Salivary Stones – Nonoperative Removal of Sialoliths and Sialodochoplasy of Salivary Duct Strictures

Objective- To describe the nonsurgical removal of sialoliths and treatment of salivary duct strictures. Design- Case series. Setting- Two 200-bed general community hospitals. Patients- Twelve consecutive patients from April 1985 to November 1994 – 8 with calculi, 3 with salivary duct strictures, and 1 with calculi and strictures. Results- Successful nonoperative removal of calculi in 7 of 9 patients. All four sialodochoplasties were successful. All 10 patients with successful procedures had no recurrent symptoms. Seven patients have been symptom-free for 10 months to ten years. Communication with 3 patients has been impossible recently, although these patients were symptom-free for at least 3 years. To date we have successfully treated twenty-five of twenty-eight patients for salivary duct calculi removal and dilatation of strictures. Conclusions- These methods of nonsurgical sialolith removal and sialodochoplasty were highly successful and should be used as the initial therapies for patients with these conditions.

SIALOLITHIASIS and salivary duct strictures are common pathological conditions of the salivary glands and their ducts. They produce similar symptoms of swelling, pain, and infection as a result of duct obstruction. Swelling and pain usually occurs during meals, when salivary secret is stimulated.Until recently, surgery has been the standard therapy for these conditions. This approach is invasive with important unavoidable risks and complications. Potential risk of damage to the facial nerve is high during parotid gland surgery.Recently, extracorporeal shock wave lithotripsy has been introduced as an alternative treatment of sialolithiasis. Miniature lithotriptors have been developed and show some promise. However, these units are not generally available and their success rates have been variable.The mechanical removal of sialoliths and sialodochoplasty for duct stricture have been our initial approach for these diseases. These minimally invasive procedures are highly effective and avoid the known complications of surgery and anesthesia. Combining these methods with extracorporeal shock wave lithotripsy promises to further increase success rates.

Results:

From April 1985 to November 1994, the mechanical removal of sialoliths was successful in 7 patients with sialolithiasis: 5 with submandibular duct calculi (See Figure 1 below) and 2 with parotid duct calculi (See Figure 2 below). Four patients underwent successful sialodochoplasties, 2 for parotid ducts and 2 for submandibular ducts. One patient had sialoliths and a stricture, so the total number of successful procedures was 11.

In 1 patient, the calculus was located close to the papilla, making retrieval especially difficult because of impaction. A grinding forceps was successfully used and a wide papillotomy was unnecessary.

In 2 patients, calculus retrieval failed: 1 each of the Stensen and Wharton ducts. These were technical failures caused by large impacted calculi and by strictures in the distal segment of the ducts, which made mechanical manipulation impossible. There were no sialodochoplasty failures.

The long-term outcomes following the procedures were excellent. No patient returned with recurrent symptoms. Seven patients remained symptom-free after clinical follow-up from 10 months to 10 years, and 3 patients were symptom-free for 3 to 5 years and then were unavailable for follow-up.

Materials and Methods:

Before the examination, the details of the procedure and its benefits and complications were explained to the patient. Informed consent was obtained for the sialography and for the mechanical removal of the calculi, sialodocholoplasty, or both.

As an initial diagnostic examination, sialography was performed to confirm the location of the strictures and calculi. The papillae were locally anesthetized by direct injection of 1% lidocaine hydrochloride. The papillotomy was accomplished by an incision toward the duct. No sedation or general anesthesia was given.

For the removal of the calculi, a 3.5F 4-wire Dormia basket (Porges, Paliseau Cedex, Salat, France), 3F Segura basket (Microvasive Co [Boston Scientific Corp.], Watertown Mass), and 3F Coaxial Sheath Grasping Forceps Cook Urological Co, Spencer, Ind) were used. For the sialodochoplasty, 3.8F 3-mm diameter Balloon catheters (Meditech, Watertown, Mass) were used.

After the papillotomy was accomplished, the papilla and adjunct salivary ducts were dilated by 3F and 4F dilators or stiff catheters of the same size. A 0.45-mm guide wire was introduced routinely to guide the balloon catheter. If there was a stricture, balloon dilatation was performed several times until full dilatation was achieved.

For the calculi, a basket was placed beyond or at the calculi site and the basket was manipulated to achieve extraction. When several calculi are present, several attempts may be required.

Comment:

The symptoms of sialoliths and salivary duct stricture are similar: intermittent swelling, tenderness, and pain usually eaten by on eating. Infection and sialadenitis are common complications. For a definitive diagnosis, sialography is imperative, especially to diagnose the presence of several calculi or to detect all strictures.

A few cases of balloon-catheter sialodochoplasty and wire-basket removal of caculi have been reported, mainly in foreign journals (ref. 1-3). Also, calculus was removed by an angioplasty balloon catheter (ref. 4).

The most likely surgical management of intraglandular parotid calculi would involve parotidectomy. There does not seem to be a consensus on managing calculi located between the hilus and anterior to the masseter muscle. Extraoral parotid sialolithotomy for calculus extraction has been performed under sialographic and ultrasonographic guidance (ref. 5).

The surgical approach to submandibular calculi is influenced by the location of the stone. Palpable stones anterior to the posterior border of the mylohyoid muscle usually are extracted using a transoral incision. When the stone is posterior to the mylohyoid muscle, removal of the entire gland is recommended (ref. 6.7). The complication rate for these procedures and associated anesthesia is not negligible (ref. 8).

In our independent small series during the last 10 years, we have achieved a high success rate. Contrary to other authors' (ref. 5) experience, we did not have difficulty removing parotid calculi located more than 1.5 cm from the papilla, although removal of calculi from the Wharton duct is generally easier than the stensen duct. The course and small size of the stensen duct often makes instrument manipulation difficult. In our 2 cases of failure, the calculi were larger than the ducts and impacted. These ducts had long strictures in their distal segments, which made instrument approach to the calculi and manipulation impossible. A successful removal of this type of calculus was reported with a vascular snare (ref. 9).

Endoscopic laser lithotripsy is unavailable at our institution. Endoscopically controlled laser lithotripsy for removal of a stone in the stensen duct (ref. 10) and submandibular lithitis (ref. 11) has been reported. Our 2 cases of failure could have benefited from this method. A success rate of 36% to 53% has been reported for extracorporeal shock wave lithotripsy (ref. 12).

Wehrmann et a1 (ref. 13) developed a miniaturized lithotriptor, and a significantly higher percentage of patients were free of calculi (stone-free rate, 67%) after treatment. The authors did not report whether any case in this series required supplemental mechanical retrieval of calculi.

In conclusion, mechanical removal of calculi and sialodochoplasty by balloon catheter are excellent alternatives to surgery. These procedures are more cost-effective, with reduced risk of morbidity when compared with the surgical alternatives. The long-term exit following the procedure is excellent. If the mechanical retrieval of calculi fails, laser lithotripsy, extracorporal lithotripsy, or both will improve the success rate.

Swollen Glands, Purging and Your Bulimia

Often when a bulimia sufferer is on the path of recovery, the most distressing sight to witness is the swollen face. Especially when working on bulimia recovery with a resolve to stop vomiting, noticing the swollen glands brings the sufferer back to throwing up in an attempt to bring the swollen neck glands back down.

Often this high motivation to beat bulimia is sabotaged by continually developing swollen glands, which makes recovery very difficult. If this is the vicious cycle you can relate to, then there are things you can do to regain a sense of health, well-being and your usual face shape and form.

In an ordinary person, any form of gland swelling is usually a normal body response to an injury, infection, disease or abnormal growth of this area.

Unlike an infection of the glands where a response to a course of antibiotics would flush out any bacterial invasion – facial swelling in the cheek and jaw regions due to bulimia is NOT curable using conventional medicines. The simple fact is as long as a person with bulimic tendencies continues to throw-up; she or he will always have signs of swelling in the facial area.

Vomiting damages the gland tissue by constant attack from the stomach acids. Swelling is a normal defense reaction to healing any irritation caused by vomiting. Most of this swelling is simply water retention in your glands, as well as the glands themselves working to over compensate the loss of fluid elsewhere in the body.

This means when you vomit, all you are doing is getting rid of the water from your glands such as Salivary glands & Parotid glands. Thus giving the impression of reduced swelling, but this is only temporary because your body immediately tries to repair the damaged glands and starts to retain water again – bringing about a vicious circle.

The only way to treat this is to stop vomiting all together, but gradually. For most bulimia sufferers like you, that means actually stopping the binges that takes place – which is far easier to control than the auto-reflex of vomiting.

Binging and purging is an automatic learned response; because it is a learned behavior, you can choose to un- learn it in no time. Once you stop vomiting, after a few months you should see your face returning to normal. But be patient, return of your normal facial size could take time, depending on your own healing process as well as where the other severe damages are found in your body (eg: stomach lining, ulceration of digestive tract, load on your heart/liver/kidney functions, abnormalities of electrolytes, teeth and gum damage, knuckles and so on).

Here are some natural remedies you can try:

Many natural remedies can also help you recover your face that much faster by taking better care and giving it the best condition for your own body to heal itself.

Gargling every day with rock-salt water (use warm water) can help to clear any minor infection, as the Iodine found in the rock salt will help to speed up this recovery process.

Nutritionally you can do a lot too:

. Eating Mackerel can reduce inflammation by the active release of prostaglandins (hormone like substance).

. Berries are a good source of vitamin C – which helps with any Thyroid glands problem due to the immune boosting abilities.

. Sea vegetables such as seaweed are a rich source of iodine, as is Salmon which also contains Omega-3 Fatty acids.

. Brazil nuts contain Selenium, which helps to maintain any endocrine systems including Parotid glands in your neck.

. Eating carrots can help to soothe the mucous membrane throughout the digestive tract, reducing irritation and inflammation. It is a very good to cleanse your overworked liver with toxins too.

Onion on the other hand counter acts fluid retention, and helps with Gout (swelling) in the neck region.

You can also flavor your food with a pinch of Saffron, as it has anti-inflammation properties, but also gives you a fantastic aroma and color to your dish.

Avoid foods such as coffee, cola, sugary foods, cabbage as well as eating salt (as opposed to gargling it) – as they hinder healing of the damaged tissue and slows recovery.

Natural interventions to treat your swollen glands due to purging, needs dedication and patience from your part! Avoid expecting over-night miracles, for the bulimia effects to wear off, as you accept your own personal responsibilities for weaning off purging. If you take better care of yourself, bulimia symptoms like swollen glands, sore throat, constant loss of voice and regular infection in this area will diminish with time and you will see a marked difference in the size and shape of your face!

What You Need to Know About Cat Food

Cat Food Info # 1 Cats Need Protein in their Cat Food

The cat food you feed to your cat should always be rich in protein. This generally should come from meat, poultry or fish. Many cat food brands advertise chicken, beef, and tuna flavored cat food because they know that cats need protein and cat owners are looking for quality cat food. However, you need to make sure the cat food you buy has a sufficient amount of cat food regardless of what flavor it is.

Cat Food Info # 2 Cat Food with Taurine

Also check the cat food you typically buy for an amino acid called taurine. This particular amino acid is very important in the overall health of your cat, and your cat will eat as much food as it has to in order to supplement this particular amino acid. So, if you are buying cheap cat food that does not have the proper nutrients your cat will eat a lot. If you buy a nutrient rich cat food then your cat will eat little and save you more money while still getting proper nutrition.

Cat Food Info # 3 Canned Cat Food or Dry Cat Food?

Many people do not know either they should buy canned or dry cat food, or whether it even matters. Because of this, many people simply buy the cat food that is most affordable or convenient for them. This is actually a mistake. Cats should be fed a mixture of cat food. The dry cat food should be given for free feeding, especially if you are away on vacation or out for the day. Canned cat food should be supplemented at other times as well because it has water in the food and significantly more protein than the carbohydrate rich dry cat food. Not to mention the same food over and over might bore your cat and cause him to stop eating that cat food alike.

Cat Food Info # 4 Avoid Cat Food Fillers

Cats need to eat a cat food that is rich in protein, so make sure the amount of fillers is kept to a minimum. Carbohydrates are not essential for a cat's existence, so do not buy cat food that is full of them. Instead, read labels and buy cat food that is not filled with fillers and other by products.

How To Heal Foot Ulcer For People With Diabetes

For people with diabetes, ulcer growing on feet can be common. It is important to heal it soonest possible before it gets worse. Healing needs good foot care and one needs to treat it with antibiotic. Also, one needs to remove the dead tissue that is growing on the feet. For people with foot ulcer, one should try not to walk too much to let the ulcer heal properly. One should also keep the feet clean to prevent more bacteria to infest the wounds, and one should follow the doctor's advice as closely as possible in order for the ulcer to heal faster.

There is a new medication in the market known as Regranex gel that is use to treat people with diabetic condition who have mouth ulcer. This medication only works for those that have enough blood vessels going to the leg. It promotes new blood vessels to grow and also to speed up the healing of ulcer. It is not created directly from blood products and hence safer for use.

To better make use of this medication, here are some tips to follow. Before applying it, you need to clean the ulcer and have all the dead tissue removed by your doctor. It will take 2 to 10 weeks for the ulcer to heal completely. The success rate of healing with Regranex is about 50 percent. This is better as compared to just letting the ulcer heal by itself. Unfortunately, Regranex is quite expensive at the moment.

You can try out Regranex for a better solution to your diabetic food ulcer. Take note to still continue giving extra care to your feet, and working closely with your doctor, for a good recovery of your foot ulcer.

How To Raise Creatinine Levels

If you're hunting out for ways in which you can improve muscle mass, it might benefit you to take a look at how creatinine can help you. Creatinine is a chemical waste molecule that is the by-product of muscle metabolism. It is produced from creatine, a molecule that plays a key role in the generation of energy in the muscles. An interesting fact is that around 2% of your body's creatine gets converted into creatinine every day, and then gets transported through the bloodstream to your kidneys. Once it reaches your kids, they filter it out and get rid of it through your urine.

In recent years, though, the positive power of creatinine has been explored and has been found to be a massive energy powerhouse. Since it is a natural element that lies in muscle cells, creatinine can make your muscles more powerful and improve your endurance. Raising creatinine levels does not always have to depend on supplements and steroids. Check out some tips that can improve creatinine b, both naturally as well as with external help.

Tips To Increase Creatinine Levels

  1. To begin with, be sure to include protein-rich foods in your daily diet. According to certain studies, a diet that has very low protein content may cause reduced creatinine levels and this shows up through urine testing. Foods such as chicken, lean beef and legumes are the richest sources of proteins. It is extremely essential to eat green leafy vegetables and iron rich foods, since lowed iron levels may also cause reduced urinary creatinine levels. The greatest natural sources of creatinine are meat and fish. Consumption of raw fish such as tuna, salmon and mackerel in the form of sushi or sashimi are certain to boost your creatinine levels. Moreover, raw fish enterprises of omega-3 fatty acids which are highly proficient antioxidant boosters for the body. Fishes are also great catalysts for creatinine synthesis, as they are very rich in amino acid, methionine. It is estimated that about two pounds of raw fish or meat contains five grams of pure creatinine monohydrate powder.
  2. Drinking plenty of water daily boosts creatinine levels. Studies have shown that dehydration can cause plunges in creatinine levels by reducing urinary output. Since creatinine gets out of your body through your urine, this decrease in output may also cause reduced kidney function by subduing creatinine urinary levels.
  3. Get checked thoroughly for any urinary tract infections. Regular health checkups can prevent and correct any infections that can affect your creatinine levels. Urinary tract infections cause reduced creatinine levels by causing your bladder to become inflated, obstructive proper urine output. Treatment with antibiotics may be necessary. Heed your physician's advice and take all mediations as prescribed.
  4. Consult your physician regarding any prescription medications or supplements you are currently on. It has been observed that certain medications lower creatinine levels by affecting the central nervous system.

A word of caution – As with anything, too much creatinine in your body can lead to harmful results and even adversely affect your kidneys. If your kidneys get overladen, toxins start building up, which in turn might cause other serious problems. There are certain side effects such as dehydration, weight gain, cramps, nausea and diarrhea, which are the result of too much creatinine in your body. If you observe any of these symptoms, consult your physical immediately and get your creatinine levels balanced out to meet your fitness goals, safely.

Hyperacidity Natural Remedies – Simple Ways to Cure the Problem

Presence of excess acid than normal is the condition of hyperacidity which can be treated effectively by simple remedies. As this condition can promote heartburn, ulcers and acid reflux, you should treat this as soon as possible. Stomach needs certain amount of acid to digest complex foods, lack of acid can slow down the digestive system, but due to many factors, sometimes gastric glands secrete more than necessary quantity of acid which causes the condition of hyperacidity.

As there are many factors which are responsible for hyperacidity and it is a situation which can give rise to other problems which are capable of disabling the normal daily routine of any person, hence all round treatment of the problem is necessary for effective treatment. Remedies can provide simple ways of curing the problem but until the root cause of the problem is not raised the problem keeps on surfacing. Too much recurrence of hyperacidity can damage the delicate internal tissues of the stomach to cause blisters which may turn into dangerous ulcers.

Frequent hunger, pain in upper abdomen after a large meal, vomiting, nausea, bitter taste in mouth, burning sensation in the stomach are few common symptoms of hyperacidity. A glass of cold milk with very little amount of sugar is the most commonly used and effective remedy for treating hyperacidity. Milk has enzymes which can nullify acid and reduce the pain or burning sensation immediately. Drinking adequate amount of water in the day is very important for treating hyperacidity as water improves digestive system and also works as alkali to effectively nullify the excess acid formation.

Chewing basil leaves after meal or fennel seeds are also good for controlling excess acid secretion, it improves digestive system to provide an effective treatment for the problem. Chewing a piece of jaggery also helps in decreasing the acid presence in the stomach. Ginger is excellent herb for all sorts of digestive problems including excess acid secretion. Ginger tea made by mixing some quantity of ginger in boiling water, using ginger in salad or as a spice in the food can very effectively alleviate the problem of hyperacidity.

Consumption of fruits like banana, apple, melon, cucumber and avocado also keeps the problem of hyperacidity under control. Avoiding consumption of tea, coffee, alcohol and beverages also helps the body in digesting food without secreting extra amount of acid. Sugar intake shall also be reduced to minimum as sugar promotes acid formation. Use lemon either with food or by mixing it in the water for treating the problem of hyperacidity effectively.

Eating habits and life style related issues also play an important role in causing hyperacidity. People with lack of physical activity and exercise can develop this problem very easily, overweight people put extra pressure on their digestive system to promote this problem. People under stress or who sleep less can also suffer with excess acid formation even though having a reliably healthy digestive system. Some simple changes can also work as effective remedies for hyperacidity like taking a light walk after meals, avoiding tight fitting clothes, eating in a right posture by keeping the back straight as much as possible and chewing well before consuming the food.

What Are the Alternative Options For Gastritis Treatment?

There are many options available for a person looking for Gastritis Treatment. Gastritis is a condition wherein the lining in the stomach gets inflamed or irritated. This can happen due to many reasons. Excessive drinking of alcohol or even prolonged use of anti inflammatory drugs can cause gastritis.

You can treat the gastritis with the help of allopathic medicines or with alternative gastritis treatments that are natural and easy on the body. There are many who believe that gastritis can be treated by taking a controlled diet conclusive to gastritis.

Allopathic gastritis treatment: the person with this condition is required to take drugs which help reduce the stomach acids. This in turn alleviates the symptoms and helps heal. Antacids and medicines which neutralize gastric acids are also used to reduce symptoms. In consultation with your doctor you may have to discontinue other medicines which aggravate gastritis.

Along with drugs doctors recommend not to partake of food stuffs, beverages and medicines which induce or aggravate the condition. In case the gastritis is resultant of an infection or other medical conditions, then as soon as they are rectified, gastritis will also recede.

Home remedies for gastritis treatment: there are a few home remedies that work great when trying to treat gastritis. Coconut water is a fabulous option. Not only does it soothe the stomach but also has a good amount of essential vitamins and minerals. It is highly recommended that on the sunset of this condition, the patient be asked to partake only of coconut water for about 24 hours to heal faster. Consumption of around half a cup of potato juice half an hour before meals also helps relive the symptoms. One cup of rice gruel twice a day also helps in this condition. Another very simple home remedy would be to consume marigold herb twice daily.

Gastritis diet treatment: this should be underaken under the supervision of an expert. It is recommended that the patient be kept on a fast for 2-3 days. During this time warm water to drink often is advised. Once the toxins have eases, a fruit diet is advised wherein the patient consumes only fruit for three days. Juicy fruits like grapes, pears, pineapples, peaches, apples, melons etc are advised. The patient is advised to stay away from spicy and fatty food. All types of chilies and peppers, alcohol, tea, coffee and cocoa are to be totally banned. Sour foods, pickles and rich foods are to be avoided. Large amounts of curd and cottage cheese are recommended for the patient. The patient then embarks on a balanced diet avoiding the aforementioned foods.

Other gastritis treatment: warm water enema once a week is advised to free the bowels of toxins. Application of heat, twice daily on an empty stomach is useful in alleviating symptoms. The patient is advised to avoid mental stress and heavy physical work as they contribute to the formation of acids in the stomach thus aggravating the condition. Light exercises and breathing exercises are good for them.

There are many gastritis treatments that you can choose from to help heal faster. Consult a doctor or an expert before you decide to choose any one of the treatments mentioned above.

What Do You Know About the Coxsackie Virus?

The Coxsackie viruses combine a large subgroup of the enteroviruses. They produce a variety of illnesses in humans, including aseptic meningitis, herpangina, pleurodynia, hand, foot and mouth disease, myo- and pericarditis, common cold, and possibly diabetes, Coxsackie viruses have been divided into 2 groups; A and B, having different pathogenic potentials for mice. Coxsackie B viruses are the most commonly identified causative agents of viral heart disease in humans.

Properties of the Viruses

General properties

Coxsackie viruses are typical enteroviruses, with a diameter of 28nm.

Animal susceptibility and Growth of Virus

Coxsackie viruses are highly infectious for newborn mice. Certain strains (B1-B6, A7, 9, 16) also grow in monkey kidney cell culture. Some group N strains grow in human amnion and human embryonic lung fibroblast cells. Chimpanzees and cynomolgus monkeys can be infected sub-clinically; virus appears in the blood and throat for short periods and is excreted in the feces for 2-5 weeks. Type A14 produces poliomyelitis-like lesions in adult mice and in monkeys, but in suckling mice this type produces only myositis, Type A7 strains produces paralysis and severe central nervous system lesions in monkeys.

Group A viruses produce widespread myositis in the skeletal muscles of newborn mice, resulting in flaccid paralysis without other observable lesions. Group B viruses may produce focal myositis, encephalitis and most typically, necrotizing steatites involving mainly fetal fat lobules. The genetic makeup of inbreed strains determines their susceptibility to Coxsackie B viruses. Some B strains also produce pancreatitis, myocarditis, endocarditis and hepatitis in both suckling and adult mice. Corticosteroids may enhance the susceptibility of older mice to infection of the pancreas. Normal adult mice tolerate infections with group B Coxsackie viruses. However, severely malnourished or immuno-deficient mice have greatly enhanced susceptibility.

Antigenic properties

At least 32 different immunologic types of Coxsackie viruses are not recognized; 26 are listed as group A and 6 as group B types.

Resistance

Coxsackie and ECHO viruses posses relatively high resistance. They survive for a long period of time in a frozen state at -70 degrees Celsius. In glycerin and horse serum at room temperature they persist for 70 days. In a refrigerator they survive for more than a year. The Coxsackie viruses resemble the poliomyelitis viruses in that they are resistant to various concentrations of hydrogen ions. They survive at pH 2.3-9.4 for 24 hours and at pH 4.0-8.0 for 7 days. They are resistant to antibiotics, 70 degrees ethyl alcohol, and 5% Lysol solutions but are extremely sensitive to solutions of hydrochloric acid and formaldehyde. A temperature of 50-55 degrees Celsius kills the viruses in 30 minutes.

Pathogenesis and pathology

Virus has been recovered from the blood in the early stages of natural infection in humans and of experimental infection in Chimpanzees. Virus is also found in the throat for a few days early in the infection and in the stools for up to 5-6 weeks. The distribution of virus is similar to that found with the other enteroviruses. Group B Coxsackie viruses may cause acute fatal encephalomyocarditis in infants. This appears to be a generalized systemic disease with virus replication and lesions in the central nervous system, heart muscle, and other organs.

Edema Treatment – Its Symptoms and Causes

Fluid accumulation in the body tissues and the area around the organs of the body is recognized as edema. Understanding the reason that leads to the condition is often the best method for edema treatment. Edema is commonly observed in the lower body or the hands, chest region or the abdomen. Heart failure may cause fluids to collect in the chest region, a condition known as pulmonary edema. This can sometimes be fatal in case it is not raised in time.

The skin may become stretched, appear shiny or puffy depending on the cause of the edema. These are the most common symptoms that are obvious. In patients who are laid up in bed for a long period, the symptoms may be visible on the lower back or the legs. In many cases, the swapping worsens at the end of the day; in some instances, it may become worse after standing or sitting for a long. Shortness of breath is a common symptom of chest edema while the abdominal size increases in abdominal edema. Failure of the heart or the lymphatic system leads to edema. Cirrhosis can be another cause of edema. An injury or the malfunctioning of the lymphatic system is the cause for lymph edema.

There can be numerous caused for edema; however, the most frequent reason for edema is venous disease. A blood clot or deep vein thrombosis is another common cause of edema. During pregnancy, women retain fluid which causes swelling. There is no need for edema treatment, as the swapping goes away by itself. In women, the menstrual menstrual cycle sometimes causes edema, but this does not need treatment. Side effects of medications for hypertension or diabetes may at times cause edema in patients. Congestive heart failure is the most serious condition that causes edema in the chest; it may also cause death. Swellings on the lower legs or around the eyes may be the result of kidney disease.

The ideal method to treat edema is to find out the factors causing it and taking care of that cause first. Often, doctors recommend the reduction of salt intake as the first line of treatment. Another easy option is to elevate the legs for about half an hour everyday to take care of the swelling. Diuretics are prescribed for the serious pulmonary edema. This helps in draining the excess water and sodium through the kidneys. Due care must be taken while using diuretics as a large dosage might cause too much fluid to drain fast, lowering the blood pressure, thus causing damage to the kidneys.

For leg edema, the doctor may prescribe compression stockings. The stocking must fit properly otherwise it will be ineffective and the patient will be uncomfortable as well. The stocking should apply the highest compression at the ankle and reduce as it goes up on the leg. Some herbal extracts have medicinal and curative properties. By and large, they are diuretics and are used to reduce the swelling. Some examples are horse chestnut, dandelion leaf and evening primrose oil. Very often, edema treatment is as simple as a dietary change; reducing the salt intake works well to keep the swilling down.

How to Purchase Forklift Parts

All forklifts have certain common components. These forklift parts are vital to the performance and operation of the equipment. Due to constant use and wear and tear, some parts such as forks, brakes and transmissions components have to be replaced quite often.

Usually forklift parts are purchased from different sources. Both new and used parts are available. There are many dealers who have printed catalogs listing all the parts that are available with them. Also there are a number of different manufacturers exclusively for forklift parts. A company that manufactures forklifts also produces replacement parts.

The most important component of the forklift is of course the forks. Without quality forks, the forklift may not be able to transport the materials quite efficiently. These forks are also called blades or tines which vary from model to model. The other important part of a forklift is the brakes. Forklift brakes operate in a similar manner to the brakes of an automobile and they have many parts in common. Brake shoes and break drums are among the most commonly purchased forklift brake parts.

Forklift transmissions are vital to the machine's operation. Forklifts can use either manual or automatic transmissions. Manual transmissions are probably more common and are easier to fix, but many people prefer automatic transmissions because they are easier to use. Many forklift parts dealers have both new and used transmissions for sale.

The Roll Clamps is also another important part of a forklift. There are various models of roll clamps which are available to handle all types and sizes of paper rolls including newsprint, Kraft paper and tissue and coated papers. The models of roll clamp include rigid arm, pivot arm, slide arm and spilt arm clamps all of which are designed to meet the different requirements.

The Carton Clamps is another important attachment for handling multiple unpalletized products such as appliances, furniture, cartooned, canned or frozen goods. Large rubber faced pads gently squeeze the side of the load (containing numerous cartons) until it can be lifted, and then transported to either the warehouse or trailer.

The Rotator is also one of the most important forklift parts. The rotator is used to aid the handling of skids that may have become excessively tilted and other specialty material handling needs. Some forklifts are fitted with an attachment that allows the tines to be rotated. This type of attachment may also be used for dumping containers for quick unloading.

It is very important that only good replacement of the forklift parts is purchased in order to keep the machines in good running condition. Many forklift parts dealers offer extensive warranties on their products. Most forklift parts of every model and make are available in the market so a replacement for a part of a particular make or size can be easily found.

Tuberculosis, a Cause for Concern?

Despite advances in treatments available, tuberculosis (TB) still remains a global pandemic. One third the human population is currently infected with tuberculosis. What is tuberculosis?

The disease tuberculosis is caused by the bacterium Mycobacterium tuberculosis. Tuberculosis can affect any part of the body but usually infects the lungs. Tuberculosis is spread through airborne droplets occurring when an infected individual sneezes, talks, or coughs. However, prolonged exposure to the infected individual must occur before you may become infected. The body may harbor the bacteria while the immune system prevails sickness. For this reason, there are two forms of TB: latent tuberculosis and active tuberculosis.

With latent tuberculosis, the immune system is able to prevent the bacteria from growing. The tuberculosis bacteria remain alive within the body but are inactive at this time. However, the bacteria can become active later in life. Those with latent tuberculosis have no symptoms, do not feel sick, are not contagious, and may develop TB later in life if they do not receive treatment.

Active tuberculosis simply means that the tuberculosis bacteria are growing within the body causing an active infection. Signs and symptoms of active tuberculosis include fatigue, slight fever, chills, night sweats, loss of appetite, unintended weight loss, a cough that lasts three or more weeks producing discolored or bloody sputum, and pain with coughing or breathing. Active tuberculosis is highly contagious.

What is causing the tuberculosis pandemic? Improved public health programs have helped to create a steady declination of tuberculosis cases in the United States. However, the problem is far from solved. Factors that contribute to the spread of tuberculosis in the US and elsewhere include the increase in number of foreign born nationalities, accrued living conditions, increase in drug resistant strains of tuberculosis, lack of access to medical care, and the increase in poverty.

Poorly ventilated and crowded conditions help to spread TB. This is one reason tuberculosis cases have reached epidemic proportions. Despite the incidence of TB cases in the US is declination, the incidence in other parts of the world is increasing. Half of the reported cases in the US (in 2000) occurred in individuals that were born outside of the US Individuals that live in poverty, move or migrate often usually do not finish the tuberculosis treatment. This is leading to drug resistant forms of tuberculosis.

Drug resistant strains of tuberculosis are a serious problem. Tuberculosis bacteria have developed strains of the bacteria that are resistant to each of the major tuberculosis medications. There are also strains of tuberculosis that are resistant to at least two tuberculosis medications. This multidrug-resistant TB (MDR-TB) is posing an even deadlier threat to those affected. Individuals affected with MDR-TB are much more difficult to treat requiring a long term therapy of up to two years. The medications required to treat these strains can cause serious side effects. This is one great reason to complete the entire course of medication as prescribed by your doctor.

Certain factors increase your risk of contracting tuberculosis. An individual in an immunocompromised state is at risk of developing TB. A number of factors can cause the immune system to be in a weakened state. Some diseases can suppress the immunity such as diabetes, HIV / AIDS, and silicosis. Certain medications can affect the body's immune system which includes chemotherapy drugs and corticosteroids. An increased risk of reactivated tuberculosis has been associated with the use of arthritis medications Enbrel and Remicade.

Individuals within close proxies of those infected with tuberculosis are at an increased risk of developing disease. Individuals in areas of high rates of tuberculosis (Asia, Africa, Latin America, former Soviet Union) have an increased risk of developing tuberculosis. Certain races (Hispanics, American Indians, Asian Americans, African Americans) in the US are at risk of developing tuberculosis. What other factors may increase your risk of developing tuberculosis?

The older adult is at an increased risk of developing tuberculosis due to a weakened immune system. Individuals who are malnourished, lack adequate medical care, or who suffers from long term drug or alcohol abuse are at increased risk of developing tuberculosis. Health care workers are at increased risk of developing tuberculosis also.

If you develop any of the signs or symptoms listed above, you should seek medical advice. Individuals with HIV should be tested for tuberculosis, since the leading cause of death in the AIDS patient is tuberculosis. HIV and tuberculosis have a severe symbiosis, in which TB increases the rate at which the AIDS virus replicates and HIV reactivates inactive TB. Health care workers are usually tested at least yearly for tuberculosis by Mantoux test. Individuals with latent tuberculosis reveal a positive Mantoux even though no symptoms of the disease are evident. Tuberculosis is also tested by chest x-ray and culture tests (urine, sputum).

Tuberculosis is a preventable disease. There are a few measures one can take to protect their health. First, you should be tested regularly. If you have an immune suppressing disease, live or work in a prison or nursing home, were born in a TB prevalent country, or have other risk factors, then a Mantoux test should be done every six months.

If you test positive without symptoms, speak with your doctor about treatments to reduce the risk of developing active tuberculosis. The most important step you can do for the public and yourself is to finish the entire course of medicine. Treatment that is stopped to early allows the bacteria a chance to mutate to a drug resistant form.

Copyright 2006 Kristy Haugen

Can You Restart Penis Growth After Puberty – Yes You Can – Find Out How With These Natural Tips

I’m going to start off by asking you a question: how would you feel about getting a bigger penis? If you said ‘excited’ and ‘happy’ then male enhancement could be something worth looking into. In the past, many men used to try surgery or pills to try to add inches to their manhood, but over the years these methods have been proven to be largely unsuccessful and quite dangerous too. Some men still want to use these techniques (usually men who haven’t done much research into how bad they are!) but most are now turning to a more natural approach. With this, you get all the benefits of growth without any of the risk. I know all of this because I have personally used these techniques and grown by a massive 4 inches! You could too…

How does natural enhancement really work?

The truth is, if you want to get your penis growing then you have to restart the growth that you saw during puberty. That means you will need to return your body to the same internal state that it was in throughout this time. It’s actually pretty logical when you think about it – your manhood grow naturally back when you were a teenager so why shouldn’t it do the same again? Well, it can, and all you need to do is apply a little science.

The science behind puberty…

During puberty, growth was cause by a series of chain reactions in your penis. These reactions were set of by a specific set of biochemicals that occurred in your body naturally. These chain reactions would have continued forever, but after puberty ended, your body stopped producing the necessary biochemicals (it was programmed to do this). This, of course, meant that no further growth could take place. When you think about growth as a biochemical process, it becomes easy to see how you can replicate it again.

All you need to do is get your body producing biochemicals – and you can do this by using a natural enhancement program. After this, you may also like to perform simple exercises to speed everything up. This way, anything up to 4 inches is possible in just a few short weeks! I have never been happier with my size – you could grow too!

What is Bone Cancer?

Someone telling you that you have cancer is one of the most horrible things one can hear. Just thinking about all the problems that can come up and how long treatment takes can affect not only the person who has it, but also the people around them. However, the scariest part of cancer is that there are so many types of it out there, and people might not even know anything about them. Yes, everyone knows the main ones like lung, breast and brain cancer, but what about the other not so common ones. Bone cancer is one such example and is a type that is often overlooked, but it's never too early for us to become informed about it.

More than 2,000 people in the United States are diagnosed with bone cancer or a bone tumor each year. The tumors often occur in children and adolescents more than it occurs in adults. If an adult does have bone cancer, it's most likely because the disease has spread from another area in the body.

There are several types of bone cancer and the most common is called Osteosarcoma. Osteosarcoma is primarily a malignant form of the cancer occurring mainly in males between 10 to 25 years of age. The cancer forms in the long bones of the arm and legs at time of rapid growth rate.

Another form of bone caner is Ewing's sarcoma. This is the most aggressive form of bone cancer and occurs in children between 4 to 15 years of age. It is more common in males but rarely occurs if they are over 30 years old.

Chondrosarcoma is the second most common form of bone cancer. It accounts for about 25% of all malignant bone tumors. However, what is interesting about this form of cancer is that it is most commonly found in adults over 40 years old. It is most commonly found in males and has a tendency to spread to the lungs. It occurs in the hips and pelvis.

These types of bone cancer are the more common forms although there are several more types which are not covered here. Cancer is becoming increasingly hard to diagnose because there are just so many different types of it. In addition, it's actually quite difficult to know where to look for it. However, the more we know about the different types of cancer, the more easier it is for us to recognize them when they occur and to take early remedial action to arrest or eradicate this deadly disease. Early positive intervention can increase our chances for an early recovery and a higher survival rate.

Pneumonia Symptoms And Treatment

If bacteria cause the pneumonia it can usually be treated with antibiotics. Viruses do not respond to antibiotics; if your pneumonia is the result of a virus antibiotics enable you to help prevent any secondary infections.

Doctors treat pneumonia in line with the type of pneumonia an individual has as well as other individual factors, such as age and general health. Bacterial pneumonia is generally treated with antibiotics. Fungal pneumonia is labeled with antifungal agents. Viral pneumonia may be treated with antiviral medicines but is much more often treated simply with recommendations of rest and plenty of fluids. Additionally, for all types of pneumonia, doctors often suggest taking over-the-counter medications to reduce fever and pain.

In the event the pneumonia is severe, or even the person affected is either early or frail they may need to be treated in hospital where antibiotics and further fluids and may be given straight into the vein (intravenously). If breathing is tough, extra oxygen may be given through a facemask. About one inch every six people with pneumonia are ill enough to need this kind of specialized care.

There is a range of bacteria which could cause disease leading to 'typical pneumonia' including Streptococcus pneumoniae which causes pneumococcal pneumonia. This is the most typical cause of pneumonia. Viruses can also be a source of infection including influenza – or flu. Disease with a bacterium and a virus can happen at the same time. A Streptococcus pneumoniae infection is normally 'secondary' to a person having flu for example. This is known as a 'secondary infection' and can slow down recovery significantly.

Typical symptoms are cough, fever, sweats, shivers, being off food, and feeling generally unwell. Headaches, and injuries are common. You always make more sputum which can become yellow / green, and is also sometimes bloodstained. You could become breathless, breathe fast, and produce a 'tight chest'. A sharp pain within the side from the chest may develop when the infection involves the pleura. (This is the membrane between your lung and the chest wall.) A doctor may hear 'crackles' within the chest when listening using a stethoscope.

Pneumonia is actually a general term for many conditions by which an infection or chemical inflames the air sacs of the lungs. They fill with liquid or pus, which disables the lungs' ability to transfer oxygen for the blood. Prior to the invention of antibiotics within the 1930s, pneumonia was a leading reason for death. Today it is extremely treatable, but remains a public medical condition. At least 100 different kinds of pneumonia exist, which range from mild to severe naturally.

During the early acute stage of pneumonia, a tea produced from fenugreek seeds will help the body to make perspiration, dispel toxicity, and shorten the period of fever. Up to four cups of the tea may be taken daily. The amount can be reduced because the condition improves. To enhance the flavor from the tea, a few drops of fresh lemon juice may be added. With this treatment, not one other food or nourishment needs to be taken, as fast and fenugreek enables the body to fix these respiratory problems in the future.

If you experience the above mentioned pneumonia symptoms , you should immediately contact your doctor for further consultation. Despite the fact that walking pneumonia will not make you bedridden, it still can be very annoying and severe.

What Are the Main Pleurisy Symptoms?

The lungs are protected by two layers of covering called the pleura. It separates the lungs from the chest wall and other organs in the body. If this tissue becomes swollen or inflamed, the condition is called pleurisy. Pleurisy symptoms are painful, and can come in varying degrees of severity. Pleurisy is result by an infection in the lower respiratory tract that is caused by a virus or bacteria such as the one that causes tuberculosis. The condition can last for a few days on some, and can run for 2 weeks on others. Pneumothorax, or a condition where the air is leaking into the pleural cavity because of a puncture in a lung can also cause pleurisy. A tumor located at the pleura can also cause pleurisy, as well as other conditions such as rheumatoid arthritis, lupus, and pulmonary embolism. It can also be caused by a complication from heart surgery.

Pleurisy symptoms can include the following:

– The most common of symptom of pleurisy is chest pain. The pain is described as a sharp, stabbing pain, but can also be perceived as a dull ache. The pain is worse when you take in a deep breath, move around, or cough. Others are forced to breathe rapid, shallow breaths just to help them ease the pain. Pressure also relieves the pain, which is observed when lying down on the side that is painful.

– Pleurisy can also be accompanied with a cough, depending on the cause of the condition. You may have dry or productive cough that has sputum or blood.

– Shortness of breath or difficulty in breathing can be felt when you have pleurisy. This can be due to the pain, but also because of the underlying cause of the condition. The lungs may have a blood clot, or it may be filled with too much phlegm as with pneumonia.

– Fever may be present if the pleurisy is caused by an infection.

Chest pain is the most common reason of all pleurisy symptoms why people seek medical attention. It is also important to seek professional advice if you have high fever, chills, and have productive cough of green or yellow sputum. Heart disease, chronic bronchitis, diabetes, or emphysema will make the condition worse, making it more important for you to visit a doctor for pleurisy management.