a to z of health

Cherrill Hicks
Tuesday 06 February 1996 00:02 GMT
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D is for dilatation and curettage (D&C), a common but increasingly unfashionable procedure used to investigate and treat menstrual disorders such as heavy, painful or irregular periods, as well as uterine fibroids and polyps. A D&C may also be carried out after miscarriage to prevent infection, and after birth if the placenta is not completely expelled.

Under general or local anaesthetic, the cervix is stretched open with a speculum, and a curette, a spoon-shaped instrument, is inserted into the womb to scrape away the womb lining, or endometrium. The tissue can then be examined under a microscope.

Doctors now regard the D&C as a rather blunt tool and it is gradually being replaced by other diagnostic techniques, such as Vabra aspiration, in which a sample of womb lining is removed by low-pressure suction, and hysteroscopy, in which a fine telescope is used to view inside the womb.

Eis for earache, an extremely common problem, especially in childhood. It is often a symptom of infection, usually of the middle ear (otitis media), but there are other causes; dental problems, eczema, boils, tonsillitis and cold, windy weather can all result in earache.

If caused by infection, earache can be extremely painful and can interrupt sleep. In adults, it may also be accompanied by tinnitus - ringing in the ears. Analgesics (paracetamol for children) will help, and so will warmth - try laying the ear on a warm hot-water bottle wrapped in a towel.

Antibiotics are usually needed to clear up an ear infection. To prevent infections in children, keep the ears warm in cold weather and use menthol drops or a chest rub during a cold to clear nasal passages and reduce the risk of infection spreading. Refraining from swimming during a cold will prevent infected mucus spreading to the ear.

F is for flat feet, which everyone is born with and most grow out of when foot muscles and ligaments start to develop. Sometimes, however, the arch fails to develop because of muscular weakness. Flat feet can also develop with a rapid increase in weight or illness.

Some children's shoes contain wedges to support the arch and corrective heel cups can also be prescribed, but there is no evidence that they work. Adults with painful flat feet can wear arch supports in their shoes or exercise to strengthen the muscles. Occasionally, surgery is needed.

CHERRILL HICKS

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