Today is World Brain Tumor Day
Labour pain is among the most severe types of physical pain that women may experience during their lifetime. The level of this discomfort varies for each woman and for each pregnancy. Thus, pain relief is an essential part of medical care during childbirth. Labour is a series of progressive, rhythmic contractions of the uterus. These contractions help the cervix open and become thinner, and this allows the baby to travel through the birth canal. Labour pains and maternal stress are associated with a poor progress of labour which can lead to complications to the mother and baby.
Fortunately, there are many several pain management strategies which include non‐ pharmacological interventions (that aim to help women cope with pain in labour) and pharmacological interventions (that aim to relieve the pain of labour). The World Health Organisation (WHO) recommends adequate pain relief during labour, to ensure a positive childbirth experience.
Non-pharmacological methods such as relaxation techniques (ie, yoga, hypnosis, and music), manual techniques (ie, massage, reflexology, and shiatsu), acupuncture and birthing ball are considered safe. Research has consistently demonstrated that women greatly value and benefit from the presence of someone they trust during labour and childbirth to provide emotional, psychological, and practical support and advice. The supportive care may include having someone who is continuously present and who reassures and praises her, assists with measures for physical comfort (e.g., providing comforting touch, massage, warm baths, or showers, and promoting adequate fluid intake and output) and undertakes any necessary advocacy on her behalf (e.g., helping the woman articulate her wishes to health workers and others).
Epidural analgesia is regarded as the leading and most effective treatment for labour and delivery pain. Epidural analgesia requires a specialist anaesthesiologist to insert a tiny tube, called a catheter, in the lower part of your back. The catheter is left in place for delivery of the medication through the tube as needed. This method has an 8.5% failure rate, and its limitations include costs, accessibility, prolonged labour, and reduction in women’s sense of control and their participation in the labour process and can involve adverse effects such as a drop in blood pressure or headache after delivery. A specialist anaesthesiologist and the midwife closely monitor the patient for possible complications.
Opioids are commonly used for pain relief during labour, as they are widely available, easy to use and are of low cost. Their main advantage is that they produce analgesia with milder side effects. Opioids can be combined with other simple but effective painkillers like acetaminophen (Panado) given in the drip. Most medications cross the placenta and may affect the baby.
Women in labour should engage their obstetricians regarding their preferences for pain management prior to the onset of labour and offered according to her wishes, facility protocols, and available resources in order to achieve a positive childbirth experience.
* Dr David N. Emvula MBChB (Pret), MMed O&G (Pret) FCOG (SA) Specialist Obstetrician & GynecologistatOB-GYNPractice
Every year 8 June is celebrated as World Brain Tumor Day. This initiative was initially taken by German Brain Tumor Association and is now celebrated worldwide to raise awareness and educate people about brain tumors. There are lots of myths and misconception about brain tumors among the general population. Here are some basic facts:
A brain tumor is a growth of cells in the brain or near it. Brain tumors can happen in the brain tissue but can happen near the brain tissue. Nearby locations include nerves, the pituitary gland, the pineal gland, and the membranes that cover the surface of the brain.
Many different types of primary brain tumors exist and some brain tumors aren’t cancerous. These are called noncancerous brain tumors or benign brain tumors. Noncancerous brain tumors may grow over time and press on the brain tissue. Other brain tumors are brain cancers, also called malignant brain tumors. Brain cancers may grow quickly. The cancer cells can invade and destroy the brain tissue.
Brain tumors range in size from very small to very large. Some brain tumors are found when they are very small because they cause symptoms that you notice right away. Other brain tumors grow very large before they’re found. Some parts of the brain are less active than others. If a brain tumor starts in a part of the brain that’s less active, it might not cause symptoms right away. The brain tumor size could become quite large before the tumor is detected.
Brain tumor treatment options depend on the type of brain tumor you have, as well as its size and location. Common treatments include surgery and radiation therapy.
The signs and symptoms of a brain tumor depend on the brain tumor’s size and location. Symptoms also might depend on how fast the brain tumor is growing, which is also called the tumor grade.
General signs and symptoms caused by brain tumors may include:
• Headache or pressure in the head that is worse in the morning.
• Headaches that happen more often and seem more severe.
• Headaches that are sometimes described as tension headaches or migraines.
• Nausea or vomiting.
•Eye problems, such as blurry vision, seeing double or losing sight on the sides of your vision.
• Losing feeling or movement in an arm or a leg.
• Trouble with balance.
• Speech problems.
• Feeling very tired.
• Confusion in everyday matters.
• Memory problems.
• Having trouble following simple commands.
• Personality or behavior changes.
• Seizures, especially if there is no history of seizures.
• Hearing problems.
• Dizziness or a sense that the world is spinning, also called vertigo.
• Feeling very hungry and gaining weight.
Brain tumors that aren’t cancerous tend to cause symptoms that develop slowly. Noncancerous brain tumors also are called benign brain tumors. They might cause subtle symptoms that you don’t notice at first. The symptoms might get worse over months or years. Cancerous brain tumors cause symptoms that get worse quickly. Cancerous brain tumors also are called brain cancers or malignant brain tumors. They cause symptoms that come on suddenly. They get worse in a matter of days or weeks.