SIDS affects about 1 in every 500 infants, although the incidence has dropped in the past few years all over the world. It is generally more common in winter, in colder climates, in families from lower socio-economic groups, and in babies who have been born very prematurely.

Cause

The exact cause of SIDS is unknown, despite an enormous amount of research. There have been literally dozens of theories advanced over the years, but none have been found to explain adequately why an apparently normal baby dies suddenly. The most common theories have been to do with the possible role of viral infections, the immaturity or vulnerability of the baby’s breathing control centre, or the erratic control or regulation of the baby’s sleep patterns. It is likely that SIDS is due to a number of different causes, one or more of which may be responsible in an individual case.

Clinical features

There are no specific features, before the death or afterwards, that either predict the event or explain why it happened. In about half the cases parents report a mild cold — perhaps a snuffly or runny nose or mild fever — in the days preceding the event, but in most instances this has been so mild that they have not been concerned enough to seek medical attention. Some have been seen just before the event by a doctor or community nurse, and the parents have been assured that all is going well.

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What do we mean by healthy?

Your general health is very important during pregnancy, and special attention should be paid to good nutrition, adequate rest and moderate regular exercise.

Most things that a pregnant woman eats, drinks or breathes in will pass through her bloodstream, cross the placenta, and finally reach the baby. The baby is at increased risk of being harmed by exposure to certain substances. It is safest to avoid the following altogether during your pregnancy:

• alcohol

• smoking

• painkillers (such as paracetamol, aspirin, codeine)

• drugs of addiction (heroin, morphine, LSD, barbiturates, amphetamines).

Be careful about taking any medications while you are pregnant. Always check with your doctor.

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As we mature, we are able to accept what life is giving and balance that with what we do not want to take. You may have more time in your later years to monitor those who are still trying to save

Sex and Problems of Dally Living: Why Nobody Has a Sex Life 267 or destroy our worid. Watching, reporting, writing, and serving as a watchperson for social values can be a healthy phase of life no less important than the more physically active tasks of younger years. We don’t have to sit back, but sit up and take notice. If you don’t do it, who will? Younger people are too busy doing things to pay much attention to what they are doing and its long-term impact. They don’t have the perspective of the older adult. The same holds true sexually. A slower, less physically vigorous sexuality is not the only sex available during our later years. It is an option all of us should consider at any time in our life.

After you have discussed these phases with your partner, sit back—better yet, lie back—and review each phase, silendy. Where are you now anyway?

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A persistent rise in pressure is either primary or secondary. Primary or essential high blood pressure is by far the commonest and the cause is unknown.

We know there is an hereditary factor, as it tends to run in families and is often associated with being overweight. A high salt intake is another factor thought to play a part.

Essential hypertension may occur in the young but becomes more common after the age of 40. It affects women more than men but is more severe in the latter.

It is a slowly progressive condition and may not cause symptoms until it has been present for many years. Occasionally, in less than one per cent, it rises rapidly and causes severe and dangerous symptoms and, if untreated, may cause death. This is called malignant essential hypertension.

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It is named from Achilles, the son of Peleus in Greek mythology. His mother, Thetis, dipped him in the river Styx when he was a baby, so as to make him invulnerable. His only weak spot was that part of the heel where she held him and which was not bathed by the waters.

Eventually, after the battle of Troy, he was slain by an arrow, shot by Paris, which hit him in the heel. We use the term “Achilles heel” to mean a weak spot in someone’s personality.

Injury to the Achilles tendon is a common injury suffered by sportsmen, particularly squash players.

The modern mania for jogging is producing a new crop of sufferers.

Complete or partial rupture of this tendon may occur. Adequate rest is necessary for healing and the injury may be treated by placing the foot in a plaster boot for about eight weeks, then raising the heel about 2 cm (1 in.) for a further four weeks. Early operative repair of a ruptured tendon also gives good results.

In the past, sprains of this tendon were often treated by an injection of cortisone. This has been abandoned, as sometimes complete rupture of the tendon has followed.

Those taking high doses of cortisone for some other condition have occasionally suffered a spontaneous rupture.

Athletes, and particularly those going back to active sport after many years, should pay particular attention to warming-up and stretching exercises.

One exercise to stretch the calf muscles and Achilles tendon is to stand about one metre away and stretch out the hands to touch a wall. The elbows are then bent so that the body rocks forward, keeping the heels flat on the ground. This position is held for 10 seconds.

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salt: Calcium fluoride

function: Promotes elasticity of tissues

uses: Cold sores at the corners of the mouth, cracked lips and

tongue, circulation problems, muscle weakness, piles, mptures,

strained tendons.stretch marks, varicose veins

2.    Calc. phos.

salt: Calcium phosphate

function: Helps build new blood cells, aids digestion, strengthens bones and teeth

uses: Convalescence, chilblains, indigestion, iron deficiency anaemia, lowered vitality, poor circulation, tooth decay and teething problems

3.    Calc. sulph.

salt: Calcium sulphate

function: Blood constituent and purifier

uses: Adolescent spots, sore lips, slow healing skin and wounds

4.    Ferr. phos.

salt: Iron phosphate

function: Constituent of red blood corpuscles which helps in distribution of oxygen in the body

uses: Chestiness, coughs, colds, chills, fever, inflammation of the skin, muscular rheumatism

5.    Kali mur.

salt: Potassium chloride

function: Promotes respiratory health

uses: Asthma, bronchitis, catarrh, colds, sluggish digestion, sore throat, tonsillitis, wheezing

6.    Kali phos.

salt: Potassium phosphate function: Nerve soother and nutrient

uses: Depression, excitement or worry causing irritability or loss of sleep, headaches, indigestion, tension

7.    Kali sulph.

salt: Potassium sulphate

function: Promotes and maintains healthy skin

uses: Catarrh, discharge of the nose or throat, poor condition of

nails, hair and scalp, skin eruptions with scaling, sticky or

yellowish discharge

8.    Mag. phos.

salt: Magnesium phosphate

function: Nerve and muscle fibre nutrient

uses: Acute spasms, colic, cramp and menstrual pains, darting

pains, hiccups, wind

9.    Nat. mur.

salt: Sodium chloride

function: Controls distribution of water in the body

uses: Loss of smell or taste, watery colds with runny nose and

eyes

10.    Nat. phos.

salt: Sodium phosphate function: pH regulator of the cells

uses: Acidity, gastric indigestion, heartburn, rheumatic pains

11.    Nat. sulph.

salt: Sodium sulphate function: Balances body water

uses: Biliousness, colic, digestive problems, headaches, influenza symptoms, morning sickness, queasiness

12.    Silica

salt: Silicon dioxide

function: Conditions, cleanses and eliminates wastes uses: Boils, pimples, sties, toxic accumulations

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The NSAIDs, however, have some serious side effects of their own, and one of these is a type of kidney damage, which occurs in about 1 percent of people treated with these drugs, particularly if they are taken for a long time. For this reason, some people are afraid to take an aspirin every day to slow blood clotting and hence to help reduce their risks of coronary heart attack and stroke.

That worry, according to correspondence in the Lancet (1:736), is an unnecessary one, since aspirin differs from all the other NSAIDs in that it lacks any ability to harm the kidneys when taken in usual doses by mouth. The reason for this is that aspirin is broken down by digestion in the intestine and further changed in the liver immediately after absorption so that, after usual dosages by mouth, not enough intact aspirin gets into the general circulation to harm the kidneys.

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Home care Do not attempt to treat at home. Treatment depends on the cause, which must be diagnosed by a doctor.

Precautions:

-    During pregnancy, do not take medications (even over-the-counter drugs) without your doctor’s approval.

-     Since not all thyroid glands are in exactly the same position, a lump in the neck should never be removed without first testing to be sure it is not the thyroid gland.

A goitre is an enlargement of the thyroid gland which causes a swelling in the front of the neck. The thyroid gland lies just below and to either side of the larynx (Adam’s apple). The thyroid gland produces hormones that control the body’s metabolism rate – the rate at which foods are used for energy and growth. A normal thyroid is barely if at all visible and can barely be felt.

A goitre may be present in a newborn infant, especially if the pregnant mother was on certain medications (including iodides in anti-asthma or cough medicines). Insufficient iodine in your child’s diet also can cause a goitre. Once common, this disease is now rare because of general use of iodized table salt and more widespread eating of seafood. (Seafood is naturally high in iodine content.)

A goitre is most common between the ages of six and 16 years. It occurs in girls nine times as often as it does in boys. It is most often due to an autoimmune (self-destructive) disease-Hashimoto’s thyroiditis -of unknown cause. Enlargement of the thyroid is rarely due to malignancy. A goitre may be hyperactive (producing too much hormone) or hypoactive (producing too little hormone), but usually it is neither.

Signs and symptoms

A goitre can be seen and felt as a swelling in the front of the neck. This swelling usually appears just below and to either side of the Adam’s apple. Often the swelling is noticed when a shirt collar or neck jewelry no longer fits. Generally, there are no other symptoms.

Home care

No home treatment should be attempted until the cause of goitre is diagnosed by your doctor. The cause cannot be diagnosed without laboratory tests.

Precautions

• During pregnancy, do not take medications (even over-the-counter drugs) without your doctor’s approval.

• Not all thyroid glands are in exactly the same position in the neck. Any lump in the midline of the neck may be a goitre of an unusually positioned thyroid. A lump should never be removed from this area without first testing to be sure it is not the thyroid gland.

Medical treatment

Blood tests, often requiring complicated laboratory work, are used to find the cause of goitre. The treatment for goitre depends on the cause and can include giving oral thyroxine (thyroid hormone) or desiccated thyroid for months or years. Surgery is rarely necessary except in rare cases of malignancy or when the goitre obstructs breathing in infants.

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There are two principal players in this death act-chronic bronchitis and emphysema-and they often do a duet in the same victim. You may have had a bout with acute bronchitis, with all that coughing and mucus accompanying a severe cold. Imagine those symptoms as a permanent result of inflamed and scarred bronchial tubes and you know what chronic bronchitis is all about.

Emphysema weakens and breaks the inner walls of the air sacs in the lungs, impairing the flow of air into the lungs and the distribution of oxygen into the rest of the body. The damage is irreversible, and emphysema victims find themselves short of breath and unable to do much of anything that requires physical exertion.

About 14 million Americans suffer from chronic bronchitis (a 60 percent increase since 1982), and 2 million from emphysema, 61 percent of them male. The cause of this sad state of affairs is smoking, for the most part. It accounts for 82 percent of all COPD. Don’t smoke, and you’re 82 percent of the way there. Here are some other ways to keep on breathing.

Find clean air. Hawaii might start looking pretty good to you if you’re in the early stages of COPD. The best way to control chronic bronchitis is to keep your nose, throat, sinuses, and bronchial tubes away from things that can inflame or irritate them, says Dr. Steven Mostow of the University of Colorado. Those things include smog, dusty working conditions, and cigarette smoke. Air pollution also aggravates emphysema symptoms. If Hawaii’s out of the question, the American Lung Association recommends that you plan your activities in the early morning or evening when smog levels are at their lowest.

Nip infections early. Any cold or respiratory infection is going to make COPD symptoms worse. So it’s not wimpy to consult a doctor at the first sniffle of a cold. And ask your doctor about getting vaccinated against influenza and pneumococcal pneumonia, two illnesses that can severely hinder breathing, says Dr. Mostow.

Keep moving. COPD or no, general health is still a good way to fight off infections. The American Lung Association recommends regular exercise that doesn’t tire you out much for chronic bronchitis sufferers. You should also exercise with emphysema, but as part of a doctor-guided pulmonary rehabilitation program, says Dr. Mostow.

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New Technique For Easier Vasectomies

A new, no-scalpel operation developed in China may prove to be faster and less painful than a standard vasectomy. Experts say the new technique is just as effective as the old procedure and is much faster, taking only 5 to 10 minutes compared with a conventional vasectomy which takes 15 to 20 minutes. The new technique also usually does not require the use of stitches because it employs a tiny puncture instead of an incision.

Reports from doctors who have used the new technique indicate that their patients experience less bleeding and pain, both during and after the operation, compared with men who undergo standard vasectomies.

New Methods To Fight Male Infertility

Two new methods of identifying and combating male infertility provide encouraging news to men who have been unable to father children.

At the University of Oklahoma Health Sciences Center in Oklahoma City, a new sperm antibody diagnostic kit is being developed. The kit will enable doctors to identify antibody-related infertility. According to medical experts, abnormal antibodies produced in the male that attack his own sperm can cause sterility. Antibodies in the female which attack all sperm can also cause sterility.

Doctors at the Iowa College of Medicine are currently using “laparascopic” surgery to remove a varicose enlargement of the veins of the spermatic cord. A varicocele is the most common cause of male infertility. With the new surgical technique, patients have recovered in three days instead of ten to fourteen days.

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