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21 Apr 2018
Purpose of the test
 
The test is performed to assess the adrenal cortex function, and evaluate and monitor the adrenal tumors and hyperplasia.
 
How to collect the urine sample for the 17-ketosteroids test?
 
  1. For the test of 17-ketosteroids in urine, 24 hours urine sample is required. Urine is collected in a container, containing one gram boric acid or 6 ml hydrochloric acid (HCl).
  2. The first urine sample is discarded and then collected the all urine sample for 24 hours.
  3. The 24 hours urine sample is transferred to the pathology laboratory for laboratory findings.
 
Why is boric acid used for the collection of the urine sample?
 
Boric acid converts the urine into a bacteriostatic medium, which inhibits the growth of bacteria in urine and preserves the urine for its bacteriological examination.
 
Precautions
 
Some medicines like aspirin, diuretics, antibiotics, birth control medication and hormones therapy (e.g. Estrogen) may interfere with laboratory findings, so avoid such types of medicine before preparing yourself for the laboratory test.
 
Normal Values
 
  • Males: 8-20 mg/24-hour
  • Females: 6-15 mg/24-hour
  • Elderly males > 70 years: 3-12 mg/24-hour
  • Elderly females > 70 years: 3-13 mg/24-hour
  • Infants: < 1 mg/24-hour
  • 1 to 5 years: < 5 mg/24-hour
 
Reasons for the increased level of 17-ketosteroids in the 24-hour urine sample
 
  • Pregnancy
  • Stein-Leventhal syndrome
  • Hyperpituitarism
  • Ectopic ACTH-secreting tumors
  • Administration of ACTH
  • Cushing’s syndrome
  • Congenital adrenal hyperplasia 
  • Testosterone secreting or androgen-secreting tumors of:
    (1) Ectopic ACTH-secreting tumors
    (2) Ovaries
    (3) Testes
 
Reasons for the decreased level of 17-ketosteroids in the 24-hour urine sample
 
  • Hypopituitarism
  • Severe infections 
  • Klinefelter's syndrome
  • Addison’s disease
  • Severe stress
  • Nephrosis
  • Debilitating diseases
  • Chronic diseases
  • Castration
  • Myxedema
  • Drugs that can decrease the level of 17-ketosteroids include:
    (a) Probenecid
    (b) Estrogens
    (c) Reserpine
    (d) Thiazide diuretics
    (e) Salicylates (prolonged use)
    (f) Birth control pills
 
The significance of 17-ketosteroids for the layman
 
  1. The test is advised if the females has hairs on her face.
  2. The test is performed to elaborate any abnormality or disorders of the adrenal gland.
05 Apr 2018
Anal sex refers to the activity in which penis is inserted into the anus. Some people found anal sex more joyful, but the fact is that the practice has the downside and it contains so many health risks.
 
It is prohibited in various cultures especially with regard to religious prohibition. It is a criminal offense in some countries and punishable by corporal or capital punishments. By disparity, people regard it a valid and natural form of sexual activity.

Is Anal Sex Safe?
 
There are so many health risks associated with the anal sex and anal intercourse, for both partners. Some of the health risks which may affect both homosexual and heterosexual couples are listed below.
,  
Risk of bacterial infection: E. coli is a Gram-negative, facultative anaerobic bacteria, that is commonly found in the lower intestine. Anal sex increases the risk of transmission of E. coli bacteria from anal to your penis, which may cause a severe type of urinary tract infection.
 
E. coli may cause many bacterial infections, including, urinary tract infection (UTI), meningitis, cholecystitis, cholangitis, bacteremia, and pneumonia.
 
Hepatitis A Virus (HAV): Hepatitis A Virus can transmit by the oral sex (anal licking). HAV causes jaundice. It is usually not a life-threatening virus but may cause illness.
 
Hepatitis C Virus (HCV): It may be transmitted through the anal intercourse. Hepatitis C Virus is the cause of fetal liver chronic disease. It is a life-threatening virus and may lead to death.
 
Human Papilloma Virus (HPV): It may be transmitted through the anal intercourse and may cause to the anal wart. A research showed that some of the strain of HPV have carcinogenic potential. Some strains of HPV cause cancer of the cervix in women and also cause cancer of the throat.
 
Human immunodeficiency virus (HIV): There is a greater risk of transmission of HIV through anal intercourse. It is a life-threatening virus and leads to death.
 
Weakening of the anal sphincter: The anal anus is enclosed by the ring-like muscle, called the anal sphincter. The main function of anal sphincter is to hold the feces until you get to the toilet. After the excretion of feces, it tightens. Penetration of something like a penis inside the anal can be difficult and painful. Anal intercourse may lead to the weakening of the sphincter muscles, and make it hard to hold the feces.
 
Lack of natural lubrication: Naturally, the anal is not made for sex. The anal has lack of lubricant as vagina have, which makes the penetration harder and painful. Penetration can tear the tissues inside the anal and cause the wound, allowing viruses and bacteria to easily enter the bloodstream. Somehow, usage of oil or other lubricants can help in preventing the tearing of tissues inside the anal but doesn't completely.
 
A research showed that risk of transmission of HIV and HPV is much higher in anal sex and compared to the vaginal sex.
 
How to Prevent Anal Sex Problems
 
There is no way to completely eliminate the risk factors of anal sex until you avoid the anal sex. However, you can reduce the risk by the following tips.
 
  1. Always use a condom during anal sex.
  2. Do not enter penis into the mouth after inserting it into the anal.
  3. Use a sufficient amount of lubricants when penetrating into the anal to reduce the risk of tissue tear. Always use water-based lubricants with condoms.
  4. Do not lick the anal as it may cause the transmission of bacteria and viruses.
  5. Take a warm bath before anal sex.
  6. Lying on your stomach will make the insertion easier.
  7. Stop if you feel so much pain during anal sex.
  8. Stop if you experience bleeding or discharge coming from it, go to the hospital as soon as possible.
01 Apr 2018
The Middle East respiratory syndrome (MERS) caused by coronavirus which has a large family of virus. This viral disease first identified in September 2012 in Saudi Arabia. This virus can cause disease ranging from common cold to Severe Acute Respiratory Disease (SARS).
 
This deadly virus may originate from bats and categorize as a zoonotic virus. Which mean a virus that transmitted from animal to human by direct or indirect contact. Especially dromedary camel which is a reservoir host for this virus.
 
Which Country Infected By MERS-CoV
 
Saudi Arabia is the leading country. About 80% of cases have reported. The United Arab Emirates and the Republic of Korea come in second. But specific antibodies that can found in previously infected animal have been identified in Middle East, Africa, and South Asia
 
*According to WHO, since 2012, 27 countries have reported cases of MERS including Algeria, Austria, Bahrain, China, Egypt, France, Germany, Greece, Islamic Republic of Iran, Italy, Jordan, Kuwait, Lebanon, Malaysia, the Netherlands, Oman, Philippines, Qatar, Republic of Korea, Kingdom of Saudi Arabia, Thailand, Tunisia, Turkey, United Arab Emirates, United Kingdom, United State, and Yemen.
 
How MERS-Cov virus Spread or Transmitted?
 
From animal to human. Taking care of infected animal without proper precaution can transmit the virus easily. Eating raw meat or milk without proper preparation can also infect the human.
 
Secondly, they spread by human to close human contact. For example, unprotected care to a patient in health-care facilities. The facilities provided inadequate prevention and didn’t separate MERS patient with another patient. Traveller whose have infected. Traveling to another country and spread the virus.
 
However, the exact route is still unknown.
 
What Are The Symptoms of MERS-CoV
 
Typical symptoms that infected patient presented are the common cold, cough, and shortness of breath. These are the common/mild symptoms. Pneumonia(not always present), and severe acute respiratory disease which leads to respiratory failure. The patient needs to use mechanical ventilation in intensive care unit (ICU).
 
Gastrointestinal symptoms also present for example diarrhea. Some of the patients might be asymptomatic meaning absent from clinical symptoms. But they are positive for MERS proved by a laboratory test.
 
Is There A Possibility For Me To Get Infected?
 
High-risk people: eating raw contaminated milk and meat. Older people. Low immunity person. Chronic disease patient such as renal disease, cancer, lung disease and diabetes. This person should avoid direct contact with camel, drinking raw camel milk or urine and eating raw meat.
 
*According to WHO, 750 death related to MERS-Cov since 2012. But there are still patient with mild cases that might miss due to ignorance about the disease. This disease has high mortality rates of 35%.
 
How Can We Treat MERS-CoV Disease?
 
Unfortunately, there is no vaccine,or specific treatment is currently available. However, according to WHO, three vaccines currently under development. One vaccine to prevent transmission from animal to human. While the other two for outbreaks of this disease and protection for high-risk people). As for now, we can only treat clinical symptoms and supportive treatment.
 
What Can We Do To Avoid The Virus?
 
We can take some precaution. For examples in the farms, market, and barns. The home where dromedary camel and other animals live; we should practice general hygiene measures. Washing hand before and after contact with the animal and avoid visiting sick animal. In health-care facilities, the worker should know or educated in the prevention of disease and applied it. Fortunately, according to WHO, a disease outbreak in healthcare facilities have significant drop compared to previous year.
 
MERS-CoV is still a threatening virus, and WHO reports the recent case. A male patient 74 years old lives in Batinah, Omani. The disease transmitted when he is taking care of his sick camel. Laboratory confirmed that it is a case of MERS-Cov disease. Take care of ourselves better. Educate yourself and take alert of what happens in our world. The world is getting sicker day by day, and we can change it. Little by little.
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