Tag Archives: Foot

Ceanothus velutinus

Botanical Name : Ceanothus velutinus
Family: Rhamnaceae
Genus: Ceanothus
Species:C. velutinus
Kingdom:Plantae
Order: Rosales

Common Names: Sticky Laurel, Snowbrush ceanothus, Hooker’s ceanothus, Red root, and Tobacco brush

Habitat : Ceanothus velutinus is native to western North America from British Columbia to California to Colorado, where it grows in several habitat types including coniferous forest, chaparral, and various types of woodland.

Description:
Ceanothus velutinus is an evergreen Shrub growing up to 4 meters tall but generally remains under three, and forms colonies of individuals which tangle together to form nearly impenetrable thickets. The aromatic evergreen leaves are alternately arranged, each up to 8 centimeters long. The leaves are oval in shape with minute glandular teeth along the edges, and shiny green and hairless on the top surface.
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The plentiful inflorescences are long clusters of white flowers. The fruit is a three-lobed capsule a few millimeters long which snaps open explosively to expel the three seeds onto the soil, where they may remain in a buried seed bank for well over 200 years before sprouting. The seed is coated in a very hard outer layer that must be scarified, generally by wildfire, before it can germinate. Like most other ceanothus, this species fixes nitrogen via actinomycetes on its roots.
Cultivation:
Prefers a warm sunny position but tolerates light shade. Tolerates some lime, but will not succeed on shallow chalk. One report says that this species is hardy to zone 5 (tolerating temperatures down to about -20°c) whilst another says that it needs the protection of a wall when grown outdoors in Britain. Plants dislike root disturbance, they should be planted out into their permanent positions whilst still small. Dislikes heavy pruning, it is best not to cut out any wood thicker than a pencil. Plants flower on the previous year’s growth, if any pruning is necessary it is best carried out immediately after flowering has finished. Constant pruning to keep a plant small can shorten its life. Fast growing, it flowers well when young, often in its second year from seed[11]. Hybridizes freely with other members of this genus. The leaves have a strong scent of balsam[200]. Some members of this genus have a symbiotic relationship with certain soil micro-organisms, these form nodules on the roots of the plants and fix atmospheric nitrogen. Some of this nitrogen is utilized by the growing plant but some can also be used by other plants growing nearby.
Propagation :
Seed – best sown as soon as it is ripe in a cold frame. Stored seed should be pre-soaked for 12 hours in warm water and then given 1 – 3 months stratification at 1°c. Germination usually takes place within 1 – 2 months at 20°c. One report says that the seed is best given boiling water treatment, or heated in 4 times its volume of sand at 90 – 120°c for 4 – 5 minutes and then soaked in warm water for 12 hours before sowing it. It then requires a period of chilling below 5°c for up to 84 days before it will germinat. Seeds have considerable longevity, some that have been in the soil for 200 years or more have germinated. The seed is ejected from its capsule with some force when fully ripe, timing the collection of seed can be difficult because unless collected just prior to dehiscence the seed is difficult to extract and rarely germinates satisfactorily. Prick out the seedlings into individual pots as soon as they are large enough to handle. Grow them on in the greenhouse for at least their first winter and plant them out into their permanent positions in late spring or early summer. Cuttings of half-ripe wood, taken at a node, July/August in a frame. Cuttings of mature wood of the current year’s growth, 7 – 12 cm with a heel, October in a cold frame. The roots are quite brittle and it is best to pot up the callused cuttings in spring, just before the roots break. Good percentage.
Edible Uses:.. Tea..The leaves are used as a tea substitute

Medicinal Uses:
The leaves are febrifuge. An infusion has been used in the treatment of coughs and fevers. A decoction of the leaves and stems has been used both internally and externally in the treatment of dull pains, rheumatism etc. The leaves contain saponins and have been used as a skin wash that is also deodorant and can destroy some parasites. The wash is beneficial in treating sores, eczema, nappy rash etc.

Other Uses
Baby care; Dye; Insecticide; Soap.

A green dye is obtained from the flowers. A poultice of the dried powdered leaves has been used as a baby powder for treating nappy rash etc. Smoke from burning the plant has been used as an insecticide to kill bedbugs. All parts of the plant are rich in saponins – when crushed and mixed with water they produce a good lather which is an effective and gentle soap. This soap is very good at removing dirt, though it does not remove oils very well. This means that when used on the skin it will not remove the natural body oils, but nor will it remove engine oil etc The flowers are a very good source, when used as a body soap they leave behind a pleasant perfume on the skin. The developing seed cases are also a very good source of saponins.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Ceanothus_velutinus
http://www.pfaf.org/user/Plant.aspx?LatinName=Ceanothus+velutinus

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Heel pain

Alternative Names: Pain – heel

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

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

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

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

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

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

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

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

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

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

The most common causes of heel pain are:

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

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

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

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

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

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

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

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

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

To learn more click to see :

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

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

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

Resources:
http://www.medicalnewstoday.com/articles/181453.php
http://www.nlm.nih.gov/medlineplus/ency/article/003181.htm

Foot order or Smelly foot

English: Grown male right foot (angle 1)

English: Grown male right foot (angle 1) (Photo credit: Wikipedia)

Description:
Our foot sometimes gives out an unpleasant smell which is very much embarrassing.         ( medical term bromohidrosis)

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It is a type of body odor that affects the feet of humans.The quality of foot odor is often reported as a thick smell. Some describe the smell like that of malt vinegar. However, it can also be ammonia-like. Brevibacteria are considered a major cause of foot odor because they ingest dead skin on the feet and, in the process, convert amino acid methionine into methanethiol, which has a sulfuric aroma. The dead skin that fuels this process is especially common on the soles and between the toes. The brevibacteria is also what gives cheeses such as Limburger, Bel Paese, Port du Salut, Pálpusztai and Munster their characteristic pungency.

Propionic acid (propanoic acid) is also present in many foot sweat samples. This acid is a breakdown product of amino acids by Propionibacteria, which thrive in the ducts of adolescent and adult sebaceous glands. The similarity in chemical structures between propionic acid and acetic acid, which share many physical characteristics such as odor, may account for foot odors identified as being vinegar-like. Isovaleric acid (3-methyl butanoic acid) is the other source of foot odor and is a result of actions of the bacteria Staphylococcus epidermidis which is also present in several strong cheese types.

Other implicated micro-organisms include Micrococcaceae, Corynebacterium and Pityrosporum.

Bart Knols, of Wageningen Agricultural University, the Netherlands, received an “IG Nobel” prize in 2006 for showing that the female malaria mosquito Anopheles gambiae “is attracted equally to the smell of limburger cheese and to the smell of human feet”. Fredros Okumu, of Ifakara Health Institute in Tanzania, received grants in 2009 and 2011 to develop mosquito attractants and traps to combat malaria. He uses a blend of eight chemicals, which is four times more effective than an actual human.

Causes;
The feet and hands contain more sweat glands than any other part of the body, with roughly 3,000 glands per square inch. Smelly feet are not only embarrassing, but can be physically uncomfortable as well.

Feet smell for two reasons: 1) shoe wear, and 2) sweating of the feet. The interaction between the perspiration and the bacteria that thrive in shoes and socks generates the odor.

Smelly feet or excessive sweating can also be caused by an inherited condition, called hyperhidrosis, which primarily affects men. Stress, some medications, fluid intake, and hormonal changes also can increase the amount of perspiration our bodies produce.

The main cause is foot sweat. Sweat itself is odorless, but it creates a beneficial environment for certain bacteria to grow and produce bad-smelling substances. These bacteria are naturally present on our skin as part of the human flora. Therefore, more smell is created with factors causing more sweating, such as wearing shoes and/or socks with inadequate air ventilation for many hours. Hair on the feet, especially on the toes, may contribute to the odor’s intensity by adding increased surface area in which the bacteria can thrive.

Given that socks directly contact the feet, their composition can have an impact on foot odor. Polyester and nylon are common materials used to make socks, but provide less ventilation than cotton or wool do when used for the same purpose. Wearing polyester or nylon socks may increase perspiration and therefore may intensify foot odor.[1] Because socks absorb varying amounts of perspiration from feet, wearing shoes without socks may increase the amount of perspiration contacting feet and thereby increase bacterial activities that cause odor

Treatments:
The best home remedy for foot odor is to soak feet in strong black tea for 30 minutes a day for a week. The acid in the tea kills the bacteria and closes the pores, keeping your feet dry longer. Use two tea bags per pint of water. Boil for 15 minutes, then add two quarts of cool water. Soak your feet in the cool solution. Alternately, you can soak your feet in a solution of one part vinegar and two parts water.

Persistent foot odor can indicate a low-grade infection or a severe case of hereditary sweating. In these cases, a prescription ointment may be required to treat the problem.

Treating Excessive Sweating:
A form of electrolysis, called iontophoresis, has been shown to reduce excessive sweating of the feet. However, it is more difficult to administer. In the worst cases of hyperhidrosis, a surgeon can cut the nerve that controls sweating. Recent advances in technology have made this surgery much safer, but may increase sweating in other areas of the body.

Prevention:
Methods of extinguishment may be used even before onset of the odor as prevention. However, a very effective and cheap way to prevent foot odor is with sodium bicarbonate (a mildly basic white salt also known as baking soda, bread soda, cooking soda, bicarbonate of soda, sodium bicarb, bicarb soda, or simply bicarb). Sodium bicarbonate

will create a hostile environment unsuitable for the bacteria responsible for the bad smell. Four pinches of it on each foot everyday are usually enough (two inside the sock and two on the insole of the shoe). Sometimes it might take one or two days before the shoes completely lose their old smell. Washing your feet and applying the sodium bicarbonate daily are also potentially useful solutions.

While there are a number of other remedies, sodium bicarbonate, if bought in a supermarket, costs approximately 20 times less than common odor-eaters or odor-killer powders.

Swabbing feet twice daily with isopropyl alcohol, found at your local drug store, for two weeks is a cheap and highly effective cure. One can also periodically remove their footwear, to reduce foot moisture and thereby reduce bacterial spawn.

Some types of powders and activated charcoal insoles, such as odor eaters, have been developed to prevent foot odor by keeping the feet dry. Special cedarsoles can be recommended for this purpose because of their antibacterial characteristics. Hygiene is considered important in avoiding odor, as is avoidance of synthetic shoes/socks, and rotation of the pairs of shoes worn

In general, smelly feet can be controlled with a few preventive measures:

•Always wear socks with closed shoes.
•Avoid wearing nylon socks or plastic shoes. Instead, wear shoes made of leather, canvas, mesh, or other materials that let your feet breathe.
•Bathe feet daily in lukewarm water, using a mild soap. Dry thoroughly.
•Change socks and shoes at least once a day.
•Check for fungal infections between toes and on the bottoms of your feet. If any redness or dry, patchy skin is observed, get treatment right away.
•Don’t wear the same pair of shoes two days in a row. If you frequently wear athletic shoes, alternate pairs so that the shoes can dry out. Give your shoes at least 24 hours to air out between wearings; if the odor doesn’t go away, discard the shoes.
•Dust your feet frequently with a nonmedicated baby powder or foot powder. Applying antibacterial ointment also may help.
•Practice good foot hygiene to keep bacteria levels at a minimum.
•Wear thick, soft socks to help draw moisture away from the feet. Cotton and other absorbent materials are best.

Extinguishment:

Once foot odor has begun, it can be extinguished, or at least alleviated, by either aromatic deodorants that neutralise the odor by their own smell, or by absorbers of the odor itself.

Among the earliest foot deodorants were aromatic herbs such as allspice, which nineteenth-century Russian soldiers would put in their boots.

Odor absorbers include activated charcoal foot insert wafers, such as Innofresh footwear odor absorbers.

General Tips: To tackle this problem, wash your feet with an antibacterial soap such as Neko and use a fresh pair of cotton socks daily. You can also apply deodorant to the soles of your feet. The best thing would be to buy another pair of work shoes and alternate wearing the two pairs so that the shoes have time to dry out.

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/Foot_odor
http://www.wolfpodiatry.com/library/1932/SmellyFeetandFootOdor.html

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Charcot-Marie-Tooth disease(CMT)

Alternative Names::Morbus Charcot-Marie-Tooth, Charcot-Marie-Tooth neuropathy, hereditary motor and sensory neuropathy (HMSN), hereditary sensorimotor neuropathy (HSMN), or peroneal muscular atrophy.

Definition:
Charcot–Marie–Tooth disease (CMT) is  an inherited disorder of nerves (neuropathy) that takes different forms. It is characterized by loss of muscle tissue and touch sensation, predominantly in the feet and legs but also in the hands and arms in the advanced stages of disease. Currently incurable, this disease is one of the most common inherited neurological disorders, with 36 in 100,000 affected.

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In 1886, Professor Jean Martin Charcot of France (1825-1893) and his student Pierre Marie (1853-1940) published the first description of distal muscle weakness and wasting beginning in the legs, calling it peroneal muscular atrophy.

Howard Henry Tooth (1856-1926) described the same disease in his Cambridge dissertation in 1886, calling the condition peroneal progressive muscular atrophy. Tooth was the first to attribute symptoms correctly to neuropathy rather than to myelopathy, as physicians previously had done.

In 1912, Hoffman identified a case of peroneal muscular atrophy with thickened nerves. This disease was referred to as Hoffman disease and later was known as Charcot-Marie-Tooth-Hoffman disease.

In 1968, CMT disease was subdivided into 2 types, CMT 1 and CMT 2, based on pathologic and physiologic criteria. CMT disease has been subdivided further based on the genetic cause of the disease.

•In CMT type 1, the peripheral nerves’ axons – the part of the nerve cell that transmits electrical signals to the muscles – lose their protective outer coverings, their myelin sheaths. This disrupts the axons’ function.

•In CMT type 2, the axons’ responses are diminished due to a defect within the axons themselves. CMT type 2, the less common of the two classes, can be further separated into at least six subtypes, caused by defects in different genes.

Symptoms:
Symptoms of the CMT usually begin in late childhood or early adulthood. Some people don’t experience symptoms until their early thirties or forties. Usually, the initial symptom is foot drop early in the course of the disease. This can also cause claw toe, where the toes are always curled. Wasting of muscle tissue of the lower parts of the legs may give rise to “stork leg” or “inverted bottle” appearance. Weakness in the hands and forearms occurs in many people later in life as the disease progresses.

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English: The foot of a person with Charcot-Mar...

English: The foot of a person with Charcot-Marie-Tooth. The lack of muscle, high arch, and hammer toes are signs of the genetic disease. This patient was diagnosed with CMT-1A. Deutsch: atrophischer Hohlfuß bei hereditärer motosensibler Neuropathie I (Charcot-Marie-Tooth) (Photo credit: Wikipedia)

Symptoms and progression of the disease can vary. Breathing can be affected in some; so can hearing, vision, and the neck and shoulder muscles. Scoliosis is common. Hip sockets can be malformed. Gastrointestinal problems can be part of CMT, as can chewing, swallowing, and speaking (as vocal cords atrophy). A tremor can develop as muscles waste. Pregnancy has been known to exacerbate CMT, as well as extreme emotional stress.

Neuropathic pain is often a symptom of CMT though, like other symptoms of CMT, it’s presence and severity varies from case to case. For some people, pain can be significant to severe and interfere with daily life activities. However, pain is not experienced by all people with CMT. When pain is present as a symptom of CMT, it is comparable to that seen in other peripheral neuropathies, as well as Postherpetic neuralgia and Complex regional pain syndrome, among other diseases

The most common symptoms of Charcot-Marie-Tooth disease may include:

*Weakness in your legs, ankles and feet
*Loss of muscle bulk in legs and feet
*High foot arches
*Curled toes (hammertoes)
*Decreased ability to run
*Difficulty lifting your foot at the ankle (footdrop)
*Awkward or higher than normal step (gait)
*Frequent tripping or falling
*Decreased sensation in your legs and feet
*Numbness in the legs and feet

As Charcot-Marie-Tooth disease progresses, symptoms may not be limited to the feet and legs but may also involve the thighs, hands and arms. Charcot-Marie-Tooth disease generally doesn’t cause pain.

Causes:
Charcot–Marie–Tooth disease is caused by mutations that cause defects in neuronal proteins. Nerve signals are conducted by an axon with a myelin sheath wrapped around it. Most mutations in CMT affect the myelin sheath. Some affect the axon.

The most common cause of CMT (70-80% of the cases) is the duplication of a large region in chromosome 17p12 that includes the gene PMP22. Some mutations affect the gene MFN2, which codes for a mitochondrial protein. Cells contain separate sets of genes in their nucleus and in their mitochondria. In nerve cells, the mitochondria travel down the long axons. In some forms of CMT, mutated MFN2 causes the mitochondria to form large clusters, or clots, which are unable to travel down the axon towards the synapses. This prevents the synapses from functioning.

Risk Factors:
Charcot-Marie-Tooth disease is hereditary, so you’re at higher risk of developing the disorder if anyone in your immediate family has had the disease. Other causes of neuropathies, such as diabetes, may cause symptoms of or worsen Charcot-Marie-Tooth disease.

 

Complecations:
Complications of Charcot-Marie-Tooth disease vary in severity from person to person, with foot abnormalities and difficulty walking generally being the most serious problems. Muscle weakness may also increase, and injury to areas of the body with decreased sensation may occur.

Diagnosis:
CMT can be diagnosed through symptoms, through measurement of the speed of nerve impulses (electromyography), through biopsy of the nerve, and through DNA testing. DNA testing can give a definitive diagnosis, but not all the genetic markers for CMT are known.CMT is first noticed when someone develops lower leg weakness and foot deformities such as foot drop, hammertoes and high arches. But signs alone do not lead to diagnosis. Patients must be referred to a neurologist or a physical medicine and rehabilitation physician (physiatrist). To see signs of muscle weakness the neurologist will ask patients to walk on their heels or to move part of their leg against an opposing force. In order to identify sensory loss the neurologist will test for deep tendon reflexes, such as the knee jerk, which are reduced or absent in CMT. The doctor will also ask about family history because CMT is hereditary. The lack of family history does not rule out CMT, but it will allow the doctor to rule out other causes of neuropathy such as diabetes or exposure to certain chemicals or drugs.

In 2010, CMT was one of the first diseases where the genetic cause of a particular patient’s disease was precisely determined by sequencing the whole genome of an affected individual. Two mutations were identified in a gene, SH3TC2, known to cause CMT. Researchers then compared the affected patient’s genome to the genomes of the patient’s mother, father, and seven siblings with and without the disease. The mother and father each had one normal and one mutant copy of this gene, and had mild or no symptoms. The offspring that inherited two mutant genes presented fully with the disease. Sequencing the initial patient’s whole genome cost $50,000, but researchers estimated that it would soon cost $5,000 and become common.

CMT is divided into the primary demyelinating neuropathies (CMT1, CMT3, and CMT4) and the primary axonal neuropathies (CMT2), with frequent overlap. Another cell involved in CMT is the Schwann cell, which creates the myelin sheath, by wrapping its plasma membrane around the axon in a structure that is sometimes compared to a Swiss roll.

Neurons, Schwann cells, and fibroblasts work together to create a working nerve. Schwann cells and neurons exchange molecular signals that regulate survival and differentiation. These signals are disrupted in CMT.

Demyelinating Schwann cells causes abnormal axon structure and function. They may cause axon degeneration. Or they may simply cause axons to malfunction.

The myelin sheath allows nerve cells to conduct signals faster. When the myelin sheath is damaged, nerve signals are slower, and this can be measured by a common neurological test, electromyography.

When the axon is damaged, on the other hand, this results in a reduced compound muscle action potential (CMAP).

There are many different genetic variants. Most cases are inherited as an autosomal dominant condition, but some are inherited in an autosomal recessive or x-linked pattern.

Treatment:
Although there is no current standard treatment, the use of ascorbic acid has been proposed, and has shown some benefit in animal models. A clinical trial to determine the effectiveness of high doses of ascorbic acid (vitamin C) in treating humans with CMT type 1A has been conducted. The results of the trial upon children have shown that a high dosage intake of ascorbic acid is safe but the efficacy endpoints expected were not met. In 2010, a study published in the Journal Science indicated that scientists had identified those proteins that control the thickness of myelin sheath. This discovery is expected to open the avenue to new treatments in the coming years.

The most important activity for patients with CMT is to maintain what movement, muscle strength and flexibility they have. Therefore, physical therapy and moderate activity are recommended but overexertion should be avoided. A physical therapist should be involved in designing a exercise program that fits a patient’s personal strengths and flexibility. Bracing can also be used to correct problems caused by CMT. Gait abnormalities can be corrected by the use of either articulated (hinged) or unarticulated, braces called AFOs (ankle-foot orthoses). These braces help control foot drop and ankle instability and often provide a better sense of balance for patients. Appropriate footwear is also very important for people with CMT, but they often have difficulty finding well-fitting shoes because of their high arched feet and hammer toes. Due to the lack of good sensory reception in the feet, CMT patients may also need to see a podiatrist for help in trimming nails or removing calluses that develop on the pads of the feet. A final decision a patient can make is to have surgery. Using a podiatrist or an orthopedic surgeon, patients can choose to stabilize their feet or correct progressive problems. These procedures include straightening and pinning the toes, lowering the arch, and sometimes, fusing the ankle joint to provide stability.

The Charcot-Marie-Tooth Association classifies the chemotherapy drug vincristine as a “definite high risk” and states that “vincristine has been proven hazardous and should be avoided by all CMT patients, including those with no symptoms.”

There are also several corrective surgical procedures that can be done to improve physical condition.

Genetic testing is available for many of the different types of Charcot-Marie-Tooth and may help guide treatment.

Lifestyle & Homeremedies:
Certain tactics may prevent complications caused by Charcot-Marie-Tooth disease and improve your ability to manage the effects of the disorder.

Started early and followed regularly, at-home activities can provide protection and relief:

*Stretch regularly. The goal of stretching is to improve or maintain the range of motion of your joints. Stretching improves your flexibility, balance and coordination. Stretching may also reduce your risk of injury. If you have Charcot-Marie-Tooth disease, regular stretching can prevent or reduce joint deformities that may result from uneven pulling of muscle on your bones.

*Exercise daily. Exercising every day keeps your bones and muscles strong. Low-impact exercises, such as biking and swimming, are less stressful on fragile muscles and joints. By strengthening your muscles and bones, you can improve your balance and coordination, reducing your risk of falls.

*Improve your stability. Muscle weakness associated with Charcot-Marie-Tooth disease may cause you to be unsteady on your feet, which can lead to falling and serious injury. Walking with a cane or a walker can increase your stability. Good lighting at night can help you avoid stumbling and falling.
Foot care is important
Because of foot deformities and loss of sensation, regular foot care is important to help relieve symptoms and to prevent complications:

*Inspect your feet. Daily inspection of your feet is important to prevent calluses, ulcers, wounds and infections.

*Take care of your nails. Cut your nails regularly. To avoid ingrown toenails and infections, cut straight across and avoid cutting into the nailbed edges. Consider regular professional pedicures.

*Wear the right shoes. Use shoes that fit properly and are roomy and protective. Consider wearing boots or high-top shoes for ankle support.

*Soak and moisturize the skin of your feet. Brief, daily cold and warm foot soaks followed by the application of moisturizing lotions keep the skin of the feet moist and pliable. This can be very effective in reducing neuropathic pain and foot discomfort.

Coping & Support:
Support groups, in conjunction with your doctor’s advice, can be valuable in dealing with Charcot-Marie-Tooth disease. Support groups bring together people who are coping with the same kinds of challenges, along with their families and friends, and offer a setting in which people can share their common problems.

Ask your doctor about support groups in your community. Your local health department, public library and telephone book and the Internet also may be good sources to find a support group in your area.

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/charcotmarietooth1.shtml
http://www.mayoclinic.com/health/charcot-marie-tooth-disease/DS00557
http://www.genome.gov/11009201
http://emedicine.medscape.com/article/1232386-overview

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Bunions

Definition:
A bunion is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal joint).The big toe (hallux) may turn in toward the second toe (angulation), and the tissues surrounding the joint may be swollen and tender.

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The term is used to refer to the pathological bump on the side of the great toe joint. The bump is partly due to the swollen bursal sac and/or an osseous (bony) anomaly on the mesophalangeal joint (where the first metatarsal bone and hallux meet). The larger part of the bump is a normal part of the head of first metatarsal bone that has tilted sideways to stick out at its top.

Although they’re more common in older people, they can begin at any age, and even children can develop them. A similar bump, but on the outer edge of the foot at the base of the smallest toe, is known as a bunionette.

The term “hallux valgus” or “hallux abducto-valgus” are the most commonly used medical terms associated with a bunion anomaly, where “hallux” refers to the great toe, “valgus” refers to the abnormal angulation of the great toe commonly associated with bunion anomalies, and “abductus/-o” refers to the abnormal drifting or inward leaning of the great toe towards the second toe, which is also commonly associated with bunions. It is important to state that “hallux abducto refers to the motion the great toe moves away from the body’s midline. Deformities of the lower extremity are usually named in accordance to the body’s midline, or the line bisecting the body longitudinally into two halves.

Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women then men.

Symptoms:
Bunions may or may not cause symptoms. A frequent symptom is pain in the involved area when walking or wearing shoes that is relieved by resting. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. This leads to intermittent or chronic pain at the base of the big toe.

Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness.

The symptoms of bunions include irritated skin around the bunion, pain when walking, joint redness and pain, and possible shift of the big toe toward the other toes. Blisters may form more easily around the site of the bunion as well.

Having bunions can also make it harder to find shoes that fit properly; bunions may force a person to have to buy a larger size shoe to accommodate the width the bunion creates. When bunion deformity becomes severe enough, the foot can hurt in different places even without the constriction of shoes because it then becomes a mechanical function problem of the forefoot.

Risk Factors & Causes:
It is found  that tight-fitting shoes, especially high-heel and narrow-toed, might increase the risk for bunion formation.
Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. There also seem to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals.

Other risk factors for the development of bunions include congenital (present from birth) abnormal formation of the bones of the foot, nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.

Bunions are mostly genetic and consist of certain tendons, ligaments, and supportive structures of the first metatarsal that are positioned differently. This bio-mechanical anomaly may be caused by a variety of conditions intrinsic to the structure of the foot – such as flat feet, excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although some experts are convinced that poor-fitting footwear is the main cause of bunion formation, other sources concede only that footwear exacerbates the problem caused by the original genetic structure.

Bunions are commonly associated with a deviated position of the big toe toward the second toe, and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal (which help the flexor tendon bend the big toe downwards) may also become deviated over time as the first metatarsal bone drifts away from its normal position. Arthritis of the big toe joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development.

Diagnosis:
A doctor can usually diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot and, in some cases, arthritis.

The doctor considers a bunion when noting the symptoms described above. The anatomy of the foot is assessed during the examination. Radiographs (x-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes.

Treatment:
Bunions may be treated conservatively with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice, and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by an orthopedic surgeon or a podiatrist, may be necessary if discomfort is severe enough or when correction of the deformity is desired.

Orthotics are splints, regulators while conservative measures include various footwear like gelled toe spacers, bunion / toes separators, bunion regulators, bunion splints, and bunion cushions.

Surgery:
Procedures are designed and chosen to correct a variety of pathologies that may be associated with the bunion. For instance, procedures may address some combination of:

*removing the abnormal bony enlargement of the first metatarsal,
*realigning the first metatarsal bone relative to the adjacent metatarsal bone,
*straightening the great toe relative to the first metatarsal and adjacent toes,
*realigning the cartilagenous surfaces of the great toe joint,
*addressing arthritic changes associated with the great toe joint,
*repositioning the sesamoid bones beneath the first metatarsal bone,
*shortening, lengthening, raising, or lowering the first metatarsal bone, and
*correcting any abnormal bowing or misalignment within the great toe.

At present there are many different bunion surgeries for different effects. Ultimately, surgery should always have function of the foot in mind besides its look. Can the proposed surgery help resolve the pain and callus under the middle metatarsal heads? Can one return to sports? Can the foot enjoy fashionable or high heel shoes like normal feet without undue discomfort? Does the proposed surgery prevent recurrence with any specific built-in mechanism? These are very reasonable challenges for any truly functional bunion surgeries but may not be so for esthetic bunion surgeries.

The age, health, lifestyle, and activity level of the patient may also play a role in the choice of procedure.

Bunion surgery can be performed under local, spinal, or general anesthetic. The trend has moved strongly toward using the less invasive local anesthesia over the years. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility. An orthopedic cast is much less common today as newer, more stable procedures and better forms of fixation (stabilizing the bone with screws and other hardware) are used.

Prognosis:
The prognosis depends on your age and activities, and the severity of the bunion. Teenagers may have more trouble treating a bunion than adults. Many adults do well by caring for the bunion when it first starts to develop, and wearing different shoes. Surgery reduces the pain in many, but not all, people with bunions.

Possible Complications:

*Chronic foot pain
*Foot deformity
*Stiff foot
*Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe

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.medicinenet.com/bunions/page2.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001231.htm
http://en.wikipedia.org/wiki/Bunion
http://www.bbc.co.uk/health/physical_health/conditions/bunions.shtml

http://www.consumerreports.org/health/conditions-and-treatments/bunions/what-is-it.htm

http://www.cafai.com/bunions.html

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