Month: February 2011

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The colour brown

It’s not just the fibre and vitamins; wholegrain brown rice has a compound that may protect you from high blood pressure and cardiovascular disease.

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Replacing that familiar mound of white on your plate with a brown variety may do a world of good to your heart. Nutritionists have known for a while that brown rice is healthier, and been exhorting rice eaters to choose the wholegrain brown type instead of polished white ones. Brown rice, they said, is rich in certain minerals and vitamins and dietary fibre, which are lost in white rice following milling and polishing.

But that’s not the end of its goodness, it now emerges. A recent study by a team of US and Japanese scientists points to the “clinical significance” of brown rice. The researchers have found that brown rice contains a compound — which is, however, yet to be isolated and identified — that offers protection against high blood pressure and cardiovascular ailments. The compound is located in a layer surrounding the grain, called subaleurone layer, which is stripped off when the milled grain is polished to a shine. This layer lies between the white centre of the grain and the brown fibrous outer layer, and is abundant in certain beneficial carbohydrates and dietary fibre. It also accounts for a good measure of nutrients such as magnesium and iron, and vitamins like niacin, vitamin B1 and vitamin B6.

More significantly, the scientists found that a new milling process developed by a Japanese firm three years ago allows the rice to retain the subaleurone layer. Thisrice, available only in Japan, has a golden tinge and appears similar to brown rice, but tastes more like white rice as it is not tough and chewy like the other.

The scientists, led by Satoru Eguchi of the Cardiovascular Research Center at the Temple University School of Medicine in Philadelphia, found that when an extract of subaleurone compounds dissolved in ethyl acetate was applied to vascular smooth muscle cells cultured in a dish, it inhibited the activity of angiotensin II, a hormone strongly implicated in hypertension and atherosclerosis. Vascular smooth muscle cells are typical cells found in the walls of blood vessels. Their contraction and relaxation in tune with the local blood pressure and blood volume is responsible for the distribution of blood to different organs in the body. Excessive constriction of smooth muscle cells in normal blood vessels leads to hypertension, while in the case of heart muscles it leads to a hardening of the arteries.

“We strongly believe the compound may be present in all rice varieties (including those consumed in India), even though its strength may vary,” says Eguchi.

The researchers say that the compound apparently inhibits the production of angiotensin II by interfering with the body’s signalling mechanism that orders its conversion from angiotensin I, which is relatively harmless. Many modern drugs for blood pressure already target enzymes that trigger the production of angiotensin II.

“Our research suggests that there is a potential ingredient in rice that may be a good starting point for looking into preventive medicine for cardiovascular diseases,” says Eguchi. Such health benefits may accrue if half-milled or brown rice is included in the diet, he adds.

“Studies in the past have only partly answered what the mechanism behind this is. The particular compound which offers the benefit is yet to be identified,” Eguchi told KnowHow. The Japan-born scientist, who has been studying the beneficial effects of the subaleurone layer of rice for the last three years, says work is on to identify the compound and elucidate its chemical composition.

“This is an interesting find,” says Kanwaljit Chopra, associate professor at the University Institute of Pharmaceutical Sciences, Punjab University, Chandigarh. “The study indicates the possibility of a promising drug molecule from rice for cardiovascular protection.” Chopra herself has worked on a compound called tocotrienol, which is abundant in rice and oil palm and has shown that it may have potential benefits for people suffering from diabetes-related kidney problems.

“Angiotensin II is a big villain when it comes to atherosclerosis,” she says. The Punjab University professor, however, feels there is a need for the scientists to identify the compound and repeat similar results in animals and humans before claiming that the study is a success.

Another study by a team of researchers from the Harvard School of Public Health last year had shown that eating two servings of brown rice every week lowered the risk of type 2 diabetes by about 16 per cent. The research, led by Qi Sun — who subsequently moved to the Brigham and Women’s Hospital in Boston — showed that dietary fibre, found abundantly in brown rice, helps deter diabetes by slowing the rush of sugar into the blood stream.

White rice comparison:
Brown rice and white rice have similar amounts of calories, carbohydrates, and protein. The main differences between the two forms of rice lie in processing and nutritional content.

When only the outermost layer of a grain of rice (the husk) is removed, brown rice is produced. To produce white rice, the next layers underneath the husk (the bran layer and the germ) are removed, leaving mostly the starchy endosperm.

Several vitamins and dietary minerals are lost in this removal and the subsequent polishing process. A part of these missing nutrients, such as vitamin B1, vitamin B3, and iron are sometimes added back into the white rice making it “enriched”, as food suppliers in the US are required to do by the Food and Drug Administration (FDA).

One mineral not added back into white rice is magnesium; one cup (195 g) of cooked long grain brown rice contains 84 mg of magnesium while one cup of white rice contains 19 mg.

When the bran layer is removed to make white rice, the oil in the bran is also removed. Rice bran oil may help lower LDL cholesterol.

Among other key sources of nutrition lost are small amounts of fatty acids and fiber.

You may click to see:Neutrition facts & analysis of brown rice

This leaves no room for doubt that brown is better.

Source : The Telegraph ( Kolkata, India)

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Bilharzia

Alternative Names: Schistosomiasis; Katayama fever; Swimmer’s itch; Blood fluke

Definition: Bilharzia is a disease caused by parasitic worms. Infection with Schistosoma mansoni, S. haematobium, and S. japonicum causes illness in humans. About 200 million people are infected worldwide.

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Although it has a low mortality rate, Bilharzia often is a chronic illness that can damage internal organs and, in children, impair growth and cognitive development. The urinary form of schistosomiasis is associated with increased risks for bladder cancer in adults. Schistosomiasis is the second most socioeconomically devastating parasitic disease after malaria.

This disease is most commonly found in Asia, Africa, and South America, especially in areas where the water contains numerous freshwater snails, which may carry the parasite.

The disease affects many people in developing countries, particularly children who may acquire the disease by swimming or playing in infected water.

Bilharzia is known as Schistosomiasis or bilharziosis in many countries, after Theodor Bilharz, who first described the cause of urinary schistosomiasis in 1851.

The first doctor who described the entire disease cycle was Pirajá da Silva in 1908.

It was a common cause of death for Ancient Egyptians in the Greco-Roman Period.

Signs and symptoms:
Above all, Bilharzia is a chronic disease. Many infections are subclinically symptomatic, with mild anemia and malnutrition being common in endemic areas. Acute schistosomiasis (Katayama’s fever) may occur weeks after the initial infection, especially by S. mansoni and S. japonicum.

Manifestations include:

*Abdominal pain

*Cough

*Diarrhea

*Eosinophilia — extremely high eosinophil granulocyte (white blood cell) count.

*Fever

*Fatigue

*Hepatosplenomegaly — the enlargement of both the liver and the spleen.

*Genital sores — lesions that increase vulnerability to HIV infection. Lesions caused by schistosomiasis may continue to be a problem after control of the schistosomiasis infection itself. Early treatment, especially of children, which is relatively inexpensive, prevents formation of the sores.

*Skin symptoms: At the start of infection, mild itching and a papular dermatitis of the feet and other parts after swimming in polluted streams containing cercariae.

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Occasionally central nervous system lesions occur: cerebral granulomatous disease may be caused by ectopic S. japonicum eggs in the brain, and granulomatous lesions around ectopic eggs in the spinal cord from S. mansoni and S. haematobium infections may result in a transverse myelitis with flaccid paraplegia.

Continuing infection may cause granulomatous reactions and fibrosis in the affected organs, which may result in manifestations that include:

*Colonic polyposis with bloody diarrhea (Schistosoma mansoni mostly);

*Portal hypertension with hematemesis and splenomegaly (S. mansoni, S. japonicum);

*Cystitis and ureteritis (S. haematobium) with hematuria, which can progress to bladder cancer;

*Pulmonary hypertension (S. mansoni, S. japonicum, more rarely S. haematobium);

*Glomerulonephritis; and central nervous system lesions.

Bladder cancer diagnosis and mortality are generally elevated in affected areas.

Causes:
You get a schistosoma infection through contact with contaminated water. The parasite in its infective stages is called a cercaria. It swims freely in open bodies of water.

On contact with humans, the parasite burrows into the skin, matures into another stage (schistosomula), then migrates to the lungs and liver, where it matures into the adult form.

Life cycle of the parasitic agents responsible for causing    Bilharzia

The adult worm then migrates to its preferred body part, depending on its species. These areas include the bladder, rectum, intestines, liver, portal venous system (the veins that carry blood from the intestines to liver), spleen, and lungs.

Schistosomiasis is not usually seen in the United States. It is common in many tropical and subtropical areas worldwide.

Diagnosis:
Microscopic identification of eggs in stool or urine is the most practical method for diagnosis. The stool exam is the more common of the two. For the measurement of eggs in the feces of presenting patients the scientific unit used is eggs per gram (epg). Stool examination should be performed when infection with S. mansoni or S. japonicum is suspected, and urine examination should be performed if S. haematobium is suspected.

Eggs can be present in the stool in infections with all Schistosoma species. The examination can be performed on a simple smear (1 to 2 mg of fecal material). Since eggs may be passed intermittently or in small amounts, their detection will be enhanced by repeated examinations and/or concentration procedures (such as the formalin-ethyl acetate technique). In addition, for field surveys and investigational purposes, the egg output can be quantified by using the Kato-Katz technique (20 to 50 mg of fecal material) or the Ritchie technique.

Eggs can be found in the urine in infections with S. japonicum and with S. intercalatum (recommended time for collection: between noon and 3 PM). Detection will be enhanced by centrifugation and examination of the sediment. Quantification is possible by using filtration through a nucleopore membrane of a standard volume of urine followed by egg counts on the membrane. Investigation of S. haematobium should also include a pelvic x-ray as bladder wall calcificaition is highly characteristic of chronic infection.

Recently a field evaluation of a novel handheld microscope was undertaken in Uganda for the diagnosis of intestinal schistosomiasis by a team led by Dr. Russell Stothard from the Natural History Museum of London, working with the Schistosomiasis Control Initiative, London.

Tissue biopsy (rectal biopsy for all species and biopsy of the bladder for S. haematobium) may demonstrate eggs when stool or urine examinations are negative.

The eggs of S. haematobium are ellipsoidal with a terminal spine, S. mansoni eggs are also ellipsoidal but with a lateral spine, S. japonicum eggs are spheroidal with a small knob.

Antibody detection can be useful in both clinical management and for epidemiologic surveys.

Treatment:
Bilharzia  is readily treated using a single oral dose of the drug praziquantel annually. As with other major parasitic diseases, there is ongoing and extensive research into developing a schistosomiasis vaccine that will prevent the parasite from completing its life cycle in humans.

The World Health Organization has developed guidelines for community treatment of schistosomiasis based on the impact the disease has on children in endemic villages:

When a village reports more than 50 percent of children have blood in their urine, everyone in the village receives treatment.
When 20 to 50 percent of children have bloody urine, only school-age children are treated.
When less than 20 percent of children have symptoms, mass treatment is not implemented.
The Bill & Melinda Gates Foundation has recently funded an operational research program—the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) to answer strategic questions about how to move forward with schistosomiasis control and elimination. The focus of SCORE is on development of tools and evaluation of strategies for use in mass drug administration campaigns.

Antimony has been used in the past to treat the disease. In low doses, this toxic metalloid bonds to sulfur atoms in enzymes used by the parasite and kills it without harming the host. This treatment is not referred to in present-day peer-review scholarship; praziquantel is universally used. Outside of the U.S., there is a drug available exclusively for treating Schistosoma mansoni (oxamniquine) and one exclusively for treating S.hematobium (metrifonate). While metrifonate has been discontinued for use by the British National Health Service, a Cochrane review found it equally effective in treating urinary schistosomiasis as the leading drug, praziquantel.

Mirazid, an Egyptian drug, was under investigation for oral treatment of the disease up until 2005. The efficacy of praziquantel was proven to be about 8 times than that of mirazid and therefore mirazid was not recommended as a suitable agent to control schistosomiasis.

Experiments have shown medicinal castor oil as an oral anti-penetration agent to prevent schistosomiasis and that praziquantel’s effectiveness depended upon the vehicle used to administer the drug (e.g., Cremophor).

Prognosis:
Treatment before significant damage or severe complications occur usually produces good results.

Possible Complications:
•Bladder cancer
•Chronic kidney failure
•Chronic liver damage and an enlarged spleen
•Colon (large intestine) inflammation with bloody diarrhea
•Kidney and bladder obstruction
•Pulmonary hypertension
•Repeated blood infections can occur, because bacteria can enter the bloodstream through an irritated colon
•Right-sided heart failure
•Seizures

Prevention:
*Avoid swimming or wading in freshwater when you are in countries in which schistosomiasis occurs. Swimming in the ocean and in chlorinated swimming pools is generally thought to be safe.

*Drink safe water. Because there is no way to make sure that water coming directly from canals, lakes, rivers, streams or springs is safe, you should either boil water for 1 minute or filter water before drinking it. Boiling water for at least 1 minute will kill any harmful parasites, bacteria, or viruses present. Iodine treatment alone WILL NOT GUARANTEE that water is safe and free of all parasites.

*Bath water should be heated for 5 minutes at 150°F. Water held in a storage tank for at least 48 hours should be safe for showering.

*Vigorous towel drying after an accidental, very brief water exposure may help to prevent the Schistosoma parasite from penetrating the skin. You should NOT rely on vigorous towel drying to prevent schistosomiasis.

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.nlm.nih.gov/medlineplus/ency/article/001321.htm
http://www.bbc.co.uk/health/physical_health/conditions/bilharzia1.shtml
http://goafrica.about.com/od/healthandsafety/p/biharzia.htm
http://en.wikipedia.org/wiki/Schistosomiasis

http://asb.wchsgis.net/huge/cano_carlos/image_page_cano.htm

http://www.eoearth.org/article/Schistosomiasis

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Beard rash

Alternative Name:sycosis barbae,Pseudofolliculitis barbae; Tinea barbae; Barber’s itch

Definition:
Beard rash or Barber’s itch is a staph infection of the hair follicles in the beard area of the face, usually the upper lip. Shaving makes it worse. Tinea barbae is similar to barber’s itch, but the infection is caused by a fungus.It  is a cutaneous condition characterized by a chronic infection of the bearded region.

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Lost Beard
Lost Beard (Photo credit: Chris and Kris)

Pseudofolliculitis barbae is a disorder that occurs mainly in black men. If curly beard hairs are cut too short, they may curve back into the skin and cause inflammation.

The bacteria most often responsible for beard rash are those usually found on the skin surface such as streptococci or staphylococci. These bacteria can’t normally penetrate the barrier that the skin forms but if the skin is broken during shaving the bacteria may get through the skin’s defenses and start an infection.

Some factors increase the risk of beard rash, such as using or sharing unclean razors, clippers, combs or scissors. Anything that reduces a person’s overall immunity may also increase the risk.

Symptoms;
Common symptoms include a rash, itching, and pimples or pustules near a hair follicle on the beard area and the area becomes red, itchy, sore, lumpy, and often very painful if small abscesses develop. The pimples may crust over and the skin may be left scarred after the rash heals, unless it’s correctly treated.

Diagnosis:
A diagnosis is primarily based on how the skin looks. Lab tests may show which bacteria or fungus is causing the infection.

Treatment :
Your GP will confirm the diagnosis for you and advise you on the most appropriate type of  antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin), or antifungal medications to control the infection. It’s important to complete the whole course.

It can return after treatment, but there are a few things that usually prevent this from happening. Although you may prefer wet shaving, because it gives a clean feel to the skin, it does remove the top layer of skin, leaving nicks and scratches where bacteria can get in. Electric shaving is probably best for the time being since it’s gentler on the skin. The best time to shave is after a bath or shower, when the skin is moist.

A hot, moist compresses may promote drainage of the affected follicles.

Tea-tree oil gel is a good antiseptic and has antibacterial benefits. Get yourself an aftershave that contains this. Never let other people use your shaving equipment and always keep it clean.

Prognosis:
Folliculitis usually responds well to treatment, but may come back.

Possible Complications:
•Folliculitis may return
•Infection may spread to other body [amazon_link asins=’B01F1NWZEY,B00OOMEV5K’ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’c2b2222e-ee7f-11e6-a8ad-6bfa4358fd3f’]areas

Prevention:
To prevent further damage to the hair follicles and infection:

•Reduce friction from clothing
•Avoid shaving the area if possible (if shaving is necessary, use a clean, new razor blade or an electric razor each time)
•Keep the area clean
•Avoid contaminated clothing and washcloths

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/beardrash.shtml
http://en.wikipedia.org/wiki/Sycosis_barbae
http://www.dermnet.com/Sycosis-Barbae
http://www.nlm.nih.gov/medlineplus/ency/article/000823.htm

http://www.skininfection.com/Resources/ImgLib/Folliculitis.html

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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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Ailmemts & Remedies

Kyphosis

Alternative Names: Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis

Definition:
Kyphosis is a curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture.

click to see the picture

Some rounding is normal, but the term “kyphosis” usually refers to an exaggerated rounding, more than 50 degrees. This deformity is also called round back or hunchback.

click to see the picture

With kyphosis, your spine may look normal, or you may develop a hump. Kyphosis can occur as a result of developmental problems; degenerative diseases, such as arthritis of the spine; osteoporosis with compression fractures of the vertebrae; or trauma to the spine. It can affect all ages.

In the sense of a deformity, it is the pathological curving of the spine, where parts of the spinal column lose some or all of their lordotic profile. This causes a bowing of the back, seen as a slouching back and breathing difficulties. Severe cases can cause great discomfort and even lead to death.

Causes:
Our spine (vertebral column) is composed of bones (vertebrae), which are held together by tough, fibrous bands (ligaments). The vertebral column consists of seven neck (cervical) vertebrae, 12 middle back (thoracic) vertebrae and five lower back (lumbar) vertebrae. Lumbar vertebrae are the largest, and they carry most of your body’s weight. The sacrum, containing five fused vertebrae, is below the lumbar vertebrae. The last three tiny vertebrae, also fused together, are called the tailbone (coccyx).

Kyphosis is a forward rounding of the vertebrae in your thoracic spine. The vertebrae in your thoracic spine connect to your ribs.

Causes of kyphosis depend on the different types of kyphosis.
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Types of kyphosis in children and adolescents:
For children or adolescents, the most common types include:

*Postural kyphosis. This type mainly becomes apparent in adolescence. The onset of postural kyphosis generally is slow. It’s more common in girls. Poor posture or slouching may cause stretching of the spinal ligaments and abnormal formation of the bones of the spine (vertebrae). Postural kyphosis often is accompanied by an exaggerated inward curve (hyperlordosis) in the lower (lumbar) spine. Hyperlordosis is the body’s way of compensating for the exaggerated outward curve in the upper spine.

*Scheuermann’s kyphosis. Like postural kyphosis, Scheuermann’s kyphosis typically appears in adolescence, often between ages 10 and 15, while the bones are still growing. Also called Scheuermann disease, it’s slightly more common in boys. Scheuermann’s kyphosis may deform the vertebrae so that they appear wedge shaped, rather than rectangular, on X-rays. There may be another finding, known as Schmorl’s nodes, on the affected vertebrae. These nodes are the result of the cushion (disk) between the vertebrae pushing through bone at the bottom and top of a vertebra (end plates).

The cause of Scheuermann’s kyphosis is unknown, but it tends to run in families. Some people with this type of kyphosis also have scoliosis, a spinal deformity that causes a side-to-side curve. Adults who developed Scheuermann’s during childhood may experience increased pain as they get older.

*Congenital kyphosis. A malformation of the spinal column during fetal development causes kyphosis in some infants. Several vertebrae may be fused together or the bones may not form properly. This type of kyphosis may worsen as the child grows. In some cases, congenital kyphosis eventually leads to paralysis of the lower body (paraplegia).

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Causes in adults:
Disorders that may cause a curvature of the spine in adults, resulting in kyphosis, include:

*Osteoporosis, a bone-thinning disease that’s associated with fractures of the vertebrae, which cause compression of the spine and contribute to kyphosis
*Degenerative arthritis of the spine, which can cause deterioration of the bones and disks of the spine
*Ankylosing spondylitis, an inflammatory arthritis that affects the spine and nearby joints
*Connective tissue disorders, such as Marfan syndrome, that may affect the connective tissue’s ability to hold joints in their proper position
*Tuberculosis and other infections of the spine, which can result in destruction of joints
*Cancer or benign tumors that impinge on bones of the spine and force them out of position
*Spina bifida, a birth defect in which part of the spine doesn’t form completely, and which causes defects of the spinal cord and vertebrae
*Conditions that cause paralysis, such as cerebral palsy and polio, and that stiffen the bones of the spine

Symptoms:
•Difficulty breathing (in severe cases)
•Fatigue
•Mild back pain
•Round back appearance
•Tenderness and stiffness in the spine


Diagnosis:
TestsPhysical examination by Your doctor confirms the abnormal curve of the spine. Your doctor will record a history of your condition and conduct a physical exam. The  physical  exam  may include the following:

*Forward bend test. Your doctor asks you to bend forward from the waist while he or she views the spine from the side. With kyphosis, the rounding of the upper back may become more obvious in this position. In postural kyphosis, the deformity corrects itself when you lie on your back.
*Neurological functions test. Although neurological changes accompanying kyphosis are rare, your doctor may check for them by looking for weakness, changes in sensation or paralysis below the site of the kyphosis.
*Spinal imaging tests. Your doctor may take an X-ray to confirm the kyphosis, determine the degree of curvature and detect any deformity of the vertebrae, which helps identify the type of kyphosis. For example, the appearance of wedge-shaped vertebrae or other features on X-ray differentiates between postural kyphosis and Scheuermann’s kyphosis. In older adults, X-rays may show arthritic changes in the spine, which can contribute to an increase in pain. If your doctor suspects a tumor or infection, he or she may request an MRI of your spine.
*Pulmonary function tests. Your doctor may also use breathing tests to assess any breathing difficulty caused by the kyphosis.

The doctor will also look for any nervous system (neurological) changes (weakness, paralysis, or changes in sensation) below the curve.


Other tests may include:
•Spine x-ray
•Pulmonary function tests (if kyphosis affects breathing)
•MRI (if there may be a tumor, infection, or neurological symptoms)

Treatment:

Kyphosis treatment depends on the cause of the condition and the signs and symptoms that are present.

Less serious cases
In some cases, less aggressive types of treatment are appropriate:

*Postural kyphosis. This type of kyphosis doesn’t progress and may improve on its own. Exercises to strengthen back muscles, training in using correct posture and sleeping on a firm bed may help. Pain relievers may help ease discomfort if exercise and physical therapies aren’t fully effective.
*Structural kyphosis. For kyphosis caused by spinal abnormalities, treatment typically depends on your age and sex, the severity of your symptoms and how rigid the curve in your spine is. With Scheuermann’s kyphosis, monitoring for progression of the curvature may be all that’s recommended if you have no symptoms. Anti-inflammatory medications may help relieve pain. General conditioning exercises and physical therapy may help alleviate symptoms.
*Osteoporosis-related kyphosis. Multiple compression fractures in people who have low bone density can lead to abnormal curvature of the spine. If no pain or other complications are present, treatment for the kyphosis may not be necessary. But your doctor may recommend treatment of the osteoporosis to prevent further fractures and worsening of the kyphosis.
More serious cases
More severe cases of kyphosis require more aggressive treatment. The primary approaches are bracing and, as a last resort, surgery. With children and adolescents, the sooner treatment begins, the more effective it may be in halting the deformity.

When bracing is necessary
If your teenager is still growing and has moderate to severe kyphosis, your doctor may recommend bracing. Wearing a brace may slow or prevent further progression of the curvature and may even provide some correction.

There are several types of braces for children who have kyphosis. Your doctor can help you decide which brace would be most effective for your child.

Children who wear braces usually have few restrictions and can participate in most activities. Although a brace may feel uncomfortable and awkward at first, it must be worn as prescribed to be effective. Once the bones are fully grown, your child can be weaned off the brace according to your doctor’s instructions.

There are different types of braces for treating kyphosis in adults, varying from postural training devices to rigid body jackets. The goal of bracing in adults is typically to control pain.

When surgery is necessary
Spinal surgery carries many risks, so your doctor may recommend surgery only if you or your child has any of the following:

*Severe curvature of the spine that doesn’t respond to other treatment measures
*Kyphosis that continues to worsen
*Debilitating pain that doesn’t respond to medication
*Resulting neurological problems, such as paralysis
*Kyphosis related to a tumor or infection
Surgery also may be recommended for an infant with congenital kyphosis, in order to straighten the spine.

The goal of surgery is to reduce the degree of curvature. This is commonly done by fusing or joining the affected vertebrae. Doctors typically perform the surgery through incisions in the back, during general anesthetic.

Fusing the vertebrae involves connecting two or more of them with pieces of bone taken from the pelvis. Eventually, the vertebrae fuse with the bone pieces to prevent further progression of the curvature. Doctors attach metal rods, hooks, screws or wires to the spine to hold the vertebrae together while the bones fuse, which may take several months. Doctors leave the metal in the body to help support the fused area even after the bones have fused.

A drawback of spinal fusion is that it stops growth in that area of the spine. A child’s ultimate height isn’t affected greatly because the leg bones and the unaffected portion of the spine continue to grow normally.

The complication rate for spinal surgery is relatively high. Complications include bleeding, infection, pain, nerve damage, arthritis and disk degeneration. If the surgery fails to correct the problem, a second surgery may be needed.

Other procedures
Procedures called vertebroplasty and kyphoplasty have been developed recently to treat vertebral fractures. These procedures involve injecting a type of inert cement into the affected vertebrae. They can be effective in controlling pain associated with compression .

Coping & Support:
Adolescence is a time when young people are struggling with physical and emotional changes. Having a noticeable spinal deformity or wearing a brace can make this challenging time even more difficult.

Make sure your child has caring people to turn to, including supportive family and friends, or even a professional counselor, if necessary. Consider joining a support group for parents and kids with kyphosis or other spinal deformities to help you and your child connect with others facing similar challenges.

Prognosis:
Adolescents with Scheuermann’s disease tend to do well even if they need surgery, and the disease stops once they stop growing. If the kyphosis is due to degenerative joint disease or multiple compression fractures, surgery is needed to correct the defect and improve pain.


Possible Complications
•Decreased lung capacity
•Disabling back pain
•Neurological symptoms including leg weakness or paralysis
•Round back deformity

Prevention:
Treating and preventing osteoporosis can prevent many cases of kyphosis in the elderly. Early diagnosis and bracing of Scheuermann’s disease can reduce the need for surgery, but there is no way to prevent the disease.

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/Kyphosis
http://www.mayoclinic.com/health/kyphosis/DS00681
http://www.nlm.nih.gov/medlineplus/ency/imagepages/9561.htm
http://www.spineuniverse.com/conditions/kyphosis/kyphosis-scheuermanns-disease
http://www.nlm.nih.gov/medlineplus/ency/article/001240.htm
http://www.bbc.co.uk/health/physical_health/conditions/backcurves1.shtml

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