A women’s uterus is the size of a clenched fist but can grow as big as a soccer ball or larger during pregnancy. In addition to pregnancy, there are many other reasons why a woman’s uterus may become enlarged.

An enlarged uterus can be the result of a medical condition that not only causes it to grow but also to bleed and become painful. A condition that results in an enlarged uterus may require treatment.

Causes and risk factors:

A woman can be unaware that she has an enlarged uterus. Most often, women discover they have a problem during a pelvic exam.

It is possible a woman may notice a bloated belly or that clothes seem too tight, but for most, a diagnosis of an enlarged uterus is unexpected.

There are multiple reasons why the uterus may become enlarged. An enlarged uterus may be more common in menopausal women, but women in their childbearing years can develop this condition too.

Fibroids

Fibroids are one of the most common causes of an enlarged uterus. Fortunately, fibroids are noncancerous.

Fibroids are small lumps that can weigh up to several pounds. They are found along the walls of the uterus.

Fibroids may be asymptomatic, or may cause pain and heavy menstrual cycles.

Fibroids also put pressure on the bladder and the rectum, causing frequent urination and rectal pressure. If they get too big, fibroids may cause the uterus to become enlarged.

Cluster Headaches

A number of conditions may require oral surgery, including:

Impacted Teeth

Wisdom teeth, otherwise known as third molars, are the last set of teeth to develop. Sometimes these teeth emerge from the gum line and the jaw is large enough to allow room for them, but most of the time, this is not the case. More often, one or more of these third molars fails to emerge in proper alignment or fails to fully emerge through the gum line and becomes entrapped or “impacted” between the jawbone and the gum tissue. Impacted wisdom teeth can result in swelling, pain, and infection of the gum tissue surrounding the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage to nearby teeth, gums, and bone and can sometimes lead to the formation of cysts or tumors that can destroy sections of the jaw. Therefore, dentists recommend people with impacted wisdom teeth have them surgically removed.

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It’s not just wisdom teeth that sometimes become impacted and need to be removed. Other teeth, such as the cuspids and the bicuspids can become impacted and can cause the same types of problems described with impacted wisdom teeth.

Tooth Loss

Dental implants are an option for tooth loss due to an accident or infection or as an alternative to bridges and dentures. The implants are tooth root substitutes that are surgically anchored in place in the jawbone and act to stabilize the artificial teeth to which they are attached. Suitable candidates for dental implants need to have an adequate bone level and density, must not be prone to infection, and must be willing to maintain good oral hygiene practices.

Jaw-Related Problems

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• Unequal jaw growth. In some individuals, the upper and lower jaws fail to grow properly. This can cause difficulty in speaking, eating, swallowing, and breathing. While some of these problems — like improper teeth alignment — can be corrected with braces and other orthodontic appliances, more serious problems require oral surgery to move all or part of the upper jaw, lower jaw, or both, into a new position that is more balanced, functional, and healthy.
• Improve fit of dentures. For first-time denture wearers, oral surgery can be done to correct any irregularities of the jaws prior to creating the dentures to ensure a better fit. Oral surgery can also help long-term denture wearers. Supporting bone often deteriorates over time, resulting in dentures that no longer fit properly. In severe cases, an oral surgeon can add a bone graft to areas where little bone remains.
• Temporomandibular joint (TMJ) disorders. Dysfunction of the TMJ, the small joint in front of the ear where the skull and lower jaw meet, is a common source of headache and facial pain. Most patients with TMJ disorders can be successfully treated with a combination of oral medications, physical therapy, and splints. However, joint surgery is an option for advanced cases and when the diagnosis indicates a specific problem in the joint.

Other Conditions Treated By Oral Surgery

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• Facial injury repair. Oral surgery is often used to repair fractured jaws and broken facial bones.
• Lesion removal and biopsy.Oral surgeons can take a small sample of abnormal growth or tissue and then send it for laboratory testing for identification. Some lesions can be managed medically or can be removed by the oral surgeon.
• Cleft lip and cleft palate repair. Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip and/or a split or opening in the roof of the mouth. Oral surgeons work as part of a team of health care specialists to correct these problems through a series of treatments and surgical procedures over many years.
• Facial infections. Pain and swelling in the face, neck, or jaws may indicate an infection. Infections in this area of the body can sometimes develop into life-threatening emergencies if not treated promptly and effectively. An oral surgeon can assist in diagnosing and treating this problem. Surgical treatment, if needed, may include cutting into and draining the infected area, as well as extracting any teeth that might be involved.
• Snoring/sleep apnea. When conservative nonsurgical methods such as positive pressure air machines and dental splint appliances fail to alleviate this problem, surgery can be tried. Surgical procedures involve removing the soft tissues of the oropharynx (an area in the back portion of the mouth) or the lower jaw. Laser surgery is a newer treatment option.

The term lordosis means inward curving of a part of the lumber and cervical vertebral column. Excessive lordosis is termed as swayback or saddle back. There are three types of curves which can be present in the human spine.

Scoliotic curves- sideways curvature of the spine; it is always abnormal

Lordotic curves- inward curve of the lumbar spine just above the buttocks

Kyphotic curves- outward curve of the thoracic spine at the level of ribs

A small degree of lordosis and kyphoysis is normally present in the spine. If kyphoysis is too much, it causes round shoulders and is termed as Scheuermann’disease. If lordotic curving is too much, it is termed as swayback or lordosis that makes the buttocks more prominent.

 

Children suffering from too much lordosis will have a space beneath their lower back when lying on their back on a hard surface. When lordotic curve is flexible, it is generally not a concern. When the curve does not move, medical evaluationis needed. Lumber and cervical segments of  the vertebral column are normally lordotic (convexity anteriorly and concavity posteriorly). Anterior pelvic tilt is a major factor of lordosis. Patients with lordosis often show a visible arch in their lower backs. When we look at them from the side, their lower back forms a defined C-shape.

People with lordosis seem to be sticking out their stomachs and buttocks. During examination of the patient with lordosis, ask the patient to lie on his or her back on a hard surface. Can the patient can slide his or her hand under lower back, with a little space to spare? If the patient has lordosis, he or she will have extra space between his or her hand and lower back^2,3.

Causes of Lordosis

There are many medical conditions that cause the spine to curve more than normal. These conditions include.

• Achondroplasia- bones do not grow normally, leading to the short stature.
• Spondylolisthesis- the vertebrae in the lower back slip forward.
• Osteoporosis- vertebra become fragile and can easily be broken.
• Obesity- can cause lordosis.
• Kyphoysis- can lead to lordosis
• Discitis- the inflammation of intervertebral disc
• Benign juvenile lordosis
• Tight lower back muscles
• Excessive visceral fat
• Pregnancy
• Rickets

Lordosis symptoms

Symptoms of this abnormality depend upon the severity of the disease. Lordosis symptoms may include:

• C-shape back when seen from a lateral aspect, with the buttocks being more prominent
• A large gap between the lower back and the floor when lying on one’s back
• Pain and discomfort in the lower back
• Problems in moving in certain ways.

Diagnosis

It is difficult to measure and diagnose lordosis. The traditional measurement of lumber lordosis is difficult because of the obliteration of the vertebral end plate landmarks by interbody fusion. L4 –L5 and L5- S1 levels are mostly involved in fusion process, and contribute to normal lumber lordosis. It is useful to identify an accurate means of measuring lordosis at these levels.

Treatment

Treatment of lordosis includes:

• Pain killer medications to relieve the discomfort and back pain
• Wearing a back brace
• Weight loss
• Vitamin D supplementation
• Surgery
• Lordosis exercises

Arthrogryposis is caused by a condition called as fetal akinesia which means that when the baby is inside the womb of the mother it is not able to move inside as much as it should resulting in underdevelopment of the muscles and joints resulting in Arthrogryposis. When it comes to Fetal Akinesia, this may occur due to the following reasons:

• Some abnormality in the central nervous system of the child in which the nerve signals do not reach the joints making them move adequately.
• Another cause may be the womb is not big enough and the baby is cramped up for room and is not able to move adequately inside the womb of the mother.
• There is an abnormality in the development of the muscles and bones of the tissue.

Arthrogryposis as stated is a medical condition in which the child is born with joints that are too stiff too move and are stuck in one position. Some of the other accompanying symptoms are:

• Muscle atrophy or missing muscles
• Extremely stiff joints
• Webbing of skin around the affected joints.

Since Arthrogryposis is not a single medical condition hence the child may also have symptoms indicating a problem with the nervous system, heart, kidneys or other vital organs of the body.

The main aim for treating Arthrogryposis is to allow the child to move the affected joints as normally as possible, which means initiating treatments to increase the flexibility of the joint, improving strength of the muscles surrounding the joint, and maintaining a normal alignment of the bones. If the condition has affected the lower extremities then the aim of the treatment is to make the child ambulatory and if the upper extremities are affected then making sure that the child is able to use the hands in as normal way as possible. The following are the treatment strategies adopted for treatment of Arthrogryposis.

Physical/Occupational Therapy for Arthrogryposis: This is the first line of treatment of Arthrogryposis. As soon as the diagnosis of Arthrogryposis is made, the therapy is started to improve the flexibility of the joints affected and to increase strength of the joints. In the initial stage of treatment, the therapist will start with stretching exercises to improve the range of motion and strength of the joint of the child so as to improve their mobility. The therapist will also work on improving the child’s motor skills. In some cases assistive devices may also be needed to help the child become mobile and is able to do things without anybody’s help. Occupational therapists will device strategies to make the child more independent with their movement, writing, eating and the like.

Splinting and Casting: This is the next stage of treatment for Arthrogryposis in which the affected joint is either casted or splinted so that the joints are aligned in a normal way which will help the child move and navigate better and will be able to be independent. The casts and splints allow the joints to remain stretched and thus help prevent development of contractures. The splints that are used may be different for different functions.

It should be noted here that as the child grows the affected joints may not show the same rate of growth as the other muscles and joints of the body and hence ongoing therapy is extremely vital to keep the joints and muscle flexible and strong.

Surgery to Treat Arthrogryposis: This is recommended when the child has maximized improvement with physical therapy and use of splints and casts. The surgery is usually done when the child is a bit older to correct Arthrogryposis. The surgeries performed to correct the condition include osteotomy to align the joints normally for maximal benefits, procedures to release the muscles or tendons which are impairing free movement of the joints, a capsulotomy procedure in case a capsule is restricting the movement, surgeries to treat conditions like scoliosis, clubfoot and the like for treatment of Arthrogryposis.

They can be bothersome or frightening. They usually aren’t serious or harmful, though, and often go away on their own. Most of the time, they’re caused by stress and anxiety, or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant.

Heart palpitations can be a sign of a more serious heart condition. So, if you have heart palpitations, see your doctor. Get immediate medical attention if they come with symptoms:

• Shortness of breath
• Dizziness
• Chest pain
• Fainting

After your doctor takes your medical history and looks you over, he may order tests to find the cause. If he finds one, the right treatment can reduce or get rid of the palpitations.

If there’s no underlying cause, lifestyle changes can help, including stress management.

Causes

There can be many. Usually, palpitations are either related to your heart or the cause is unknown. Non-heart-related causes include:

• Strong emotions like anxiety, fear, or stress. They often happen during panic attacks.
• Vigorous physical activity
• Caffeine, nicotine, alcohol, or illegal drugs such as cocaine and amphetamines
• Medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration
• Hormonal changes during menstruation, pregnancy, or just before menopause. Sometimes, palpitations during pregnancy are signs of anemia.
• Medications, including diet pills, decongestants, asthma inhalers, and some drugs used to prevent arrhythmias (a serious heart rhythm problem) or treat an underactive thyroid
• Some herbal and nutritional supplements
• Abnormal electrolyte levels

Some people have palpitations after heavy meals rich in carbohydrates, sugar, or fat. Sometimes, eating foods with a lot of monosodium glutamate (MSG), nitrates, or sodium can bring them on, too.

If you have heart palpitations after eating certain foods, it could be due to food sensitivity. Keeping a food diary can help you figure out which foods to avoid.

They can also be related to heart disease. When they are, they’re more likely to represent arrhythmia. Heart conditions tied to palpitations include:

• Prior heart attack
• Coronary artery disease
• Heart failure
• Heart valve problems
• Heart muscle problems

Diagnosis:

Electrocardiogram (EKG): This can be done while you’re at rest or exercising. The latter is called a stress EKG. In both cases, the test records your heart’s electrical signals and can find unusual heart rhythms.Holter monitoring : You’ll wear a monitor on your chest. It continuously records your heart’s electrical signals for 24 to 48 hours. It can identify rhythm differences that weren’t picked up during an EKG.Event recording: You’ll wear a device on your chest and use a handheld gadget to record your heart’s electrical signals when symptoms occur.

Chest X-ray: Your doctor will check for changes in your lungs that could come from heart problems. For example, if he finds fluid in your lungs, it may come from heart failure.

Echocardiogram : This is an ultrasound of your heart. It provides detailed information about its structure and function.

If necessary, your doctor may refer you to a cardiologist for more tests or treatment.

Treatment

This depends on their cause. Often, palpitations are harmless and go away on their own. In that case, no treatment is needed.

If your doctor doesn’t find a cause, he may advise you to avoid the things that might trigger the palpitations. Strategies may include:

Easing anxiety and stress. Common ways include:

• Relaxation exercises
• Yoga
• Tai chi
• Biofeedback
• Guided imagery
• Aromatherapy

Cutting out certain foods, beverages, and other substances. These may include:

• Alcohol
• Nicotine
• Caffeine
• Illegal drugs

Avoiding medications that act as stimulants. You may have to steer clear of:

• Cough and cold medicines
• Certain herbal and nutritional supplements

If lifestyle changes don’t help, you may be prescribed medications. In some cases, these will be beta-blockers or calcium-channel blockers.

If your doctor finds a reason for your palpitations, he will focus on treating that reason.

If they’re caused by a medication, he will try to find a different treatment.

If they represent an arrhythmia, you may get medications or procedures. You may also be referred to a heart rhythm specialist known as an electrophysiologist.

Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Diagnosis

Tests and procedures used to diagnose hepatocellular carcinoma include:

• Blood tests to measure liver function
• Imaging tests, such as CT and MRI with contrast, and advanced imaging procedures, such as magnetic resonance elastography
• Liver biopsy, in some cases, to remove a sample of liver tissue for laboratory testing

Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common.

Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. And this type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver. Cancer that spreads to the liver is more common than cancer that begins in the liver cells.

Symptoms

Most people don’t have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

Causes

It’s not clear what causes most cases of liver cancer. But in some cases, the cause is known. For instance, chronic infection with certain hepatitis viruses can cause liver cancer.

Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells.

Risk factors

Factors that increase the risk of primary liver cancer include:

• Chronic infection with HBV or HCV. Chronic infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.
• Cirrhosis. This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.
• Certain inherited liver diseases. Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson’s disease.
• Diabetes. People with this blood sugar disorder have a greater risk of liver cancer than those who don’t have diabetes.
• Nonalcoholic fatty liver disease. An accumulation of fat in the liver increases the risk of liver cancer.
• Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored poorly. Crops such as corn and peanuts can become contaminated with aflatoxins, which can end up in foods made of these products. In the United States, safety regulations limit aflatoxin contamination. Aflatoxin contamination is more common in certain parts of Africa and Asia.
• Excessive alcohol consumption. Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.

Prevention

Reduce your risk of cirrhosis

Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce your risk of cirrhosis if you:

• Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount you drink. For women, this means no more than one drink a day. For men, this means no more than two drinks a day.
• Maintain a healthy weight. If your current weight is healthy, work to maintain it by choosing a healthy diet and exercising most days of the week. If you need to lose weight, reduce the number of calories you eat each day and increase the amount of exercise you do. Aim to lose weight slowly — 1 or 2 pounds (0.5 to 1 kilograms) each week.
• Use caution with chemicals. Follow instructions on chemicals you use at home or at work.

Get vaccinated against hepatitis B

You can reduce your risk of hepatitis B by receiving the hepatitis B vaccine, which provides more than 90 percent protection for both adults and children. The vaccine can be given to almost anyone, including infants, older adults and those with compromised immune systems.

Take measures to prevent hepatitis C

No vaccine for hepatitis C exists, but you can reduce your risk of infection.

• Know the health status of any sexual partner. Don’t engage in unprotected sex unless you’re certain your partner isn’t infected with HBV, HCV or any other sexually transmitted infection. If you don’t know the health status of your partner, use a condom every time you have sexual intercourse.
• Don’t use intravenous (IV) drugs, but if you do, use a clean needle. Reduce your risk of HCV by not injecting illegal drugs. But if that isn’t an option for you, make sure any needle you use is sterile, and don’t share it. Contaminated drug paraphernalia is a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
• Seek safe, clean shops when getting a piercing or tattoo. Needles that may not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or tattoo, check out the shops in your area and ask staff members about their safety practices. If employees at a shop refuse to answer your questions or don’t take your questions seriously, take that as a sign that the facility isn’t right for you.

Ask your doctor about liver cancer screening

For the general population, screening for liver cancer hasn’t been proved to reduce the risk of dying of liver cancer, so it isn’t generally recommended. The American Association for the Study of Liver Diseases recommends liver cancer screening for those thought to have a high risk, including people who have:

• Hepatitis B and one or more of the following apply: are Asian or African, have liver cirrhosis, or have a family history of liver cancer
• Hepatitis C infection and liver cirrhosis
• Liver cirrhosis from other causes, such as an autoimmune disease, excessive alcohol use, nonalcoholic fatty liver disease and inherited hemochromatosis
• Primary biliary cirrhosis

Discuss the pros and cons of screening with your doctor. Together you can decide whether screening is right for you based on your risk. Screening typically involves an ultrasound exam every six months.

Treatment

Which treatment is best for you will depend on the size and location of your hepatocellular carcinoma, how well your liver is functioning, and your overall health.

Hepatocellular carcinoma treatments include:

• Surgery. Surgery to remove the cancer and a margin of healthy tissue that surrounds it may be an option for people with early-stage liver cancers who have normal liver function.
• Liver transplant surgery. Surgery to remove the entire liver and replace it with a liver from a donor may be an option in otherwise healthy people whose liver cancer hasn’t spread beyond the liver.
• Destroying cancer cells with heat or cold. Ablation procedures to kill the cancer cells in the liver using extreme heat or cold may be recommended for people who can’t undergo surgery. These procedures include radiofrequency ablation, cryoablation, and ablation using alcohol or microwaves.
• Delivering chemotherapy or radiation directly to cancer cells. Using a catheter that’s passed through your blood vessels and into your liver, doctors can deliver chemotherapy drugs (chemoembolization) or tiny glass spheres containing radiation (radioembolization) directly to the cancer cells.
• Targeted drug therapy. Targeted drugs, such as sorafenib (Nexavar), may help slow the progression of the disease in people with advanced liver cancer.
• Radiation therapy. Radiation therapy using energy from X-rays or protons may be recommended if surgery isn’t an option. A specialized type of radiation therapy, called stereotactic body radiotherapy (SBRT), involves focusing many beams of radiation simultaneously at one point in your body.
• Clinical trials. Clinical trials give you a chance to try new liver cancer treatments. Ask your doctor whether you’re eligible to participate in a clinical trial.