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South African Medical Directory

(Quick Reference)

Obesessive-Compulsive Disorder (OCD): A person with Obsessive Compulsive Disorder is completely normal - other than being dominated by unwanted thoughts that enters the mind repeatedly.These persistent thoughts (obsessions) cause the affected person to perform repetitive,pointless actions.In OCD,obsessive thoughts are frequently accompanied by a form of a compulsive,but pointless ritual,in which a behaviour or action,such as checking that your keys are still in your pocket,is repeated again and again.The person affected does not want to perform these actions - but feels driven to do so.Thoughts may be concerns about hygiene,personal safety,security or possessions.Alternatively,there may be violent and obscene thoughts that are completely out of character.Examples of common compulsions include - hand washing,checking that windows and door are locked and arranging objects on desk precise patterns

Carrying out ritual reinforces a sense of control and brings short-lived relief but, in severe cases,the ritual is done hundreds of times a day and interferes with work and social life. About 3 in 100 people experience OCD at some time in their lives.It sometimes runs in families and stressful life events may trigger the condition.Many famous people have suffered OCD - the American tycoon Howard Hughes was obsessed about hygiene.Personality traits of orderliness and cleanliness are said to be related.It is important for family and friends to understand that while they regard the behaviour as senseless,the person suffering from OCD - are unable to ignore or resist them.That is because,once the disorder has developed,a chemical imbalance occurs in the brain that is been identified as changes in seratonin levels,which is why selective serotonin re-uptake inhibitor (SSRI) drugs are helpfu

Symptoms: Intrusive,irrational mental images.Repeated attempts to resist thoughts,Repetitive behaviour .The person may be aware that the behaviour is irrational and be distressed by it - but cannot control the compulsions

Treatment: Deeply established,severe OCD needs professional help.Psychotherapy and counselling - are 'talking treatments' that provide the opportunigy to discuss difficulties with someone who will listen and accept what you say without ridicule and who will offer support in your attempts to overcome your compulsion.Talking treatments boost self-esteem and increase condicence because it is therapeutic to express feelings and feel understood.Cognitive therapy - is a behaviour therapy that help us to change our mood by changing the way we think.It teaches us to challenge self-defeating beliefs and develop positive ones Behaviour Therapy - is a treatment that has been used successfully to treat phobias and compulsive disorder for many years.The focus is placed on practical forms of treatment that aim to modify behaviour and overcome fears.The major tool is exposure treatment which means confronting whatever frightens you until you get used to it Drugs for OCD - have proven helpful.There are several types available,all within the category of anitdepressants though the newer ones such as SSRL's have many other actions.Drugs for OCD,have a specific anti-phobic action on the brain,and some of the most successful are SSRI's - which include Prozac and Seroxat.They work by increasing levels of serotonin in the brain

Obesity: Overweight.Many causes and many complications.Obesity in children is serious.There will be an emotional strain on the child when he is teased by other children.Overweight children tend to grow into overweight adults - who run higher risks of heart desease, high blood pressure and joint disorders

Obstetrician: A Doctor who specializes in looking after women during pregnancy and immediatley after childbirth

Occult Blood: This is the presence of small amounts of blood in the faeces that cannot be seen by the naked eye.This blood, known as OCCULT BLOOD is not immediately visible and can indicate a disorder that causes bleeding from the digestive tract, such as a Peptic ulcer,Polyps in the colon or Bowel cancer.The test is usually repeated several times over a period of days,because blood may not appear in every sample.If blood is found in the faeces,other tests may be done to look for the cause,including endoscopy of the digestive tract and contrast X-rays to look for ulcers or tumours

Occupational Dermatitis: In some cases a person's dermatitis is caused primarily by substances to which they are exposed at work.These may be irritants or allergens depending on the nature of the job.Patch tests should be carried out if the work involves exposure by substances that can cause allergy.Preventing Futher Dermatitis: Minimize contact with all irritant substances at work or at home.Avoid skin contact with the substance you are allergic to.Take general skin care measures to keep the skin strong and healthy.Active Treatment: Treat the Dermatitis with frequent application of moisturizers and regular use of steroid creams or ointments once of twice a day.If the dermatitis has become additionally infected,a course of antibiotic cream may be necessary

Oedema: Dropsy.Swelling caused by fluid which has leaked from the cirulatory system and accumulated in the body's tissues.Commonly around the ankles, but also other parts of the body.May be the result of injury, but also diseases of the circulatory, respiratory and urinary systems

Oesophageal Varices: Condition in which the network of Veins at the lower end of the Oesophagus (gullet), becomes varicose or swollen and twisted.Caused by rise in blood pressure in these veins due to certain disorders

Oesophagitis: Inflammation of the Oesophagus.Causes could be a faulty valve

Oliguria: Passing of smaller than normal amounts of Urine,which is often darker than usual.Often a feature of certain kidney,liver or heart disease, but aslo occur in people who have not drunk enouhg to replace water lost by heavy sweating

Olfactory Nerves: Nerves that detect smells and carry the infomation to the Brain

Open Surgery: Most operations are carried out using open surgery.An incision is made in the skin large enough to see clearly the internal body parts that require treatment and the surrounding tissues.Although a large incision provides easy access, it may leave an obvious scar.Most open surgery is carried out under general anaesthesia.Once you are fully anaesthetized, the surgeon makes an incision through the skin and the layers of fat and muscle below it.The skin and muscles may be held back by clamps, and organs and tissues that are not being operated on are pulled out of the way by retractors.When the are to be worked on is clearly visible, the surgeon is then able to carry out the procedure.All surgical procedures, whether major or minor, involve some risk *also see keyhole surgery*

Opthalmoscope: An instrument for examining the tissues of the interior of the eye, by shining a light through the pupil

Optic Atrophy: Degeration of the Optic Nerve which connects the rear of the eye to the Brain.Impairs vision irreversibly, and in severe cases lead to blindness.Caused by certain Eye diseases, and some disorders of the nervous system

Optician: Tests vision and eye defects and supplies corrective lenses, but does not treat injury or disease

Orchitis: Inflammation of the Testes.Occur at any age.Mumps Virus most common causes

Orthodontist: A Dentist who specializes in treating teeth abnormalities and jaw disorders

Orthopaedics: The process of curing deformities arising from disease of or injury to bones and joints

Orthorexia Nervosa: Orthorexia was first described in 1997. The name of the condition is derived from the Greek word 'orthos' - which means 'right' or 'pure' and 'rexia' - appetite.People suffering from this disease, obsesses with eating the right food and not with being thin.They cross the line between healthy eating habits and an obsession that can deprive them of important nutrients and eventually make them sick and even in severe this condition can lead to death.This is a condition where the sufferers become so obsessed with eating healthily - that they cut out more and more foods from their diet in an attempt to eat as naturally and purely as possible.The condition develops gradually, starting with cutting out one food group such as diary, wheat or sugar - usualy due to illness such as high cholesterol, asthma or diabetes.Later they increasingly limit their food choices.If they eat 'wrong' foods - they feel guilty.If they stick to the rules - they feel in control and even euphoric.For some sufferers, it becomes almost a Spiritual mission to convert others to their diet.Ironically some sufferers may binge on 'wrong or junk' food just to feel very guilty filled with self hate afterwards- resulting in them fasting to try and make up for it

Orthorexia often incorrectly diagnosed as Anorexia.They eventually land up being painfully thin and undernourished and sick and this could lead to getting incorrectly diagnosed as Anorexic.Unlike Anorexics they aren't usually obsessive about exercise - many don't exercise

Possible Causes & Profile: A poor self-image and problems at home can trigger Orthorexia.Some sufferers may come from homes where the focus was on health rather than being thin.They are usually educated people in the middle age high-income bracket who can afford 'pure' foods.They are good academic achievers.And come from close-knit somewhat overprotective families.They are often perfectionists and seek approval.Sufferers often don't realise they have a problem and even if they are aware of it, they can't escape the hold the condition has on them.The boom in the health shop and organic food culture, a resistance to the junk food labelling - all play a role in the increase in Orthorexia.Sufferers take supplements and health shakes and devour every bit of information about the nutritional value of food.Processed foods and any sign of pesticides or toxins in food are taboo.They eat natural & wholewheat products and only a certain kind of muesli or sweets.Only certain restaurants are good enough for them.The nutritional value of food is always more important than the enjoyment of eating.They study food labels in the finest detail - how much and what kinds of fats, carbohydrates, proteins and so on each type of food contains.They overlook the body's need for fat and carbohydrates as a supply of energy and therefore limit fat & carbohydrates to the minumum or cut them out completely. They become physically tired.They often feel proud of having a healthier diet than other people and may come across as feeling slightly superior about it.They are always on the lookout for healthy recipes.Psychologically they torture themselves by splitting hairs about how much and what they should eat and end up becoming depressed

1. Parents can play a role in preventing their kids from becoming obsessive about healthy eating by allowing them to eat a wide variety of healthy food

4. Don't overact if your child wants to eat sweets, cake or junk food - It's not harmful if they do it only occasionally

7. Caution - If your interest in food becomes increasingly obsessive and you cut out more food types, you run the risk of becoming Orthorexic

8. Remember that moderation is the key word. Normal healthy eating habits don't cause problems in your relationships and isolate you from others

9. Someone with a healthy attitude to food can deviate occasionally from their usual healthy eating habits without feeling guilty or that they have to compensate for indulging by fasting or exercising

Osteoarthritis: Degenerative Joint disease caused by the ageing process in which the protective shock-absorbing cartilage space between bones of the joints, wears away.Effects mainly the hip,knee,spine and fingers

Osteochondritis: Softening of an area of Bone with the risk of causing deformity.Spine,hip and shin most likely to be affected.Children main victims

Osteogenesis Imperfecta: Rare hereditary condition.Bones are unusually brittle and liable to fracture.Patients with the condition often have a blue tinge to the whites of their eyes and may be deaf from otosclerosis and be very 'loose jointed'

Osteomalacia: Adult equivalent of Rickets.Bones become softened because of insufficient Vit D which is necessary for the uptake of Calcium

Osteomyelitis: Inflammation of the bone by Bacterial Infection.Sufferer often child or teenager.Infection may arise because of an injury to the bone itself, or it may be carried in the blood from an infected cut elsewhere in the body.Pus forms in the bone and the area becomes tender and painful resulting in swelling.Osteomyelitis is always SERIOUS and can result in bone deformity or stiffness

Osteopathy: System of treating Mechanical disorders of the Body, particularly the spine through manipulation

Osteoporosis: Weakening of the Bones.Most common in women past the Menopause since they have a failure for Oestrogen secretion

Otitis Externa: Also known as Swimmers Ear.Infection of the Outer-Ear Canal.Occur any age

Otitis Media: Infective inflammation of the Middle Ear.3 variations.Acute,Chronic-secretory and Chronic Suppurative.Can cause evere Earache and Deafness if not treated

Otosclerosis: Condition can cause deafness.Involves a thickening of the Bone around the Oval window through which sound is transmitted from the Middle Ear to the Inner Ear

Otoscope: An instrument for examining the outer and middle ear in order to diagnose disease

Ovaries: The organs in which the Female Sex Hormones & Eggs are produced and stored

Ovarian Cancer: Cancer of the ovary is a malignant tumour that can develop in one or both ovaries.Usually in women after the menopause - but occasional in younger women.Ovarian cancer does not usually cause any symptoms untill it is advanced - by which time it may be very difficult to treat effectively.Ovarian cancer is usually aggressive and can spread quite early in the course of the disease

Causes: There are many theories about what causes ovarian cancer to develop.It is more common in older women and in women who have not had any children and less common in women who have used the oral contraceptive pill or HRT for a number of years and in those women who had a late start to their periods and an early menopause.'Resting' the ovary by suppressing ovulation,for example during pregnancy or while on the pil, may protect a woman against developing ovarian cancerGenetic factors are important in ovarian cancer - sometimes runs in families.A triad of cancers - ovary,breast and colon - run through some cancer families where a gene is at work

Symptoms: Abdominal Pain.Swelling of the abdomen.A hard lump in the abdomen.If the tumour is large,pressure on the bladder can cause Frequent Urination.Occasional breathlessness if the tumour presses upwards on the Diaphragm

Treatment: Some families carry a gene called BRCAI that increases the likelihood of both ovarian and breast cancer.Genetic tests for this gene are now available to help identify those women at risk of developing ovarian and breast cancer.If you have a strong history of ovarian or breast cancer in your family - it is important to tell your doctor.Treatment of ovarian cancer usually involves several things.Your surgeon will attempt to remove the whole tumour and any local spread.The extent of surgery depends on the type of tumour found.Minimal surgery involves the removal of both ovaries and the fallopian tubes as well as the uterus.If the disease has already spread beyond the reproductive organs,much more extensive surgery may be necessry.This may involve surgery to other organs,such as removing part of the bowel and bladder.Drugs containing platinum are commonly used to treat ovarian cancer, but radiotherapy has been found to have limited effect.Futher surgery may well be performed to remove any recurrences.

Prognosis:The outlook in the longer term depends on the stage of the disease and the type of malignant cell present in the ovary,but the figures are not reassuring.If the cancer is restricted to the ovary 60-70% of women can expect to live for 5years.If the growth has spread - the five year survival rate is only 10-20%

Ovarian Cysts: This is a swelling in the Ovary which contains Fluid and is usually only a few centimetres in diameter.Occasionally may become cancerous and others may grow large to simulate pregnancy.Caused by the retention fluid within in the Ovarian Glands. Cysts filld with blood are caused by Endometriosis.Occasionaly be due to Cancer of the Ovaries.Benign cysts may be subdivided into 2 major catergories.Functional cysts - that are merely small follicicles that occur normally in a woman's monthly cycle.They do not usually cause any problems,but there may be several and they may be present in both ovaries.They rarely grow larger than about 3-4cm in diameter and commonly shrink back to normal size spontaneously.They are usually detected or routine ultrasound screening.The second type are true Benign Ovarian Cysts,of which the dermoid cyst is the most common.These are most often found in women in their 30's.Dermoid cysts may occasionally be present in both ovaries.They do not usually cause any problems unless they cause the ovary to twist or if the cyst leaks.Dermoid cysts contain immature cells that are capable of growing into various type of tissue and it is therefore not uncommon for dermoid cysts to contain bone,teeth,and hair.There are also other less common benign cysts

Symptoms:Pain during intercourse,painful heavy periods,if a cyst twists or rupture,it results in severe abdominal pain,nausea and fever.Urinary problems due to pressure on the bladder.While ovarian cysts are small,they produce few symptoms.Functional cysts disappear without treatment and you may never even know you had themAs true cysts get larger,however,they may cause pain and discomfort and may also affect your menstrual cycle.The severe pain of a twisted ovary requires an emergency operation - so see your doctor as soon as possible if you suffer any of the symptoms above

Treatment: Your doctor will examine you in order to assess externally and internally in order to assess the size of the Ovarian Cyst.Futher tests will probably include an ultrasound examination of your ovaries plus blood test and MRI.Laparoscopic surgery may be attempted to help diagnose the type of cyst present and in younger women - to remove the cyst if it is benign.In older women - in women in whom the cyst is too large to be removed by laparoscopic surgery,or if there is a suspicion of malignancy, and abdominal operation will be performed.Both ovaries are alway examined and checked during surgery.If malignancy is confirmed it is usual to remove both ovaries and the uterus (hysterctomy)

Ovulation Syndrome: Condition when mild pain can be felt when the Ovary discharge an egg into the Fallopian Tube at Ovulation.Slight bleeding at the point where the Ovary discharges the egg, irritates the abdominal lining and causes pain.Ovulation Syndrome does not arise while taking the contraceptive pill because ovulation does not occur

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