: Some low-grade (non-aggressive) lymphomas need no treatment - but most require treatment with radiotherapy,chemotherapy or a combination of both.Radiotherapy uses powerful X-rays that kill cancer cells.Chemotherapy uses powerful chemicals in the form of pills,injections or a drip into a vein to do the same thing

Chemotherapy: Lymphomas are one of the most sensitive cancers to Chemotherapy.The overall aim of chemotherapy is to give drugs that hve maximum anti-cancer effect,but with the least possible damage to the body's normal cells.Chemotherapy drugs interrupt cell growth so they end up killing large numbers of cells.However, many normal body cells - such as bone marrow and the lining of the intestines and mouth - divide rapidly and are vulnerable to cancer drugs, giving rise to many of the side effects caused by chemotherapy

Type of Chemotherapy: The type of chemotherapy you will get depends on the type of Lymphoma and the extent to which it may have spread.Although some chemotherapy drugs are given as tablets,most people with Lymphoma are treated with intravenous chemotherapy.Several drugs are usually given in combination to help stop cancer cells becoming resistant to any one drug.There are several combinations in routine use, and new ones are being tried all the time.If you are asked to take part in a clinical trial - don't be afraid - trials usually compare a standard treatment with one that is judged to do better

How is it given? Method: Most chemotherapy is given as out-patient treatment.Either as a short injection into a vein or as an intravenous drip over an hour or so.It rarely involves staying in hospital overnight

Timing: Chemotherapy is given once every 3-4 weeks.You will receive 6-8 courses of treatment.Treatment usually last around 5-6 months.Some treatments may be given on a weekly basis

Side effects of Chemotherapy: You may have no of very few side effects.However it is preferable to know something about possible consequences so that you can let your medical team know if you get them

1. Nausea and Vomitiong: Chemotherapy drugs can cause nausea and vomiting.However,this can largely be controlled by new anti-sickness medications,given as injections or tablets.You may be given them before chemotherapy to avoid sickness in the first place

2. Tiredness: For unknown reasons this is one of the most common side effects of chemotherapy.If the cause is Anaemia,then a simple blood transfusion may correct the problem

3. Hair Loss (Alopecia): Hair loss is an effect of the chemotherapy on the rapidly dividing cells of the hair follicle - but many patients have NO hair loss at all.If it does occur, it will only be temporary and your hair WILL grow back when the chemo is over.Many people find that a wig is helpful and it is worth organizing one sooner than later,so that your hair can be matched.Scalp cooling slows blood flow to the scalp and can stop the chemotherapy reaching hair follicles.Ask your medical team about this

1. Sterility: Chemotherapy agents can affect fertility - though it is usually temporary.Women may stop having periods.Rarely chemotherapy has been known to cause permanent sterility

2. Low White-cell count: If your white cell count drops (neutropaenia) - a fairly common side effect of chemotherapy,you will have an increased risk of infection.Look out for signs of infection and let your doctor know if you have any of the following symptoms - Fever with temp above 38o/c ,Chills and sweating,Mouth sores and ulcers,Coughs and sore throat,Redness or swelling around sores on the skin,Loose stools / diarrhoea,Cystitis or burning sentation during urination,Unsual vaginal discharge or itching

What kind of Lymphoma do I have? What is the spread of the Lymphoma? It is non-Hodgkin's Lymphoma? Is it high or low grade? What is the difference? Where is it? Is there any doubt? What do these tests I'm having tell you? What are they for? Does the hospital have modern radiotherapy equipment,specialists in radiotherapy and chemotherapy,hormone therapy & surgery? Does it have supportive care and couselling? What kind of treatment will I have - radiotherapy,chemotherapy or none? Is it aimed at curing the disease or relieving the symptoms? Are there any other options? How will the drugs be given? Are there any special instructions about taking the tablets at home? How do these tablets help? Are there things I should or shouldn't do during the treatment? What are the possible side effects? Will the treatment affect the possibility of having children? Do I contact the hospital or my GP if I feel unwell at home? Can I drive during and after treatment? May I drink alcohol and take medicines for other complaints? Are there foods I should or should not eat during the treatment? When will I know if the treatment has worked?

Lymph: A colourless liquid which contains white blood cells. Lymph flows in channels taking nutrients to and removing waste products from local cells. The white blood cells in lymph are an important part of the body's defence system against infection

Lupus: Sometimes known as Systemic Lupus erythematosis or SLE is an autoimmune disease that can attack many different parts of the body and produces a great variety of different symptoms.Because the effects of Lupus are so variable,this disorder can be very difficult to diagnose.Although few people have heard of Lupus,woldwide it is far more common than Leukaemia,Muscular dystrophy and Multiple Sclerosis,which after extensive publicity,have become household names.Lupus mainly attacks women during their child-bearing years,but sometimes men and even your childen are affected.It is estimated that 1 in 750 women sufferers from Lupus in the UK and for reasons unknown, it is more common in some races than in others.The frequency in white women is 1 in 1000 compared with that in black women of 1 in 250

Symptoms: Becasue Lupus can attack so many parts of the body,it can show up in a bewildering number of ways,even to the extent of mimicking other diseases such as Rheumatiod Arthritis, Multiple Sclerosis or Chronic Fatigue Syndrome (ME).So Lupus can be difficult to diagnose and it can be overlooked often for years.Lupus is a disease that can present many different facets.Rarely do two people have exactly the same symptoms and they can vary from just one to many.Joint & Muscle aches and pains.Permanent Rash - typical butterfly shape which may be raised and scaly over the nose and cheeks.Extreme fatigue and weakness.Rashes from sunlight.Recurring flu-like symptoms and / or night sweats.Poor blood circulation causing the tips of the fingers and toes to turn white then blue on exposure to cold - Raynaud's Phenomenon.Anaemia.Headaches & Migraines.Increased risk of miscarriage.Kidney problems.Oral ulcers.Hair loss.Depression.Some drugs,such as certain antihypertensive drugs,may cause similar symptoms

Triggers of Lupus: at Puberty,after Childbirth,through Sunlight,by some Medications,during Menopause,after a Viral infection,as a result of Injury

Treatment for Lupus: At present there is no cure for Lupus,but it can be controlled with specialist treatment so that most patients are able to live a normal life span.The majority of Lupus patients should be in the ongoing care of their specialist.If you have a Lupus-like condition that has been triggered by a particular drug,your doctor may be able to prescrive and alternative drug.Symptoms should then disappear gradually over a period of weeks of months

1. You will have your urine tested for protein,blood and glucose to check on your kidneys and for Diabetes 2. You will be weighed at each visit as some treatments such as steroids, can cause water retention 3. You will have a blood test to check for Anaemia 4. An MRI scan,X-rays and nerve conduction tests may be done 5. Eye checks will be done before starting some treatments 6. When your start new medication,you will be given booklets so you can understand how your treatment works 7. You may need a lot of support and understanding in coming to terms with Lupus.You may have gone undiagnosed for several of years and feel frustrated than no one understands what your are going through.If there is a nurse counsellor attached to the clinic,get her help

2. Lupus is usually treated with 4 main groups of drugs,depending on the severity of the disease.Aspirin & non-steroidals - Non-steroidal anti-inflammatory drugs (NSAID's) are used for patients with mainly joint and muscle pain.In the case of patients with sticky blood,aspirin in low dossage 75-150mg,is used to thin the blood.Antimalarials - These drugs are of help in patients with skin and joint disease.They may be sufficient for patients with moderately active Lupus to avoid using steroids.Hydroxychloroquine and mepacrine are most commonly used. Steroids - Drugs such as prednisone have been vital in the improvement in Lupus and for some people can be life-saving.They have a profound effect on inflammation and can suppress the disease.Once Lupus is under control,you can be weaned off steroids gradually under your doctor's supervision.Immunosuppressants - These drugs are used in more severe disease.The most commonly used are azathioprine,methotrexate and cyclophosphamide.You will have regular blood tests to check on your bone marrow and liver.You may also have physiotherapy to help improve mobility in affected joints.It is important to remain as physically active as the condition will allow,so try to take moderate exercise regularly.With treatment, most people with Lupus are able to lead normal,active lives

Self-Help: Become well educated on Lupus.Try to prepare for the up and down nature of the disease.Plan for alternatives.Allow for rest when the disease is active but try to maintain general fitness.Reduce fatigue by developing priorities and learning to pace yourself.Break down big,long-term goals into small,manageabel steps that can be easily accomplished.Be open with family and friends about the unpredictable pattern of Lupus,and how the disease affects you.By listening to your pain,you can begin to control it.Try to accept the things your cannot change,rather than feeling constantly frustrated and upset over situations beyond your control.Remember that stess,depression and pain are all closely connected and each affects the other.Reduce one and your reduce them all.Approx one-third of Lupus patients are light-sensitive,so avoid direct & prolonged sun exposure and ultraviolet light from artificial sources (fluorescent).Wear broad-brimmed hats and cover other exposed parts of the body when out in sunlight and use sunblock creams.Ask for help from family and friends, health-care professionals & support groups

Lymphoedema: Swelling of arms or legs due to any disease which blocks the circulation of lymph to the lymph glands, which help the body to resist disease

Lymphogranuloma Venereum: Chlamydial infection.Venereal Disease.Occurs mainly in the Tropical regions

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