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Buerger’s Disease

Alternative Nane:Thromboangiitis obliterans

Definition:
Buerger’s disease is a rare disease of the arteries and veins in the arms and legs.In this disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger’s disease usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs.

CLICK & SEE THE PICTURES

Buerger’s disease is rare in the United States, but is more common in the Middle East and Far East. Buerger’s disease usually affects men younger than 40 years of age, though it’s becoming more common in women.

Virtually everyone diagnosed with Buerger’s disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger’s disease. For those who don’t quit, amputation of all or part of a limb may be necess

Symptoms:
The following are the symptoms of Buerger’s:
•Intermittent leg pains
•Leg numbness
•Leg tingling
•Leg burning
•Leg paresthesias
•Foot pains
•Leg pain worse with exertion
•Foot pain worse with exertion
•Foot paresthesias
•Foot numbness
•Foot tingling
•Foot burning
•Cold feet
•Foot discoloration
•Poor leg circulation
•Poor hand circulation – in some less common cases
•Severe pain in extremities at rest
•Insomnia
•Sensation of cold at extremities
•Cold hypersensibility
•Sudden sweating
•Dyshidrosis
•Ulceration of extremities
•Gangrene of extremities
•Blood vessel inflammation
•Blood vessel thrombosis
•Rest pain
•Unremitting ischemic ulcerations
•Gangrene of the digits of hands and feet

The lack of sufficient blood flow to the hands and feet leads to the development of tissue ischemia and sores or lesions. This can eventually lead to the death (necrosis) of affected tissues and gangrene, which may require removal of the dead tissues or amputation in the most severe cases.

Buerger’s disease can mimic or occur in conjunction with a condition called Raynaud’s phenomenon. Symptoms of Raynaud’s phenomenon include a change in color of the affected fingers and toes. The fingers and toes may appear pale, grey or bluish (cyanosis). The hands and feet may feel very cold and there may also be pain, throbbing, burning or numbness….more about Buerger’s disease »

Causes:
The precise cause of Buerger’s disease is unknown.
It’s believed that in genetically susceptible individuals, smoking triggers an autoimmune response that causes the inflammation. The symptoms occur as a result of inadequate blood supply to the tissues.

Diagnosis:
Patient history and physical examination strongly suggest Buerger’s disease.
The condition is characterized by swelling in the arteries and veins of the arms and legs. The cells that cause the inflammation and swelling — and eventually blood clots — form in the vessels leading to your hands and feet and block the blood flow to those parts of your body.

Reduced blood flow means that the skin tissue in your hands and feet doesn’t get adequate oxygen and nutrients. This leads to the signs and symptoms of Buerger’s disease, beginning with pain and weakness in your fingers and toes and spreading to other parts of your arms and legs.

While no tests can confirm whether you have Buerger’s disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger’s disease brought on by your signs and symptoms.

Tests may include:

Blood tests
Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out scleroderma, lupus, blood-clotting disorders and diabetes, along with other diseases and conditions.

The Allen’s test
Your doctor may perform a simple test called the Allen’s test to check blood flow through the arteries carrying blood to your hands. In the Allen’s test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color. Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger’s disease.

Angiogram
An angiogram, also called an arteriogram, helps doctors see the condition of your arteries. A special dye is injected into an artery, after which you undergo

X-rays or other imaging tests. The dye helps to delineate any artery blockages that show up on the images. Your doctor may order angiograms of both your arms and your legs — even if you don’t have signs and symptoms of Buerger’s disease in all of your limbs. Buerger’s disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.

* Doppler ultrasonography to show diminished circulation in the peripheral vessels

* plethysmography to help detect decreased circulation in the peripheral vessels

Risk Factors:

Tobacco use
Cigarette smoking greatly increases your risk of Buerger’s disease. Heavy cigarette smokers (people who smoke one and a half packs a day or more) are most likely to develop Buerger’s disease, though it can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger’s disease.

It isn’t clear how tobacco use increases your risk of Buerger’s disease, but virtually everyone diagnosed with Buerger’s disease uses tobacco. It’s thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. Rates of Buerger’s disease are highest in areas of the Middle

East and Far East where heavy smoking is most common.

Although secondhand smoke isn’t thought to be a major risk factor for Buerger’s disease, if you’re diagnosed, you should stay away from people who are

Smoking. Secondhand smoke could worsen your condition.

Chronic gum disease :Long-term infection of the gums is also associated with the development of Buerger’s disease.

Treatment:
The only effective treatment for Buerger’s disease is to quit smoking (smoking cessation) and to abstain from the use of all tobacco products, such as chewing tobacco. At this time, there are no medications that are effective in treating Buerger’s disease.

If an affected individual continues to smoke, they’re likely to have toes and/or fingers amputated. Infections should be treated promptly.

Smoking cessation is a challenging process and requires a multifaceted approach to be successful. For optimal results with smoking cessation, it is recommended that a smoker consults with a health care provider prior to quitting. Smoking cessation can include a combination of nicotine replacement therapy to minimize the nicotine cravings associated with nicotine withdrawal, and participation in a smoking cessation support group, such as Freedom From Smoking (http://www.ffsonline.org/ ) or Nicotine Anonymous (http://www.nicotine-anonymous.org).

Lifestyle & Home Remedies:
Take care of your fingers and toes if you have Buerger’s disease. Check the skin on your arms and legs daily for cuts and scrapes, keeping in mind that if you’ve lost feeling to a finger or toe you may not feel, for example, a cut when it happens. Keep your fingers and toes protected and avoid exposing them to cold.

Low blood flow to your extremities means your body can’t resist infection as easily. Small cuts and scrapes can easily turn into serious infections. Clean any cut with water, apply antibiotic ointment and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they’re healing. If they get worse or heal slowly, see your doctor promptly.

Visit your dentist regularly to keep your gums and teeth in good health and avoid gum disease, which in its chronic form is associated with Buerger’s disease.
Prognosis: The disease is progressive in patients who do not stop smoking. Areas with gangrene must be removed surgically.

Prevention:
Quit using tobacco in any form
Virtually everyone who has Buerger’s disease has used tobacco in some form, most prominently cigarettes. To prevent Buerger’s disease, it’s important to not use tobacco.

Quitting smoking can be hard. If you’re like most people who smoke, you’ve probably tried to quit in the past, but haven’t been successful. It’s never too late to try again. Talk to your doctor about strategies to help you quit.

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

Resources:
http://www.wrongdiagnosis.com/b/buergers_disease/intro.htm
http://edition.cnn.com/HEALTH/library/buergers-disease/DS00807.html
http://www.mayoclinic.com/health/buergers-disease/DS00807
http://www.bbc.co.uk/health/physical_health/conditions/buergher1.shtml

Buerger’s Disease

http://modernmedicalguide.com/buergers-disease/

http://indiahealthtour.com/treatments/vascular/buerger-disease-thromboangiitis-obliterans-treatment-india.html

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Healthy Tips News on Health & Science

Lower Your BP, Live Longer

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In western countries, the number of people affected by high blood pressure (BP) or hypertension is decreasing. In India, however, the figure is creeping up, albeit marginally (2-3 per cent). This is worrying because, untreated, hypertension may result in complications like a heart attack, heart or kidney failure, tearing of the blood vessels and loss of vision. It can also cause subtle loss of memory and the ability to think clearly.
…....click & see
BP indicates the force with which the heart pumps blood against the blood vessel. It has two values — an upper or systolic and a lower or diastolic. Values of 120/80 are normal, while 139/89 indicates pre-hypertension and 140/90 or above hypertension. With age, the blood vessels tend to harden, decreasing their pliability. This causes a peculiar type of hypertension where only the upper value is high. About 70 per cent of the population over the age of 60 has this type of systolic hypertension. BP should be measured every two years after the age of 20 and yearly after 40.

Normal BP:->..
The risk of hypertension increases with age, obesity, a family history of high BP, kidney diseases, diabetes, endocrine diseases, smoking, alcohol consumption, medications like corticosteroids, birth control pills or those for losing weight. Narrow abnormally placed blood vessels present from birth can also lead to high BP. If no cause can be detected, it’s called “essential hypertension” and requires medication to prevent complications. Even isolated systolic hypertension requires treatment.

BP is linked to salt intake. A high salt intake results in elevated BP. The effect is even more pronounced in people (around 20 per cent of the population) who are “salt sensitive”.

The recommended salt intake for a normal person is 5gm or 1 teaspoon a day. But the “hidden salt” must also be considered. All food and even drinking water contains varying amounts of natural salt. Sodium (a component of salt) is added to food products in the form of monosodium glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate) or sodium benzoate. These are ingredients in condiments and seasonings like tomato sauce, soy sauce and pickles. Processed meats such as bacon, sausage and ham, and fast foods like burgers and pizzas are high in sodium content.

Medications belonging to groups such as diuretics, alpha blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers and rennin inhibitors are available to control blood pressure. The pharmaceutical industry also introduces “new and improved” drugs in the market with monotonous regularity. Control remains unsatisfactory in many patients who are then dosed with two or more anti hypertensives. The older, long-acting diuretics, surprisingly, remain one of the most effective medications, either as an adjuvant to existing medicine or alone.

Better control of BP with lower doses of medication can often be achieved if the person is willing to make certain lifestyle changes. Weight needs to be ideal. As weight increases, so does the pressure on your artery walls. To calculate your ideal body weight, multiply your height in meter squared by 23.

Inactive people have a faster heart rate, forcing the heart to work harder for longer periods of time. Aerobic exercise like walking, jogging, swimming or running needs to be done daily. It should be started at the age of around six with 20 minutes of running. Gradually this should be increased to an hour by the age of 18 years.

Smoking (even second-hand smoke), using snuff or chewing tobacco releases chemicals into the body which damage the blood vessels, making them narrow and thus increasing the BP.

Salt makes the body retain fluid, which in turn increases the BP. Limit your intake to 5gm a day. Sodium can be balanced by potassium found in fresh fruits and vegetables. Eat four to six helpings of this a day.

Vitamin D obtained through the diet and by exposure to sunlight affects the levels of a BP-regulating enzyme in the kidneys. Inadequate levels can indirectly elevate the BP.

Heavy drinking can cause permanent heart damage. Even two or three drinks in a single sitting can cause the release of chemicals that temporarily elevate the BP.

Stress can elevate the BP. It needs to tackled with meditation and yoga. Chronic diseases like diabetes, high cholesterol, kidney disease and sleep apnoea need to be controlled as they contribute to the risk of high BP.

Children too are at risk from as early as six or eight years if they are obese, inactive and eat high sodium snacks. These lifestyle changes, therefore, need to be initiated from a young age.

You may click to see :10 Ways to Lower Your Blood Pressure Without Medication

Source: The Telegraph (Kolkata, India)

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Ailmemts & Remedies

Behçet’s Disease

Definition:
Behcet’s disease is a rare, chronic disorder involving inflammation of blood vessels throughout the body. It is marked by recurrent oral and genital ulcers and eye inflammation.It is  an autoimmune response where the immune system turns on the body, causes inflammation of parts of the body. In particular, small blood vessels around the body become inflamed, a condition known as vasculitis.

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The cause of Behcet’s remains unknown, but it’s often preceded by a viral infection, for example, which may trigger the autoimmune process, causing the body to attack its own blood vessels and making them inflamed. Experts in the field of Behcet’s research agree the causes may be genetic.

Life for people with Behcet’s is made more difficult because of misunderstandings about the illness. With the appearance of ulcers on the mouth and genitals, it’s often incorrectly assumed the condition is infectious and sexually transmitted – it’s not either of these.

You may click to see more pictures  of Bechcet’s disesse

The disease was first described in 1937 by Dr. Hulusi Behçet, a dermatologist in Turkey. Behçet’s disease is now recognized as a chronic condition that causes canker sores or ulcers in the mouth and on the genitals, and inflammation in parts of the eye. In some people, the disease also results in arthritis (swollen, painful, stiff joints), skin problems, and inflammation of the digestive tract, brain, and spinal cord.

Sign & Symptoms;
Integumentary system (Skin and mucosa):
Nearly all patients present with some form of painful oral mucocutaneous ulcerations in form of aphthous ulcers or non-scarring oral lesions. The oral lesions are similar to those found in inflammatory bowel disease and can be relapsing. Painful genital ulcerations usually develop on the vulva and the scrotum and cause scarring in 75% of the patients. Additionally, patients may present with erythema nodosum, cutaneous pustular vasculitis, and lesions similar to pyoderma gangrenosum.

Ocular system (eyes):…..
Inflammatory eye disease can develop early in the disease course and lead to permanent vision loss in 20% of the cases.  Ocular involvement can be in form of posterior uveitis, anterior uveitis, or retinal vasculitis. Anterior uveitis presents with painful eyes, conjuctival redness, hypopyon, and decreased visual acuity, while posterior uveitis presents with painless decreased visual acuity and visual field floaters. A rare form of ocular (eye) involvement in this syndrome is retinal vasculitis which presents with painless decrease of vision with possibility of floaters or visual field defects.

Gastrointestinal tract (bowels)
GI manifestations include abdominal pain, nausea, diarrhea with or without blood and often involves the ileocecal valve.

Pulmonary (lungs)
Lung involvement is typically in form of hemoptysis, pleuritis, cough, fever, and in severe cases can be life threatening if the outlet pulmonary artery develops an aneurysm which ruptures causing severe vascular collapse and death from bleeding in the lungs.

Musculoskeletal system (muscle, joint)
Arthralgia is seen in up to half of patients, and is usually a non-erosive poly or oligoarthritis of primarily the large joints of the lower extremities.

Neurological system:
Neurological involvements range from aseptic meningitis, to vascular thrombosis such as dural sinus thrombosis and or organic brain syndrome manifesting with confusion, seizures, and memory loss. They oftern appear late in the progression of the disease but are associated with a poor prognosis.

Causes:
The exact cause of Behçet’s disease is unknown. Most symptoms of the disease are caused by inflammation of the blood vessels. Inflammation is a characteristic reaction of the body to injury or disease and is marked by four signs: swelling, redness, heat, and pain. Doctors think that an autoinflammatory reaction may cause the blood vessels to become inflamed, but they do not know what triggers this reaction. Under normal conditions, the immune system protects the body from diseases and infections by killing harmful “foreign” substances, such as germs, that enter the body. In an autoimmune reaction, the immune system mistakenly attacks and harms the body’s own tissues.

Behçet’s disease is not contagious; it is not spread from one person to another. Researchers think that two factors are important for a person to get Behçet’s disease. First, it is believed that abnormalities of the immune system make some people susceptible to the disease. Scientists think that this susceptibility may be inherited; that is, it may be due to one or more specific genes. Second, something in the environment, possibly a bacterium or virus, might trigger or activate the disease in susceptible people.

Diagnosis:
There is no specific pathological testing or technique available for the diagnosis of the disease, although the International Study Group criteria for the disease are highly sensitive and specific, involving clinical criteria and a pathergy test.[2][3] Behçet’s disease has a high degree of resemblance to diseases that cause mucocutaneous lesions such as Herpes simplex labialis, and therefore clinical suspicion should be maintained until all the common causes of oral lesions are ruled out from the differential diagnosis.

International Study Group diagnostic guidelines:

According to the International Study Group guidelines, for a patient to be diagnosed with Behçet’s disease,[3] the patient must have oral (aphthous) ulcers (any shape, size or number at least 3 times in any 12 months period)along with 2 out of the next 4 “hallmark” symptoms:

*genital ulcers (including anal ulcers and spots in the genital region and swollen testicles or epididymitis in men)
*skin lesions (papulo-pustules, folliculitis, erythema nodosum, acne in post-adolescents not on corticosteroids)
*eye inflammation (iritis, uveitis, retinal vasculitis, cells in the vitreous)
*pathergy reaction (papule >2 mm dia. 24-48 hrs or more after needle-prick). The pathery test has a specificity of 95% to 100%, but the results are often negative in American and European patients

Despite the inclusive criteria set forth by the International Study Group, there are cases where not all the criteria can be met and therefore a diagnosis can not readily be made. There is however a set of clinical findings that a physician can rely upon in making a tenative diagnosis of the disease; essentially Behçet’s disease does not always follow the International Study Group guidelines and so a high degree of suspicion for a patient who presents having any number of the following findings, is necessary:

*mouth ulcers
*arthritis/arthralgia
*nervous system symptoms
*stomach and/or bowel inflammation
*deep vein thrombosis
*superficial thrombophlebitis
*cardio-vascular problems of an inflammatory origin
*inflammatory problems in chest and lungs
*problems with hearing and/or balance
*extreme exhaustion
*changes of personality, psychoses
*any other members of the family with a diagnosis of Behçet disease.

Pathogenesis:
The etiology is not well-defined, but it is primarily characterized by auto-inflammation of the blood vessels. Although sometimes erroneously referred to as a “diagnosis of exclusion,” the diagnosis can sometimes be reached by pathologic examination of the affected areas.

The primary mechanism of the damage is an overactive immune system that seems to target the patient’s own body. The primary cause is not well known. In fact, as of now, no one knows why the immune system starts to behave this way in Behçet’s disease. There does however seem to be a genetic component involved as first degree relatives of the affected patients are often affected in more than expected proportion for the general population.

Treatment:
There’s no cure for Behcet’s yet, but research continues and treatment is available to keep inflammation and symptoms at bay.

Current treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system. High dose Corticosteroid therapy (1 mg/kg/d oral prednisone) is indicated for severe disease manifestations. Anti-TNF therapy such as infliximab has shown promise in treating the uveitis associated with the disease. Another Anti-TNF agent, Etanercept, may be useful in patients with mainly skin and mucosal symptoms.

Interferon alfa-2a may also be an effective alternative treatment, particularly for the genital and oral ulcers as well as ocular lesions. Azathioprine, when used in combination with interferon alfa-2b also shows promise, and Colchicine can be useful for treating some genital ulcers, erythema nodosum, and arthritis.

Thalidomide has also been used due to its immune-modifying effect. Dapsone and rebamipide have been shown, in small studies, to have beneficial results for mucocutaneous lesions.

Rest and Exercise:
Although rest is important during flares, doctors usually recommend moderate exercise, such as swimming or walking, when the symptoms have improved or disappeared. Exercise can help people with Behçet’s disease keep their joints strong and flexible.

Pathophysiology
HLA-B51 is strongly associated with Behçet’s disease Behçet disease is considered more prevalent in the areas surrounding the old silk trading routes in the Middle East and in Central Asia. Thus, it is sometimes known as Silk Road Disease. However, this disease is not restricted to people from these regions. A large number of serological studies show a linkage between the disease and HLA-B51. HLA-B51 is more frequently found from the Middle East to South Eastern Siberia, but the incidence of B51 in some studies was 3 fold higher than the normal population. However, B51 tends not to be found in disease when a certain SUMO4 gene variant is involved, and symptoms appear to be milder when HLA-B27 is present. At the current time, a similar infectious origin has not yet been confirmed that leads to Behçet’s disease, but certain strains of Streptococcus sanguinis has been found to have a homologous antigenicity.

Prognosis:
Most people with Behçet’s disease can lead productive lives and control symptoms with proper medicine, rest, and exercise. Doctors can use many medicines to relieve pain, treat symptoms, and prevent complications. When treatment is effective, flares usually become less frequent. Many patients eventually enter a period of remission (a disappearance of symptoms). In some people, treatment does not relieve symptoms, and gradually more serious symptoms such as eye disease may occur. Serious symptoms may appear months or years after the first signs of Behçet’s disease.

Risk Factors
A risk factor is something that increases your chances of getting a disease or condition. Although the exact cause of Behcet’s disease is unknown, some groups of people are more likely to develop the condition than others. Risk factors include:

*Location: the Middle East, Asia, and Japan
*Sex:
*In the US, men are more likely than women to develop this condition.
*In the Middle East, Asia, and Japan, women are more likely than men to develop Behcet’s.
*Age: 20s and 30s

Researches:
Researchers are exploring possible genetic, bacterial, and viral causes of Behçet’s disease as well as improved drug treatment. For example, genetic studies show strong association of the gene HLA-B51 with the disease, but the exact role of this gene in the development of Behçet’s is uncertain. Researchers hope to identify genes that increase a person’s risk for developing Behçet’s disease. Studies of these genes and how they work may provide new understanding of the disease and possibly new treatments.

Researchers are also investigating factors in the environment, such as bacteria or viruses, that may trigger Behçet’s disease. They are particularly interested in whether Streptococcus, the bacterium that causes strep throat, is associated with Behçet’s disease. Many people with Behçet’s disease have had several strep infections. In addition, researchers suspect that herpesvirus type 1, a virus that causes cold sores, may be associated with Behçet’s disease.

Finally, researchers are identifying other medicines to better treat Behçet’s disease. TNF inhibitors are a class of drugs that reduce joint inflammation by blocking the action of a substance called tumor necrosis factor (TNF). Although serious side effects have been reported for TNF inhibitors, they have shown some promise in treating Behçet’s disease. Examples of TNF inhibitors include etanercept and infliximab. TNF inhibitors belong to a family of drugs called biologics, which target the immune response. Also, interferon alpha, a protein that helps fight infection, has shown promise in treating Behçet’s disease. Thalidomide, which is believed to be a TNF inhibitor, appears effective in treating severe mouth sores, but its use is experimental and side effects are a concern. Thalidomide is not used to treat women of childbearing age because it causes severe birth defects.

Where Can People Get More Information About Behçet’s Disease?

•National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
National Institutes of Health

1 AMS Circle
Bethesda,  MD 20892-3675
Phone: 301-495-4484
Toll Free: 877-22-NIAMS (226-4267)
TTY: 301-565-2966
Fax: 301-718-6366
Email: NIAMSinfo@mail.nih.gov
Website: http://www.niams.nih.gov

•National Institute of Dental and Craniofacial Research (NIDCR)
National Institutes of Health
45 Center Drive, MSC 6400
Building 45, Room 4AS-25
Bethesda,  MD 20892-2510
Phone: 301-496-4261
Email: nidcrinfo@mail.nih.gov
Website: http://www.nidcr.nih.gov

•National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Institutes of Health
1 Information Way
Bethesda,  MD 20892-3560
Toll Free: 800-860-8747
TTY: 866-569-1162
Fax: 703-738-4929
Email: ndic@info.niddk.nih.gov
Website: http://www.niddk.nih.gov

•National Eye Institute (NEI)
National Institutes of Health
31 Center Drive MSC 2510
Bethesda,  MD 20892-2510
Phone: 301-496-5248
Email: 2020@nei.nih.gov
Website: http://www.nei.nih.gov

•National Institute of Neurological Disorders and Stroke (NINDS)
NIH Neurological Institute
P.O. Box 5801
Bethesda,  MD 20824
Phone: 301–496–5751
Toll Free: 800–352–9424
TTY: 301–468–5981
Website: http://www.ninds.nih.gov

•American Academy of Dermatology (AAD)
P.O. Box 4014
Schaumberg,  IL 60618-4014
Phone: 847-330-0230
Toll Free: 866-503-SKIN (7546)
Fax: 847-240-1859
Website: http://www.aad.org

•American College of Rheumatology (ACR)
2200 Lake Boulevard NE
Atlanta,  GA 30319
Phone: 404-633-3777
Fax: 404-633-1870
Website: http://www.rheumatology.org

•Dermatology Foundation
1560 Sherman Avenue, Suite 870
Evanston,  IL 60201-4808
Phone: 847-328-2256
Fax: 847-328-0509
Email: dfgen@dermatologyfoundation.org
Website: http://www.dermfnd.org

(This organization is “research only.” Contact should be made by U.S. mail or e-mail.)
•American Behçet’s Disease Association
P.O. Box 869
Smithtown,  NY 11787-0869
Phone: 631-656-0537
Toll Free: 800-7-BEHCET (723-4238)
Fax: 480-247-5377
Website: http://www.behcets.com

•American Skin Association (ASA)
346 Park Avenue S., 4th floor
New York,  NY 10010
Phone: 212-889-4858
Toll Free: 800-499-SKIN
Website: http://www.americanskin.org

•Arthritis Foundation
P.O. Box 7669
Atlanta,  GA 30357-0669
Phone: 404-872-7100
Toll Free: 800-283-7800
Website: http://www.arthritis.org

•National Organization For Rare Disorders (NORD)
55 Kenosia Avenue, P.O. Box 1968
Danbury,  CT 06813-1968
Phone: 203-744-0100
Toll Free: 800-999-6673
TTY: 203-797-9590
Fax: 203-798-2291
Email: orphan@rarediseases.org
Website: http://www.rarediseases.org

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

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/behcets1.shtml
http://www.niams.nih.gov/Health_Info/Behcets_Disease/default.asp#beh_i
http://en.wikipedia.org/wiki/Beh%C3%A7et’s_disease
http://www.lifescript.com/Health/A-Z/Conditions_A-Z/Conditions/B/Behcets_disease.aspx?gclid=CNSczv6IkqcCFcZw5Qodbmg-cw&trans=1&du=1&ef_id=5jhNXmWk-CMAAMAQ:20110218155657:s

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Yoga

Yoga Is The Best Medicine For Heart Patients

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Heart attack is a condition where a blood clot in the coronary artery blocks the flow of blood to the heart. Consequently, some tissues die due to lack of oxygen. Once dead, these tissues are lost forever as unlike the other body tissues, heart tissues do not regenerate. Though the heart remains crippled and needs medication for life, the remaining tissues should be strengthened to prevent further problems and yoga is the best means to achieve that. Pawanmuktasana series and uthitpadasanaare excellent for the health of the heart.

.click to see the picture

Pawanmuktasana, with its mild stretching and flexible movements, maintains the elasticity of the blood vessels, making the heart’s job of pushing blood into them easier, while uthanapadasanabrings more blood to the organ and makes its tissues healthier. This asana can be done even during the recovery period after a heart attack. Though no prop is required for utthitpadasana, for heart patients, it is necessary to take a support so as not to strain the heart in any way. It is a simple position where lying on the back, the feet are placed on a six inch high platform such as a rolled blanket. To further enhance the effect and hasten the recovery, the following meditative technique should be practiced.

Lie down in shavasana–legs apart, hands little away from the body.

Imagine you are breathing in from the left nostril and breathing out from the right one; and then breathing in from the right nostril, breathing out from the left.

When the rhythmic alternate breathing pattern is established, add the mantra sohamto your breath when you breathe in and hamwhen you breathe out.

Practice this for 20 to 30 minutes twice a day.

After a few days, when you are comfortable with the practice, maintain the ratio of 1:2 for inhalation and exhalation. Then the mantra will become: so – ham‘¦m‘¦m‘¦m. You can also practice this meditation for 2/3 minutes to maintain a relaxed state.

Source: Yoga.am

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Health Alert

Overcoming Oedema

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Swollen feet — medically called  oedema — can make life miserable. Shoes and slippers don’t fit — they are tight and uncomfortable and sometimes impossible to put on. The feet feel like dead weights, and walking becomes a Herculean task. It is much easier to simply sit. But inactivity makes the swelling worse, and the sufferer is caught in a vicious cycle of swelling-inactivity-more swelling.

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The fluid that accumulates and causes oedema leaks from tiny blood vessels called capillaries. This can occur as a result of increased pressure, damage to the vessels or a fall in the protein concentration of the blood. As soon as the body senses that the capillaries are leaking, compensatory mechanisms come into play and fluid is retained in the body by the kidney. The amount of fluid circulating in the body therefore increases. This, in turn, causes the capillaries to leak more. This fluid from the capillaries leaks into the surrounding tissue, causing the swelling. At least five litres of fluid need to be retained before actual swelling appears.

Feet swell before any other part of the body. This is because the hydrostatic pressure on the blood vessels of the lower limbs are, by virtue of gravity, one metre more than the pressure on the face. Also, when we sit and stand, our feet are at a lower level than the heart and this aggravates the problem.

To demonstrate oedema, press firmly with your forefinger and maintain the pressure for 10 seconds. A persistent dimple like depression indicates the presence of oedema.

However, swollen feet do not always indicate disease. Overweight individuals may develop some amount of swelling at the end of a stationery day. (Fat is fluid at body temperature). This can be normal. The swelling can extend up to the knees.

Salt also causes fluid retention. If you consume a lot of salty snacks and pickles, the kidney is not able to handle the sodium overload and fluid is retained.

Women are more prone to develop oedema than men. The female hormones oestrogen and progesterone cause fluid retention. Women tend to “swell up” during the pre-menstrual period, pregnancy and if they are on hormones, either as oral contraceptive pills or as part of hormone replacement therapy (HRT). This can extend to the hands, making finger rings tight. The face may also appear puffy. This type of oedema disappears spontaneously in a few days once menstruation occurs, the baby is born or the hormones discontinued.

Oedema can be a side effect of prescribed medication like nifedepine, amlodepin and other anti-hypertensives. Medicines for pain belonging to the non-steroidal anti-inflammatory drugs (NSAIDs) group can also cause fluid retention. Some like diclofenac may damage the kidneys. If you develop swelling while on medication, consult your doctor.

At times, oedema can be the first sign of a serious underlying medical condition. If the heart is unable to pump blood efficiently, blood can accumulate in the capillaries of the legs, ankles and feet, causing oedema.

The liver regulates the protein content of the blood. It is also responsible for adjusting the hormones and chemicals that regulate the fluid content of the body. The organ can become damaged as a result of alcoholism, hepatitis B infection or other diseases. This injury results in scar formation and is called cirrhosis. Fluid can then accumulate in the legs and abdomen. But two of the causal factors can be prevented — don’t drink excessively and take your hepatitis B immunisations.

Damaged kidneys cannot excrete excess fluid. The oedema then occurs typically around the legs and eyes. Kidney damage can occur for a variety of reasons. Preventable causes are uncontrolled, neglected diabetes and hypertension.

The veins in the leg may be damaged or weak. Sometimes the valves in these veins — which prevent back flow of blood — may be inefficient. Chronic venous insufficiency and varicose veins can result in swelling.

Excess fluid from tissues is cleared by the lymphatic system. These drain into lymph nodes and eventually into the large veins. Infections like filaria can damage the lymphatic system. The nodes can be infiltrated by cancerous deposits. The nodes may have been removed or damaged during surgery. All this can result in swelling. Usually this is present in any one limb and not symmetrically on both sides of the body.

Always keep in mind:-
• Oedema can be treated if the causal factor is removed

• Reduce weight if the BMI (body mass index or weight divided by height in metre squared ) is more than 23

• Walk, jog or swim for 40 minutes a day

• Try to move the legs every half hour during the day

• Do not add extra salt to food and avoid salty snacks

• Keep the feet elevated

• Use elastocrepe bandages or compression stockings on affected limbs

• Do not consume NSAIDs unnecessarily

• Seek medical advice immediately for filaria

• Use diurectics to get rid of fluid only if prescribed by a doctor

• Control diabetes and hypertension.

Source: The Telegraph (Kolkata, India)

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