Health news blog

In a recent case series, the cause of an FUO was found to be undetermined in 10% to 25% of cases. Close observation of the patient may be required to determine whether the fevers resolve or a disease becomes apparent. When a patient is clinically deteriorating, however, watchful waiting is not appropriate. In this situation, the clinician should consider empiric therapeutic trials in conjunction with consultation with an infectious disease physician, rheumatologist, or oncologist, if clues lead in one or more of these directions.Knockaert et al followed a group of 60 of these patients for 5 years to determine the prognoses of patients with undiagnosed FUO. Approximately 20% of patients had a diagnosis established and 50% had resolution of symptoms soon after their evaluation. Less than 10% had persistent symptoms.The inability to make a diagnosis can be an anxiety-provoking prospect for a patient who has submitted to countless tests in the hopes of finding a diagnosis. In this situation, one should council the patient on the generally favorable prognosis in this situation, modifying the discussion for factors that might apply in relation to the diagnostic findings. The fever itself should be managed symptomatically. Non-steroidal anti-inflammatory drugs are the first-line agents for this. Meanwhile, observation, with emphasis on a noninvasive approach, should continue.*158/348/5*

A longer-term study compared the effects of glucosamine and the anti-inflammatory drug ibuprofen and found that they were equally effective. This double-blind comparison trial (meaning that it compared two treatments) involved 40 participants with osteoarthritis of the knee who attended a Portuguese clinic. Over an 8-week period, 20 patients received 1,500 mg (500 mg 3 times a day) of glucosamine, while the other 20 received 1,200 mg of ibuprofen.
During the first 2 weeks of the study, ibuprofen appeared to be providing more pain relief than glucosamine. However, while the amount of relief gained from ibuprofen remained the same after that time, those in the glucosamine group continued to report gradual improvement throughout the study. It turned out to be a “tortoise and hare” situation – slow and steady won the race. By the end of the 8 weeks, the patients taking glucosamine felt significantly better than the group taking ibuprofen.
Unfortunately, the dose of ibuprofen used in this study (1,200 mg) was half what is usually prescribed for the treatment of osteoarthritis. This means that the comparison wasn’t really fair. Does glucosamine work as well as a full dose of ibuprofen? We don’t really know.
This same study design was used again in the early 1990s in a study with 200 participants, and more recently with a group of 178 individuals. Again, the comparison dose of ibuprofen was on the low side, and these studies lasted only 4 weeks. Similar results have been seen in other, smaller studies.
One study did use full doses of an anti-inflammatory drug, and a stronger NSAID at that: piroxicam (Feldene). Results suggest that glucosamine can match the full benefits of appropriate drug treatment for osteoarthritis.
This study compared 1,500 mg of glucosamine to 20 mg of piroxicam per day. There were two other groups in the study as well: one that received placebo and another that received both piroxicam and glucosamine. A total of 329 participants were enrolled, a sizable number that increases the study’s validity. Another point in this study’s favor was that the treatment lasted for 90 days.
Questionnaires given to the participants allowed the researchers to assign numeric scores representing their levels of pain and freedom of joint movement. At the end of 90 days, the participants completed the same questionnaires, and these were compared with the first set.
The results showed that glucosamine alone was at least as effective as piroxicam. Combining glucosamine and piroxicam didn’t seem to add any extra benefit over using each treatment alone.
Again the glucosamine group had about the same number of reported side effects as the placebo group. This study had one more interesting feature. All treatment was stopped after 90 days, but patients were followed for an additional 60 days. Among patients given piroxicam, pain rapidly returned. However, the relief from glucosamine persisted. This seems to indicate that glucosamine is somehow doing more than just reducing symptoms of the disease.
All together, this was a very impressive study. It does have some problems, however. It has never been published at full length in a peer-reviewed scientific journal. The most complete description was only one page long, and it was given at a conference rather than published in a scientific journal. Brief descriptions have been published in journals, but they disagree about some details!
Furthermore, numerous participants appear to have dropped out of the study before the end, somewhat decreasing the validity of the conclusions. These drawbacks are unfortunate, because this appears to be an impressive study with impressive results.
*34/306/5*

Essential oils should only be blended for massage purposes by a qualified aromatherapist as they are highly potent substances.
For the lay person to use on adults only there are many relaxing formulations which are blended in a carrier oil base. It is important to note that if these are used on elderly people they should be diluted to half strength in a suitable carrier oil such as cosmetically refined soyabean oil or avocado oil.
Essential oils should always be diluted for use in massage in a carrier oil base and should never be taken internally.
A gentle back massage releases muscular tension, which is an important step in tackling any physical problem, and formulations which include sandalwood, ylang ylang, lavender and neroli all have calming and relaxing qualities which are good for this purpose.
Before you begin a massage treatment, ensure that the room you are using is warm, and that you have sufficient towels to place beneath you, and to cover the areas that are not being exposed to massage treatment.
When I give someone a back massage, I always smooth a little of the substance being used on to the person’s forearm, so as they lie face downwards they have the benefit of inhaling the fragrance at the same time. Some people enjoy the sound of soft music playing in the background, and the light in the room should be gentle and unobtrusive. Any disturbance from outside noise and interruptions should be avoided so that the whole atmosphere is calm and receptive to the treatment.
Essential oils can be used in the bath, either blended with a carrier oil, or in their pure concentrated form. Six drops in the bath water should provide adequate fragrance for a relaxing bath. Ensure that you agitate the water well before you sit down, as the oils can sink to the bottom of the bath, and in the event of direct contact may cause skin sensitivity. Peppermint and citrus oils should be used with caution for this same purpose.
Oil burners can create an interesting fragrance in your home environment. As all the oils contain antiseptic qualities, they make useful air fresheners. Frankincense and Bergamot can calm and uplift our senses. In this way you can experiment with the use of essential oils, and through your own intuition discover ways of alleviating your stresses and enhancing your well-being.
*179\326\8*

“The doctor had him hyperventilate in the office. It didn’t cause a seizure, but could running hard and being out of breath cause a seizure while he is playing?”
No. Hyperventilation during exercise is balanced by changes in body chemistry and cannot produce a seizure. We took care of one young woman who was so sensitive to hyperventilation that with only a few deep breaths she would experience seizures we could show our medical students every time she came to clinic for her check-up. Yet she was a long-distance bicycle rider and never had a seizure while riding.
“Jennifer wants to go on the Outward Bound trip this summer. We still haven’t been able to get complete control of her absence seizures. They aren’t often, but suppose one occurred while she was on one of those rope swings?”
If a spell occurred while she was on a rope, she could fall and hurt herself. On the other hand, anyone in the group who fell from the rope could injure himself, so the group leader should be quite careful. Perhaps you and Jennifer should talk with the leader. Maybe she could join the trip but avoid doing some of the most dangerous things. The independence taught by the trip and the benefits of being part of the group might be good for her and might also help her to realize that everyone has some limitations, at times. If her seizures were under control, her risks of injury would be little greater than those of others on the trip, and she could participate fully.
*254\208\8*

At some time nearly everyone’s love life is affected by the daily stresses of living. Changes in energy, emotions, personal body image, and self-esteem directly affect how you feel as a sexual person. If you do not feel attractive, for example, you will not expect others to be attracted to you. To improve or renew your intimate relationships, you must first address the issues of energy, emotions, body image, and self-esteem in your life. When you start feeling strong and in control of your life, everything will change for you. With renewed confidence and self-esteem you will realize that you are a loving (and lovable) person capable of, and deserving of, an enduring and fulfilling relationship with your partner.
One key to a successful, loving relationship is communication, and this is particularly true when one partner has a health problem. It is not always easy for people to discuss their intimate concerns, however. But consider the following questions. If they are left unasked – and unanswered – they can seriously damage a relationship.
•      Am I still attractive to my partner?
•      Am I hurting her?
•      Is he still interested?
•      Why isn’t he more concerned with my needs?
Misunderstandings over issues of intimacy can linger for months if they are not addressed. As a result, one or both partners may begin to avoid intimacy and even situations that may lead to intimacy. Once this pattern of aloofness is begun, it may be difficult to break. Communication is the key. Express your concerns to your partner:
•      Do you still find me attractive?
•      Am I hurting you?
•      I want to make love but you seem distant. What’s going on?
•      Maybe you don’t realize that sex first thing in the morning is often painful for me. Can we schedule a rendezvous for lunchtime?
There may be times during which physical limitations – fatigue, painful joints, and restricted motion – interfere with your sex life. Creativity is very helpful in overcoming these obstacles. Upon request, the Arthritis Foundation will send you a free pamphlet called “Living and Loving” which provides guidelines for comfortable physical intimacy. Here are some suggestions:
•      Plan for sex at the time of day when you feel best.
•      Take pain relief medicine ahead of time so that it takes effect before intercourse.
•      Pace activities during the day to avoid becoming fatigued before sex.
•      Perform range-of-motion exercises to relax your joints before sex.
•      Take a warm bath or shower before sex to relax both you and your joints.
Planning for sexual activity may seem awkward and contrived when you first start doing it. But it need not be. With creativity and imagination the preparation can become an exciting and stimulating addition to your relationship. It also sends a message to your partner that you desire to continue and expand your intimate relationship.
*63/209/5*

Jutting into the vault of the vagina is the cervix, the neck part of the womb or uterus. This is a heavy, muscularorgan the size and shape of an inverted pear. In women who have not reproduced, it measures about 9 cm in length. 6 an in width at its widest part, and 4 cm from Cram to hack. It weighs about 50 g, and its walls are 1-2cm thick. In women who have reproduced, these figures increase, by about 13 cm.
The uterus is a very stout muscular organ, consisting of the cervix, or neck, which joins the larger, expanded part called the corpus, or body.
A small hole, called the external os, is located in the centre of the cervix as it lies in the vaginal canal. This joins with a tract called the cervical canal which extends upwards to join with the hollow interior of the body of the uterus at the internal os.
At the upper outer limits of the uterus are exit canals that join with the oviducts, or Fallopian tubes. These are called the cornua, or “horns’, of the uterus.
The uterus tends to lie in a forward direction, usually at a 90 degree angle to the direction of the vagina. This is of importance, for in some conditions it is located in a different situation, and troublesome symptoms may arise: the best known is when it tends to flop backwards in a condition called retroversion. A major problem with this is often the inability of the woman to become pregnant The cervix is away from the pool of seminal fluid deposited by the male’s penis in the upper part of the vagina in intercourse, and it is simply impossible, in many cases, for sperms to penetrate the cervical canal preparatory to a possible pregnancy occurring.
Women with this problem have often become pregnant within a few months once the retroversion has been corrected and the uterus brought back to its normal, so-called ante-verted position.
The cervix is an extremely important organ. In nulliparous women (those who have not reproduced), it tends to be elongated and cylindrical. After reproduction, it is much shorter and flatter.
But it is very susceptible to cancer. This is the spot where the world-famous ‘smear test’ is carried out. The doctor removes a thin smear of cells from the cervix with a simple instrument called a spatula. These are placed on to a slide with a ‘smearing’ motion (hence the term ‘smear test), then they are stained and examined under the microscope by the pathologist for possible cancerous cells.
It is claimed that cancer may be detected in the very early stages, possibly 10-15 years before actual symptoms appear, by this simple yet extremely valuable test. The importance of all women—from age 20 onwards for life—having regular smear tests, say, every 2-3 years, cannot be overemphasized. Already, enormous numbers of lives have been saved in the few years that mass screening programmes have been carried out in doctors’ surgeries, hospitals and other places.
Incidentally, the body of the uterus is also a popular spot for cancers. These are more common in women who have passed through the change of life. For this reason, any bleeding or unusual vaginal discharge in women past the menopause is considered to be cancer by doctors until proved otherwise. It is a sign for immediate examination by the doctor. Today, not tomorrow, or next week.
The uterus is the place where babies are developed. It is lined with special cells, called the endometrium. This tissue is very responsive to hormonal changes occurring during the menstrual cycle throughout the reproductive years. If pregnancy occurs, the entire organ undergoes enormous changes, and copes with the formation of a brand-new life.
On the other hand, if a pregnancy does not occur, the total lining is shed in the form of a menstrual bleed. This is not all blood, but the disintegrating lining. Once expelled, a new lining starts to build up in preparation for coping with a pregnancy—or, if a pregnancy does not occur, to the next disintegration of the lining, and another menstrual bleed.
*8\45\4*

Many drugs designed to help people lose weight are available over the counter. Some of these drugs are advertised as “appetite suppressants.” Their active chemical is phenylpropanolamine. Its stimulant effects can cause dangerous reactions in people suffering from diabetes or heart or thyroid ailments.
Recently the FDA has issued warnings for the most potent and frequently used OTC diet aid ingredient, phenylpropanolamine (PPA) (e.g., Acutrim, Dexatrim), which is a sympathomimetic (affecting the sympathetic nervous system). PPA is believed responsible for 200 to 500 strokes each year. The FDA is warning that it will issue a ban on PPA early in 2001. This drug affects the central nervous system, causing reactions similar to those experienced when angry or excited. These reactions include a dry mouth and lack of appetite.
Estimates show that, when taken as recommended, even the best of these OTC products significantly reduces appetite in less than 30 percent of the users and tolerance occurs in one to three days of use. Clearly, these products have no value in the treatment of obesity. However, there is a 200 million dollars market for these diet aids in the United States.
Most manufacturers of appetite suppressants include a written diet to complement their drug. The majority of these diets contains 1,200 calories. On this number of calories, most people will lose weight without appetite suppressants.
Some people rely on laxatives and diuretics (“water pills”) to aid weight reduction. Frequent use of laxatives to aid weight loss disrupts the body’s natural elimination patterns and may cause constipation or even obstipation (inability to have a bowel movement). The use of laxatives to produce weight loss has generally unspectacular results and can rob the body of needed fluids, salts, and minerals.
Use of diuretics as part of a weight-loss plan is also dangerous. Not only will the user gain the weight back upon drinking fluids, but diuretic use may contribute to dangerous chemical imbalances. The potassium and sodium eliminated by diuretics play important roles in maintaining electrolyte balance. Depletion of these vital minerals may cause weakness, dizziness, fatigue, and sometimes death.
*29/277/5*

A variety of more sophisticated mechanical and electrical measurement instruments have been used with increasing frequency in the past decade. In one way or another, these procedures measure changes in blood flow or volume in the genital areas, a technique called plethysmography. For the measurement in penile changes, instruments have been developed which are attached around the penis. One such device consists of an airtight container (Freund, Sedlacek, and Knob, 1965), with changes in penile volume causing changes in the air pressure in the surrounding instrument which can be measured. Another type of device consists of a small loop of hollow, elastic tubing filled with mercury (Fisher, Gross, and Zuch, 1965). As the penis enlarges and the tubing is stretched, the diameter of the tube interior, containing the mercury, is reduced. This reduction changes the electrical conducting capacity of the mercury, and these changes in electrical resistance can then be monitored.
Measures of vaginal changes have generally been measured by some form of optical plethysmography (Geer, Morokoff, and Greenwood, 1974; Cerny, 1977). These devices consist of a transparent tube, somewhat like the artificial penis developed by Masters and Johnson. Contained in the tube are both a light source and a photosensitive recording apparatus. The light source produces a steady illumination which is reflected from the walls of the vagina and recorded by the photosensitive cell. The reflective characteristics of the vaginal walls change as blood flow increases or decreases during sexual arousal, and these differences are measured through the photosensitive cell.
While these new procedures are innovative and show promise, the art of direct measurement of genital changes is still in its infancy. Many problems have arisen with these measurement techniques.   For  example,   McConaghy   (1974)  made simultaneous penile recordings by two different types of measurement instrument and found the relationship between the two to be quite variable. While the responses did parallel each other much of the time, on several occasions one device indicated a penile volume increase while the other indicated a decrease. Finally, external variables such as sexual experience (Mosher and Abramson, 1977) or alcohol (Rubin and Henson, 1976) can affect arousal; however, these variables have rarely been controlled and very likely have confounded in unknown ways many if not most of the studies utilizing direct genital measurement.
*94\265\8*

The actinomycetes has been found to be the most promising group of microorganisms particularly for their industrial uses for the production of antibiotics, enzymes and related compounds. Among the antibiotic producing actinomycetes, the genus Streptomyces, is well known since the discovery of streptomycin. Later on several other antibiotics have been reported from various strains of this genus. However, species of this genus differ greatly in their response to various physical and chemical conditions around them. The characterization of morphological and biochemical properties, and the conditions favouring production of antibiotic like substances by this group of organisms is an important aspect for should be worked out in detail for their practical application.
MATERIALS AND METHODS
More that hundred actinomycetes were isolated from soil samples collected from places of Sagar District (Madhya Pradesh) by using the method of Williams and Cross. Out of these isolates one strain, i.e., Ac43 which showed promising antagonistic activity during screening was selected for further detailed study.

Antagonistic activity

Antagonistic activity of the above strain was tested against 14 pathogens by using the cross streak method as suggested by Casida.

Cultural characteristics

The test strain Ac43 was grown on the following three media and the cultural characteristics were noted:

(i)    Yeast Extract Malt Extract Agar

Yeast Extract – 4.0 gm, Malt extract – 10.0 gm, Dextrose – 4.0 gm, Distilled Water – 1000 ml, Agar-agar – 20.0 gm, pH adjusted to 7.3.

(ii)    Inorganic Salts – Starch Agar

Solution (A). 10.0 gm. starch was dissolved in distilled
water and then final volume of the solution was made to 500
ml.    *

Solution (B). K2HP04 – 1.0 gm, MgSo4.7H20 – 1.0 gm, NaCI -1.0 gm, (NH4)2S04 – 2.0 gm, CaC03 – 2.0 gm, were dissolved in 400 ml distilled water and to this 1.0 ml trace salt solution (FeS04.7H20 – 0.1 gm, MnCI2.4H20- 0.1 gm, ZnS04.7H20 – 0.1 gm, Distilled water – 1000.00 ml) was added to this. Its pH was adjusted to 7.0 before raising its. final volume to 500 ml.

Both solution A and B were fixed together and then to this, 20 gm Agar-agar was added before sterilization.

(iii)     Glycerol – Asparagine Agar

L – asparagine (anhydrous basis ) – 1.0 gm, Glycerol -10.0 gm, K2HP04 (anhydrous basis) – 1.0.gm.

Trace salts solution – 1.0 ml were dissolved in distilled water. The pH was adjusted to 7.2 and then the volume finally raised to 1000 ml with distilled water. To this 20 gm agar was added.

The morphological details of the mycelium, spore bearing structures, etc. were made by using microscopic methods. The colour of the colony, mycelium, etc. were recorded with the help of Rayner’s Mycological Colour Chart (CMI, Kew) while the melanin formation was studied following the method of Shirling and Gottlieb.

Biochemical Characterization

Tests were made to evaluate the production of H2S gas and acid by using standard methods (Hi-Media). For the study of catalase activity and starch hydrolysing capacity the method described by Waksman was used. The utilization of carbohydrates was determined by the method as given by Pridham and Gottlieb.

Antibiotic Production

The production of antibiotic was tested in the starch peptone broth having pH 7.2 . For this the organism was grown in 150 ml flask containing 30 ml of above medium on a reciprocating shaker (160 rpm) at 28°±2°C for 10 days. After incubation all the flasks were taken out and the content of each flask was filtered and to obtain a cell free extract the filtrate was then centrifuged at 6000 rpm for 20 minutes. The supernatant was condensed to 2 ml and purified by using silica gel column.

The purified sample was then studied by using thin layer chromatography. For chromatograpic analysis three solvent systems i.e., ethyl acetate : methanol (95:5), acetone : water (9:4) and butanol saturated with water were used as suggested by Stahl. The developed chromatograms were observed under ultraviolet Tight. Samples indicating the flourescent spot at or above Rf 0.80 were considered positive for production of polyene antibiotics. To confirm antibiotic production the spots were eluated by using ethyl acelate: methanol and the absorption spectrum of the eluate was obtained using Shimadzu, Double – beam spectrophotometer, UV-190. The spectrum was obtained at a wave length of 250 – 340 nm.
*3\218\2*

Glucosamine is a molecule used by your body to make connective tissues. Because of its chemical structure, it can’t exist by itself but must be bound to another substance. For this reason, when you find glucosamine in stores, it is usually as glucosamine sulfate. Sometimes you may also see glucosamine hydrochloride or acetylglucosamine. The sulfate form was the first to be commercially available in Europe and has been studied most extensively.
Glucosamine is one of the primary building blocks of the substances that make up both cartilage and synovial fluid, which lubricates the joints. Even though glucosamine is primarily produced in the body, a small amount may be supplied by the diet as well.
When you swallow a capsule containing glucosamine, approximately 90% is absorbed into your body. Some of it then enters the joints, where it is incorporated into joint tissues. Your body uses glucosamine to make long-chain chemicals, called glycosaminoglycans (GAGs). These GAGs are then bound to protein cores to form proteoglycans. The end result resembles a pipe cleaner (on a microscopic scale) – the “wire” is made of the protein core, and the GAGs stick out all around. These molecules act like sponges to hold water, which makes up most of the weight of the cartilage, along with dissolved minerals and vitamins. The water acts like a shock absorber, helping connective tissue withstand forces that squeeze or stretch it.
It appears that taking supplemental glucosamine improves the health and quantity of these important parts of your joints, reducing pain and increasing mobility.
*32/306/5*