Iron Deficiency Anemia

Anemia occurs when you have a level of red blood cells (RBCs) in your blood that is lower than normal. Iron deficiency anemia is the most common type of anemia, and it occurs when your body doesn’t have enough of the mineral iron. Your body needs iron to make a protein called hemoglobin. This protein is responsible for carrying oxygen to your body’s tissues, which is essential for your tissues and muscles to function effectively. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs.

While the condition may be common, a lot of people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever knowing the cause.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Doctors normally treat the condition with iron supplements or changes to diet.

What causes iron deficiency anemia?

According to the American Society of Hematology, iron deficiency is the most common cause of anemia. There are many reasons why a person might become deficient in iron. These include:

•Inadequate iron intake , Eating too little iron over an extended amount of time can cause a shortage in your body. Foods such as meat, eggs, and some green leafy vegetables are high in iron. Because iron is essential during times of rapid growth and development, pregnant women and young children may need even more iron-rich foods in their diet.

•Pregnancy or blood loss due to menstruation , In women of childbearing age, the most common causes of iron deficiency anemia are heavy menstrual bleeding and blood loss during childbirth.

•Internal bleeding , Certain medical conditions can cause internal bleeding, which can lead to iron deficiency anemia. Examples include an ulcer in your stomach, polyps in the colon or intestines, or colon cancer. Regular use of pain relievers, such as aspirin, can also cause bleeding in the stomach.

•Inability to absorb iron , Certain disorders or surgeries that affect the intestines can also interfere with how your body absorbs iron. Even if you get enough iron in your diet, celiac disease or intestinal surgery, such as gastric bypass, may limit the amount of iron your body can absorb.

Who is at risk for iron deficiency anemia?

Anemia is a common condition and can occur in both men and women of any age and from any ethnic group. Some people may be at greater risk for iron deficiency anemia than others. These include:

•women of childbearing age , •pregnant women , •people with poor diets •people who donate blood frequently , •infants and children, especially those born prematurely or experiencing a growth spurt •vegetarians who don’t replace meat with another iron-rich food.


What is osteoporosis?

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis. Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

What are osteoporosis causes and risk factors?

The following are factors that will increase the risk of developing osteoporosis: •Female gender •Caucasian or Asian race •Thin and small body frame •Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture) •Personal history of fracture as an adult •Cigarette smoking •Excessive alcohol consumption •Lack of exercise •Diet low in calcium •Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease •Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from bowel diseases, such as celiac sprue that can be associated with skin diseases, such as dermatitis herpetiformis •Low estrogen levels in women (which may occur in menopause or with early surgical removal of both ovaries) •Low testosterone levels in men (hypogonadism) •Chemotherapy that can cause early menopause due to its toxic effects on the ovaries •Amenorrhea (loss of the menstrual period) in young women is associated with low estrogen and osteoporosis; amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat (for example, women with anorexia nervosa) •Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases •Immobility, such as after a stroke, or from any condition that interferes with walking •Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave’s disease) or is ingested as thyroid hormone medication •Hyperparathyroidism is a disease wherein there is excessive parathyroid hormone production by the parathyroid gland, a small gland located near or within the thyroid gland. Normally, parathyroid hormone maintains blood calcium levels by, in part, removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis. •When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis. Vitamin D deficiency can result from dietary deficiency, lack of sunlight, or lack of intestinal absorption of the vitamin such as occurs in celiac sprue and primary biliary cirrhosis. •Certain medications can cause osteoporosis. These medicines include long-term use of heparin (a blood thinner), antiseizure medicine such as phenytoin (Dilantin) and phenobarbital, and long-term use of oral corticosteroids (such as prednisone). Inherited disorders of connective tissue, including osteogenesis imperfecta, homocystinuria, osteoporosis-pseudoglioma syndrome and skin diseases, such as Marfan syndrome and Ehlers-Danlos syndrome (These causes of hereditary secondary osteoporosis each are treated differently.

What are osteoporosis symptoms and signs?

Osteoporosis can be present without any symptoms for decades because osteoporosis doesn’t cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women Fractures of the spine (vertebra) can cause severe “band-like” pain that radiates from the back to the sides of the body. Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height and/or curving of the spine due to collapse of the vertebrae. The collapse gives individuals a hunched-back appearance of the upper back, often called a “dowager hump” because it commonly is seen in elderly women. A fracture that occurs during the course of normal activity is called a minimal trauma, or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb. Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial slip-and-fall accidents. Hip fractures also may heal slowly or poorly after surgical repair because of poor healing of the bone.

Calcium supplementation in pregnant women

Poor maternal and newborn health and nutrition remain significant contributors to the burden of disease and mortality. , Calcium supplementation has the potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during pregnancy, which are associated with a significant number of maternal deaths and considerable risk of preterm birth, the leading cause of early neonatal and infant mortality.

Recommendation

In populations where calcium intake is low, calcium supplementation as part of the antenatal care is recommended for the prevention of preeclampsia in pregnant women, particularly among those at higher risk of developing hypertension.

Premature Ejaculation

You’re not alone.

Approximately 20 to 30 percent of men experience premature ejaculation, according to a study published in July 2016 in Drug Discovery Today. And this often embarrassing sexual issue can affect men of any age.

What is premature ejaculation?

Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life.

What causes premature ejaculation?

Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines.

What are the symptoms?

The main symptom is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation.

How is premature ejaculation diagnosed?

Your doctor will discuss your medical and sexual history with you. He or she will do a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order lab tests to rule out any other medical problem.

How is it treated?

In many cases premature ejaculation gets better on its own over time.

Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve how well they can control ejaculation.


Vaginitis

What is vaginitis?

Vaginitis refers to inflammation of the vagina that often occurs in combination with inflammation of the vulva, a condition known as vulvovaginitis. Vaginitis is often the result of an infection with yeast, bacteria, or Trichomonas, but it may also arise due to physical or chemical irritation of the area. Not all infections that cause vaginitis are considered sexually transmitted diseases (STDs), but some STDs cause vaginitis.

What causes vaginitis?

Infectious causes of vaginitis include bacteria, yeast, and Trichomonas. •Bacterial vaginosis is the most common bacterial infection that causes vaginitis. This condition results from an imbalance in the bacteria normally present in the vagina. It is not clear if sexual activity plays a role in the development of bacterial vaginosis, and some experts believe it can occur in women who have not had sexual contact. The STDs gonorrhea and Chlamydia are other bacterial causes of vaginitis. •Yeast infections, such as Candida infection, are a common cause of vaginitis. Yeast infections are not considered to be STDs. •Trichomonas (“Trich”) is a parasitic infection that is transmitted through sexual contact.

Non-infectious causes of vaginitis include physical or chemical irritation, such as: •Douches, soaps, or fragrances •Spermicides •Reduced estrogen levels around the time of menopause , Vaginitis in young girls has also been described and is thought to arise from poor hygiene practices that allow the spread of fecal bacteria from the anal area into the vagina.

What are the risk factors for vaginitis?

The risk factors for vaginitis depend upon the type of vaginitis.

•Risk factors for STDs include multiple sexual partners and unprotected intercourse. • •Some of the known risk factors for bacterial vaginosis include cigarette smoking, multiple sex partners, douching, and using IUDs for contraception. • •Risk factors for yeast infection are varied. They can include suppression of the immune system either due to cancer or other conditions, or by taking immune-suppressing medications. Antibiotic use is another known risk factor. Pregnancy, diabetes, taking oral contraceptives, and douching can all increase a woman’s likelihood of developing yeast vaginitis.

What are the symptoms of vaginitis?

Vaginitis causes irritation of the vagina that can result in burning, itching, or pain. Vaginal discharge is another common symptom of vaginitis. Other common symptoms include pain during sexual intercourse or urination and a vaginal odor. It is also possible to have vaginitis or an STD without experiencing any symptoms.

How is vaginitis diagnosed?

The symptoms and signs of vaginitis strongly suggest the diagnosis. At the time of diagnosis, a pelvic examination is typically performed that may include removal of a sample of vaginal discharge. The sample may be viewed under the microscope to look for Trichomonas organisms, or it may be sent to a laboratory for culture or other specialized tests to identify infectious organisms.

What is the treatment for vaginitis?

The treatment for vaginitis depends upon its cause. Infectious vaginitis is treated with antibiotic medications. Bacterial vaginitis is treated either with oral antibiotics, intra-vaginal antibiotic creams, or injections (shots) of antibiotics. Treatment guidelines are always updated to reflect the patterns of resistance to antibiotics of circulating bacterial strains.

Medications to treat vaginitis.

•Antibiotics that may be used in the management of bacterial vaginosis include ceftriaxone , erythromycin, metronidazole , clindamycin , cefixime , doxycycline , and azithromycin . •Antifungal medications are used to treat yeast infections, and antifungal preparations are also available over-the-counter for yeast vaginitis. Examples of antifungal medications include fluconazole, terconazole , clotrimazole , miconazole, butoconazole , and Nystatin. •Metronidazole  is the drug of choice for treating Trichomonas infections. • Feminine Wash • Vaginitis due to thinning and irritation of the vaginal wall as a result of lowered estrogen levels at menopause can be treated with hormonal therapy, either in topic (applied directly to the vagina) or oral form. Non-hormonal vaginal lubricant products are also available.