Eatching & tearing of Eyes (Epiphora)

Definition:

Watery eyes (epiphora) tear persistently or excessively.

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Depending on the cause, watery eyes may clear up on their own. Self-care measures at home can help treat watery eyes, particularly if caused by inflammation or dry eyes.

Causes:
Watery eyes can be due to many factors and conditions.

In infants, persistent watery eyes, often with some matter, are commonly the result of blocked tear ducts. The tear ducts don’t produce tears, but rather carry away tears, similar to how a storm drain carries away rainwater. Tears normally drain into your nose through tiny openings (puncta) in the inner part of the lids near the nose. In babies, the tear duct may not be fully open and functioning for the first several months of life.

In older adults, persistent watery eyes may occur as the aging skin of the eyelids sags away from the eyeball, allowing tears to accumulate and flow out.

Sometimes, excess tear production may cause watery eyes as well.

Allergies or viral infections (conjunctivitis), as well as any kind of inflammation, may cause watery eyes for a few days or so.

There may be some more other cause like due to different medication & other  diseases.

Do your eyes itch after you’ve been near a cat? Do they puff up or run with tears when pollen is in the air? Allergies of the eye affect about 20% of Americans each year, and are on the rise. The same inhaled airborne allergens — pollens, animal dander, dust mite feces, and mold — that trigger allergic rhinitis (the familiar sneezing, runny nose, and congestion) can lead to allergic conjunctivitis (inflammation of the conjunctiva, the lining of the eye). It’s not surprising that people with allergic rhinitis often suffer from allergic conjunctivitis as well.

About 50% of allergic conjunctivitis sufferers, who tend to be young adults, have other allergic diseases or a family history of allergies. About 80% of eye allergies are seasonal; the rest are perennial (year-round). The symptoms are itchy and red eyes, tearing, edema (swelling) of the conjunctiva or eyelid, and a mucous discharge. Although it can be uncomfortable, you can rest assured that it is not a threat to your vision.

Diagnosing allergic conjunctivitis:

Allergic conjunctivitis usually can be confirmed by your doctor based on your symptoms. Testing is not usually needed to diagnose the condition, but skin testing (the same kind that’s done for other allergic reactions) may help identify the allergens causing your symptoms.

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If your symptoms don’t quickly respond to treatment, see your doctor in case you have a different condition. Dry eye, in particular, can mimic the symptoms of allergic conjunctivitis.

Treating allergic conjunctivitis:-

Avoidance is your first line of defense. If you are allergic to cats, for example, avoid them (or at least don’t touch your eyes when near one), and wash your hands immediately after touching one. If pollen is your nemesis, keep your windows closed and an air purifier or air conditioner going in pollen season. Also, don’t rub your eyes, because rubbing causes cells in the conjunctiva to release histamine and other inflammatory chemicals, which worsens symptoms. Use artificial tears (available without prescription) frequently for relief and to dilute allergens in the eye.

If your only allergy problem is allergic conjunctivitis, then medicated eye drops would be your first step. You can start with an over-the-counter product, such as ketotifen eye drops (Zaditor, Alaway). The active ingredient is an antihistamine and a mast cell stabilizer, both of which can control the immune system overreaction that leads to your symptoms. Prescription-strength products that have similar actions are also available.

Allergic conjunctivitis can also be treated with over-the-counter oral antihistamines such as loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra), or the prescription antihistamines desloratadine (Clarinex) and levocetirizine (Xyzal). These are especially useful for people that have other allergy symptoms in addition to conjunctivitis.

For allergic conjunctivitis that is very severe and doesn’t improve with other medications, there are prescription eye drops that contain corticosteroids, such as loteprednol etabonate (Alrex, Lotemax) and fluorometholone (Fluor-Op, FML Forte). However, these eye medications should only be used under the guidance of an ophthalmologist.

General  precautions  & Alternative treatment of eatching & tearing eyes:

*Remember to keep their eyes free from dust and other particles that cause a blocking of the tear ducts.

*Wash the face and eyes frequently as this will also help to keep you refreshed. Washing your eyes frequently also removes the impurities from around the area of the tear ducts, keeping them free from blockages.

*You could also keep your eyes moist with the use of some mild eye drops. This will help in reducing the itchiness and the dryness that you experience.

*If you are going outdoors, make sure to wear some protective eye wear that help to keep impurities out of the eyes, thereby avoiding any irritability of the sense organs.

*Rose water is an excellent remedy to soothe dryness or burning sensations that are experienced in the eyes. Washing out the eyes in a capful of rose water will provide instantaneous relief.

*There are occasions where the optical nerve of the eyes and the muscles around the eyes have been strained, leading to dryness and itching, followed by a continuous flow of secretions. In order to relax the eyes and the relevant muscles, place slices of cucumber over the eyelids while you rest your eyes. The cooling effect of the cucumber slices will provide a great deal of relief to your tired eyes.

*On certain occasions, a warm compress, made by dipping a piece of towel into warm water and pressing it gently over the eyes will provide relief from symptoms of itching and continuous flow of tears

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:
Harvard Medical School healthbeat@mail.health.harvard.edu via nf163.n-email.net
http://www.home-remedies-for-you.com/askquestion/83237/causes-of-itchy-eyes-what-could-be-the-root-of-itc.html
http://www.mayoclinic.org/symptoms/watery-eyes/basics/causes/SYM-20050821

Asthma

Definition:   Asthma is a common long term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These episodes may occur a few times a day or a few times per week. Depending on the person they may become worse at night or with exercise.

Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry. Asthma is classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. It may also be classified as atopic or non-atopic where atopy refers to a predisposition toward developing a type 1 hypersensitivity reaction…..CLICK & SEE 

There is no cure for asthma. Symptoms can be prevented by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids. Long-acting beta agonists (LABA) or antileukotriene agents may be used in addition to inhaled corticosteroids if asthma symptoms remain uncontrolled. Treatment of rapidly worsening symptoms is usually with an inhaled short-acting beta-2 agonist such as salbutamol and corticosteroids taken by mouth. In very severe cases, interavenous corticosteroids, magnesium sulfate, and hospitalization may be required.
Symptoms:
Asthma symptoms vary from person to person. One may have infrequent asthma attacks, has symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

*Shortness of breath
*Chest tightness or pain
*Trouble sleeping caused by shortness of breath, coughing or wheezing
*A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
*Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:

*Asthma signs and symptoms that are more frequent and bothersome
*Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
*The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

*Exercise-induced asthma, which may be worse when the air is cold and dry
*Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
*Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen.

Causes:
Asthma is caused by a combination of complex and incompletely understood environmental and genetic interactions. These factors influence both its severity and its responsiveness to treatment. It is believed that the recent increased rates of asthma are due to changing epigenetics (heritable factors other than those related to the DNA sequence) and a changing living environment…..CLICK & SEE

Asthma triggers:

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

*Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
*Respiratory infections, such as the common cold
*Physical activity (exercise-induced asthma)
*Cold air
*Air pollutants and irritants, such as smoke
*Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
*Strong emotions and stress
*Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
*Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat.

Diagnosis:
While asthma is a well recognized condition, there is not one universal agreed upon definition. It is defined by the Global Initiative for Asthma as “a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment”.

There is currently no precise test with the diagnosis typically based on the pattern of symptoms and response to therapy over time. A diagnosis of asthma should be suspected if there is a history of: recurrent wheezing, coughing or difficulty breathing and these symptoms occur or worsen due to exercise, viral infections, allergens or air pollution.
Physical exam:

To rule out other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.

Tests to measure lung function

One may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:

*Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.

*Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.

Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it’s likely you have asthma.

Other additional tests:

Other tests to diagnose asthma include:

*Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.

*Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.

*Imagingtest:   test:A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.

*Allergy testing. : This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy.

*Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin).

*Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air.

Risk Factors:
A number of factors are thought to increase your chances of developing asthma. These include:

*Having a blood relative (such as a parent or sibling) with asthma
*Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
*Being overweight
*Being a smoker
*Exposure to secondhand smoke
*Exposure to exhaust fumes or other types of pollution
*Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

Complications:
Asthma complications include:

*Signs and symptoms that interfere with sleep, work or recreational activities
*Sick days from work or school during asthma flare-ups
*Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
*Emergency room visits and hospitalizations for severe asthma attacks
*Side effects from long-term use of some medications used to stabilize severe asthma
*Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Treatment:
While there is no cure for asthma, symptoms can typically be improved. A specific, customized plan for proactively monitoring and managing symptoms should be created. This plan should include the reduction of exposure to allergens, testing to assess the severity of symptoms, and the usage of medications. The treatment plan should be written down and advise adjustments to treatment according to changes in symptoms.

The most effective treatment for asthma is identifying triggers, such as cigarette smoke, pets, or aspirin, and eliminating exposure to them. If trigger avoidance is insufficient, the use of medication is recommended. Pharmaceutical drugs are selected based on, among other things, the severity of illness and the frequency of symptoms. Specific medications for asthma are broadly classified into fast-acting and long-acting categories.

Bronchodilators are recommended for short-term relief of symptoms. In those with occasional attacks, no other medication is needed. If mild persistent disease is present (more than two attacks a week), low-dose inhaled corticosteroids or alternatively, an oral leukotriene antagonist or a mast cell stabilizer is recommended. For those who have daily attacks, a higher dose of inhaled corticosteroids is used. In a moderate or severe exacerbation, oral corticosteroids are added to these treatments.

Lifestyle modification:
Avoidance of triggers is a key component of improving control and preventing attacks. The most common triggers include allergens, smoke (tobacco and other), air pollution, non selective beta-blockers, and sulfite-containing foods. Cigarette smoking and second-hand smoke (passive smoke) may reduce the effectiveness of medications such as corticosteroids. Laws that limit smoking decrease the number of people hospitalized for asthma. Dust mite control measures, including air filtration, chemicals to kill mites, vacuuming, mattress covers and others methods had no effect on asthma symptoms.[48] Overall, exercise is beneficial in people with stable asthma.

Medications:
Medications used to treat asthma are divided into two general classes: quick-relief medications used to treat acute symptoms; and long-term control medications used to prevent further exacerbation.

*Short-acting beta2-adrenoceptor agonists (SABA), such as salbutamol (albuterol USAN) are the first line treatment for asthma symptoms. They are recommended before exercise in those with exercise induced symptoms.

*Anticholinergic medications, such as ipratropium bromide, provide additional benefit when used in combination with SABA in those with moderate or severe symptoms. Anticholinergic bronchodilators can also be used if a person cannot tolerate a SABA. If a child requires admission to hospital additional ipratropium does not appear to help over a SABA.

*Older, less selective adrenergic agonists, such as inhaled epinephrine, have similar efficacy to SABAs.[130] They are however not recommended due to concerns regarding excessive cardiac stimulation.

Long–term control:

Fluticasone propionate metered dose inhaler commonly used for long-term control.

*Corticosteroids are generally considered the most effective treatment available for long-term control. Inhaled forms such as beclomethasone are usually used except in the case of severe persistent disease, in which oral corticosteroids may be needed. It is usually recommended that inhaled formulations be used once or twice daily, depending on the severity of symptoms.

*Long-acting beta-adrenoceptor agonists (LABA) such as salmeterol and formoterol can improve asthma control, at least in adults, when given in combination with inhaled corticosteroids. In children this benefit is uncertain. When used without steroids they increase the risk of severe side-effects  and even with corticosteroids they may slightly increase the risk.

*Leukotriene receptor antagonists (such as montelukast and zafirlukast) may be used in addition to inhaled corticosteroids, typically also in conjunction with a LABA. Evidence is insufficient to support use in acute exacerbations. In children they appear to be of little benefit when added to inhaled steroids, and the same applies in adolescents and adults. They are useful by themselves. In those under five years of age, they were the preferred add-on therapy after inhaled corticosteroids by the British Thoracic Society in 2009. A similar class of drugs, 5-LOX inhibitors, may be used as an alternative in the chronic treatment of mild to moderate asthma among older children and adults. As of 2013 there is one medication in this family known as zileuton.

*Mast cell stabilizers (such as cromolyn sodium) are another non-preferred alternative to corticosteroids.

Alternative medicine:
Many people with asthma, like those with other chronic disorders, use alternative treatments; surveys show that roughly 50% use some form of unconventional therapy. There is little data to support the effectiveness of most of these therapies. Evidence is insufficient to support the usage of Vitamin C. There is tentative support for its use in exercise induced brochospasm.

Acupuncture is not recommended for the treatment as there is insufficient evidence to support its use. Air ionisers show no evidence that they improve asthma symptoms or benefit lung function; this applied equally to positive and negative ion generators.

Manual therapies, including osteopathic, chiropractic, physiotherapeutic and respiratory therapeutic maneuvers, have insufficient evidence to support their use in treating asthma. The Buteyko breathing technique for controlling hyperventilation may result in a reduction in medication use; however, the technique does not have any effect on lung function. Thus an expert panel felt that evidence was insufficient to support its use.

But regular Yoga with Pranayama (the breathing exercise) under the guideline of an expart shows lot of improvement among most asthma patients.

Some home remedies:

*Express the juice from garlic. Mix 10 to 15 drops in warm water and take internally for asthma relief.Mix, onion juice ¼ cup, honey 1 tablespoon and black pepper 1/8 tablespoon.Mix licorice and ginger together. Take ½ tablespoon in 1 cup of water for relief from asthma.

*Drink a glass of 2/3 carrot juice, 1/3 spinach juice, 3 times a day .

*Add 30-40 leaves of Basil in a liter of water, strain the leaves and drink the water throughout the day effective for asthma.

Prevention:

The evidence for the effectiveness of measures to prevent the development of asthma is weak. Some show promise including: limiting smoke exposure both in utero and after delivery, breastfeeding, and increased exposure to daycare or large families but none are well supported enough to be recommended for this indication. Early pet exposure may be useful. Results from exposure to pets at other times are inconclusive and it is only recommended that pets be removed from the home if a person has allergic symptoms to said pet. Dietary restrictions during pregnancy or when breast feeding have not been found to be effective and thus are not recommended. Reducing or eliminating compounds known to sensitive people from the work place may be effective. It is not clear if annual influenza vaccinations effects the risk of exacerbations. Immunization; however, is recommended by the World Health Organization. Smoking bans are effective in decreasing exacerbations of asthma

Progonosis:
The prognosis for asthma is generally good, especially for children with mild disease. Mortality has decreased over the last few decades due to better recognition and improvement in care. Globally it causes moderate or severe disability in 19.4 million people as of 2004 (16 million of which are in low and middle income countries). Of asthma diagnosed during childhood, half of cases will no longer carry the diagnosis after a decade. Airway remodeling is observed, but it is unknown whether these represent harmful or beneficial changes. Early treatment with corticosteroids seems to prevent or ameliorates a decline in lung function.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Asthma
http://www.mayoclinic.org/diseases-conditions/asthma

Zica Virus

 

Definition:
Zika virus is a member of the virus family Flaviviridae and the genus Flavivirus, transmitted by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus, the same type of mosquito that spreads dengue, chikungunya and yellow fever. The Pan American Health Organization (PAHO) said Aedes mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where Aedes mosquitoes are found.
The infection, known as Zika fever, often causes no or only mild symptoms. Since the 1950s it has been known to occur within a narrow equatorial belt from Africa to Asia. In 2014, the virus spread eastward across the Pacific Ocean to French Polynesia, then to Easter Island and in 2015 to Mexico, Central America, the Caribbean, and South America, where the Zika outbreak has reached pandemic levels.

Click  & see  : zika virus – News Images

The Zika virus is found in tropical locales with large mosquito populations. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Southern Asia and the Western Pacific. The virus was first identified in Uganda in 1947 in rhesus monkeys and was first identified in people in 1952 in Uganda and Tanzania, according to the World Health Organization.
Transmission:
The vertebrate hosts of the virus were primarily monkeys in a so-called enzootic mosquito-monkey-mosquito cycle, with only occasional transmission to humans. Before the current pandemic began in 2007, Zika virus “rarely caused recognized ‘spillover’ infections in humans, even in highly enzootic areas”. Infrequently, other arboviruses have become established as a human disease though, and spread in a mosquito–human–mosquito cycle, like the yellow fever virus and the dengue fever virus (both flaviruses), and the chikungunya virus (a togavirus)

Can Zika be transmitted through sexual contact?

Two cases of possible person-to-person sexual transmission has been described, but the PAHO said more evidence is needed to confirm whether sexual contact is a means of Zika transmission.

It is unknown whether women can transmit Zika virus to their sexual partners. As of February 2016, the CDC recommends that men “who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy.” Men who reside in or have traveled to an area of active Zika virus transmission and their non-pregnant sex partners “might consider” abstinence or condom use. The CDC did not specify how long these practices should be followed with non-pregnant partners because the “incidence and duration of shedding in the male genitourinary tract is limited to one case report” and that “testing of men for the purpose of assessing risk for sexual transmission is not recommended.

The PAHO also said Zika can be transmitted through blood, but this is an infrequent transmission mechanism. There is no evidence the virus can be transmitted to babies through breast milk.

CDC issued new recommendations to those who have traveled to Zika-prone areas: Use condoms during sex or don’t have sex. – Click  & See 
Symptoms:
Zika virus is related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses. The illness it causes is similar to a mild form of dengue fever, is treated by rest, and cannot yet be prevented by drugs or vaccines. There is a possible link between Zika fever and microcephaly in newborn babies by mother-to-child transmission, as well as a stronger one with neurologic conditions in infected adults, including cases of Guillain–Barré syndrome.

People who get Zika virus disease typically have a mild fever, skin rash, conjunctivitis, muscle and joint pain and fatigue that can last for two to seven days. But as many as 80 percent of people infected never develop symptoms. The symptoms are similar to those of dengue or chikungunya, which are transmitted by the same type of mosquito.

Diagnosis:
The PAHO said there is no evidence that Zika can cause death, but some cases have been reported with more serious complications in patients with pre-existing medical conditions.

The virus has been linked to microcephaly, a condition in newborns marked by abnormally small heads and brains that have not developed properly. It also has been associated with Guillain-Barre syndrome, a rare disorder in which the body’s immune system attacks part of the nervous system. Scientists are studying whether there is a causal link between Zika and these two disorders.

Treatment:
There is no defenite treatment developed yet.Patients are adviced to take rest. Doctors sometimes prescribe few nominal medicines to get little relieve from extenal symptoms.

Prevention:
Defense against mosquitoes is defense against Zika. The CDC recommends long clothing and insect repellent. If you develop symptoms, go see a doctor.

Vaccine development:
Effective vaccines exist for several flaviviruses. Vaccines for yellow fever virus, Japanese encephalitis, and tick-borne encephalitis were introduced in the 1930s, while the vaccine for dengue fever only became available for use in the mid-2010s.

Work has begun towards developing a vaccine for Zika virus, according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.  The researchers at the Vaccine Research Center have extensive experience from working with vaccines for other viruses such as West Nile virus, chikungunya virus, and dengue fever.   Nikos Vasilakis of the Center for Biodefense and Emerging Infectious Diseases predicted that it may take two years to develop a vaccine, but 10 to 12 years may be needed before an effective Zika virus vaccine is approved by regulators for public use.

Indian company Bharat Biotech is working on two approaches to a vaccine: “recombinant”, involving genetic engineering, and “inactivated”, where the virus is incapable of reproducing itself but can still trigger an immune response. On 3 February 2016, the company claimed animal trials of the inactivated version would commence in two weeks.

Since April 2015, a large, ongoing outbreak of Zika virus that began in Brazil has spread to much of South and Central America and the Caribbean. In January 2016, the CDC issued a level 2 travel alert for people traveling to regions and certain countries where Zika virus transmission is ongoing.   The agency also suggested that women thinking about becoming pregnant should consult with their physicians before traveling. Governments or health agencies of the United Kingdom, Ireland, New Zealand,   Canada, and the European Union soon issued similar travel warnings. In Colombia, Minister of Health and Social Protection Alejandro Gaviria Uribe recommended to avoid pregnancy for eight months, while the countries of Ecuador, El Salvador, and Jamaica have issued similar warnings.

Plans were announced by the authorities in Rio de Janeiro, Brazil, to try to prevent the spread of the Zika virus during the 2016 Summer Olympic Games in that city.

According to the CDC, Brazilian health authorities reported more than 3,500 microcephaly cases between October 2015 and January 2016. Some of the affected infants have had a severe type of microcephaly and some have died. The full spectrum of outcomes that might be associated with infection during pregnancy and the factors that might increase risk to the fetus are not yet fully understood. More studies are planned to learn more about the risks of Zika virus infection during pregnancy. In the worst affected region of Brazil, approximately 1 percent of newborns are suspected of being microcephalic.

Click & see  : 2007 Yap Islands Zika virus outbreak   
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
https://en.wikipedia.org/wiki/Zika_virus
http://www.whio.com/news/news/national/what-zika-virus-and-isnt/nqKzc/
http://news.yahoo.com/factbox-why-zika-virus-causing-alarm-233408770.html;_ylt=AwrXnCHbw7ZWumkA6oHQtDMD;_ylu=X3oDMTByNDZ0aWFxBGNvbG8DZ3ExBHBvcwM2BHZ0aWQDBHNlYwNzcg–

Coccydynia

Definition:
Coccydynia is a medical term meaning pain in the coccyx or tailbone area, usually brought on by sitting too abruptly.
We humans have evolved biologically so much that we tend to forget that we were once animals and had a tail. That is, till we suddenly develop a pain deep down in the cleft between the buttocks, making it difficult to abruptly shift positions, from sitting to standing or getting up after lying down. This pain is called coccydynia.

That last bone in the vertebral column is called a coccyx. It actually is a vestigial tail, which has shrunk over generations. About 2.7 per cent of patients who see a doctor for “backache” actually had pain in the tailbone. It is more likely to occur in physically active youngsters and adults over the age of 40. Women, with their wide pelvis, are more prone to coccodynia.

Coccydynia occurs in the lowest part of the spine, the coccyx, which represents a vestigial tail, or in other words the “tail bone”. The name coccyx is derived from the Greek word for cuckoo due to its beak like appearance. The coccyx itself is made up of 3 to 5 vertebrae, some of which may be fused together. The ventral side of the coccyx is slightly concave whereas the dorsal aspect is slightly convex. Both of these sides have transverse grooves that show where the vestigial coccygeal units had previously fused. The coccyx attaches the sacrum, from the dorsal grooves with the attachment being either a symphysis or as a true synovial joint, and also to the gluteus maximus muscle, the coccygeal muscle, and the anococcygeal ligament.

CLICK & SEE THE PICTURES:

Symptoms:
Pain and local tenderness at the tailbone are the major symptoms of coccydynia. This can lead to difficulty sitting or leaning against the buttocks. Along with the pain with sitting, there is typically exquisite tenderness at the tailbone area. Coccydynia is also known as coccygodynia, coccygeal pain, coccyx pain, or coccalgia.

Causes:
One way of classifying coccydynia is whether the onset was traumatic versus non-traumatic. In many cases the exact cause is unknown and is referred to as idiopathic coccydynia.

The coccyx is prone to injury. Acute dislocations, sprains and fractures can occur. Usually there is a history of having fallen abruptly, on a staircase, the side of the swimming pool or some other hard surface. It can also occur while cycling or rowing. Chronic injury can occur if work or academics involves sitting for prolonged periods on hard surfaces like a wooden bench or a chair without cushions. In women, the coccyx can be injured during childbirth, especially if labour is prolonged. Overweight and obese men and women are more likely to develop problems with the coccyx.

There are common pathophysiological ways that a person may develop coccydynia. The two main causes for this condition are sudden impact due to fall, and coccydynia caused by childbirth pressure in women. Other ways that coccydynia develops are partial dislocation of the sacrococcygeal synchondrosis that can possibly result in abnormal movement of the coccyx from excessive sitting, and repetitive trauma of the surrounding ligaments and muscles, resulting in inflammation of tissues and pain.

Coccydynia is a fairly common injury which can often result from falls, particularly in leisure activities such as cycling and skateboarding. Coccydynia is often reported following a fall or after childbirth. In some cases, persistent pressure from activities like bicycling may cause the onset of coccyx pain. Coccydynia due to these causes usually is not permanent, but it may become very persistent and chronic if not controlled. Coccydynia may also be caused by sitting improperly thereby straining the coccyx.

Rarely, coccydynia is due to the undiagnosed presence of a sacrococcygeal teratoma or other tumor in the vicinity of the coccyx. In these cases, appropriate treatment usually involves surgery and/or chemotherapy.
Diagnosis:
A number of different conditions can cause pain in the general area of the coccyx, but not all involve the coccyx and the muscles attached to it. The first task of diagnosis is to determine whether the pain is related to the coccyx. Physical rectal examination, high resolution x-rays and MRI scans can rule out various causes unrelated to the coccyx, such as Tarlov cysts and pain referred from higher up the spine. Note that, contrary to most anatomical textbooks, most coccyxes consist of several segments: ‘fractured coccyx’ is often diagnosed when the coccyx is in fact normal or just dislocated at an intercoccygeal joint.

A simple test to determine whether the coccyx is involved is injection of local anesthetic into the area. If the pain relates to the coccyx, this should produce immediate relief.

If the anesthetic test proves positive, then a dynamic (sit/stand) x-ray or MRI scan may show whether the coccyx dislocates when the patient sits.

Use of dynamic x-rays on 208 patients who gave positive results with the anesthetic test showed:

* 31% Not possible to identify the cause of pain
* 27% Hypermobility (excessive flexing of the coccyx forwards and upwards when sitting)
* 22% Posterior luxation (partial dislocation of the coccyx backwards when sitting)
* 14% Spicule (bony spur) on the coccyx
* 5% Anterior luxation (partial dislocation of the coccyx forwards when sitting)

This study found that the pattern of lesions was different depending on the obesity of the patients: obese patients were most likely to have posterior luxation of the coccyx, while thin patients were most likely to have coccygeal spicules.

Angle of incidence:
Sagittal coccygeal movement is measured using the angle of incidence—or the angle at which the coccyx strikes the seat when an individual sits down. A smaller angle indicates the coccyx being more parallel to the seat, resulting in flexion (or “normal” movement) of the coccyx. A larger angle indicates the coccyx being more perpendicular to the seat, causing posterior subluxation (or “backward” movement) of the coccyx. CLICK & SEE THE PICTURE : Stand to Sit Coccyx

Treatment:
Once coccydynia has been diagnosed, conservative treatment can make the pain disappear in 8-12 weeks. This involves sitting in a basin of hot water (sitz bath) for 10-15 minutes at least twice a day. A donut shaped cushion makes sitting during work easier. Inflatable rubber cushions are available which can be carried around. When seated on chairs or in the toilet, try to lean slightly forwards.

Stretches can be done for that area. The two common ones are the kneeling stretch, when you kneel on one leg keeping the other bent at a right angle. After 30 seconds switch sides. The other stretch involves lying down, bending the knees, crossing the legs at the ankle and then pulling the legs towards you with your arms.
You may click & see : BACK PAIN REMEDY.. 

Since sitting on the affected area may aggravate the condition, a cushion with a cutout at the back under the coccyx is recommended. If there is tailbone pain with bowel movements, then stool softeners and increased fiber in the diet may help. For prolonged cases, anti-inflammatory medications such as NSAIDS(non-steroidal anti inflammatory drugs) or pain-relieving drugs may be prescribed. The use of anti-depressants such as Elavil (amitriptyline) may help alleviate constant pain. Tailbone pain physicians specializing in Physical Medicine and Rehabilitation at New Jersey Medical School have published that sometimes even just a single local nerve block injection at the ganglion impar can give 100% relief of coccydynia when performed under fluoroscopic guidance.

Additionally if the pain is caused by a malignment of the coccyx, manipulation by a chiropractor, osteopathic physician (D.O.) or physical therapist can offer relief.

In rare cases, surgery to remove the coccyx (coccygectomy) may be required. Typically, surgery is reserved for patients with cancer (malignancy) or those whose tailbone pain has failed to respond to non-surgical treatment (such as medications by mouth, use of seat cushions, and medications given by local injections done under fluoroscopic guidance, as noted above.

Prevention:
Body positioning and alignment is significant for producing less stress in the coccyx region. Bad posture can influence coccyx pain. People may not realize that they are over stressing their coccyx while doing daily activities. Pain in the coccyx can be caused from many incidents like falling, horseback riding, or even sitting on hard surfaces for a long period of time. The main focus is to prevent coccyx pain from occurring, by correcting everyday activities that contribute to tailbone pain.

Proper equipment used to preventing coccyx pain:
There is no definite way to fully prevent coccyx pain because an accident can occur at any given time. However, people who are obese are at a higher risk for developing coccyx pain. Carrying excessive weight contributes to more stress on the coccyx while sitting down causing increased chances of pain.  Prevention of carrying excessive weight gain can help reduce the tension and pressure on the coccyx. In other words the coccyx for obese people may be more posteriorly outward when they are sitting down.  Avoidance of contact sports like basketball, football, and or hockey can decrease the risks of coccyx pain, because it can help reduce the chances of falling. Another method is proper safety equipment for sports is to prevent coccyx pain. For example, there are hockey pants that provide extra cushion that protect the thigh, coccyx, and buttocks. These results will lead to less falls that can cause trauma to the coccyx.

Stretches & strengthening exercises for prevention:
A kneeling groin stretch can help prevent coccyx pain from occurring after long periods of sitting. The adductor magnus is involved in the kneeling groin stretch, and when it is tight it can contribute to tailbone pain, so stretching can help prevent tailbone pain. Other stretches like piriformis stretch, and hands to feet stretch, can relieve stress off the muscles around the coccyx, after sitting for a long time. These release tension built up around the muscles in the coccyx.
Every part of our body (even the coccyx) needs looking after.

*While cycling on a stationery bike or on the road, make sure the cycle seat is soft and comfortable. Special “cycling innerwear” is available with padding and should be used.

*Do not run on slippery surfaces like the edges of the swimming pool.

*Wear footwear that is rubber soled or has a “grip”, not smooth leather.

*Maintain ideal body weight. This can be calculated as height in metre squared X 23.

*Walk and sit with the correct posture. If you feel you are slouching, stand with both shoulders touching the wall and balance a book on your head.

*Do not sit on hard surfaces for prolonged periods of time.

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

Resources:
https://en.wikipedia.org/wiki/Coccydynia
http://www.medicinenet.com/coccydynia/article.htm
http://www.telegraphindia.com/1160201/jsp/knowhow/story_66774.jsp

Dyslexia

 

Definition:
Dyslexia is a disorder occurs in children. It is a learning disorder characterized by difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words. Also called specific reading disability, dyslexia is a common learning disability in children

Dyslexia, also known as reading disorder, is characterized by trouble with reading despite normal intelligence. Different people are affected to varying degrees. Problems may include difficulties in spelling words, reading quickly, writing words, “sounding out” words in the head, pronouncing words when reading aloud and understanding what one reads. Often these difficulties are first noticed at school. When someone who previously could read loses their ability, it is known as alexia. The difficulties are involuntary and people with this disorder have normal desire to learn…………..CLICK & SEE THE  PICTURES

It occurs in children with normal vision and intelligence. Sometimes dyslexia goes undiagnosed for years and isn’t recognized until adulthood.

Dyslexia is the most common learning disability, affecting 3–7 % of the population; however, up to 20% may have some degree of symptoms. While dyslexia is more often diagnosed in men, it has been suggested that it affects men and women equally. Dyslexia occurs in all areas of the world. Some believe that dyslexia should be best considered as a different way of learning, with both benefits and downsides.

There’s no cure for dyslexia. It’s a lifelong condition caused by inherited traits that affect how our brain works. However, most children with dyslexia can succeed in school with tutoring or a specialized education program. Emotional support also plays an important role.
Symptoms:
It is very difficult to recognize dysplexia before the child enters school, but some early clues may indicate a problem. Once the child reaches school age, the school teacher may be the first to notice a problem. The condition often becomes apparent as a child starts learning to read.

Symptoms found before school age:

Signs and symptoms that a young child may be at risk of dyslexia include:

*Late talking
*Learning new words slowly
*Difficulty learning nursery rhymes
*Difficulty playing rhyming games
Symptoms found at the school age:

Once the child is in school, dyslexia signs and symptoms may become more apparent, including:

*Reading well below the expected level than the child’s age
*Problems processing and understanding what he or she hears
*Difficulty comprehending rapid instructions
*Problems remembering the sequence of things
*Difficulty seeing (and occasionally hearing) similarities and differences in letters and words
*Inability to sound out the pronunciation of an unfamiliar word
*Difficulty spelling
*Trouble learning a foreign language

Symptoms found in teens and adults:

The symptoms are similar to those in children. Though early intervention is beneficial for dyslexia treatment, it’s never too late to seek help. Some common dyslexia symptoms in teens and adults are :

* Difficulties with summarizing stories
* Difficulty with memorization, reading aloud.
*Difficulty in learning foreign languages.
*Difficulty with time management
*Trouble learning a foreign language
*Difficulty memorizing
*Difficulty doing math problems

Adult dyslexics can often read with good comprehension, though they tend to read more slowly than non-dyslexics and perform worse in spelling tests or when reading nonsense words – a measure of phonological awareness.

A common myth about dyslexia is that its defining feature is reading or writing letters or words backwards, but this is true of many children as they learn to read and write

Associated conditions:
Dyslexia is often accompanied by several learning disabilities, but it is unclear whether they share underlying neurological causes. These associated disabilities include:

*Dysgraphia – A disorder which primarily expresses itself through difficulties with writing or typing, but in some cases through difficulties associated with eye–hand coordination and direction- or sequence-oriented processes such as tying knots or carrying out repetitive tasks. In dyslexia, dysgraphia is often multifactorial, due to impaired letter-writing automaticity, organizational and elaborative difficulties, and impaired visual word forming which makes it more difficult to retrieve the visual picture of words required for spelling.

*Attention deficit hyperactivity disorder – A significant degree of comorbidity has been reported between ADHD and reading disorders such as dyslexia. ADHD occurs in 12–24% of all individuals with dyslexia.

*Auditory processing disorder – A listening disability that affects the ability to process auditory information. This can lead to problems with auditory memory and auditory sequencing. Many people with dyslexia have auditory processing problems, and may develop their own logographic cues to compensate for this type of deficit. Some research indicates that auditory processing skills could be the primary shortfall in dyslexia.

*Developmental coordination disorder – A neurological condition characterized by marked difficulty in carrying out routine tasks involving balance, fine-motor control, kinesthetic coordination, difficulty in the use of speech sounds, problems with short-term memory, and organization.
Causes:
Researchers have been trying to find the neurobiological basis of dyslexia since the condition was first identified in 1881. For example, some have tried to associate the common problem among dyslexics of not being able to see letters clearly to abnormal development of their visual nerve cells.

CLICK & SEE THE PICTURE : 

Dyslexia has been linked to certain genes that control how the brain develops. It appears to be an inherited condition — it tends to run in families.

These inherited traits appear to affect parts of the brain concerned with language, interfering with the ability to convert written letters and words into speech.

Neuroanatomy:
Modern neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have shown a correlation between both functional and structural differences in the brains of children with reading difficulties. Some dyslexics show less electrical activation in parts of the left hemisphere of the brain involved with reading, such as the inferior frontal gyrus, inferior parietal lobule, and the middle and ventral temporal cortex. Over the past decade, brain activation studies using PET to study language have produced a breakthrough in the understanding of the neural basis of language. Neural bases for the visual lexicon and for auditory verbal short-term memory components have been proposed,   with some implication that the observed neural manifestation of developmental dyslexia is task-specific (i.e. functional rather than structural). fMRIs in dyslexics have provided important data which point to the interactive role of the cerebellum and cerebral cortex as well as other brain structures.

The cerebellar theory of dyslexia proposes that impairment of cerebellum-controlled muscle movement affects the formation of words by the tongue and facial muscles, resulting in the fluency problems that are characteristic of some dyslexics. The cerebellum is also involved in the automatization of some tasks, such as reading.[48] The fact that some dyslexic children have motor task and balance impairments has been used as evidence for a cerebellar role in their reading difficulties. However, the cerebellar theory is not supported by controlled research studies

Genetics:
Research into potential genetic causes of dyslexia has its roots in post-autopsy examination of the brains of people with dyslexia. Observed anatomical differences in the language centers of such brains include microscopic cortical malformations known as ectopias, more rarely, vascular micro-malformations, and microgyrus. The previously cited studies and others[51] suggest that abnormal cortical development presumed to occur before or during the sixth month of fetal brain development was the cause of the abnormalities. Abnormal cell formations in dyslexics have also been reported in non-language cerebral and subcortical brain structures. Several genes have been associated with dyslexia, including DCDC2 and KIAA0319 on chromosome 6, and DYX1C1 on chromosome 15

Mechanisms:
The dual-route theory of reading aloud was first described in the early 1970s. This theory suggests that two separate mental mechanisms, or cognitive routes, are involved in reading aloud. One mechanism is the lexical route, which is the process whereby skilled readers can recognize known words by sight alone, through a “dictionary” lookup procedure. The other mechanism is the nonlexical or sublexical route, which is the process whereby the reader can “sound out” a written word. This is done by identifying the word’s constituent parts (letters, phonemes, graphemes) and applying knowledge of how these parts are associated with each other, for example, how a string of neighboring letters sound together. The dual-route system could explain the different rates of dyslexia occurrence between different languages (e.g. the Spanish language dependence on phonological rules accounts for the fact that Spanish-speaking children show a higher level of performance in non-word reading, when compared to English-speakers).

Dyslexia disorder is not caused by mutation in one gene; in fact, it appears to involve the combined effects of several genes. Studying the cognitive problems associated with other disorders helps to better understand the genotype-phenotype link of dyslexia. Neurophysiological and imaging procedures are being used to ascertain phenotypic characteristics in dyslexics, thus identifying the effects of certain genes.

Diagnosis:
There’s no one test that can diagnose dyslexia. Your child’s doctor will consider a number of factors, such as:

*Child’s mental development, educational issues and medical history.
The doctor will likely ask the chil questions about these areas. The doctor will likely also want to know about any conditions that run in your child’s family, including whether any family members have a learning disability.

*Child’s home life.
The doctor may ask for a description of hi or her family and home life, including who lives at home and whether there are any problems at home.

*Questionnaires.
The child’s doctor may have the child, family members or teachers answer written questions. Child may be asked to take tests to identify reading and language abilities.
Vision, hearing and brain (neurological) tests. These can help determine whether another disorder may be causing or adding to the child’s poor reading ability………....CLICK & SEE 

*Psychological testing.
The doctor may ask the parent or child questions to better understand the child’s psychological state. This can help determine whether social problems, anxiety or depression may be limiting his or her abilities.

*Testing reading and other academic skills.
Child may take a set of educational tests and have the process and quality of reading skills analyzed by a reading expert.
Treatment & Management:
There’s no known way to correct the underlying brain abnormality that causes dyslexia — dyslexia is a lifelong problem. However, early detection and evaluation to determine specific needs and appropriate treatment can improve success.

Through the use of compensation strategies, therapy and educational support, dyslexic individuals can learn to read and write. There are techniques and technical aids which help to manage or conceal symptoms of the disorder. Removing stress and anxiety alone can sometimes improve written comprehension. For dyslexia intervention with alphabet-writing systems, the fundamental aim is to increase a child’s awareness of correspondences between graphemes (letters) and phonemes (sounds), and to relate these to reading and spelling by teaching how sounds blend into words. It has been found that reinforced collateral training focused on reading and spelling yields longer-lasting gains than oral phonological training alone. Early intervention – that done while the language areas of the brain are still developing – is the most successful in reducing the long-term impacts of dyslexia. There is some evidence that the use of specially-tailored fonts may mitigate the effects of dyslexia. These fonts, which include Dyslexie, OpenDyslexic, and Lexia Readable, were created based on the idea that many of the letters of the Latin alphabet are visually similar and may therefore confuse dyslexics. Dyslexie and OpenDyslexic both put emphasis on making each letter more unique in order to be more easily identified. Font design can have an effect on reading, reading time, and the perception of legibility of all readers, not only those with dyslexia.

There have been many studies conducted regarding intervention in dyslexia. Among these studies one meta-analysis found that there was functional activation as a result.

Alternative therapy: Regular practice of Yaga with Pramayama under the supervision of an expart may give very good result in improving neurogical difficulties.

Prognosis:
The prognosis for children with dyslexia is variable and dependent on the cause. In the case of primary dyslexia, the earlier the diagnosis is made and intervention started, the better the outcome. It is also important to focus on the child’s self-esteem, since dealing with dyslexia can be extremely frustrating.

Dyslexic children require special instruction for word analysis and spelling from an early age. However, there are fonts that can help dyslexics better understand writing. The prognosis, generally speaking, is positive for individuals who are identified in childhood and receive support from friends and family.

Lastly it is important to recognize that many well-known and successful individuals have suffered from dyslexia, including Albert Einstein and Steven Spielberg, just to name a couple.

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

Resources:
https://en.wikipedia.org/wiki/Dyslexia
http://www.mayoclinic.org/diseases-conditions/dyslexia
http://www.medicinenet.com/dyslexia/page6.htm#what_is_the_prognosis_for_a_person_with_dyslexia

Tinnitus

Definition:   Tinnitus is noise or ringing in the ears.It may be a the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you’re trying to fall asleep in a quiet room. In very rare cases, the sound beats in sync with your heart (pulsatile tinnitus)……..CLICK & SEE THE PICTURES 

A common problem, tinnitus affects about 1 in 5 people. Tinnitus isn’t a condition itself — it’s a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder.

Although bothersome, tinnitus usually isn’t a sign of something serious. Although it can worsen with age, for many people, tinnitus can improve with treatment. Treating an identified underlying cause sometimes helps. Other treatments reduce or mask the noise, making tinnitus less noticeable.

There are two kinds of tinnitus:

Subjective tinnitus is tinnitus only one can hear. This is the most common type of tinnitus. It can be caused by ear problems in the outer, middle or inner ear. It also can be caused by problems with the hearing (auditory) nerves or the part of your brain that interprets nerve signals as sound (auditory pathways).

Objective tinnitus is tinnitus the doctor can hear when he or she does an examination. This rare type of tinnitus may be caused by a blood vessel problem, an inner ear bone condition or muscle contractions.
Symptoms:
Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise but, in some patients, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging or whistling sound or as ticking, clicking, roaring, “crickets” or “tree frogs” or “locusts (cicadas)”, tunes, songs, beeping, sizzling, sounds that slightly resemble human voices or even a pure steady tone like that heard during a hearing test and, in some cases, pressure changes from the interior ear. It has also been described as a “whooshing” sound because of acute muscle spasms, as of wind or waves. Tinnitus can be intermittent or it can be continuous: in the latter case, it can be the cause of great distress. In some individuals, the intensity can be changed by shoulder, head, tongue, jaw or eye movements.

Most people with tinnitus have some degree of hearing loss: they are often unable to clearly hear external sounds that occur within the same range of frequencies as their “phantom sounds”. This has led to the suggestion that one cause of tinnitus might be a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss.

The sound perceived may range from a quiet background noise to one that can be heard even over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one’s own pulse or muscle contractions, which is typically a result of sounds that have been created from the movement of muscles near to one’s ear, changes within the canal of one’s ear or issues related to blood flow of the neck or face.

Causes:
Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus...CLICK & SEE : 

A variety of other conditions and illnesses may lead to tinnitus and they are as follows:
*Blockages of the ear due to a buildup of wax, an ear infection, or rarely, a benign tumor of the nerve that allows us to hear (auditory nerve)

*Certain drugs — most notably aspirin, several types of antibiotics, anti-inflammatories, sedatives, and antidepressants, as well as quinine medications; tinnitus is cited as a potential side effect for about 200 prescription and nonprescription drugs.

*The natural aging process, which can cause deterioration of the cochlea or other parts of the ear

*Meniere’s disease, which affects the inner part of the ear

*Otosclerosis, a disease that results in stiffening of the small bones in the middle ear

*Other medical conditions such as high blood pressure, cardiovascular disease, circulatory problems, anemia, allergies, an underactive thyroid gland, and diabetes

*Neck or jaw problems, such as temporomandibular joint (TMJ) syndrome

*Multiple sclerosis

*Injuries to the head and neck

*External ear infection

*Acoustic shock

*Cerumen (earwax) impaction

*Middle ear effusion

*Superior canal dehiscence

*Sensorineural hearing loss

*Acoustic neuroma*Mercury or lead poisoning

*Neurologic disorders

*Temporomandibular joint dysfunction

*Giant cell arteritis

*Metabolic disorders like thyroid disease, hyperlipidemia, vitamin B12 deficiency, iron deficiency anemia, psychiatric disorders,diabetis

*Psychiatric disorders like depression, anxiety
Tinnitus can worsen in some people if they drink alcohol, smoke cigarettes, drink caffeinated beverages, or eat certain foods. For reasons not yet entirely clear to researchers, stress and fatigue seem to worsen tinnitus.

Diagnosis:
The basis of quantitatively measuring tinnitus relies on the brain’s tendency to select out only the loudest sounds heard. Based on this tendency, the amplitude of a patient’s tinnitus can be measured by playing sample sounds of known amplitude and asking the patient which they hear. The volume of the tinnitus will always be equal to or less than that of the sample noises heard by the patient. This method works very well to gauge objective tinnitus (see above). For example: if a patient has a pulsatile paraganglioma in their ear, they will not be able to hear the blood flow through the tumor when the sample noise is 5 decibels louder than the noise produced by the blood. As sound amplitude is gradually decreased, the tinnitus will become audible and the level at which it does so provides an estimate of the amplitude of the objective tinnitus.

Objective tinnitus, however, is quite uncommon. Often, patients with pulsatile tumors will report other coexistent sounds, distinct from the pulsatile noise, that will persist even after their tumor has been removed. This is generally subjective tinnitus, which, unlike the objective form, cannot be tested by comparative methods. However, pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for bruits by a medical professional with auscultation over the neck, eyes and ears. If the exam reveals a bruit, imaging studies such as transcranial doppler (TCD) or magnetic resonance angiography (MRA) should be performed.

The accepted definition of chronic tinnitus, as compared to normal ear noise experience, is five minutes of ear noise occurring at least twice a week. However, people with chronic tinnitus often experience the noise more frequently than this and can experience it continuously or regularly, such as during the night when there is less environmental noise to mask the sound.

Treatment:
Psychological:
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person. It decreases the amount of stress those with tinnitus feel. These benefits appear to be independent of any effect on depression or anxiety in an individual. Relaxation techniques may also be useful. A program has been developed by the United States Department of Veterans Affairs.

Medications:
There are no medications as of 2014 that are effective for tinnitus and, thus, none is recommended. There is not enough evidence to determine if antidepressants or acamprosate is useful. While there is tentative evidence for benzodiazepines, it is insufficient to support usage. Anticonvulsants have not been found to be useful.

Botulinum toxin injection has been tried with some success in cases of objective tinnitus (palatal tremor)

Others:
The use of sound therapy by either hearing aids or tinnitus maskers helps the brain ignore the specific tinnitus frequency. Although these methods are poorly supported by evidence, there are no negative effects, which makes them a reasonable option. There is some tentative evidence supporting tinnitus retraining therapy. There is little evidence supporting the use of transcranial magnetic stimulation. It is thus not recommended.

Alternative   Therapy :
Ginkgo biloba does not appear to be effective. Tentative evidence supports zinc supplementation and in those with sleep problems, melatonin. The American Academy of Otolaryngology, however, recommends against melatonin and zinc.

Doing YOGA EXERCISE daily with PRANAYAMA (specially Anuloma belome , Kapalabhati and Bhramari ) may help a lot to improve and sometimes cure totally.
Prognosis:
Most people with tinnitus get used to it over time; for a minority, it remains a significant problem.

Prevention:
Prolonged exposure to sound or noise levels as low as 70 dB can result in damage to hearing (see noise health effects). This can lead to tinnitus. Ear plugs can help with prevention.

Avoidance of potentially ototoxic medicines. Ototoxicity of multiple medicines can have a cumulative effect and can increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details, such as dose and dosage interval, can reduce the damage done.

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

Resources:
https://en.wikipedia.org/wiki/Tinnitus
http://www.mayoclinic.org/diseases-conditions/tinnitus/multimedia/tinnitus/
http://www.webmd.com/a-to-z-guides/understanding-tinnitus-basics

Urinary tract infection (UTI)

OTHER  NAMES: Acute cystitis or Bladder infection,

Definition:
A urinary tract infection (UTI), is an infection that affects part of the urinary tract.(kidneys, ureters, bladder and urethra.) Most infections involve the lower urinary tract — the bladder and the urethra.When it affects the lower urinary tract it is known as a simple cystitis (a bladder infection) and when it affects the upper urinary tract it is known as pyelonephritis (a kidney infection). …..CLICK & SEE… :Female urinary system .……. Male urinary system 

Women are at greater risk of developing a UTI than men are. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to kidneys.

CLICK &  SEE THE PICTURES

Doctors typically treat urinary tract infections with antibiotics. But you can take steps to reduce your chances of getting a UTI in the first place.

SIGN  &  SYMPTOMS:   
Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:

*A strong, persistent urge to urinate
*A burning sensation when urinating
*Passing frequent, small amounts of urine
*Urine that appears cloudy
*Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
*Strong-smelling urine
*Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone

UTIs may be overlooked or mistaken for other conditions in older adults.

Types of urinary tract infection:

Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.

These symptoms may vary from mild to severe and in healthy persons last an average of six days.

KIDNEYS (acute pyelonephritis):...CLICK & SEE
*Upper back and side (flank) pain
*High fever
*Shaking and chills
*Nausea
*Vomiting

BLADDER (cystitis): ….CLICK & SEE
*Pelvic pressure
*Lower abdomen discomfort (Some pain above the pubic bone or in the lower back may be present.)
*Frequent, painful urination
*Blood in urine (Rarely the urine may appear bloody  or contain visible pus in the urine.)

URETHRA (urethritis): …….CLICK & SEE
:Burning with urination
:Discharge

Children:
In young children, the only symptom of a urinary tract infection (UTI) may be a fever. Because of the lack of more obvious symptoms, when females under the age of two or uncircumcised males less than a year exhibit a fever, a culture of the urine is recommended by many medical associations. Infants may feed poorly, vomit, sleep more, or show signs of jaundice. In older children, new onset urinary incontinence (loss of bladder control) may occur.

Elderly:
Urinary tract symptoms are frequently lacking in the elderly. The presentations may be vague with incontinence, a change in mental status, or fatigue as the only symptoms, while some present to a health care provider with sepsis, an infection of the blood, as the first symptoms. Diagnosis can be complicated by the fact that many elderly people have preexisting incontinence or dementia.

It is reasonable to obtain a urine culture in those with signs of systemic infection that may be unable to report urinary symptoms, such as when advanced dementia is present. Systemic signs of infection include a fever or increase in temperature of more than 1.1 °C (2.0 °F) from usual, chills, and an increase white blood cell count.

CAUSES:    
Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

The most common UTIs occur mainly in women and affect the bladder and urethra.

E. coli is the cause of 80–85% of community-acquired urinary tract infections, with Staphylococcus saprophyticus being the cause in 5–10%. Rarely they may be due to viral or fungal infections. Healthcare-associated urinary tract infections (mostly related to urinary catheterization) involve a much broader range of pathogens including: E. coli (27%), Klebsiella (11%), Pseudomonas (11%), the fungal pathogen Candida albicans (9%), and Enterococcus (7%) among others. Urinary tract infections due to Staphylococcus aureus typically occur secondary to blood-borne infections. Chlamydia trachomatis and Mycoplasma genitalium can infect the urethra but not the bladder. These infections are usually classified as a urethritis rather than urinary tract infection

Sex:
In young sexually active women, sexual activity is the cause of 75–90% of bladder infections, with the risk of infection related to the frequency of sex. The term “honeymoon cystitis” has been applied to this phenomenon of frequent UTIs during early marriage. In post-menopausal women, sexual activity does not affect the risk of developing a UTI. Spermicide use, independent of sexual frequency, increases the risk of UTIs. Diaphragm use is also associated. Condom use without spermicide or use of birth control pills does not increase the risk of uncomplicated urinary tract infection.

Women are more prone to UTIs than men because, in females, the urethra is much shorter and closer to the anus. As a woman’s estrogen levels decrease with menopause, her risk of urinary tract infections increases due to the loss of protective vaginal flora. Additionally, vaginal atrophy that can sometimes occur after menopause is associated with recurrent urinary tract infections.

Chronic prostatitis may cause recurrent urinary tract infections in males. Risk of infections increases as males age. While bacteria is commonly present in the urine of older males this does not appear to affect the risk of urinary tract infections.

Urinary catheters:
Urinary catheterization increases the risk for urinary tract infections. The risk of bacteriuria (bacteria in the urine) is between three to six percent per day and prophylactic antibiotics are not effective in decreasing symptomatic infections. The risk of an associated infection can be decreased by catheterizing only when necessary, using aseptic technique for insertion, and maintaining unobstructed closed drainage of the catheter.

Male scuba divers utilizing condom catheters or the female divers utilizing external catching device for their dry suits are also susceptible to urinary tract infections.

Others:
A predisposition for bladder infections may run in families. Other risk factors include diabetes, being uncircumcised, and having a large prostate. Complicating factors are rather vague and include predisposing anatomic, functional, or metabolic abnormalities. In children UTIs are associated with vesicoureteral reflux (an abnormal movement of urine from the bladder into ureters or kidneys) and constipation.

Persons with spinal cord injury are at increased risk for urinary tract infection in part because of chronic use of catheter, and in part because of voiding dysfunction. It is the most common cause of infection in this population, as well as the most common cause of hospitalization. Additionally, use of cranberry juice or cranberry supplement appears to be ineffective in prevention and treatment in this population.

Pathogenesis:
The bacteria that cause urinary tract infections typically enter the bladder via the urethra. However, infection may also occur via the blood or lymph. It is believed that the bacteria are usually transmitted to the urethra from the bowel, with females at greater risk due to their anatomy. After gaining entry to the bladder, E. Coli are able to attach to the bladder wall and form a biofilm that resists the body’s immune response.

RISK FACTORS  &  COMPLICATIONS:
*Urinary tract abnormalities. Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.

*Blockages in the urinary tract. Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.
A suppressed immune system. Diabetes and other diseases that impair the immune system — the body’s defense against germs — can increase the risk of UTIs.

*Catheter use. People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed.

*A recent urinary procedure. Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.
When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.

Complications of a UTI are as follows::

*Recurrent infections, especially in women who experience three or more UTIs.
*Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
*Increased risk in pregnant women of delivering low birth weight or premature infants.
*Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
*Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up to urinary tract to the kidneys.

DIAGNOSIS:
In straightforward cases, a diagnosis may be made and treatment given based on symptoms alone without further laboratory confirmation. In complicated or questionable cases, it may be useful to confirm the diagnosis via urinalysis, looking for the presence of urinary nitrites, white blood cells (leukocytes), or leukocyte esterase. Another test, urine microscopy, looks for the presence of red blood cells, white blood cells, or bacteria. Urine culture is deemed positive if it shows a bacterial colony count of greater than or equal to 103 colony-forming units per mL of a typical urinary tract organism. Antibiotic sensitivity can also be tested with these cultures, making them useful in the selection of antibiotic treatment. However, women with negative cultures may still improve with antibiotic treatment. As symptoms can be vague and without reliable tests for urinary tract infections, diagnosis can be difficult in the elderly.

Classification:
A urinary tract infection may involve only the lower urinary tract, in which case it is known as a bladder infection. Alternatively, it may involve the upper urinary tract, in which case it is known as pyelonephritis. If the urine contains significant bacteria but there are no symptoms, the condition is known as asymptomatic bacteriuria. If a urinary tract infection involves the upper tract, and the person has diabetes mellitus, is pregnant, is male, or immunocompromised, it is considered complicated. Otherwise if a woman is healthy and premenopausal it is considered uncomplicated. In children when a urinary tract infection is associated with a fever, it is deemed to be an upper urinary tract infection.

Children:
To make the diagnosis of a urinary tract infection in children, a positive urinary culture is required. Contamination poses a frequent challenge depending on the method of collection used, thus a cutoff of 105 CFU/mL is used for a “clean-catch” mid stream sample, 104 CFU/mL is used for catheter-obtained specimens, and 102 CFU/mL is used for suprapubic aspirations (a sample drawn directly from the bladder with a needle). The use of “urine bags” to collect samples is discouraged by the World Health Organization due to the high rate of contamination when cultured, and catheterization is preferred in those not toilet trained. Some, such as the American Academy of Pediatrics recommends renal ultrasound and voiding cystourethrogram (watching a person’s urethra and urinary bladder with real time x-rays while they urinate) in all children less than two years old who have had a urinary tract infection. However, because there is a lack of effective treatment if problems are found, others such as the National Institute for Health and Care Excellence only recommends routine imaging in those less than six months old or who have unusual findings.

Differential diagnosis:
In women with cervicitis (inflammation of the cervix) or vaginitis (inflammation of the vagina) and in young men with UTI symptoms, a Chlamydia trachomatis or Neisseria gonorrheae infection may be the cause. These infections are typically classified as a urethritis rather than a urinary tract infection. Vaginitis may also be due to a yeast infection. Interstitial cystitis (chronic pain in the bladder) may be considered for people who experience multiple episodes of UTI symptoms but urine cultures remain negative and not improved with antibiotics. Prostatitis (inflammation of the prostate) may also be considered in the differential diagnosis.

Hemorrhagic cystitis, characterized by blood in the urine, can occur secondary to a number of causes including: infections, radiation therapy, underlying cancer, medications and toxins. Medications that commonly cause this problem include the chemotherapeutic agent cyclophosphamide with rates of 2 to 40%. Eosinophilic cystitis is a rare condition where eosinophiles are present in the bladder wall. Signs and symptoms are similar to a bladder infection. Its cause is not entirely clear; however, it may be linked to food allergies, infections, and medications among others.

TREATMENTS;
Medications:
For those with recurrent infections, taking a short course of antibiotics when each infection occurs is associated with the lowest antibiotic use. A prolonged course of daily antibiotics is also effective. Medications frequently used include nitrofurantoin and trimethoprim/sulfamethoxazole (TMP/SMX). Methenamine is another agent used for this purpose as in the bladder where the acidity is low it produces formaldehyde to which resistance does not develop. Some recommend against prolonged use due to concerns of antibiotic resistance.

In cases where infections are related to intercourse, taking antibiotics afterwards may be useful. In post-menopausal women, topical vaginal estrogen has been found to reduce recurrence. As opposed to topical creams, the use of vaginal estrogen from pessaries has not been as useful as low dose antibiotics. Antibiotics following short term urinary catheterization decreases the subsequent risk of a bladder infection. A number of vaccines are in development as of 2011.

Children:
The evidence that preventative antibiotics decrease urinary tract infections in children is poor. However recurrent UTIs are a rare cause of further kidney problems if there are no underlying abnormalities of the kidneys, resulting in less than a third of a percent (0.33%) of chronic kidney disease in adults. Whether routine circumcisions prevents UTIs has not been well studied as of 2011.

Alternative medicine:
Some research suggests that cranberry (juice or capsules) may decrease the number of UTIs in those with frequent infections. A Cochrane review concluded that the benefit, if it exists, is small. Long-term tolerance is also an issue with gastrointestinal upset occurring in more than 30%. Cranberry juice is thus not currently recommended for this indication. As of 2011, intravaginal probiotics require further study to determine if they are beneficial.

Lifestyle and home remedies:

Urinary tract infections can be painful, but you can take steps to ease your discomfort until antibiotics treat the infection.
The following tips should be followed:

*Drink plenty of water. Water helps to dilute your urine and flush out bacteria.

*Avoid drinks that may irritate the bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate the bladder and tend to aggravate frequent or urgent need to urinate.

*Use a heating pad. Apply a warm, but not hot, heating pad to your abdomen to minimize bladder pressure or discomfort.
PREVENTIONS:
The following steps can be taken to reduce the risk of urinary tract infections:

*Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.

*Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful.

*Wash  or  Wipe properly   from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.

*Empty the bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.

*Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.

*Change the birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.

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

Resources:
https://en.wikipedia.org/wiki/Urinary_tract_infection
http://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/

Alzheimer’s disease

 

Other Names: Alzheimer’s disease (AD), also known as Alzheimer disease, or just Alzheimer’s

Definition:
Alzheimer’s is a chronic neurodegenerative disease that usually starts slowly and gets worse over time. It destroys memory and other important mental functions.
It’s the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. These changes are severe enough to interfere with day-to-day life.
In this disease, the brain cells themselves degenerate and die, causing a steady decline in memory and mental function….CLICK  & SEE

Alzheimer’s is a type of dementia that is more common with increasing age. People with a family history of the condition are also at increased risk of developing it.

At present Alzheimer’s disease medications and management strategies may temporarily improve symptoms. This can sometimes help people with Alzheimer’s disease maximize function and maintain independence.But because there’s no cure for this disease, it’s important to seek supportive services and tap into one’s support network as early as possible.

Symptoms:
At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer’s disease that one notices. But over time, the disease robs one of more of one’s memory, especially recent memories. The rate at which symptoms worsen varies from one person to other person.

If some one has Alzheimer’s, he or she may be the first to notice that the person are having unusual difficulty remembering things and organizing different thoughts. Or may not be recognizing that anything is wrong, even when changes are noticeable by the family members, close friends or co-workers.

Brain changes associated with Alzheimer’s disease lead to growing trouble with:
Alzimer’s is a slowly progressive chronic disease. It progresses in different stages:
Stages of Alzheimer’s disease:

*Effects of ageing on memory but not AD
*Forgetting things occasionally
*Misplacing items sometimes
*Minor short-term memory loss
*Not remembering exact details

Early stage Alzheimer’s:

*Not remembering episodes of forgetfulness
*Forgets names of family or friends
*Changes may only be noticed by close friends or relatives
*Some confusion in situations outside the familiar

Middle stage Alzheimer’s:

*Greater difficulty remembering recently learned information
*Deepening confusion in many circumstances
*Problems with sleep
*Trouble knowing where they are

Late stage Alzheimer’s:

*Poor ability to think
*Problems speaking
*Repeats same conversations
*More abusive, anxious, or paranoid

Causes:
Scientists believe that for most people, Alzheimer’s disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time.

Less than 5 percent of the time, Alzheimer’s is caused by specific genetic changes that virtually guarantee a person will develop the disease.

Although the causes of Alzheimer’s are not yet fully understood, its effect on the brain is clear. Alzheimer’s disease damages and kills brain cells. A brain affected by Alzheimer’s disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain.

As more and more brain cells die, Alzheimer’s leads to significant brain shrinkage. When doctors examine Alzheimer’s brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease:

*Plaques. These clumps of a protein called beta-amyloid may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer’s isn’t known, the collection of beta-amyloid on the outside of brain cells is a prime suspect.

*Tangles. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau.

In Alzheimer’s, threads of tau protein twist into abnormal tangles inside brain cells, leading to failure of the transport system. This failure is also strongly implicated in the decline and death of brain cells.

Click & see: Transmittable Alzheimer’s’ concept raised :

Risk Factors:
Age:
Increasing age is the greatest known risk factor for Alzheimer’s. Alzheimer’s is not a part of normal aging, but your risk increases greatly after 65 years of age. Nearly half of those older than age 85 have Alzheimer’s.

People with rare genetic changes that virtually guarantee they’ll develop Alzheimer’s begin experiencing symptoms as early as their 30s.

Family history and genetics:

The risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative — parent or sibling — has the disease. Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease.

Most genetic mechanisms of Alzheimer’s among families remain largely unexplained. The strongest risk gene researchers have found so far is apolipoprotein e4 (APOE e4). Other risk genes have been identified but not conclusively confirmed.

Sex: Women may be more likely than are men to develop Alzheimer’s disease, in part because they live longer.

Mild cognitive impairment:

People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia.

Those with MCI have an increased risk — but not a certainty — of later developing dementia. Taking action to develop a healthy lifestyle and strategies to compensate for memory loss at this stage may help delay or prevent the progression to dementia.

Past head trauma: People who’ve had a severe head trauma or repeated head trauma appear to have a greater risk of Alzheimer’s disease.

Lifestyle and heart health:

There’s no lifestyle factor that’s been conclusively shown to reduce your risk of Alzheimer’s disease.

However, some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include:

*Lack of exercise (a sedentry life style)
*Smoking
*High blood pressure
*High blood cholesterol
*Elevated homocysteine levels
*Poorly controlled diabetes
*A diet lacking in fruits and vegetables

These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of Alzheimer’s disease and vascular dementia

Diagnosis:
There is no specific test today that can confirms the Alzheimer’s disease. The doctor will make a judgment about whether Alzheimer’s is the most likely cause of the symptoms based on the information that the patient provides and results of various tests that can help clarify the diagnosis.

The doctor will Physical and neurological exam:

The doctor will perform a physical exam, and is likely to check the overall neurological health by testing the patient following:

*Reflexes
*Muscle tone and strength
*Ability to get up from a chair and walk across the room
*Sense of sight and hearing
*Coordination
*Balance

The doctor may ask the patient to under take the following tests:

1. Blood test: The tests may help the doctor to rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies

2. Mental status testing: The doctor may conduct a brief mental status test to assess the patient’s memory and other thinking skills. Short forms of mental status testing can be done in about 10 minutes.

3. Neuropsychological testing : The doctor may recommend a more extensive assessment of the patient’s thinking and memory. Longer forms of neuropsychological testing, which can take several hours to complete, may provide additional details about the mental function compared with others’ of a similar age and education level.

4. Brain imaging: Images of the brain are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer’s disease — such as strokes, trauma or tumors — that may cause cognitive change. New imaging applications — currently used primarily in major medical centers or in clinical trials — may enable doctors to detect specific brain changes caused by Alzheimer’s.

Brain-imaging technologies include:

i) Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into a tube-shaped MRI machine, which makes loud banging noises while it produces images. MRIs are painless, but some people feel claustrophobic inside the machine and are disturbed by the noise.

MRIs are used to rule out other conditions that may account for or be adding to cognitive symptoms. In addition, they may be used to assess whether shrinkage in brain regions implicated in Alzheimer’s disease has occurred.

ii) Computerized tomography (CT). For a CT scan, you’ll lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images (slices) of your brain. It’s currently used chiefly to rule out tumors, strokes and head injuries.

Positron emission tomography (PET). During a PET scan, you’ll be injected in a vein with a low-level radioactive tracer. You’ll lie on a table while an overhead scanner tracks the tracer’s flow through your brain.

The tracer may be a special form of glucose (sugar) that shows overall activity in various brain regions. This can show which parts of your brain aren’t functioning well. New PET techniques may be able to detect your brain level of plaques and tangles, the two hallmark abnormalities linked to Alzheimer’s.

Future diagnostic tests:

Researchers are working with doctors to develop new diagnostic tools to help definitively diagnose Alzheimer’s. Another important goal is to detect the disease before it causes the symptoms targeted by current diagnostic techniques — at the stage when Alzheimer’s may be most treatable as new drugs are discovered. This stage is called preclinical Alzheimer’s disease.

New tools under investigation include:

* Additional approaches to brain imaging
* More-sensitive tests of mental abilities
* Measurement of key proteins or protein patterns in blood or spinal fluid (biomarkers)

Treatment:
Current Alzheimer’s medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:

Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication chemical depleted in the brain by Alzheimer’s disease. Most people can expect to keep their current symptoms at bay for a time.

Less than half of those taking these drugs can expect to have any improvement. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The main side effects of these drugs include diarrhea, nausea and sleep disturbances.

Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer’s disease. It’s sometimes used in combination with a cholinesterase inhibitor.

Creating a safe and supportive environment:

Adapting the living situation to the needs of a person with Alzheimer’s is an important part of any treatment plan. For someone with Alzheimer’s, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.

One can take these steps to support a person’s sense of well-being and continued ability to function:

*Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don’t become lost.
*See if the doctor can simplify the medication regimen to once-daily dosing, and arrange for the finances to be on automatic payment and automatic deposit.
*Develop the habit of carrying a mobile phone with location capability so that one can call in case the person is lost or confused and people can track the location via the phone. Also, program important phone numbers into the person’s phone, so that he or she does not have to try to recall them.
*Make sure regular appointments are on the same day at the same time as much as possible.
*Use a calendar or white board in the home to track daily schedules. Build the habit of checking off completed items so that you can be sure they were completed.
*Remove excess furniture, clutter and throw rugs.
*Install sturdy handrails on stairways and in bathrooms.
*Ensure that shoes and slippers are comfortable and provide good traction.
*Reduce the number of mirrors. People with Alzheimer’s may find images in mirrors confusing or frightening.

Exercise:

Regular exercise is an important part of everybody’s wellness plan — and those with Alzheimer’s are no exception. Activities such as a daily 30-minute walk can help improve mood and maintain the health of your joints, muscles and heart.

Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer’s carries identification if she or he walks unaccompanied.

People with Alzheimer’s who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. You may be able to find exercise programs geared to older adults on TV or on DVDs.

Yoga & Meditation : It is proved that even an acute Alzheimer’s patient can improve a lot if he or she does Yoga & meditation regularly under the guidance of an expart teacher.

Alzheimer’s patients should be careful of taking daily nutritional food in time.

Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. But these healthy choices promote good overall health and may play a role in maintaining cognitive health, so there’s no harm in including the above good and healthy lifestyle.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
https://en.wikipedia.org/wiki/Alzheimer%27s_disease
http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/basics/definition/con-20023871

Pimples

Other Names: Acne,Acne vulgaris, Zit or Spot

Definition;
Pimple is a kind of comedo and one of the many results of excess oil getting trapped in the pores. Some of the varieties are pustules or papules.It is an inflammatory skin condition that causes spots.Spots result from the build up of dead skin cells and grease that block the pores or hair follicles, typically on the face, upper arms, upper back and chest.

CLICK & SEE THE PICTURES

It is not contagious and is nothing to do with not being clean.Hormonal changes, such as those related to puberty, menstruation and pregnancy, can contribute to acne.
Some medicines will also make it worse, including some contraceptive pills and steroids.

Pimples can be treated by various acne medications prescribed by a physician, or purchased at a pharmacy with a wide variety of treatments.

Acne occurs most commonly during adolescence, affecting an estimated 80–90% of teenagers in the Western world. Lower rates are reported in some rural societies.

It is 8th most common disease in the world. People may also be affected before and after puberty. Though it becomes less common in adulthood than in adolescence, nearly half of people in their twenties and thirties continue to have acne. About 4% continue to have difficulties into their forties.

Clasification:
Acne is commonly classified by severity as mild, moderate, or severe. This type of categorization can be an important factor in determining the appropriate treatment regimen. Mild acne is classically defined as open (blackheads) and closed comedones (whiteheads) limited to the face with occasional inflammatory lesions. Acne may be considered to be of moderate severity when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and acne lesions also occur on the trunk of the body. Lastly, severe acne is said to occur when nodules and cysts are the characteristic facial lesions and involvement of the trunk is extensive
Symptoms:
As the pores of the skin become blocked, blackheads develop and small, tender, red spots appear. These can turn into pimples or whiteheads filled with pus.Typical features of acne include seborrhea (increased oil secretion), microcomedones, comedones, papules, pustules, nodules (large papules), and possibly scarring. The appearance of acne varies with skin color. It may result in psychological and social problems.

Some of the large nodules were previously called cysts and the term nodulocystic has been used to describe severe cases of inflammatory acne.

Scars:
Acne scars are the result of inflammation within the dermal layer of skin brought on by acne and are estimated to affect 95% of people with acne vulgaris. The scar is created by an abnormal form of healing following this dermal inflammation. Scarring is most likely to occur with severe nodulocystic acne, but may occur with any form of acne vulgaris. Acne scars are classified based on whether the abnormal healing response following dermal inflammation leads to excess collagen deposition or collagen loss at the site of the acne lesion.

Atrophic acne scars are the most common type of acne scar and have lost collagen from this healing response.[19] Atrophic scars may be further classified as ice-pick scars, boxcar scars, and rolling scars. Ice pick scars are typically described as narrow (less than 2 mm across), deep scars that extend into the dermis.[19] Rolling scars are wider than ice pick scars (4–5 mm across) and have a wave-like pattern of depth in the skin. Boxcar scars are round or ovoid indented scars with sharp borders and vary in size from 1.5–4 mm across.

Hypertrophic scars are less common and are characterized by increased collagen content after the abnormal healing response. They are described as firm and raised from the skin. Hypertrophic scars remain within the original margins of the wound whereas keloid scars can form scar tissue outside of these borders. Keloid scars from acne usually occur in men and on the trunk of the body rather than the face.

Pigmentation:
Postinflammatory hyper pigmentation (PIH) is usually the result of nodular or cystic acne (the painful ‘bumps’ lying under the skin). They often leave behind an inflamed red mark after the original acne lesion has resolved. PIH occurs more often in people with darker skin color. Pigmented scar is a common but misleading term, as it suggests the color change is permanent. Often, PIH can be avoided by avoiding aggravation of the nodule or cyst. These scars can fade with time. However, untreated scars can last for months, years, or even be permanent if deeper layers of skin are affected. Daily use of SPF 15 or higher sunscreen can minimize pigmentation associated with acne.

Causes:
Inside the pore are sebaceous glands which produce sebum. When the outer layers of skin shed (as they do continuously), the dead skin cells left behind may become ‘glued’ together by the sebum. This causes the blockage in the pore, especially when the skin becomes thicker at puberty. The sebaceous glands produce more sebum which builds up behind the blockage, and this sebum harbours various bacteria including the species Propionibacterium acnes, causing infection and inflammation.

Genetic:
The predisposition for specific individuals to acne is likely explained in part by a genetic component, which has been supported by twin studies as well as studies that have looked at rates of acne among first degree relatives. The genetics of acne susceptibility is likely polygenic, as the disease does not follow classic Mendelian inheritance pattern. There are multiple candidates for genes which are possibly related to acne, including polymorphisms in TNF-alpha, IL-1 alpha, and CYP1A1 among others.

Hormonal:
Hormonal activity, such as menstrual cycles and puberty, may contribute to the formation of acne. During puberty, an increase in sex hormones called androgens cause the follicular glands to grow larger and make more sebum. A similar increase in androgens occurs during pregnancy, also leading to increased sebum production.[25]

Several hormones have been linked to acne including the androgens testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS), as well as insulin-like growth factor 1 (IGF-I) and growth hormone. Use of anabolic steroids may have a similar effect.

Acne that develops between the ages of 21 and 25 is uncommon. True acne vulgaris in adult women may be due to pregnancy or polycystic ovary syndrome.

Infectious:
Propionibacterium acnes (P. acnes) is the anaerobic bacterium species that is widely suspected to contribute to the development of acne, but its exact role in this process is not entirely clear. There are specific sub-strains of P. acnes associated with normal skin and others with moderate or severe inflammatory acne. It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains either have the capability of changing, perpetuating, or adapting to, the abnormal cycle of inflammation, oil production, and inadequate sloughing of acne pores. One particularly virulent strain has been circulating in Europe for at least 87 years. Infection with the parasitic mite Demodex is associated with the development of acne. However, it is unclear if eradication of these mites improves acne.

Lifestyle:
Cigarette smoking is known to increase the risk of developing acne. Additionally, acne severity worsens as the number of cigarettes a person smokes increases. The relationship between diet and acne is unclear as there is no high-quality evidence. However, a high glycemic load diet is associated with worsening acne. There is weak evidence of a positive association between the consumption of milk and a greater rate and severity of acne. Other associations such as chocolate and salt are not supported by the evidence. Chocolate does contain a varying amount of sugar that can lead to a high glycemic load and it can be made with or without milk. There may be a relationship between acne and insulin metabolism and one trial found a relationship between acne and obesity. Vitamin B12 may trigger acneiform eruptions, or exacerbate existing acne, when taken in doses exceeding the recommended daily intake.

Psychological:
While the connection between acne and stress has been debated, research indicates that increased acne severity is associated with high stress levels.

Acne excorie is a type of acne in which a person picks and scratches pimples due to stress.

Diagnosis:
There are multiple scales for grading the severity of acne vulgaris, three of these being:

*Leeds acne grading technique: Counts and categorizes lesions into inflammatory and non-inflammatory (ranges from 0–10.0).
*Cook’s acne grading scale: Uses photographs to grade severity from 0 to 8 (0 being the least severe and 8 being the most severe).
*Pillsbury scale: Simply classifies the severity of the acne from 1 (least severe) to 4 (most severe).

Differential diagnosis:
Similar conditions include rosacea, folliculitis, keratosis pilaris, perioral dermatitis, and angiofibromas among others. Age is one factor that may help a physician distinguish between these disorders. Skin disorders such as perioral dermatitis and keratosis pilaris can mimic acne but tend to occur more frequently in childhood whereas rosacea tends to occur more frequently in older adults. Facial redness triggered by heat or the consumption of alcohol or spicy food is suggestive of rosacea. The presence of comedones can also help health professionals differentiate acne from skin disorders that are similar in appearance

Treatment:
Many different treatments exist for acne including benzoyl peroxide, antibiotics, retinoids, antiseborrheic medications, anti-androgen medications, hormonal treatments, salicylic acid, alpha hydroxy acid, azelaic acid, nicotinamide, and keratolytic soaps. They are believed to work in at least four different ways, including the following: normalizing skin cell shedding and sebum production into the pore to prevent blockage, killing P. acnes, anti-inflammatory effects, and hormonal manipulation.

Commonly used medical treatments include topical therapies such as retinoids, antibiotics, and benzoyl peroxide and systemic therapies including oral retinoids, antibiotics, and hormonal agents. Procedures such as light therapy and laser therapy are not considered to be first-line treatments and typically have an adjunctive role due to their high cost and limited evidence of efficacy
Over-the-counter medications:
Common over-the-counter medications for pimples are benzoyl peroxide and/or salicylic acid and antibacterial agents such as triclosan. Both medications can be found in many creams and gels used to treat acne (acne vulgaris) through topical application. Both medications help skin slough off more easily, which helps to remove bacteria faster. Before applying them the patient needs to wash his or her face with warm water and dry. A cleanser may also be used for that purpose. Acne rosacea is not caused by bacterial infection. It is commonly treated with tretinoin. A regimen of keeping the affected skin area clean plus the regular application of these topical medications is usually enough to keep acne under control, if not at bay altogether. The most common product is a topical treatment of benzoyl peroxide, which has minimal risk apart from minor skin irritation that may present similar as a mild allergy. Recently nicotinamide, applied topically, has been shown to be more effective in treatment of pimples than antibiotics such as clindamycin. Nicotinamide (vitamin B3) is not an antibiotic and has no side-effects typically associated with antibiotics. It has the added advantage of reducing skin hyperpigmentation which results in pimple scars.

Prescription medication:
Severe acne usually indicates the necessity of prescription medication to treat the pimples. Prescription medications used to treat acne and pimples include isotretinoin, which is a retinoid. Historically, antibiotics such as tetracyclines and erythromycin were prescribed. While they were more effective than topical applications of benzoyl peroxide, the bacteria eventually grew resistant to the antibiotics and the treatments became less and less effective. Also, antibiotics had more side effects than topical applications, such as stomach cramps and severe discoloration of teeth. Common antibiotics prescribed by dermatologists include doxycycline and minocycline.  For more severe cases of acne dermatologists might recommend accutane, a retinoid that is the most potent of acne treatments. However, accutane can cause various side effects including vomiting, diarrhea, and birth defects (women).

Hygiene:
Practicing good hygiene, including regularly washing skin areas with neutral cleansers, can reduce the amount of dead skin cells and other external contaminants on the skin that can contribute to the development of pimples. However, it is not always possible to completely prevent pimples, even with good hygiene practices.

Alternative medicine:
Numerous natural products have been investigated for treating people with acne. Low-quality evidence suggests topical application of tea tree oil or bee venom may reduce the total number of skin lesions in those with acne. There is a lack of high-quality evidence for the use of acupuncture, medicine, and cupping therapy for acne.

Perfectly balanced hormones give a person a pimple-free face. One could try to correct internal hormonal levels by exercising aerobically (jog, swim, run, cycle) for 40 minutes a day, preferably in the fresh air. This needs to be balanced with 20 minutes of stretching and yoga with pranayama.

Prognosis:
Acne usually improves around the age of 20 but may persist into adulthood. Permanent physical scarring may occur. There is good evidence to support the idea that acne has a negative psychological impact and worsens mood, lowers self-esteem, and is associated with a higher risk of anxiety, depression, and suicidal thoughts.

Research:
In 2007, the first genome sequencing of a P. acnes bacteriophage (PA6) was reported. The authors proposed applying this research toward development of bacteriophage therapy as an acne treatment in order to overcome the problems associated with long-term antibiotic therapy, such as bacterial resistance.

A vaccine against inflammatory acne has been tested successfully in mice, but has not yet been proven to be effective in humans. Other workers have voiced concerns related to creating a vaccine designed to neutralize a stable community of normal skin bacteria that is known to protect the skin from colonization by more harmful microorganisms.

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

Resources:
https://en.wikipedia.org/wiki/Acne_vulgaris#Management

Acne


https://en.wikipedia.org/wiki/Pimple
http://www.telegraphindia.com/1150810/jsp/knowhow/story_36267.jsp

Leprosy

Other name :  Hansen’s disease

Description:
Leprosy is a chronic infection caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Initially, infections are without symptoms and typically remain this way for 5 to as long as 20 years. Symptoms that develop include granulomas of the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain and thus loss of parts of extremities due to repeated injuries. Weakness and poor eyesight may also be present.

Leprosy is spread between people. This is believed to occur through a cough or contact with fluid from the nose of an infected person. Leprosy occurs more commonly among those living in poverty and is believed to be transmitted by respiratory droplets. It is not very contagious. The two main types of disease are based on the number of bacteria present: paucibacillary and multibacillary. The two types are differentiated by the number of poorly pigmented, numb skin patches present, with paucibacillary having five or fewer and multibacillary having more than five. The diagnosis is confirmed by finding acid-fast bacilli in a biopsy of the skin or via detecting the DNA by polymerase chain reaction.

Leprosy is curable with treatment.  Treatment for paucibacillary leprosy is with the medications dapsone and rifampicin for 6 months.Treatment for multibacillary leprosy consists of rifampicin, dapsone, and clofazimine for 12 months.  These treatments are provided for free by the World Health Organization.  A number of other antibiotics may also be used.  Globally in 2012, the number of chronic cases of leprosy was 189,000 and the number of new cases was 230,000.  The number of chronic cases has decreased from some 5.2 million in the 1980s.  Most new cases occur in 16 countries, with India accounting for more than half.  In the past 20 years, 16 million people worldwide have been cured of leprosy.  About 200 cases are reported per year in the United States.

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Leprosy has affected humanity for thousands of years.  The disease takes its name from the Latin word lepra, which means “scaly”, while the term “Hansen’s disease” is named after the physician Gerhard Armauer Hansen.  Separating people by placing them in leper colonies still occurs in places such as India,  China,   and Africa.   However, most colonies have closed since leprosy is not very contagious.   Leprosy has been associated with social stigma for much of history, which is a barrier to self-reporting and early treatment.  The word “leper” is considered insulting with the term leprosy being preferred.   World Leprosy Day was started in 1954 to draw awareness to those affected by leprosy.

Forms of Leprosy:
Leprosy may also be divided into the following forms:

*Early and indeterminate leprosy
*Tuberculoid leprosy
*Borderline tuberculoid leprosy
*Borderline leprosy
*Borderline lepromatous leprosy
*Lepromatous leprosy
*Histoid leprosy
*Diffuse leprosy of Lucio and Latapí
This disease may also occur with only neural involvement, without skin lesions

Symptoms:
Leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions (light or dark patches) are the primary external sign. It first affects the skin and the nerves outside the brain and spinal cord, called the peripheral nerves. It may also strike the eyes and the thin tissue lining the inside of the nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored.

Nerve damage can lead to:
*Loss of feeling in the arms and legs
*Muscle weakness

It usually takes about 3 to 5 years for symptoms to appear after coming into contact with the leprosy-causing bacteria. Some people do not develop symptoms until 20 years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy got infected.

If untreated, leprosy can progress and cause permanent damage to the skin, nerves, limbs, and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body’s defenses being compromised by the primary disease.  Secondary infections, in turn, can result in tissue loss.
How the infection produces the symptoms of the disease is not known.

Causes:
Leprosy is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.
M. leprae and M. lepromatosis are the causative agents of leprosy. M. lepromatosis is a relatively newly identified mycobacterium isolated from a fatal case of diffuse lepromatous leprosy in 2008.

An intracellular, acid-fast bacterium, M. leprae is aerobic and rod-shaped, and is surrounded by the waxy cell membrane coating characteristic of the Mycobacterium genus.

Due to extensive loss of genes necessary for independent growth, M. leprae and M. lepromatosis are obligate intracellular pathogens, and unculturable in the laboratory, a factor that leads to difficulty in definitively identifying the organism under a strict interpretation of Koch’s postulates. The use of nonculture-based techniques such as molecular genetics has allowed for alternative establishment of causation.

While the causative organisms have to date been impossible to culture in vitro, it has been possible to grow them in animals such as mice and armadillos.

Naturally occurring infection also has been reported in nonhuman primates, including the African chimpanzee, sooty mangabey, and cynomolgus macaque, as well as in armadillos and red squirrels.

Risk factors:
At highest risk are those living in areas with polluted water and poor diet or people suffering from diseases that compromise immune function. There appears to be little interaction between HIV and the risk of leprosy. Genetic predisposition appears to play a role in susceptibility.

Transmission:
Transmission of leprosy occurs during close contact with those who are infected.  Transmission is believed to be by nasal droplets.

Leprosy is not known to be either sexually transmitted or highly infectious. People are no longer infectious after as little as two weeks of treatment.

Leprosy may also be transmitted to humans by armadillos  and may be present in three species of non-human primates.

Two exit routes of M. leprae from the human body often described are the skin and the nasal mucosa, although their relative importance is not  very clear. Lepromatous cases show large numbers of organisms deep in the dermis, but whether they reach the skin surface in sufficient numbers is doubtful.

The skin and the upper respiratory tract are most likely entry route. While older research dealt with the skin route, recent research has increasingly favored the respiratory route. Experimental transmission of leprosy through aerosols containing M. leprae in immune-suppressed mice was accomplished, suggesting a similar possibility in humans

Diagnosis:
Endemic areas:
Per the World Health Organization, diagnosis in an endemic area is based on one of these cardinal signs:

*Skin lesion consistent with leprosy and with definite sensory loss
*Positive skin smears
*Skin lesions can be single or multiple, usually hypopigmented, although occasionally reddish or copper-colored. The lesions may be macules (flat), papules (raised), or nodular. Sensory loss at the skin lesion is important because this feature can help differentiate from other causes of skin lesions such as tinea versicolor.

*Thickened nerves are associated with leprosy and can be accompanied by loss of sensation or muscle weakness. However, without the characteristic skin lesion and sensory loss, muscle weakness is not considered a reliable sign of leprosy.

*Positive skin smears: In some case, acid-fast leprosy bacilli are considered diagnostic; however, the diagnosis is clinical.

Treatment:
A number of leprostatic agents are available for treatment. For paucibacillary (PB or tuberculoid) cases, treatment with daily dapsone and monthly rifampicin for six months is recommended. While for multibacillary (MB or lepromatous) cases, treatment with daily dapsone and clofazimine along with monthly rifampicin for twelve months is recommended.

Multidrug therapy (MDT) remains highly effective, and people are no longer infectious after the first monthly dose.  It is safe and easy to use under field conditions due to its presentation in calendar blister packs.  Relapse rates remain low, and no resistance to the combined drugs is seen.

Prevention:
Early detection of the disease is important, since physical and neurological damage maybe irreversible even if cured. Medications can decrease the risk of those living with people with leprosy from acquiring the disease and likely those with whom people with leprosy come into contact outside the home. However, concerns are known of resistance, cost, and disclosure of a person’s infection status when doing follow-up of contacts. Therefore, the WHO recommends that people who live in the same household be examined for leprosy and only be treated if symptoms are present.

The Bacillus Calmette–Guérin (BCG) vaccine offers a variable amount of protection against leprosy in addition to tuberculosis. It appears to be 26 to 41% effective (based on controlled trials) and about 60% effective based on observational studies with two doses possibly working better than one.  Development of a more effective vaccine is ongoing as of 2011

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/Leprosy
http://www.webmd.com/skin-problems-and-treatments/guide/leprosy-symptoms-treatments-history#1