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Palmar hyperhidrosis

Description:
Palmer hyperhidrosis is profuse perspiration (excessive sweating) of the palms.It is one form of focal hyperhidrosis, meaning profuse perspiration affecting one area of the body. Sweaty palms may be accompanied by profuse perspiration of the feet, forehead, ckeeks, armpits (axillae) or be part of general hyperhidrosis (profuse perspiration throughout the body). Hyperhidrosis refers to profuse perspiration beyond the body’s thermoregulatory (temperature control) needs.

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Palmer  hyperhidrosis is a common condition in which the eccrine (sweat) glands of the palms and soles secrete inappropriately large quantities of sweat. The condition may become socially and professionally debilitating. The condition usually is idiopathic  and  it begins in childhood and frequently runs in families.

Symptoms:
The intensity of symptoms may vary among sufferers and trigger factors should be carefully noted. Common symptoms  are :

*Perspiration of the hands can vary from mild clamminess to severe perspiration resulting in dripping sweat.
*Temperature differences of palmar surface compared to surface temperature of other parts of the body may be noted.
*Sloughing (peeling) of skin may be noted in profuse perspiration.
*Episodes of profuse perspiration may be followed by periods of extreme dryness on the palmar surface.
*Hyperhidrosis often starts in puberty, and family history is often reported.

The secondary effects of palmar hyperhidrosis can result in both psychosocial effects as well as difficulty in undertaking certain tasks or handling equipment. Sufferers of palmar hyperhidrosis are often reluctant to partake in socially expected actions like shaking hands or touching loved ones. The embarrassment of dealing with this condition can affect the level of interactivity in both social and work situations. Difficulties with holding objects, gripping equipment or soiling electronic devices like keyboards may affect functioning at work. Daily activities such as writing with a pen or counting cash notes is often difficult.

Causes:
Hyperhidrosis is either primary focal or secondary generalized.

1. Primary Palmar  Hyperhidrosis

Focal palmar hyperhidrosis is usually localized and is referred to as primary (essential, idiopathic), meaning no obvious cause, except strong family predisposition can be found (4,5), and affected persons are otherwise healthy . Sweating on other locations as feet, armpits and face may appear. Primary palmar hyperhidrosis is caused by overactivity of the sympathetic nervous system, primarily triggered by emotional causes including anxiety, nervousness, anger and fear .

There may be a significant reduction in perspiration during sleep or sedation.

2. Secondary Palmar Hyperhidrosis

In secondary palmar hyperhidrosis hands sweat due to an obvious underlying disorder like:

*Infections including local infections, tuberculosis and tinea ugunium.
*Neurological disorders like peripheral autonomic neuropathy
*Frostbite
*Arteriovenous Fistulas
*Acromegaly
*Acrodynia
*Complex Regional Pain Syndromes
*Pachyonychia Congenita
*Primary Hypertrophic osteoarthropathy
*Dyskeratosis Congenita
*Blue rubber-bleb nevus
*Glomus tumor

*Secondary palmar hyperhidrosis as part of generalized hyperhidrosis due to  several  hormonal causes (diabetes, hyperthyroidism, thyrotoxicosis, menstruation, menopause), metabolic disorders, malignant disease (lymphoma, pheochromocitoma), autoimmune disorders (rheumatoid arthritis, systemic lupus erythrematosus), drugs like hypertensive drugs and certain classes of antidepressants (list of medications causing hyperhidrosis), chronic use of alcohol, Parkinson’s disease, neurological disorders (toxic neuropathy), homocystinuria, plasma cell disorders. Detailed list of conditions causing generalyzed hyperhidrosis.

How Sweat Glands Work:
In eccrine glands, the major substance enabling impulse conduction is acetylcholine, and in apocrine glands, they are catecholamines.

Body temperature is controlled by the thermoregulatory center in the hypothalamus and this is influenced not only by  by core body temperature but also by hormones, pyrogens, exercise and emotions.

Diagnosis:
The first step in diagnosing  the  Palmar  hyperhidrosis is to differentiate between generalized and focal hyperhidrosis.

A thorough case taking and medical history is usually sufficient to diagnose palmar hyperhidrosis and any trigger factors (scheduled drugs, narcotics, chronic alcoholism).

Diagnostic criteria for primary focal (including palmar) hyperhidrosis  are:

*Bilateral and relatively symmetric sweating
*Frequency of at least 1 episode per week
*Impairment of daily activities
*Age at onset before 25 years
*Family history
*Cessation of sweating during sleep

Tests may include:
*Hematological studies may be necessary to identify thyroid disorders (thyroid function test for T3 and T4 as well as thyroid antibodies) and diabetes (fasting blood glucose or a glucose tolerance test).

*X-rays and MRI scans will assist for diagnosing tuberculosis, pneumonia and tumors.

*Superficial electroconductivity can be monitored as any hyperhidrosis reduces skin electrical resistance.

*Thermoregulatory sweat test uses moisture-sensitive indicator powder to monitor moisture. Changes in the color of the powder at room temperature will highlight areas of increased perspiration.

Treatment:
Conservative management should be coupled with prescribed treatment by the Doctor to reduce the symptoms.

*Counseling may be effective in managing primary palmar hyperhidrosis in cases of mental-emotional etiology.

*Trigger foods and aggravating factors should be noted if possible and relevant dietary changes should be implemented.

*Effective prevention of secondary palmar hyperhidrosis is difficult with conservative management and drug therapy or surgery may be required.

*Excessive physical activity and extremes of heat may be two trigger factors that should be avoided as far as possible.

*In cases of diabetes, a glucose controlled diet with low glycemic index may improve glucose tolerance which could assist with palmar hyperhidrosis.

*Abstinence from alcohol and narcotics is advisable if it is the causative factor for sweaty palms.

*Stimulants such as caffeine and nicotine may aggravate palmar hypehidrosis and should relevant dietary and lifestyle changes should be implemented.

*Anti-perspirant compounds like aluminum chloride can be applied on the palms to reduce moisture or palmar surfaces. Recent research on an aluminum sesquichlorohydrate foam has shown that it is effective in reducing sweat in palmar hyperhidrosis

Treatment remains a challenge: options include topical and systemic agents, iontophoresis, and botulinum toxin type A injections, with surgical sympathectomy as a last resort. None of the treatments is without limitations or associated complications. Topical aluminum chloride hexahydrate therapy and iontophoresis are simple, safe, and inexpensive therapies; however, continuous application is required because results are often short-lived, and they may be insufficient. Systemic agents such as anticholinergic drugs are tolerated poorly at the dosages required for efficacy and usually are not an option because of their associated toxicity. While botulinum toxin can be used in treatment-resistant cases, numerous painful injections are required, and effects are limited to a few months.

Standard therapeutic protocol may differ among cases of palmar hyperhidrosis depending on medical history and underlying pathology.

*Anticholinergic drugs have a direct effect on the sympathetic nervous system although there are numerous side effects.

*Treatment should be directed at contributing factors.

*Ionophoresis involves the use of electrotherapeutic measures to reduce the activity of sweat glands.

*Botulinum injections at the affected area may be useful for its anticholinergic effects.

*Surgery should be considered if drug therapy proves ineffective. Endoscopic transthoracic sympathectomy involves resection of the sympathetic nerve supply to the affected area. This prevents nerve stimulation of the sweat gland of the palms. However surgery has a host of complications including exacerbating the problem or increasing generalized hyperhidrosis.

Surgical sympathectomy should be reserved for the most severe cases and should be performed only after all other treatments have failed. Although the safety and reliability of treatments for palmoplantar hyperhidrosis have improved dramatically, side effects and compensatory sweating are still common, potentially severe problems.

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

Resources:
http://www.aafp.org/afp/2004/0301/p1117.html

Causes and Treatment of Palmar Hyperhidrosis – Sweaty Palms/Hands

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Lumbar Spondylosis

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources:
http://www.ehow.com/about_5039006_lumbar-spondylosis-exercises.html
http://www.physiotherapy-treatment.com/lumbar-spondylosis.html

 

Knee Care

The knees are one of the larger joints in the body, supporting its entire weight. It is a hinge joint, like that of a door, capable only of moving forwards and backwards. Attempts to force a door to move sideways or push it open in the wrong direction will result in the door “coming off its hinges.” A similar problem occurs when the knee is forced to move in the wrong direction.

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The knee joint is composed of three bones, the lower end of the femur and the upper ends of the tibia and fibula, articulating with one another. The raw bones do not grate against each other. They are separated by a “joint space” filled with synovial fluid, lined with articulating cartilage and separated by little washers called meniscii. There are ligaments inside the joint holding it in place. Considering the size of the knee joint, these ligaments are woefully inadequate. In the front of the knee is the kneecap or patella.

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The knee undergoes constant wear and tear. Our daily activities involve walking and climbing stairs as well as exercising. In a lifetime, the knee joint functions over and above its capacity!

The knee undergoes constant wear and tear. Our daily activities involve walking and climbing stairs as well as exercising. In a lifetime, the knee joint functions over and above its capacity!

Pain in the joint can be acute and occurs owing to injury, infection, or age-(or overuse) related degeneration. The cartilage breaks down, exposing parts of the bone underneath. The raw nerves are exposed and this becomes very painful. Bits of broken cartilage can get trapped in the joint. When that occurs, movement can result is sudden pain and the joint can get locked.

Dislocations and injuries are more common in the young — basketball and football are notorious for causing knee injuries. This is because there are sudden abrupt changes in the direction of movement, which may be against the normal anatomical direction of movement. The player may land awkwardly or fall, bruising and injuring the joint.

The two knees support the weight of the entire body between them. The bones are physically capable of supporting only a certain amount of weight. Obesity causes the knees to degenerate rapidly. Depending on gait and posture, one side may wear out faster than the other. This may result in a bow-legged appearance. Walking is extremely painful and the gait may be crab like. The entire joint may be swollen and painful. Or, the pain may be localised on one side. At times, instead of the whole joint, the area under the patella gets worn down and irregular. As that rubs against the bones underneath, there is terrible pain with movement.

Children seldom develop knee pain without injury or a fracture. Boys can develop pain as part of certain inherited congenital syndromes or birth defects in the knee. The patella may also get dislocated. This is more common in teenage girls.

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Infections, acute trauma and fractures result in swollen, warm and tender joints. Arthritis, especially rheumatoid or osteoarthritis, can produce a similar picture. Infection always produces fever. Gout usually affects the big toe but can present itself as a painful knee joint. It may be worth checking uric acid levels.

CLICK & SEE:

Ayurvedic remedies  of knee pain

Ayurvedic Therapy – A Promising Treatment for Knee Osteoarthritis?

Natural Ayurvedic Home Remedies for Knee Pain
Ayurveda for Osteo Arthritis (Knee Joint Pain)

Homeopathy for Knee Pain

Knee Injury Treatment With Six Homeopathic Medicines

Source: The Telegraph (Kolkata, Indi

Neuropathy

Definition:
Neuropathy is a general term that refers to diseases or malfunctions of the nerves. Any nerves at any location in the body can be damaged from injury or disease. Neuropathy is often classified according to the types or location of nerves that are affected. It is a disease caused by changes in the nerve cells. These changes may be age related. The degeneration is accelerated and aggravated if the patient suffers from diabetes, hypertension or has an abnormal lipid profile. Neuropathy can affect all three nervous systems — central, peripheral and autonomous.

If the central nervous system is affected, memory and cognitive skills decline. Forgetfulness becomes an accepted way of life. Peripheral neuropathy produces the most obvious, incapacitating, and distressing symptoms.

In some, the affected nerves may produce symptoms that are symmetrical (occurring in both limbs) and appear first in the furthest extremity. There may be paraesthesia (tingling, burning or numb sensation), hyperalgesia (abnormally acute pain sensation to innocuous stimuli) or deep aching. The symptoms tend to get worse at night and interfere with sleep.

Neuropathy can also be classified according to the disease causing it. (For example, neuropathy from the effects of diabetes is called diabetic neuropathy.)

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Types of Neuropathy::

Peripheral neuropathy: Peripheral neuropathy is when the nerve problem affects the nerves outside of the brain and spinal cord. These nerves are part of the peripheral nervous system. Accordingly, peripheral neuropathy is neuropathy that affects the nerves of the extremities- the toes, feet, legs, fingers, hands, and arms. The term proximal neuropathy has been used to refer to nerve damage that specifically causes pain in the thighs, hips, or buttocks.

Cranial neuropathy: Cranial neuropathy occurs when any of the twelve cranial nerves (nerves that exit from the brain directly) are damaged. Two specific types of cranial neuropathy are optic neuropathy and auditory neuropathy. Optic neuropathy refers to damage or disease of the optic nerve that transmits visual signals from the retina of the eye to the brain. Auditory neuropathy involves the nerve that carries signals from the inner ear to the brain and is responsible for hearing.

Autonomic neuropathy: Autonomic neuropathy is damage to the nerves of the involuntary nervous system, the nerves that control the heart and circulation (including blood pressure), digestion, bowel and bladder function, the sexual response, and perspiration. Nerves in other organs may also be affected.

Focal neuropathy: Focal neuropathy is neuropathy that is restricted to one nerve or group of nerves, or one area of the body. Symptoms of focal neuropathy usually appear suddenly.

Symptoms:
Neuropathy is associated with varied characteristic symptoms. Although some people with neuropathy may not have symptoms, certain symptoms are common. The degree to which an individual is affected by a particular neuropathy varies.

Damage to the sensory nerves is common in peripheral neuropathy. Symptoms often begin in the feet with a gradual onset of loss of feeling, numbness, tingling, or pain and progress toward the center of the body with time. The arms or legs may be involved. The inability to determine joint position may also occur, which can result in clumsiness or falls. Extreme sensitivity to touch can be another symptom of peripheral neuropathy. The sensation of numbness and tingling of the skin is medically known as paresthesia.

The loss of sensory input from the foot means that blisters and sores on the feet may develop rapidly and not be noticed. Because there is a reduced sensation of pain, these sores may become infected and the infection may spread to deeper tissues, including bone. In severe cases, amputation may be necessary.

When damage to the motor nerves (those that control movement) occurs, symptoms include weakness, loss of reflexes, loss of muscle mass, cramping, and/or loss of dexterity.

Autonomic neuropathy, or damage to the nerves that control the function of organs and glands, may manifest with a wide variety of symptoms, including:

•Nausea, vomiting, or abdominal bloating after meals

•Urinary symptoms, such as incontinence, difficulty beginning to urinate, or feeling that the bladder was not completely emptied

•Impotence (erectile dysfunction) in men

•Dizziness or fainting

•Constipation or diarrhea

•Blurred vision

•Heat intolerance or decreased ability to sweat

•Hypoglycemia unawareness: Low blood sugar levels (hypoglycemia) are associated with trembling, sweating, and palpitations. In people with autonomic neuropathy, these characteristic symptoms may not occur, making dangerously low blood sugar levels difficult to recognize.

Causes:
Neuropathy or nerve damage may be caused by a number of different diseases, injuries, infections, and even vitamin deficiency states.
Some of them are :-

•Diabetes: Diabetes is the condition most commonly associated with neuropathy. The characteristic symptoms of peripheral neuropathy often seen in people with diabetes are sometimes referred to as diabetic neuropathy. The risk of having diabetic neuropathy rises with age and duration of diabetes. Neuropathy is most common in people who have had diabetes for decades and is generally more severe in those who have had difficulty controlling their diabetes, or those who are overweight or have elevated blood lipids and high blood pressure.

•Vitamin deficiencies: Deficiencies of the vitamins B12 and folate as well as other B vitamins can cause damage to the nerves.

•Autoimmune neuropathy: Autoimmune diseases such as rheumatoid arthritis, systemic lupus, and Guillain-Barre syndrome can cause neuropathies.

•Infection: Some infections, including HIV/AIDS, Lyme disease, leprosy, and syphilis, can damage nerves.

•Post-herpetic neuralgia: Post-herpetic neuralgia, a complication of shingles (varicella-zoster virus infection) is a form of neuropathy.

•Alcoholic neuropathy: Alcoholism is often associated with peripheral neuropathy. Although the exact reasons for the nerve damage are unclear, it probably arises from a combination of damage to the nerves by alcohol itself along with the poor nutrition and associated vitamin deficiencies that are common in alcoholics.

•Genetic or inherited disorders: Genetic or inherited disorders can affect the nerves and are responsible for some cases of neuropathy. Examples include Friedreich’s ataxia and Charcot-Marie-Tooth disease.

•Amyloidosis: Amyloidosis is a condition in which abnormal protein fibers are deposited in tissues and organs. These protein deposits can lead to varying degrees of organ damage and may be a cause of neuropathy.

•Uremia: Uremia (a high concentration of waste products in the blood due to kidney failure) can lead to neuropathy.

•Toxins and poisons can damage nerves. Examples include, gold compounds, lead, arsenic, mercury, some industrial solvents, nitrous oxide, and organophosphate pesticides.

•Drugs or medication: Certain drugs and medications can cause nerve damage. Examples include cancer therapy drugs such as vincristine (Oncovin, Vincasar), and antibiotics such as metronidazole (Flagyl), and isoniazid (Nydrazid, Laniazid).

•Trauma/Injury: Trauma or injury to nerves, including prolonged pressure on a nerve or group of nerves, is a common cause of neuropathy. Decreased blood flow (ischemia) to the nerves can also lead to long-term damage.

•Tumors: Benign or malignant tumors of the nerves or nearby structures may damage the nerves directly, by invading the nerves, or cause neuropathy due to pressure on the nerves.

•Idiopathic: Idiopathic neuropathy is neuropathy for which no cause has been established. The term idiopathic is used in medicine to denote the fact that no cause is known.

Diagnosis:
The diagnosis of neuropathy and its cause involve a thorough medical history and physical examination to help your health care professional determine the cause and severity of neuropathy. A neurological examination, testing the reflexes and function of sensory and motor nerves, is an important component of the initial examination.

Although there are no blood tests that are specific for determining whether of not neuropathy is present, when neuropathy is suspected, blood tests are often used to check for the presence of diseases and conditions (for example, diabetes or vitamin deficiencies) that may be responsible for nerve damage.

Imaging studies such as X-rays, CT scans, and MRI scans may be performed to look for sources of pressure on or damage to nerves.

Exams and Tests:

Specific tests of nerve function include:

•Electromyography (EMG) is a test that measures the function of the nerves. For this test a very thin needle is inserted through the skin into the muscle. The needle contains an electrode that measures the electrical activity of the muscle.

•A nerve conduction velocity test (NCV) measures the speed at which signals travel through the nerves. This test is often done with the EMG. In the NCV test, patches containing surface electrodes are placed on the skin over nerves at various locations. Each patch gives off a very mild electrical impulse, which stimulates the nerve. The electrical activity of the nerves is measured and the speed of the electrical impulses between electrodes (reflecting the speed of the nerve signals) is calculated.

•In some cases, a nerve biopsy may be recommended. A biopsy is the surgical removal of a small piece of tissue for examination under a microscope. A pathologist, a physician specially trained in tissue diagnosis, examines the specimen and can help establish the cause of the neuropathy. The procedure is performed using a local anesthetic. The sural nerve (in the ankle), or the superficial radial nerve (wrist) are the sites most often used for biopsy.

Treatment:
The treatment of neuropathy involves measures to control the symptoms as well as treatment measures that address the underlying cause of neuropathy, if appropriate. Medical treatments for diabetes, autoimmune diseases, infections, kidney disease, and vitamin deficiencies are varied and are directed at the specific underlying condition. In many cases, treatment of the underlying disease can reduce or eliminate the symptoms of neuropathy. Some cases, especially those involving compression or entrapment of nerves by tumors or other conditions, can be relieved by surgery.

Many adjuvant medications have been tried, such as mega doses of vitamins, iron, zinc, calcium, alpha lipoic acid, acetyl-L carnitine. Increasing doses of painkillers like tramadol are also used. Sometimes they are combined with anti histamines like diphendydramnine (Benadryl) and pain modifying drugs. Combinations with anti epileptics such as gabapentin and anti depressants like amitriptyline reduce the intensity of symptoms. None of these treatments has been 100 per cent successful. The pain is still present in 80 per cent of the patients 5-10 years later.

Control of blood glucose (sugar) levels is important in the treatment of diabetic neuropathy to help prevent further damage to nerves.

Clinical trials are underway to help find new and more effective treatments for neuropathy. For example, treatments that involve electrical nerve stimulation or magnetic nerve stimulation are being studied.

Self care at home:
Special and careful care of the feet is important in people with neuropathy to reduce the chance of developing sores and infections. The nerves to the feet are the nerves most commonly affected by neuropathy. Proper foot care includes:

•wash the feet with warm water each day and thoroughly dry feet after washing (especially between the toes);

•never go barefoot or wear improperly-fitting, damaged, or too-tight footwear;

•inspect the feet daily, looking for cuts, blisters, or other problems;

•cut and file toenails when needed;

•thick, seamless socks can help prevent irritation of the feet;

•call your health care practitioner if you have any problems with your feet;

•massaging the feet can improve circulation; and

•smoking cessation can further improve blood circulation, since smoking damages circulation to the extremities and may worsen foot problems.

.The intensity of the pain can be reduced by soaking the legs up to the knees in warm salted water for 10 minutes, half-an-hour before bed. Application of pain relieving ointments that contain capsaicin also provides relief. The ointment should be applied every 3-4 hours. Do not rub the ointment in too vigorously as it will damage the skin.

Prevention:

Neuropathy is preventable only to the extent that the underlying condition or cause is preventable. For those with diabetes, studies have conclusively shown that long-term control of blood glucose levels is critically important in preventing the development of neuropathy and other complications of diabetes. Neuropathy that arises due to poor nutrition or alcohol abuse may be preventable if these causes can be eliminated. Genetic or inherited causes of neuropathy are not preventable.

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.emedicinehealth.com/neuropathy/article_em.htm
http://www.telegraphindia.com/1130211/jsp/knowhow/story_16546702.jsp

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Some Health Advices

No time to exercise :
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Many peaple say that they donot have any time to exercise but everyone (irrespective of age) should do some form of exercise regularly to mainten good health and less sufferings from ailments.There is a saying “people who donot have time to exercise will have much more time to suffer from illness”

Walking or skiping are very good exercises. There are several innovative ways to skip — using one leg, two legs, alternating legs. That makes in interesting.

Continuous stair climbing for 15 minutes, up and down, not 15 times but 15 minutes. One thing one must do to wear good supportive footwear for these activities. You also need to stretch before and after.

Girl aged 16 years has not yet started getting her periods:
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Usually, if the height, weight and other physical characteristics (figure) are normal, you can wait until the age of 18 years to see if she matures. If you are worried, you can do an endocrinology work up and a scan of the pelvic organs. If there is any specific defect, an endocrinologist will be able to treat it.

Cat bites or scratches:
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Cat bites are as dangerous as dog bites because cats can also transmit rabies. If you get bitten by an animal, clean the wound well with soap and water. You need to take a tetanus booster, and anti rabies injections. You need the post exposure schedule, which consists of five injections. The newer vaccines do not hurt, are given in the upper arm (deltoid) and not around the navel or in the buttock. They are available in private clinics, pharmacies and hospitals. You do not have to go to a government hospital.

Back ache:
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Sometimes if the bed or mattress is not ideal — too soft, too hard, lumpy — this can happen. Try sleeping on a mat on the floor for a few days. If this does not help then you need to consult a doctor to evaluate your spine.

To Prevent UTI:
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Women tend to develop urinary tract infection (UTI) more frequently than men. The problem is anatomical. The urethra is shorter and has only a single valve. It is situated close to the anal opening where there are a lot of potentially infective bacteria. A few preventive measures will help: drink 3-4 litres of water a day, empty your bladder before and after intercourse and lean backwards while passing urine to reduce the angulation between urethra and bladder.
Click to see the pic

Period pain:
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You need to consult a gynaecologist and get an ultrasound scan of the pelvis done. If everything is normal, you just need a painkiller like mefenemic acid on the days that you have pain. If there is anything wrong, the gynaecologist will be able to advice you.

If there are no abnormalities, pain during periods will reduce with regular exercise.

Resources: The Telegraph,(Kolkata, India)

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