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A large number of symptoms and maladies constitute defects with in metabolism. Inherited genetic anomaly is the cause of these defects. As a result there is abnormal metabolism in the person concerned. Peisonoces substances accumulate on account of this. This also results in the prevention of the use of essential ingredients which are brought together during normal metabolism.

Brief History of inborn Errors

These were the types of conditions classified as errors that were inborn in metabolism by Sir Archibald Garrod, second generation British physician. First he recognized four inborn errors in metabolism. But hundreds of these types of disorders have been discovered by the doctors.
According to Archibald Garrod, albinism, alkaptonuria, cystinuria and pentosuria are the inherent defect of metabolism. These are also called as congenital or inherited metabolic diseases.

What types of diseases are Inborn Errors of metabolism

A few examples are albinism, a lack of pigment in the skin, hair, and eyes. Phenylketonuria, or PKU, cystinuria the cause of continuing kidney stones and thyroid disorders and hundreds of others.
Feeding problems, frequent emesis, increased rate of breathing, lethargy, diarrhea,apnea or seizures are some of the symptoms shown by children with inborn defects of metabolism. The child though normal at first may not show any signs till many days after birth.

Help for those affected

Parents are anxious and afraid of their children contacting these weakening diseases. Relief can be obtained by obtaining correct information and getting support from others in your community.
National Institutes of Healths office or rate diseases and genetics and National Human Genome Research Institute can give valuable information. The family doctor too can refer to local sources of information and support groups and agencies like NORTD and KUMC. Modern technological advance and testing methods have allowed earlier detection and treatment of genetic disorders of the metabolic kind. Researchers hope that someday these disorders can be prevented totally as the causes are known already.

Why it is Necessary to Alter Metabolism for Avoiding Disorders

Mostly metabolism is an involuntary process and a person is not aware of its effect except when it goes wrong. It is when sugar absorption is defective and energy is not converted in to fuel. Metabolic disorder and negative chemical reaction in the cells of the body is thus triggered.
Metabolic disorder necessitates a speed up in metabolism through a change in your living style or medicating yourself to normalize the process of metabolism. Some require metabolism to cure their diseases while others want to shed their excess weight. As obesity and slimness depend upon the rate of metabolism, many try to take different means to augment their metabolism to take care of their problems.

Metabolic abnormalities like irregular levels of hormonal enzymes and defects and difficulties with enzyme or hormone function, are the chief causes for the increase of metabolism. The body is disabled to perform its functions of metabolism when affected by these problems. In consequence it collects poisonous compounds in your body, brings about substance deficiency or creates serious conditions of health.

Metabolic Disorders

It is possible to treat and cure metabolic diseases by an increase or decrease of metabolism. For example, over active, thyroid gland is responsible for hyper thyroidism, releasing surplus thyroxin hormones that increase metabolism. You feel as a result, a severe loss of weight, a spurt in blood pressure, heart rate, goiter or swelling. Cure can be obtained by either surgery or radiation. The opposite of this is “hypothyroidism” where the gland is inactive or has low activity. Brain disorders, thyroid disease of a serious nature and health problems may occur. You should speed up your metabolism when there is too much of weight gain, slow heart rate, constipation and fatigue. Medical attention is required for these symptoms.

You can get these problems genetically. Inborn errors of metabolism like galactosemia, phenylketonuria should be treated by doctors and diagnosed properly. Treatment should be for either increase or decrease of metabolism to enable the body to function properly and normally. As metabolism is very important for body function, it should be maintained at a standard level without ups and downs through proper diagnosis and treatment.

While metabolism converts what ever we eat into energy, metabolism rate is the speed with which it works. People with high metabolic rate do not gain weight easily and are less likely to get coronary artery disease for lower metabolic rate. People can try to raise their rate to a healthier rate.

Our in take of food is broken down in to different parts and enters the blood stream to give us energy. The rate or speed with which they are split indicates if they are utilized as energy or stored as fat. Serious health are caused by very high level of fat, some times leading to death.

Increasing Your Rate

Do regular exercise to boost your metabolism. Muscles expend more energy than fat. More activity not only increases the rate of metabolism during the activity but increases the rate even during sleep or resting.

Metabolic rates, often are related directly to own genetic nature under active over active thyroid and other medical conditions can affect the rate of metabolism.

A regular schedule for exercise, intake of healthy foods are best to keep a healthy metabolism rate. You may have 30 minutes of exercise a day for four to five days a week for good results. Good aerobic exercises like walking, jogging, dancing or riding a bike will maintain the metabolism rate at a greater level for many hours after the exercise schedule. For building muscle mass take to lifting of weights. This will increase the rate while being active or at rest.

Controlling your weight as well as an intake of different types of food is important to get the correct balance of nutrients and vitamins. Try to experiment with the amount of calorie intake you can expend every day without weight gain. More food can be taken with an increase in the level of activity while inactivity leads to storage of fat.

People with high metabolism rate feel like gaining weight. You should not gain weight to look better. It would be better for you and healthier to try to build muscle mass rather than gain fat. Muscle weight is more than fat and it is more healthy compared to storage of fats in our body.

A bunch of chemical reactions that convert the food we take in to fuel and energy for the use of our body is called metabolism. This energy released by metabolism is utilized not only for voluntary actions like running and talking but for involuntary actions like growth. The innumerable metabolic reactions taking place in our bodies have specific functions to discharge. Metabolism is of two kinds, namely, anabolism and catabolism. The former is constructive, building and storing materials. Catabolism is destructive as it breaks down molecules that release energy.

The rate of metabolism can be distorted and affected by hormones like Insulin and thyroxin. Metabolism has a large part either in weight gain or loss. The basal metabolic rate decides as to the number of calories you can expend while at rest.

Metabolic Disorders

These are caused by irregular or abnormal chemical reaction in your body. These are the results of hormonal abnormal functioning or levels. While a few metabolic disorders are inherited, some more are developed. A few of common metabolic disorders are Glucose-6-phosphate dehydrogenase deficiency, Galactosemia, Hyperthyroidism, Hypothyroidism, Phenylketonuria, Type1 diabetes mellitus and Type 2 diabetes. Most of these disorders can lead to serious conditions. For instance, Glucose-6-phosphate dehydrogenase deficiency can cause hemolytic anemia an in ability to produce enough red blood cells in the body. Diabetes increases the risk for heart disease and other problems.

Thus metabolism and its processes have a major role and effect on every aspect of your body and life. So you should understand metabolism and look after the body and ensure consistent metabolism. Do not experiment problems with metabolism without visiting your doctor and consulting him.

How Does the Thyroid Metabolism Affect You in Your Weight Gain or Loss

Wherever there is weight loss or gain, it is metabolism that is first affected since it converts food in to energy for body activities. Thyroid gland is placed exactly above the Adams apple in the throat producing hormones directly in charge of the proper working of our bodys metabolism.

The Direct connection

Malfunction of the thyroid gland creates problems with metabolism. This in turn affects your gain in weight and loss. There is a direct link between thyroid and metabolism. Weight gain through thyroid cannot be easily discarded as increasing your metabolism rate.

Treatment for Thyroid Metabolism problems

A qualified doctor alone must treat thyroid metabolism problem. The hormones have to be regulated to deal with the rate of metabolism and finally control weight gain or loss. The two main thyroid disorders are hypothyroidism and hyperthyroidism. It is unlucky that both these diseases directly affect ones weight gain or loss.

Specific thyroid therapy involves a considerable amount of time and is totally unconnected with the amount of food intake or how much you exercise. It just depends on the regulation of the hormones released by the thyroid gland to boost and regulate your metabolism to its normal, natural levels.

Helpful tips

Understand your own body and feel when it does not respond to ordinary things like weight loss with exercise or activity and controlled balanced diet. Diagnosing the thyroid metabolism problem well in advance may help you to avoid extra weight gain or loss.

In spite of any of the diets and exercises, if your weight gain is sudden, consult a doctor to know if the weight problem is not directly due to a thyroid metabolism problem. Weight gain by thyroid metabolism problem can frustrate you since nothing can be done to stop weight gain, except to continue the treatment fully and without a break. The only help can be through balanced diet, exercise, and the helping hand of family and friends.

A very serious condition called hypothyroidism or inactivity of the thyroid has a number of symptoms like fatigue, gain in weight abnormally, metabolic disorders like drop in metabolic rate etc. In such a case you have to boost metabolism, store and use energy the body needs. Metabolism is a significant process absorbing, converting and using the energy to execute all kinds of body functions like thinking and movement. You may think it is very simple process but you should be aware that the metabolic rate should not be too low or too high. A drop in the metabolic rate makes the person unhealthy. Natural increase in the metabolic rate is the only panacea for this defect.

Ways to boost Metabolism

For loss of excess weight, you have to treat metabolic disorders and be ready for metabolic accelaration during the old age. Follow these five sure five ways to boost metabolism without supplements. Balanced metabolic rate is the secret of most body builders. A few people have born effective metabolism. Others have to boost it through exercise. The most effective and traditional way to boost metabolism is this.

Slowing down of metabolism through age can be countered by building muscles and keeping physically fit and active. Remember that muscles are important in metabolizing food, burning calories and losing body fat. In order to build muscles, and boost metabolism, you must perform strength training and aerobic exercises at least three times a week.

There is no point in fasting to lose weight. You have to eat regularly to boost metabolism. A low calorie diet slows down metabolism. You should take small meals every four hours to help increase your metabolism and help weight loss. Add to this, eat breakfast daily, avoid sugar and include spicy foods to your diet.

Remember to drink lots of water to keep out any toxins caffeine can help in increasing metabolism. Better you take to green tea for safety. Nicotine or coffee can boost metabolism but may lead to severe health conditions. If you have no metabolic disorders you do not need supplements to boost metabolism. A little change in your life style is all you need to lose the weight you want.

Tremors of the Hands and Fingers. Tremors in the fingers and hands may designate various diseases. They are present in some forms of thyroid disease, and frequently in excessive nervousness. In later years however, the most common hand and finger tremor, sometimes called “pill rolling disease,” is Parkinsonism, or Paralysis Agitans, a neurological disease thought to be caused by arteriosclerosis within the brain and spinal cord. The difficulty may progress for ten or twenty years, but, fortunately, is usually painless, and though cure of the tremor is usually not possible, there are drugs in use which reduce the tremor considerably.

There are also some surgical procedures which are sometimes advised for the treatment of this disease which have been successful in some cases. Happily the physician’s treatment can be relied upon for improvement of this disease in nearly all cases.

Raynaud’s Disease. This disease is a sudden reduction of blood circulation in the hands which brings about a blanched almost white-appearing hand which can be extremely painful. The condition is brought on by exposure to cold, such as cold water or cold weather, and is seen most often in women at younger ages, but often extends far beyond the fifty year mark.

THENAR


Figs. 149, 150. Hand infections with pus accumulations within the palm and web usually derive from finger infections or perforating injuries. They are very serious and demand immediate attention.

Care of Raynaud’s disease requires the therapy of certain drugs, and occasionally surgery, for extreme cases.

Sufferers of Tinnitus hearing loss describe this condition as one of the most physically and emotionally devastating signs they have ever experienced. According to heavy metal rocker OZZY Osboume, a sufferer of this hearing loss, “You try living your life at 30000 db and see if you can hear”. Tinnitus is not a disease in itself but a very pervasive sign with causes like ear infections, foreign objects in the ear and chronic exposure to blaring noise. It is also a side effect to some medications that is unwelcome.

Tinnitus can affect one or both ears. It is a state where there is a constant ringing noise, buzzing and hissing, humming, whistling, ticking, clicking, roaring, chirping, tunes beeping or whooshing. These noises change from quiet “background” noises to an internal sound loud enough to eliminate the reception of all sound from the outside world. This brings in partial and some times total hearing loss.

With so many causes, doctors find it difficult some times to treat Tinnitus hearing loss. A few of the causes leading to Tinnitus hearing loss are ear infections, fever, too much of loud noise, aspirin, non steroid medications, antibiotics, chemotherahy drugs, diuretics, neurological disorders like multiple scslerosis, head injury, TMJ{temporomandibular joint disorder in the jaw} thyroid disease, vitamin B 12 deficiency, depression, anxiety, and Fibromylgia. Since tinnitus causes permanent hearing loss, its prevention is absolutely essential. Ear plugs, where there is loud noise, are highly recommended as noise levels as low as 70db can cause reduced hearing. Any medication, suspected to create tinnitus may safely be discontinued on the advice of the physician or the dose reduced.

Emotional Issues

Tinnitus is an unrelenting, plaguing nealady for the sufferer all day, every day. It shatters and takes a horrific toll of one s emotional state by causing depression, hopelessness and helplessness. Actor William Shatner once said that his tinnitus physically and emotionally impaired him so much that he considered suicide several times. It is also a source of chronic pain. If the inner ear noise is loud enough to cause deafness, aching and shooting pain is felt in some parts of the ear. Chronic pain, both a medical and phychological issue, must be treated.

Living with Tinnitus, Hearing Loss

Eric Clapton, Phil Collins, David Letterman, Leonard Nimoy, Sysvester Stallone and Barbra Streisand, all live with tinnitus daily. Treatment for this includes ear surgery, removal of loud noise, use of ear protection, anti anxiety drugs like klonopin antidepressant medication, avoidance of caffeine, nicotine and salt, electrical stimulation to the ears, acupuncture, use of “white noise” to block tinnitus sounds and psychotherapy.

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Sciatica. Sciatica is a soreness of the sciatic nerve, with sharp shooting pain and soreness along the nerve distribution in the hip, the back of the thigh and down into the leg. Usually, these pains are not constant but are produced suddenly and painfully by movements which stretch the nerve itself. These movements are straightening the knee, flexing the hip, or bending the ankle upward.

Because sciatic pain frequently is due to compression of the nerve within the spine, actions which suddenly increase this pressure on the nerve also produce the leg pain. So, coughing, sneezing, straining at bowel movement, and lifting heavy objects often bring down the lash of sciatic pains.

In diagnosing sciatic pain, the physician always considers the possibility of a slipped disk injury between the vertebrae, which is a common cause of sciatica, along with arthritis of the spinal column. After a diagnosis of sciatica has been made by the physician, surgical removal of an injured disk of the spine, or correction of spinal deformity may be indicated. Treatment for arthritis, or treatment of the sciatic nerve itself are also possibilities.

Absent Knee Jerk Reflexes. Tapping the tendon of the hanging leg just below the knee cap should cause the leg to kick
forward slightly. This happens because the tap slightly stretches the thigh muscles, which respond automatically with a quick contraction. This response is called the knee jerk reflex and is usually present under all circumstances. Absence of the knee jerk reflex frequently indicates diseases such as pernicious anemia, thyroid disease, or disease of the spinal cord or brain itself. Only on rare occasions are knee jerks absolutely absent in healthy individuals.

The Lower Extremities

Examination of the Lower Extremities

The lower extremities are examined unclothed, standing, and in all positions of functions, with the aid of enough light and the support of a table.

1. Stand on the leg to be tested and bend forward horizontally, putting the other leg straight out behind. Reversing this action, bend backward with the free leg straight out forward. Pain and limited motion in the hip indicates probably arthritis within the joint, or rheumatism around the joint.

2. Examine motion of the knee. Cup both hands over one knee in a sitting position, then lift and swing the leg and
foot back and forth as far as possible. A grating sensation or limited motion of the knee probably indicates arthritis.

3. Examine the ankle motion. Bend the ankle in all directions as far as possible. Painful motion or soreness about this joint, means probable arthritis.

4. Examine blood circulation in the foot. Feel the pulse at the dorsal artery located just beside the highest bone on the top

Fig. 135. The extremities have no glands or body-serving structure within them. They serve the body in its external needs, and are capable of fantastic abilities, as well as many diseases.

of the foot. A strong pulse in this artery indicates good circulation in the legs; its absence may mean circulatory difficulty. Observe also any swelling of the lower leg, ankle and foot which “pits” on deep finger pressure. This can be a sign of heart or kidney disease.

5. Examine the veins of the legs. Lie down with the feet elevated for several minutes and observe the disappearance of nearly all veins. Quickly stand erect and see if the veins fill rapidly into enlarged tortuous knots. Varicose veins will fill rapidly on standing, but normal veins fill slowly, taking about a full minute or more. Examine the skin just above the inner ankle joint for any long standing sore or ulcer, usually the result of varicose veins.

6. Examine the skin sensation of the legs and feet. Run the fingertips lightly over the legs and feet and note any areas of numbness, burning, heat, coldness or pain. Unusual or improper sensations often point to nerve disease in the leg or elsewhere in the body.

7. Standing with the heels flat and the knees locked, bend over and attempt to touch the floor. Soreness in the back of the thighs that travels downward into the calves may mean sciatica.

8. Sit on a table with the legs hanging down. Tap quickly just below the knee cap with a book edge, and note the presence or absence of the kicking reflex in the leg. It is absent in some forms of thyroid disease, pernicious anemia and nerve disease. It is normally absent in very few people.

9. Examine the foot and note any growth or thickening enlargements at the toe joints, side and soles of the foot.
These conditions are corns, callouses, bunions or planter warts.

Hearing loss indications being slow and sure, it is not at all noticed by the sufferers but by the family friends or through a hearing test. Very high levels of noise emanating form tractors, factory machineries, fire arms, power tools cause hearing loss when the ear is not properly protected. A feeling of nervous tension, irritability or fatigue, are symptoms of hearing loss as the person tries to hear perfectly. The fist sign of hearing loss is mumbling and speech that is not clear. Other sure signs of hearing loss are straining himself to hear and understand others, misunderstanding, a request for repetition, or watching the speaker s face intently while listening.

Take Care of your Hearing Levels

Various other symptoms of hearing loss are (1)increasing the volume of TV and radio leading others to complain, (2)family history of hearing loss,(3)diabetes,(4)hear, thyroid, circulation problems. Not only these, recurring ear infections, constant rings in the ears, dizziness, exposure to ototoxic drugs and medications are also symptoms of hearing loss.

Many persons with hearing loss acknowledge it and feel embarrassed in meeting new people. Consequently they rarely visit their friends and lose the family reunion or chit-chat neighbor-hood. A feeling of depression and inability to hear properly is also a sign of hearing loss.

Specifically parents should be all alert and active in discovering the signs of hearing loss in their children. They should discuss with a pediatrician and get their children worsens. When a person is not startled or shocked when a loud noise is heard, it is a definite and sure sign of hearing loss. The person will not even turn to the direction of the sound. Carelessness and negligence on the part of parents in detecting these signs of hearing loss jeopardize their lives and lead to serious consequences. The result will be slow learning curve, difficulty in understanding speech and an in attentiveness very bad for school going children.

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This examination is best carried out lying on the back with the knees well bent and held wide apart. With good light and a large hand mirror, the external vagina and its component parts can be visualized easily.

Fig. 111. Much of the female genital system, excluding the vagina, is within the abdomen. Only the vaginal entrance is visible externally, without the aid of instruments.

1. Examine the skin of the vulva, the labia majora and minora, surrounding and enfolding the entrance of the vaginal vault. Note any irritation, redness, ulceration, or sore on these skin structures, along with areas of drying, leathery whitening or skin cracking. These possibilities may mean leukoplakia or cancer of the vulva.

2. Feel the labia themselves, and note any one-sided ball-like enlargement under the skin, creating a bulge which may possibly be sore. An enlargement here may be a Bartholin cyst.

3. Look closely at the condition of the urinary exit, the dimpled-like opening just inside of the entrance into the deeper vagina. Observe any polyp-like reddened or bleeding growth about it. The possibility here is a urethral
polyp or caruncle.

4. Examine closely the entrance of the true, or deep vagina. An irritated blanched and cracking skin, covered possibly with a coating of pus or streaked with blood, is the appearance of vaginitis when it occurs.

LABIA MAJORA
CLITORIS
LABIA MINORA
ORIFICE OF VAGINA
URINARY OPENING

Fig. 112. External female genitalia include only the unimportant skin folds about the vaginal entrance. The urinary tract exit is visible recessed into this region. Most diseases of the external genitals are not serious.

5. With a hand separating the labia on each side, strain with great effort as in child birth or at stool, and note any balloon-like or other structure from the vagina coming into view. Such structures may be a fallen bladder, called a cystocele, a fallen uterus, called a prolapsed uterus, or a fallen rectum, called a rectocele.

6. After gentle soap and water cleaning of the vagina and hands, insert one finger into the vagina and feel the rounded cervix, high in the vaginal vault. Normally, the tissue here is soft and smooth, and any grossly rough, ir
regular or bleeding areas may include the possibilities of cancer or cervicitis.

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Cancer of the Prostate Gland. Cancer of the prostate gland behaves exactly like non-cancerous enlargement of the prostate, and is treated in essentially the same manner-removal of the gland. Cancer, however, which has a characteristic feel to the finger, and a distinguishing appearance under the microscope, can spread to other sections of the body, just like any other cancer.

There is divided opinion about the prevalence of pros-tatic cancer, but some authorities state that nearly one-half of all males over sixty develop cancer in the prostate, of a low degree of malignancy.

The treatment of prostate cancer in addition to its removal, includes the use of hormones effective in slowing these growths considerably. Obviously such treatment is very technical and can be obtained only through a physician familiar with prostatic diseases.

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Growths of the Prostate. One of the most common and troublesome difficulties for males beyond the age of fifty is non-

Fig. 109. The prostate gland’s tendency to enlarge with age can cause great difficulty with urination. Because the narrow urinary channel runs through the prostate, pressure from an enlarging growth may completely blockade the urine’s outlet. Surgical removal cures the condition.

cancerous enlargement of the prostate gland which creates urinating difficulties known the world over. Developing gradually from an unknown cause, the symptoms begin as a slow starting stream of urine, which becomes greatly weakened and at times even dribbling. There might be a full minute or more of waiting before urination commences, and the weak urinary stream is only a faint shadow of the forceful stream of urination known in youth.

The enlarging prostate not only obstructs the urinary flow, but also makes nearly impossible complete emptying of the bladder which, like a half emptied glass of water, is refilled quickly. This makes frequent urination necessary, sleep is interrupted possibly five to ten times a night. With each urination, however, only a small portion of the urine present escapes from the overfilled bladder and the urge to urinate quickly returns. Several aids of doubtful value, in common practice to encourage urinating ability, include the psychological benefit of running water from a nearby faucet and sitting in a tub of warm water.

Prostate growth difficulties often follow an uneven course, worse one day than another, but progressive worsening may eventually find these people unable to urinate at all, and a state of semi-emergency arises. At this stage a mechanical drainage of urine from the bladder must be done by introducing a small tube through the urethra into the urinary bladder, to provide an orifice for the escape of the entrapped urine.

The permanent cure of prostate hypertrophy, calls for the mechanical removal of the prostate tissue which is squeezing and obstructing the urinary channel. This operation, called prostatectomy, is usually done directly through the urethra itself, by means of a slender electrical cautery specially devised for this purpose. Removal of the prostate gland, properly done, restores urinary function as known in youth. This operation does not interfere with sexual relations, so far as erection of the penis is concerned, but it does usually render a male sterile. As most prostate gland operations are done after fifty or sixty years of age, sterility is usually not of great concern.

Fig. 110. Once the prostate gland is removed, the urinary stream again becomes forceful.

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Prostate difficulties

Infection of the Prostate. Most prostate infections are incurred during youth in the active sexual years and are caused

PROSTATE NORMAL

Fig. 108. The prostate gland has a minor sexual and hormonal function. The urine must pass through the prostate gland as through a worm hole in an apple. An infection or growth may close this narrow channel.

by gonorrhea and similar infections. However, in later years, prostate infections are more often due to focal points of infection, such as the teeth or tonsils. When the prostate gland harbors infection, it tends to spread, not only into the urinary tract, but to the rest of the body as well. In youth, or in later years, prostate infection is very stubborn and difficult to eradicate completely. It is often the underlying cause of arthritis and headaches, and complete cure of this infection becomes very important.

Treatment of prostate infections cannot be accomplished by drinking large amounts of water, flushing the kidneys or other simple remedies. The complete cure of these infections is often very difficult and time consuming, even for the experienced physician who must direct the patient through many weeks of scheduled treatment before effective cure is certain.

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Erection Difficulties. After the age of fifty, varying with the individual, erection of the penis, and sexual activity, are not as frequent as in earlier years. Unusual episodes through the years, such as accidents may also affect this function considerably.

As a result of trauma, scar tissue can form on the penis and a painful erection called Peyronie’s Disease may result. The scar tissue along one side of the penis will not stretch, and creates a curve in the penis of such magnitude that intercourse is difficult or impossible. The scar tissue in these cases is very dense, and is similar to the scar contraction sometimes seen in the palm of hard-working men. Because the scar tends to contract, and has no ability to stretch, erection difficulty becomes very great and requires considerable medical skill for any kind of satisfactory treatment.

An erection that is normal except that it is painful and unrelated to sexual function is known as priapism. This difficulty is often seen in the later years of life, and is usually due to some body disease which affects the nervous system, the blood, or the penis itself. The treatment of priapism demands careful and complete physical examination to determine, if possible, the bodily disease responsible for this and perhaps other conditions.

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All over the world, coronary heart disease is one among the top three killer diseases. Out of various coronary heart diseases cardiomyopathy, heart failure, congenital heart disease, heart valve disease, abnormal heart failure, vascular disease, and marfan syndrome are the major ones that are prevalent today.

What are the Possible Causes?

Certain heart dysfunction can result in coronary heart disease and may in turn lead to fatal heart attacks. Coronary heart disease is caused due to many factors, and if the cause is due to birth related malfunction then there is no cure for the same. However, if the condition could be diagnosed before the actual birth of the child, then few corrective treatment methods are in place that has to be carried out even at the fetus level itself.

Drug and alcohol use and abuse can result in coronary heart diseases and there are other reasons such as chromosomal abnormalities and viral infection that can cause coronary heart disease in persons.

There are also possibilities of pregnant mothers contracting viral infection passing the effect of infection as coronary heart disease to the developing child or the fetus. In case of adult people, any damage to the heart tissues or diabetes condition or kidney disease or thyroid malfunction or any of these diseases in solitary or in combination can result in coronary heart disease in persons.

Best and effective treatment can be devised only if the coronary heart disease is diagnosed early and only with an early diagnosis, you can avoid the fatal heart attacks. A periodic check up and in case of heart diseases running in family history, a regular and frequent periodic check ups alone can help in diagnosing the coronary heart disease in a person.

There is no need for the person who has been diagnosed with the coronary heart disease to panic and lose hope. People who have been diagnosed with the condition can still lead a normal life, but with few easy to follow restrictions or prescriptions.

The prescription may range from regular exercise, total avoidance of smoking, healthy diet devoid of any fat, abstinence from alcohol totally. It should be the patient s endeavour to reduce the LDL cholesterol in blood, as a high level of LDL can lead to atherosclerosis and subsequent strokes or heart attacks.

In fact, persons with coronary heart disease can lead a normal life like any other healthy person provided the laid down precautions are followed scrupulously without fail.

Scrotal Hernia, Rupture into the Scrotum. Long-standing hernias or ruptures frequently descend into the scrotum and create enlargement of the scrotal sac. When standing or straining, the mass appears to fall outside of the lower abdomen, underneath the skin, and find its way into the scrotum, which then may balloon-up to the size of an orange or more. Usually these enlargements return to the abdomen when lying down, or when pressure is placed under the enlargement in the scrotum.

Hernia is an age-old condition that has been treated by numerous means. The simplest thing to do is to wear a truss, but they are often exceptionally cumbersome, frequently quite painful and usually limit the physical ability through necessary tightness of the truss.

A truss will not heal a hernia, and any such claim is misleading. It is common to find men who have worn a truss twenty or more years in an attempt to “fix” their rupture, but they finally realize the hernia has been slowly enlarging all along. Only a few who wear a truss for hernia, are satisfied with the end results.

Other treatments for hernia have been injections of various waxes and sands into the hernia itself. This form of treatment has had occasional success, but more often produces undesirable results or makes the hernia condition even worse. Fortunately, these practices are almost extinct today.

Surgical operation for rupture is most satisfactory. There is complete healing, complete comfort, and a strengthened body wall usually follows the hernia operation. It is thought, that within six months of a surgical hernia repair, the repaired region will have grown stronger than the same region of the average person. These operations are not completely fool-proof, but it is by far the most satisfactory treatment available for hernia.

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Testicle Diseases-Absence, Pain, Tumors. Absence of the testicle at any age is nearly always a physical defect, present since childhood. It is usually an undescended testicle, which has remained unnoticed in the abdomen. Many men with just one external testicle have fathered several children, and have noticed no lack of virility through the absence of one testicle.

The atrophic, smaller size of one testicle, often noticed in adult men, is most often the result of serious virus infections in childhood-especially mumps. The smaller sized testicle remains the same throughout life, but has no significance so far as male hormone, virility, or sexual ability is concerned. The affection of both testicles in this manner, however, usually renders a man sterile.

Pain in the testicle is quite common, because it is a very sensitive organ, and trauma or other pressure causes immediate and severe pain. The sudden onset of unexplained severe pain of the testicle however, usually heralds an infection within the testicle or its tract, the epididymis, especially if accompanied by a mild blood discharge from the urethra. The infected testicle sometimes produces a bloody discharge, and its severe pain is markedly increased by any pressure, jarring or slight trauma. The pain forces the patient to drop his work and seek effective treatment. After diagnosing the difficulty, the physician may prescribe antibiotics, ice bag coverage, and occasionally incision and drainage in a surgical manner.

Tumor growth of the testicles, other than water cysts, are not very common after the age of fifty years. Most growth of the

Fig. 107. Scrota I hernia is simply a large ordinary hernia in the male. The protruding hernia mass, often the intestine, descends into the scrotum which may become the size of a football.

testicles that are cancerous in nature, are found during early youth and adolescence but there is no guarantee, that a growth of the testicle will not occur in the later years of life. Because of this, any growths or enlargements of the testicles, whether they be painful or not, should command an early visit to the physician for an examination.

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Cysts, Hydrocele, Spermatocele. Hydrocele and spermatocele, commonly called water cysts, occur frequently in the male genital tract. They are felt in either side of the scrotum as a smooth, balloon-like enlargement, which slowly may enlarge to the size of a lemon or orange. Although these cysts are usually painless,

Fig. 106. Hydrocele or water cyst of the spermatic cord presents a smooth, soft enlargement above the testicle. In a dark room, light shines through it easily, distinguishing it from other scrotat difficulties.

they frequently become a nuisance because of their size and location about the testicles.

The so-called water cysts, in the scrotum on the cord of the testicles, can easily be identified in the following manner: In a dark room, a flashlight is placed against the back of the scrotum, so that its rays shine through the scrotum. Water cysts will illuminate readily, whereas, the solid testicles or possibly other growth, appear as dark, non-illuminated masses.

Hydrocele is not a condition leading to malignancy or serious disease. A needle may be used to drain the enclosed fluid of the cyst for temporary relief, but afterward, the fluid nearly always reforms to fill the cyst again. The cysts are readily removed by simple surgical operation for lasting and satisfactory results.

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