Management principles

• Detect possible presence of thymoma with CT or MR scan of thorax. If present, removal is recommended.

• Thymectomy is recommended early for generalised myasthenia, especially in all younger patients with hyperplasia of the thymus, even if not confirmed preoperatively.

• Plasmapheresis is useful for acute crisis or where temporary improvement is required or patients are resistant to treatment.

• Avoid drugs that are relatively contraindicated.

• Pharmacological agents:

o anticholinesterase drugs, e.g. pyridostigmine, neostigmine or distigmine: should be used only for mild to moderate symptoms o corticosteroids: useful for all grades of MG; should be introduced slowly

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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