FEET – BUNION

Bunions are thought to develop because we squeeze our feet into shoes which are too narrow for the forefoot. Coupled with this may be an inherited tendency for the first metatarsal or long bone of the foot to splay medially or inwards.

The first deformity is a hallux valgus. The joint of the great toe (hallux) is forced laterally, or outward, so that the toe turns inward, crowding the other toes.

An exostosis, or bony projection, develops on the medial or inner side of the head of the metatarsal, where it forms the big toe joint.

Osteoarthrosis usually develops in this joint and causes pain and stiffness and overgrowth of bone at the joint edges.

The bunion is a small bursa or fluid sac which forms on the medial side of the joint over the projecting bone. It may become inflamed or infected. The second toe gets crowded out and may over or under-ride the first toe.

A foot with all these deformities doesn’t look good but may not, at first, be painful. Doctors are reluctant to operate for cosmetic reasons only and usually wait until the person is inconvenienced by progressing pain.

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CYSTITIS – DRINKING ANY FLUIDS

Even drinking large amounts of any fluid, usually water, will relieve the discomfort. But although the symptoms are eased, this does not mean that the condition is cured. It may, and often does, recur.

That is why it is necessary to go to a doctor if you have cystitis and for the doctor to treat it seriously.

In true cystitis or infection of the bladder, germs have usually entered from the urethra, which has been contaminated from the bowel or a vaginal discharge.

The proper treatment involves taking a sample of urine under sterile conditions and looking at it under the microscope. A culture is set up, and any germs present are grown and matched against a number of antibiotics.

It may take three days for the results and a woman should not be expected to suffer discomfort for this length of time.

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HOW MAJOR IMPROVEMENTS IN CHEMOTHERAPY HAVE COME ABOUT – MID-1970S

In the mid-1970s, the same degree of improvement occurred in the treatment of testicular cancer. This time it was a new drug rather than a new technique (the use of high dose combinations) that was responsible for the breakthrough. A new drug called cis-platinum had been shown to be active against testicular cancer in Phase II studies. This drug, when combined with the two previously best drugs (vinblastine and bleomycin) produced complete remissions in most patients with cancer of the testes, many of whom were later shown to be cured altogether. Prior to that about one in three patients with extensive cancer of the testes experienced remissions which were only partial and temporary, cures were unusual. Again, special research techniques were not necessary to prove that the new treatment was much better than what had been used previously.

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