Category Archives: Ailmemts & Remedies

Lupus Nephritis

Alternative Names: Nephritis – lupus; Lupus glomerular disease

Definition:
Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. Apart from the kidneys, SLE can also damage the skin, joints, nervous system and virtually any organ or system in the body.

CLICK & SEE THE PICTURES

Symptoms:
General symptoms of lupus include malar rash, discoid rash, photosensitivity, oral ulcers, nonerosive arthritis, pleuropericarditis, renal disease, neurological manifestations, and haematological disorders.

Clinically, SLE usually presents with fever, weight loss (100%), arthralgias, synovitis, arthritis (95%), pleuritis, pericarditis (80%), malar facial rash, photodermatosis, alopecia (75%), anaemia, leukopaenia, thrombocytopaenia, and thromboses (50%).

About half of cases of SLE demonstrate signs of lupus nephritis at one time or another. Renal-specific signs include proteinuria (100%), nephrotic syndrome (55%), granular casts (30%), red cell casts (10%), microhematuria (80%), macrohematuria (2%), reduced renal function (60%), RPGN (30%), ARF (2%), hypertension (35%), hyperkalemia (15%) and tubular abnormalities (70%).

The World Health Organization (WHO) developed a system to classify the six different stages of lupus nephritis:

Stage 1: no evidence of lupus nephritis:
In histology, Stage I (minimal mesangial) disease has a normal appearance under light microscopy, but mesangial deposits are visible under electron microscopy. At this stage urinalysis is typically normal.
Stage 2: mildest form, easily treated with corticosteroids:
Stage 2 disease (mesangial proliferative) is noted by mesangial hypercellularity and matrix expansion. Microscopic haematuria with or without proteinuria may be seen. Hypertension, nephrotic syndrome, and acute renal insufficiency are rare at this stage.
Stage 3: earliest stage of advanced lupus. Treatment requires high amounts of corticosteroids. The outlook remains favorable.

Stage 3 disease (focal lupus nephritis) is indicated by sclerotic lesions involving less than 50% of the glomeruli, which can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions. Under electron microscopy, subendothelial deposits are noted, and some mesangial changes may be present. Immunofluorescence reveals the so-called “Full House” stain, staining positively for IgG, IgA, IgM, C3, and C1q. Clinically, haematuria and proteinuria is present, with or without nephrotic syndrome, hypertension, and elevated serum creatinine.
Diffuse proliferative lupus nephritis; photo shows the classic “flea-bitten” appearance of the cortical surface in the diffuse proliferative glomerulonephritides

Stage 4: advanced stage of lupus.

Stage 4 lupus nephritis (diffuse proliferative) is both the most severe, and the most common subtype. More than 50% of glomeruli are involved. Lesions can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions. Under electron microscopy, subendothelial deposits are noted, and some mesangial changes may be present. Immunofluorescence reveals the so-called “Full House” stain, staining positively for IgG, IgA, IgM, C3, and C1q. Clinically, haematuria and proteinuria are present, frequently with nephrotic syndrome, hypertension, hypocomplementemia, elevated anti-dsDNA titres and elevated serum creatinine. There is the risk of kidney failure. Patients require high amounts of corticosteroids and immune suppression medications.
A wire-loop lesion may be present in stage III and IV. This is a glomerular capillary loop with subendothelial immune complex deposition that is circumferential around the loop. Stage V is denoted by a uniformly thickened, eosinophilic basement membrane. Stage III and IV are differentiated only by the number of glomeruli involved (which is subject to inherent sample bias), but clinically the presentation and prognosis are both expected to be more severe in stage 4 versus stage 3.
Stage 5:
Stage 5 (membranous lupus nephritis) is characterized by diffuse thickening of the glomerular capillary wall (segmentally or globally), with diffuse membrane thickening, and subepithelial deposits seen under electron microscopy. Clinically, stage V presents with signs of nephrotic syndrome. Microscopic haematuria and hypertension may also been seen. Plasma creatinine is usually normal or slightly elevated, and stage V may not present with any other clinical/serological manifestations of SLE (complement levels may be normal; anti-DNA Ab may not be detectable). Stage 5 also predisposes the affected individual to thrombotic complications such as renal vein thromboses or pulmonary emboli.Excessive protein loss and swelling. Doctors will treat with high amounts of corticosteroids. Doctors may or may not give immune-suppressing drugs.
A final stage is usually included by most practitioners, stage VI, or advanced sclerosing lupus nephritis. It is represented by Global sclerosis involving more than 90% of glomeruli, and represents healing of prior inflammatory injury. Active glomerulonephritis is usually not present. This stage is characterised by slowly progressive renal dysfunction, with relatively bland urine sediment. Response to immunotherapy is usually poor.

A tubuloreticular inclusion is also characteristic of lupus nephritis, and can be seen under electron microscopy in all stages. It is not diagnostic however, as it exists in other conditions. It is thought to be due to chronic interferon exposure.
Causes:
Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body’s immune system.

Normally, the immune system helps protect the body from infection or harmful substances. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissue.

SLE may damage different parts of the kidney, leading to interstitial nephritis, nephrotic syndrome, and membranous GN. It may rapidly worsen to kidney failure.

Lupus nephritis affects approximately 3 out of every 10,000 people. In children with SLE, about half will have some form or degree of kidney involvement.

More than half of patients have not had other symptoms of SLE when they are diagnosed with lupus nephritis.

SLE is most common in women ages 20 – 40.
Diagnosis:
The diagnosis of lupus nephritis depends on blood tests, urinalysis, X-rays, ultrasound scans of the kidneys, and a kidney biopsy. On urinalysis, a nephritic picture is found and RBC casts, RBCs and proteinuria is found.

The World Health Organization has divided lupus nephritis into five stages based on the biopsy. This classification was defined in 1982 and revised in 1995.

* Class I is minimal mesangial glomerulonephritis which is histologically normal on light microscopy but with mesangial deposits on electron microscopy. It constitutes about 5% of cases of lupus nephritis. Renal failure is very rare in this form.[2]

*Class II is based on a finding of mesangial proliferative lupus nephritis. This form typically responds completely to treatment with corticosteroids. It constitutes about 20% of cases.[2] Renal failure is rare in this form.[2]

* Class III is focal proliferative nephritis and often successfully responds to treatment with high doses of corticosteroids. It constitutes about 25% of cases. Renal failure is uncommon in this form.

*Class IV is diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs. It constitutes about 40% of cases. Renal failure is common in this form.

* Class V is membranous nephritis and is characterized by extreme edema and protein loss. It constitutes about 10% of cases.[2] Renal failure is uncommon in this form.

Medicines are prescribed that decrease swelling, lower blood pressure, and decrease inflammation by suppressing the immune system: Patients may need to monitor intake of protein, sodium, and potassium. Patients with severe disease should restrict their sodium intake to 2 grams per day and limit fluid as well. Depending on the histology, renal function and degree of proteinuria, patients may require steroid therapy or chemotherapy regimens such as cyclophosphamide, azathioprine, mycophenolate mofetil, or cyclosporine.
Possible Complications:

*Acute renal failure
*Chronic renal failure
*End-stage renal disease
*Nephrotic syndrome
Treatment:

There is no cure for lupus nephritis. The goal of treatment is to keep the problem from getting worse. Stopping kidney damage early can prevent the need for a kidney transplant.

Treatment can also provide relief from lupus symptoms.

Common treatments include:

*minimizing intake of protein and salt
*taking blood pressure medication
*using steroids to reduce swelling and inflammation
*taking immune-suppression medicines like prednisone to reduce immune system damage to the kidneys

Extensive kidney damage may require additional treatment.

Drug regimens prescribed for lupus nephritis include mycophenolate mofetil (MMF), intravenous cyclophosphamide with corticosteroids, and the immune suppressant azathioprine with corticosteroids. MMF and cyclophosphamide with corticosteroids are equally effective in achieving remission of the disease. MMF is safer than cyclophosphamide with corticosteroids, with less chance of causing ovarian failure, immune problems or hair loss. It also works better than azathioprine with corticosteroids for maintenance therapy.

Prognosis:  How well you do depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms.

Some people with this condition develop chronic kidney failure.

Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.
Prevention: There is no known prevention for lupus nephritis.

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:

http://en.wikipedia.org/wiki/Lupus_nephritis

http://www.nlm.nih.gov/medlineplus/ency/article/000481.htm

http://www.healthline.com/health/lupus-nephritis#Diagnosis3

Lumbar Spondylosis

Definition:
Lumbar Spondylosis is a condition associated with degenerative changes in the intervertebral discs and facet joints. Spondylosis, also known as spinal osteoarthritis, can affect the lumbar, thoracic, and/or the cervical regions of the spine. Although aging is the primary cause, the location and rate of degeneration is individual. As the lumbar discs and associated ligaments undergo aging, the disc spaces frequently narrow. Thickening of the ligaments that surround the disc and those that surround the facet joints develops. These ligamentous thickening may eventually become calcified. Compromise of the spinal canal or of the openings through which the spinal nerves leave the spinal canal can occur.

CLICK & SEE THE PICTURES

Lumbar spondylosis encompasses lumbar disc bulges, herniations, facet joint degeneration, and vertebral bony overgrowths (osteophytes). Degenerative changes, including osteophyte formation, increase with age but are often asymptomatic. Disc herniation is symptomatic when it causes nerve root compression and spinal stenosis. Common symptoms include low back pain, sciatica, and restriction in back movement. Treatment is usually conservative, although surgery is indicated for spinal cord compression or intractable pain. Relapse is common, with patients experiencing episodic back pain.

Symptoms:
Symptoms of lumbar spondylosis follow those associated with each of the various aspects of the disorder: disc herniation, sciatica, spinal stenosis, degenerative spondylolisthesis, and degenerative scoliosis. Pain associated with disc degeneration may be felt locally in the back or at a distance away. This is called referred pain, as the pain is not felt at its site of origin. Lower back arthritis may be felt as pain in the buttock, hips, groin, and thighs. As with spinal stenosis or disc herniation in the lumbar region, it is important to be aware of any bowel or bladder incontinence, or numbness in the perianal area. These signs and symptoms could represent an important massive nerve compression needing surgical intervention (cauda equina syndrome).

Causes:
Spondylosis is mainly caused by ageing. As people age, certain biological and chemical changes cause tissues throughout the body to degenerate. In the spine, the vertebrae (spinal bones) and intervertebral discs degenerate with ageing. the intervertebral discs are cushion like structures that act as shock absorbers between the vertebral bones.

One of the structures that form the discs is known as the annulus fibrosus. The annulus fibrosus is made up of the 60 or more tough circular bands of collagen fiber (called lamellae). Collagen is a type of inelastic fiber. Collagen fibers, along with water and proteoglycans (types of large molecules made of a protein and at least one carbohydrate chain) help to form the soft, gel-like center part of each disk. This soft, center part is known as the nucleus pulposus and is surrounded by the annulus fibrosus.

The degenerative effects of ageing can cause the fibers of the discs to weaken, causing wear and tear. Constant wear and tear and injury to the joints of the vertebrae causes inflammation in the joints. Degeneration of the discs leads to the formation of mineral deposits within the discs. The water content of the center of the disc decreases with age and as a result the discs become hard, stiff, and decreased in size. This, in turn, results in strain on all the surrounding joints and tissues, causing the sensation of stiffness. With less water in the center of the discs, they have decreased shock absorbing qualities. An increased risk of disc herniation also results, which is when the disc abnormally protrudes from its normal position.

Each vertebral body contains four joints that act as hinges. These hinges are known as facet joints or zygapophyseal joints. The job of the facet joins is to allow the spinal column to flex, extend, and rotate. The bones of the facet joints are covered with cartilage (a type of flexible tissue) known as end plates. The job of the end plates is to attach the disks to the vertebrae and to supply nutrients to the disc. When the facet joints degenerate, the size of the end plates can decrease and stiffen. Movement can stimulate pain fibers in the facet joints and annulus fibrosus. Furthermore, the vertebral bone underneath the end plates can become thick and hard.

Degenerative disease can cause ligaments to lose their strength. A ligament is a tough band of tissue that attaches to joint bones. In the spine, ligaments connect spinal structures such as vertebrae and prevent them from moving too much. In degenerative spondylosis, one of the main ligaments (known as the ligamentum flavum) can thicken or buckle, making it weaken.

Knobby, abnormal bone growths (known as bone spurs or osteophytes) can form in the vertebrae. These changes can also cause osteoarthritis. Osteoarthritis is a disease of the joints that is made worse by stress. In more severe cases, these bones spurs can compress nerves coming out of the spinal cord and/or decreased blood supply to the vertebrae. Areas of the body supplied by these nerves may become painful or develop loss of sensation and function.

Carrying around excessive weight can cause lumbar spondylosis. Spending much of the day seated can also be a contributing factor. An injury or trauma to the back can also contribute, as can genetic factors.

The main Risk Factors:
• Age: As a person ages the healing ability of the body decreases and developing arthritis at that time can make the disease progress much faster. Persons over 40 years of age are more prone to developing lumbar spondylosis.

• Obesity: Overweight puts excess load on the joints as the lumbar region carries most of the body’s weight, making a person prone to lumbar spondylosis.

• Sitting for prolonged periods: Sitting in one position for prolonged time which puts pressure on the lumbar vertebrae.

• Prior injury: Trauma makes a person more susceptible to developing lumbar spondylosis.

• Heredity or Family history
Diagnosis:
Physical Examination:
A thorough physical examination reveals much about the patient’s health and general fitness. The physical part of the exam includes a review of the patient’s medical and family history. Often laboratory tests such as complete blood count and urinalysis are ordered. The physical exam may include:

*Palpation (exam by touch) determines spinal abnormalities, areas of tenderness, and muscle spasm.

*Range of Motion measures the degree to which a patient can perform movement of flexion, extension, lateral bending, and spinal rotation.

*A neurologic evaluation assesses the patient’s symptoms including pain, numbness, paresthesias (e.g. tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes. Particular attention may be given to the extremities. Either a CT Scan or MRI study may be required if there is evidence of neurologic dysfunction.

X-rays and Other Tests:
Radiographs (X-rays) may indicate loss of vertebral disc height and the presence of osteophytes, but is not as useful as a CT Scan or MRI. A CT Scan may help reveal bony changes sometimes associated with spondylosis. An MRI is a sensitive imaging tool capable of revealing disc, ligament, and nerve abnormalities. Discography seeks to reproduce the patient’s symptoms to identify the anatomical source of pain. Facet blocks work in a similar manner. Both are considered controversial.

The physician compares the patient’s symptoms to the findings to formulate a diagnosis and treatment plan. The results from the examination provide a baseline from which the physician can monitor and measure the patient’s progress.

Treatment:
Each patient is treated differently for arthritis depending on their individual condition. In the early stages lifestyle modifications or medicines are used for treatment and surgery is needed only if these measures are ineffective.

Yoga:
A few yoga poses and sequences can help lumbar spondylosis. Sun salutations, also known as Surya Namaskar A and B, are good for back strengthening and flexibility. The cobra pose, or Bhjangasana, stretches the lower back. The locust pose, or Shalabhasana, strengthens the lower back because it requires lifting one’s upper and lower body off the ground from a prone position on the floor. Meditation & pranayam 

Exercises:
Physical therapy is often prescribed to relieve problems caused by lumbar spondylosis. Back extensions are used on patients who can tolerate them. The patient lies face down on her stomach and then slowly lifts only her upper body off the floor. The arms may be placed palms down under her chest to take some strain off the back muscles. If lying down is too painful, this exercise can also be done against a wall. The patient puts her hands against a wall, standing about a foot away, and bends back, using a combination of lower back muscles and arms.

Stretches to Avoid:
Lying on the back and bringing the knees into the chest is an example of a common lower back stretch that flexes the spine. This is not recommended for people with lumbar spondylosis. Bending down to touch one’s toes from a standing position is also not recommended. Reaching for the toes while sitting can be problematic, too.

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:

http://www.ehow.com/about_5039006_lumbar-spondylosis-exercises.html

http://www.physiotherapy-treatment.com/lumbar-spondylosis.html

 

BALANCE DISORDER

Definition:
A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by feelings of giddiness or wooziness, or having a sensation of movement, spinning, or floating. Balance is the result of several body systems working together: the visual system (eyes), vestibular system (ears) and proprioception (the body’s sense of where it is in space). Degeneration or loss of function in any of these systems can lead to balance deficits
CLICK  & SEE THE PICTURES
Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain.

Our sense of balance is primarily controlled by a maze-like structure in our inner ear called the labyrinth, which is made of bone and soft tissue. At one end of the labyrinth is an intricate system of loops and pouches called the semicircular canals and the otolithic organs, which help us maintain our balance. At the other end is a snail-shaped organ called the cochlea, which enables us to hear. The medical term for all of the parts of the inner ear involved with balance is the vestibular system.

Symptoms:
When balance is impaired, an individual has difficulty maintaining upright orientation. For example, an individual may not be able to walk without staggering, or may not even be able to stand. They may have falls or near-falls. The symptoms may be recurring or relatively constant. When symptoms exist, they may include:

*Dizziness or vertigo (a spinning sensation)
*Falling or feeling as if you are going to fall
*Lightheadedness, faintness, or a floating sensation
*Blurred vision
*Confusion or disorientation

Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period.

Cognitive dysfunction (disorientation) may occur with vestibular disorders. Cognitive deficits are not just spatial in nature, but also include non-spatial functions such as object recognition memory. Vestibular dysfunction has been shown to adversely affect processes of attention and increased demands of attention can worsen the postural sway associated with vestibular disorders. Recent MRI studies also show that humans with bilateral vestibular damage undergo atrophy of the hippocampus which correlates with their degree of impairment on spatial memory tasks

Causes:
Problems with balance can occur when there is a disruption in any of the vestibular, visual, or proprioceptive systems. Abnormalities in balance function may indicate a wide range of pathologies from causes like inner ear disorders, low blood pressure, brain tumors, and brain injury including stroke.

Many different terms are often used for dizziness, including lightheaded, floating, woozy, giddy, confused, helpless, or fuzzy. Vertigo, Disequilibrium and pre-syncope are the terms in use by most physicians and have more precise definitions.

*Vertigo: Vertigo is the sensation of spinning or having the room spin about you. Most people find vertigo very disturbing and report associated nausea and vomiting.

*Disequilibrium: Disequilibrium is the sensation of being off balance, and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.

*Pre-syncope (links to syncope, which is different): Pre-syncope is a feeling of lightheadedness or simply feeling faint. Syncope, by contrast, is actually fainting. A circulatory system deficiency, such as low blood pressure, can contribute to a feeling of dizziness when one suddenly stands up.

Problems in the skeletal or visual systems, such as arthritis or eye muscle imbalance, may also cause balance problems.

Related to the ear:
Causes of dizziness related to the ear are often characterized by vertigo (spinning) and nausea. Nystagmus (flickering of the eye, related to the Vestibulo-ocular reflex [VOR]) is often seen in patients with an acute peripheral cause of dizziness.

*Benign Paroxysmal Positional Vertigo (BPPV) – The most common cause of vertigo. It is typically described as a brief, intense sensation of spinning that occurs when there are changes in the position of the head with respect to gravity. An individual may experience BPPV when rolling over to the left or right, upon getting out of bed in the morning, or when looking up for an object on a high shelf.  The cause of BPPV is the presence of normal but misplaced calcium crystals called otoconia, which are normally found in the utricle and saccule (the otolith organs) and are used to sense movement. If they fall from the utricle and become loose in the semicircular canals, they can distort the sense of movement and cause a mismatch between actual head movement and the information sent to the brain by the inner ear, causing a spinning sensation.

*Labyrinthitis - An inner ear infection or inflammation causing both dizziness (vertigo) and hearing loss.

*Vestibular neuronitis – an infection of the vestibular nerve, generally viral, causing vertigo

*Cochlear Neuronitis – an infection of the Cochlear nerve, generally viral, causing sudden deafness but no vertigo

*Trauma – Injury to the skull may cause either a fracture or a concussion to the organ of balance. In either case an acute head injury will often result in dizziness and a sudden loss of vestibular function.

*Surgical trauma to the lateral semicircular canal (LSC) is a rare complication which does not always result in cochlear damage. Vestibular symptoms are pronounced. Dizziness and instability usually persist for several months and sometimes for a year or more.

   *Ménière’s disease – an inner ear fluid balance disorder that causes lasting episodes of vertigo, fluctuating hearing loss, tinnitus (a ringing or roaring in the ears), and the sensation of fullness in the ear. The cause of Ménière’s disease is unknown.

    *Perilymph fistula - a leakage of inner ear fluid from the inner ear. It can occur after head injury, surgery, physical exertion or without a known cause.

    *Superior canal dehiscence syndrome - a balance and hearing disorder caused by a gap in the temporal bone, leading to the dysfunction of the superior canal.

  *Bilateral vestibulopathy - a condition involving loss of inner ear balance function in both ears. This may be caused by certain antibiotics, anti-cancer, and other drugs or by chemicals such as solvents, heavy metals, etc., which are ototoxic; or by diseases such as syphilis or autoimmune disease; or other causes. In addition, the function of the semicircular canal can be temporarily affected by a number of medications or combinations of medications.

Related to the brain and central nervous system:
Brain related causes are less commonly associated with isolated vertigo and nystagmus but can still produce signs and symptoms, which mimic peripheral causes. Disequilibrium is often a prominent feature.

*Degenerative: age related decline in balance function
*Infectious: meningitis, encephalitis, epidural abscess, syphilis
*Circulatory: cerebral or cerebellar ischemia or hypoperfusion, stroke, lateral medullary syndrome (Wallenberg’s syndrome)
*Autoimmune: Cogan syndrome
*Structural: Arnold-Chiari malformation, hydrocephalus
*Systemic: multiple sclerosis, Parkinson’s disease
*Vitamin deficiency: Vitamin B12 deficiency
*CNS or posterior neoplasms, benign or malignant
*Neurological: Vertiginous epilepsy
*Other – There are a host of other causes of dizziness not related to the ear.

*Mal de debarquement is rare disorder of imbalance caused by being on board a ship. Patients suffering from this condition experience disequilibrium          even when they get off the ship. Typically treatments for seasickness are ineffective for this syndrome.

*Motion sickness – a conflict between the input from the various systems involved in balance causes an unpleasant sensation. For this reason, looking          out of the window of a moving car is much more pleasant than looking inside the vehicle.

*Migraine-associated vertigo
*Toxins, drugs, medications

Pathophysiology:
The semicircular canals, found within the vestibular apparatus, let us know when we are in a rotary (circular) motion. The semicircular canals are fluid-filled. Motion of the fluid tells us if we are moving. The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ). The vestibular system works with the visual system to keep objects in focus when the head is moving. This is called the vestibulo-ocular reflex (VOR).
Click & see :
Movement of fluid in the semicircular canals signals the brain about the direction and speed of rotation of the head – for example, whether we are nodding our head up and down or looking from right to left. Each semicircular canal has a bulbed end, or enlarged portion, that contains hair cells. Rotation of the head causes a flow of fluid, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. Two other organs that are part of the vestibular system are the utricle and saccule. These are called the otolithic organs and are responsible for detecting linear acceleration, or movement in a straight line. The hair cells of the otolithic organs are blanketed with a jelly-like layer studded with tiny calcium stones called otoconia. When the head is tilted or the body position is changed with respect to gravity, the displacement of the stones causes the hair cells to bend.

click & see
The balance system works with the visual and skeletal systems (the muscles and joints and their sensors) to maintain orientation or balance. For example, visual signals are sent to the brain about the body’s position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular, visual and the skeletal systems.
Diagnosis:
Diagnosis of a balance disorder is complicated because there are many kinds of balance disorders and because other medical conditions — including ear infections, blood pressure changes, and some vision problems — and some medications may contribute to a balance disorder. A person experiencing dizziness should see a physiotherapist or physician for an evaluation. A physician can assess for a medical disorder, such as a stroke or infection, if indicated. A physiotherapist can assess balance or a dizziness disorder and provide specific treatment.

The primary physician may request the opinion of an otolaryngologist to help evaluate a balance problem. An otolaryngologist is a physician/surgeon who specializes in diseases and disorders of the ear, nose, throat, head, and neck, sometimes with expertise in balance disorders. He or she will usually obtain a detailed medical history and perform a physical examination to start to sort out possible causes of the balance disorder. The physician may require tests and make additional referrals to assess the cause and extent of the disruption of balance. The kinds of tests needed will vary based on the patient’s symptoms and health status. Because there are so many variables, not all patients will require every test.

Diagnostic testing:
Tests of vestibular system (balance) function include electronystagmography (ENG), Videonystagmograph (VNG), rotation tests, Computerized Dynamic Posturography (CDP), and Caloric reflex test.

Tests of auditory system (hearing) function include pure-tone audiometry, speech audiometry, acoustic-reflex, electrocochleography (ECoG), otoacoustic emissions (OAE), and auditory brainstem response test (ABR; also known as BER, BSER, or BAER).

Other diagnostic tests include magnetic resonance imaging (MRI) and computerized axial tomography (CAT, or CT).

Treatment and Prevention:
There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, such as ear infection, stroke, multiple sclerosis, spinal cord injury, Parkinson’s, neuromuscular conditions, acquired brain injury, cerebellar dysfunctions and/or ataxia. Individual treatment will vary and will be based upon assessment results including symptoms, medical history, general health, and the results of medical tests. Additionally, tai chi may be a cost-effective method to prevent falls in the elderly.

Many types of balance disorders will require balance training, prescribed by an occupational therapist or physiotherapist. Physiotherapists often administer standardized outcome measures as part of their assessment in order to gain useful information and data about a patient’s current status. Some standardized balance assessments or outcome measures include but are not limited to the Functional Reach Test, Clinical Test for Sensory Integration in Balance (CTSIB), Berg Balance Scale and/or Timed Up and Go The data and information collected can further help the physiotherapist develop an intervention program that is specific to the individual assessed. Intervention programs may include training activities that can be used to improve static and dynamic postural control, body alignment, weight distribution, ambulation, fall prevention and sensory function. Although treatment programs exist which seek to aid the brain in adapting to vestibular injuries, it is important to note that it is simply that – an adaptation to the injury. Although the patient’s balance is restored, the balance system injury still exists

Benign Paroxysmal Positional Vertigo (BPPV):
It is caused by misplaced crystals within the ear. Treatment, simply put, involves moving these crystals out of areas that cause vertigo and into areas where they do not. A number of exercises have been developed to shift these crystals. The following article explains with diagrams how these exercises can be performed at the office or at home with some help: The success of these exercises depends on their being performed correctly.

The two exercises explained in the above article are:

*The Brandt-Daroff Exercises, which can be done at home and have a very high success rate but are unpleasant and time consuming to perform.

*The Epley’s exercises are often performed by a doctor or other trained professionals and should not be performed at home. Various devices are available      for home BPPV treatment.

Ménière’s disease:
  *Diet:
Dietary changes such as reducing intake of sodium (salt) may help. For some people, reducing alcohol, caffeine, and/or avoiding nicotine may be               helpful. Stress has also been shown to make the symptoms associated with Ménière’s worse.

 *Drugs:
#Beta-histine (Serc) is available in some countries and is thought to reduce the frequency of symptoms
#Diuretics such as hydrochlorothiazide (Diazide) have also been shown to reduce the frequency of symptoms
#Aminoglycoside antibiotics (gentamicin) can be used to treat Ménière’s disease. Systemic streptomycin (given by injection) and topical gentamicin         (given directly to the inner ear) are useful for their ability to affect the hair cells of the balance system. Gentamicin also can affect the hair  cells of the cochlea, though, and cause hearing loss in about 10% of patients. In cases that do not respond to medical management, surgery may be indicated.

      *Surgery for Ménière’s disease is a last resort.
#Vestibular neuronectomy can cure Ménière’s disease but is very involved surgery and not widely available. It involves drilling into the skull and  cutting the balance nerve just as it is about to enter the brain.
#Labyrinthectomy (surgical removal of the whole balance organ) is more widely available as a treatment but causes total deafness in the affected ear.

Labyrinthitis:
Treatment includes balance retraining exercises (vestibular rehabilitation). The exercises include movements of the head and body specifically developed for the patient. This form of therapy is thought to promote habituation, adaptation of the vestibulo-ocular reflex, and/or sensory substitution. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body.

Bilateral vestibular loss:
Dysequilibrium arising from bilateral loss of vestibular function – such as can occur from ototoxic drugs such as gentamicin – can also be treated with balance retraining exercises (vestibular rehabilitation) although the improvement is not likely to be full recovery

Medication:
Sedative drugs are often prescribed for vertigo and dizziness, but these usually treat the symptoms rather than the underlying cause. Lorazepam (Ativan) is often used and is a sedative which has no effect on the disease process rather helps patients cope with the sensation.

Anti-nauseants, like those prescribed for motion sickness, are also often prescribed but do not affect the prognosis of the disorder.

Specifically for Meniere’s disease a medication called Serc (Beta-histine) is available. There is some evidence to support it is effective to reduce the frequency of attacks. Also Diuretics, like Diazide (HCTZ/triamterene), are effective in many patients. Finally, ototoxic medications delivered either systemically or through the eardrum can eliminate the vertigo associated with Meniere’s in many cases, although there is about a 10% risk of further hearing loss when using ototoxic medications.

Treatment is specific for underlying disorder of balance disorder:

#anticholinergics
#antihistamines
#benzodiazepines
#calcium channel antagonists, specifically Verapamil and Nimodipine
#GABA modulators, specifically gabapentin and baclofen
#Neurotransmitter reuptake inhibitors such as SSRI’s, SNRI’s and Tricyclics

Research:
Scientists at the National Institute on Deafness and Other Communication Disorders (NIDCD) are working to understand the various balance disorders and the complex interactions between the labyrinth, other balance-sensing organs, and the brain. NIDCD scientists are studying eye movement to understand the changes that occur in aging, disease, and injury, as well as collecting data about eye movement and posture to improve diagnosis and treatment of balance disorders. They are also studying the effectiveness of certain exercises as a treatment option.

Other projects supported by the NIDCD include studies of the genes essential to normal development and function in the vestibular system. NIDCD scientists are also studying inherited syndromes of the brain that affect balance and coordination.

The NIDCD supports research to develop new tests and refine current tests of balance and vestibular function. For example, NIDCD scientists have developed computer-controlled systems to measure eye movement and body position by stimulating specific parts of the vestibular and nervous systems. Other tests to determine disability, as well as new physical rehabilitation strategies, are under investigation in clinical and research settings.

Scientists at the NIDCD hope that new data will help to develop strategies to prevent injury from falls, a common occurrence among people with balance disorders, particularly as they grow older.
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:

http://en.wikipedia.org/wiki/Balance_disorder

http://www.medicinenet.com/vestibular_balance_disorders/article.htm#what_is_a_balance_disorder

Gestational Diabetes

Definition:
Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy (especially during their third trimester). Gestational diabetes is caused when insulin receptors do not function properly. This is likely due to pregnancy-related factors such as the presence of human placental lactogen that interferes with susceptible insulin receptors. This in turn causes inappropriately elevated blood sugar levels.

CLICK & SEE THE PICTURES

Gestational diabetes generally has few symptoms and it is most commonly diagnosed by screening during pregnancy. Diagnostic tests detect inappropriately high levels of glucose in blood samples. Gestational diabetes affects 3-10% of pregnancies, depending on the population studied.

As with diabetes mellitus in pregnancy in general, babies born to mothers with untreated gestational diabetes are typically at increased risk of problems such as being large for gestational age (which may lead to delivery complications), low blood sugar, and jaundice. If untreated, it can also cause seizures or stillbirth. Gestational diabetes is a treatable condition and women who have adequate control of glucose levels can effectively decrease these risks. The food plan is often the first recommended target for strategic management of GDM.

Clasifications:
There are two subtypes of gestational diabetes:
Type A1: abnormal oral glucose tolerance test (OGTT), but normal blood glucose levels during fasting and two hours after meals; diet modification is sufficient to control glucose levels

Type A2: abnormal OGTT compounded by abnormal glucose levels during fasting and/or after meals; additional therapy with insulin or other medications is required

Approximately 7% of all pregnancies are complicated by GDM, resulting in more than 200,000 cases annually. The prevalence may range from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic tests employed.

Symptoms:
Because gestational diabetes does not cause much symptoms, the patient need to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy. It is surprised if your test shows a high blood sugar level and is important for the patient to be tested for gestational diabetes, because high blood sugar can cause problems for both the pregnent woman and the baby.Sometimes, a pregnant woman has been living with diabetes without knowing it. If she has the  symptoms of diabetes  and that may include:

*Increased thirst.
*Increased urination.
*Increased hunger.
*Blurred vision.

Pregnancy causes most women to urinate more often and to feel more hungry, so having these symptoms doesn’t always mean that a woman has diabetes.Doctor should be consulted wheather  these symptoms are for diabetes  and then he can suggest for the test of diabetes.

*Infections:
Since diabetes interferes with the body’s ability to fight infections, the pregnant woman may experience frequent infections in areas such as the bladder, vagina and skin. White blood cells defend the body against bacteria, but these cells aren’t able to function normally when a person has a high blood sugar. A woman with gestational diabetes may also complain of a yeast infection in the vagina or on the skin. Yeast cells are normally present in the vaginal area in small amounts. The vaginal secretions and urine contain more glucose when a woman has gestational diabetes. The yeast cells use the glucose as food, which causes the cells to multiply. With the body’s immune system compromised by the high level of glucose in the blood, this increase in yeast cells turns into a yeast infection.

*High Blood Sugar:
Since a woman may not have any noticeable symptoms of gestational diabetes and symptoms can mimic regular pregnancy symptoms, screening for this condition is part of prenatal care for at-risk women between weeks 24 and 28 of pregnancy. The doctor will initially order a blood test called a glucose challenge test. If the glucose challenge test indicates a high blood sugar level, the doctor may order a glucose tolerance test to confirm the diagnosis of gestational diabetes. Both tests involve drinking a sweet glucose solution and having your blood drawn after a prescribed amount of time.

Causes:
Almost all women have some degree of impaired glucose intolerance as a result of hormonal changes that occur during pregnancy. That means that their blood sugar may be higher than normal, but not high enough to have diabetes. During the later part of pregnancy (the third trimester), these hormonal changes place pregnant woman at risk for gestational diabetes.

During pregnancy, increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus) help shift nutrients from the mother to the developing fetus. Other hormones are produced by the placenta to help prevent the mother from developing low blood sugar.

They work by resisting the actions of insulin.
Over the course of the pregnancy, these hormones lead to progressive impaired glucose intolerance (higher blood sugar levels). To try to decrease blood sugar levels, the body makes more insulin to get glucose into cells to be used for energy.
Usually, the mother’s pancreas is able to produce more insulin (about three times the normal amount) to overcome the effect of the pregnancy hormones on blood sugar levels. If, however, the pancreas cannot produce enough insulin, blood sugar levels will rise, resulting in gestational diabetes.

Risk factors:
Any woman can develop gestational diabetes, but some women are at greater risk. Risk factors for gestational diabetes include:

*Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.
*Family or personal health history. the risk of developing gestational diabetes increases if the woman has prediabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes.the woman is also more likely to develop gestational diabetes if she had it during a previous pregnancy, if the woman delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if she had an unexplained stillbirth.
*Excess weight. You’re more likely to develop gestational diabetes if you’re significantly overweight with a body mass index (BMI) of 30 or higher.
*Race factor. For reasons that aren’t clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.

Complications:
Most women who have gestational diabetes deliver healthy babies. However, gestational diabetes that’s not carefully managed can lead to uncontrolled blood

sugar levels and cause problems for patient and the baby, including an increased likelihood of needing a C-section to deliver.

Complications that may affect the baby are:
1.Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby’s pancreas to make extra insulin. This can cause the baby to grow too large (macrosomia). Very large babies — those that weigh 9 pounds or more — are more likely to become wedged in the birth canal, sustain birth injuries or require a C-section birth.

2.Early (preterm) birth and respiratory distress syndrome. A mother’s high blood sugar may increase her risk of early labor and delivering her baby before its due date. Or her doctor may recommend early delivery because the baby is large.

3.Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult. Babies with this syndrome may need help breathing until their lungs mature and become stronger. Babies of mothers with gestational diabetes may experience respiratory distress syndrome even if they’re not born early.

4.Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.

5.Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.

Complications that may affect the patient are:
1.High blood pressure and preeclampsia. Gestational diabetes raises your risk of high blood pressure, as well as, preeclampsia — a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten the lives of both mother and baby.

2.Future diabetes. If the pregnent woman has gestational diabetes, she is more likely to get it again during a future pregnancy and also more likely to develop type 2 diabetes as she gets older. However, making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes.Of those women with a history of gestational diabetes who reach their ideal body weight after delivery, fewer than 1 in 4 eventually develops type 2 diabetes.

Diagnosis:
Gestational diabetes usually starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy.

Once the pregnent woman is diagnosed with gestational diabetes, she can see how well she is doing by testing the glucose level at home. The most common way involves pricking her finger and putting a drop of the blood on a machine that will give her the glucose reading.

Treatment:
The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the growing baby is healthy.

Watching the baby:
1.The health care provider should closely check both the patient  and the baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus.

2.A nonstress test is a very simple, painless test for the patient and the baby.

3.A machine that hears and displays the baby’s heartbeat (electronic fetal monitor) is placed on the abdomen.
The health care provider can compare the pattern of the baby’s heartbeat to movements and find out whether the baby  is doing well.

Diet and exercise:
The best way to improve the pregnent woman’s diet is by eating a variety of healthy foods.She should learn how to read food labels, and check them when making food decisions.The doctor or dietitian  should advice the diet chart and that should be strictly followed  during pregnancy.

In general, when the pregnent woman has gestational diabetes the diet should:
*Be moderate in fat and protein.

#Provide  carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice)
Be low in foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries.

#If managing the diet does not control blood sugar (glucose) levels, she may be prescribed diabetes medicine by mouth or insulin therapy.
Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.

Prevention:
Theoretically, smoking cessation may decrease the risk of gestational diabetes among smokers.Physical exercise has not been found to have a significant effect of primary prevention of gestational diabetes in randomized controlled trials. It may be effective as tertiary prevention for women who have already developed the condition.
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:

http://en.wikipedia.org/wiki/Gestational_diabetes

http://www.webmd.com/diabetes/guide/gestational-diabetes-symptoms

http://www.ehow.com/list_6080912_signs-symptoms-gestational-diabetes.html

http://www.webmd.com/diabetes/guide/gestational_diabetes

http://www.mayoclinic.org/diseases-conditions/gestational-diabetes/basics/risk-factors/CON-20014854

http://www.nytimes.com/health/guides/disease/gestational-diabetes/overview.html

Pelvic pain

Definition:
Pelvic pain is pain in the lowest part of your abdomen and pelvis. In women, pelvic pain may refer to symptoms arising from the reproductive or urinary systems or from musculoskeletal sources. Pelvic pain can occur suddenly, sharply and briefly (acute) or over the long term (chronic). Chronic pelvic pain refers to any constant or intermittent pelvic pain that has been present for more than a few months. It can affect both women and men.

CLICK & SEE THE PICTURES

Depending on its source, pelvic pain may be dull or sharp; it may be constant or off and on (intermittent); and it may be mild, moderate or severe. Pelvic pain can sometimes radiate to one’s lower back, buttocks or thighs.

Common causes in include: endometriosis in women, bowel adhesions, irritable bowel syndrome, and interstitial cystitis. The cause may also be a number of poorly understood conditions that may represent abnormal psychoneuromuscular function.

Most women, at some time in their lives, experience pelvic pain. As girls enter puberty, pelvic or abdominal pain becomes a frequent complaint.
Sometimes, it is noticed that pelvic pains only at certain times, such as when  urinating  or during sexual activity.

According to the CDC, Chronic pelvic pain (CPP) accounted for approximately 9% of all visits to gynecologists in 2007. In addition, CPP is the reason for 20—30% of all laparoscopies in adults.

Causes:
Several types of diseases and conditions may cause pelvic pain. Often chronic pelvic pain results from more than one condition.

Pelvic pain may arise from one’s digestive, reproductive or urinary system. Recently, doctors have recognized that some pelvic pain, particularly chronic pelvic pain, may also arise from muscles and connective tissue (ligaments) in the structures of the pelvic floor. Occasionally, pelvic pain may be caused by irritation of nerves in the pelvis.

The different conditions that may cause pelvic pain includs:

*exaggerated bladder, bowel, or uterine pain sensitivity (also known as visceral pain)
pelvic girdle pain (SPD or DSP)

Gynecologic:

*Dysmenorrhea—pain during the menstrual period

*Endometriosis—pain caused by uterine tissue that is outside the uterus. Endometriosis can be visually confirmed by laparoscopy in approximately 75% of adolescent girls with chronic pelvic pain that is resistant to treatment, and in approximately 50% of adolescent in girls with chronic pelvic pain that is not necessarily resistant to treatment.

*Müllerian abnormalities

*Pelvic inflammatory disease—pain caused by damage from infections

*Ovarian cysts—the ovary produces a large, painful cyst, which may rupture

*Ovarian torsion—the ovary is twisted in a way that interferes with its blood supply

*Ectopic pregnancy—a pregnancy implanted outside the uterus

Abdominal:

*Loin pain hematuria syndrome

*Proctitis—infection or inflammation of the anus or rectum

*Colitis—infection or inflammation of the colon

*Appendicitis—infection or inflammation of the bowel

Internal hernias are difficult to identify in women, and misdiagnosis with endometriosis or idiopathic chronic pelvic pain is very common. One cause of misdiagnosis that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman’s body in a way that provokes symptoms.

Female reproductive system:
Pelvic pain arising from the female reproductive system may be caused by conditions such as:

*Adenomyosis
*Endometriosis
*Menstrual cramps (dysmenorrhea)
*Ectopic pregnancy (or other pregnancy-related conditions)
*Miscarriage (before the 20th week) or intrauterine fetal death
*Mittelschmerz (ovulation pain)
*Ovarian cancer
*Ovarian cysts
*Pelvic inflammatory disease (PID)
*Uterine fibroids
*Vulvodynia

Other causes in women or men:
Examples of other possible causes of pelvic pain — in women or men — include:

*Colon cancer
*Chronic constipation
*Crohn’s disease
*Diverticulitis
*Fibromyalgia
*Interstitial cystitis (also called painful bladder syndrome)
*Intestinal obstruction
*Irritable bowel syndrome
*Kidney stones
*Past physical or sexual abuse
*Pelvic floor muscle spasms
*Prostatitis
*Ulcerative colitis
*Urinary tract infection (UTI)

Diagnosis:
The diagnostic workup begins with a careful history and examination, followed by a pregnancy test. Some women may also need bloodwork or additional imaging studies, and a handful may also benefit from having surgical evaluation.

The absence of visible pathology in chronic pain syndromes should not form the basis for either seeking psychological explanations or questioning the reality of the patient’s pain. Instead it is essential to approach the complexity of chronic pain from a psychophysiological perspective which recognises the importance of the mind-body interaction. Some of the mechanisms by which the limbic system impacts on pain, and in particular myofascial pain, have been clarified by research findings in neurology and psychophysiology.

Differential diagnosis:
In men, chronic pelvic pain (category IIIB) is often misdiagnosed as chronic bacterial prostatitis and needlessly treated with antibiotics exposing the patient to inappropriate antibiotic use and unnecessarily to adverse effects with little if any benefit in most cases. Within a Bulgarian study, where by definition all patients had negative microbiological results, a 65% adverse drug reaction rate was found for patients treated with ciprofloxacin in comparison to a 9% rate for the placebo patients. This was combined with a higher cure rate (69% v 53%) found within the placebo group.

Treatment:
Many women will benefit from a consultation with a physical therapist, a trial of anti-inflammatory medications, hormonal therapy, or even neurological agents.

A hysterectomy is sometimes performed.

Spinal cord stimulation has been explored as a potential treatment option for some time, however there remains to be consensus on where the optimal location of the spinal cord this treatment should be aimed. As the innervation of the pelvic region is from the sacral nerve roots, previous treatments have been aimed at this region; results have been mixed. Spinal cord stimulation aimed at the mid- to high-thoracic region of the spinal cord have produced some positive results.

The sensation of pain travels through nerves up the spinal cord to the brain. Mild antidepressants like amitriptyline and gabapentin can block these transmissions and relieve the pain. They are especially effective if combined with anti-inflammatory medications like ibuprofen.

IBS and food allergies should also be tackled. Sometimes avoiding milk or wheat or both, and tackling abnormal gut motility works.

Physical activity reduces pain to an extent. Walking, jogging or running for 40 minutes a day is important. This should be combined with stretching and pelvic exercises. And if there is stress, cut it down with yoga and meditation.

Click to see :.—>..Homeopathic Treatment for Pelvic Pain

 Ayurvedic Treatment..(1) ...(2)

The treatment of pelvic pain with acupuncture

Pelvic Pain Recovery: Getting Your Life Back with Yoga  :

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:

http://en.wikipedia.org/wiki/Pelvic_pain

http://www.mayoclinic.org/symptoms/pelvic-pain/basics/definition/sym-20050898

http://www.telegraphindia.com/1141103/jsp/knowhow/story_18992189.jsp#.VFmWH2d2E1I

Heel pain

Alternative Names: Pain – heel

Defination:
Heel pain is a very common foot problem. The sufferer usually feels pain either under the heel (planter fasciitis) or just behind it (Achilles tendinitis), where the Achilles tendon connects to the heel bone.

click & see the pictures

Even though heel pain can be severe and sometimes disabling, it is rarely a health threat. Heel pain is typically mild and usually disappears on its own; however, in some cases the pain may persist and become chronic (long-term).

There are 26 bones in the human foot, of which the heel (calcaneus) is the largest. The human heel is designed to provide a rigid support for the weight of the body. When we are walking or running it absorbs the impact of the foot when it hits the ground, and springs us forward into our next stride. Experts say that the stress placed on a foot when walking may be 1.25 times our body weight, and 2.75 times when running. Consequently, the heel is vulnerable to damage, and ultimately pain.

Heel pain is usually felt either under the heel or just behind it.
There are 26 bones in the human foot, of which the heel is the largest.
Pain typically comes on gradually, with no injury to the affected area. It is often triggered by wearing a flat shoe.
In most cases the pain is under the foot, towards the front of the heel.
The majority of patients recover with conservative treatments within months.
Home care such as rest, ice, proper-fitting footwear and foot supports are often enough to ease heel pain.
To prevent heel pain, it’s recommended to reduce the stress on that part of the body

Symptoms:
Pain typically comes on gradually, with no injury to the affected area. It is frequently triggered by wearing a flat shoe, such as flip-flop sandals. Flat footwear may stretch the plantar fascia to such an extent that the area becomes swollen (inflamed).

In most cases, the pain is under the foot, toward the front of the heel.

Post-static dyskinesia (pain after rest) – symptoms tend to be worse just after getting out of bed in the morning, and after a period of rest during the day.

After a bit of activity symptoms often improve a bit. However, they may worsen again toward the end of the day.

Causes:
In the majority of cases, heel pain has a mechanical cause. Heel pain tends to occur if a person has flat feet or high arches, is overweight, diabetic, wears poorly fitting or worn out shoes, runs or jogs on hard surfaces or has an abnormal gait.  Quite often the pain is due to a “spur” or extra bone growth.It may also be caused by arthritis, infection, an autoimmune problem trauma, a neurological problem, or some other systemic condition (condition that affects the whole body).

Heel pain is not usually caused by a single injury, such as a twist or fall, but rather the result of repetitive stress and pounding of the heel.

The most common causes of heel pain are:

*Plantar fasciitis (plantar fasciosis) – inflammation of the plantar fascia. The plantar fascia is a strong bowstring-like ligament that runs from the calcaneum (heel bone) to the tip of the foot. When the plantar fasciitis is stretched too far its soft tissue fibers become inflamed, usually where it attaches to the heel bone. Sometimes the problem may occur in the middle of the foot. The patient experiences pain under the foot, especially after long periods of rest. Some patients have calf-muscle cramps if the Achilles tendon tightens too

*Heel bursitis  - inflammation of the back of the heel, the bursa (a fibrous sac full of fluid). Can be caused by landing awkwardly or hard on the heels. Can also be caused by pressure from footwear. Pain is typically felt either deep inside the heel or at the back of the heel. Sometimes the Achilles tendon may swell. As the day progresses the pain usually gets worse

*Heel bumps (pump bumps) - common in teenagers. The heel bone is not yet fully mature and rubs excessively, resulting in the formation of too much bone. Often caused by having a flat foot. Among females can be caused by starting to wear high heels before the bone is fully mature

*Tarsal tunnel syndrome - a large nerve in the back of the foot becomes pinched, or entrapped (compressed). This is a type of compression neuropathy that can occur either in the ankle or foot..

*Chronic inflammation of the heel pad—caused either by the heel pad becoming too thin, or heavy footsteps
Stress fracture – this is a fracture caused by repetitive stress, commonly caused by strenuous exercise, sports or heavy manual work. Runners are particularly prone to stress fracture in the metatarsal bones of the foot. Can also be caused by osteoporosis

*Severs disease (calcaneal apophysitis) - the most common cause of heel pain in child/teenage athletes, caused by overuse and repetitive microtrauma of the growth plates of the calcaneus (heel bone). Children aged from 7-15 are most commonly affected

*Achilles tendonosis (degenerative tendinopathy) - also referred to as tendonitis, tendinosis and tendinopathy. A chronic (long-term) condition associated with the progressive degeneration of the Achilles tendon. Sometimes the Achilles tendon does not function properly because of multiple, minor microscopic tears of the tendon, which cannot heal and repair itself correctly – the Achilles tendon receives more tension than it can cope with and microscopic tears develop. Eventually, the tendon thickens, weakens and becomes painful.

Treatment:
Treatment for heel pain usually involves using a combination of techniques, such as stretches and painkillers, to relieve pain and speed up recovery.
Most cases of heel pain get better within 12 months. Surgery may be recommended as a last resort if your symptoms don’t improve after this time. Only 1 in 20 people with heel pain will need surgery.

Rest:
Whenever possible, rest the affected foot by not walking long distances and standing for long periods. However, you should regularly stretch your feet and calves using exercises such as those described  in the pictures...>…..click & see

To learn more click to see :

Prevention:
Maintaining flexible and strong muscles in your calves, ankles, and feet can help prevent some types of heel pain. Always stretch and warm-up before exercising.

Wear comfortable, properly fitting shoes with good arch support and cushioning. Make sure there is enough room for your toes.

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:

http://www.medicalnewstoday.com/articles/181453.php

http://www.nlm.nih.gov/medlineplus/ency/article/003181.htm

Syphillis

Other names:
Other names that people use for syphilis include:
*Pox
*Bad blood
*The great imitator
*Siff.

Description:
Syphilis is a sexually transmitted infective diseas caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis. Other human diseases caused by related Treponema pallidum include yaws (subspecies pertenue), pinta (subspecies carateum), and bejel (subspecies endemicum)……….click & see the pictures

Symptoms:
The signs and symptoms of syphilis vary depending in which of the four stages :primary, secondary, latent, and tertiary.

Primary stage of Syphilis:
The primary stage of syphilis typically begins with a sore (called a “chancre”) on the skin that’s initially exposed to the infection — usually the genitals, rectum or mouth. The sore has been described as feeling like a button: firm, round, usually measuring half an inch across, and not tender to the touch. Swelling of the lymph nodes in the groin may occur, but the nodes are not usually tender.

Infected individuals do not usually feel ill in the primary stage of syphilis, and the chancre heals spontaneously after 4 to 6 weeks. This is a problem because the syphilis has not gone away: syphilis continues to spread throughout the body.

Secondary stage of syphilis:
From the primary stage, the disease moves into the secondary stage of syphilis. Secondary syphilis can often occur several weeks after the chancre heals, once the bacteria have spread through the body. An individual may feel sick; common symptoms include headache, achiness, loss of appetite and maybe rash.

The rash in secondary syphilis is usually reddish-brown in color, not itchy and widespread. But the appearance of the rash’s individual lesions can vary dramatically: they may be flat or raised, they may or may not be scaly, and pustules may or may not be present. It’s partially due to the variability of this rash that led to syphilis being called “the great imitator,” because it can resemble many other conditions. The rash can last for a few weeks or months.

Other symptoms of secondary syphilis include sores in the mouth, nose, throat, and on the genitals or folds of the skin. Lymph node swelling is common, and patchy hair loss can occur. All signs and symptoms of the second stage of syphilis will disappear without treatment in 3 weeks to 9 months, but the infection will still be present in the body.

Latent stage of Syphilis:
The latent stage of syphilis, which occurs after the symptoms of secondary syphilis have disappeared, can last from a few years to up to 50 years! There are no symptoms in this stage, and after about two years, an infected man may cease to be contagious. However, a man in the latent stage of syphilis is still infected, and the disease can be diagnosed by a blood test. During the latent stage, a pregnant woman can transmit syphilis to her fetus.

Tertiary stage of Syphillis:
The final stage of syphilis, which occurs in about one third of those who are not treated, is known as the tertiary stage. Many organs may be affected. Common symptoms include fever; painful, non-healing skin ulcers; bone pain; liver disease; and anemia. Tertiary syphilis can also affect the nervous system (resulting in the loss of mental functioning) and the aorta (resulting in heart disease)…….click & see : http://upload.wikimedia.org/wikipedia/commons/7/73/Tertiary_syphilis_head.JPG

Congenital:
Congenital syphilis is that which is transmitted during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms. Common symptoms that develop over the first couple years of life include: hepatosplenomegaly (70%), rash (70%), fever (40%), neurosyphilis (20%), and pneumonitis (20%). If untreated, late congenital syphilis may occur in 40%, including: saddle nose deformation, Higoumenakis sign, saber shin, or Clutton’s joints among others.

Causes:
The cause of syphilis is a bacterium called Treponema pallidum. The most common route of transmission is through contact with an infected person’s sore during sexual activity. The bacteria enter your body through minor cuts or abrasions in your skin or mucous membranes. Syphilis is contagious during its primary and secondary stages, and sometimes in the early latent period.

Syphilis is transmitted primarily by sexual contact or during pregnancy from a mother to her fetus; the spirochaete is able to pass through intact mucous membranes or compromised skin. It is thus transmissible by kissing near a lesion, as well as oral, vaginal, and anal sex. Approximately 30 to 60% of those exposed to primary or secondary syphilis will get the disease. Its infectivity is exemplified by the fact that an individual inoculated with only 57 organisms has a 50% chance of being infected. Most (60%) of new cases in the United States occur in men who have sex with men. It can be transmitted via blood products. However, it is tested for in many countries and thus the risk is low. The risk of transmission from sharing needles appears limited. Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.Once cured, syphilis doesn’t recur. However, you can become reinfected if you have contact with someone’s syphilis sore.

Risk Factors:
One may face an increased risk of acquiring syphilis if he or she:

*Engage in unprotected sex
*Have sex with multiple partners
*Are a man who has sex with men
*Are infected with HIV, the virus that causes AIDS

Complications:
Without treatment, syphilis can lead to damage throughout your body. Syphilis also increases the risk of HIV infection and, for women, can cause problems during pregnancy. Treatment can help prevent future damage but can’t repair or reverse damage that’s already occurred.

Small bumps or tumors:
Called gummas, these bumps can develop on your skin, bones, liver or any other organ in the late stage of syphilis. Gummas usually disappear after treatment with antibiotics.

Neurological problems:
Syphilis can cause a number of problems with your nervous system, including:

*Stroke
*Meningitis
*Deafness
*Visual problems
*Dementia
*Cardiovascular problems

These may include bulging (aneurysm) and inflammation of the aorta —  body’s major artery — and of other blood vessels. Syphilis may also damage heart valves.

HIV infection:
Adults with sexually transmitted syphilis or other genital ulcers have an estimated two- to fivefold increased risk of contracting HIV. A syphilis sore can bleed easily, providing an easy way for HIV to enter your bloodstream during sexual activity.

Pregnancy and childbirth complications:
Pregnent woman  may pass syphilis to her unborn baby. Congenital syphilis greatly increases the risk of miscarriage, stillbirth or her newborn’s death within a few days after birth.

Diagnosis:
Syphilis can be diagnosed by testing samples of:

*Blood. Blood tests can confirm the presence of antibodies that the body produces to fight infection. The antibodies to the bacteria that cause syphilis remain in your body for years, so the test can be used to determine a current or past infection.

*Fluid from sores. Your doctor may scrape a small sample of cells from a sore to be analyzed by microscope in a lab. This test can be done only during primary or secondary syphilis, when sores are present. The scraping can reveal the presence of bacteria that cause syphilis.

*Cerebral spinal fluid. If it’s suspected that you have nervous system complications of syphilis, your doctor may also suggest collecting a sample of cerebrospinal fluid through a procedure called a lumbar puncture (spinal tap).

Treatment:
Early infections:
The first-choice treatment for uncomplicated syphilis remains a single dose of intramuscular benzathine penicillin G or a single dose of oral azithromycin. Doxycycline and tetracycline are alternative choices; however, due to the risk of birth defects these are not recommended for pregnant women. Antibiotic resistance has developed to a number of agents, including macrolides, clindamycin, and rifampin. Ceftriaxone, a third-generation cephalosporin antibiotic, may be as effective as penicillin-based treatment.
Late infections

For neurosyphilis, due to the poor penetration of penicillin G into the central nervous system, those affected are recommended to be given large doses of intravenous penicillin for a minimum of 10 days. If a person is allergic, ceftriaxone may be used or penicillin desensitization attempted. Other late presentations may be treated with once-weekly intramuscular penicillin G for three weeks. If allergic, as in the case of early disease, doxycycline or tetracycline may be used, albeit for a longer duration. Treatment at this stage limits further progression, but has only slight effect on damage which has already occurred.

Jarisch-Herxheimer reaction:
One of the potential side effects of treatment is the Jarisch-Herxheimer reaction. It frequently starts within one hour and lasts for 24 hours, with symptoms of fever, muscles pains, headache, and tachycardia. It is caused by cytokines released by the immune system in response to lipoproteins released from rupturing syphilis bacteria

Prevention:
As of 2010, there is no vaccine effective for prevention.Abstinence from intimate physical contact with an infected person is effective at reducing the transmission of syphilis, as is the proper use of a latex condom. Condom use, however, does not completely eliminate the risk. Thus, the Centers for Disease Control and Prevention recommends a long-term, mutually monogamous relationship with an uninfected partner and the avoidance of substances such as alcohol and other drugs that increase risky sexual behavior.

Congenital syphilis in the newborn can be prevented by screening mothers during early pregnancy and treating those who are infected. The United States Preventive Services Task Force (USPSTF) strongly recommends universal screening of all pregnant women,[18] while the World Health Organization recommends all women be tested at their first antenatal visit and again in the third trimester. If they are positive, they recommend their partners also be treated. Congenital syphilis is, however, still common in the developing world, as many women do not receive antenatal care at all, and the antenatal care others do receive does not include screening, and it still occasionally occurs in the developed world, as those most likely to acquire syphilis (through drug use, etc.) are least likely to receive care during pregnancy. A number of measures to increase access to testing appear effective at reducing rates of congenital syphilis in low- to middle-income countries.

Syphilis is a notifiable disease in many countries, including Canada the European Union, and the United States. This means health care providers are required to notify public health authorities, which will then ideally provide partner notification to the person’s partners. Physicians may also encourage patients to send their partners to seek care. The CDC recommends sexually active men who have sex with men are tested at least yearly.

Research:
There is no vaccine available for people; however, a vaccine has been developed that is effective in an animal model and research is ongoing.

Click & see:—>
Ayurvedic treatment ofSyphillis….(1).…..(2)..(3)

Homeopathic treatment of Syphillis:....(1)….(2)....(3)

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:

http://en.wikipedia.org/wiki/Syphilis

http://www.mayoclinic.org/diseases-conditions/syphilis/basics/causes/con-20021862

http://menshealth.about.com/od/sexualdiseasesstds/a/syphilis_signs.htm

http://www.mayoclinic.org/diseases-conditions/syphilis/basics/tests-diagnosis/con-20021862

Milia

Alternative Names: milk spots or an oil seeds

Definition:
Milia are small, white (or sometimes pale yellow) spots that usually appear around the eyes, on the cheeks and on the eyelids. They’re a type of cyst filled with a substance called keratin, a protein that provides strength to the skin…..click & see

Milia are keratin-filled cyst that can appear just under the epidermis or on the roof of the mouth. Milia are commonly associated with newborn babies but can appear on people of all ages. They are usually found around the nose and eyes, and sometimes on the genitalia, often mistaken by those affected as warts or other STDs. Milia can also be confused with stubborn whiteheads.

In children milia often disappear within two to four weeks. In adults they may require removal by a physician or an esthetician.

Symptoms:
Milia are most commonly seen on a baby’s nose, chin or cheeks, though they may also occur in other areas, such as on the upper trunk and limbs.

Sometimes similar bumps appear on a baby’s gums or the roof of the mouth. These are known as Epstein pearls. Some babies also develop baby acne, often characterized by small red bumps and pustules on the cheeks, chin and forehead.

Causes:
No one really understands why they appear or why some people get them while others don’t. They don’t appear to be related to different lifestyles or diets and are certainly not infectious or caused by poor hygiene.

Diagnosis: The doctor can usually diagnose milia just by examining the skin. No specific testing is needed.

Treatment:
Milia typically disappear on their own within several weeks, and no medical treatment is recommended.

The following may help to get rid of milia:

•Hold a hot, wet face cloth over the skin for a few minutes – the temperature should feel comfortable, not painful. This simple facial sauna helps to loosen and remove dead skin cells and debris from the skin.

•Use an exfoliating facial scrub to remove the top layer of skin, which can enable the cysts to fall out. These scrubs are available from the pharmacist and are the kind of facial wash used for treating mild acne. Those containing salicylic acid work well, but always read the label or ask the pharmacist to make sure the one you select is suitable for you.

A qualified beautician may also be able to recommend possible  help.

Most importantly, resist the temptation to pick at them. This will hurt, damage and possibly scar the skin, and may introduce a nasty infection.
.

Lifestyle & Homeremedies:
You may try these tips to help your baby’s skin look its best:

*Keep your baby’s face clean. Wash your baby’s face with warm water daily.

*Dry your baby’s face gently.Simply pat your baby’s skin dry.

*Avoid any other type of treatment. Don’t pinch or scrub the tiny bumps, and don’t use any type of lotions, oils or medicated creams on your baby’s skin.

Prognosis:
In babies & children, milia usually disappear after the first several weeks of life without treatment and without any lasting effects.

In adults, milia removal can usually be done without scarring.

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:
http://www.mayoclinic.com/health/milia/DS01059

http://www.nlm.nih.gov/medlineplus/ency/article/001367.htm

http://www.bbc.co.uk/health/physical_health/conditions/milia.shtml

http://www.webmd.com/skin-problems-and-treatments/picture-of-white-bumps-milia

http://www.bion-research.com/whiteheads_(milia).htm

Related articles

 

Odontoma

Definition:
Odontoma is a benign tumor that usually forms at the root of a tooth. It may have genetic origins or may result from some sort of trauma to the tooth.
It  is a hamartoma of odontogenic origin.The average age of people found with an odontoma is 14, and the condition is frequently associated with an unerupted tooth…..CLICK & SEE THE PICTURES

There are two types: compound and complex.

A compound odontoma still has the three separate dental tissues (enamel, dentin and cementum), but may present a lobulated appearance where there is no definitive demarcation of separate tissues between the individual “toothlets” (or denticles). It usually appears in the anterior maxilla.

 

The complex Odontoma is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities. It usually appears in the posterior maxilla or in the mandible.

In 2011; 66% of odontogenic tumors are odontomas (University of Louisville School of Dentistry). 22% of odontogenic tumors are odontomas.

In July of 2014 in Mumbai, India, surgeons at Mumbai’s JJ Hospital removed 232 tooth-like growths from a complex odontoma growing in the lower jaw of 17 year old Ashik Gavai. This odontoma is proposed as “The World Record” to date.

Symptoms:

The most common symptoms are:Pain,Rash,Diarrea,Headache,Back pain,Constipation,Fever,Caugh,Runing nose,Vision change.

The list of signs and symptoms mentioned in various sources for Odontoma includes the 6 symptoms listed below:

*Dysphagia ( Dysphagia is difficulty in swallowing.There are about 194 causes of Dysphagia, including diseases and drug side effect causes.)
*Lump on gums
*Delayed tooth eruption (It is a condition in which there is a slow or late development of a tooth. There are about  60 causes of Delayed tooth eruption)
*Absent tooth
*Delayed primary tooth loss
*Increased bone size under tooth

Causes:
There are several causes of odontoma, some of them are :

*Dental conditions(Any condition that affects dental organs such as the teeth and gums. Examples of dental conditions include tooth decay, tooth infection, gingivitis, periodontitis, impacted tooth and canker sores)

*Oral conditions(Any condition affecting the mouth. Mouth conditions can affect any structure of the mouth such as teeth, gums, lips, tongue and cheeks. Conditions that can affect the mouth include candidiasis, oral cancer, stuttering, cleft palate, bad breath and gingivitis. )

*Head conditions(Any condition affecting the head. Some head conditions can be serious such as cancers and skull fractures whereas other conditions may be less threatening such as headaches and head lice)

*Benign tumors (A benign tumor is one that does not spread or “metastasize” to other parts of the body; a “malignant tumor” is one that does. A benign tumor is caused by cell overgrowth, and thus is different from a cyst or an abcess,)

Diagnosis:
Odontoma does not usually show external symptoms. These tumors are revealed when the x-rays are examined by the dentist. Although it is true that a delayed tooth or absent tooth may suggest there is a need for further examination.

The presence of an a tumor of dental origin requires further examination to determine what type of tumor it is before further action is taken. In addition, a histological diagnosis of the tissues that were extracted provides valuable information to the dentist.

No one really knows why an odontoma forms. The most likely reasons are trauma and/or infection at the site. Some dentists and researchers believe they are hereditary or they develop because of genetic mutations. One example of an inherited syndrome is known as Gardener Syndrome. It is responsible for a wide range of tumors in the body, including occasional odontoma.  When examined at the cellular level, all of the dental tissues are found, but in an abnormal combination.

Pulp, dentin, enamel and cementum may sometimes resemble a tooth like structure in a compound odontoma. These denticles are found in a surrounding supporting layer of fibrous cells. Since it is decalcified, the enamel looks like spaces around the tiny tooth structures.   Looking closer, you can see the calicified material either as a solid mass or as multiple, small tooth-like bodies visible by x-rays. Because it is easily separated from its bony location it can be distinguished from other possible tumors.

A complex odontoma has no specific sequence for all of the dental tissue. It does not resemble normal tooth structure. At the cellular level it appears as mostly tubular dentin that encloses hollow spaces. These circular spaces are decalcified but they once held enamel. On the edges there may be a thin layer of cementum which forms a capsule like tissue surrounding the mass.

Treatment :
The only real treatment of an these dental tumors is removal by surgery. An early discovery and treatment will be beneficial to the patient. It is a benign tumor made of dental tissue and it is a fairly simple extraction in most cases. A speedy recovery is generally expected.  Some complex tumors can result in complications after extraction. So it is essential to stay in contact with the dental surgeon.

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:

http://en.wikipedia.org/wiki/Odontoma

http://www.allhealthsite.com/odontoma.html

http://www.rightdiagnosis.com/o/odontoma/intro.

Acanthosis nigricans

Definition:
Acanthosis nigricans is a fairly common skin pigmentation disorder.It is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, forehead, and other areas.

CLICK & SEE THE PICTURES
Types:
This is conventionally divided into benign and malignant forms., although may be divided into syndromes according to cause.

*Benign This may include obesity-related, hereditary, and endocrine forms of acanthosis nigricans.

*Malignant. This may include forms that are associated with tumour products and insulin-like activity, or tumour necrosis factor.

An alternate classification system still used to describe acanthosis nigricans was proposed in 1994 by dermatologist Schwartz. This classification system delineates acanthosis nigricans syndromes according to their associated syndromes, including benign and malignant forms, forms associated with obesity and drugs, acral acanthosis nigricans, unilateral acanthosis nigricans, and mixed and syndromic forms.

Acanthosis nigricans may be a sign of a more serious health problem such as pre-diabetes. The most effective treatments focus on finding and resolving medical condition at the root of the problem. Fortunately, these skin patches tend to disappear after successfully treating the root condition.

Signs and symptoms:
Acanthosis nigricans may present with thickened, relatively darker areas of skin on the neck, armpit and in skin folds.These patches may also appear on the groin, elbows, knees, knuckles, or skin folds. Lips, palms, and soles of the feet.

Causes:
It typically occurs in individuals younger than age 40, may be genetically inherited, and is associated with obesity or endocrinopathies, such as hypothyroidism, acromegaly, polycystic ovary disease, insulin-resistant diabetes, or Cushing’s disease.

This occurs when epidermal skin cells begin to rapidly reproduce. This abnormal skin cell growth is most commonly triggered by high levels of insulin in the blood. In rare cases, the increase in skin cells may be caused by medications, cancer, or other medical conditions, as describe below.

*Too Much Insulin
The most frequent trigger for acanthosis nigricans is too much insulin in your bloodstream. Here’s why.

When you eat, your body converts carbohydrates into sugar molecules such as glucose. Some of this glucose is used for energy while the rest is stored. In order to use the glucose for energy, insulin must also be used. The insulin enables the glucose to enter the cells.

Overweight people tend to develop resistance to insulin over time. So although the pancreas is making insulin, the body cannot use it properly. This creates a buildup of glucose in the bloodstream, which can result in high levels of both blood glucose and insulin in your bloodstream.

Excess insulin causes normal skin cells to reproduce at a rapid rate. For those with dark skin, these new cells have more melanin. This increase in melanin produces a patch of skin that is darker than the skin surrounding it. Thus, the presence of acanthosis nigricans is a strong predictor of future diabetes. If this is indeed the cause, it is relatively easy to correct with proper diet, exercise, and blood sugar control.

*Medications:
Acanthosis nigricans can also be triggered by certain medications such as birth control pills, human growth hormones, thyroid medications, and even some body-building supplements. All of these medications can cause changes in insulin levels. Medications used to ease the side effects of chemotherapy have also been linked to acanthosis nigricans. In most cases, the condition clears up when the medications are discontinued.

Some Other Causes:(Potential but rare)

#stomach cancer (gastric adenocarcinoma)
#adrenal gland disorders such as Addison’s disease
#disorders of the pituitary gland
#low levels of thyroid hormones
#high doses of niacin

Diagnosis:
Acanthosis nigricans is typically diagnosed clinically.It is easy to recognize by sight. The doctor may want to check for diabetes or insulin resistance as the root cause. These tests may include blood glucose tests or fasting insulin tests. Your doctor may also review all your medications to see if they are a contributing factor.

It is important to inform the doctor of any dietary supplements, vitamins, or muscle-building supplements you may be taking in addition to your prescription medications.

In rare cases, the doctor may perform other tests such as a small skin biopsy to rule out other possible causes.

Treatment :
People with acanthosis nigricans should be screened for diabetes and, although rare, cancer. Controlling blood glucose levels through exercise and diet often improves symptoms. Acanthosis nigricans maligna may resolve if the causative tumor is successfully removed.

Cosmetic treatments exist for cases that are especially unsightly or embarrassing. Dark patches may be covered up with cosmetics or lightened with prescription skin lighteners. Although these treatments are not as effective as treating the root cause of the condition, they can provide some relief. Available skin lighteners include Retin-A, 20 percent urea, alpha hydroxy acids, and salicylic acid.

Prognosis:
Acanthosis nigricans often fades if the underlying cause can be determined and treated  properly.

 

Prevention:
Maintaining a healthy lifestyle & exercisIng regularly can usually prevent Acanthosis nigricans. Losing weight, controlling your diet, and, perhaps adjusting any medications that are contributing to the condition are all crucial steps. Healthier lifestyle choices will also reduce your risks for many other types of illnesses.

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:

http://www.healthline.com/health/acanthosis-nigricans#Definition

http://en.wikipedia.org/wiki/Acanthosis_nigricans

Enhanced by Zemanta