Sarcoidosis Symptoms – The Danger Signs You Can’t Ignore

Sarcoid is considered an autoimmune disease whereby the body over-reacts to a trigger like a bacteria, virus (like Epstein Barr) or irritant. Sarcoidosis symptoms are due to the formation of “granulomas” or clumps of abnormal immune cells in the body.

Sarcoidosis symptoms can vary between different people. In some people, symptoms are mild and go into remission on their own accord. In other people, symptoms can be debilitating, causing the patient to be bedridden for weeks, months or years. In severe cases, particularly when the heart and brain are affected, the disease can be fatal.

Sarcoidosis symptoms are most commonly seen in females aged 20 to 40, particularly in those of Northern European or African American descent.

Sarcoidosis symptoms are best grouped according to the area the disease targets:

1) The lungs

It is estimated that 90% of sarcoid patients suffer from lung involvement. Symptoms like coughing, chest pain, breathlessness, fatigue and wheezing are often seen. In the early stages of the disease, symptoms are not always obvious.

2) The lymph nodes

Symptoms of swollen, tender lymph nodes are common. These swollen glands may be felt in the neck, armpit and groin. Sometimes they are picked up during X rays of the lungs or affected organs. Some patients experience a cyclical re-activation of their swollen glands.

3) The skin

About 20% of sufferers experience skin problems like a rash or purplish raised patches. These skin patches commonly occur on the face, arms, legs and buttocks and can make the patient feel embarrassed and socially isolated.In some patients the rash can be painful.

4) The liver

Liver symptoms may include nausea, malaise, anorexia, fever, yellowing of the eyes and weight loss. An enlarged liver, fatty liver and cirrhosis may also eventuate.

5) The heart

This illness can affect the heart muscle causing chest pain, abnormal heart beat and congestive heart failure. Once sarcoid affects the heart, there is a higher risk of complications and death from the illness.

6) The brain

Brain involvement can include facial weakness, dizziness, weakness, delirium, dementia and disturbances in hearing, taste and smell. Brain sarcoid symptoms need to be addressed urgently.

7) The eyes

Eye inflammation and visual symptoms like tearing of the eyes, blurred vision and field defects may indicate the eyes have been affected.

8) The bones

Pain and swelling can appear in the joints, especially in the hands and feet.

9) The kidneys

Sarcoid in the kidneys can appear as pain or the formation of kidney stones.

10) The nervous system

Sarcoidosis symptoms arising from nervous system involvement may include muscle weakness, shaking and poor co-ordination.

Because sarcoidosis symptoms are so varied, the disease is often mis-diagnosed. To confirm a sarcoid diagnosis, a blood test which looks for elevated angiotensin-converting enzyme is often done. X-rays and tissue biopsy can confirm the diagnosis.

Standard conventional medicine treats sarcoidosis symptoms with corticosteroids. Although these drugs can disguise the symptoms, they do not address the underlying cause of the disease. Steroids also come with undesirable side effects like reduced immunity, osteoporosis, liver damage, high blood pressure and an increased cancer risk.

Fortunately sarcoidosis symptoms can be relieved in many sufferers with the use of natural treatments. A new protocol from Dr Jani Hajjri – a medical doctor from Ohio claims an 82% success rate. This protocol called “The Aden Protocol” detoxifies the body, breaks down granulomas, dampens inflammation and protects the body from further injury.

Unveiling the History and Myths of Ultrasonic Liposuction

Liposuction has evolved a great deal since surgeons originally used coarse curettage techniques to scrape away unwanted subcutaneous fat. Several sentinel modifications have occurred in recent decades to help produce better, safer surgical results. Included among the innovations are improved instrumentation, better patient selection and the incorporation of pre-aspiration wetting solutions.

It was Yves Ilouz, a French gynecologist who was largely credited with the popularity of the technique we now know as liposuction. American plastic surgeons, trained in Europe, adopted the technique and brought it into the mainstream. Three decades and millions of cases later, liposuction remains one of the most popular procedures in plastic surgery.

A Rough Start

The introduction of liposuction into the United States was met with mixed enthusiasm in the 1970s. Anecdotal reports soon surfaced of serious complications, even deaths associated with the new procedure. These tragic cases were especially significant because the whole concept of aesthetic, elective surgery was just evolving. The thought of a patient suffering serious complications from a medically unnecessary surgical procedure made these reports newsworthy. The negative media coverage cast a stigma upon the emerging procedure that has remained even to this day.

The reasons for the early catastrophic cases were complex. Among the problems were poor patient selection and varying degrees of practitioner skills. In addition, a lack of appreciation for significant losses of blood volume in the aspirate created hemodynamic instability. In an overzealous attempt to remove large volumes of fat, surgeons often created unacceptably low hematocrit levels.

A Safer Surgery

The mechanism of traditional liposuction, also termed suction assisted lipectomy (S.A.L.) is conceptually simple. A rigid, hollow cannula, connected to a suction machine, is inserted into the subcutaneous space. Rapid, coarse strokes by the surgeon create a series of tunnels, eventually becoming confluent, diminishing the fat panniculus. The underlying problem with the technique is that there is no tissue selectivity. The suction energy evacuates or destroys all elements of the subcutaneous tissue plane, including valuable structures such as blood vessels, nerves and fibrous tissue.

Critics of the procedure describe it as rough and traumatic, translating clinically into a painful, bloody process with a prolonged recovery. In addition, loss of essential connective tissue leads to rippling of the skin, the most common complaint following traditional liposuction. One study reported an 80 % incidence of skin irregularities following S.A.L.

The key to producing a safer result with liposuction needed to include the successful removal of fat tissue while at the same time sparing the other elements of the subcutaneous parenchyma. Several improvements were made towards this goal.

A leap forward occurred in the 1980s with the introduction of wetting solutions. Previously liposuction was a simple one-step “dry” procedure. Wetting solutions vary in their formula and quantity. However, the three fundamental elements to most infiltration solutions are saline, epinephrine and local anesthetic. The saline alters the tonicity of the adiposite, creating a more fragile cell, epinephrine is a potent vasoconstrictor, and the local anesthetic is used for pain relief. The solution is introduced into the subcutaneous tissue as a pre-aspiration step. The overwhelming benefit of wetting solutions is the significant reduction in blood loss associated with the lipoaspiration.

A New Idea

In the late 1980s and early 1990s several surgeons from Europe and South America began experimenting with a new concept. These surgeons began using ultrasound energy at a specific frequency to selectively destroy fat cells.

Ultrasonic energy was not new to medicine. Colleagues in other specialties have utilized ultrasound in a great number of both diagnostic and therapeutic capacities. Pregnant women certainly are familiar with the diagnostic uses and safety record of ultrasound. In addition, ultrasonic energy has been harnessed in ophthalmology for phacoemulsification and by urologists performing lithotripsy for renal calculi. Neurosurgeons and general surgeons are familiar with the Cavitron ultrasonic dissection device. Applications for ultrasonic energy continue to grow.

The use of ultrasound for body contouring was innovative. Previously, with traditional liposuction, the aspiration cannula could not distinguish between desirable tissue and fat. Consequently, the parenchymal architecture, including blood vessels, nerves and fibrous elements would be aspirated by the coarse cannula, along with the fat cells.

For the first time the concept of selective tissue aspiration could be achieved. The idea was simple, remove only the elements of the subcutaneous tissue needed to achieve the desired effect and preserve the rest. Like picking off the grapes, but leaving the vine intact.

The application of this energy to plastic surgery was appealing for three reasons. First, ultrasound has an established history of safety. Secondly, the vibratory frequency of the ultrasonic energy can be made specific to the adipocyte. It is this tissue specificity that underlies the mechanism and benefit of ultrasonic lipoplasty. And finally, since the energy for tissue fragmentation does not come from rapid surgical strokes, the process is markedly less traumatic to both the patient and the surgeon.

How it Works

The procedure is performed using a device made up of three component parts. Electrical energy is converted into ultrasonic energy using an ultrasonic generator attached to a handpiece containing a piezoelectric crystal.

The application of ultrasonic energy is an extension of the concept of a conversion of electrical energy to a mechanical wave. The wave is propagated down a titanium cannula shaft with a specific length producing a nodal sine wave pattern. The wave is calibrated to intersect at the tip of the titanium cannula producing a specific vibratory frequency of approximately 20-27 kHz. It is this precise calibration that prohibits bending of the titanium ultrasonic cannulae.

The specific frequency of 20-27 kHz produced by the vibratory tip will affect primarily tissue with the lowest density, defined as tissue impedence. Fat has the lowest tissue impedence. Wetting the adipose tissue with tumescent infiltration can even further lower the impedance value. The result is an energy absorption specific to adipocytes. Ultrasonic energy absorption by adipocytes at a frequency of 20-27 kHz creates internal cellular instability leading to cell wall fragmentation and implosion. The phenomenon known as cavitation produces cell destruction leading to fat emulsification.

The end result is that ultrasonic energy yields selective destruction of fat tissue, largely sparing other types of connective tissue. This tissue selectivity is fundamental to the principles of ultrasonic lipoplasty and is evident at both a gross and microscopic level. In addition, in vivo endoscopic videos have demonstrated successful fat removal with preservation of soft tissue parenchymal architecture after application of ultrasonic energy.

Born in Europe, Raised in the U.S.

Several surgeons in Europe and South America began experimenting with ultrasonic lipoplasty in the early 1990s.

Instruments were rudimentary and ultrasonic generators were cumbersome, requiring constant calibration.

Nevertheless the early ultrasonic pioneers persisted. The International Society for Ultrasonic Surgery was formed to facilitate an active exchange of information. Michele Zocchi, an Italian plastic surgeon and physicist, is largely credited for introducing and advancing ultrasonic lipoplasty in these early formative years.

Zocchi brought together a small group of physicians from around the world for the first international symposium dedicated to ultrasonic lipoplasty in Algarve Portugal in 1995. The meeting was attended by surgeons from Europe, the Middle East, and Latin America. Only a hand full of American surgeons attended. Those of us who were present were very impressed with the potential of the exciting new technology. Also present were American manufacturers eager to produce an ultrasonic device for the U.S. and international markets.

The symposium included clinical presentations and original scientific research. In addition, innovative endoscopic video material prepared by Hassane Tazi from Casablanca gave us a unique internal view of ultrasonic activity at a cellular level. The first I.S.U.S. meeting generated a great degree of excitement among the participants.

Meanwhile in the U.S. the major plastic surgery societies, anticipating the popularity of the emerging technology, formed a task force ostensibly to coordinate the safe introduction of ultrasound. The U.A.L. Task Force created a one day training course combining didactic lectures and a hands-on cadaver lab. The largest malpractice insurer for plastic surgeons, joined in the effort. The company required its insureds to attend the seminar to obtain coverage for U.A.L. cases.

Ultrasonic assisted lipoplasty arrived in the U.S. mainstream in early 1997. The technology was greeted with great fanfare and hype. U.A.L. was touted as a cure for everything from cellulite to obesity. It was not long before the media began to feature the procedures on mainstream broadcasts such as Primetime and 20/20. Patients began to ask specifically for ultrasonic liposuction. In response, surgeons clamored to take the few available courses.

The Pendulum Swings

The U.A.L. pendulum had reached an apex in late 1997. The momentum soon began to shift, however. Fueled by a series of independent events, enthusiasm for the technology began to diminish. Many surgeons began to question the value of an investment in U.A.L.

Confounding the issue of ultrasonic lipoplasty was the introduction of an external ultrasound used as a pre-treatment for traditional suction lipectomy. The device used transcutaneous ultrasound similar to machines used in physical therapy. Though markedly different from internal U.A.L. the procedures were often confused and regarded as equivalent.

Finally, and most significantly, a number of assertions were made regarding U.A.L. that were not supported by clinical experience. These myths caused surgeons to both fear, and rethink the value of, U.A.L.

The Myths of Ultrasonic Lipoplasty

1. U.A.L. causes severe burns.

Isolated anecdotal cases of burns associated with U.A.L. surfaced in the late 1990s. They soon self-multiplied much like Mussolini’s air force in World War II*. It is true that ultrasonic lipoplasty differs from traditional liposuction in that there is an exchange of energy. It is possible that prolonged stationary exposure can cause a buildup of thermal energy in the tissues. It is therefore especially important to adhere to the two basic rules of U.A.L. described by Zocchi: keep the tissue wet and keep the cannula moving. However, strict adherence to these two basic rules minimizes any serious risk of burn injury. Data published by this author (1) demonstrated no burns in a series of 351 consecutive cases. The three potential mechanisms of thermal-ischemic injury were outlined in this study.

2. U.A.L. causes seromas.

Certainly seromas can occur with ultrasonic lipoplasty just as they do with traditional liposuction. However, there is no evidence that any inherent features of U.A.L. predispose to a greater frequency or severity of seromas. To the contrary, our study (1) data reported only 3 small abdominal seromas which all resolved with conservative management. Careful review of published data regarding U.A.L. seromas suggest that these occur more frequently in the abdomen. However, abdominal seromas, which occur with traditional liposuction as well as abdominoplasty, are more accurately a reflection of the difficulty obtaining post-operative compression to the surgical dead space, not the particular technique utilized.

3. Ultrasonic energy time should be limited to 5 minutes per area because of the risk of burns and seromas.

Based upon myths 1 and 2 some have speculated that the cause of these supposed burns and seromas is related to ultrasonic energy time. Guidelines have been created to limit ultrasonic energy time per area. Some have suggested that energy time should not exceed 5 minutes because of the potential for burns and seromas. Analysis of published data does not support these artificial limits. Our study data revealed no correlation between complications and energy time and no such limits were imposed. Surgeons in Europe and Latin America routinely use energy in excess of 5 minutes.

More importantly, if one believes that the true value of U.A.L. is its less traumatic, tissue selectivity, then it is illogical to limit ultrasonic treatment to only a few minutes and complete the procedure, and traumatize the tissue, with traditional liposuction. In fact, this is the flaw of so-called “comparison” studies. In any analysis of the two techniques it is important to compare true, complete U.A.L. with traditional liposuction. To date, this author is not aware of such a published comparison. Moreover, this type of study would be limited by ethical considerations.

4. U.A.L. is an extension, but not a substitute, for traditional S.A.L.

I find this statement confusing yet I have heard it often. Even opponents of the technology admit that the tissue selectivity of U.A.L. make it especially helpful in difficult areas. Tissue higher in fibrous density such as the back, flanks or male breasts respond well to ultrasonic treatment. However, if U.A.L. is better for the difficult areas, why not use it everywhere? In fact, with few exceptions, ultrasonic lipoplasty has become our procedure of choice everywhere. U.A.L. is indeed an acceptable substitute for S.A.L.

5. It is necessary to complete the U.A.L. procedure with S.A.L.

Many authors favor the use of combined U.A.L. and S.A.L. The reasoning for this sequence is to use the ultrasound to “soften” the tissue, followed by the speedier traditional liposuction to complete the procedure. The flaw in this approach is that any use of traditional S.A.L. diminishes the benefit of the ultrasonic tissue selectivity. Our preferred technique has evolved to even exclude the so-called “mopping up” phase of U.A.L. The procedure in most cases is performed, through completion, with simultaneous and continuous suction and ultrasonic energy.

6. U.A.L. should be avoided in certain body areas.

Some authors admonish the use of U.A.L. to certain body areas. Using U.A.L. in areas of thinner skin such as the arms, face, neck, inner thighs, knees and even saddle bags has been described as risky. The risks ascribed are primarily associated with burns or devascularization injury. However, clinical data does not support this assertion. In fact, several authors have reported successful results with few complications in these body areas. Our experience in these areas is also free of significant complications with very satisfactory results.

7. The U.A.L. cannula should be kept > 1cm. deep to the dermis.

The concern again here is the risk of thermal or ischemic injury to the skin. It is appropriate that surgeons treating the underside of the dermis have a level of skill and experience with this area. However, proponents of U.A.L. feel that the greatest opportunity for skin contraction is via stimulation in this plane. It is advisable that suction not be applied simultaneously during this step in order to avoid tissue dessication. Otherwise, subdermal stimulation can be performed safely with adherence to the two rules of U.A.L.

8. U.A.L. is a treatment for obesity.

Reports in Europe, Latin America and the U.S. of large volume liposuction have led some to suggest that liposuction may be an effective adjunct in the treatment of obesity. The tissue selectivity and markedly diminished blood loss associated with ultrasonic certainly make it an attractive option with this strategy. However, many authors have very effectively outlined the potential problems, including significant hemodynamic issues, associated with large volume lipoplasty. Moreover, obesity is regarded as a complex condition, requiring behavior modification in addition to loss of adipose tissue. Our experience is with moderate volume cases (average ~2000cc, largest 7000cc) primarily used for localized body contouring.

It is advisable that surgeons choosing to perform large volume U.A.L. do so only after significant experience with smaller cases.

9. U.A.L. is a cure for cellulite.

Early optimistic reports included the hope that U.A.L. would “cure” cellulite. This has not been the case. However, it is true that U.A.L. is gentler and therefore smoother on the skin than the coarse gouging associated with traditional liposuction. The mechanism has been described as an air brush effect creating a smoother plane in the subcutaneous tissue. This coupled with subdermal stimulation produces a more even skin retraction. Skin irregularities and waves, the most common complaint following S.A.L., are much less common with U.A.L.

10. U.A.L. is hard to learn.

Certainly any new technology will require a learning curve, both for the specialty as well as for the individual practitioner. We all approach a new procedure from a different level of skill and experience. Complications can occur with any technology, including traditional liposuction. Disastrous complications have been reported with lasers. The assertion, however, that U.A.L. is more dangerous or difficult to learn is not correct. In fact, it is this author’s opinion that with careful adherence to the two basic rules described by Zocchi, U.A.L. can be learned quickly, performed safely and produce satisfactory results.

11. Ultrasonic energy produces dangerous free radicals.

It has been speculated that U.A.L. creates free radicals as well as potential sonoluminescent or sonochemical by-products. These are theoretical considerations lacking any clinical support. In fact in vivo studies have concluded that there is no evidence of free radical generation. Moreover, the lengthy safety record of ultrasound in ophthalmology and neurosurgery argue against such a risk.

Where Do We Go From Here?

We have seen the ultrasonic lipoplasty pendulum swing from one extreme to the other in the decade since the first international congress held in Portugal. As with any emerging technology, U.A.L. has been the focus of controversy, both scientific and non-scientific. Politicians say that if something is repeated often enough it eventually becomes fact. Many assertions made about U.A.L. are based upon personal bias and not scientific evidence. These assertions have become myths.

The introduction of phacoemulsification over three decades ago had no less a tumultuous beginning, yet the ultrasonic procedure is now largely regarded as the standard of care in cataract ophthalmology.

The vacillating interest among surgeons has prompted manufacturers to reconsider their level of commitment to U.A.L. Recent modifications have included changes in cannula design and pulsed energy mode generators. The theory behind pulsed energy devices is to limit ultrasonic energy delivery to the tissues to avoid burns. In this author’s opinion this is a solution in search of a problem since burns can be largely avoided by simply adhering to the two basic rules proposed by Zocchi. More importantly, pulsed energy slows the procedure down, contributing to longer surgical times.

The next generation of U.A.L. devices needs to be faster, less expensive and portable. Existing patent protection will soon expire and other manufacturers may enter the international U.A.L. marketplace. U.A.L. has great potential for the future. To insure its continued success, it is necessary for those of us who use U.A. L. to work to dispel the myths and to continue to fine-tune this safe and sophisticated technology. The final result will be improved patient and physician satisfaction.

* Italy’s dictator Benito Mussolini had a meager air force in comparison to the German Luftwaffe, yet his generals dared not tell him. Instead the generals would fly the same planes from city to city prior to Mussolini’s review.

Several Stomach Flu Symptoms

Stomach flu is also known as Gastroenteritis or stomach virus. Irritation of the stomach and the intestines is known as stomach flu. Generally within a couple of days this flu goes away on its own. Even though this condition is known as stomach flu, it is not caused because of the influenza virus. This strain of flu involves the stomach area and intestines, while influenza involves the respiratory tract, lungs, head and sinuses. The causative factors are bacteria, viruses and certain parasites such as cryptosporidium, giardia, E.coli, Shigella, Salmonella, Adenovirus, Rotavirus, Caliciviruses, Astrovirus, etc. These bacteria, viruses and parasites enter the stomach through the mouth.

The symptoms of stomach flu are manifested after having physical contact with an infected person such as shaking hands, drinking from the infected glass or sharing food with an infected person which can transmit the virus from the infected person. Once a contact with the flu virus is established, the virus travels to the stomach and intestines. The virus causes inflammation of the stomach and intestines which leads to vomiting and diarrhea.

Stomach flu is manifested through several symptoms. The symptoms generally take several days to appear after the infection with the causative factor. The symptoms may last for 1 to 10 days, depending on the type of infection. Generally most of the flu symptoms settle without the need of any assistance of a physician. Stomach flu symptoms differ from person to person and the flu symptoms basically depend on the causative factor. The severity of the symptoms is based on the resistance of the body.

Some of the stomach flu symptoms are as follows:-

· Diarrhea is the commonest symptom,

· Fever,

· Headache,

· Abdominal cramps,

· Severe burning pains in the stomach,

· Pain in muscles,

· Weakness,

· Dizziness,

· Nausea,

· Stomach pain,

· Swollen lymph glands,

· Vomiting,

· Loss of appetite,

· Weight loss,

· Blackouts,

· Fainting spells,

· Dehydration, etc.

Generally, stomach flu fails to be a serious illness. Though, at times a person may become very ill, and if the condition is untreated, the infection can become life-threatening. One needs to be very careful and cautious regarding the development of dehydration. Dehydration is the most serious and life-threatening complication of stomach flu. Continuous vomiting and diarrhea leads to loss of fluids and electrolytes which causes dehydration. 

Some of the symptoms of dehydration are as follows – 

Eyes sunken, thirst increased, loss of elasticity of the skin, fever higher than 101 degrees F, dry or sticky mucous membranes in the mouth, bloody vomit or bloody stool, decreased urination, drowsiness, swollen abdomen or pain in the lower part of the abdomen, constant vomiting lasting for more than 48 hours.

All the flu symptoms can be taken care of by adequate rest, consumption of excessive fluids and medications.

10 Commandments For Kitchen Safety

“Nonna, can I please wash the dishes?” pleaded Ally, my eight-year-old granddaughter. Ally is like most kids, she loves to help in the kitchen. Although she’s eager to wash dishes , I’ll guarantee, that in four or five years the sight of dirty dishes won’t be so exciting. Today, helping to wash dishes is fun, as she’s learning how things work. She’s learning to appreciate whole foods and what makes a nutritious meal by helping in the kitchen.

Involving kids with meal preparation gives them an opportunity to have multi-sensory experiences with various foods. This is especially valuable when introducing new food items or when changing the family’s diet from processed foods to whole foods. In fact, multi-sensory learning is foundational when transforming a picky eater to a healthy eater.

So how do you avoid common kitchen hazards, especially for children? As valuable as tactile experiences are for appreciation of nutritious foods, when children are helping you in the kitchen, it takes only one unguarded moment for an accident to occur. Injuries and potential food poisoning are less likely if you adhere to the following sage advice.

1. Always wash hands with soap and water before handling food.

This applies to everyone working in the kitchen. Germs can spread easily if hands aren’t properly cleaned. Wash hands with soap and water for at least twenty seconds. Rubbing the hands together under water is as important as the soap is for cleanliness. With kids, make a game of it. Sing the alphabet song while washing hands. Make it educational by counting off the twenty seconds with your child while washing her hands. When your youngster can count to twenty by herself; count backwards from twenty to one.

2. Use a sturdy step stool for your child to comfortably reach the counter.

Children love to help and their involvement in the kitchen is vital for food appreciation. Purchase a sturdy step stool to prevent falls and injuries.

3. Never allow children to eat uncooked eggs.

Kids love to lick the batter off the spoon when making cookies. But salmonella from uncooked eggs is a real concern. Explain that it’s better to taste the cookie after it’s baked, so you won’t get sick.

4. Caution kids about the hazard of a hot stove and oven.

Always be alert when a small child is around hot surfaces. So many accidents are preventable. Burns from scalding water and hot ovens are two of them. Keep cords to cooking appliances out of harms way. Always keep a fire extinguisher in your kitchen. To extinguish small fires, throw baking soda over flames. If grease in a pan begins to flame, cover the pan to cut off the oxygen supply. Turn off the heat.

5. Point pot and pan handles toward the back or center of the stove.

This is such an easy habit to start. This simple step prevents lively children (and adults) from coming in contact with a handle sticking out from the stove and spilling its scalding contents. Even though my kids are grown, I still point handles to the back or center of the stove. Just so I won’t accidentally burn myself!

6. Keep kitchen work surfaces clean.

Many times the “flu” that goes through your family is actually food poisoning. You can negate this by thoroughly washing kitchen surfaces. Use surface cleaners with bleach to disinfect countertops and other work areas. Or add a half teaspoon of bleach to a spray bottle filled with water and spray on countertops to disinfect. Keep purses and other items off prep surfaces as they carry bacteria. Make sure you also disinfect kitchen faucet handles when you scour the sink.

7. Avoid cross contamination of foods.

Never put cooked meat on a plate which once held the uncooked meat. Wash knives and cutting boards between use on meat, dairy, and produce.

8. Wash dish towels and replace sponges often.

Purchase seven dish towels. That way you’ll have a clean towel for each day of the week. A sponge is perfect breading grounds for bacteria. Squeeze dry after use and allow to air dry. Replace sponges once a week. During the week, disinfect your sponge by rinsing it, squeeze dry, then nuke it for two minutes in your microwave.

9. Always wash fruit and vegetables.

Wash vegetables and fruit before placing them in the refrigerator. That way they’ve been pre-cleaned making meal prep easier. The kids can grab a healthful snack without worry of harmful bacteria lurking on the surface. Also, Bacteria on food rapidly multiplies, when left at a temperature between 45 F and 140 F. Avoid this danger zone as much as possible by quickly refrigerating cooked foods. Refrigerate or freeze leftovers immediately after dinner to prevent bacteria from forming in the food.

10. Take precaution with knives.

Obviously, sharp objects are a hazard for small children. Keep all knives out of reach of children. Toddlers and preschoolers love to spread softened butter, cream cheese, and nut butters. Small hands can safely use plasticware, the kind purchased for picnics and barbecues.

What Causes Lower Left Side Back Pain?

Many people experience lower left side back pain, which can last for days, weeks or months at a time. Common symptoms may include localized pain below the ribs and around the side of the torso. In addition, lower left side back pain may be intermittent in frequency in which it is more tolerable during certain hours of the day. Often times, people who have lower left side back pain will notice a stabbing or dull, aching pain. Many people may also be hyper-sensitive to touch, which stays localized to the lower left side of the back. For others, the pain remains unaffected even with changes in dietary habits. Some people who have lower left side back pain may also experience discomfort when taking deep breaths, lying still or during exercise. Changes in bowel movements may also be accompanied with lower left side back pain.

Frustration can be a common emotion for many people experiencing these symptoms because many doctors have trouble finding an accurate diagnosis. Even extensive testing such as medical imaging, colonoscopy, ultrasound, heart scan, blood tests, urine tests and stool tests may all come out normal.

Your doctor may prescribe pain medication, which may or may not help alleviate your pain. Although it is difficult to remain patient during period, please remember that lower left side back pain can be caused by many factors, which make it very difficult to diagnose your condition. If you and your doctor have tried every approach to diagnosing and treating your pain, ask your physician to refer you to a specialist. If you have tried this approach without much success, you may want to consider seeing a new physician. Doctors are very knowledgeable about medical conditions but some may have more expertise and relevant experience with your particular condition. The key to your success is finding a physician who is willing to work with you in treating your condition.

Here is a list of conditions which can cause pain in the lower left side of the back:

Hypochondrial pain: Symptoms include pain under the rib cage, which can be referred from the colon or spleen.

Ectopic pregnancy: A woman with a developing ectopic pregnancy may not display any signs or symptoms of being pregnant. Symptoms include lower abdominal pain, vaginal bleeding, cramping or stabbing pain around the pelvic area, dizziness and felling lightheaded.

Endometriosis: Symptoms may include pain in the pelvis, abdomen and lower back. Heavy flow of vaginal bleeding may accompany these symptoms.

Pancreatitis: Symptoms that are chronic may include indigestion, abdominal pain, back pain, weight loss and steatorrhea (stool that is appears oily and foul smelling).

Irritable Bowel Syndrome (IBS): Also known as spastic colon, IBS may be accompanied by abdominal pain, diarrhea, headaches, low back pain and chest pain.

Peptic Ulcer: Symptoms may include a burning pain in the chest, nausea, vomiting, weight loss, change in appetite and back pain.

Gastroesophageal Reflux Disorder: Symptoms may include heartburn, chest pain, back pain, difficulty swallowing or dry cough.

Gastrointestinal bleeding: Common causes include esophageal varices, stomach ulcer, erosions of the esophagus, duodenum or stomach; duodenal ulcer, abnormal blood vessels, colon cancer, anal fissures, colon polyps, diverticulitis, inflammatory bowel disease, internal hemorrhoids and inflammation of the large bowels.

Celiac Disease: Symptoms of celiac disease may mimic those of other conditions such as anemia, parasite infections, irritable bowel syndrome, gastric ulcers and skin disorders. Symptoms may include joint pain, weight loss, back pain, weakness and fatigue, bone disorders such as osteoporosis, diarrhea, abdominal cramps and anemia.

Radicular pain: This occurs when there is irritation or compression along the nerves exiting the spine. Symptoms include pain that is accompanied by weakness, numbness or a tingling sensation. Causes of radicular pain can be due to injury, trauma, soft tissue, disc degeneration, disc herniation, facet syndrome or bony changes to the vertebral column.

Kidney stones: Symptoms include pain below the ribs, pain around the torso and back pain. It is also common to experience pain radiating into the lower abdomen and groin region. Other symptoms include pain during urination, nausea and vomiting.

Gallstones: Symptoms may include pain between the shoulder blades, pain in the center and upper right region of the abdomen, back pain and pain into the right shoulder. Additional symptoms may include abdominal pain after eating meals.

Problems with the adrenal gland: Common symptoms include headaches, dizziness when standing up or changing positions quickly, sensitivity to bright lights and low back pain.

Peptic Ulcer – 10 Ways To Manage It

Different types of drugs are employed in the management of peptic ulcer. The different groups of drugs each play a specific role in the healing of the ulcer or in helping to reduce the secretion of gastric juices. Diet control and surgery can also be involved depending on the type and stage of the ulcer. Some of the drugs for the management of peptic ulcer include:

1. Anbiotics: With recent knowledge that peptic ulcer is caused by a bacterium, antibiotics treatment is now being employed to get rid of the offending organism. In most cases there is the use of a combination of two different antibiotics which ensure the organism is completely destroyed.

2. Antacids: Antacids are used for the symptomatic relief of peptic ulcer pains. They help to neutralize the gastric acid and also inactivate pepsin. When given for a fairly long period they aid healing. One basic problem they have is that they may interfere with the absorption of other drugs employed in the treatment of the ulcer. It is therefore advisable to take antacids about 1hr before taking other medications or 2hrs after. Examples of antacids include: Magnesium hydroxide (Philip’s milk of magnesia); Magnesium hydroxide and Aluminium hydroxide (Gestid, Maalox and Mylanta); Aluminium hydroxide (Amphogel and Alternagel); Sodium bicarbonate and Calcium carbonate (Rolaids, Titralac, etc)

3. Histamine H2-receptor antagonists: They block histamine receptor thereby minimizing gastric secretions. Examples of these drugs are Cimetidine (Tagament), Ranitidine (Zantac), Nizatidine (Axid), Famotidine (Pepcid) etc

4. Proton-pump inhibitors: helps to decrease gastric acid production and as such limit the damage done by the gastric acid on the gastric mucosal lining. Examples of this drug include Omeprazole (Prilosec), Rabeprazole (Aciphex), Esomeprazole (Nexium), Pantoprazole (Protonix) and Lansoprazole (Prevacid).

5. Sedatives: May help to reduce stress and tension which are known to increase gastric secretion. These drugs include Diazepam and Phenobarbitone. They may be given in large doses at bed time.

6. Anticholinergics: They inhibit the action of acetylcholine thereby helping to reduce gastric acid secretion and also reduce pain. They may produce nasty side effects such as decreased visual acuity, difficulty in urinating and dryness of the mouth. Example of such drug is Pro-Banthine.

7. Sucralfate (Carafate): This drug helps to make a protective coating over the crater created by the ulcer thereby preventing further damage to the affected area.

8. Surgery: Surgery may be advocated if the use of drugs fail to control the acid secretion. Surgery could also be carried out when there is severe bleeding or perforation. Some of the surgical treatments include Vagotomy and Gastric resection (subtotal gastrectomy). Gastrectomy involves removal of the ulcer bearing part of the stomach, while vagotomy is to select the branches of the vagus nerve supplying the stomach and resect it to reduce gastric secretion and decrease gastric motility.

9. Patient education: Patient should be properly educated as to the cause of the disease, complications and their prevention; the need to adhere to the diet and drug therapy and the need to report signs of complication to the doctor. Patient should also be told to avoid NSAIDS, corticosteroids, alcohol, cigarette, caffeine, etc

10. Other methods of management may include the use of herbs, homeopathy and chiropractic.

Acid Reflux Diet And Breakfast

Acid reflux diet and breakfast is a dilemma for a number of reasons. With the frequency that people have reflux problems through the night while they are sleeping, chances are they are waking up with heartburn. And in that case, they are more likely to go eat antacids for breakfast, than they are food that is going to make them feel worse.

However, breakfast is also the most important meal of the day. Breakfast helps stabilize your blood sugar levels after sleeping, and provides energy to start the day. It has also been shown that people who skip breakfast will eat more throughout the day. And what is one of the biggest problems for acid reflux and heartburn – eating fewer and larger meals, as that is shown to cause and/or make your problems worse. Deleting breakfast from your acid reflux diet is not a heartburn remedy.

Acid Reflux And Life Style

Preventing acid reflux and heartburn is going to entail making lifestyle changes. You eat breakfast, and then what happens? That overnight heartburn that you may have already had, coupled with the food that you just ate for breakfast [you just couldn’t resist ‘wolfing’ down that Egg McMuffin while you were driving] get together and give you more reflux and worse heartburn. Start your day with more energy, not hardly; you are starting your day in pain, and just want to go turn around and go home. But instead, there goes another round of antacids to try to keep you going.

How is that for breakfast and an acid reflux diet – acid reflux trigger foods ‘washed’ down with antacids to get rid of the heartburn pain. Lunch and dinner tend to be easier meals for heartburn sufferers. You have a wider range of food choices that are more appealing later in the day than they are for breakfast. And you also aren’t in such a rush, giving you more time to prepare a good meal – and not having to eat it so fast, which of course is one of the heartburn don’ts.

Yes, acid reflux diet and breakfast is quite a problem, because so many of the breakfast food choices cause heartburn. Your fried eggs, with toast and butter, and orange juice and coffee – or that rush through the fast food restaurant, are of the worst foods that can be eaten. These can be expected to cause heartburn, certainly negating the benefits that eating breakfast are supposed to give you.

Breakfast Food Choices For Acid Reflux

So what are you going to do – you need to eat breakfast, but you aren’t going to do so if it is only going to make you feel worse. To begin with, how about getting up 15 minutes earlier so you aren’t in such a rush and fast food becomes your only breakfast alternative. And then, how about if you quit brain washing yourself into thinking that you need caffeine to get going? I remember my old routine, get up and skip breakfast except for 2-3 cups of coffee, have a diet coke at my desk, and then eat Tums throughout the morning – I have chipped teeth from Tums.

There are many acid reflux diet food choices for breakfast that don’t take much time to prepare, and that can actually help to reduce reflux and heartburn instead of causing it. And you can adapt to some changes in food choices that will help you even more – you really don’t need to eat that last piece of cold pizza for breakfast to keep it from going to waste J

Good food choices will include whole-grains, fruits and vegetables, and protein – just like any well balance healthy meal. In fact, that is one of the major benefits of an acid reflux diet, besides helping prevent or getting rid of heartburn, it is also a diet that promotes good health.

Whole grain breakfast food choices can be found in oatmeal, whole grain cereals, or whole grain breads. These are important for your acid reflux diet. They have fiber which makes them easier to digest, they don’t require as much acid during digestion, and actually they break down during digestion in a way that can absorb excess acid. Additionally, whole grains include the antioxidant selenium, which has been shown to help protect the cell lining in the esophagus.

Fruits and vegetables are great for breakfast – what could be better than starting the day with an apple, or eating some fruit on your whole grain cereal. Just remember to stay away from the citrus fruits or juices, and especially no tomato juice as it is very highly acidic. Drink natural apple or grape juice as something that helps reduce acid. And if you can eat pizza and drink coke for breakfast, then you sure could get used to eating some broccoli – or how about some steamed broccoli with some egg whites.

Protein is an important food choice. It makes you feel more full and thus can help prevent overeating. And protein is the food source that helps build and repair muscles – this could include strengthening the muscles associated with your esophagus. As in all acid reflux diets, make sure that your proteins are low in fat content, because fat takes longer to digest and needs more acid to do so, thus increasing the likelihood of reflux heart burn. This means skim milk instead of whole milk, egg whites instead of the whole egg – and no more of that bacon or the fatty meats and fried foods in those breakfast sandwiches.

Breakfast And Lifestyle Changes

My lifestyle has changed the last few years; I was gaining weight as I was getting older, and I had heartburn that became acid reflux disease. Besides making some very big acid reflux diet changes, it now includes going to the gym in the morning before starting work. So, breakfast is very important to me after working out, but I also lose some extra time that I could have had for eating.

I eat a banana on the way to the gym, which helps settle my stomach. And then for breakfast I want a lot of protein, and to be sure that I have a relatively high protein to carbohydrate ratio; I want energy and not a spike in my blood sugar level. I usually drink a vanilla protein powder shake, and eat a cup of Greek yogurt [it is low-fat and has extra protein], and an apple – delicious.

I feel very good throughout the morning, and with no more coffee and diet coke to ‘help’ me through – if I want something else to eat, I have another apple. Breakfast is very important to our health, and you have lots of food choices that not only won’t cause heartburn, but can actually help control it. But like in the case of all acid reflux diet choices, there are tradeoffs and lifestyle changes to be made to get rid of heartburn, and to get health benefits from what we eat -vs- eating in a way that makes heartburn become worse, and lead to acid reflux disease.

When Symptoms of Constipation are Left Untreated, Bigger Health Problems May Arise

One mistake that you no longer wish to make is to simply ignore the constipation symptoms no matter how often the problem occurs or disappears. Of course, there are many factors that may lead to problems with short term cases of constipation which is perhaps why the problem is extremely common and so rarely treated by a doctor. When the signs and symptoms do not intensify and normal bowel movements return within a few days, there are certainly no long term health issues caused by the constipation.

There are times when the bowel functioning don’t normalize and the signs and symptoms persist for many days without lessening. A long term problems with constipation pain is a serious medical concern because it may lead to the accumulation of toxic products in the colon and along the walls of the gastrointestinal tract. Future bowel movements will surely compact this waste along the walls where it will harden and dry. Compacted feces along the intestinal walls make it easier for parasites like hook worms to cling to the lining of the intestines. And in time, these parasites would become a drain upon your body and may weaken your immune system’s ability to repel bacteria.

Listed below are some medical problems that can occur when waste and undigested food are allowed to accumulate in the colon system and intestines:

* Diverticulitis. This condition is very severe for our overall health because it causes herniated pockets to develop in the colon system. Literally, these pockets store toxic waste and thus are potential sources for long term toxic damage including cancer. The accumulation of compacted waste and undigested foods make the entire colon system more toxic and lead to a number of health problems like colon cancer, and even the development of polyps.

* Candidasis. This is yeast infection growing out of control within your intestinal tract. Normally, symptoms are caused by a weakened immune system and include: Chronic or severe fatigue and general loss of energy, even during midday; Diarrhea; Indigestion; Constipation; Severe constipation abdominal pain; Gastritis; Skin problems like acne and rashes; lastly, Mucus in stool.

* Septicemia. In cases of protracted fecal impaction and the resulting inability to pass stool, bacteria and harmful toxins will be absorbed into your blood stream. These harmful substances will surely cause cell damage to several systems. Now if the bacteria are permitted to accumulate for a prolonged period or if the immune system weakens by other causes, a condition known as septicemia may develop and this is little more than a massive infection raging in your body, in fact it can lead to death if not treated immediately with antibiotic or other antimicrobial treatments.

Obviously no one can avoid constipation forever. Even using enemas, suppositories, and laxatives will only alleviate short term case of constipation. You can help prevent pesky constipation problems, however, by eating fiber-rich food and helping your gastrointestinal system to function more effectively. Drinking adequate amount of fluid, exercise and eating the daily recommended amount of fiber will certainly help keep the stool soft and bowel movements regular. However, if constipation prevention fails, do not ignore symptoms of constipation because there may be severe consequences to your long term health when you do.

Vitamin B12 Injection Side Effects – Common and Rare

Vitamin B12 injections, also known as cobalamin or cyanocobalamin injections, are administered to patients with deficiency of B12 and symptoms associated with the deficiency, such as fatigue and anemia. B12 injections are given to patients who have low resistance to diseases and remain sick from common illness for long period of time.

Although it is better to consume foods rich in vitamin B12 naturally, such as meat, fish, and dairy products, often the doctor may recommend the supplement of Vitamin B12 in injection form. Injections are beneficial to those individuals who show signs of vitamin B12 deficiency but are unable to absorb it into the body.

Injecting B12 shots are often painful to those sensitive to injections, because they are injected deep into the muscle under the skin.

Common Side Effects

Side effects of vitamin B12 injections vary from person to person depending on the mode of delivery and the health of the person. Some side effects are temporary and may last for just a few days.

Some of the most common side effects are:

1. Muscle cramps:

Some people get cramps or spasms in their muscles after injecting vitamin B12 shots. This will occur usually within 6 hours of receiving the injection.

2. Sleeplessness:

Insomnia, or the inability to sleep, is a commonly-occurring side effect of receiving a vitamin B12 injection.

3. Skin infections and Acne:

Shots of Vitamin B12 may lead to some skin infection, known as Folliculitis, around the hair follicles. Acne may also develop on skin accompanied by skin rashes.

4. Nausea and Headache:

Runny nose and headache are other common side effects after injecting vitamin B12. Some people might experience shortness of breath, unusual coughing, or unusual wheezing.

5. Stomach upset:

Another common side effect of B12 injections is upset stomach followed by diarrhea, difficulty in swallowing food, and feeling of extreme dizziness. A few patients may also feel extreme thirst and tiredness.

6. Rapid heart beat:

Some patients have reported rapid palpitation of the heart and a sensation of heart burn accompanied by chest pain.

Uncommon Side Effects:

There do exist some side effects, though not very common, that may be severe, and possibly life threatening.

1. Clotting of Blood:

Blood clots in the arteries of legs and arms, followed by swelling of the affected areas known as peripheral vascular thrombosis, a serious condition that has the potential to cause loss of limb or even loss of life.

2. Severe Allergic reaction:

Severe allergic reaction is very rare but can be life threatening. Researchers and medical professionals alike question whether the allergy is caused by preservatives in injection or by the vitamin itself. Vitamin B12 injections should be avoided by persons who are allergic to cobalt or cobalamin, as it may lead to allergies.

3. Vision loss in case of “Leber’s Disease”:

A person who has or has had Leber’s Disease should not take vitamin B12 injections, since it can result in optic nerve damage (and possibly blindness). Leber’s Disease is hereditary optic neuropathy which will cause slow vision loss, first in one eye and then in the other eye.

4. Pulmonary Edema:

In very rare cases, fluids get accumulated in the lungs of the person taking vitamin B12 injections, a condition known as pulmonary edema. The person may experience pain in the chest and shortness of breath.

This is not an exhaustive list of side effects. There are others. Please do some research to become informed, and always consult with your doctor if you suspect that you are experiencing side effects to any medication.

Heart Saver CT – Screening For Heart Disease

The Heart Saver CT screening for heart disease (also known as the UltraFast CT or Calcium Scoring CT) has been available for about 10 years now. This study looks for calcified plaque in the arteries of the heart. Plaque, put simply, is the fatty, waxy type of substance produced by the liver that proceeds throughout the bloodstream. You may also hear or read this referred to as cholesterol. Frequently, plaque will adhere itself to the walls of arteries and over time solidify. Then, it becomes known as calcified plaque. The Heart Saver CT looks specifically at the arteries of the heart searching for calcified plaque.

It is a reasonable test for those with the desire to satisfy their curiosity regarding the probability of future heart disease. The test takes about a half an hour and there are no needles or preparation involved. This study is NOT for someone with known heart disease. Since its purpose is to be a predictor of future disease, it would be a waste of money to do the test if you already know you have heart disease. The Heart Saver CT is an excellent tool when used properly.

In many instances, this study is done when a person is over the age of 35 and more likely over the age of 40. The cost can range from $100 to $300 and some insurance companies will cover this test. However, be prepared to pay out of pocket even if your insurance company will cover and then seek reimbursement. Many facilities that offer this study will not file your insurance for this particular test. The reason for lack of coverage is some insurance companies still consider this test experimental. If you have a family history of heart disease and / or high cholesterol then you should consider this test.

There is potential good and bad news about your results. If your calcium scoring result is zero, then congratulations. Zero is the perfect score meaning there is no indication of calcified plaque in the arteries of your heart. You do not have heart disease from atherosclerosis. However, any score higher than zero means that you do have heart disease. Many people do not understand this fact. Even though you have not had a heart attack, yet, an elevated calcium score means that someday you just might. Calcium score can range into the thousands of an unsuspecting victim. This person would be the epitome of a ticking time bomb. The type of person you hear someone telling about, “He was out mowing the yard and just dropped dead.” A score like that in itself makes this test a must do for anyone over the age of 45 with no known history of heart disease. Lives are saved because of it, but that is part of the good news.

Now for the bad news: Another thing many do not realize is while some insurance companies will not cover this test, they will consider it for future coverage and premiums. Again, any score higher than zero equals heart disease. Insurance companies do acknowledge this much, at least. It is important to keep in mind even if you are outwardly in apparent good health a calcium score of any number other than zero will damage your prospects for life insurance and reasonable insurance premiums. People are denied life insurance based solely on their calcium score with no other apparent health issues. While this is a good test as a predictor of future heart disease it comes with a potential price that you will not be informed of until it happens so be prepared.

If you decide to have a Heart Saver CT scan done and your score is higher than zero there is nothing that can be done to get rid of it. It did not happen overnight and it will not go away. Then the priority becomes to slow the momentum of plaque buildup by combating your cholesterol and optimizing those numbers. Often with proper treatment, the progression of disease can be significantly reduced. Medical technology today can slow the progression, but it cannot turn back the hands of time, yet.

STD’s, Cardiomyopathy and Wilt Chamberlain

He was the greatest basketball player and possibly the greatest athlete who ever lived. The 63-year-old Wilt Chamberlain was reported to have died of a heart attack, but that tells you nothing. You are supposed to ask why the world’s greatest athlete would die of a heart attack?

He was born in 1936, in Philadelphia. He was 6-11 when he entered Philadelphia’s Overbrook High School, led them to three public school championships and two all-city titles, Chamberlain became one of the most recruited players ever with more than 200 colleges interested, scored more than 100 points in a single National Basketball Association game and averaged more than 30 points a game throughout his professional career. However, when he was in high school, he was the best high school quarter miler in the United States and ran under 48 second. He also high jumped over 6 feet, five inches and was the best shot putter in Pennsylvania. He remained active after his NBA career and was considered an outstanding volleyball player. He also ran in the Honolulu marathon and competed in a 50-mile race in Canada.

Long after his career ended, Chamberlain made news by claiming in an autobiography that he had had sex with 20,000 women. Let’s see how good you are in diagnosing disease. Chamberlain’s health first became an issue in the 1960s, when a former coach told the news media that the star player might have had a heart attack before the 1964 season. But Chamberlain denied it. In 1992, when Chamberlain gathered with former teammates for a halftime ceremony marking the anniversary of their 1971-72 NBA championship, he had to leave early because he was having trouble breathing. He was admitted to a hospital and found to have an irregular heart beat. He was released from the hospital after three days wearing a heart monitoring device.

During his last years, he was diagnosed as having cardiomyopathy which means that his heart was too weak to pump blood through his body and he lost 50 pounds in the months prior to his death. There are three causes of a weak heart muscle. Lack of nutrients, blocked arteries, and infection.

You can suffer from a nutritional deficiency such as beriberi caused by lack of the vitamin thiamine or pellagra caused by lack of the vitamin niacin. This is almost impossible today in North America. The second possible cause of a failing heart is blocked arteries caused by arteriosclerosis and he did not have a very high cholesterol and he did not have arteriosclerosis. The third possibility is an infection in his heart caused by such bacteria as chlamydia and mycoplasma.

The fact that he lost 50 pounds and was unable to go anywhere in the last months of his life point to a diagnosis of cardiomyopathy, that’s heart muscle damage, caused by infection with chlamydia or mycoplasma, from making love to considerably less than the 20,000 women that he claimed. That comes to 500 women per year, or 10 different women per week for 40 years, which would make the world’s greatest athlete, the most prolific lover of all time. Cardiomyopathy is often caused by chlamydia.

Chamberlain’s body was cremated, so we will never know for sure how he died.

Top Four Facts Patients Should Know About Cortef

Here some great facts about Cortef:

1. Purpose – When your body does not make enough cortisol, conditions may arise that may make taking hydrocortisone, a corticosteroid, necessary. Cortef is a well-known brand name medication of hydrocortisone on the market today. This medication is used to relieve inflammation and treat various medical conditions such as asthma, severe allergies, certain cancers, and skin, thyroid, and intestinal disorders.

2. Drug Interactions- Medications may interact with Cortef, so it is crucial that you tell your health care provider of all medications that you are taking, including prescription and over-the-counter, dietary and herbal supplements. Known medications to increase or decrease the effectiveness of Cortef and increase side effects include the following:

• Anticoagulants

• Aprepitant

• Aspirin

• Azole antifungals

• Barbiturates 

• Carbamazepine

• Clarithromycin

• Hydantoins

• Live vaccines

• Methotrexate

• Mifepristone 

• Rifampin 

• Ritodrine 

• Steroidal contraceptives 

• Troleandomycin 

3. Prior to Taking Cortef – There are certain conditions that may interfere with your taking Cortef. You need to talk to your health care provider if any of the following medical conditions apply:

• Planning to become pregnant, pregnant, or breastfeeding. If you become pregnant while taking this medication, contact your physician.

• Taking any prescription or over-the-counter medications, herbal or dietary supplements.

• Have a system fungal infection.

• Allergies to medications, particularly components within Cortef, tartrazine, aspirin, and yellow dye; other substances; or foods.

• Scheduled to have a live virus vaccination.

• History of medical conditions such as problems with mood, liver, kidneys, stomach, bowel, or heart, tuberculosis or a positive skin test, osteoporosis, heart attacks, high blood pressure, seizures, ulcers, diabetes, esophageal inflammation, myasthenia gravis, bowel blockage, herpes eye infection, or mental disorder

• Prior to any sort of surgery, tell your doctor or dentist that you are taking this medication. Limit your alcohol intake while taking Cortef as hydrocortisone can make your gastrointestinal tract more susceptible to the effects of aspirin, arthritic medications, and alcohol. 

4. Side Effects – As with most medications, side effects can occur; however, it is important to understand the side effects prior to taking Cortef so that if you experience any of these, you are better able to determine if your side effect is severe in nature or if you are experiencing a symptom that needs reported straightaway. 

The following are severe side effects that need reported to your health care provider if they do not subside:

• Acne

• Bruises easily

• Increased hair growth

• Headache or dizziness

• Insomnia or restlessness

• Irregular or absent menstrual periods

• Mental or mood disorders, such as anxiety or depression

• Gastrointestinal problems, such as an upset stomach or vomiting

In addition, certain other symptoms may occur that need reported immediately. Call your health care provider if you experience the any of the following:

• Skin rash

• Muscle weakness

• Black or tarry stools

• Problems with vision

• Swollen face and/or lower extremities 

• Cold or infection for an extended period of time

What Are the Symptoms of Skin Cancer?

The symptoms of skin cancer are the easiest symptoms to detect. This is because cancer of the skin usually manifests itself in abnormal skin growths that are in plain sight. Although these may sometimes look like a simple sore or a pimple, when it fails to heal over time, this can immediately alert the patient that something is wrong. Also, most cancerous skin growths often ooze some fluid, bleed, and crust or scab over, which are more telltale signs that it is more than just a simple growth. These, however, are usually painless, which is why some people still fail to report their case, leading to delayed treatments.

If you see a new growth on the skin that looks abnormal or does not seem to heal or go away, these should be reported to a doctor. Although many skin growths such as moles are nothing to worry about, it is still best to seek the advice of a medical professional. When a growth is cancerous, however, you can usually tell over time as they often change in size or color.

Symptoms of the Most Dangerous Type of Skin Cancer

The most dangerous type of skin cancer is malignant melanoma. This usually forms on the trunk or on the legs. Although these don’t get constantly exposed to the sun, these areas usually get rare but very intense exposure to the sun, such as when a person spends an excessive amount of time at the beach without applying skin protection products. However, melanomas can also form from an existing mole or freckle, so it is sometimes difficult to identify as well. Keep in mind that when a freckle-like spot on the skin is multi-colored and combines shades of brown, black, red, white, and blue, then it could be a melanoma, not a freckle, which is just light to dark brown in color. Melanomas also have an irregular or uneven border, while a freckle usually have clear-cut borders.

Diagnosing Skin Cancer

Experienced doctors who are trained in diagnosing skin cancer can often recognize its symptoms with one look. To get an idea of the full extent of the disease, however, a complete examination of the entire skin surface will still be needed. Once some symptoms are spotted, a specialist will do a biopsy to determine whether cancer cells are indeed present in the skin cells. This is the surest way to diagnose whether the disease is present or not and to determine its specific type.

In a biopsy, a doctor will take cells or tissues from your skin and analyze them under a microscope. There are two types of biopsy: excisional and incisional. Excisional, which obtains a wider margin of tissue around the affected area, is more effective in diagnosing malignant melanoma. Incisional biopsy removes only a small sample of the growth. This is more common and can usually identify other forms of the disease.

For an accurate testing in China, you should trust only a specialized Chinese cancer hospital.

Leiomyosarcoma – Ayurvedic Herbal Treatment

A leiomyosarcoma, also known as spindle cell sarcoma, is a cancerous tumor of the smooth muscle or fibrous tissue and can occur anywhere in the body. The term “spindle cell” is based upon the elongated spindle shaped appearance of the cells, along with cigar shaped nuclei. These types of tumors, depending upon the location, are also termed as fibrosarcoma or malignant fibrous histiocytoma. Most of these tumors are fast spreading and have an overall poor prognosis.

The Ayurvedic treatment of this condition is aimed at treating the tumor, boosting the immune status of the body, reducing symptoms and prolonging survival. Medicines like Arogya-Vardhini, Triphala-Guggulu, Kanchnaar-Guggulu, Mahamanjishthadi-Qadha, Medohar-Guggulu, Chandraprabha-Vati, Punarnavadi-Guggulu and Panch-Tikta-Ghrut-Guggulu are used to treat the actual tumor. Medicines which act on the ‘Rakta’, ‘Mansa’ and ‘Meda’ dhatus (tissues) are useful in such tumors. These medicines include Patol (Tricosanthe dioica), Saariva (Hemidesmus indicus), Patha (Cissampelos pareira), Musta (Cyperus rotundus), Kutki (Picrorrhiza kurroa), Nimba (Azadirachta indica), Triphala (Three fruits), Amalaki (Emblica officinalis), Draksha (Vitis vinifera), Kutaj (Holarrhina antidysentrica), Chirayta (Swertia chirata), Guduchi (Tinospora cordifolia), Chandan (Santalum album) and Vishwa (Zinziber officinalis).

Herbal medicines like Ashwagandha (Withania somnifera), Haridra (Curcuma longa), Daruharidra (Berberis aristata), Manjishtha (Rubia cordifolia), Mandukparni (Centella asiatica), Tulsi (Ocimum sanctum), Guggulu (Commiphora mukul) and Shallaki (Boswellia serrata) are useful in the treatment of leiomyosarcoma because of their inherent therapeutic action on solid tumors. Immunomodulatory medicines like Amalaki, Tulsi, Bhrungraj (Eclipta alba), Yashtimadhuk (Glycyrrhiza glabra), Shatavari (Asparagus racemosus), Bala (Sida cordifolia), Trivang-Bhasma, Abhrak-Bhasma, Suvarna-Bhasma, Heerak-Bhasma and Suvarna-Bhasma can be used to boost the immune status of the body. These medicines help in stopping the growth of the tumor and are also useful in treating weight loss.

Medicines like Agnitundi-Ras, Shankh-Vati, Vat-Gajankush-Ras and Maha-Vat-Vidhvans-Ras can be used to treat symptoms of localized pain and discomfort. Medicines like Mahamanjishthadi-Qadha, Kachnaar-Guggulu and Triphala-Guggulu can be used to prevent the spread of the tumor to different parts of the body. In addition, different medicines are added in the treatment of leiomyosarcoma, depending upon the location of the tumor in the body. For example, Pathyadi-Qadha is believed to be effective in head and neck tumors and Varunadi-Qadha is believed to act on abdominal tumors; Kutki, Sharpunkha (Tephrosia purpurea) and Amalaki are believed to be more effective in the upper abdomen whereas Punarnava (Boerhaavia diffusa) and Gokshur (Tribulus terrestris) are believed to be more effective in the lower abdomen.

Ayurvedic medicines can thus be used to treat leiomyosarcoma effectively, improve the quality of life and prolong the overall survival of affected individuals. These medicines can be used in addition to standard modern treatment. All such patients should be under the regular supervision and care of an Oncology team.

Longinus’ Literary Sublimity in O. Henry’s "The Last Leaf"

In the short story, O. Henry used various literary devices such as personification:“Mr. Pneumonia was not what you would call a chivalric old gentleman.”1, and simile: “… said Johnsy, closing her eyes, and lying white and still as a fallen statue.“1 What’s remarkable in O. Henry’s writing style is his ability of making the ivy ‘leaf’ very symbolical and essential throughout the story. This particular leaf symbolizes Johnsy’s life throughout the story. This leaf is a recurring motif which also signifies hope, both for the said character and the readers. This symbolism shows that the piece, indeed, has sublimity, since it possesses excellence in the use of language, more specifically, through the use of certain kinds of figures of speech with appropriateness. The figurative language certainly adds grandeur to the piece, just like in the stated excerpts above. These figures of speech do not just serve as pure beautifier to the piece but these serve as contributors to the artistic meaning of the story. Longinus emphasized that figures of speech should be used with definite purpose and not just as mere ornaments. Thus, these should be used appropriately throughout the story to serve their purpose. In the short story, pneumonia is decsribed as an opposite of a ‘chivalric old gentleman’.1 Merriam-Webster defines chivalric or chivalrous, as a “consideration and courtesy, especially toward women”.The disease, can not be considered chivalric because  it had caused Johnsy’s suffering and hopelessness. On the other hand, Mr. Behrman became the means in saving Johnsy’s life and in ending her suffering, through painting the ivy leaf. Therefore, Mr. Behrman can be considered as the “chivalric old gentleman” in contrast to pneumonia, and is exactly the disease’s perfect opposite, as the story implies. Hence, the use of figures of speech did not just decorate the piece or falsely imply something, because the figurative language used has a direct bearing to the meaning of the story, which was magnificently established by its writer. In addition, this also echoes nobility in diction, since metaphors and personifications are appropriately used in the story, with the proper use of words, which in turn can give a great impact to the readers.

Literary sublimity is also defined as the “expression of a great spirit”2 or showing the act of benevolence. Mr. Behrman, serving as the story’s hero, showed a great spirit in making his greatest masterpiece, which is painting “the last leaf”. This leads in giving Johnsy the hope and courage to continue her life, as resembled by the remaining ivy leaf-

“And then they found a lantern, still lighted, and a ladder that had been dragged from its place, and some scattered brushes, and a palette with green and yellow colors mixed on it, and-look out the window, dear, at the last ivy leaf on the wall.”1

This is no doubt a great act of benevolence, since it reflects very lofty ideas of the writer, thus proves that this piece has a grander of thought. It is probably the writer’s innate ability to produce such thoughts since O. Henry was able to conceptualize a character like Mr. Behrman, who is quite admirable for his unexpected but noble and kind deeds. This feature makes this short story one of the most memorable pieces of all time. This paves the way for the story to have its moral or lesson that will leave a mark in every reader’s heart. Through the writer’s natural writing prowess triggered by his creativity and imagination, this piece stimulates the reader’s emotions and feelings, and thus fulfills the second source of sublimity which is the “capacity for strong emotions”.3

Lastly, literary sublimity has “the power to provoke ecstasy”2 in one’s reader. O. Henry’s amazing writing style of creating an unusual ending certainly incites happiness and extreme excitement. The story provokes ecstasy to the readers when Johnsy is able to live because the ivy leaf stays, (though just painted) due to Mr. Behrman’s act of benevolence. Most importantly, the old man has fulfilled his dream to make the greatest masterpiece of his life, and indeed a great masterpiece, for it has saved a life which was once in danger. This gives the reader a feeling of ecstasy, as the last line of the story goes-

“Didn’t you wonder why it never fluttered or moved when the wind blew? Ah, darling, it’s Behrman’s masterpiece-he painted it there the night the last leaf fell.”1

In entirety, with lofty thoughts, powerful emotions, appropriate figures of speech and diction, this short story is considered a dignified composition. These sources of sublimity that are present in this short story made a piece with excellence in substance. As Longinus said, “Sublimity is a certain distinction and excellence in expression.” Truly, Longinus’ literary sublimity is reflected in O. Henry’s “The Last Leaf”.