Author: Mukul

Description:
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.

Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening.

The liver damage done by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

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Symptoms:
You may not have any symptoms at first. But as time goes on, and the damage to your liver gets worse, you may notice things like:

*Fatigue and weakness
*Lack of appetite and weight loss
*Nausea
*Jaundice (when your skin and eyes turn yellow)
*Intense itching
*Spider web-like blood vessels in your skin
*Redness in the palms of your hands or whitening of your nails
*Vomiting blood
*Fluid retention (swelling in legs, abdominal distension)
*Severe muscle cramps
*Brownish urine
*Fever
*Enlarged spleen
*Bone disease, causing bones to break more easily

Keep in mind that you may not get all these symptoms, and some of these problems are also signs of other conditions.

Causes:

A wide range of diseases and conditions can damage the liver and lead to cirrhosis.

Some of the causes include:

*Chronic alcohol abuse
*Chronic viral hepatitis (hepatitis B, C and D)
*Fat accumulating in the liver (nonalcoholic fatty liver disease)
*Iron buildup in the body (hemochromatosis)
*Cystic fibrosis
*Copper accumulated in the liver (Wilson's disease)
*Poorly formed bile ducts (biliary atresia)
*Alpha-1 antitrypsin deficiency
*Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
*Genetic digestive disorder (Alagille syndrome)
*Liver disease caused by your body's immune system (autoimmune hepatitis)
*Destruction of the bile ducts (primary biliary cirrhosis)
*Hardening and scarring of the bile ducts (primary sclerosing cholangitis
*Infection, such as syphilis or brucellosis
*Medications, including methotrexate or isoniazid

Diagnosis:
Your doctor will ask about your symptoms. He or she will also ask if you have a history of health conditions that make you more likely to develop cirrhosis.

Your doctor will ask about your use of alcohol and over-the-counter and prescription medicines.

Physical exam:
Your doctor will examine your body, use a stethoscope to listen to sounds in your abdomen, and tap or press on specific areas of your abdomen. He or she will check to see if your liver is larger than it should be. Your doctor will also check for tenderness or pain in your abdomen.

Different tests:
*Blood tests
Your doctor may recommend the following blood tests

*liver tests NIH external link that can show abnormal liver enzyme levels, which may be a sign of liver damage. Your doctor may suspect cirrhosis if you have
*increased levels of the liver enzymes alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP)
*increased levels of bilirubin
*decreased levels of blood proteins
*complete blood count NIH external link, which can show signs of infection and anemia that may be caused by internal bleeding
*tests for viral infections to see if you have hepatitis B or hepatitis C
*blood tests for autoimmune liver conditions, which include the antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-mitochondrial antibody (AMA) tests

Based on the blood test results, your doctor may be able diagnose certain causes of cirrhosis.

Your doctor can use blood tests to tell how serious your cirrhosis is.

Imaging tests:
Imaging tests can show the size, shape, texture, and stiffness of your liver. Measuring the stiffness of the liver can show scarring. Your doctor can use stiffness measures to see if the scarring is getting better or worse. Imaging tests can also show how much fat is in the liver. Your doctor may use one or more of the following imaging tests

*magnetic resonance imaging (MRI) NIH external link
*ultrasound NIH external link
*x-rays such as computerized tomography (CT) scans
*transient elastography, a special ultrasound that measures the stiffness of your liver and can measure liver fat

Liver biopsy:
Your doctor may perform a liver biopsy to see how much scarring in is your liver. A liver biopsy can diagnose cirrhosis when the results of other tests are uncertain. The biopsy may show the cause of cirrhosis. Sometimes your doctor may find that something other than cirrhosis has caused your liver to become damaged or enlarged. Your doctor can also diagnose liver cancer external link based on liver biopsy results.

Treatment:
Treatment of cirrhosis involves managing symptoms and preventing further damage to the liver, since the existing scarring cannot be repaired or reversed. The specific cause for the cirrhosis will be addressed. Treatment varies depending on the cause.

Doctors most often treat the causes of cirrhosis with medicines. Your doctor will recommend that you stop activities such as drinking alcohol and taking certain medicines that may have caused cirrhosis or may make cirrhosis worse. If you have alcoholic liver disease, your doctor will recommend that you completely stop drinking alcohol.

Liver transplant surgery:
In advanced cases of cirrhosis, when the liver stops working properly, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is one of the most common reasons for a liver transplant. Candidates for liver transplant have extensive testing to determine whether they are healthy enough to have a good outcome following surgery.

Historically, those with alcoholic cirrhosis have not been liver transplant candidates because of the risk that they will return to harmful drinking after transplant. Recent studies, however, suggest that carefully selected people with severe alcoholic cirrhosis have post-transplant survival rates similar to those of liver transplant recipients with other types of liver disease.

For transplant to be an option if you have alcoholic cirrhosis, you would need to:

Find a program that works with people who have alcoholic cirrhosis.
Meet the requirements of the program. These would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center.

(Liver transplant dramatically improves the prognosis of liver cirrhosis. If the disease is detected at its earlier stage, cirrhosis life expectancy is about 15 to 20 years. Life expectancy decreases to about 6 to 10 years, when cirrhosis is detected during the second stage. But these patients have enough time and can opt for liver transplant.)

Lifestyle and home remedies:
If you have cirrhosis, be careful to limit additional liver damage:

*Don’t drink alcohol. Whether your cirrhosis was caused by chronic alcohol use or another disease, don’t drink alcohol. Drinking alcohol may cause further liver damage.

*Eat a low-sodium diet. Excess salt can cause your body to retain fluids, worsening swelling in your abdomen and legs. Use herbs for seasoning your food, rather than salt. Choose prepared foods that are low in sodium.

*Eat a healthy diet. People with cirrhosis can experience malnutrition. Combat this with a healthy diet that includes a variety of fruits and vegetables. Choose lean protein, such as legumes, poultry or fish. Don’t eat raw seafood.

*Protect yourself from infections. Cirrhosis makes it more difficult for you to fight off infections. Protect yourself by avoiding people who are sick and washing your hands frequently. Get vaccinated for hepatitis A and B, influenza, and pneumonia.

*Use over-the-counter medicines carefully. Cirrhosis makes it more difficult for your liver to process medicines. For this reason, ask your provider before taking any medicines, including nonprescription ones. Don’t take aspirin and ibuprofen (Advil, Motrin IB, others). If you have liver damage, your provider may recommend that you not take acetaminophen (Tylenol, others) or take it in low doses for pain relief.

Regular Yoga and meditation under the guideline of an expart is very helpful.

CLICK TO SEE AYURVEDIC TREATMENT : OmShree Sidha Hospital, Vayala P.O, Kottayam, Kerala, India.:(1)

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487
https://www.webmd.com/digestive-disorders/understanding-cirrhosis-basic-information
https://www.healthline.com/health/cirrhosis#causes

Description:
A chest infection is an infection of the lungs or large airways. Some chest infections are mild and clear up on their own, but others can be severe and life threatening also.

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Symptoms:

Chest infections often follow colds or flu.

The main symptoms are:

*a chesty cough – you may cough up green or yellow mucus
*wheezing and shortness of breath
*chest pain or discomfort
*a midium or even high temperature
*a headache
*aching muscles
*tiredness

These symptoms can be unpleasant, but they usually get better on their own in about 7 to 10 days.

The cough and mucus can last up to 3 weeks.

Causes:
Many germs can cause chest infection. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your immune system, even if your health is generally good.

Chest infection is classified according to the types of germs that cause it and where you got the infection.

Community-acquired Chest infection:
Community-acquired chest infection is the most common type. It occurs outside of hospitals or other health care facilities. It may be caused by:

*Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you’ve had a cold or the flu. It may affect one part (lobe) of the lung, a condition called lobar pneumonia.

*Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces milder symptoms than do other types of pneumonia. Walking pneumonia is an informal name given to this type of pneumonia, which typically isn’t severe enough to require bed rest.

*Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings and vary depending upon geographic location.

*Viruses, including COVID-19. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral chest infection is usually mild. But in some cases it can become very serious. Coronavirus 2019 (COVID-19) may cause chest infection, which can become severe.

*Hospital-acquired chest infection
Some people catch chest infection during a hospital stay for another illness. Hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia.

Health care-acquired chest infection
Health care-acquired pneumonia is a bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.

*Aspiration chest infection:
Aspiration chest infection occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Risk factors:
Chest infection can affect anyone. But the two age groups at highest risk are:

*Children who are 2 years old or younger
*People who are age 65 or older

Other risk factors include:

*Being hospitalized. You’re at greater risk of pneumonia if you’re in a hospital intensive care unit, especially if you’re on a machine that helps you breathe (a ventilator).

*Chronic disease. You’re more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease (COPD) or heart disease.

*Smoking. Smoking damages your body’s natural defenses against the bacteria and viruses that cause pneumonia.

*Weakened or suppressed immune system. People who have HIV/AIDS, who’ve had an organ transplant, or who receive chemotherapy or long-term steroids are at risk.

Complications:
Even with treatment, some people with pneumonia, especially those in high-risk groups, may experience complications, including:

*Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.

*Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing machine (ventilator) while your lung heals.

*Fluid accumulation around the lungs (pleural effusion). Pneumonia may cause fluid to build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to have it drained through a chest tube or removed with surgery.

*Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus.

Prevention:

To help prevent pneumonia:

Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with your doctor about getting these shots. The vaccination guidelines have changed over time so make sure to review your vaccination status with your doctor even if you recall

previously receiving a pneumonia vaccine.
Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease. Children who attend a group child care center should also get the vaccine.

Doctors also recommend flu shots for children older than 6 months.

Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.

Don’t smoke. Smoking damages your lungs’ natural defenses against respiratory infections.
Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.

Treatment:
Things you can do yourself
*get plenty of rest.
*drink lots of water to loosen the mucus and make it easier to cough up.
*raise your head up while sleeping using extra pillows to make breathing *easier and clear your chest of mucus.
*use painkillers to bring down a fever and ease headaches and muscle pain.

Normally Antibiotics aren’t recommended for many chest infections. They only work if the infection is caused by bacteria, rather than a virus. Your GP will usually only prescribe antibiotics if they think you have pneumonia, or you’re at risk of complications such as fluid building up around the lungs (pleurisy).

Home remedies for chest infection:
These home remedies may help ease the symptoms of your chest infection. Try these tips:

Take OTC medications such as ibuprofen (Advil) or acetaminophen (Tylenol) to lower your fever and help relieve any aches and pains.

*Use OTC decongestants or expectorants to help loosen mucus and make it easier to cough up.

*Be sure to get plenty of rest.

*Drink lots of fluids. This keeps you hydrated and can loosen mucus, making it easier to cough up.

*Avoid lying flat when sleeping. This can cause mucus to settle in your chest. Use extra pillows to elevate your head and chest at night.

*Use a humidifier or inhale steam vapor to help relieve coughing.

*Have a warm drink of honey and lemon if your throat is sore from too much coughing.

*Avoid smoking, or being around secondhand smoke or other irritants.

*Stay away from cough suppression medicines. Coughing actually helps you to get over your infection through clearing mucus from your lungs.

*inhaling steam from a warm bath.

*inhaling the vapor from essential oils, such as rosemary or eucalyptus.

*Boil 1/2 cup of ginzer dust in one cup of water till it becomes one cup, drink one sip in every hour for the whole day.

Prognosis:
Although most chest infections are mild and improve on their own, some cases can be very serious, even life-threatening. A bout of infection of the large airways (bronchi) in the lungs (acute bronchitis) usually gets better on its own within 7-10 days without any medicines.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.nhs.uk/conditions/chest-infection/
https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204

Other Name : Bulimia nervosa; Binge-purge behavior; Eating disorder – bulimia

Description:
Bulimia is an eating disorder. It is characterized by uncontrolled episodes of overeating, called bingeing. This is followed by purging with methods such as vomiting or misuse of laxatives. Bingeing is eating much larger amounts of food than you would normally eat in a short period of time, usually less than 2 hours. The person may feel like thaty he or she can’t stop or control these episodes of binge eating.

The binge-purge cycles can happen from many times a day to several times a week.

Often, people with bulimia keep a normal or above normal body weight. This lets them hide their problem for years. Many people with bulimia don’t seek help until they reach the ages of 30 or 50. By this time, their eating behavior is deeply ingrained and harder to change.

It is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.

Other efforts to lose weight may include the use of diuretics, stimulants, water fasting, or excessive exercise. Most people with bulimia are at a normal weight. The forcing of vomiting may result in thickened skin on the knuckles, breakdown of the teeth and effects on metabolic rate and caloric intake which cause thyroid dysfunction. Bulimia is frequently associated with other mental disorders such as depression, anxiety, borderline personality disorder, bipolar disorder and problems with drugs or alcohol. There is also a higher risk of suicide and self-harm.

Bulimia is more common among those who have a close relative with the condition. The percentage risk that is estimated to be due to genetics is between 30% and 80%. Other risk factors for the disease include psychological stress, cultural pressure to attain a certain body type, poor self-esteem, and obesity. Living in a culture that commercializes or glamorizes dieting and having parental figures who fixate about weight are also risks.

There are 2 ways people with bulimia restrict calories:

*Purging type. The person engages in self-induced vomiting or misuse of laxatives, diuretics, or enemas, or other medicines that clear the intestines.

*Nonpurging type. The person uses other behaviors, such as fasting or excessive exercise, rather than purging behaviors.

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Symptoms:
These are the most common symptoms of bulimia:

*Usually a normal or above average body weight

*Recurrent episodes of binge eating and fear of not being able to stop eating

*Self-induced vomiting (usually secretive)

*Excessive exercise

*Excessive fasting

*Peculiar eating habits or rituals

*Inappropriate use of laxatives or diuretics

*Irregular or absence of menstruation

*Anxiety

*Discouraged feelings related to dissatisfaction with themselves and the way their body looks

*Depression

*Preoccupation with food, weight, and body shape

*Throat is always inflamed or sore

*Tiredness and decreased energy

*Dental problems due to erosion of enamel from vomiting

Most people with eating disorders also share certain traits including:

*Low self-esteem
*Feelings of helplessness
*Fear of getting fat
*Intense unhappiness with their body shape and size

If one has bulimia, he or she may binge to reduce stress and ease anxiety.

*With binge eating comes guilt, disgust, and depression.
*Purging brings only short-term relief.
*He or she may be impulsive and more likely to take part in risky behaviors, such as alcohol and drug use.

The symptoms of bulimia may look like other medical problems or mental health conditions. Always talk with a healthcare provider for a diagnosis.

Causes:

Many more women than men have bulimia. The disorder is most common in teenage girls and young women. The person usually knows that her eating pattern is abnormal. She may feel fear or guilt with the binge-purge episodes.

The exact cause of bulimia is unknown. Genetic, psychological, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.

Risk Factors:
Being female and having bulimia nervosa takes a toll on mental health. Women frequently reported an onset of anxiety at the same time of the onset of bulimia nervosa. Another concern with eating disorders is developing a coexisting substance use disorder.

Complications from bulimia can include:

*kidney failure
*heart problems
*gum disease
*tooth decay
*digestive issues or constipation
*ulcers and stomach damage
*dehydration
*nutrient deficiencies
*electrolyte or chemical imbalances
*absence of a menstrual period
*anxiety
*depression
*drug or alcohol misuse

Diagnosis:

The onset of bulimia nervosa is often during adolescence, between 13 and 20 years of age, and many cases have previously experienced obesity, with many relapsing in adulthood into episodic bingeing and purging even after initially successful treatment and remission. A lifetime prevalence of 0.5 percent and 0.9 percent for adults and adolescents, respectively, is estimated among the United States population. Bulimia nervosa may affect up to 1% of young women and, after 10 years of diagnosis, half will recover fully, a third will recover partially, and 10–20% will still have symptoms.

Adolescents with bulimia nervosa are more likely to have self-imposed perfectionism and compulsivity issues in eating compared to their peers. This means that the high expectations and unrealistic goals that these individuals set for themselves are internally motivated rather than by social views or expectations.

Criteria:
Bulimia nervosa can be difficult to detect, compared to anorexia nervosa, because bulimics tend to be of average or slightly above average weight. Many bulimics may also engage in significantly disordered eating and exercise patterns without meeting the full diagnostic criteria for bulimia nervosa. Recently, the Diagnostic and Statistical Manual of Mental Disorders was revised, which resulted in the loosening of criteria regarding the diagnoses of bulimia nervosa and anorexia nervosa. The diagnostic criteria utilized by the DSM-5 includes repetitive episodes of binge eating (a discrete episode of overeating during which the individual feels out of control of consumption) compensated for by excessive or inappropriate measures taken to avoid gaining weight. The diagnosis also requires the episodes of compensatory behaviors and binge eating to happen a minimum of once a week for a consistent time period of 3 months. The diagnosis is made only when the behavior is not a part of the symptom complex of anorexia nervosa and when the behavior reflects an overemphasis on physical mass or appearance. Purging often is a common characteristic of a more severe case of bulimia.

Exams and Tests:

A dental exam may show cavities or gum infections (such as gingivitis). The enamel of the teeth may be worn away or pitted because of too much exposure to the acid in vomit.

A physical exam may also show:

*Broken blood vessels in the eyes (from the strain of vomiting)
*Dry mouth
*Pouch-like look to the cheeks
*Rashes and pimples
*Small cuts and calluses across the tops of the finger joints from forcing oneself to vomit

Blood tests may show an electrolyte imbalance (such as low potassium level) or dehydration.

Treatment:
There are two main types of treatment given to those with bulimia nervosa; psychopharmacological and psychosocial treatments.
Psychotherapy

Cognitive behavioral therapy is the primary treatment for bulimia. Antidepressants of the selective serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant classes may have a modest benefit. While outcomes with bulimia are typically better than in those with anorexia, the risk of death among those affected is higher than that of the general population. At 10 years after receiving treatment about 50% of people are fully recovered.

Cognitive behavioral therapy (CBT), which involves teaching a person to challenge automatic thoughts and engage in behavioral experiments (for example, in session eating of “forbidden foods”) has a small amount of evidence supporting its use.

By using CBT people record how much food they eat and periods of vomiting with the purpose of identifying and avoiding emotional fluctuations that bring on episodes of bulimia on a regular basis. Barker (2003) states that research has found 40–60% of people using cognitive behaviour therapy to become symptom free. He states in order for the therapy to work, all parties must work together to discuss, record and develop coping strategies. Barker (2003) claims by making people aware of their actions they will think of alternatives. People undergoing CBT who exhibit early behavioral changes are most likely to achieve the best treatment outcomes in the long run. Researchers have also reported some positive outcomes for interpersonal psychotherapy and dialectical behavior therapy.

Maudsley family therapy, developed at the Maudsley Hospital in London for the treatment of anorexia, has been shown promising results in bulimia.

The use of CBT has been shown to be quite effective for treating bulimia nervosa (BN) in adults, but little research has been done on effective treatments of BN for adolescents. Although CBT is seen as more cost-efficient and helps individuals with BN in self-guided care, Family Based Treatment (FBT) might be more helpful to younger adolescents who need more support and guidance from their families. Adolescents are at the stage where their brains are still quite malleable and developing gradually. Therefore, young adolescents with BN are less likely to realize the detrimental consequences of becoming bulimic and have less motivation to change, which is why FBT would be useful to have families intervene and support the teens. Working with BN patients and their families in FBT can empower the families by having them involved in their adolescent’s food choices and behaviors, taking more control of the situation in the beginning and gradually letting the adolescent become more autonomous when they have learned healthier eating habits.
Medication

Antidepressants of the selective serotonin reuptake inhibitors (SSRI) class may have a modest benefit. This includes fluoxetine, also known as prozac, which is FDA approved, for the treatment of bulimia, other antidepressants such as sertraline may also be effective against bulimia. Topiramate may also be useful but has greater side effects. Compared to placebo, the use of a single antidepressant has been shown to be effective. Combining medication with counseling can improve outcomes in some circumstances. Some positive outcomes of treatments can include: abstinence from binge eating, a decrease in obsessive behaviors to lose weight and in shape preoccupation, less severe psychiatric symptoms, a desire to counter the effects of binge eating, as well as an improvement in social functioning and reduced relapse rates.

Alternative medicine:
Some researchers have also claimed positive outcomes in hypnotherapy. The first use of hypnotherapy in Bulimic patients was in 1981. When it comes to hypnotherapy, Bulimic patients are easier to hypnotize than Anorexia Nervosa patients. In Bulimic patients, hypnotherapy focuses on learning self-control when it comes to binging and vomiting, strengthening stimulus control techniques, enhancing ones ego, improving weight control, and helping overweight patients see their body differently (have a different image)

Yoga Therapy:
Regular doing Yoga and meditation under the guideline of a proper teacher can improve Bulimia very fast.

Prognosis:

Bulimia is a long-term illness. Many people will still have some symptoms, even with treatment.

People with fewer medical complications of bulimia and those willing and able to take part in therapy have a better chance of recovery.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Bulimia_nervosa
https://medlineplus.gov/ency/article/000341.htm

Description:
Bronchiectasis is a lung disease that usually results from an infection or other condition that injures the walls of the airways in the lungs. This injury is the beginning of a cycle in which the airways slowly lose their ability to clear out mucus, resulting in mucus buildup and an environment in which bacteria can grow. This leads to repeated serious lung infections that cause more damage to the airways. Over time, the airways become stretched out, flabby and scarred and unable to move air in and out. Bronchiectasis usually begins in childhood, but symptoms may not appear until months or even years after he or she has started having repeated lung infections.

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Symptoms:
The most common signs and symptoms are:

*Daily cough, over months or years

*Daily production of large amounts of mucus, or phlegm

*Repeated lung infections

*Shortness of breath

*Wheezing

*Pain in the Chest

Over time, more serious symptoms may develop, including:

*Coughing up blood or bloody mucus

*Weight loss

*Fatigue

*Sinus drainage

Bronchiectasis can also lead to other serious health conditions, including collapsed lung, heart failure and brain abscess.

Causes:
Bronchiectasis is caused by two phases of airway damage. In the first phase, the initial damage (or “insult”) is caused by an infection, inflammatory disorder or another condition that affects the lungs. Healthcare providers don’t know the initial cause in up to 40% of people with bronchiectasis.

The first insult makes you more likely to get inflammation and repeated infections that cause further damage to lungs. This is the second phase, or the “vicious cycle.”

Some of the specific causes of the initial damage (“insult”) which starts the cycle of bronchiectasis include:

*Cystic fibrosis.

*Mycobacterial infections, like MAC infections or tuberculosis (TB).

*Autoimmune or inflammatory disorders, like rheumatoid arthritis (RA), inflammatory bowel disease (IBD), lupus (SLE) and Sjögren’s syndrome.

*Foreign bodies, tumors or lymph nodes that block airways and prevent mucus clearance.

*Conditions that decrease immunity and increase risk of infections (like HIV and hypogammaglobulinemia).

*Primary ciliary dyskinesia

*Organ transplant. Transplant medications decrease immunity and can increase risk of infection and bronchiectasis.

*Allergic bronchopulmonary aspergillosis (ABPA), an allergy to a type of fungus.

*Fibrosis (scarring) from radiation.

*Alpha-1 antitrypsin deficiency.

• COVID-19 cause bronchiectasis:
  Research suggests that COVID-19 isn’t a very common cause of bronchiectasis. But if you’ve had acute respiratory distress syndrome (ARDS) with COVID-19, you may have pseudobronchiectasis. Pseudobronchiectasis looks like bronchiectasis, but it resolves over time rather than causing the cycle of repeated infections and lung damage.

The most common cause of bronchiectasis depends on where a person lives. In the U.S. and other western countries, the most common cause of bronchiectasis is cystic fibrosis. Worldwide, it’s tuberculosis. In many cases, healthcare providers can’t determine the cause of bronchiectasis.

Risk Factors:
One can reduce his or her risk of developing bronchiectasis by managing his or her lung health:

*To make sure every person family is up-to-date on recommended vaccinations. Pertussis, the flu, pneumococcal disease, measles and staph infections can all cause or worsen bronchiectasis.

*Work with the healthcare provider to treat any ongoing health conditions, especially ones that affects the lungs.

*Always avoid breathing in things that can hurt lungs, like cigarette smoke, vaping, fumes and gases.

DIAGNOSIS AND TESTS:

A healthcare provider will diagnose bronchiectasis by examining the patient and asking abouthis or her health history. He will listen to lungs and test how well it is working. Now if he or she thinks the patient has bronchiectasis or another lung condition, the health care provider will order imaging tests to look at the structure of the lungs.

The followibng tests are recomended to diagnose bronchiectasis:

*Chest CT scan or X-ray. A provider uses a machine to take pictures of the lungs to see if the airways are damaged.

*Blood tests and sputum cultures. A provider takes samples of blood or mucus (sputum) to find out if the patient has have an infection.

*Lung function tests. A provider uses lung function tests to determine how well the lungs are working. THe patient will breathe into a machine that measures the lung function.

*Genetic testing. A provider may take samples of patient’s blood or other body fluid to test for diseases.

*Sweat chloride test. If a provider thinks the patient could have cystic fibrosis, he or she will perform a sweat test. The provider will make thre patient’s arm or leg sweat, collect a sample and test it for signs of cystic fibrosis.

*Bronchoscopy. In some cases, a provider may use a procedure to look more closely at the patient’s airways (bronchoscopy). he or she will use a bronchoscope (a long flexible tube with a light and camera at the end) to find and remove anything blocking the airways and get samples of mucus or pus from the lungs for testing.

Treatment:
Bronchiectasis treatments help get rid of infected mucus, kill bacteria and decrease inflammation. They include:

*Antibiotics. Antibiotics can treat infections caused by bacteria. You can take antibiotics in pill form, but if you have a severe infection, a provider will use an IV to give you antibiotics directly into your bloodstream. Providers also often prescribe inhaled antibiotics for bronchiectasis. You may use a nebulizer for inhaled medications, which makes the medicine into a mist that you breathe in.

*Macrolides. Macrolides are drugs that treat infections and inflammation at the same time.

*Expectorant and mucolytics. These are medications that thin mucus and help you cough it out. These are available over-the-counter or by prescription.

*Physical therapy. Postural draining and chest percussion therapy can help loosen and remove mucus. Breathing exercises can help open up your airways.

*Medical devices. Oscillating positive expiratory pressure (PEP) devices and percussive vests break up and pull mucus out from your lungs.

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Prevention:
You can reduce your risk of developing bronchiectasis by managing your lung health:

Make sure you and your family are up-to-date on recommended vaccinations. Pertussis, the flu, pneumococcal disease, measles and staph infections can all cause or worsen bronchiectasis.
Work with your healthcare provider to treat any ongoing health conditions, especially ones that affect your lungs. Keep your appointments and stick to your treatment plan. Talk to your provider if you feel like medications or therapies aren’t working.
Avoid breathing in things that can hurt your lungs, like cigarette smoke, vaping, fumes and gases.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Bronchiectasis
https://www.hopkinsmedicine.org/health/conditions-and-diseases/bronchiectasis
https://my.clevelandclinic.org/health/diseases/21144-bronchiectasis

Description:
Muscle atrophy is the loss of muscle tissue.

Muscle atrophy can occur after long periods of inactivity. If a muscle does not get any use, the body will eventually break it down to conserve energy.

Muscle atrophy that develops due to inactivity can occur if a person remains immobile while they recover from an illness or injury. Getting regular exercise and trying physical therapy may reverse this form of muscle atrophy.

People can treat muscle atrophy by making certain lifestyle changes, trying physical therapy, or undergoing surgery.

Muscle atrophy results from an imbalance between protein synthesis and protein degradation, although the mechanisms are incompletely understood and are variable depending on the cause. Muscle loss can be quantified with advanced imaging studies but this is not frequently pursued. Treatment depends on the underlying cause but will often include exercise and adequate nutrition. Anabolic agents may have some efficacy but are not often used due to side effects. There are multiple treatments and supplements under investigation but there are currently limited treatment options in clinical practice. Given the implications of muscle atrophy and limited treatment options, minimizing immobility is critical in injury or illness.

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Symptoms:
The hallmark sign of muscle atrophy is loss of lean muscle mass. This change may be difficult to detect due to obesity, changes in fat mass or edema. Changes in weight, limb or waist circumference are not reliable indicators of muscle mass changes.

The predominant symptom is increased weakness which may result in difficulty or inability in performing physical tasks depending on what muscles are affected. Atrophy of the core or leg muscles may cause difficulty standing from a seated position, walking or climbing stairs and can cause increased falls. Atrophy of the throat muscles may cause difficulty swallowing and diaphragm atrophy can cause difficulty breathing. Muscle atrophy can be asymptomatic and may go undetected until a significant amount of muscle is lost.

Causes:
Skeletal muscle serves as a storage site for amino acids that can be used for energy production when demands are high or supplies are low. If metabolic demands remain greater than protein synthesis, muscle mass is lost. Many diseases and conditions can lead to this imbalance, either through the disease itself or disease associated appetite-changes. Causes of muscle atrophy, include immobility, aging, malnutrition, certain systemic diseases (cancer, congestive heart failure; chronic obstructive pulmonary disease; AIDS, liver disease, etc.), deinnervation, intrinsic muscle disease or medications (such as glucocorticoids)

Immobility:
Disuse is a common cause of muscle atrophy and can be local (due to injury or casting) or general (bed-rest). The rate of muscle atrophy from disuse (10-42 days) is approximately 0.5–0.6% of total muscle mass per day although there is considerable variation between people. The elderly are the most vulnerable to dramatic muscle loss with immobility. Much of the established research has investigated prolonged disuse (>10 days), in which the muscle is compromised primarily by declines in muscle protein synthesis rates rather than changes in muscle protein breakdown. There is evidence to suggest that there may be more active protein breakdown during short term immobility (<10 days}

Cachexia:….CLICK & SEE
Certain diseases can cause a complex muscle wasting syndrome known as cachexia. It is commonly seen in cancer, congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease and AIDS although it is associated with many disease processes, usually with a significant inflammatory component. Cachexia causes ongoing muscle loss that is not entirely reversed with nutritional therapy. The pathophysiology is incompletely understood but inflammatory cytokines are considered to play a central role. In contrast to weight loss from inadequate caloric intake, cachexia causes predominantly muscle loss instead of fat loss and it is not as responsive to nutritional intervention. Cachexia can significantly compromise quality of life and functional status and is associated with poor outcomes.

Sarcopenia:…CLICK & SEE
Sarcopenia is the degenerative loss of skeletal muscle mass, quality, and strength associated with aging. This involves muscle atrophy, reduction in number of muscle fibers and a shift towards “slow twitch” or type I skeletal muscle fibers over “fast twitch” or type II fibers. The rate of muscle loss is dependent on exercise level, co-morbidities, nutrition and other factors. There are many proposed mechanisms of sarcopenia and is considered to be the result of changes in muscle synthesis signalling pathways and gradual failure in the satellite cells which help to regenerate skeletal muscle fibers, but is incompletely understood.

Sarcopenia can lead to reduction in functional status and cause significant disability but is a distinct condition from cachexia although they may co-exist. In 2016 an ICD code for sarcopenia was released, contributing to its acceptance as a disease entity.

Intrinsic muscle diseases:……..CLICK & SEE
Muscle diseases, such as muscular dystrophy, amyotrophic lateral sclerosis (ALS), or myositis such as inclusion body myositis can cause muscle atrophy.

Central nervous system damage:…….CLICK & SEE
Damage to neurons in the brain or spinal cord can cause prominent muscle atrophy. This can be localized muscle atrophy and weakness or paralysis such as in stroke or spinal cord injury. More widespread damage such as in traumatic brain injury or cerebral palsy can cause generalized muscle atrophy.

Peripheral nervous system damage:……..CLICK & SEE
Injuries or diseases of peripheral nerves supplying specific muscles can also cause muscle atrophy. This is seen in nerve injury due to trauma or surgical complication, nerve entrapment, or inherited diseases such as Charcot-Marie-Tooth disease.

Medications:
Some medications are known to cause muscle atrophy, usually due to direct effect on muscles. This includes glucocorticoids causing glucocorticoid myopathy or medications toxic to muscle such as doxorubicin.

Endocrinopathies:
Disorders of the endocrine system such as Cushing’s disease or hypothyroidism are known to cause muscle atrophy.

Diagnosis:
Screening for muscle atrophy is limited by a lack of established diagnostic criteria, although many have been proposed. Diagnostic criteria for other conditions such as sarcopenia or cachexia can be used.[3] These syndromes can also be identified with screening questionnaires.[citation needed]

Muscle mass and changes can be quantified on imaging studies such as CT scans or Magnetic resonance imaging (MRI). Biomarkers such as urine urea can be used to roughly estimate muscle loss during circumstances of rapid muscle loss. Other biomarkers are currently under investigation but are not used in clinical practice.

Treatment:
Muscle atrophy can be delayed, prevented and sometimes reversed with treatment. Treatment approaches include impacting the signaling pathways that induce muscle hypertrophy or slow muscle breakdown as well as optimizing nutritional status.

Physical activity provides a significant anabolic muscle stimulus and is a crucial component to slowing or reversing muscle atrophy. It is still unknown regarding the ideal exercise “dosing.” Resistance exercise has been shown to be beneficial in reducing muscle atrophy in older adults. In patients who cannot exercise due to physical limitations such as paraplegia, functional electrical stimulation can be used to externally stimulate the muscles.

Adequate calories and protein is crucial to prevent muscle atrophy. Protein needs may vary dramatically depending on metabolic factors and disease state, so high-protein supplementation may be beneficial. Supplementation of protein or branched-chain amino acids, especially leucine, can provide a stimulus for muscle synthesis and inhibit protein breakdown and has been studied for muscle atrophy for sarcopenia and cachexia. ?-Hydroxy ?-methylbutyrate (HMB), a metabolite of leucine which is sold as a dietary supplement, has demonstrated efficacy in preventing the loss of muscle mass in several muscle wasting conditions in humans, particularly sarcopenia. Based upon a meta-analysis of seven randomized controlled trials that was published in 2015, HMB supplementation has efficacy as a treatment for preserving lean muscle mass in older adults.[28] More research is needed to determine the precise effects of HMB on muscle strength and function in various populations.

In severe cases of muscular atrophy, the use of an anabolic steroid such as methandrostenolone may be administered to patients as a potential treatment although use is limited by side effects. A novel class of drugs, called selective androgen receptor modulators, is being investigated with promising results. They would have fewer side effects, while still promoting muscle and bone tissue growth and regeneration. These effects have yet to be confirmed in larger clinical trials.

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Prognosis:
Prognosis of muscle atrophy depend on the underlying cause and the health of the patient. Immobility or bed rest in populations predisposed to muscle atrophy, such as the elderly or those with disease states that commonly cause cachexia, can cause dramatic muscle atrophy and impact on functional outcomes. In the elderly, this often leads to decreased biological reserve and increased vulnerability to stressors known as the “frailty syndrome.” Loss of lean body mass is also associated with increased risk of infection, decreased immunity, and poor wound healing. The weakness that accompanies muscle atrophy leads to higher risk of falls, fractures, physical disability, need for institutional care, reduced quality of life, increased mortality, and increased healthcare costs

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Muscle_atrophy
https://www.healthline.com/health/muscle-atrophy