Month: March 2011

Categories
Ailmemts & Remedies Pediatric

Concussion

Alternative Names :Mild brain injury, Mild traumatic brain injury (MTBI), mild head injury (MHI), minor head trauma

Definition:
A concussion is a traumatic brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally.Effects are usually temporary, but can include problems with headache, concentration, memory, judgment, balance and coordination.

You may click to see the picture

Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. These injuries can cause a loss of consciousness, but most concussions do not. Because of this, some people have concussions and don’t realize it.

Concussions are common, particularly if you play a contact sport, such as football, boxing etc. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Luckily, most concussive traumatic brain injuries are mild, and with rest, most people fully recover from concussions within a few hours to a few weeks.

On rare occasions, concussions cause more serious problems. Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking. Because of the small chance of permanent brain problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

Symptoms:
It is not always easy to know if someone has a concussion. Not everyone who has a concussion passes out. A person who might have a concussion should immediately stop any kind of activity or sport. Becoming active again before the brain returns to normal functioning increases the person’s risk of having a more serious brain injury.

Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.

Symptoms of a concussion include:
*Passing out.
*Not being able to remember what happened after the injury.
*Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
*Feeling lightheaded, seeing “stars,” having blurry vision, or experiencing ringing in the ears.
*Not being able to stand or walk; or having coordination and balance problems.
*Feeling nauseous or throwing up.

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can’t readily communicate how they feel. Nonverbal clues of a concussion may include:
*Listlessness, tiring easily
*Irritability, crankiness
*Change in eating or sleeping patterns
*Lack of interest in favorite toys
*Loss of balance, unsteady walking

Occasionally a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:

*Changes in your ability to think, concentrate, or remember.
*Headaches or blurry vision.
*Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
*Changes in your personality such as becoming angry or anxious for no clear reason.
*Lack of interest in your usual activities.
*Changes in your sex drive.
*Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

Causes:
Your brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. But if your head or your body is hit unexpectedly hard, your brain can suddenly crash into your skull and temporarily stop working normally.

There are many ways to get a concussion. Some common ways include fights, falls, playground injuries, car crashes, and bike accidents. Concussions can also happen while participating in rough or high-speed sports such as football, boxing, hockey, soccer, skiing, or snowboarding.

Risk Factors:
Factors that may increase your risk of a concussion include:

*Participating in a high risk sport, such as football, hockey, soccer or other contact sport; the risk is further increased if there’s a lack of proper safety equipment and supervision
*Being involved in a motor vehicle collision
*Being a soldier involved in combat
*Being a victim of physical abuse
*Falling, especially in young children and older adults
*Having had a previous concussion

Complications:
Potential complications of concussion include:

*Epilepsy. People who have had a concussion double their risk of developing epilepsy within the first five years after the injury.

*Cumulative effects of multiple brain injuries. Evidence exists indicating that people who have had multiple concussive brain injuries over the course of their lives may acquire lasting, and even progressive, cognitive impairment that limits functional ability.

*Second impact syndrome. Sometimes, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and typically fatal brain swelling. After a concussion, the levels of brain chemicals are altered. It usually takes about a week for these levels to stabilize again. However, the time it takes to recover from a concussion is variable, and it is important for athletes never to return to sports while they’re still experiencing signs and symptoms of concussion.
Diagnosis:
Diagnosis of Concussion is based on physical and neurological exams, duration of unconsciousness (usually less than 30 minutes) and post-traumatic amnesia (PTA; usually less than 24 hours), and the Glasgow Coma Scale (MTBI sufferers have scores of 13 to 15). Neuropsychological tests exist to measure cognitive function. The tests may be administered hours, days, or weeks after the injury, or at different times to determine whether there is a trend in the patient’s condition. Athletes may be tested before a sports season begins to provide a baseline comparison in the event of an injury.

Health care providers examine head trauma survivors to ensure that the injury is not a more severe medical emergency such as an intracranial hemorrhage. Indications that screening for more serious injury is needed include worsening of symptoms such as headache, persistent vomiting, increasing disorientation or a deteriorating level of consciousness,   seizures, and unequal pupil size. People with such symptoms, or who are at higher risk for a more serious brain injury, are CT scanned to detect brain lesions and are frequently observed for 24 – 48 hours.

If the Glasgow Coma Scale is less than 15 at two hours or less than 14 at any time a CT recommended.[8] In addition, they may be more likely to perform a CT scan on people who would be difficult to observe after discharge or those who are intoxicated, at risk for bleeding, older than 60, or younger than 16. Most concussions cannot be detected with MRI or CT scans.   However, changes have been reported to show up on MRI and SPECT imaging in concussed people with normal CT scans, and post-concussion syndrome may be associated with abnormalities visible on SPECT and PET scans. Mild head injury may or may not produce abnormal EEG readings.

Concussion may be under-diagnosed. The lack of the highly noticeable signs and symptoms that are frequently present in other forms of head injury could lead clinicians to miss the injury, and athletes may cover up their injuries to remain in the competition. A retrospective survey in 2005 found that more than 88% of concussions go unrecognized;.

Diagnosis of concussion can be complicated because it shares symptoms with other conditions. For example, post-concussion symptoms such as cognitive problems may be misattributed to brain injury when they are in fact due to post-traumatic stress disorder (PTSD).

Treatment:
Usually concussion symptoms go away without treatment, and no specific treatment exists. About one percent of people who receive treatment for MTBI need surgery for a brain injury. Traditionally, concussion sufferers are prescribed rest, including plenty of sleep at night plus rest during the day. Health care providers recommend a gradual return to normal activities at a pace that does not cause symptoms to worsen. Education about symptoms, how to manage them, and their normal time course can lead to an improved outcome.

Medications may be prescribed to treat symptoms such as sleep problems and depression. Analgesics such as ibuprofen can be taken for the headaches that frequently occur after concussion, but paracetamol (acetaminophen) is preferred to minimize the risk for complications such as intracranial hemorrhage. Concussed individuals are advised not to drink alcohol or take drugs that have not been approved by a doctor, as they could impede healing.

Observation to monitor for worsening condition is an important part of treatment. Health care providers recommend that those suffering from concussion return for further medical care and evaluation 24 to 72 hours after the concussive event if the symptoms worsen. Athletes, especially intercollegiate or professional athletes, are typically followed closely by team trainers during this period. But others may not have access to this level of health care and may be sent home with no medical person monitoring them unless the situation gets worse. Patients may be released from the hospital to the care of a trusted person with orders to return if they display worsening symptoms or those that might indicate an emergent condition, like unconsciousness or altered mental status; convulsions; severe, persistent headache; extremity weakness; vomiting; or new bleeding or deafness in either or both ears. Repeated observation for the first 24 hours after concussion is recommended; however it is not known whether it is necessary to wake the patient up every few hours.

Prognosis:
Concussion has a mortality rate of almost zero. The symptoms of most concussions resolve within weeks, but problems may persist. Problems are seldom permanent, and outcome is usually excellent. People over age 55 may take longer to heal from MTBI or may heal incompletely. Similarly, factors such as a previous head injury or a coexisting medical condition have been found to predict longer-lasting post-concussion symptoms. Other factors that may lengthen recovery time after MTBI include psychological problems such as substance abuse or clinical depression, poor health before the injury or additional injuries sustained during it, and life stress.  Longer periods of amnesia or loss of consciousness immediately after the injury may indicate longer recovery times from residual symptoms. For unknown reasons, having had one concussion significantly increases a person’s risk of having another. Having previously sustained a sports concussion has been found to be a strong factor increasing the likelihood of a concussion in the future. Other strong factors include participation in a contact sport and body mass size. The prognosis may differ between concussed adults and children; little research has been done on concussion in the pediatric population, but concern exists that severe concussions could interfere with brain development in children.

A 2009 study published in Brain found that individuals with a history of concussions might demonstrate a decline in both physical and mental performance for longer than 30 years. Compared to their peers with no history of brain trauma, sufferers of concussion exhibited effects including loss of episodic memory and reduced muscle speed.

Prevention:
The following tips may help you to prevent or minimize your risk of head injury:

*Wear appropriate protective gear during sports and other recreational activities. Always use the appropriate protective gear for any sport you or your child undertakes. Make sure the equipment fits properly, is well maintained and worn correctly. Follow the rules of the game and practice good sportsmanship. When bicycling, motorcycling, snowboarding or engaging in any recreational activity that may result in head injury, wear protective headgear.

*Buckle your seat belt. Wearing a seat belt may prevent serious injury, including an injury to your head, during a traffic accident.

*Make your home safe. Keep your home well lit and your floors free of clutter — meaning anything that might cause you to trip and fall. Falls around the home are the leading cause of head injury for infants, toddlers and older adults.

*Protect your children. To help lessen the risk of head injuries to your children, pad countertops and edges of tables, block off stairways and install window guards. Don’t let your children play sports that aren’t suitable for their ages.

*Use caution in and around swimming areas. Don’t dive into water less than 9 feet (3 meters) deep. Read and follow posted safety rules at water parks and swimming pools.

*Wear sensible shoes. If you’re older, wear shoes that are easy to walk and maneuver in. Avoid wearing high heels, sandals with thin straps, or shoes that are either too slippery or too sticky.

Prevention of  Concussion  involves taking general measures to prevent traumatic brain injury, such as wearing seat belts and using airbags in cars. Older people are encouraged to try to prevent falls, for example by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance.

Use of protective equipment such as headgear has been found to reduce the number of concussions in athletes. Improvements in the design of protective athletic gear such as helmets may decrease the number and severity of such injuries. New “Head Impact Telemetry System” technology is being placed in helmets to study injury mechanisms and potentially help reduce the risk of concussions among American Football players. Changes to the rules or the practices of enforcing existing rules in sports, such as those against “head-down tackling”, or “spearing,” which is associated with a high injury rate, may also prevent concussions.

Post-concussion syndrome:
In post-concussion syndrome, symptoms do not resolve for weeks, months, or years after a concussion, and may occasionally be permanent. Symptoms may include headaches, dizziness, fatigue, anxiety, memory and attention problems, sleep problems, and irritability. There is no scientifically established treatment, and rest, a recommended recovery technique, has limited effectiveness. Symptoms usually go away on their own within months. The question of whether the syndrome is due to structural damage or other factors such as psychological ones, or a combination of these, has long been the subject of debate.

Cumulative effects:
Cumulative effects of concussions are poorly understood. The severity of concussions and their symptoms may worsen with successive injuries, even if a subsequent injury occurs months or years after an initial one. Symptoms may be more severe and changes in neurophysiology can occur with the third and subsequent concussions. Studies have had conflicting findings on whether athletes have longer recovery times after repeat concussions and whether cumulative effects such as impairment in cognition and memory occur.

Cumulative effects may include psychiatric disorders and loss of long-term memory. For example, the risk of developing clinical depression has been found to be significantly greater for retired American football players with a history of three or more concussions than for those with no concussion history.[74] Three or more concussions is also associated with a fivefold greater chance of developing Alzheimer’s disease earlier and a threefold greater chance of developing memory deficits.

Dementia pugilistica:
Chronic encephalopathy is an example of the cumulative damage that can occur as the result of multiple concussions or less severe blows to the head. The condition called dementia pugilistica, or “punch drunk” syndrome, which is associated with boxers, can result in cognitive and physical deficits such as parkinsonism, speech and memory problems, slowed mental processing, tremor, and inappropriate behavior. It shares features with Alzheimer’s disease.

Second-impact syndrome:
Second-impact syndrome, in which the brain swells dangerously after a minor blow, may occur in very rare cases. The condition may develop in people who receive a second blow days or weeks after an initial concussion, before its symptoms have gone away. No one is certain of the cause of this often fatal complication, but it is commonly thought that the swelling occurs because the brain’s arterioles lose the ability to regulate their diameter, causing a loss of control over cerebral blood flow.  As the brain swells, intracranial pressure rapidly rises. The brain can herniate, and the brain stem can fail within five minutes. Except in boxing, all cases have occurred in athletes under age 20. Due to the very small number of documented cases, the diagnosis is controversial, and doubt exists about its validity.

Epidemiology:
Most cases of traumatic brain injury are concussions. A World Health Organization (WHO) study estimated that between 70 and 90% of head injuries that receive treatment are mild. However, due to underreporting and to the widely varying definitions of concussion and MTBI, it is difficult to estimate how common the condition is. Estimates of the incidence of concussion may be artificially low, for example due to underreporting. At least 25% of MTBI sufferers fail to get assessed by a medical professional. The WHO group reviewed studies on the epidemiology of MTBI and found a hospital treatment rate of 1–3 per 1000 people, but since not all concussions are treated in hospitals, they estimated that the rate per year in the general population is over 6 per 1000 people.

Young children have the highest concussion rate among all age groups. However, most people who suffer concussion are young adults. A Canadian study found that the yearly incidence of MTBI is lower in older age groups (graph at right). Studies suggest males suffer MTBI at about twice the rate of their female counterparts. However, female athletes may be at a higher risk for suffering concussion than their male counterparts.

Up to five percent of sports injuries are concussions. The U.S. Centers for Disease Control and Prevention estimates that 300,000 sports-related concussions occur yearly in the U.S., but that number includes only athletes who lost consciousness.  Since loss of consciousness is thought to occur in less than 10% of concussions, the CDC estimate is likely lower than the real number. Sports in which concussion is particularly common include football and boxing (a boxer aims to “knock out”, i.e. give a mild traumatic brain injury to, the opponent). The injury is so common in the latter that several medical groups have called for a ban on the sport, including the American Academy of Neurology, the World Medical Association, and the medical associations of the UK, the U.S., Australia, and Canada.

Due to the lack of a consistent definition, the economic costs of MTBI are not known, but they are estimated to be very high. These high costs are due in part to the large percentage of hospital admissions for head injury that are due to mild head trauma, but indirect costs such as lost work time and early retirement account for the bulk of the costs. These direct and indirect costs cause the expense of mild brain trauma to rival that of moderate and severe head injuries.

You may click to learn more

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/concussion1.shtml
http://en.wikipedia.org/wiki/Concussion
http://www.mayoclinic.com/health/concussion/DS00320
http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview?page=2

Related articles
Enhanced by Zemanta
Categories
Herbs & Plants

Oca(Oxalis tuberosa)

[amazon_link asins=’B06WWC86LP,B06WWC87K8′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’6950d2a2-2272-11e7-b4c8-25a5be0c5d98′]

[amazon_link asins=’B01B7KKUC4,B06WWC87K8′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’9e108c0f-2272-11e7-bb36-335690ba908a’]

Botanical Name :Oxalis tuberosa
Family: Oxalidaceae
Genus: Oxalis
Species: O. tuberosa
Kingdom: Plantae
Order: Oxalidales
Synonym:Oxalis crenata
Common Names: oca , oka, or New Zealand Yam

Alternative Names: Apilla in Bolivia,Hibia in Colombia and Yam in many other places, such as Polynesia.

Habitat :Ocas (Oxalis tuberosa) is extensively cultivated in Peru and Bolivia. It is also grown commercially in New Zealand where it is known as yam,  and grows very well in the UK and Ireland. It has small edible tubers which are washed, and can then be boiled, roasted, stir fried, or even eaten row in salads.

Description:
PERENNIAL growing to 0.5 m (1ft 8in) by 0.3 m (1ft).
It is hardy to zone 7 and is not frost tender. It is in flower from Jul to August. The flowers are hermaphrodite (have both male and female organs) and are pollinated by Insects.

click to see the pictures…….>..….(1).…….…(2)………(3)…......

The plant prefers light (sandy) and medium (loamy) soils and requires well-drained soil.The plant prefers acid, neutral and basic (alkaline) soils..It cannot grow in the shade.It requires moist soil.

.

Typical trifoliate leaves with silvery soft hairs and bright yellow oxalis flowers. Produces numerous, buff, pink, red or brown tubers, much smaller than a potato and yields about 8lbs of tubers per plant on moderate soil.

This plant is by no means frost hardy, tubers can be lifted and replanted the following year, left in a large container under glass over the winter and repotted the following year.

Edible Uses:
Edible Parts: Flowers;  Leaves;  Root.

Tubers – raw or cooked. An acid lemon flavour when first harvested, if left out in the sun the tubers turn sweet, so sweet in some varieties that they are said to resemble dried figs and are sold as fruits in local markets in S. America. The cooked root is delicious whether in its sweet or acid state, it can be boiled, baked etc in similar ways to potatoes[K]. The tubers tend to be rather smaller than potatoes, with good sized specimens reaching 8cm or more in length. The slightly waxy skin makes cleaning them very easy[K]. They contain about 70 – 80% moisture, 11 – 22% carbohydrate, 1% fat, 1% fibre and 1% ash. The carbohydrate is rich in sugar and easy to digest. Acid types are rich in oxalic acid (up to 500ppm) but sweet forms have much less oxalic acid than is found in potatoes. Edible young leaves and flowers – raw or cooked. Poor quality. Use in moderation, see notes at top of sheet,

The flavour is slightly tangy, and texture ranges from crunchy (like a carrot) when undercooked, to starchy or mealy when fully cooked. Though the original Andean varieties are widely variable in colour from purple to yellow, the usual New Zealand variety is a fleshy pink.

Most New Zealanders know the oca simply as the yam; the Dioscorea vegetables known elsewhere as yams are generally very uncommon there.

Yams are commonly confused with Sweet potatoes, although they are not closely related. In New Zealand Sweet potatoes are commonly referred to by their M?ori name of k?mara.

Oca can be boiled, baked or fried. In the Andes it is used in stews and soups, served like potatoes or can be served as a sweet. Oca is eaten raw in Mexico with salt, lemon, and hot pepper.

Cultivation:
Prefers a light rich soil in a warm sunny position. Tolerates a pH range from 5.3 to 7.8. Plants succeed in areas with an average rainfall ranging from 570 – 2150mm per year. Oka is widely cultivated in the Andes for its edible tubers, there are many named varieties[33, 97]. This species has an excellent potential as a major root crop in temperate zones, it has the potential to yield as highly as potatoes but does not have the susceptibility to pests and diseases that are a bugbane for potato growers[K]. Plants are slightly more hardy than the potato, tolerating light frosts but the top-growth being severely damaged or killed by temperatures much below freezing. The main drawback is that development of the tubers is initiated by the number of hours of daylight in a day. In Britain this means that tubers do not begin to form until after the 21st of September and, if there are early frosts in the autumn, yields will be low. There are possibly some forms in southern Chile that are not sensitive to daylength, these will be more suitable to higher latitudes such as Britain. It is said that the varieties with white tubers are bitter because they contain calcium oxylate crystals whilst those with tubers that are of other colours are sweet. However, we are growing one variety with white tubers and it most certainly is not bitter[K]. Yields tend to average about 7 – 10 tonnes per hectare but experimentally yields of 40 tonnes per hectare have been achieved. Earthing up the growing stems as they start to form tubers can increase yields significantly.

Propagation    :
Seed – best sown as soon as it is ripe in a cold frame. Prick out the seedlings into individual pots when they are large enough to handle and plant them out in late spring or early summer. Seed is not usually produced in Britain. Harvest the tubers in late autumn after the frosts have killed off top growth. Store in a cool dry frost free place and plant out in April. Basal cuttings in spring[196]. Harvest the shoots with plenty of underground stem when they are about 8 – 10cm above the ground. Pot them up into individual pots and keep them in light shade in a cold frame or greenhouse until they are rooting well. Plant them out in the summer.

Edible Uses;
The stem tubers of oca form in the ground in the autumn. These are commonly boiled before eating although they can also be eaten raw. The leaves and young shoots can be eaten as a green vegetable. Introduced to Europe in 1830 as a competitor to the potato and to New Zealand as early as 1860, it has become popular in that country under the name New Zealand yam and is now a common table vegetable. It is also widely known in the Polynesian islands of the South Pacific under the name yam.

Medicinal Uses; Not known.

Known hazards :
The leaves contain oxalic acid, which gives them their sharp flavour. Perfectly all right in small quantities, the leaves should not be eaten in large amounts since oxalic acid can bind up the body’s supply of calcium leading to nutritional deficiency. The quantity of oxalic acid will be reduced if the leaves are cooked. People with a tendency to rheumatism, arthritis, gout, kidney stones or hyperacidity should take especial caution if including this plant in their diet since it can aggravate their condition.

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

Resources:
http://en.wikipedia.org/wiki/Oca
http://www.pfaf.org/user/Plant.aspx?LatinName=Oxalis%20tuberosa
http://www.naturalmedicinalherbs.net/herbs/o/oxalis-tuberosa=oca.php
http://davesgarden.com/guides/pf/go/2039/
http://ecofarm.ie/oca/

Related articles
Enhanced by Zemanta
Categories
Ailmemts & Remedies

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.

You may click to see the picture

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.

CLICK & SEE

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

Related articles
Enhanced by Zemanta
Categories
Featured

Five for Fitness

[amazon_link asins=’B003MWQYSA,B01G6T8ZUK,B01N808QIH,B01354KV3S,B075B3QSN3,B075WX2W9N,B076BQFHV8,B01G9KIQL4,B0787WZCP9′ template=’ProductCarousel’ store=’finmeacur-20′ marketplace=’US’ link_id=’d5df7d32-063f-11e8-8688-fd3244cfe3b8′]

Most of us are born healthy and usually remain so with minimal effort till around 20. After that, our body starts to fall apart — like an old, unserviced machine — unless some effort is made to maintain the inherent fitness levels.

……..CLICK & SEE

The recommendations vary from walking an hour daily (ideal) to 30 minutes three days a week (just about enough to scrape along). Despite doing this, people develop stress, bad posture, arthritis, diabetes, abnormal lipid profiles, hypertension and heart attacks. That’s because they are unaware of the other components of an ideal fitness regimen, the need to simultaneously develop “core strength”, flexibility, strength training and balance.

People are bombarded by adverts of gyms and expensive exercise equipment. The latter may target specific muscle groups to produce a six-pack abdomen and bulging biceps. Most people do not, however, have the time to go to a gym regularly. As for fancy equipment, it usually starts to gather dust after a short period of activity.

Corporate gurus talk about maintaining core strength, and employees take to meditation, religion and prayer as they try to maintain their inner fortitude. Actually, in fitness terms, strengthening the “core” means exercising the muscles deep within the torso, the abdominal muscles, those of the back and pelvic floor. The core is a group of muscles, so a balanced approach is needed to work them all. All body movement is powered by these muscles. A strong back and fit abdominal muscles are needed, or else it results in poor posture and back problems. These muscles work together to support the spine when we sit, stand, bend over, pick up things and exercise. In sum, they are the body’s epicentre of power and balance.

Dancers and yoga practitioners do exercises that give them strong core muscles. They are thus fitter, have better postures and more energy than their peers in old age.

Core training can be done at home. It requires just 20 minutes thrice a week. The exercises are regularly taught as part of yoga and Pilates. CDs and books are also available. Proper demonstration will enable you to do them correctly.

A simple, effective core workout routine which covers all the basic muscles includes the plank exercise (balancing on the toes and forearms), the side plank (where you balance on one arm and leg), push-ups, squats, cycling in the air and lunges. All movements need to be held for 20 seconds at a time. Repeat five or six times.

Strength training does not involve heavy weight lifting. The muscles of the arms legs and lower back can be effectively trained using 1kg weights. This can be done with an iron or aluminum baby dumbbell (available at sports shops). You could even fabricate one by filling a 1-litre plastic bottle with water. The movements are similar to those in a school PT drill. Doing this regularly will slowly and surely build up muscle power.

People often do not give enough importance to flexion training of the muscles. If you don’t do anything more stressful than slow walking, your calf muscles may contract and eventually become tight. They can then restrict the range of motion at the knee and ankle resulting in eventual injury. All the groups of muscles in the body need to be stretched to their limit but there should not be any pain. Stretching is taught in yoga. The exercises are also demonstrated on the Doordarshan sports channel. If you discontinue the activity, benefits are lost in three or four days.

Balance becomes more and more important with age. Training for balance involves standing on one leg at a time with the arms stretched out. Once you are able to do this with ease, try doing it with your eyes closed.

A common misconception is that exercise tires you out. On the contrary, it improves stamina and the ability to perform day-to-day activities. Several studies have shown that it reduces cortisol levels and therefore improves mental strength and reduces stress.

To be effective, exercise training needs to balance the five elements of good health. The routine should include aerobic activity, muscular fitness, stretching, core exercise and balance training.

Sometimes fitting in an exercise schedule with all these components becomes difficult. Try getting up half an hour earlier in the morning to complete the routine. Regular exercise will improve balance and posture and reduce the risk of injury, lifestyle diseases and arthritis, leading to a long, healthy and happy life.

Source : The Telegraph ( Kolkata, India)

Related articles
Enhanced by Zemanta
Categories
Ailmemts & Remedies

Carbon Monoxide Poisoning

Introduction:
Carbon monoxide is a gas. It is a product of incomplete combustion of natural or petroleum gas.  It has no odor or color. You can’t see it, smell it, or taste it; but carbon monoxide can kill you. Inhaling the gas reduces the blood’s ability to carry oxygen, leaving the body’s organs and cells starved of oxygen.

CLICK TO SEE..>...…..(01).……….(1)..….(.2).……...(3).……...(4)……….(5).…………(6)
...Click to see the picture.
Common sources of carbon monoxide is automobiles on road and in  in the home include faulty central heating systems, gas appliances and fires. Blocked flues and chimneys mean the gas can’t escape and is inhaled by the unsuspecting individual.CO from these fumes can build up in places that don’t have a good flow of fresh air.  One  can be poisoned by breathing them in.

It is often hard to tell if someone has CO poisoning, because the symptoms may be like those of other illnesses. People who are sleeping or intoxicated can die from CO poisoning before they have symptoms. A CO detector can warn you if you have high levels of CO in your home.

Symptoms:
The symptoms of mild carbon monoxide poisoning may be non-specific and similar to those of viral cold and flu infections or food poisoning: headache, nausea, abdominal pain, dizziness, sore throat and dry cough.

The most common symptoms of CO poisoning are:
•Headache
•Dizziness
•Nausea
•Flu-like symptoms, fatigue
•Shortness of breath on exertion
•Impaired judgment
•Chest pain
•Confusion
•Depression
•Hallucinations
•Agitation
•Vomiting
•Abdominal pain
•Drowsiness
•Visual changes
•Fainting
•Seizure
•Memory and walking problems

In children, the symptoms are similar to those of a stomach upset, with nausea and vomiting.

More severe poisoning can result in a fast and irregular heart rate, hyperventilation, confusion, drowsiness and difficulty breathing. Seizures and loss of consciousness may also occur.

Some symptoms can occur a few days or even months after exposure to carbon monoxide. These may include confusion, loss of memory and problems with coordination.

Causes:
Carbon monoxide is formed when organic compounds burn. The most common sources are motor vehicle exhaust, smoke from fires, engine fumes, and nonelectric heaters. Carbon monoxide poisoning is often associated with malfunctioning or obstructed exhaust systems and with suicide attempts.

Sources of carbon monoxide:

•Gas water heaters
•Kerosene space heaters
•Charcoal grills
•Propane heaters and stoves
•Gasoline and diesel powered generators
•Cigarette smoke
•Propane-fueled forklifts
•Gasoline powered concrete saws
•Indoor tractor pulls
•Any boat with an engine
•Spray paint, solvents, degreasers, and paint removers

Risk Factors:
Risks for exposure to carbon monoxide include:
•Children riding in the back of enclosed pickup trucks (particularly high risk)
•Industrial workers at pulp mills, steel foundries, and plants producing formaldehyde or coke (a hard grey fuel)
•Personnel at fire scenes
•Using heating sources or electric generators during power outages
•Those working indoors with combustion engines or combustible gases
•Swimming near or under the stern or swim-step of a boat with the boat engine running
•Back drafting when a boat is operated at a high bow angle
•Mooring next to a boat that is running a generator or engine
•Improper boat ventilation

Diagnosis:
Because signs and symptoms of carbon monoxide poisoning are not specific, a blood test to look for it is the best way to make the diagnosis.

Treatment;
•The treatment for carbon monoxide poisoning is high-dose oxygen, usually using a facemask attached to an oxygen reserve bag.
•Carbon monoxide levels in the blood may be periodically checked until they are low enough to safely send you home.
•In severe poisoning, if available, a hyperbaric pressure chamber may be used to give even higher doses of oxygen.
•It is important to find the source of the carbon monoxide. Your local fire department or public service company will help find the source of carbon monoxide and make sure the building is safe.

Self-Care at Home:
•Move all family members and pets to fresh air away from the source of carbon monoxide (CO).
•No home therapy is available for carbon monoxide poisoning.
•You must seek medical care in a hospital emergency department.

Prognosis:
The prognosis for a person with carbon monoxide poisoning is difficult to predict.
•Death can result from severe cases.
•Even with proper treatment, some people develop long-term brain damage, resulting in complications such as severe memory loss, difficulty thinking, or other neurologic or psychiatric problems.
•Others appear to have no long-term problems.
*People who suffer mild poisoning invariably make a full recovery. Between ten and 50 per cent of those with severe poisoning may suffer long-term problems.

Prevention:
Your best protection is to install a carbon monoxide alarm on each level of your home or boat as your first line of defense. According to the National Fire Protection Association some 93% of homes have smoke alarms, yet the Consumer Product Safety Commission estimates that only 15% have carbon monoxide alarms. A carbon monoxide monitor with an audible alarm works much like a home smoke alarm and beeps loudly when the sensors detect carbon monoxide.

CLICK TO SEE.>...(1).…………..(2)……...(3).……..(4)...…….

•If the alarm sounds, evacuate the building. People who have symptoms of carbon monoxide poisoning should seek emergency medical care. Call the fire department or public service company to investigate.

•Inspect your home for hazards.

*Your home heating system, chimney, and flue must be inspected and cleaned by a qualified technician every year. Keep chimneys clear of bird and squirrel nests, leaves, and residue to ensure proper ventilation.

*Be sure your furnace and other appliances, such as gas ovens, ranges, and cook tops, are inspected for adequate ventilation.

*Do not burn charcoal inside your house (even in the fireplace). Have gas fireplaces inspected each fall to ensure the pilot light burns safely.

*Do not operate gasoline-powered engines in confined areas such as garages or basements. Do not leave your car, mower, or other vehicle running in an attached garage, even with the door open.

*Do not block or seal shut exhaust flues or ducts for appliances such as water heaters, ranges, and clothes dryers.

*Become familiar with the hazards of carbon monoxide poisoning and boating (please see Web Links section).

For More Information:
——————————–

You may click & see:-
*Environmental Protection Agency, Protect Your Family and Yourself from Carbon Monoxide Poisoning

*Centers for Disease Control – Prevent Carbon Monoxide Poisoning on Your Boat

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/carbonmonoxide1.shtml
http://www.emedicinehealth.com/carbon_monoxide_poisoning/article_em.htm
http://www.salem-news.com/articles/december212006/tips_122106.php
http://healthforworld.blogspot.com/2008/11/carbon-monoxide-poisoning.html

http://www.cdc.gov/co/faqs.htm

Related articles
Enhanced by Zemanta
css.php