Effects of Epidural Anesthesia on Labor Progress

Labor pain is known and defined as one of the most severe varieties of pain. As a result, an appropriate pain management plan is important both for a successful delivery and to decrease pain as much as possible (Poole, 2003). A variety of anesthesia methods for delivery are used in different regions of the world. Epidural anesthesia is the most frequently used method of pain control. It is reliable and is the preferred method of anesthesia for over 50% of hospitalized women in developed countries (Balcioglu, 2004; Camann, 2005; Essam & Arulkumaran, 2005 Lieberman 2004, Robert and Gaiser 2005). Today, the use of epidural analgesia is rapidly on the rise globally. Reasons for this increase include the decreased risk of morbidity, developments in epidural techniques, and women's pain-free delivery experiences (Robert and Gaiser 2005, Vincent and Chestnuta 1998).

Although delivery is a normal physiologic process, it causes a certain level of pain in women. Today, the most frequently preferred and the most used method is epidural anesthesia. The objective of the present study was to review the reasons, effects, and risks associated with epidural analgesia for pain relief. The study was conducted at Akdeniz University Hospital, Antalya, Turkey, between October 2004 and July 2005. Epidural analgesia was administered to 51 pregnant women in the experimental group, and 51 pregnant women in the control group did not receive analgesia. Data were collected by questionnaire and observation forms. Epidural anesthesia was chosen by 76.5% of the participants because they wanted to experience a pain-free childbirth, 66.7% because they were afraid of the process of delivery, 25.5% because they had had a previous bad labor experience, 35.3% because they had people around them with positive experiences, 29.4% because they wanted to have a normal delivery, and 31.4% because they wanted first to see their baby. The overwhelming majority of the participants (94.1%) experienced nervousness before the administration of epidural analgesia. It was determined that epidural analgesia extended the time of labor and increased oxygen and oxytocin requirement but did not increase the risk for interventional delivery and cesarean. To give better obstetric care and control of labor pain, it is of clinical importance to know obstetric anesthesia and analgesics.

Epidural labor analgesia can have positive effects, such as a decrease in mothers' stress as a result of labor pain relief, balancing of respiratory rate and amplitude, lack of disturbance in maternal and fetal acid base balance and uteroplacental circulation, and decrease in blood pressure in preeclampsia. In addition to these physiologic benefits, epidural labor analgesia also provides patients with psychologic comfort and alleviation of excessive pain and ensures that they leave the hospital more satisfied (Bofill et al., 1997). In contrast, Mayberry et al. (2002) found that epidural anesthesia causes maternal exhaustion, which in turn causes the pelvic floor to be damaged and an increase in the incidence of cesarean. Other side effects of epidural analgesia may be cited, such as maternal hypotension, itching, shivering, fever, urinary retention, and dural puncture (Leighton and Halpern 2002a, Lieberman 2004, Mayberry et al 2002).

However, there are some studies showing the contrary, it is reported that epidural analgesia procedure does not increase the percentage of cesarean procedures (Bofill et al 1997, Clark et al 1998, Owen et al 1998, Robert and Gaiser 2005, Sharma et al 1997). According to Nystedt et al.'s (2004) review, with unclear evidence it was difficult to confirm that adverse effects in terms of dystocia and increased frequency of cesarean section were associated with the use of epidural analgesia. In the present study, no cesarean procedures were conducted in either the epidural analgesia group or the control group . This finding is consistent with other studies showing that epidural analgesia does not increase the incidence of Cesarean procedures (Clark et al 1998, Segal et al 1999; Sahin & Owen, 2002). It was determined that women receiving epidural anesthesia required more supplemental oxygen than those who did not receive epidural anesthesia. This may be due to the fact that women become more tired with the increased duration of stages one and two of labor. Essam and Arulkumaran (2005) determined that, although there are benefits to using high-dose oxytocin in both multiparas and nulliparas in advanced labor and for optimal contractions, if the labor process is slow it is necessary to give oxytocin in the first 6-8 hours. In the present study, oxytocin was used regardless of whether women were nulliparous or multiparous. Bodner et al. (2003) determined that there was a difference in newborns' APGAR scores in cases where epidural analgesia was and was not used. The most common side effects related to epidural anesthesia were sedation and nausea. These were followed by shivering, vomiting, itching, hypotension, fetal bradycardia, and ringing in the ears . These findings are similar to those seen in other studies (Leighton and Halpern 2002b, Vincent and Chestnuta 1998). Whereas 68.6% of women who received epidural anesthesia were happy in the fourth stage, this ratio was only 31.4% for women who had not received epidural anesthesia. This shows that women did not feel pain during labor, that labor concluded successfully, that women were aware of all the events during labor, and that they felt comfortable. (El-Hamamy & Arulkumaran, 2005)

The present findings demonstrate that antenatal care and education should be focused on helping women work through their fears and increase their understanding of the process of labor and childbirth. Nurses and midwives who work in primary care settings and in labor and delivery wards need to be given education by experts concerning effects, side effects, potential emergency complications, and the emergency interventions for these complications in pregnant women who are given epidural analgesia.

This article was quoted from http://www.medscape.com/viewarticle/573875_5.

By Izzaty....

Overcome the Stress Effectively

When talking about stress, it is the common problem and synonym to the people who has personal problems, family problems and etc. Stress is a debilitating condition that affect people negatively and destructive. Prolonged stress will become out of control and consequently, it will affect our emotion. A serious stress can lead to various types of diseases such as heart attack, hypertension and stroke.
Due to that, there are many techniques can be used to calm ourselves. The trick is that we have to make a conscious decision not to allow ourselves to get stressed. For example, breathing techniques, visualization, and taking care about our health by doing exercise are a few common things that many people do to release stress. Having enough sleep and rest at night and being particular in taking a good diet are also essential to reduce stress. At the meantime, we have to be open – minded as well as think rationally and positively in all matters. When something happens that would normally make you mad, think about it for a second. When you step back and look at your situation from another point of view, you tend to see how trivial it really is.

Lastly, it is important to remind that stress is completely in the mind of the person that creates it. No one ever creates stress for you other than yourself.

http://www.depression-stress-anxiety-help.com/how-to-overcome-stress.html
magazine: Rapi (01Dec2007) v81 by karangkraf (http://www.karangkraf.com/)

by: -Elina-

Are Cosmetics Safe ? Part 2

The fact is, cosmetics can be pretty harmful for your skin and they can aggravate you skin problem because of their chemical-based ingredients. Here are a couple of pointers on what type of cosmetics you can avoid to keep away from those that can harm your skin:

>> If your cosmetics label says ‘Parabens’, look for another one, because this ingredient has preservatives that cause allergies and skin rashes. It is used in cosmetic products to increase its shelf life but this factor actually makes it bad for the skin.

>> If your see the ingredient ‘Sodium lauryl sulphate’ on the cosmetic, forget it! This can irritate your eye, cause rashes and allergies. It used in the cosmetics to cleanse you face, but it’s the same ingredient that’s also used in foaming washes.

>> Many anti-aging creams and moisturizers have an ingredient called ‘Mineral Oil’. This oil actually leads to premature aging of the skin and removes the skin’s natural oils. Over a period of time, the usage of such cosmetics can make your skin dry and chap easily.

>> Cosmetics are seen in such beautiful colors now-a-days. The colors we see range from natural ones to rare ones. However, these colors are more than a point of wonder, because something to be noted here is that these shades are made from synthetic colors. Synthetic colors can cause cancer and they are labeled as FD&C or D&C, seen along with a color number. Avoid cosmetics with such ingredients at all costs.

>> Be sure to find cleansers that contain natural ingrediants . Any cosmetic cleanser which smells nice can actually have benzene derivatives or aldehydes, which can cause headaches and dizziness.

>> Talc is yet another ingredient to be avoided through it is widely used in baby powder and make-up. This is because there are strong links to it causing ovarian and it can testicular cancer

>> Quarternium-15 causes allergies and it is commonly used as a preservative in cosmetics, skin moisturizers and toiletry items.

If you look at all that’s given above, you will get a pretty dismal picture of cosmetic products and probably think never to use then again. However, not using them can put you into a dilemma. How do you look and feel great, without make-up because you have been using it so much as part of your style and simply can’t do without it?

One alternative is to go in for home-remedies. They do not cause any side effects and can give you skin a natural glow and shine… something no cosmetic will ever be able to do. However, if you want to look glossy just for some special occasion, try out mineral cosmetics because they are a great alternative to chemical-based cosmetics that contain harmful chemicals.

Donna Collins, a beautician with experience in facial massage and usage of cosmetics according to the type of the skin. Visit Facials and Massages site for more info on facials and types of massages to relieve your stress and tension.

with love and care ~kaled~

link :
http://help2health.co.cc/cosmetics-that-can-harm-your-skin/

Abnormal Perspiration: Hyperhidrosis

About Hyperhidrosis
Hyperhidrosis is the condition characterized by abnormally increased perspiration in excess of that required for regulation of body temperature and causing embarrassment and interfering with daily activities.
Alternatively, hyperhydrosis may be classified according to the amount of skin that is affected. Excessive sweating in an area that is greater than 100 cm2 (up to generalized sweating of the entire body) is differentiated from sweating that affects only a small area.
Hyperhidrosis can either be generalized or localized to specific parts of the body. There are two types of hyperhidrosis:

Primary hyperhidrosis: emotional stimuli are believed to trigger excessive sweating.
• Palmar/plantar hyperhidrosis affects the hands/feet. Sweaty palms are the most troublesome symptom.
• Palmar/axillary hyperhidrosis affects palms/armpits.
• Isolated axillary hyperhidrosis affects only the armpits.
• Craniofacial hyperhidrosis affects the face and head. It's the least common form.

Secondary hyperhidrosis: associated with an underlying medical condition, such as infection, malignancy, neurologic or endocrine disorders, spinal cord injury, and other conditions.

Treatment
Treatment options for hyperhidrosis range from over-the-counter and prescription antiperspirants to surgery to interrupt the nerve causing excessive sweating.

Topical medications
For light-to-moderate hyperhidrosis, doctors will likely recommend applying a nonprescription, over-the-counter, clinical strength antiperspirant on problem areas as an initial treatment.
Prescription antiperspirants with aluminum chloride are the next step. Typically, prescription antiperspirants (Drysol, Xerac) are applied to dry skin before bedtime. Six to eight hours later, the antiperspirant should be washed off. Prescription antiperspirants may cause red, swollen and itchy skin.

Iontophoresis
A battery-powered device is used to deliver a low current of electricity to the hands or feet, and sometimes the armpits, through water-saturated wool pads. This treatment alters the outer layers of skin to prevent sweat from coming to the surface. This intense treatment can decrease sweating for several weeks. However, it is not suitable for pregnant women or people who have a pacemaker.

Oral Medications
• Anticholinergics (such as glycopyrrolate) block nerve impulses to sweat glands.
• Carbonic anhydrase inhibitors (such as topiramate) inhibit sweating.
• Clonidine reduces nerve stimuli, thereby reducing sweat output.
Older types of antidepressants, such as amitriptyline, can reduce sweating and also can help patients cope with hyperhidrosis.

Surgery
If you have severe hyperhidrosis and other treatments haven't worked, surgery may be an option. Two approaches involve interrupting the nerve signal triggering excessive sweating. The other approach is to remove some sweat glands.

Read more about hyperhidrosis at
http://www.mayoclinic.org/hyperhidrosis/treatment.html


By: -eLiNA-

Are Cosmetics Safe?

Have u ever wonder whether your cosmetic product is safe or not? do you know that the cosmetics we used everyday can harm you if you are using it in wrong ways and the ingredients may also give bad effect to your health especially those who have sensitive skin. suprisingly, the most common injury from cosmetic is scratching the eye with a mascara wand! Eye infections can result if the eye scratches go untreated. Such infections can lead to ulcers on the cornea, loss of lashes, or even blindness.

so, here are some precaution steps when handling with makeup:

1. Never try to apply mascara while riding in a car, bus, train or plane.
2. Sharing makeup can also lead to serious problems. Cosmetics become contaminated with bacteria the brush or applicator sponge picks up from the skin--and if you moisten brushes with saliva, the problem is much more severe.
3. Washing your hands before using makeup will help prevent exposing the makeup to bacteria.
4. Sleeping while wearing eye makeup can cause problems, too. If mascara flakes into your eyes while you sleep, you might awaken with itching, bloodshot eyes, and possibly infections or eye scratches. To avoid eye infections or injury, remove all makeup before going to bed.
5. Keep makeup containers closed tight when not in use.
6. Keep makeup out of the sunlight to avoid destroying the preservatives.
7. Don't use eye cosmetics if you have an eye infection such as conjunctivitis(pink eye), and throw away any makeup you were using when you first discovered the infection.
8. Never add any liquid to a product unless the instructions tell you to.
9. Throw away any makeup if the color changes or an odor develops.Preservatives can degrade over time and may not be able to fight bacteria.

the information for this article has been obtained at http://www.medicinenet.com/script/main/art.asp?articlekey=21573
written by ani arina

Migraines Linked to Lower Breast Cancer Risk

Migraines & Breast cancer, link to one another

Have you ever heard that migraines can reduce the breast cancer risk ? It is the first time for me. How about you ??
According to the recent study which is a follow-up to research published in 2008, Women who suffer from migraine headaches have a significantly lower risk of getting breast cancer than those who don't suffer the headaches.Yes, The lead author of both studies and a breast cancer epidemiologist and associate member of the Fred Hutchinson Cancer Research Center's Public Health Sciences Division in Seattle , Christopher Li, MD, PhD said that "It does appear that migraines may protect women from breast cancer, and that it's equally protective for both younger and older women". After surveys and research had done, it shown about 26% reduction of breast cancer risk when the women experience migraines.

It's not known why having migraine headaches appears to lower breast cancer risk but it might due to the hormone level and other factors as well. Scott Maul, MD, a medical oncologist in Milwaukee who also reviewed the study for WebMD says the potential link between migraines and reduced breast cancer risk does make sense. Higher lifetime exposure to estrogen is a known risk factor for breast cancer, he notes, and some migraines seem to be associated with a drop in estrogen. "But not all migraines are due to hormone fluctuations" -WebMD

For more info, you can visit this webisite :- http://www.webmd.com/migraines-headaches/news/20090709/migraines-linked-lower-breast-cancer-risk

-JihanDiyana-

Psoriatic Arthritis: A Chronic Disease

First of all, what is psoriatic arthritis? Actually, psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriatic arthritis affects one in ten people about who have psoriasis.The inflamed joints become painful, swollen, hot, and red. The cause of this condition is currently unknown. A combination of genetic and immune as well as environmental factors are likely involved. Briefly, there are five types of psoriatic arthritis which are symmetric (affects joints on both sides of the body simultaneously and most similar to Rheumatoid arthritis), asymmetric (does not occur in the same joints on both sides of the body and usually only involves less than 3 joints), arthritis mutilans (deforming and destructive arthritis and can progress over months or years causing severe joint damage), spondylitis (stiffness of the spine or neck, and also affect the hands and feet) and distal interphalangeal predominant (inflammation and stiffness in the joints nearest to the ends of the fingers and toes). Psoriatic arthritis can develop at any age. For the majority of people this is between the ages of 20 and 50. Both males and females are affected equally. In addition, some patients have had arthritis for over 20 years before psoriasis eventually appears!

Treatments

First line medication used are NSAIDs such as diclofenac and naproxen. While, joint injections with corticosteroids is the other treatment practical if a few joints are affected. However, if the first line medication is not effective, second line treatments with immunosuppressants such as methotrexate or leflunomide are added to the treatment regimen. Recently, a new class of therapeutics developed using recombinant DNA technology called Tumor necrosis factor-alpha inhibitors have come available. For example, infliximab, etanercept, Golimumab and adalimumab. These are becoming increasingly commonly used but are usually reserved for the most severe cases. As more is learned regarding the long-term safety of these biologic agents, there is a trend toward earlier use to prevent irreversible joint destruction.

Change your life style:

• Exercise : Exercise maintains mobility of your joints and strengthens muscles to protect the joints. However, if an exercise becomes painful, reduce it a little.
• Rest : Avoid carrying heavy objects which drag down your shoulders or strain your fingers. You should have sufficient rest.
• Diet : balanced diet is important in promoting overall good health. If you are overweight, you need to diet because of the strain this puts on the leg joints.

http://www.medicinenet.com/psoriatic_arthritis/article.htm

http://www.afm.org.my/info/psoriatic_arthritis.php

http://emedicine.medscape.com/article/331037-overview

by: -Elina-