A dose of the hormone Oxytocin reduces the stress hormone Cortisol in arguing couples. In addition, Oxytocin strengthens positive behaviour,as researchers at the University of Zurich have discovered. The study by the psychologist Beate Ditzen has appeared in the specialist magazine “Biological Psychiatry”.

Various studies in recent years have repeatedly shown that the hormone Oxytocin in the brain of mammals – and therefore human beings too – is jointly responsible for regulating the social behaviour. Beate Ditzen from the Psychological Institute of the UZH has now, together with colleagues from the University of Zurich, examined the hormone particularly in terms of the behaviour in partnerships.

The scientists asked 47 couples aged between 20 and 50 to argue in the laboratory about a typical subject of conflict for them. Before this conflict discussion, the couples received either the hormone Oxytocin or a placebo in the form of a nasal spray. The behaviour of the couples was recorded on video and analysed with the aid of a coding system. Moreover, the stress hormone Cortisol was repeatedly measured in the saliva of both partners in order to record the psychobiological stress reaction to the conflict.

Beate Ditzen and her colleagues then assessed the positive behaviour, such as listening, confirming or laughing during the conflict in relation to the negative conflict behaviour such as interrupting, criticising or degrading the partner. “Couples that received Oxytocin behaved significantly more positively than couples with the placebo”, said Beate Ditzen in summarising the results. Oxytocin prolongs the duration of positive behaviour in relation to negative behaviour. In addition, the Cortisol values of couples who received Oxytocin were lower after the conflict than those of the placebo group.

The results suggest that Oxytocin as a neuronal mechanism might influence the behaviour and the stress reaction in couples. “Oxytocin might be a possible biological candidate to explain how close relationships – and particularly couple relationships – have a positive effect on our health” explains Beate Ditzen.

Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In many countries infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception.

Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors. According to The Mayo Clinic, USA:

• About 20% of cases of infertility are due to a problem in the man.
• About 40% to 50% of cases of infertility are due to a problem in the woman.
• About 30% to 40% of cases of infertility are due to problems in both the man and the woman.

According to Medilexicon’s medical dictionary, infertility is “Diminished or absent ability to produce offspring; in either the male or the female, not as irreversible as sterility.”

According to the Department of Health and Human Services, USA, approximately 10% to 15% of couples in the USA are infertile – meaning they have not conceived after at least one year of regular, unprotected sex.

Many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors.

Chances of conceiving within one year

In Europe, North America and much of the world approximately 85% of couples will conceive within one year if they have regular unprotected sex. Averages in the UK are as follows (National Health Service)

:

• 20% will conceive within one month
• 70% will conceive within six months
• 85% will conceive within 12 months
• 90% will conceive within 18 months
• 95% will conceive within 24 months

Therefore, doctors in the UK will not usually diagnose a couple as infertile until 24 months have passed without conception and regular unprotected sex. Most people will see their GP (general practitioner, primary care physician) if there is no pregnancy within 12 months.

According to the National Health Service, UK, a couple that has been trying to conceive for over three years has a maximum 25% chance of conceiving over the subsequent 12 months if they continue trying.

What are the risk factors of infertility?

In medicine, a risk factor is something that raises the risk of developing a condition, disease or symptom. For example, obese people are more likely to develop diabetes type 2 compared to people of normal weight; therefore, obesity is a risk factor for diabetes type 2.

• Age – a woman’s fertility starts to drop after she is about 32 years old, and continues doing so. A 50-year-old man is usually less fertile than a man in his 20s (male fertility progressively drops after the age of 40).
• Smoking – smoking significantly increases the risk of infertility in both men and women. Smoking may also undermine the effects of fertility treatment. Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
• Alcohol consumption – a woman’s pregnancy can be seriously affected by any amount of alcohol consumption. Alcohol abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but is thought to lower fertility in men who already have a low sperm count.
• Being obese or overweight – in industrialized countries overweight/obesity and a sedentary lifestyle are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
• Eating disorders – women who become seriously underweight as a result of an eating disorder may have fertility problems.
• Being vegan – if you are a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate, otherwise your fertility may become affected.
• Over-exercising – a woman who exercises for more than seven hours each week may have ovulation problems.
• Not exercising – leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
• Sexually transmitted infections (STIs) - chlamydia  can damage the fallopian tubes, as well as making the man’s scrotum become inflamed. Some other STIs may also cause infertility.
• Exposure to some chemicals – some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
• Mental stress – studies indicate that female ovulation and sperm production may be affected by mental stress. If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, resulting in a lower chance of conception.

What are the causes of infertility?

There are many possible causes of infertility. Unfortunately, in about one-third of cases no cause is ever identified.

Causes of infertility in women

• Ovulation disorders – problems with ovulation are the most common cause of infertility in women, experts say. Ovulation is the monthly release of an egg. In some cases the woman never releases eggs, while in others the woman does not release eggs during come cycles. Ovulation disorders can be due to:
  • Premature ovarian failure – the woman’s ovaries stop working before she is 40.
  • PCOS (polycystic ovary syndrome) – the woman’s ovaries function abnormally. She also has abnormally high levels of androgen. About 5% to 10% of women of reproductive age are affected to some degree. Also called Stein-Leventhal syndrome.
  • Hyperprolactinemia – if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality – eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk.
  • Overactive thyroid gland
  • Underactive thyroid gland
  • Some chronic conditions, such as AIDS or  cancer.
• Problems in the uterus or fallopian tubes

  The egg travels from the ovary to the uterus (womb) where the fertilized egg grows. If there is something wrong in the uterus or the fallopian tubes the woman may not be able to conceive naturally. This may be due to:

  • Surgery – pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids – benign or non-cancerous tumors found in the muscular wall of the uterus, occurring in 30% to 40% of women of childbearing age. They may interfere with implantation. They can also block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine   fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis – cells that are normally found within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment – if a woman chose to have her fallopian tubes blocked. It is possible to reverse this process, but the chances of becoming fertile again are not high .however an eight-year study showed tubal revesal surgery results in higher pregnancy and live birth rates and is less costly than IVF.
• Medications – some drugs can affect the fertility of a woman. These include:
  • NSAIDs (non-steroidal anti-inflammatory drugs) – women who take aspirin or ibuprofen long-term may find it harder to conceive.
  • Chemotherapy – some medications used in chemotherapy can result in ovarian failure. In some cases, this side effect of chemotherapy may be permanent.
• Radiotherapy – if radiation therapy was aimed near the womans reproductive organs there is a higher risk of fertility problems.
• Illegal drugs – some women who take marijuana or cocaine may have fertility problems.

Causes of infertility in men

Semen

Semen is the milky fluid that a man’s penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, seminal vesicle and other sex glands. The sperm is produced in the testicles. During orgasm a man ejaculates (releases semen through the penis). The seminal fluid helps transport the sperm during ejaculation. The seminal fluid has sugar in it – sugar is an energy source for sperm.

Abnormal semen is responsible for about 75% of all cases of male infertility. Unfortunately, in many cases doctors never find out why. The following semen problems are possible:

• Low sperm count (low concentration) – the man ejaculates a lower number of sperm, compared to other men. Sperm concentration should be 20 million sperm per milliliter of semen. If the count is under 10 million there is a low sperm concentration (subfertility).
• No sperm – when the man ejaculates there is no sperm in the semen.
• Low sperm mobility (motility) – the sperm cannot “swim” as well as it should.
• Abnormal sperm – perhaps the sperm has an unusual shape, making it more difficult to move and fertilize an egg.

Sperm must be the right shape and able to travel rapidly and accurately towards the egg. If the sperm’s morphology (structure) and motility (movement) are wrong it is less likely to be able to reach the egg and fertilize it.

The following may cause semen to be abnormal:

• Testicular infection
• Testicular cancer
• Testicular surgery
• Overheating the testicles – frequent saunas, hot tubs, very hot baths, or working in extremely hot environments can raise the temperature of the testicles. Tight clothing may have the same effect on some people.
• Ejaculation disorders – for some men it may be difficult to ejaculate properly. Men with retrograde ejaculation ejaculate semen into the bladder. If the ejaculatory ducts are blocked or obstructed the man may have a problem ejaculating appropriately.
• Varicocele – this is a varicose vein in the scrotum that may cause the sperm to overheat.
• Undescended testicle – one (or both) testicle fails to descend from the abdomen into the scrotum during fetal development. Sperm production is affected because the testicle is not in the scrotum and is at a higher temperature. Healthy sperm need to exist in a slightly lower-than-body temperature. That is why they are in the scrotum, and not inside the body.
• Hypogonadism – testosterone deficiency can result in a disorder of the testicles.
• Genetic abnormality – a man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome (Klinefelter’s syndrome) there will be an abnormal development of the testicles, low testosterone, and a low sperm count (sometimes no sperm at all).
• Mumps – this viral infection usually affects young children. However, if it occurs after puberty inflammation of the testicles may affect sperm production.
• Hypospadias – the urethral opening is at the underside of the penis, instead of its tip. This abnormality is usually surgically corrected when the male is a baby. If it is not the sperm may find it harder to get to the female’s cervix. Hypospadias occur in about 1 in every 500 newborn boys.
• Cystic fibrosis – Cystic fibrosis is a chronic disease that affects organs such as the liver, lungs, pancreas, and intestines. It disrupts the body’s salt balance, leaving too little salt and water on the outside of cells and causing the thin layer of mucus that usually keeps the lungs free of germs to become thick and sticky. This mucus is difficult to cough out, and it clogs the lungs and airways, leading to infections and damaged lungs. Males with  cystic fibrosis  commonly have a missing or obstructed vas deferens (tube connecting the testes to the urethra; it carries sperm from the epididymis to the ejaculatory duct and the urethra).
• Radiotherapy – radiation therapy can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
• Some diseases – the following diseases and conditions are sometimes linked to lower fertility in males:
  anemia
  Cushing’s syndrome
  Diabetes
  Thyroid disease
• Medications
  Sulfasalazine – this anti-inflammatory drug can significantly lower a man’s sperm count. The drug is often prescribed for patients with  crohn’s disease  or rheumatoid  arthritis . Usually this side effect goes away after the patient stops taking the medication.

  Anabolic steroids – often taken by bodybuilders and athletes; anabolic steroids, especially after long term use can seriously reduce sperm count and mobility.

  Chemotherapy – some medicines may significantly reduce sperm count.

• Illegal drugs – consumption of marijuana and cocaine can lower a man’s sperm count.

Diagnosing infertility

Most people will visit their GP (general practitioner, primary care physician) if there is no pregnancy after 12 months of trying. For anybody who is concerned about fertility, especially if they are older (women over 35), it might be a good idea to see a doctor earlier. As fertility testing can sometimes take a long time, and female fertility starts to drop when a woman is in her thirties, seeing the doctor earlier on if you are over 35 makes sense.

A GP can give the patient advice and carry out some preliminary assessments. As it takes two to make a baby it is better for both the male and female to see the doctor together.

Before undergoing testing for fertility it is important that the couple be committed. The doctor will need to know what the patients’ sexual habits are, and may make recommendations regarding them. Tests and trials might extend over a long period. Even after thorough testing, no specific cause is ever found for 30% of infertility cases.

In some countries where universal healthcare cover does not exist, evaluation and eventual treatment may be expensive.

Tests for males

• General physical exam – the doctor will ask the man about his medical history, medications, and sexual habits. The physician will also carry out an examination of his genitals. The testicles will be checked for lumps or deformities, while the shape and structure of the penis will be examined for any abnormalities.
• Semen analysis – the doctor may ask for some specimens of semen. They will be analyzed in a laboratory for sperm concentration, motility, color, quality, infections and whether any blood is present. As sperm counts can fluctuate, the man may have to produce more samples.
• Blood test – the lab will test for several things, including the man’s level of testosterone and other male hormones.
• Ultrasound test – the doctor will determine whether there is any ejaculatory duct obstruction, retrograde ejaculation, or other abnormality.
• Chlamydia test – if the man is found to have Chlamydia, which can affect fertility, he will be prescribed antibiotics  to treat it.

Tests for females

• General physical exam – the doctor will ask the woman about her medical history, medications, menstruation cycle, and sexual habits. She will also undergo a gynecological examination.
• Blood test – several things will be checked, for example, whether hormone levels are correct and whether the woman is ovulating (progesterone test).
• Hysterosalpingography – fluid is injected into the woman’s uterus which shows up in X-ray pictures. X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If the doctor identifies any problems, such as a blockage, surgery may need to be performed.
• Laparoscopy – a thin, flexible tube with a camera at the end (laparoscope) is inserted into the abdomen and pelvis to look at the fallopian tubes, uterus and ovaries. A small incision is made below the belly button and a needle is inserted into the abdominal cavity; carbon dioxide is injected to create a space for the laparoscope. The doctor will be able to detect  endometriosis , scarring, blockages, and some irregularities of the uterus and fallopian tubes.
• Ovarian reserve testing – this is done to find out how effective the eggs are after ovulation.
• Genetic testing – this is to find out whether a genetic abnormality is interfering with the woman’s fertility.
• Pelvic ultrasound – high frequency sound waves create an image of an organ in the body, which in this case is the woman’s uterus, fallopian tubes, and ovaries.
• Chlamydia test – if the woman is found to have Chlamydia, which can affect fertility, she will be prescribed antibiotics to treat it.
• Thyroid function test – according to the National Health Service (UK) between 1.3% and 5.1% of infertile women have an abnormal thyroid.

What are the treatment options for infertility?

This will depend on many factors, including the age of the patient(s), how long they have been infertile, personal preferences, and their general state of health. Even if the woman has causes that cannot be corrected, she may still become pregnant.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often. Sex two to three times per week may improve fertility if the frequency was less than this. Some fertility experts warn that too-frequent sex can lower the quality and concentration of sperm. Male sperm can survive inside the female for up to 72 hours, while an egg can be fertilized for up to 24 hours after ovulation.

Fertility treatment for men

• Erectile dysfunction or premature ejaculation – medication and/or behavioral approaches can help men with general sexual problems, resulting in possibly improved fertility.
• Varicocele – if there is a varicose vein in the scrotum, it can be surgically removed.
• Blockage of the ejaculatory duct – sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
• Retrograde ejaculation – sperm can be taken directly from the bladder and injected into an egg in the laboratory.
• Surgery for epididymal blockage – if the epididymis is blocked it can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked sperm may not be ejaculated properly.

Fertility treatment for women

• Ovulation disorders – if the woman has an ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation. These include:
  • Clomifene (Clomid, Serophene) – this medication helps encourage ovulation in females who do not ovulate regularly, or who do not ovulate at all, because of polycystic ovary syndrome (PCOS) or some other disorder. It makes the pituitary gland release more FSH (follicle-stimulating hormone) and LH (luteinizing hormone).
  • Metformin (Glucophage) – women who have not responded to Clomifene may have to take this medication. It is especially effective for women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG, (repronex ) – this medication contains both FSH and LH. It is an injection and is used for patients who don’t ovulate on their own because of a fault in their pituitary gland.
  • Follicle-stimulating hormone (gonal-f ,bravelle) – this is a hormone produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin ( ovidrel, Pregnyl) – this medication is used together with clomiphene, hMG and FSH. It stimulates the follicle to ovulate.
  • Gn-RH (gonadotropin-releasing hormone) analogs – for women who ovulate prematurely, before the lead follicle is mature enough during hmG treatment. This medication delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel) – this drug inhibits prolactin production. Prolactin stimulates milk production in breast feeding mothers. If non-pregnant, non-breast feeding women have high levels of prolactin they may have irregular ovulation cycles and have fertility problems.

Risk of multiple pregnancies

Injectable fertility drugs can sometimes be the victims of their own success and cause multiple births – when the woman gets pregnant she has twins, triplets, or perhaps more babies in one go. Oral fertility drugs also raise the risk of multiple pregnancies, but much less so than injectable ones. It is important to monitor the patient carefully during treatment and pregnancy. The more babies the mother carries inside her the higher is her risk of premature labor.

If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

Multifetal pregnancy reduction is possible if too many babies are conceived – one or more of the fetuses is removed. Couples will have to consider the ethical and emotional aspects of this procedure.

• Surgical procedures for women
  • Fallopian tube surgery – if the fallopian tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through them.
  • Laparoscopic surgery – a small incision is made in the woman’s abdomen. A thin, flexible microscope with a light at the end (laparoscope) is inserted through the incision. The doctor can then look at internal organs, take samples and perform small operations. For women with endometriosis, laparoscopy removes implants and scar tissue, reducing pain and often aiding fertility.

Assisted conception

• IUI (intrauterine insemination) - a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected. This procedure must be done when ovulation occurs. The woman may be given a low dose of ovary stimulating hormones.

  IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. The procedure is also helpful for males suffering from severe erctile dysfunction.

• IVF (in vitro fertilization) - sperm are placed with unfertilized eggs in a Petri dish; the aim is fertilization of the eggs. The embryo is then placed in the uterus to begin a pregnancy. Someitmes the embryo is frozen for future use (cryopreserved). Louise Joy Brown, born in England in 1978, was the world’s first IVF baby. Before IVF is done the female takes fertility drugs to encourage the ovaries to produce more eggs than normal.
• ICSI (Intracytoplasmic sperm injection) - a single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.
• Donation of sperm or egg – if there is either no sperm or egg in one of the partners it is possible to receive sperm or eggs from a donor. Fertility treatment with donor eggs is usually done using IVF. In the UK and a growing number of countries the egg donor can no longer remain anonymous – the offspring can legally trace his/her biological parent when reaching the age of 18.
• Assisted hatching – this improves the chances of the embryo’s implantation; attaching to the wall of the uterus. The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to leave its shell and implant into the uterine lining. Patients who benefit from assistant hatching include women with previous IVF failure, poor embryo growth rate, and older women. In some women, particularly older women, the membrane is hardened, making it difficult for the embryo to hatch and implant.
• Electric or vibratory stimulation to achieve ejaculation – ejaculation is acheived with electric or vibratory stimulation. This procedure is useful for men who cannot ejaculate normally, such as those with a spinal cord injury.
• Surgical sperm aspiration – the sperm is removed from part of the male reproductive tract, such as the vas deference, testicle or epididymis.

What are the complications of infertility treatment?

• Ovarian hyperstimulation syndrome (OHSS)

  The ovaries become very swollen, leaking excess fluid into the body. The ovaries produce too many follicles (small fluid sacs in which an egg develops). OHSS usually occurs as a result of taking medications to stimulate the ovaries, such as clomifene and gonadtrophins, and can also develop after IVF. Symptoms can include:

  • Bloating
  • constipation
  • Dark urine
  • diarrhea
  • Nausea
  • Pain in the abdomen
  • Vomiting

  In most cases symptoms are mild and easy to treat. On very rare occasions the patient may develop a blood clot (thrombosis) in an artery or vein, liver or kidney problems, and respiratory distress. In very severe cases OHSS can be potentially fatal.

• Ectopic pregnancy

  This is a pregnancy when the fertilized egg does not implant in the womb – in most cases the fertilized egg grows in the fallopian tube. If it stays in the fallopian tube the mother will usually miscarry before complications develop, such as the rupture of the fallopian tube. Women receiving fertility treatment have a slightly higher risk of having an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.

• Coping mentally

  As it is impossible to know how long treatment will go on for and how successful it will be, coping and persevering can be stressful. The emotional toll on both partners might be considerable and can have an impact on their relationship. Some people find that joining a support group helps – being able to talk to others who share similar problems, aspirations and  anxieties  can be uplifting. It is important to tell your doctor if you are suffering mentally and/or emotionally. Most fertility doctors have access to counselors, as well as other people and professionals who can offer helpful support.

For people with allergies and asthma, toasting the New Year could result in more than a hangover; it could also set off a variety of unpleasant reactions, warns an organization of allergists.

“It is usually not the alcohol itself that produces the reaction. It is most likely ingredients, such as sulfur dioxide [metabisulfite], yeast and additives. Common allergic reactions include hives, skin rashes, flushing and warmth of the skin, bronchospasm or shortness of breath, especially in those with asthma,” Dr. Clifford W. Bassett, chairman of the American Academy of Allergy, Asthma & Immunology’s Public Education Committee, said in a news release.

Sulfur dioxide is naturally produced during the production of wine and can cause allergic reactions when people drink wine, the experts say. It has the same effects when allergic people eat foods in which it’s used as a preservative, such as baked goods, condiments, shellfish and canned foods such as tomatoes and fruit juices.

Histamine, generated by bacteria and yeast in alcohol, can also cause allergic reactions and result in a runny or stuffy nose, itchy and watery eyes and worsening asthma symptoms. These symptoms can be worse inred wine as compared to white wine, the allergists noted.

Beer can also cause allergic symptoms because of ingredients such as barley, corn, wheat and rye, they added.

What is acne?

Acne is a disorder that causes outbreaks of skin lesions commonly called pimples. It is caused by the skin’s oil glands making too much sebum, an oily substance, which leads to plugged pores. It also can be caused by the rapid production of a bacteria P. acnes.

Acne lesions occur mostly on the face, neck, back, chest, and shoulders. It is the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring and permanent scarring.

How does acne affect women?

Most young women and men will have at least a few pimples over the course of their lives. But acne seems to affect men and women in different ways. Young men are more likely to have a more serious form of acne. Acne in young women tends to be more random and linked to hormone changes, such as the menstrual cycle.

As women get older, acne often gets better. But some women have acne for many years. Some women even get acne for the first time at age 30 or 40.

For many women, acne can be an upsetting illness. Women may have feelings of depression, poor body image, or low self-esteem. But you don’t have to wait to outgrow acne or to let it run its course. Today, almost every case of acne can be resolved. Acne also can, sometimes, be prevented. Talk with your doctor or dermatologist (a doctor who specializes in treating skin problems) about how you can help prevent acne and if treatment would help you.

What are the different types of acne lesions?

• Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it’s called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.
• Pustules or pimples. Pustules or pimples are acne lesions that contain pus and are red at the base.
• Nodules. These are more serious acne lesions. They lodge deeper in the skin, are painful, and can cause scarring.
• Cysts. Like nodules, these lesions are deep within in the skin, are painful, and are filled with pus, and can cause scarring.

What triggers acne in women?

Many things can trigger acne in women:

• Hormone changes during puberty. During puberty, girls have an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.
• Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
• Medicines. Certain medicines, such as those used to treat epilepsy and types of depression.
• Make-up.
• Pressure or friction on the skin. Friction caused by bike helmets or backpacks can make acne worse.
• Family history. If other people in your family have acne, there is a greater chance you will have it.

Does poor hygiene cause acne?

It is a myth that women get acne because they don’t wash enough. Too much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn’t do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.

Can stress cause acne?

Stress does not cause acne. But, acne may be a side effect of some medicines used to treat stress or depression. And in some cases, the social and emotional impact of acne lesions causes stress. Talk with your doctor if you have concerns.

Can eating chocolate or greasy foods cause acne?

While many women feel that eating chocolate or greasy foods causes acne, experts have not found a link between the diet and acne. Foods seem to have little effect on acne in most people. But, it’s important to eat a healthy diet for good health.

How is mild acne treated?

There are many treatments for mild acne. Mild acne can consist of whiteheads, blackheads and small pustules. At home, you can wash your face twice per day with warm water and a gentle cleanser or soap. Your doctor may suggest you also try an over-the-counter lotion or cream. These medicines may make your skin dry if you use them too much. Be sure to follow the directions.

If these medicines don’t work, your doctor may prescribe a cream or lotion with benzoyl peroxide, resorcinol, salicylic acid, or sulfur.

• Benzoyl peroxide works to reduce oil made by the glands.
• Resorcinol, salicylic acid, and sulfur help breakdown whiteheads and blackheads.

If your acne does not get better after six to eight weeks, talk with your doctor about changing your treatment.

Can more serious forms of acne be treated?

Yes. Work with your doctor to find the best treatment for you.

Moderate to moderately severe acne. This type of acne consists of several whiteheads, blackheads, papules and pustules that cover from � to � of the face and/or other parts of the body. It can be treated with antibiotic lotions or gels, as well as retinoic acid. Retinoic acid is an altered form of vitamin A. It helps prevent whiteheads and blackheads. Your doctor may also prescribe an antibiotic pill, such as erythromycin. If you take birth control pills to prevent pregnancy, antibiotics can affect how well they work. Be sure to use a second method of birth control with the pill, such as a condom. Retinoic acid and antibiotic pills can make the skin sensitive to the sun. So, wear sunscreen and stay in the shade while using them.

Severe acne. Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.

Your dermatologist may prescribe Accutane�, if other treatments have not worked. This is a strong medicine that can help prevent scarring and treat active disease. But, Accutane also can cause birth defects. It is important that you are not pregnant and do not plan to get pregnant while taking this medicine. You must use two methods of birth control at the same time. This is done for one month before treatment begins, during treatment, and for a full month after stopping the drug. Talk with your dermatologist about when it’s safe to get pregnant. Other side effects of this drug may include dry eyes, itching, mood changes, and changes in the blood and liver. You and your dermatologist can decide whether this medicine is right for you based on the pros and cons. Use any prescribed medicine exactly as you are advised. Taking more medicine than you are supposed to take may make acne or your general health worse. Ask your doctor what to do if you miss a dose.

Some large cysts do not respond to medication and may need to be drained or removed. Your dermatologist is the only person who should drain or remove these. You should never try to drain or remove your acne by squeezing or picking. This can lead to infection, worsen your acne, and cause scarring.

Overall, if you don’t see a change in your skin in six to eight weeks, talk with your doctor about your treatment plan.

Can birth control pills help treat acne?

For women who break out mainly around their menstrual cycle, some birth control pills can help. Research shows that these pills can clear acne by slowing down overactive oil glands in the skin. Sometimes, birth control pills are used along with a drug called spironolactone to treat acne in adult females. This medication lowers levels of the hormone androgen in the body. Androgen stimulates the skin’s oil glands. Side effects of this drug include irregular menstruation, breast tenderness, headache and fatigue. Spironolactone is not appropriate therapy for all patients.

When is surgery used for acne scarring?

If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring. A laser can reshape scar tissue and reduce redness. Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars. Another option is to transfer fat from one part of the body to the face. In some cases, a single treatment can help scarring. But for lasting results, several are often needed. There are also topical treatments for acne scarring.

Photodynamic therapy is a new acne treatment. It begins with light microdermabrasion. This is used to remove dead skin cells on the face’s surface. Then, an acid is put on the skin for 30 to 60 minutes. After this period, the acid is taken off. Lastly, the skin is treated with a laser. This treatment is still being researched, but seems to give positive long-term results.

How can I help prevent acne and acne scars?

You can help prevent acne flare-ups and scars by taking good care of your skin:

• Clean your skin gently with a mild soap or cleanser twice a day?once in the morning and once at night. You should also gently clean the skin after heavy exercise. Avoid strong soaps and rough scrub pads. Harsh scrubbing of the skin may make acne worse. Wash your entire face from under the jaw to the hairline and rinse thoroughly. Remove make-up gently with a mild soap and water. Ask your doctor before using an astringent.
• Wash your hair on a regular basis. If your hair is oily, you may want to wash it more often.
• Do not squeeze or pick at acne lesions. This can cause acne scars.
• Avoid getting sunburned. Many medicines used to treat acne can make you more prone to sunburn. Many people think that the sun helps acne, because the redness from sunburn may make acne lesions less visible. But, too much sun can also increase your risk of skin cancer and early aging of the skin. When you’re going to be outside, use sunscreen of at least SPF 15. Also, try to stay in the shade as much as you can.
• Choose make-up and hair care products that are �non-comedogenic� or �non-acnegenic.� These products have been made in a way that they don’t cause acne. You may also want to use products that are oil-free.
• Avoid things that rub the skin as much as you can, such as backpacks and sports equipment.
• Talk with your doctor about what treatment methods can help your acne. Take your medicines as prescribed. Be sure to tell your doctor if you think medicines you take for other health problems make your acne worse.

Is rosacea the same as acne?

Rosacea is a common skin problem often called �adult acne.� Fair-skinned and menopausal women are more likely to have rosacea. Rosacea also seems to run in families. It causes redness in the center parts of the face and pimples. Blood vessels under the skin of the face may enlarge and show through the skin as small red lines. The skin may be swollen and feel warm.

Women with rosacea don’t have the same lesions as seen with common acne. They may have flushing of the face, when they are hot, drink alcohol or hot drinks, or eat spicy foods. This flushing causes the face to appear red. In the most severe form, this redness does not go away. The eyes may become swollen and nodules in the skin may be painful.

You can help keep rosacea under control by keeping a record of things that cause it to flare up. Try to avoid or limit these triggers as much as you can. Antibiotic lotions or gels can also help. Sometimes, you may need to take antibiotic pills. Your dermatologist may treat you with laser surgery. If you think you have rosacea, talk with your doctor about these treatments

Q. I have been suffering from back pain for the past two months. I have tried several treatments. Any ideas? I don’t have a history of back pain. I started to experience pain in my shoulders, neck and upper back about two months ago. Prior to the condition I started to work out with a personal trainer, but I felt good for three months, so the doctor and I don’t think there is a connection. I tried many types of massages, chiropractic treatment, and Acupunctures. I also went to an orthopedic MD. The doctor prescribed Arxocia for ten days and another round of Arxocia pills . I still have pain in my shoulders and neck. Any ideas what can I do. The doctor says it’s nothing serious and that it’s called upper back pain and that it will pass with time. Any ideas to ease the pain and treat this?

Q. How can I get my doctor to believe me about my back and neck pain and the numbness in my hand? My doctor referred me to a pain clinic and I waited 2 months for the appointment. So i went to the appointment and the doctor was very short with me and asked me why I was there even though I had just given my complete history to his nurse 5 minutes earlier. i said I wanted to know what was wrong with my back and if it could be fixed. He said we don’t do that here and looked at a cat scan of my neck from a year and a half prior and an x ray of my back from 4 months prior. He said there is nothing wrong with me and told me to have a nice day. i asked if he could at least send me for an MRI and he gave me a prescription for one and said his nurse would make the appointment for me. I’m still waiting for the appointment. The other thing is is that I am on medicaid and filed for disability because I can not work. I just can’t find a doctor to help me. I’m very frustrated.

The best way to prevent novel H1N1 swine flu would be the same best way to prevent other influenza infections, and that is vaccination. The CDC has multiple recommendations for vaccination based on who should obtain the first doses when the vaccine becomes available (to protect the most susceptible populations) and according to age groups. The CDC based the recommendations on data obtained from vaccine trials and infection reports gathered over the last few months. The current (October 2009) vaccine recommendations from the CDC say the following groups should get the vaccine as soon as it is available:

• pregnant women,
• people who live with or provide care for children younger than 6 months of age,
• health-care and emergency medical services personnel,
• people between 6 months and 24 years of age, and
• people from the ages of 25 through 64 who are at higher risk because of chronic health disorders such as asthma, diabetes, or a weakened immune system.

Currently, the CDC is stating that people ages 10 and above are likely to need only one vaccine shot to provide protection against novel H1N1 swine flu and further suggest that these shots will be effective in about 76% of people who obtain the vaccine. New vaccine trial data showed that healthy adults produce protective antibodies in about 98% of people in 21 days. Unfortunately, the vaccine shot in children ages 6 months to 9 years of age is not as effective as it is in older children and adults. Consequently, the CDC currently recommends that for ages 6 months up to and including 9 years of age, the children obtain two shots of the novel H1N1 vaccine, the second shot 21 days after the first shot.

Pregnant women are strongly suggested to get vaccinated as stated above. Although some vaccine preparations (multidose vials) contain low levels of thimerosal preservative (a mercury-containing preservative), the CDC still considers the vaccine safe for the fetus and mother. However, some vaccine preparations that are in single-dose vials will not have thimerosal preservative, so those pregnant individuals who are concerned about thimerosal can get this vaccine preparation when it is available.

Another type of vaccine (currently named Influenza A [H1N1] 2009 Monovalent Vaccine Live, Intranasal) has been made available during the first week in October 2009. It is a live attenuated novel H1N1 flu vaccine that contains no thimerosal, is produced by MedImmune, LLC, and is sprayed into the nostrils. This vaccine is only for healthy people 2-49 years of age, and some data suggest that it is less effective in generating an immune response in adults than the vaccine injection. The dosing schedule is as follows:

• Children 2-9 years of age should receive two doses (0.1 ml in each nostril; total equals 0.2 ml per dose) — the second dose should be given the same way about one month after the first dose
• Children, adolescents and adults, 10-49 years of age should receive one dose — (0.1 ml in each nostril; total equals 0.2 ml per dose)

The CDC occasionally makes changes and updates its information on vaccines and other recommendations about the current flu pandemic. The CDC states, “for the most accurate health information, visit http://www.cdc.gov or call 1-800-CDC-INFO, 24/7.” Caregivers should check the vaccine package inserts for more detailed information on the vaccines when they become available. This article has an updated timeline for novel H1N1 swine flu attached (see below) and provides the reader with current details about the pandemic. The following is a list of the CDC-approved H1N1 vaccines and the companies that name and manufacture them as of 10/29/09:

• Influenza A (H1N1) 2009 Monovalent Vaccine by Sanofi Pasteur
• Influenza A (H1N1) 2009 Monovalent Vaccine by Novartis
• Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal by MedImmune, LLC
• Influenza A (H1N1) 2009 Monovalent Vaccine by CSL Limited

The CDC says that a good way to prevent any flu disease is to avoid exposure to the virus; this is done by frequent hand washing, not touching your hands to your face (especially the nose and mouth), and avoiding any close proximity to or touching any person who may have flu symptoms. Since the virus can remain viable and infectious for about 48 hours on many surfaces, good hygiene and cleaning with soap and water or alcohol-based hand disinfectants are also recommended. Some physicians say face masks may help prevent getting airborne flu viruses (for example, from a cough or sneeze), but others think the better use for masks would be on those people who have symptoms and sneeze or cough. The use of Tamiflu or Relenza may help prevent the flu if taken before symptoms develop or reduce symptoms if taken within about 48 hours after symptoms develop. Some investigators say that administration of these drugs is still useful after 48 hours, especially in high-risk patient populations .However, taking these drugs is not routinely recommended for prevention for the healthy population because investigators suggest that as occurs with most drugs, flu strains will develop resistance to these medications. Recently, the CDC made further suggestions about the use of these antiviral medications. Dr. Schuchat, a CDC official, indicated that three modifications were being suggested (Sept. 8, 2009) to the interim guidelines for use of Tamiflu and Relenza:

1. Patients with high-risk factors should discuss flu symptoms and when to use antiviral medications; doctors should provide a prescription for the antiviral drug for the patient to use if the patient is exposed to flu or develops flu-like symptoms without having to go in to see the doctor.

2. “Watchful waiting” was added as a response to taking antiviral medications, with the emphasis on the fact that those people who develop fever and have a preexisting health condition should then begin the antiviral medication.

3. The antiviral medications are the first-line medicines for treatment of novel H1N1 swine flu, and most current cases of flu are novel H1N1 and are, to date, susceptible to Tamiflu and Relenza.

Your doctor should be consulted before these drugs are prescribed.

In general, preventive measures to prevent the spread of flu are often undertaken by those people who have symptoms. Symptomatic people should stay at home, avoid crowds, and take off from work or school until the disease is no longer transmittable (about two to three weeks) or until medical help and advice is sought. Sneezing, coughing, and nasal secretions need to be kept away from other people; simply using tissues and disposing of them will help others. Quarantining patients is usually not warranted, but such measures depend on the severity of the disease. The CDC recommends that people who appear to have an influenza-like illness upon arrival at work or school or become ill during the day be promptly separated from other people and be advised to go home until at least 24 hours after they are free of fever (100 F [37.8 C] or greater), or signs of a fever, without the use of fever-reducing medications. The novel H1N1 swine flu disease takes about seven to 10 days before fevers stop, but new research data (Sept. 14, 2009) suggests waiting until the cough is gone since many people are still infectious about one week after fever is gone. The CDC has not yet extended their recommendations to stay home for that extra week.

In 1976, there was an outbreak of swine flu at Fort Dix. This virus is not the same as the 2009 outbreak, but it was similar insofar as it was an influenza A virus that had similarities to the swine flu virus. There was one death at Fort Dix. The government decided to produce a vaccine against this virus, but the vaccine was associated with neurological complications (Guillain-Barré syndrome) and was discontinued. Some individuals speculate that formalin, used to inactivate the virus, may have played a role in the development of this complication in 1976. There is no evidence that anyone who obtained this vaccine would be protected against the 2009 swine flu. One of the reasons it takes a few months to develop a new vaccine is to test the vaccine for safety to avoid the complications seen in the 1976 vaccine. New vaccines against any flu virus type are usually made by growing virus particles in eggs. A serious side effect (allergic reaction such as swelling of the airway) to vaccines can occur in people who are allergic to eggs; these people should not get flu vaccines. Individuals with active infections or diseases of the nervous system are also not recommended to get flu vaccines.

The best treatment for influenza infections in humans is prevention by vaccination. Work by several laboratories has recently produced vaccines. The first vaccine released in early October 2009 was a nasal spray vaccine. It is approved for use in healthy individuals ages 2 through 49. This vaccine consists of a live attenuated H1N1 virus and should not be used in anyone who is pregnant or immunocompromised. The injectable vaccine, made from killed H1N1, became available in the second week of October. This vaccine is approved for use in ages 6 months to the elderly, including pregnant females. Both of these vaccines have been approved by the CDC only after they had conducted clinical trials to prove that the vaccines were safe and effective. However, caregivers should be aware of the vaccine guidelines that come with the vaccines, as occasionally, the guidelines change. Please see the sections below titled “Can novel H1N1 swine flu be prevented with a vaccine?” and the timeline update for the current information on the vaccines.

Two antiviral agents have been reported to help prevent or reduce the effects of swine flu. They are zanamivir (Relenza) and oseltamivir (Tamiflu), both of which are also used to prevent or reduce influenza A and B symptoms. These drugs should not be used indiscriminately, because viral resistance to them can and has occurred. Also, they are not recommended if the flu symptoms already have been present for 48 hours or more, although hospitalized patients may still be treated past the 48-hour guideline. Severe infections in some patients may require additional supportive measures such as ventilation support and treatment of other infections like pneumonia that can occur in patients with a severe flu infection. The CDC has suggested in their interim guidelines that pregnant females can be treated with the two antiviral agents.

Anxiety is manifest by disturbances of mood, thinking and behavior. It is debilitating and should not be taken lightly

Anxiety disorders are possibly the most common and frequently occurring mental disorders. They include a group of conditions that share extreme anxiety as the principal disturbance of mood or emotional tone. Anxiety, which may be understood as the pathological counterpart of normal fear, is manifest by disturbances of mood, as well as of thinking, behavior and physiological activity. Included in this category are panic disorder (with or without a history of agoraphobia), agoraphobia (with or without a history of panic disorder), generalized anxiety disorder, specific phobia, social phobia, obsessive-compulsive disorders,acute stress disorder and post-traumatic stress disorder.

Anxiety disorders are ubiquitous across human cultures. The longitudinal course of these disorders is characterized by relatively early ages of onset, chronicity, relapsing or recurrent illness and periods of disability. Panic disorder and agoraphobia are particularly associated with suicidal tendencies.

PANIC ATTACKS

A panic attack is a period of intense fear or discomfort that is associated with numerous physical and psychological symptoms such as:
• Palpitations
• Sweating
• Trembling
• Shortness of breath
• Sensations of choking or smothering
• Chest pain
• Nausea or gastrointestinal distress
• Dizziness
• Tingling sensations
• Chills or blushing
• Hot flashes

The attack typically has an abrupt onset, building to maximum intensity within 10 to 15 minutes. Most people report a fear of dying or a loss of control over emotions and behavior. This generally evokes a strong urge to flee the place where the attack begins and, when associated with chest pain  or shortness of breath, frequently leads to  seeking urgent assistance from a hospital emergency room. Yet an attack rarely lasts for more than 30 minutes. According to current diagnostic practice, a panic attack must be characterized by at least four of the associated physical and psychological symptoms described above. The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature.

Panic attacks are not always indicative of a mental disorder, and up to 10 per cent of otherwise healthy people experience an isolated panic attack per year

PANIC DISORDER

When a person has experienced at least two unexpected panic attacks, develops persistent concern or worries about having further attacks or changes his or her behavior to avoid such attacks, he is diagnosed with panic disorder. Whereas the number and severity of the attacks varies widely, concern and avoidance behavior are essential features. The diagnosis is inapplicable, however, when the attacks are caused by drugs or medication or by another disorder, such as hyperthyroidism.

COMPLICATIONS

Major depressive disorder, alcoholism and substance abuse  frequently complicate panic disorder. Panic disorder also co-occurs with other specific anxiety disorders, including social phobia (up to 30 per cent), generalized anxiety disorder (up to 25 per cent), specific phobia (up to 20 per cent), and obsessive-compulsive disorder (up to 10 per cent.) Approximately half the people with panic disorder at some point develop such severe avoidance as to warrant a separate description.

Panic disorder is about twice as common among women as men. Age of onset is mostly between late adolescence and mid-adulthood, with the onset relatively uncommon past the age of 50. Typically, an early onset of panic disorder carries greater risks of chronicity and impairment. Panic disorder also occurs as a familial condition.

AGORAPHOBIA

The ancient term ‘agoraphobia’ is translated from Greek as ‘fear of an open marketplace’. Agoraphobia today describes severe and pervasive anxiety about being in situations from which escape might be difficult or avoidance of situations such as being alone outside one’s home, traveling in a car, bus, or airplane, or being in a crowded area.

ANXIETY DISORDERS

The likelihood of developing anxiety involves a combination of life experiences, psychological traits, and genetic factors. There are several major psychological theories explaining anxiety-psychoanalytic, psycho-dynamic, behavioral and cognitive theories. Anxiety disorders are so heterogeneous that the relative roles of these factors are likely to differ. Some anxiety disorders, like panic disorder, appear to have a stronger genetic basis than others, although actual genes have not been identified. Other anxiety disorders are more rooted in stressful life  events.

It is not clear why more women than men suffer from anxiety disorders, although some theories have suggested the possible role of steroids. Research on women’s responses to stress suggests that women experience a wider range of life events that are stressful as compared to men.

TREATMENT

• Counseling and Psychotherapy
Anxiety disorders are responsive to counseling and to a wide variety of psychotherapies. During the past several decades, there has been an increasing enthusiasm for focused, time-limited therapies that address ways of coping with anxiety symptoms directly, rather than exploring unconscious conflict or other personal vulnerabilities.

• Pharmacotherapy
The medications typically used to treat patients with anxiety disorders benzodiazepines, antidepressants and newer compounds such as buspirone.

• Combination Treatment
Some patients with anxiety disorders may benefit both from psychotherapy  and pharmacotherapy treatment, either combined or used in sequence. It is likely that such combinations are not uniformly necessary and are probably more cost-effective when reserved for patients with more complex, complicated or severe disorders.

Panic disorders are extremely debilitating and common, yet respond well to treatment if started early enough in the course of the disease. It is not a condition to be taken lightly in view of its effect on the quality of the sufferer’s life.

Depression is  traditionally been considered a female disorder. But, men can and do get depressed. The big difference is that men may be less likely to seek treatment for depression because they see mental illness as a sign of weakness.

Depression is not a sign of weakness, however. It is a disease with biochemical causes. More than 17 million Americans suffer from depression every year, according to the American Psychiatric Association (APA). And, the APA estimates that at least one out of every 10 men will have depression during their lifetime.

The Stigma

Many of those men will never get treated for their depression for a variety of reasons. The most important is that men are less willing to admit depression, according to Teodoro Bottiglieri, Ph.D., a senior research scientist and associate professor at Baylor University Medical Center and the author of Stop Depression Now. “There is a stigma attached to having any psychiatric illness. It’s a point of vulnerability, like admitting you’re impotent in public,”

Men, he said, are taught to just grin and bear it, get on with life and provide for their families. Dr. Norman Sussman, a psychiatrist at New York University Medical Center, agrees. “Men are less likely to seek treatment, in part because there’s a tendency for men to tough it out,” she says.

It’s important for men to realize that “depression is a medical disorder that affects one’s ability to feel and think in certain ways. It’s a form of reversible brain failure,” says Sussman. “It’s not an indication of their character.”

The problem with not coming forward is that depression tends to get worse, and affects all areas of a man’s life. Many men will self-medicate with alcohol or drugs, says Sussman. And, men — especially older men — have higher rates of suicide than women do.

Another reason men don’t get treatment may be that their doctors are missing the signs of depression. Sussman says it’s possible that there may be a biased tendency in diagnosing depression, with doctors looking for it more in women than in men because the disease is so much more prevalent in women. Men also tend to downplay their symptoms if they discuss them with their doctors at all.

Depression, particularly in older men, may not always be obvious, says Dr. Steven Roose, a professor of clinical psychiatry at Columbia University and the director of the Neuropsychiatric Research Clinic at the New York State Psychiatric Institute. He says the symptoms are a little bit different, with older men reporting sleep disturbances, pain and loss of energy. Older men may not complain about having a depressed mood, he says. And many primary care physicians lack the training to recognize that it’s depression. According to Roose, suicide is an epidemic in men over 60 — 20 percent of older men who attempted suicide had seen their doctor that day, and 70 percent had seen their doctor during the month leading up to their suicides.

“A review of mood state and ruling out the diagnosis of depression should be as much a standard procedure as taking a blood pressure,” says Roose.

Roose adds that undiagnosed depression can also affect other areas of health. For example, men diagnosed with heart disease who are also depressed do much worse in terms of survival, according to Roose.

Signs and Symptoms

• It’s important that family members — particularly spouses — be on the lookout for signs of depression, says Bottiglieri, because many depressed people will not seek help.
• Symptoms include:
• sad mood that lasts for more than two weeks
• feelings of hopelessness
• lack of enjoyment from everyday activities, such as playing with children or playing golfchanges in sleep patterns
• changes in appetite
• trouble concentrating and making decisions
• preoccupation with death and thoughts of suicide

In more severe cases of depression, people can be agitated or very lethargic. Eventually, they may be unable to function in their daily routine

Treatment

There are a number of medications available to treat depression and according to the APA, up to 90 percent of those treated have significant improvements. Treatment options include tricyclic antidepressants, MAO inhibitors, and the very popular selective serotonin reuptake inhibitors or SSRIs, like Prozac and Zoloft. Alternative treatments such as St. John’s Wort and SAM-e are also available. Psychotherapy is sometimes useful in treating depression, though it is most effective when used in conjunction with medication. But, Sussman says, some men have difficulty opening up in psychotherapy

The problem with some of the medical treatments is that they cause other problems, such as a loss of interest in sex. “SSRIs are well tolerated and safe, but they do have an effect on quality of life,” says Sussman. Depending on which medication you take, side effects can include a loss of libido, difficulty or an inability to achieve orgasm, sleep problems, weight gain and a lack of feeling the full range of emotions. Tricylcic antidepressants may have dangerous interactions with heart medication.

“Patients should be told up front of the likelihood of side effects happening,” says Sussman. “But, in primary care, people are often not forewarned.”

Patients need to talk to their doctors about side effects because there are many choices out there, and if one medication produces unpleasant side effects, it’s possible a different medication may not.

SSRIs can also have unexpected benefits. They are fairly effective at treating premature ejaculation, which may be something a man hasn’t even discussed with his doctor. Also, according to Roose, they seem to have an antiplatelet effect similar to that of aspirin. So, while taking a medication to cure depression, men may also be improving their cardiovascular health.

St. John’s Wort and SAM-e have also been used to treat depression. St. John’s Wort doesn’t appear to be as effective as was once believed, says Bottiglieri. He says it depends a lot on the dose taken and the actual amount of St. John’s Wort in the product.

However, Bottliglieri does believe that SAM-e can be very useful in treating depression and says it’s often used as a first-line treatment in Europe. It also has fewer side effects than other medications.�He adds that dietary supplements like SAM-e have been criticized because doctors fear patients will self-medicate themselves instead of seeking help. But, he feels they have a place.

“At least they have a choice of something that may help if they’re the type of person that won’t seek help anyway,” he says. He recommends 400 milligrams per day for mild depression, and for more severe depression, he recommends 800-1200 milligrams.�

SAM-e also may work well in conjunction with SSRIs and may reduce the need for a high dose of the SSRI. Such a combination would have to be prescribed and monitored by a physician, however.

“Men really should seek medical attention for their depression. It is a life threatening situation that needs to be properly diagnosed and monitored,” says Bottiglieri.

Roose concurs. “Depression is an illness and men should not feel it results from weakness. It doesn’t reflect on their character any more than a broken leg does,” he says.

Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.

First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus’ antigenic makeup over time (usually years).

Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a “mixing pot” for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.

Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S. and has been recognized by pork producers and veterinarians to cause infections in pigs worldwide. In a number of instances, people have developed the swine flu infection when they are closely associated with pigs (for example, farmers, pork processors), and likewise, pig populations have occasionally been infected with the human flu infection. In most instances, the cross-species infections (swine virus to man; human flu virus to pigs) have remained in local areas and have not caused national or worldwide infections in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change. Investigators think the 2009 swine flu strain, first seen in Mexico, should be termed novel H1N1 flu since it is mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1). Recent investigations show the eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains.

With some work, and patience you can overcome panic and anxiety disorders.  You already know how nerve-wracking it can be to have a panic attack.  Sometimes the fear of getting another panic attack can take over your life and get in the way of everyday things.  It can even get to the point of feeling like nothing can give you panic attack relief.

Since no two people are the same, there are many paths to recovery.   Depending on where you are right now, you may need to try many things before you find what works for you.  But here are a few pointers that you might find helpful no matter where you are.

Identify the trigger — Firstly, you will want to find what is triggering your panic attack to begin with.  Some people will say that their panic attacks don’t have a trigger.  Although it may seem that way, if you look just a little deeper, you may notice that they follow periods of high stress, such as working late nights to finish a project or studying for an exam.  Once you identify the cause, you can begin working on that problem. Keeping track in a journal, look back on a time in your life when you would have panic attacks and look for patterns.

Lifestyle Adjustment –  An important part in panic attack relief is adapting your lifestyle.  Make sure that you adopt a healthy diet, get some form of regular exercise, and remain well-rested.  Don’t overlook how these simple changes can help you improve your stamina.  Make sure to limit the amounts of caffeine, nicotine, and sugar you take in as well.  They can make you tense and jumpy, possibly triggering a panic attack.

Reduce Stress — You can make your life much easier by removing unneeded stress.  Cut out the things that just build up aren’t that important anyway.  Also, take some time to do some relaxing things like going for walks, listening to soothing music, or meditating.  Taking some time to focus on yourself can be very beneficial for you too.

Find Help — Think of someone that you feel comfortable with and whom you trust–maybe a friend or professional therapist.  The above points will help you to find relief from panic attacks can take you a long way, but don’t discount the benefits of sharing your experience with someone you trust.  Make sure you feel comfortable with this person and make sure that they are non-judgmental of your problem.

Use the above advice to help you in your recovery from panic attacks.  Panic attacks and anxiety disorders can be quite terrifying, but you can take control of your life and regain your confidence.

Natural remedies can tackle high diastolic blood pressure but doctor may suggest medicines to lower down. If high diastolic blood pressure is not treated by the doctor it may damage organs in the body.

High Diastolic Blood Pressure Remedy:Medicines

Coenzyme Q10 (CoQ10): There is some proof that the supplementations CoQ10 may help to bring down high diastolic blood pressure. This is one of the high diastolic blood pressure remedy. A 12 week test, placebo-controlled trial of many people with systolic hypertension proved the result of CoQ10 supplements (60 mg twice daily). After the 12 weeks, there was a average reduction in systolic blood pressure of 17.8 mm Hg in the Coq10-treated group.
Garlic: This is another high diastolic blood pressure remedy. In a meta-analysis of seven irregular checked trials of garlic supplementations, three trials showed a substantial decrease in systolic blood pressure and four in diastolic blood pressure. Researchers reasoned out that garlic powder supplementation may be of objective use in patients with gentle high blood pressure.

Garlic supplementations should only be used under the inspection of a certified health practician. Garlic can reduce the blood (reduce the power of blood to clot) similar to aspirin. Garlic may act with numerous drugs and supplements such as the prescription drug “blood-thinners” drugs such as Coumadin (warfarin) or Trental (pentoxifylline), aspirin, vitamin E, gingko. It is normally suggested that people taking garlic stop in the weeks ahead and after any kind of surgery.
Hawthorn: The herb hawthorn is oft used by traditional herbal practicians for high diastolic blood pressure. This is used for high diastolic blood pressure remedy. In an irregular checked trial carried on by researchers in Reading, UK, some patients with type 2 diabetes were randomized to have either 1200 mg of hawthorn extract a day or placebo for 16 weeks. Medicine for high diastolic blood pressure was taken by most of the patients. At the last of the 16 weeks, patients taking the hawthorn supplementation had a substantial reduction in average diastolic blood pressure (2.6 mm Hg). No herbal drug interactions were reported.

Fish oil: Preliminary studies recommend that fish oil may have a low effect on high diastolic blood pressure. Though fish oil supplementations oft contain both DHA (docohexaenoic acid) and EPA (eicosapentaenoic acid), there is some proof that DHA is the component that lowers high diastolic blood pressure.
Folic acid: Folate is a B vitamin essential for shaping of red blood cells. It may help to lower high diastolic blood pressure in some people, potentially by decreasing raised homocysteine levels.
Four weeks of folic acid supplementation significantly lowered blood pressure and this is found in a small study of 24 cigarette smokers.

Sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) are prevalent all over the world and Nepal is not an exception. Most of these have even been associated with adverse outcome and increased susceptibility to HIV infection as well as cervical cancer, in addition to the discomfort caused by the inflammation of the genital tract. However, vaccines against these infections have not yet been developed. But HepatitisB and Human Papilloma Virus are exceptions: one can be immune to these infections by getting the prescribed doses of vaccination.

Many are aware of Hepatitis B infection and vaccination against it thanks to the various awareness campaigns regarding it. “Vaccination against Hepatitis B is even in the national programme of immunisation and given along with DPT at six, 10 and 14 weeks after birth,” informs Dr Alish Prajapati, medical officer at Maiti Nepal. However, only a very few people know about Human Papilloma Virus and the vaccine available against it.

Hepatitis B
What is Hepatitis B?
Hepatitis B is a potentially serious disease attacking one’s liver, and is transmitted through interpersonal exchange of bodily fluids, unprotected vaginal, oral or anal sex, infected mother to an unborn child, use of infected needles, and receiving of contaminated blood and tissues and/or organs.

How can we prevent Hepatitis B?
The best way to prevent the contraction of Hepatitis B is to get a Hepatitis vaccination. It is especially important to vaccinate newborns and infants. If vaccinated properly, you are protected for life against the disease. In order to prevent contraction of Hepatitis B, abstain from sex with infected partners. It is also important to minimise the number of sexual partners that you have. Though condoms have not been proven to safeguard against Hepatitis B, their proper use may reduce the risk of infection. Avoid sharing razors, toothbrushes and other personal items with others. Check into all health practices before you get a tattoo or piercing. If you are a health or medical worker, ensure you follow the proper safety procedures when handling potentially infectious materials. If you already have Hepatitis B or have had it in the past, do not donate blood, tissues or organs.

How effective is the vaccine?
After three properly administered doses of vaccine, at least nine out of 10 healthy young adults and more than nine out of 10 infants, children, and adolescents develop protective antibodies and subsequent immunity to Hepatitis B infection.
Hepatitis B vaccines are available in all health clinics and hospitals.

Human Papilloma Virus (HPV)
What is HPV Infection?
Genital Human Papilloma virus (also called HPV) is one of the most common sexually transmitted infections. There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it. Most people with HPV do not develop symptoms or health problems from it. In 90 percent of cases, the body’s immune system clears HPV naturally within two years.

However, certain types of HPV can cause genital warts in men and women. Other HPV types can cause cervical cancer. These types can also cause other less common but serious cancers including cancers of the vulva, vagina, penis, anus, and head and neck (tongue, tonsils and throat).

How can we prevent HPV infection?
Vaccines can protect against some of the most common types of HPV.

Who should take the HPV vaccine?
Centres for Disease Control and Prevention (CDC) (www.cdc.gov) recommend the HPV vaccine for all girls aged 11 and 12 years. The recommendation also allows for the vaccination to begin at age nine. It is also recommended for females aged 13 through 26 years who have not been previously vaccinated or who have not completed the full series of shots.

However, anyone who has ever had a life-threatening allergic reaction to yeast, to any other component of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine. Consult your doctor if the person getting the vaccine has any severe allergies. Pregnant women should not take the vaccine. The vaccine appears to be safe for both the mother and the unborn baby, but it is still being studied. As for people who are mildly ill when the shot is scheduled, they can still take HPV vaccine. But people with moderate or severe illnesses should wait until they recover.

How and when is the vaccine administered?
The vaccine is given in a series of three injections over a six-month period. The second and third doses should be given after two and six months of the first dose. HPV vaccine may be given at the same time as other vaccines.

How effective is it?
This vaccine is highly effective in preventing HPV in young women who have not been previously exposed to HPV, i.e. before their first sexual contact. This vaccine targets HPV types that cause up to 70 percent of all cervical cancers and about 90 percent of genital warts. The vaccine will not treat existing HPV infections or their complications.

Corns develop to protect your feet from the hardships they are exposed to.You tend to work day in day out with your feet and hands in mud and otherwise. Your feet get exposed. To protect the feet from dirt, corns and calluses ( thick hardened layers of skins) develop, which if cause discomfort, need to be treated.

signs and symptoms for corn on foot

You have a corn or callus if you notice:

• A thick, rough area of skin
• A hardened,raised bump
• Tenderness or pain under your skin
• Flaxy,dry or waxy skin

Difference between corns and callus.
Corns are smaller than calluses and have a hard center surrounded by inflamed skin. They develop on parts of body that do not carry any weight, such as tops and sides of your toes. If corns are pushed then they can cause pain or suffer from a dull ache. Calluses usually develop on the soles of the feet, especially under the heels or balls, on the palms, or the knees.They are rarely painful and vary in size and shape. They can be more than inch in diameter, making them larger than corns

Causes of Corns and Calluses

• Ill-fitting shoes: When shoes are too tight, then your feet get compressed causing discomfort and corns and calluses develop. If the shoes are too loose, then the feet rub against the shoe. The foot may rub against a poorly placed seam or stitch inside the shoe.
• Skipping socks- Wearing shoes or sandals without socks can be a problem. socks should fit properly.
• Using hand tools- The use of tools with your hands can also cause calluses on them

Risk Factors that increase the incidence of calluses and corns on foot:

• Bunions or hammertoe- A bunion is an abnormal, bony bump that forms on the joint at the base of the big toe. A hammertoe is a toe deformity in which your toe becomes curled up like a claw. These conditions can cause rubbing of the feet in the shoes.
• Lack of protection for hands- Using hand tools without gloves can cause friction  in the hands leading to corns and calluses.
• Foot Deformities- A pre-existing foot deformity, such as bone spur, may cause problems to your feet.

Treatment of Calluses and Foot Corns:
Severe or persistent corns need to be treated, although they rarely require surgery. Persons suffering from diabetes, or artherosclerosis should not treat a corn on their own, as it can increase the risk of  infection. They are acid preparations to reduce corns and calluses. A commonly used preparation is a mixture of salicylic acid,lactic acids and collodion (Duofilm, Salactic Film and Viranol). Over the counter acids are weaker than the ones prescribed.

Acids should not be used by diabetic patients and are not advisable for individuals with impaired sensation or for the elderly with thin skin. Medicated pads are also available.comfortable shoes should be worn.

Protect your feet from corn and calluses; but if you do suffer then take the necessary precautions to avoid any discomfort. One need not worry about them, if they are not painful.

Migraine  headaches are one of the most common problems seen in emergency departments and doctors’ offices. Migraines are due to changes in the brain and surrounding blood vessels.

Migraine headaches typically last from 4-72 hours and vary in frequency from daily to fewer than 1 per year. Migraine affects about 15% of the population. Three times as many women as men have migraines. More than 80% of people with migraines (called migraineurs) have other members in the family who have them too.

Different types of migraine headaches

• Common migraine accounts for 80% of migraines. There is no “aura” before a common migraine.

• People with classic migraines experience an aura before their headaches. Most often, an aura is a visual disturbance (outlines of lights or jagged light images). Classic migraines are usually much more severe than common migraines.

• Status migrainosus is a migraine that does not go away by itself.

Causes of migraine

The exact cause of migraine headaches is not clearly understood, though experts believe they are due to a combination of the expansion of blood vessels and the release of certain chemicals, which causes inflammation and pain.

The chemicals dopamine  and serotonin are among those involved in migraine. These chemicals are found normally in the brain and can cause blood vessels to act abnormally if they are present in abnormal amounts or if the blood vessels are unusually sensitive to them.

Various triggers are thought to bring about migraine in certain people prone to developing migraine. Different people may have different triggers:

• Certain foods, especially chocolate, cheese, nuts, alcohol, and MSG, bring on headaches in some people. (MSG is a food enhancer used in many foods including Chinese food.)
• Missing a meal may bring on a headache.
• Stress and tension are also risk factors. People often have migraines during times of increased emotional or physical stress.
• Birth control pills are a common rigger. Women may have migraines at the end of the pill cycle as the estrogen component of the pill is stopped. This is called an estrogen-withdrawal headache.
• Smoking may cause migraines or interfere with treatment.

Migraine Headache Symptoms

Symptoms vary from person to person and from migraine to migraine. Five phases can often be identified:

• Prodrome: A variety of warnings can come before a migraine. These may consist of a change in mood (for example, feeling “high,” irritable, or depressed) or a subtle change of sensation (for example, a funny taste or smell). Fatigue and muscle tension are also common
• Aura: This is commonly a visual disturbance that precedes the headache phase. Some migraineurs develop blind spots (called scotomas); see geometric patterns or flashing, colorful lights; or lose vision on one side (hemianopsia).
• Headache: Although migraine pain usually appears on one side of the head, 30-40% of migraines occur on both sides. Throbbing pain may be present. More than 80% of migraineurs feel nauseated, and some vomit . About 70% become sensitive to light (photophobia) and sound (phonophobia). This phase may last 4-72 hours.
• Headache termination: Even if untreated, the pain usually goes away with sleep.
• Postdrome: Other signs of the migraine (for example, inability to eat, problems with concentration, or fatigue) may linger after the pain has disappeared.

When to Seek Medical Care

Call a doctor if any of the following occur:

• A change in frequency, severity, or features of the migraine commonly experienced
• A new, progressive headache that lasts for days
• A headache brought on by coughing, sneezing, bearing down, straining while on the toilet, and so on
• Large, unintentional loss of body weight
• Weakness or paralysis that lasts after the headache

Go to a hospital emergency department if any of the following occur:

• Having the worst headache ever, especially if the headache came on very quickly
• Headache associated with trauma to the head
• Trauma to the head with loss of consciousness
• Fever or stiff neck associated with headache
• Decreased level of consciousness or confusion
• Paralysis of one side of the body
• Seizure

Exams and Tests

The diagnosis of migraine headache rests solely on what a patient describes to a doctor. A doctor’s physical examination of a typically migraineur reveals nothing out of the ordinary; however, a neurological examination will be performed to rule out other causes of headache.

Other causes include stroke, tumor, inflammation of a blood vessel, and infection of the brain’s coverings (meningitis) or of the sinuses. In such cases, the following tests may also be performed:

• Blood tests
• X-rays
• CT scan or MRI of the head to look for bleeding, stroke, or tumor
• A  spinal tap (also called a lumbar puncture) to look for evidence of infection or bleeding

Migraine Headache Treatment

Self-Care at Home

Most migraineurs can manage mild-to-moderate attacks at home with the following strategies:

• Using a cold compress to the area of pain
• Resting with pillows comfortably supporting the head or neck
• Resting in a room with little or no sensory stimulation (light, sound, odors)
• Withdrawing from stressful surroundings
• Sleeping
• Drinking a moderate amount of caffeine
• Trying certain  over-the-counter  headache medications
  • Nonsteroidal anti-inflammatory drugs (NSAIDS): These include medications like asprin,ibuprofen (Motrin, Advil),naproxen (Naprosyn, Aleve), and ketoprofen (Orudis). Stomach ulcers and bleeding are serious potential side effects. This type of medication should not be taken by anyone with a history of stomach bleeding. A doctor or pharmacist should be asked about possible medicine interactions if the migraineur is taking other drugs.
  • Acetaminophen : Acetaminophen may be safely taken with NSAIDs for an additive effect. Taking acetaminophen by itself is usually safe, even with a history of stomach ulcers or bleeding. Acetaminophen should not be taken if the migraineur has liver problems or has 3 or more alcohol drinks a day.
  • Combination medications: Some over-the-counter pain relievers have been approved for use with migraine. These include Excedrin Migraine, which contains acetaminophen and aspirin combined with caffeine. A similar effect can be achieved by taking 2 aspirin or acetaminophen tablets with a cup of black coffee.

The common cold is a viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses, (picornaviruses) or rhinoviruses,. It is the most common infectious disease in humans, there is no known cure, but it is very rarely fatal.

It is  mostly  recommended for home treatments (drinking plenty of warm fluids, keeping warm, etc.)

common symptoms are

sore throat, runny nose ,nasal congestion and sneezing , sometimes accompanied by  pink eye ,muscle aches, fatigue, malaise ,headache  and muscle weakness. Fever is more commonly a symptom of influenza.

complications

The common cold can lead to opportunistic coinfections  or superinfections  such as acute bronchitis , bronchiolitis, pneumonia, sinusitis , and  otitis media. People with chronic lung diseases such as asthma  and COPD are especially vulnerable. Colds may cause acute exacerbations of asthma , empysema  or chronic bronchitis

causes

viruses

rhinoviruses, (picornaviruses) or coronaviruses.

sleep

Lack of sleep has been associated with the common cold. Those who sleep fewer than 7 hours per night were three times more likely to develop an infection when exposed to a rhinovirus when compared to those who sleep more than 8 hours per night

Vitamin D

People with the lowest blood vitamin D levels reported having significantly more recent colds or cases of the flu. The risks were even higher for those with chronic respiratory disorders, such as asthma and emphysema.  vitamin D can be recommended to prevent colds and flu.

cold weather

By prolonged exposure to cold weather such as rain or winter conditions  Although common colds are seasonal, with more occurring during winter, experiments so far have failed to produce evidence that short-term exposure to cold weather or direct chilling increases susceptibility to infection, implying that the seasonal variation is instead due to a change in behaviors such as increased time spent indoors at close proximity to others.

With respect to the causation of cold-like symptoms, researchers at the Common Cold Centre at Cardiff University  conducted a study to “test the hypothesis that acute cooling of the feet causes the onset of common cold symptoms.The study measured the subjects’ self-reported cold symptoms, and belief they had a cold, but not whether an actual respiratory infection developed. It found that a significantly greater number of those subjects chilled reported cold symptoms 4 or 5 days after the chilling. In particular, 13 of the 90 chilled subjects reported having a cold 4 or 5 days after the study, in contrast to 5 of the 90 control subjects reporting the same (p-value was 0.047). The study concluded that the onset of common cold symptoms can be caused by acute chilling of the feet. One possible explanation postulated by past researchers is that, during the cold season, “many people are mildly infected but show no symptoms,” but “if they become chilled, this causes a pronounced constriction of the blood vessels in the nose and shuts off the warm blood that supplies the white cells that fight infection. Although the chilled subject believes they have ‘caught a cold’ what has, in fact, happened is that the dormant infection has taken hold.”[19]. However, this explanation has not been scientifically verified.

Another possibility which remains to be explored involves the role that proteins of the complement system play in the prevention of a sustained infection. Decreased temperature may result in a drop in tissue permeability and, as a result, may lead to reduced plasma leakage. Among the many proteins suspended in plasma are complement proteins (e.g. C3) which serve to disable, destroy, or tag for destruction foreign particulate (in this case viral capsids). Thus, sustained exposure to cold may inhibit the effectiveness of the complement system and allow the virus a better chance of establishing a state of infection.[citation needed]

ICAM-1, the receptor that Rhinovirus binds to in order to infect cells, is known to increase in number and receptiveness in response to many irritants, including dust and pollen. That a cold climate in combination with varying degrees of humidity can act as a similar “irritant” needs to be investigated

Prevention

The best way to avoid a cold is thorough and regular washing of the hands. This resulted in a 16% decrease in the rate of respiratory infections and as much as a 20% decrease in the common cold.Anti-bacterial and non anti-bacterial soaps are equally effective. Alcohol-based hand sanitizers also reduce viruses significant and are recommended as a method in health care environments. The use of alcohol based hand gels in the home reduced rate of transmission of respiratory illnesses among family members.

Probiotics in children 3 – 5 years old were found effective in decreases cold symptoms when taken over 6 months.

Developing a vaccine for the common cold has been unsuccessful. This is due to a number of reasons including: a large variety of viruses and the fact that they mutate rapidly. Many thus believe that successful immunization is highly improbable.

Management

“Consult your Physician” for treatment of the common cold

There are no medications or herbal remedies proven to shorten the duration of illness. Treatment is symptomatic support usually via analgesics for fever, headache and myalgia, nasal decongestants, and lozenges for sore throat.

The common cold usually resolves spontaneously in 7 to 10 days, but some symptoms can last for up to three weeks. A history of smoking extends the duration of illness about three days.

Conservative

Treatments that help alleviate symptoms include simple analgesics and antipyretics such as ibuprofen and acetaminophen / paracetamol.

Evidence does not show that cold medicines are any more effective than simple analgesics. They are not recommended for use in children due to no evidence supporting their effectiveness and the potential of harm.

Getting plenty of rest, drinking fluids to maintain hydration, gargling with warm salt water, or use of over-the-counter pain medicines are reasonable conservative measures. Saline nasal drops may help alleviate nasal congestion.

Evidence for encouraging the active intake of fluids in acute respiratory infections is lacking as is the use of heated humidified air.

Antibiotics and antivirals

amtibiotics are not effective against the viruses that causes the common cold and due to their side effects cause overall harm. There are no approved anti viral drugs  for the common cold even though some preliminary research has shown benefit

Alternative treatments

Alternative treatments used for the common cold

Many alternative treatments are used to treat the common cold. None however are recommended due to insufficient scientific evidence[dead link Some alternative treatments, like echinacea, have not been shown to have any effects on the frequency of infection, the duration of infection, or the severity of symptoms of the common cold. Other alternative treatments which similarly lack solid scientific evidence include calendula,ginger, garlic and vitamin C supplements.

While vitamin C in normal or increased doses has not been shown to be beneficial in a normal population for the prevention or treatment of the common cold, it might be beneficial in people exposed to periods of severe physical exercise or cold environments.

Prognosis

The common cold is generally mild and self-limiting.