Treatment of Cout


Complications of Gout

Recurrent attacks of gout can lead to chronic gout, which can cause a form of arthritis in the joints and permanent joint damage. Swellings, called tophi, can occur in the joints due to a build-up of large amounts of uric acid crystals. These uric acid crystals can also deposit in the kidneys, causing kidney stones.

Acute attacks of gout can be effectively treated by taking anti-inflammatory medication. Caution is needed with anti-inflammatories, however, as they can affect the stomach and kidneys. Other options include colchicine (although this can cause vomiting and diarrhoea) or short courses of steroids.

If someone is suffering from recurrent attacks of gout they can be prescribed medication, known as allopurinol, to lower the uric acid level. However, while allopurinol is very effective at preventing attacks of gout, it must be stopped if someone suffers an attack while taking it as it can make an acute episode of gout worse.

Tips to Prevent Cout

Drinking lots of water is important to flush out the kidneys and help to remove uric acid from the body. While only about 10 per cent of uric acid comes from our diet, making some dietary changes can be worthwhile. It is recommended to cut back on purine-rich foods and keep your alcohol consumption within safe limits, particularly avoiding binge drinking. Keep your weight healthy. If you are overweight this puts extra strain and pressure on your joints as well as increasing the risk of high uric acid levels and gout. Avoid crash diets as they can increase uric acid levels in the blood, and also low-carbohydrate diets that are high in protein and fat, which can increase uric acid levels.

Kidney Stones

Kidney stones are small bits of mineral and acid salts inside the kidneys. They are caused by the urine flowing through the kidneys becoming rich or heavy in minerals that form into crystals, which in time can stick together, solidify and develop into tiny bits of gravel and eventually stones. Normally these substances are diluted in the urine. The main mineral found in most kidney stones is calcium, while others less commonly found include oxalate or phosphate. About 10 per cent of kidney stones are due to excess uric acid.

How Common Are Kidney Stones?

Kidney stones mainly occur in men. An Irish man has about a 10 per cent chance of getting a kidney stone at some stage during his life, most commonly between the ages of 20 and 50. They also have a nasty habit of recurring. Up to 50 per cent of men will suffer a reoccurrence within ten years of getting a kidney stone.


Antidepressants and Suicide

Sometimes depression medication can cause an increase – rather than a decrease – in depression and suicidal thoughts and feelings. Therefore, anyone on antidepressants should be aware of and watch out for increases in suicidal thoughts and behaviours. This is thought to be most important early on in the treatment programme and when the dose of medication is changed.

Warning Signs of Suicide

  • Signs of severe depression:
    • unrelenting low mood
    • pessimism
    • hopelessness
    • worthlessness
  • Social withdrawal:
    • Sleep problems
    • Increased alcohol and/or other drug use
    • Impulsive behaviour and taking unnecessary risks
    • Talking about suicide or expressing a strong wish to die
    • Unexpected mood swings, including rage or anger

Take any suicidal talk or behaviour seriously as it is often a cry for help. More subtle warning signs of suicide are feelings of hopelessness or worthlessness. People who feel hopeless about their situation may talk about ‘unbearable’ feelings, predict a bleak future and state that they have nothing to look forward to. A suicidal person may have dramatic mood swings or sudden personality changes, such as becoming very withdrawn, losing interest in day-to-day activities, neglecting his appearance and showing big changes in eating or sleeping habits.

Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other mental illnesses.

Some Misconceptions About Suicide

  • Men who commit suicide are unwilling to seek help. FALSE:

Many suicide victims have sought medical help within the six months prior to their deaths.

  • People who talk about suicide won’t really commit suicide. FALSE:

Many men who tempt or commit suicide give some warning clue in advance. It may be something that’s said; statements like ‘I’d be better off dead’ or ‘I can’t see any way out’ should raise the alarm. Rather than ignoring talk about suicide, discussing the subject openly can be helpful.

  • If a man is determined to commit suicide nothing is going to stop him. FALSE:

The sense of hopelessness that can be experienced with severe depression can lead to impulsive thoughts of suicide and temporarily push someone over the edge.

Prevention of Suicide

Suicide prevention starts with recognising the warning signs and taking them seriously. If you think a friend or family member is considering suicide, don’t be afraid to bring up the subject. Be willing to listen. Speak up if you’re concerned and encourage the person to seek professional support from a doctor.

  • Take it seriously:

Many people who commit suicide give some warning of their intentions to a friend or family member. Therefore all suicide threats and attempts should be taken seriously.

  • Be willing to listen:
  • Get appropriate help:

Get the person appropriate professional help as soon as possible. If necessary, bring him to his doctor. You can make a difference.

Alcohol and Other Drugs

Don’t try any Drugs – this is information only!!!


Speed can increase your blood pressure, which can cause a stroke. Regular users can become very run-down with a weakened immune system, which makes them more prone to all types of infections. Mental health can be severely affected by regular use, leading to severe depression and paranoia, with an increased risk of psychosis.


Ecstasy is made up of a mixture of substances, including a synthetic drug called MDMA, and is classed as a hallucinogenic amphetamine. It comes in tablet form and is swallowed. Other names for ecstasy include ‘E’, ‘doves’, ‘XTC’ and ‘disco biscuits’. Taking ecstasy can cause relaxation, disinhibition and feelings of warmth. It is sometimes known as the ‘love drug’. Initial effects can last for several hours and include feeling more alert; colours, sound and emotions can also seem more intense. Feelings of confusion, anxiety and paranoia may occur. The ‘come down’ phase can cause profound fatigue, inability to sleep and feelings of depression. Viagra Generic Canada

Health risks include blurred vision, liver and kidney problems and a danger of overheating and getting dehydrated if you are out dancing in a club. This is known as ‘heat stroke’ due to a combination of a raised body temperature from the ecstasy and dehydration from dancing and the rise in temperature. It can lead to convulsions, coma or even heart attack and stroke. Heart palpitations can occur with an increase in blood pressure and skin temperature. Mental health problems include long-term damage to serotonin receptors in the brain with an increased risk of depression.


Heroin is made from the pain-killing drug morphine and comes from the opium plant. It is a highly addictive drug with tolerance developing rapidly so that users need to take more and more heroin to get the same ‘high*. Heroin can be smoked, sniffed or injected. When you take heroin there is an intense rush of excitement followed by a dream-like state of relaxation. These effects can last several hours and are much more intense if the heroin is injected. First time use, especially if injected, often causes nausea, vomiting and severe headaches. Sharing needles when injecting heroin increases the risk of blood-acquired infections such as blood poisoning or HIV, and Hepatitis B and C. Withdrawal symptoms can occur within 24 hours of the last ‘fix’ and include a multitude of symptoms known collectively as ‘cold turkey’. These can include sweats, chills, anxiety, irritability, cramps and muscle spasms.

The use of heroin can lead to significant health problems. These include a weakened immune system from poor nutrition, collapsed veins, skin abscesses, an increased risk of pneumonia and other chest problems, and chronic constipation. Using heroin can affect your fertility and cause erectile dysfunction. The drug can consume a user’s life, leading to the breakdown of relationships, career and home life. Many addicts get involved in crime to feed their habit. Heroin can lead to mental health problems, including depression and suicide.

Arginine, Citrulline, and Nitric Oxide

There are certain elements created within the body that are crucial to maintaining circulation and heart health. There are others that go towards the production of those key elements; elements that can reduce your risk for heart disease, stroke, and many more cardiovascular related diseases. Arginine and citrulline are critical proponents of nitric oxide, which is a critical proponent of a healthy heart. Here’s how it works:

What is Arginine?

Arginine is an amazing little organic compound that has been medically proven to improve vasodilation, or the widening of blood vessels, allowing increased blood flow and decreasing blood pressure. Vasodilation is an automatic and direct response to distress within the body’s tissues and muscles. When these tissues and muscles are not receiving enough nutrients or oxygen, they send out the distress signal that alerts the body to increase vasodilation, widen the blood vessels, and send more blood with oxygen to the distressed areas.

According to the, this improved blood flow can help decrease the risk for, and treat, chest pain, atherosclerosis (clogged arteries), heart disease or failure, erectile dysfunction, intermittent claudication/peripheral vascular disease, and vascular headaches (headache-inducing blood vessel swelling).

What is Citrulline?

Like arginine, citrulline is an amino acid that has been researched in association with reducing high blood pressure and improving symptoms of sickle cell disease. This organic compound has also been used for Alzheimer’s disease, dementia, fatigue, muscle weakness, sickle cell disease, erectile dysfunction, high blood pressure, and diabetes, according to

Arginine and Citrulline Together

Separately, arginine and citrulline are powerful amino acids that facilitate the production of nitric oxide (NO). However, together these two components can increase quicker production of NO, support exercise performance, increase weightlifting performance, delay muscle fatigue in weight training, improve immune system levels, improve vasodilation, and benefit overall heart health.

Nitric Oxide

Arginine and citrulline work together to create NO. Nitric oxide is a gas that is found naturally in the body. It’s main purpose is to keep oxygen flowing through the body by maintaining circulation with vasodilation. Nitric oxide is produced through nitric oxide synthase, which can only take place with the presence of amino acids like arginine and citrulline.

Once created, NO works wonders for athletes and those at high risk for cardiovascular diseases, as well as your everyday Joe. Bodybuilders and athletes take NO in the form of arginine supplements to increase blood flow, oxygen delivery, glucose uptake, muscle velocity, muscle growth, and after-work out recovery.

Nitric Oxide and Heart Disease

Nitric oxide has been used for many years as a preventative measure for those at high risk for heart disease. By increasing blood flow and keeping the blood vessels wide enough to avoid plaque build-up, NO can reduce an individual’s overall risk for certain cardiovascular diseases.

According to Dr. John P. Cooke, head of Stanford University’s vascular unit, the number one contributing factor to heart disease is damage to the inner lining of arteries, or the endothelium. A damaged endothelium cannot produce enough nitric oxide to widen the vessels enough, and more damage can occur as plaque builds up in the arteries.

“When the endothelium is healthy it’s like Teflon, and things don’t stick. When it’s unhealthy, it becomes more like Velcro, attracting blood-borne gunk like flies to flypaper.”

Maintaining a healthy diet that includes foods that contain arginine such as cottage cheese, milk, yogurt, beef, pork, poultry, seafood, granola, oatmeal and many more nuts can help increase nitric oxide production and reduce your risk for heart disease. Exercise is another wonderful way to reduce your risks.



If you have had unprotected exposure to the HIV virus, make sure to get yourself tested. Blood tests can accurately diagnose HIV. However, there is a recognised window period, meaning that it may take some time – at least three months and sometimes longer – after unprotected exposure to HIV before the test may show up positive in your blood.

Signs and Symptoms of HIV/AIDS

Early signs of HIV/AIDS infection can include flu-like symptoms, unexplained rashes, fungal infections in the throat, swollen glands and unusual tiredness. These symptoms and signs are similar to many different flu-like or viral infections and diseases. The person appears to recover, usually between a week and a month later. Often, however, early infection with HIV/AIDS has no symptoms.

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Later signs and symptoms of HIV/AIDS can include rapid weight loss, dry cough, fevers or night sweats, fatigue, swollen lymph glands in the armpits, groin or neck, recurrent infections such as chest infections, pneumonia or Candida infections (thrush) in the mouth, memory loss and depression. At this stage the person is said to have progressed from having a HIV infection to having full-blown AIDS. As the disease progresses and the immune system is weakened further, cancers and other life-threatening infections can occur.

Many people who carry the HIV virus don’t know they are infected; that’s why being tested is so important. If you are sexually active with more than one partner – or have any reason to think you might have been exposed to HIV in the past – go to your doctor and discuss whether you should be screened or not.

Can STIs Be Prevented?

Yes, in fact STIs are easily prevented. The only foolproof way is to avoid sex. The next best way to prevent an STI is simply to have sex with an uninfected partner in the context of a monogamous, faithful relationship. The third way is to always practise safe sex. Using condoms that prevent the sharing of body fluids cuts down on the likelihood of cross-infection, but occasionally they do fail during use. However, they are still highly effective at preventing the spread of STIs.

There is no doubt that there is a big knowledge deficit among men when it comes to men’s sexual health issues, as with other health-related areas. The challenge is to provide information and education about sexually Generic viagra Australia Pharmacy transmitted infections so that men can make informed choices. It is also important that equal emphasis is put on alcohol and drug awareness as unplanned sexual encounters often occur in the context of alcohol and/or drug use.


What Are the Symptoms of Stroke?

As the name suggests, stroke is like a bolt of lightening, and can bring on sudden death. Symptoms include weakness or paralysis down one side of the body (face, arms or legs), numbness or loss of sensation in the face or limbs, and loss of bladder control, speech or vision. Other symptoms can include weakness, difficulty swallowing, face drooping to one side, dizziness, loss of balance, severe headache, difficulty speaking or understanding simple statements, and loss of vision, especially in one eye. There is potential for a certain amount of recovery in the first few weeks after a stroke, which is why expert rehabilitation with a range of different health professionals is so important.

What Type of Man Is at Risk of Stroke?

  • Older men – two-thirds of strokes occur in people aged over 65.
  • Those with a history of heart disease, previous stroke or mini-stroke
  • Men with risk factors such as high blood pressure, high cholesterol, obesity and lack of exercise, smokers and heavy drinkers
  • Those with an irregular heartbeat, called atrial fibrillation, which increases the chances of clots in the system
  • Men with a high red blood cell count, as thicker blood is more likely to clot
  • Men with a family history of stroke Prevention of Stroke

Just like heart disease, you can reduce your chances of getting a stroke by making certain changes in your lifestyle, especially by not smoking and controlling high blood pressure. If you have high cholesterol, lowering your cholesterol levels may also reduce your risk. Your doctor may tell you to change your lifestyle as well as prescribing medication to lower your blood pressure or cholesterol. Aspirin or warfarin is often used to prevent clotting and reduce the risk of stroke.


These are also known as transient ischemic attacks or TIAs, brought on when an artery in the brain becomes temporarily blocked. This can cause symptoms similar to a stroke but the symptoms disappear without any permanent damage within 24 hours. This is the key difference between a TIA and a stroke. However a TIA is a warning sign that you are at much greater risk of a stroke in the future. Therefore it is an early warning sign that you need to sit up and take notice of your health, and work with your doctor to do all that can be done to prevent a stroke later on.

Key Points

  • Heart disease Canadian HealthCare Mall and stroke are the number one causes of death and premature illness in Irish men.
  • High blood pressure is very common in Irish men and is a major risk factor for heart disease and stroke.
  • High blood pressure often has no symptoms; it is ‘the silent killer’.
  • Atherosclerosis is a disease process that damages the circulation and can affect the heart, brain, aorta and legs, causing heart disease, stroke, aneurysms and blocked arteries.
  • We can’t change our genes but many of the risk factors for atherosclerosis can be controlled – these include cigarette smoking, high blood pressure, diabetes, high cholesterol, stress, obesity and lack of exercise.
  • Know your numbers – you should get your blood pressure and cholesterol checked regularly.
  • High blood pressure, high cholesterol and many of the risk factors for heart disease, stroke and atherosclerosis can be very successfully treated, but only if you are aware that you have them.
  • Prevention is better than cure.

Herpes Part

Herpes can destroy relationships, but fortunately Kathy and Dylan had worked hard at talking through problems and had built a relationship based on honesty. Kathy believed Dylan that this was not a new infection and forgave his rather naive neglect of openness about it. Dr. Seip was tremendously helpful to the young couple and helped them to see that this was not the end of the world and that they could still realise all their dreams.

Genital herpes is caused by herpes simplex, type 2. This is a virus and there are other members of the herpes virus family. Type 1 causes the common cold sore and, much less often than type 2, can also cause a genital herpes infection. But here, to all intents and purposes, we are not talking about type 1. Make no mistake about it: genital herpes is a sexually transmitted disease. You will not get it from using your friend’s towel. The virus likes warm, moist areas and can infect the genitals, mouth, throat and anus — in other words, wherever sexual contact may occur. Condoms can protect to a great extent but not completely, and the virus may be passed to a sexual partner even when no symptoms are present.

Within two to 20 days of exposure, you may experience — as did Dylan — flu-like symptoms, followed by tingling and pain. Dylan experienced this on his penis, but it can occur anywhere in the lower pelvic area. Then come the blisters, which quickly open out to shallow and very painful ulcers. The active manifestation of the illness is self-limiting and the ulcers and pain clear within two weeks for most people. Each occurrence is usually milder than the last, with the first being the worst. Treatment buy Sublingual Viagra helps to moderate the severity and length of the outbreak and is most effective in the first episode. As mentioned before, treatment needs to begin during the first six days of symptoms.

It is critical to understand that, although the rash goes away and the outbreaks get milder, the virus resides happily in your cells and you remain infected. Our drugs can suppress it (like caging a wild lion), but will not cure it. Therefore, if you have new sexual partners, you need to be honest with them. If you have an active attack, it is best to abstain from intercourse; otherwise, use condoms at all times. Although we are not sure that these measures are 100 per cent effective, studies of monogamous couples in which one partner has the infection and the other doesn’t indicate about a 15 per cent infectivity over an eighteen-month period.

Abnormalities of female genital tract and intersex disorders

Transverse fusion abnormalities

The surgery required is a simple incision, which should be performed when the diagnosis is made to prevent too big a build up of menstrual blood, which may lead to a haematometra8 and consequent increased risk of endometriosis (secondary to retrograde menstruation). A transverse vaginal septum, due to failure of fusion or canalization between the Müllerian tubercle and sinovaginal bulb, may present like an imperforate hymen but is associated with a pink bulge at the introitus as the septum is thicker than the hymen. Great care must be taken during surgery to prevent annular constriction rings and the procedure should only be performed in dedicated centres by experienced surgeons. When there is a transverse septum it has been found to be high in 46 per cent of patients, in the middle of the vagina in 40 per cent and low in the remaining 14 per cent. It is the patients in the last two groups who have higher pregnancy rates after surgery.

Müllerian/uterine anomalies

Uterine anomalies occur in between 3 and 10 per cent of the fertile female population and are often discovered by chance during coincidental investigations for infertility. They have usefully been classified by the American Society for Reproductive Medicine into five groups. Women with uterine anomalies are usually asymptomatic, unless there is obstruction to menstrual flow, when cyclical pain may be experienced. While infertility per se is rarely caused by uterine anomalies, they may be associated with endometriosis if there is retrograde menstruation secondary to obstruction. Furthermore, recurrent miscarriage may be experienced by some women with uterine malformations.

Surgery is reserved for those cases where there is obstruction, for example the removal of a rudimentary uterine horn or excision of a vaginal septum. The excision of a uterine septum has been shown to improve pregnancy outcome and should be performed by an experienced hysteroscopist. On the other hand, metroplasty (Strassman procedure) of the horns of a bicornuate (having two horns) uterus is currently seldom performed as its benefit has been questioned.

Abnormalities of male genital tract

Bilateral castration and anorchia10 (incidence of 1 in 20,000 males) are rare causes of absent testicular tissue. Other rare anatomical causes of male  infertility include agenesis (absence) of the epididymis or other parts of the ductal system including the vas deferens. The latter is found in most males discount viagra Canadian with cystic fibrosis (CF). The majority of males found to have isolated bilateral agenesis of the vas deferens without any other signs of CF have been found to be carriers of a point mutation in the CF gene. In these individuals, genetic counselling is indicated.