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A small tear around the anus can occur in toddlers and babies who are constipated.
Cause
Straining to pass a large, hard stool can overstretch and tear the delicate lining of the anus.
Clinical features
Your child may experience a sharp pain in the anal region during a bowel movement. You will usually notice a bright red streak of fresh blood either on the stool, or on the toilet paper after wiping. Sometimes the child will hold back his bowel movements because of painful defaecation. This can make the constipation worse and may be a predisposing factor in encopresis.
Treatment
Anal fissures heal well without any treatment. The mainstay of treatment should be directed towards dealing with any underlying constipation. Even if the child’s constipation has been relieved, he may continue to cry for several weeks afterwards when he opens his bowels, because he associates the pain he experienced with passing a bowel movement. This requires patience and understanding on the parents’ part, and lots of reassurance.
ANAL ITCH
The commonest cause of anal itching is due to traces of soap left on the skin after washing. This becomes an irritant. Other possible causes include worm infections or an anal fissure. Treatment of the underlying cause will stop the itch. Cleanse the anal area thoroughly and pat dry with a soft cloth.
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Breast engorgement
In the first few days after the baby is born, your breasts may swell and feel quite uncomfortable. This swelling is due to the build up of an excess amount of milk inside the milk ducts, and usually occurs during the transition from colostrum to full breastmilk. The discomfort may be eased by massaging your breasts before a feed to reduce any lumps, and by feeding frequently. Expressing a small amount of milk before each feed can also help. The application of a warm compress at the start of a feed can often provide relief, as can cold compresses between feeds.
Occasionally, if breast engorgement continues for some time, the breasts will become inflamed and a secondary infection may set in. This can be distressing and quite painful if not treated promptly. If you have mastitis, your breasts will be swollen and tender and you may also feel generally unwell or feverish. The affected area may look red and be sore to touch. The treatment for mastitis is usually paracetamol for pain relief, in addition to a short course of antibiotics. It is important to continue breastfeeding, and it may be easier for you to position your baby so that feeding positions for different feeds, in order to allow drainage of all milk ducts. Check for lumps after each feed and if you find any either massage them, or express the milk from the ducts in this area.
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Meet people who almost lost their sexual intimacy for the rest of their lives.
WIFE: “Now that I finally have my own career, every second counts. I take a lot of work home, and when I’m not working, ] talk with the kids. I know I neglect my husband. I have to run twice as fast just to stay even. When you are a woman and a CEO [chief executive officer], you have to prove yourself every day. I’m just too exhausted to have sex most nights. Even when we have it, I àù usually thinking about a damned work problem.”
HUSBAND: “I really think sometimes that we could end up broke. My wife makes much more, I mean much more, than I do, and if she didn’t, my teacher’s salary would never keep us living like we do. Ever since she started making that money, our sex life changed. The roles are just different. I know it sounds small of me, but I just don’t have the pride, the assertiveness I should have with her in our lovemaking. She’s like my superior. I even hate it when she is on top.”
WIFE: “I need friends. He complains that I am always on the phone, but I really give them support and they help me. He thinks I am more into them than into our marriage. He said he waited up one night until midnight while I talked to Cindy. He just stopped wanting sex and he says it’s because I am distracted and ignore him. He resents my involvement with anyone but him. It takes away my respect for him.”
HUSBAND: “I golf. I would golf at night with a ceal miner’s hat on if I could. She doesn’t golf. She isn’t even athletic at all. She is angry because she wanted to make love Saturday morning and I was late for a golf game. It’s my only recreation, my only escape, and I think she is just jealous. She should find her own interests.”
WIFE: “This is our third move in five years. New friends, no old friends, no family, new schools, new stores, same old house problems of moving in again. You can’t spend much time making love if you are never really unpacked. Would you believe that one night I just could not find my diaphragm. I had packed it up somewhere and started tearing through every box in the house. When I came back empty-handed, he was mad and told me to forget the whole thing.”
HUSBAND: “Everybody jokes about retirement; the old gold watch routine. Well, I just don’t know. I lost my energy with this early-retirement thing. I worked twenty years for this, and now it all
Sex and Problems of Daily Living: Why Nobody Has a Sex Life 239 seems kind of empty. We don’t have sex and we haven’t had sex. As soon as retirement neared, I lost my reactions and my sex drive. If it’s in my head, I still can’t do a thing about it. I’m in sexual retirement, too, I guess.”
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SUPER MARITAL HEALTH: LOVE LIE NUMBER ONE
Author: admin
“Love is an emotion. ”
It’s the deepest feeling, the most intense of all feelings. You can’t describe it, but you’ll know it when it happens. Love just knocks you out. It’s an emotional powerhouse.
HUSBAND
Ask anyone and that person will tell you that love is an emotion, some type of euphoric bliss with which you are smitten. We tell our teenagers that the love they feel is not “real,” and that they will know the real thing later. We tell them that their hormones are deceiving them. We tell them that love it an adult emotion, and they must wait until their hormones are out of the way before they can feel the true power of emotional love.
Actually, love is not what we are describing to these young people, but “limerence,” a term coined by Dorothy Tennov. Limerence is a vacillation between elation at a partner’s perceived reciprocity of feelings and melancholic jealousy when the partner is seen as not returning this feeling. It is intense mood change because of another person, not stable and meaningful feeling for someone else. In real love, there is little vacillation, for real love is not just a feeling at all, but a complex interaction between thinking, feeling, intentionally behaving, and believing in a “bonding manner.” Love is not exclusively a feeling, it is a multidimensional combination and balance between what researcher Robert J. Sternberg identifies as commitment, intimacy, and passion. Commitment is volitional, intellectual, and intentional. Intimacy is a feeling of bondedness evolved between two people over time. Passion is the combination of intense feelings and physical longing resulting in the strong desire to be a part of someone else, to join together physically.
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THREADWORMS
Author: admin
While there are many different parasitic worms which may affect Australians and a greater number in other countries, the commonest infestation is with the pin or threadworm.
This is a small thin threadworm, about one centimetre in length. Its normal habitat is the human bowel and large numbers may infest the small and large bowel. The female may crawl out through the anus on to the skin of this area. Here they may die and disintegrate and release large numbers of eggs.
They rarely cause symptoms, except itching, unless they migrate forward to enter and irritate the vagina, and because it is usual for more than one family member to be infested at the same time, the whole family should receive treatment when the condition is discovered.
There are a number of effective drugs which can kill the worms. Some of these can be obtained directly from the chemist without the need for a doctor’s prescription.
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DIVERTICULITIS - DIAGNOSIS
Author: admin
Complications are common and are the usual reason for operation. Diagnosis of the condition should be made on the history and the physical examination. The special tests are used only to confirm that diagnosis and determine the extent of the disease.
Treatment of the condition will depend on its extent and severity. In the past, a low residue diet was recommended to rest the bowel. We now know that this is the main cause of the complaint, so such a diet is suggested only during an acute attack.
At all other times, a diet high in bulk or residue is advised. It should include fruit, vegetables and wholemeal cereals. Added bulk may be gained by taking bran or one of the prepared vegetable extracts which swell when water is added.
Laxatives should be avoided as they increase the pressure inside the bowel and may contribute to the formation of diverticula.
Pain relieving tablets which do not constipate, and also the antispasmodic drugs which reduce the muscular contractions, may be necessary.
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ANOREXIA NERVOSA – DIET AS IMPORTANT THING
Author: admin
Food is rejected, dieting becomes the all important thing. At this time the girl’s parents may commence nagging her to eat more. To avoid this she may dawdle over meals or state that she has already eaten at school or with a friend. If she is made to eat she may go the bathroom and make herself sick or else take regular and large doses of laxatives so that diarrhoea is caused. She may exercise to excess in an attempt to “burn up” more weight.
Now when diuretic tablets are so widely prescribed, she may take these to excess in an effort to lose fluid, and so, weight.
When the weight falls well below what is ideal there is a disturbance of menstrual function. The periods usually stop and it is this symptom that often prompts either the girl or her mother to go to the doctor.
Mild cases of anorexia nervosa may be treated at home by an informed general practitioner, particularly if he has a good relationship with that family.
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EXTENT OF PRIMARY GROWTH - SURGERY
Author: admin
Surgery and radiotherapy are both local forms of treatment. This means that they act only where they are applied and not in other parts of the body. Obviously they have a chance of being successful only if all of the cancer is within the treated area. A lung cancer starting near the heart and extending into it would not be cured by removing the lung. Radiotherapy for the same lung cancer would have no chance of controlling it unless the heart was included in the area being treated. Local treatment cannot be properly planned until the local extent of disease is known. To assess this, the doctor must firstly find out exactly what symptoms the patient is having and then examine him or her carefully. Depending where in the body the primary growth is, endoscopic methods, X-rays, scans or other tests might also be useful. For example, if a patient with lung cancer complains of chest pain, the doctor should suspect that the cancer has grown out of the lung into nearby structures because cancer in the lung itself is not painful. With or without pain, bronchoscopy, mediastinoscopy, ordinary X-rays and CT scanning are tests which should be considered before deciding to go ahead with surgery. Surgical removal of part or all of the lung should not be attempted until it is fairly sure that removal of the whole cancer is possible.
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MEASLES - BLOOD TEST
Author: admin
A blood test can determine if rubella antibodies are present. If they are, the woman is immune to rubella and there is no risk to any children she may have. A history of previous infection is unreliable, as rubella may be mistaken for other infections or vice-versa.
Sometimes it is so mild, and the rash so fleeting, the patient may be unaware she has it.
If the woman shows no antibodies and is therefore susceptible, she can be given the injection but must be careful to avoid pregnancy for the next 12 weeks.
If they have antibodies, they can be reassured there is no risk to this or subsequent children. If
they do not have immunity, the foetus may be at risk. Immediately after delivery, the mother can be immunised and so all future children protected.
If a woman who is pregnant comes into contact with a case of rubella, what should she do? If she has had the blood test and is immune, she has no worries. If, by chance, she has not been tested, this should be done within 10 days of the contact.
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CRITICAL PERIODS FOR FAT GAIN: PHYSIOLOGICAL
Author: admin
After quitting smoking. Smokers who quit have been shown to gain an average of around 3.5kg of body weight over twelve months after quitting. This is due to a variety of reasons. Nicotine tends to speed up metabolic rate and a significant drop is noted on quitting. Smoking also suppresses the taste and smell senses so that after smoking cessation, food can smell and taste better. Also, withdrawal from nicotine is a difficult experience and activities involving the hands and mouth (such as eating) are often used as a substitute for smoking.
Research carried out at the University of California, however, has shown that not all quitting smokers put on weight. There are those who gain a lot (over 12kg), those who gain a little (up to 3kg), those whose weight remains stable, and those who actually lose weight. In over 2000 twins studied over 16 years.
Comparisons of super-gainers with non-gainers after quitting showed that super-gainers were younger, of lower socioeconomic status, started smoking at a younger age, were heavier smokers, exercised less and drank more coffee than non-gainers. There were no differences in their body mass before quitting, the number of alcoholic drinks taken per month, or the likelihood of dieting to keep weight low. Hence, lifestyle and socioeconomic factors seem to influence whether there is weight gain or not after smoking.
Interestingly, comparisons between identical and non identical twins showed that there was considerable similarity in weight change after quitting amongst the identical twins. This suggests genetic factors may also be important in determining whether weight gain occurs after quitting smoking.
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