Saturday, September 1, 2018

Prostate Cancer

Prostate cancer is now the most common cancer in men. One of every 10 men will develop prostate cancer at some time in his life. Prostate cancer is usually diagnosed and treated early. Since early prostate cancer causes no symptoms, it can only be detected by regular checkups. Prostate cancer is now the most common cancer in men. Since early prostate cancer causes no symptoms, it can only be detected and treated by regular checkups.
What is the prostate and what does it do?

The prostate is a small gland in men (Urology), which is about the size and shape of a walnut. It covers the urethra, the tube that carries urine from the bladder out through the tip of the penis. The gland's secrets fluid for semen, which helps to transports sperm. During sex, the prostate's fluid is enters into the urethra where it combines with the sperm coming from the testicles. This fluid leaves the penis during ejaculation.


What is prostate cancer? What causes it?
Prostate cancer is a malignant tumor that usually starts in the outer part of the prostate. As the tumor grows, it may spread to the inner part of the prostate and then beyond the gland to other parts of the body. In the early stages, prostate cancer causes no symptoms.

Symptoms
Men who have an increased risk of developing prostate cancer, and who have a father or brother who has had prostate cancer, should start having these yearly examinations at age 40.
The major treatments for localized prostate cancer are surgery and radiotherapy.

The survival rate for men with localized prostate cancer that is treated promptly is about the same as that for men who have never had the disease. The surgery, which is called radical prostatectomy, involves complete removal of the prostate and adjacent structures. Regional lymph nodes are often removed at the time of the procedure. In some cases, radiotherapy can be used. This involves focusing a beam of radiation on the tumor or implanting radioactive seeds directly into the prostate.
Immediate treatment may not always be recommended because some prostate cancers grow very slowly and take a long time to spread. Therefore, some doctors may recommend "watchful waiting," especially for men who are very old or who have a life expectancy of less than 10 years.
In cases where the cancer has spread beyond the prostate, hormonal therapy or chemotherapy may be done. You should discuss the pros and cons of these treatments 

Saturday, August 25, 2018

Kidney Disorder During Pregnancy





Often, pregnancy does not cause a kidney disorder to worsen. Usually, kidney disorders worsen only in pregnant women who have high blood pressure that is not well-controlled. If pregnant women have a kidney disorder, they are more likely to develop high blood pressure, including preeclampsia (a type of high blood pressure that develops during pregnancy)
Having a before becoming pregnant increases the risk that the fetus will not grow as much as chronic kidney disorder expected or be stillborn. Having a severe kidney disorder usually prevents women from carrying a baby to term.
In pregnant women who have a kidney disorder, kidney function and blood pressure are monitored closely, as is growth of the fetus. If the kidney disorder is severe, women may need to be hospitalized after 28 weeks of pregnancy so that bed rest is guaranteed, blood pressure can be controlled well, and the fetus can be monitored closely.


Women who have had a kidney transplant are usually able to safely give birth to healthy babies if they have all of the following:
·         A transplant that has been in place for 2 or more years
·         Normal kidney function
·         No episodes of rejection
·         Normal blood pressure
Women who have a kidney disorder that regularly requires hemodialysis are often at high risk of pregnancy complications, including miscarriage, stillbirth, preterm birt, and preeclampsia. But because of advances in dialysis treatment, up to 90% of babies born to these women survive.
Usually, delivery is required before the due date because the woman develops preeclampsia or the fetus is not growing as much as expected. Doctors may remove and analyze a sample of the fluid that surrounds the fetus (amniotic fluid). This procedure, called amniocentesis, helps doctors determine whether the fetus’s lungs are mature enough to breathe air and thus when the baby can be delivered safely.
Cesarean delivery is often done, but sometimes vaginal delivery is possible.

Thursday, August 16, 2018

Diabetic Kidney Disease


 Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body.
What does diabetes do to the kidneys?
With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.
What are the early signs of kidney disease in patients with diabetes?
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor's office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.


Signs of Kidney Disease in Patients with Diabetes
  1. Albumin/protein in the urine
  2. High blood pressure
  3. Ankle and leg swelling, leg cramps
  4. Going to the bathroom more often at night
  5. High levels of BUN and creatinine in blood
  6. Less need for insulin or antidiabetic medications
  7. Morning sickness, nausea and vomiting
  8. Weakness, paleness and anemia
  9. Itching

What will happen if my kidneys have been damaged?
First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can cause kidney damage. Your kidneys will work better and last longer if you:
  • Control your diabetes
  • Control high blood pressure
  • Get treatment for urinary tract infections
  • Correct any problems in your urinary system
  • Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)

How is kidney failure treated in diabetic patients?
Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis and peritoneal dialysis.

Friday, August 10, 2018

Male Sexuality and Chronic Kidney Disease


It’s a silent disease that’s often overlooked for fear of something more prominent, but with so many of us already dealing with the effects of poor kidney health ,it might be time to start seriously questioning that lack of commitment to your love life.
 “Kidney disease is a common condition which can lead to a range of health complications, such as heart disease. However, early detection of kidney disease can reduce the associated cardiovascular risk by 20- 50%.
First, be aware that those most at risk of developing kidney disease are:
• People with diabetes
• Those who suffer from high blood pressure, have established heart problems or have had a stroke
• People who are overweight
• People who smoke
Sexuality has physical and emotional components, both of which can be affected by chronic kidney disease (CKD). Kidney Disease can cause chemical changes in the body affecting circulation, nerve function, hormones and energy level. Also, any underlying health conditions that contribute to CKD like high blood pressure or diabetes can affect male sexuality.
Too tired for sex?
Fatigue is one of the most common symptoms men with kidney disease experience. In the early stages of CKD, low levels of waste and fluid remain in the body. This can leave you feeling tired and sluggish. Your doctor can perform tests to determine how much kidney function you have left. If you are in the later stages of CKD or end stage renal disease (ESRD), your doctor may refer you to a renal dietitian. The dietitian will place you on a kidney-friendly diet designed to limit the amount of waste that can build up in your body. The less waste and fluid in your system, the better you will feel.
People with ESRD may feel tired after their hemodialysis session. If you are new to hemodialysis, it may take several treatments for your body to adjust. Ongoing fatigue should be discussed with your doctor and renal dietitian. Your doctor can recommend changes to your dialysis treatment or medicines. Your renal dietitian can help you go over your food and fluid intake and make any needed changes.

Low sex drive
Hormones are chemicals produced by the body’s endocrine system. They play a major role in a person’s ability to feel sexual desire. The kidneys are part of the endocrine system. The adrenal glands, located at the top of each kidney, produce certain hormones. If hormone levels become out of balance, you may experience a decrease in your sex drive.
Your doctor can perform blood work to determine if your lack of interest in sex is due to your changing hormone levels. He may prescribe medicine to bring your levels to a normal range.
Erectile dysfunction
Erectile dysfunction (ED), commonly called "impotence," affects many men—even those without kidney disease. An estimated 20 to 30 million men in the U.S. have problems with impotence. ED can happen when blood vessels and nerves to the penis become damaged. Without proper blood flow, the penis cannot maintain an erection.
Diabetes and high blood pressure affect blood flow and weaken blood vessels. If you have either of these conditions, follow your doctor’s treatment plan to prevent further damage.
Sometimes ED is a side effect of medicines, particularly those taken to control blood pressure. Talk to your doctor about the medicines you’re taking if you’re experiencing impotence. Your doctor may be able to make changes to your medications or suggest treatments for impotence
Psychological effects of CKD on men's sexuality
Sexuality is not just about sexual intercourse. It’s also about how people feel and express themselves. Feeling sexual or attractive becomes more difficult when the body undergoes unexpected changes. This can affect how people interact with others and their ability to develop intimate relationships.
Body image
People with CKD may experience some undesirable changes to their bodies, making them feel less attractive Symptoms such as breath and body odor, complexion problems, weight gain or unusual facial or body hair can occur. A man on hemodialysis may feel self-conscious about how his vascular access site looks and feels. Men on peritoneal dialysis (PD) may worry about the size of their abdomens. Discuss any uncomfortable physical changes with your partner and your healthcare team. Some physical changes are temporary, while others may indicate a health complication.
Worry and stress
Men may feel worried, anxious and depressed when faced with CKD. This is normal, but these emotions may cause loss of energy and lower interest in activities, including sex.
If feelings of depression or sadness last for more than two weeks, tell your doctor and social worker immediately.
Fear
Some men are afraid sexual activity may be harmful to their condition or harmful to their partners. Speak with your doctor about your concerns. In very rare instances, sexual intercourse may not be possible. But activities such as touching, hugging and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods of sexual expression.
As with any condition, eating healthily to control your weight and making sure you exercise regularly will help with kidney function, and being aware of your symptoms is the first step towards improving your kidneys.

Friday, August 3, 2018

Hypothyroidism and sickle cell may affect Kidney

Although hypothyroidism this is a site in which the thyroid gland does not produce enough thyroid hormone -which is common in hemodialysis ( Kidney) patients, it's unclear how it affects their health and quality of life


Increase of thyrotropin levels may effect multiple areas of health-related quality of life, including energy/fatigue, physical function, and pain.


"Given the high prevalence of thyroid dysfunction and low levels of quality of life in dialysis patients, Many research is needed to determine the underlying mechanisms of these associations, and whether replacement of thyroid hormone can improve the health-related quality of life of this population. "In addition, as the first study in dialysis patients to document an association between higher thyrotropin levels and low levels of physical function, a strong predictor of death, future studies are needed to determine whether correction of thyroid status with exogenous thyroid hormone can improve physical function in this population."


Sickle cell disease, a blood disorder, can impact the function of the kidneys, and the earliest sign of kidney damage in affected patients is albuminuria, or the presence of albumin in the urine



Hydroxyurea (HU), which makes red blood cells more flexible, is one of the cornerstones of sickle cell disease treatment, but its effects on kidney function are unclear. Adults with sickle cell disease who were starting HU therapy. After 6 months of treatment, patients' kidney function, as measured by the urinary albumin/creatine ratio, improved significantly.
"The findings offer further evidence, albeit not yet definitive, of a potential renal benefit of HU, and should strengthen arguments favoring its use in sickle cell disease for other indications and encouraging patient adherence to this drug," "Our preliminary results require additional larger, prospective, randomized, controlled trials to clearly demonstrate the positive effect of HU to reduce albuminuria levels and delay chronic kidney disease progression," 

Sunday, July 8, 2018

Do You Think Beer Prevents Kidney Stones

Yes, here are the few reasons that beer can be healthy, if taken in the right amount and quantity.

1.     In comparison to other alcoholic beverages, beer is relatively healthier for your kidneys. As a matter of fact, studies show that a bottle of beer can actually reduce the risk of acquiring kidney stones by up to 40%.
2.     Fiber, as we all know, plays a vital role in digestion. The presence of up to one gram of soluble fiber in just a 30 ml glass of beer (dark beer, in particular) makes the beverage very beneficial for digestion.
3.     Fiber present in beer can also help reduce the level of LDL cholesterol (a harmful proponent of cholesterol).
4.     It has been proved that beer is a rich source of various B vitamins like vitamin B1, vitamin B2, vitamin B6 and vitamin B12.
5.     The presence of both nicotinic acid and Lactoflavin in beer makes it an effective cure for insomnia.



1.     Beer is also helpful in the prevention of blood clots.
2.     The presence of high levels of silicon in beer is responsible for bestowing a stronger bone density.
3.     Studies have concluded that beer can also reduce the risk of suffering a heart attack.
4.     Unlike their non-drinking counterparts, beer drinkers are less vulnerable of experiencing dementia or Alzheimer's disease.

1.     Because of the presence of certain vitamins, beer has a ton healthy nourishing benefits for the skin.
2.     Beer is also useful in fighting against stress.

What are the recommended safe limits of Beer?
1.     Men should drink no more than 14 units of Beer per week, these units should be spread out through the week and they should have at least two alcohol-free days a week.
2.     Women should drink no more than 14 units of Beer per week, these units should be spread out through the week and they should have at least two alcohol-free days a week.
3.     Pregnant women or women trying to conceive should not drink alcohol at all. If they do choose to drink, to minimise the risk to the baby, they should not drink more than 1-2 units of beer once or twice a week and should not get drunk.
4.     Despite the above people with increased Triglyceride, Uric Acid should be restricted for consumption of alcohol. People with fatty liver patient with other medication for hypertension, etc. also should refrain from drinking.

People with diabetes who drink should follow these alcohol consumption guidelines:
1.     Do not drink more than two drinks of alcohol in a one-day period if you are a man, or one drink if you are a woman.
2.     Drink beer only with food.




1.     Drink slowly.
2.     Avoid "sugary" mixed drinks, sweet wines, or cordials. If you wish to discuss any specific problem, you can consult a General Physician.

Saturday, June 30, 2018

Evolving Paradigms for Managing Prostate Cancer



Management of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) has been central to urology for many years.The urologic community has increasingly come to realize that most of the men with LUTS do not have prostate enlargement and do not need their prostates debulked surgically.





 Of all the factors that have emerged to alter the trends associated with management of LUTS and BPH, none has had more impact than the advent of medical therapy Drugs for Kidney Disease . The selective, long-acting, α1-blocking agents terazosin, doxazosin, and tamsulosin have become most popular because of their specificity in the urinary tract, reduced side effects, and simplicity of dosage. In addition, finasteride, a 5-α-reductase inhibitor, was found to be effective in men with prostates of ≥40 g. Furthermore, the larger the prostate at baseline, the greater the efficacy of finasteride on symptom relief and flow rate improvement. In addition to medical therapy, an array of device therapies has emerged in the management of LUTS and BPH. Laser prostatectomy is the oldest of the device therapies and includes transurethral vaporization of the prostate (VLAP), transurethral evaporation of the prostate (TUEP), and transurethral interstitial laser prostatectomy (TILP). Studies report beneficial outcomes approaching those achieved with transurethral resection of the prostate (TURP) with less morbidity and a shorter hospital stay. Common diseases contribute the most to national healthcare expenditures. The management of LUTS and BPH are such disorders and result in the expenditure of vast healthcare resources worldwide. The surgical strategies have an established record of outcomes documenting their potential for symptom relief and the avoidance of future complications. Medical and device therapies, although currently promising and attractive, therefore must prove comparable durability.

Nutcracker syndrome is caused by compression of the left renal vein between the aorta and the superior mesenteric artery where it passes in the fork formed at the bifurcation of these arteries. The phenomenon results in left renal venous hypertension.

 The syndrome is manifested by left flank and abdominal pain, with or without unilateral haematuria. Other common presentation is as ‘pelvic congestion syndrome’ characterized by symptoms of dysmenorrhea, dyspareunia, post-coital ache, lower abdominal pain, dysuria, pelvic, vulvar, gluteal or thigh varices and emotional disturbances. Likewise compression of the left renal vein can cause left renal-to-gonadal vein reflux resulting in lower limb varices and varicoceles in males.




 Its diagnosis is based on history and physical examination, basic lab tests to exclude other causes of haematuria, cystoscopy and ureteroscopy to confirm unilateral haematuria and exclude other causes of this sinister symptom. Sequence of imaging has more or less been rationalised to USS with Doppler studies, CT or MR angiography and finally phlebography with renal vein and IVC manometery to confirm the diagnosis.