Nature provided the whale and the bat with the miracle of an innate sonar system. Scientists studied the process, pretty much duplicating it for its original technological intent—wartime vigilance. During world War II, navy submarines negotiated their way through deepest waters using sonar to detect the location of enemy vessels unseen by peritcopic sighting.

Sonar is the simple process of bouncing high-frequency acoustical vibrations off solid masses. The waves then bounce back in echo patterns that appear as a picture on a specially devised screen. Sonar is the mother of sonography, or ultrasonography, known familiarly as ultrasound—a relatively new and popular diagnostic technique, gaining ever increasing acceptance for confirmation of pelvic abnormalities. It is a convenient way to diagnose both pelvic masses and fetal size (sometimes, too, the sex of the unborn child) during pregnancy. Doctors are choosing sonography over X rays for a variety of diagnoses, especially since ultrasound is completely harmless to the body.

When these high-frequency sounds are projected into the body, the reflected “echo” on the screen indicates the size and location of a tumor. Doctors can freeze the picture of a growth on the screen and measure it. The technique is especially useful in locating uterine fibroids and ovarian cysts, although occasionally, there is difficulty in sonographic diagnosis in defining the precise location of a tumor—is it growing on the side of the uterus or on the ovary? Since ovarian tumors are a more serious matter than uterine masses, laparoscopy might be necessary if sonography proves ineffective as a confirming diagnostic tool.

As with laparoscopy, sonography facilitates an accurate diagnosis when pelvic organs are lifted from view. The “lifting” here is done not with gas, but with water. That is, women prepare for ultrasound testing before coming to the doctor’s office by drinking six to eight glasses of water, thus filling their bladders. The amply filled bladder moves organs up just enough so that the doctor can see the uterus and ovaries more clearly. A practiced ultrasonographer can usually detect a cyst and identify its type (and its contents) by the echo pattern on the screen and determine if the cyst is endometriotic in nature.

Ultrasound has its benefits, but in my opinion, this technique cannot pick up endometriosis in its early stages, when many women really need help in managing the disease and when it is most adroitly treated.

*49\43\4*

This used to be a very common and disfiguring disease in western countries. It still occurs in some underdeveloped countries and atypical forms still appear in western communities. The declining incidence may be largely attributed to better hygiene, less malnutrition, improving living standards, elimination of infected milk herds, and BCG vaccinations.

The disease is caused by the bacillus Mycobacterium tuberculosis. It affects other animals as well as man, and may occur in most organs of the body, particularly the lungs. The type of skin infection depends on the person’s resistance to the germ. When a person with good immunity is infected, the host resistance may be sufficient to confine the infection to fairly localized nodules. If immunity is less effective in localizing the infection, multiple chronic nodules will appear.

There are various forms of tuberculosis. One of these, warty tuberculosis, may begin as a lump, nodule or pustule, which becomes warty. There are no associated enlarged lymph glands, and spontaneous healing of the disease usually occurs.

Another form, primary inoculation tuberculosis, typically takes the form of a raised red lump or ulcer, with associated enlargement of the nearby lymph glands. This may spontaneously heal or may proceed to Lupus vulgaris, the chronic progressive form of tuberculosis.

Lupus vulgaris is the commonest tuberculosis of the skin, and is the chronic progressive form. It usually begins as a brown mark on the face, which becomes lumpy and translucent. It progresses slowly, with resultant scarring and ulceration, leading to severe mutilation. The name lupus’ (Latin for ‘wolf’) is a reference to the wolf-like ugly appearance of the advanced, and fortunately rare, case.

Other rarer forms of skin tuberculosis also exist. The treatment of all forms is as for tuberculosis elsewhere, together with plastic surgery where necessary. The drugs most frequently used are Isoniazid, Paraminosalicylic acid and Streptomycin, either singly or in combination. In certain cases Rifampidn may be used. Treatment is for two to three months. Plastic surgery may be necessary for the rehabilitation of those with disfiguring scarring.

*77\44\4*

Most of the fad diets incorporate a strategy that has some potential merit in fat loss, or perpetuate a belief that has existed for many years. These diets pick and select amongst the techniques and package them as the new wonder diet. Almost all fad diets require strict adherence to a plan, which means that people are not learning how to cope with their own environment. Very few use the main principle espoused in this book which is that for a fat loss plan to be successful, it has to be something that can be done comfortably for life.

Some of the characteristic strategies employed by fad diets, which may be useful in a more ‘balanced’ food intake program, but which are ineffective when used alone are:

Fillers: (e.g. Water drinking and fibre supplement diets, soup diets, macrobiotic diets, liquid protein diets and fruit diets). This strategy works on the principle that if you fill up on high-fibre foods or water then there will be less hunger for other foods. The difficulty is that nutritious foods may be displaced, contributing to a deficient micronutrient intake. Examples are the ‘rice diet’ and the ’soup diet’.

Slowed absorption time: (e.g. High-carbohydrate diets, rice diets, fibre supplements and macrobiotic diets). Bulky, high-fibre foods that require a lot of chewing (e.g. 32 times each mouthful) are encouraged, as is the consumption of water between bites of food. Other strategies include the putting down of utensils after each bite and encouraging conversation between each mouthful. Examples are the ‘bran diet’ and the ’spinach diet’.

*129\186\4*

The uterus is about the size and shape of a small hollow pear with its wide end upwards. Two fine tubes, the Fallopian tubes, branch outwards from the upper part of the uterus towards the ovaries. During reproductive life, a mature egg bursts from an ovary at approximately monthly intervals. In the normal course of events, an egg travels through a Fallopian tube to the uterus. On the way there, conception can occur if the egg meets and fuses with a sperm cell. The resulting embryo may develop into a viable pregnancy if it successfully embeds in the uterus.

The largest part of the uterus, the myometrium, is strong and flexible, being composed of thick bands of muscle and elastic tissue that run in several directions. This muscular web enables the uterus to be either small and tidy, somewhat like a clenched fist or, should conception occur, to stretch and grow into a strong, flexible capsule capable of nourishing and protecting a developing baby. The lower end of the uterus, the cervix, has some specialised functions including the production of lubricative or dense secretions at different times of the menstrual cycle. These secretions help minimise friction during sexual intercourse and seem to have a role in sperm movement through the vagina and cervix. During the Pap or cervical smear test, the cervix is the tissue that is sampled.

In addition to the thick myometrium and the cervix, the other important component of the uterus is its very active inner lining, called the endometrium. This is shed during menstruation or, if circumstances permit and a pregnancy occurs, it provides nutrients to an embryo. Before a girl has her first period (an event referred to as the menarche) and after a woman has her last (menopause), the endometrium usually consists of a thin layer of cells which may grow and be shed slowly without any menstrual bleeding.

The fertile years see a big change with menstruation typically occurring for several days about once every month. In the lead up to the menstrual bleed, row upon row of endometrial cells grow rapidly, influenced by sex hormones from the ovaries (particularly oestrogen and progesterone). Recent research suggests that the shedding process requires substances produced by the endometrium itself (such as the hormone-like prostaglandins and enzymes known as matrix metalloproteinases), together with decreasing levels of sex hormones.

*3\198\4*

Sleep is a fascinating biological function which we all experience. In fact, one-third of our lives is spent in sleep. Most of us take it for granted that we fall asleep at night and wake up the next morning. We do this night after night, and we do this from the day we enter this earth to the day we depart. However, have you stopped and asked what sleep actually is and why we need to sleep at all? Sleep is something we have no control over. We cannot close our eyes and give the magic word sleep, as sleep may not follow. In studies of how people fall asleep, it is observed that we are not folly awake one second and asleep the next. We all go through a very brief hypnotic state, which is called the Transitional Hypnotic State or THS.

We have all experienced the fact that after a good night’s sleep we are refreshed and appear to function better than after a restless night. The exact nature of this is not fully understood. Sleep is not unique to man. Nearly all species of the Animal Kingdom sleep. But the amount of sleep in animals varies a great deal between different species. Gorillas sleep 14 hours a day, elephants only 2. We will explain the possible reasons why we sleep under the following headings:

* Evolution theory

* Chemical theory

* Biological theory

* Dream theory

* Neurone theory

*2\174\4*