Category Archives: Ailmemts & Remedies

Candida auris

Description:
Candida auris is a species of fungus first described in 2009, which grows as yeast. It is one of the few species of the genus Candida which cause candidiasis in humans. Often, candidiasis is acquired in hospitals by patients with weakened immune systems. C. auris can cause invasive candidiasis (fungemia) in which the bloodstream, the central nervous system, and internal organs are infected. It has recently attracted increased attention because of its multiple drug resistance. Treatment is also complicated because it is easily misidentified as other Candida species. C. auris was first described after it was isolated from the ear canal of a 70-year-old Japanese woman at the Tokyo Metropolitan Geriatric Hospital in Japan in 2009. In 2011 South Korea saw its first cases of disease-causing C. auris. Reportedly, this spread across Asia and Europe, and first appeared in the U.S. in 2013. DNA analysis of four distinct but drug-resistant strains of Candida auris indicate an evolutionary divergence taking place at least 4,000 years ago, with a common leap among the four varieties into drug-resistance possibly linked to widespread azole-type antifungal use in agriculture.

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Candida auris is an emerging fungus that presents a serious global health threat. Healthcare facilities in several countries have reported that C. auris has caused severe illness in hospitalized patients. Some strains of Candida auris are resistant to all three major classes of antifungal drugs. This type of multidrug resistance has not been seen before in other species of Candida.

Symptoms:
This is where things get a little tricky. The most common symptoms are a fever and chills that don’t get better with antibiotic treatment, the CDC says. But, given that people who develop the infection usually have another underlying illness, it can be tough to spot Candida auris from symptoms alone.

Once it takes hold, the fungal infection can get into a person’s bloodstream or wounds and cause serious health issues like sepsis. “A patient’s temperature may go up, their blood pressure can go down, and they have complications of a preexisting illness because of Candida auris,” Dr. Schaffner says. The fungal infection has a high mortality rate (more than one in three patients with invasive Candida auris die, according to CDC data), but it’s tricky for doctors to say whether a person died from the fungal infection or their underlying illness. “Whatever the cause, having Candida auris doesn’t help a patient in any way,” Dr. Schaffner says.

Causes:
C. auris has caused bloodstream infections, wound infections, and ear infections. It also has been isolated from respiratory and urine specimens, but it is unclear if it causes infections in the lung or bladder.

Diagnosis:
C. auris is difficult to identify with standard laboratory methods and can be misidentified in labs without specific technology.

Healthcare facilities in several countries have reported that C. auris has been causing severe illness in hospitalized patients. In some patients, this yeast can enter the bloodstream and spread throughout the body, causing serious invasive infections. This yeast often does not respond to commonly used antifungal drugs, making infections difficult to treat. Patients who have been in the intensive care unit for a long time or have a central venous catheter placed in a large vein, and have previously received antibiotics or antifungal medications, appear to be at highest risk of infection with this yeast.

Specialized laboratory methods are needed to accurately identify C. auris. Conventional lab techniques could lead to misidentification and inappropriate treatment, making it difficult to control the spread of C. auris in healthcare settings.

CDC is concerned about C. auris for three main reasons:

1.It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections.

2.It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.

3.It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.

Prevention:
In general, it comes down to “meticulous infection control,” Dr. Adalja says. That means that hospital and nursing home rooms need to be well cleaned and that people interacting with patients need to practice good hand hygiene, which will kill the infection. “There’s no other way to prevent it,” Dr. Adalja says.

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

Resources:
https://en.wikipedia.org/wiki/Candida_auris
https://www.cdc.gov/fungal/candida-auris/index.html
https://www.medicinenet.com/candida_auris_c_auris/article.htm#candida_auris_c_auris_facts
https://www.prevention.com/health/health-conditions/a27074966/superbug-fungus-candida-auris-symptoms/

Knee Pain

Description:

Knee pain is a complaint of many people of all ages but most common with old aged ones. Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee. Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems (such as a foot injury). Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

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Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. But in some cases, however, it needs surgical repair.

Symptoms:
Signs and symptoms of knee pain include:

1.Swelling and stiffness

2.Redness and warmth to the touch

3.Weakness or instability

4.Popping or crunching noises

4.Inability to fully straighten the knee

5.Limping when walking.

6.Pain on knees at the time of walking

Causes:
Knee pain can be divided into three major categories:

  1. Acute injury: such as a broken bone, torn ligament, or meniscal tear
  2. Medical conditions: rheumatoid arthritis, osteoarthritis, infections
  3. Chronic use/overuse conditions: osteoarthritis, chondromalacia, IT band syndrome, patellar syndromes, tendinitis, and bursitis

1.Acute injury:

Some common acute injuries are:

A) ACL injury. An ACL injury is a tear of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.

B) Fractures. The bones of the knee, including the kneecap (patella), can be broken during motor vehicle collisions or falls. People whose bones have been weakened by osteoporosis can sometimes sustain a knee fracture simply by stepping wrong.

C) Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.

D) Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.

E) Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities may develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

2.Medical conditions:

Some common medical conditions are:

A) Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.

B) Iliotibial band syndrome. This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners and cyclists are especially susceptible to iliotibial band syndrome.

C) Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. In some cases, the kneecap may stay displaced and you’ll be able to see the dislocation.

D) Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can place more stress on your knee joint. In some cases, problems in the hip or foot can cause knee pain.:

Arthritis:

Types of arthritis:

More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

A) Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.

B) Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.

C) Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.

D) Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.

E) Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever, and there’s usually no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see your doctor right away.

Other Factors:
Patellofemoral pain syndrome is a general term that refers to pain arising between the kneecap (patella) and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight maltracking of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Complications:
Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you’ll have similar injuries in the future.

Diagnosis:
During the physical exam, the doctor is likely to Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
Check to see how far you can move your lower leg in different directions
Push on or pull the joint to evaluate the integrity of the structures in your knee

Imaging tests
In some cases, your doctor might suggest tests such as:

X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.

Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body.
CT scans can help diagnose bone problems and subtle fractures. A special kind of CT scan can accurately identify gout even when the joint is not inflamed.

Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee. Your doctor may want to move your knee into different positions during the ultrasound to check for specific problems.

Magnetic resonance imaging (MRI): An MRI uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Lab tests:
If your doctor suspects an infection or inflammation, you’re likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Treatment:
Treatments will vary, depending upon what exactly is causing your knee pain.

Medications:
Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Tyherapy:
Strengthening the muscles around your knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain.

If you are physically active or practice a sport, you may need exercises to correct movement patterns that may be affecting your knees and to establish good technique during your sport or activity. Exercises to improve your flexibility and balance also are important.

Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.

Injections:
In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include:

Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that may last a few months. These injections aren’t effective in all cases.

Hyaluronic acid. A thick fluid, similar to the fluid that naturally lubricates joints, hyaluronic acid can be injected into your knee to improve mobility and ease pain. Although study results have been mixed about the effectiveness of this treatment, relief from one or a series of shots may last as long as six months.

Platelet-rich plasma (PRP). PRP contains a concentration of many different growth factors that appear to reduce inflammation and promote healing. These types of injections tend to work better in people whose knee pain is caused by tendon tears, sprains or injury.

Surgery:
If you have an injury that may require surgery, it’s usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what’s most important to you. If you choose to have surgery, your options may include:

Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage (especially if it is causing your knee to lock), and reconstruct torn ligaments.

Partial knee replacement surgery. In this procedure, your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed through small incisions, so you’re likely to heal more quickly than you are with surgery to replace your entire knee.

Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

Lifestyle and home remedies:
Over-the-counter medications — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help ease knee pain. Some people find relief by rubbing the affected knee with creams containing a numbing agent, such as lidocaine, or capsaicin, the substance that makes chili peppers hot.

Self-care measures for an injured knee include:

Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time.

Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don’t use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin.

Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee.


Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that’s lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.

Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.
Alternative medicine

Glucosamine and chondroitin. Study results have been mixed about the effectiveness of these supplements for relieving osteoarthritis pain.

Acupuncture. Research suggests that acupuncture may help relieve knee pain caused by osteoarthritis. Acupuncture involves the placement of hair-thin needles into your skin at specific places on your body.

Yoga: Regular yoga exercises for knee pain and meditation.

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:
https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849
https://www.medicinenet.com/knee_pain_facts/article.htm#what_causes_knee_pain_continued

Dyslipidemia

Definition:

Dyslipidemia is an abnormal amount of lipids (e.g. triglycerides, cholesterol and/or fat phospholipids) in the blood. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood. This is often due to diet and lifestyle. Prolonged elevation of insulin levels can also lead to dyslipidemia. Likewise, increased levels of O-GlcNAc transferase (OGT) may cause dyslipidemia.

A disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency. Dyslipidemias may be manifested by elevation of the total cholesterol, the “bad” low-density lipoprotein (LDL) cholesterol and the triglyceride concentrations, and a decrease in the “good” high-density lipoprotein (HDL) cholesterol concentration in the blood.

Dyslipidemia comes under consideration in many situations including diabetes, a common cause of hyperlipidemia. For adults with diabetes, it has been recommended that the levels of LDL, HDL, and total cholesterol, and triglyceride be measured every year. Optimal LDL cholesterol levels for adults with diabetes are less than 100 mg/dL (2.60 mmol/L), optimal HDL cholesterol levels are e4qual to or greater than 40 mg/dL (1.02 mmol/L), and desirable triglyceride levels are less than 150 mg/dL (1.7 mmol/L).

From dys- + lipid (fat) + -emia (in the blood) = essentially, disordered lipids in the blood.

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Symptoms:

*Leg pain, especially when walking or standing
*Chest pain
*Tightness or pressure in the chest and shortness of breath
*Pain, tightness, and pressure in the neck, jaw, shoulders, and back
*Indigestion and heartburn
*Sleep problems and daytime exhaustion
*Dizziness
*Heart palpitations
*Cold sweats
*Vomiting and nausea
*Swelling in the legs, ankles, feet, stomach, and veins of the neck
*Fainting

These symptoms may get worse with activity or stress and get better when a person rests.

Types and causes:
Dyslipidemia can be categorized into two types, based on the cause:

Primary dyslipidemia:

Dyslipidemia can be diagnosed with a blood test.
Genetic factors cause primary dyslipidemia, and it is inherited. Common causes of primary dyslipidemia include:

*Familial combined hyperlipidemia, which develops in teenagers and young adults and can lead to high cholesterol.
*Familial hyperapobetalipoproteinemia, a mutation in a group of LDL lipoproteins called apolipoproteins.
*Familial hypertriglyceridemia, which leads to high triglyceride levels.
*Homozygous familial or polygenic hypercholesterolemia, a mutation in LDL receptors.

Secondary dyslipidemia:

Secondary dyslipidemia is caused by lifestyle factors or medical conditions that interfere with blood lipid levels over time.

Common causes of secondary dyslipidemia include:

*Obesity, especially excess weight around the waist
*Diabetes
*Hypothyroidism
*Alcohol use disorder, also known as alcoholism
*Polycystic ovary syndrome
*Metabolic syndrome
*Excessive consumption of fats, especially saturated and trans fats
*Cushing’s syndrome
*Inflammatory bowel disease, commonly known as IBS
*Severe infections, such as HIV
*An abdominal aortic aneurysm

Treatment :

Treatment for dyslipidemia will usually involve taking medication.
A doctor will usually focus on lowering a person’s levels of triglycerides and LDL. However, treatment can vary, depending on the underlying cause of dyslipidemia and how severe it is.

Doctors may prescribe one or more lipid-modifying medications for people with very high total cholesterol levels of at least 200 milligrams per deciliter of blood.

High cholesterol is usually treated with statins, which interfere with the production of cholesterol in the liver.

If statins fail to lower LDL and triglyceride levels, a doctor may recommend additional medications, including:

*Ezetimibe
*Niacin
*Fibrates
*Bile acid sequestrants
*Evolocumab and alirocumab
*Lomitapide and mipomersen
Some lifestyle changes and supplements can help to encourage healthy blood lipid levels.

Natural treatments include:

*Reducing the consumption of unhealthy fats, such as those found in red meats, full-fat dairy products, refined carbohydrates, chocolate, chips, and fried foods
*Exercising regularly (Specially Yoga with Pranayama)
*Maintaining a healthy body weight, by losing weight if necessary
*Reducing or avoiding alcohol consumption
*Quitting smoking and other use of tobacco products
*Avoiding sitting for long periods of time
*Increasing consumption of healthy polyunsaturated fats, such as those found in nuts, seeds, legumes, fish, whole grains, and olive oil
*Taking omega-3 oil, either as a liquid or in capsules
*Eating plenty of dietary fiber from whole fruits, vegetables, and whole grains
*Getting at least 6– 8 hours of sleep a night
*Drinking plenty of water

Outlook :

People with minor dyslipidemia usually have no symptoms. They can often manage or resolve the condition by making lifestyle adjustments.

People with dyslipidemia should contact a doctor if they experience symptoms relating to the heart or circulation, including:

*Chest pains or tightness
*Dizziness
*Heart palpitations
*Exhaustion
*Swelling of the ankles and feet
*Trouble breathing
*Cold sweats
*Nausea and heartburn
People who have severe dyslipidemia, especially those with other medical conditions, may need to manage their blood lipid levels with medication, in addition to making lifestyle changes.

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:
https://en.wikipedia.org/wiki/Dyslipidemia
https://www.medicinenet.com/script/main/art.asp?articlekey=33979
https://www.medicalnewstoday.com/articles/321844.php

Neuroblastoma

Description:
Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.

Neuroblastoma most commonly arises in and around the adrenal glands, which have similar origins to nerve cells and sit atop the kidneys. However, neuroblastoma can also develop in other areas of the abdomen and in the chest, neck and near the spine, where groups of nerve cells exist.

Neuroblastoma most commonly affects children age 5 or younger, though it may rarely occur in older children.

Some forms of neuroblastoma go away on their own, while others may require multiple treatments. Your child’s neuroblastoma treatment options will depend on several factors.

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Symptoms:

Signs and symptoms of neuroblastoma vary depending on what part of the body is affected.

Neuroblastoma in the abdomen — the most common form — may cause signs and symptoms such as:

  • Abdominal pain
  • A mass under the skin that isn’t tender when touched
  • Changes in bowel habits, such as diarrhea or constipation

Neuroblastoma in the chest may cause signs and symptoms such as:

  • Wheezing
  • Chest pain
  • Changes to the eyes, including drooping eyelids and unequal pupil size

Other signs and symptoms that may indicate neuroblastoma include:

  • Lumps of tissue under the skin
  • Eyeballs that seem to protrude from the sockets (proptosis)
  • Dark circles, similar to bruises, around the eyes
  • Back pain
  • Fever
  • Unexplained weight loss
  • Bone pain

Causes:
The cause of neuroblastoma is not well understood. The great majority of cases are sporadic and nonfamilial. About 1–2% of cases run in families and have been linked to specific gene mutations.

Occasionally, neuroblastoma may be due to a mutation inherited from a person’s parents. Environmental factors have not been found to be involved. Diagnosis is based on a tissue biopsy. Occasionally it may be found in a baby by ultrasound during pregnancy. At diagnosis, the cancer has usually already spread. The cancer is divided into low-, intermediate-, and high-risk groups based on a child’s age, cancer stage, and what the cancer looks like.

Cancer cells grow and multiply out of control. The accumulating abnormal cells form a mass (tumor).

Neuroblastoma begins in neuroblasts — immature nerve cells that a fetus makes as part of its development process.

As the fetus matures, neuroblasts eventually turn into nerve cells and fibers and the cells that make up the adrenal glands. Most neuroblasts mature by birth, though a small number of immature neuroblasts can be found in newborns. In most cases, these neuroblasts mature or disappear. Others, however, form a tumor — a neuroblastoma.

It isn’t clear what causes the initial genetic mutation that leads to neuroblastoma.

Risk factors:

Children with a family history of neuroblastoma may be more likely to develop the disease. Yet, familial neuroblastoma is thought to comprise a very small number of neuroblastoma cases. In most cases of neuroblastoma, a cause is never identified.

Diagnosis:

Tests and procedures used to diagnose neuroblastoma include:

Physical exam. Your child’s doctor conducts a physical exam to check out any signs and symptoms. The doctor will ask you questions about your child’s habits and behaviors.

  • Urine and blood tests. These may indicate the cause of any signs and symptoms your child is experiencing. Urine tests may be used to check for high levels of certain chemicals that result from the neuroblastoma cells producing excess catecholamines.
  • Imaging tests. Imaging tests may reveal a mass that can indicate a tumor. Imaging tests may include an X-ray, ultrasound, computerized tomography (CT) scan, metaiodobenzylguanidine (MIBG) scan and magnetic resonance imaging (MRI), among others.
  • Removing a sample of tissue for testing. If a mass is found, your child’s doctor may want to remove a sample of the tissue for laboratory testing (biopsy). Specialized tests on the tissue sample can reveal what types of cells are involved in the tumor and specific genetic characteristics of the cancer cells. This information helps your child’s doctor devise an individualized treatment plan.
  • Removing a sample of bone marrow for testing. Your child may also undergo bone marrow biopsy and bone marrow aspiration procedures to see if neuroblastoma has spread to the bone marrow — the spongy material inside the largest bones where blood cells are formed. In order to remove bone marrow for testing, a needle is inserted into your child’s hipbone or lower back to draw out the marrow.

Staging:

Once neuroblastoma is diagnosed, your child’s doctor may order further testing to determine the extent of the cancer and whether it has spread to distant organs — a process called staging. Knowing the cancer’s stage helps the doctor decide what treatment is most appropriate.

Imaging tests used to stage cancer include X-rays, bone scans, and CT, MRI and MIBG scans, among others.

The stages of neuroblastoma are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating cancer that is limited to one area. By stage IV, the cancer is considered advanced and has spread to other areas of the body.

Treatment:

When the lesion is localized, it is generally curable. However, long-term survival for children with advanced disease older than 18 months of age is poor despite aggressive multimodal therapy (intensive chemotherapy, surgery, radiation therapy, stem cell transplant, differentiation agent isotretinoin also called 13-cis-retinoic acid, and frequently immunotherapy with anti-GD2 monoclonal antibody therapy).

Biologic and genetic characteristics have been identified, which, when added to classic clinical staging, has allowed patient assignment to risk groups for planning treatment intensity. These criteria include the age of the patient, extent of disease spread, microscopic appearance, and genetic features including DNA ploidy and N-myc oncogene amplification (N-myc regulates microRNAs , into low, intermediate, and high risk disease. A recent biology study (COG ANBL00B1) analyzed 2687 neuroblastoma patients and the spectrum of risk assignment was determined: 37% of neuroblastoma cases are low risk, 18% are intermediate risk, and 45% are high risk. (There is some evidence that the high- and low-risk types are caused by different mechanisms, and are not merely two different degrees of expression of the same mechanism.)

The therapies for these different risk categories are very different.

  • Low-risk disease can frequently be observed without any treatment at all or cured with surgery alone.
  • Intermediate-risk disease is treated with surgery and chemotherapy.
  • High-risk neuroblastoma is treated with intensive chemotherapy, surgery, radiation therapy, bone marrow / hematopoietic stem cell transplantation, biological-based therapy with 13-cis-retinoic acid (isotretinoin or Accutane) and antibody therapy usually administered with the cytokines GM-CSF and IL-2.

With current treatments, patients with low and intermediate risk disease have an excellent prognosis with cure rates above 90% for low risk and 70–90% for intermediate risk. In contrast, therapy for high-risk neuroblastoma the past two decades resulted in cures only about 30% of the time. The addition of antibody therapy has raised survival rates for high-risk disease significantly. In March 2009 an early analysis of a Children’s Oncology Group (COG) study with 226 high-risk patients showed that two years after stem cell transplant 66% of the group randomized to receive ch14.18 antibody with GM-CSF and IL-2 were alive and disease-free compared to only 46% in the group that did not receive the antibody. The randomization was stopped so all patients enrolling on the trial will receive the antibody therapy.

Chemotherapy agents used in combination have been found to be effective against neuroblastoma. Agents commonly used in induction and for stem cell transplant conditioning are platinum compounds (cisplatin, carboplatin), alkylating agents (cyclophosphamide, ifosfamide, melphalan), topoisomerase II inhibitor (etoposide), anthracycline antibiotics (doxorubicin) and vinca alkaloids (vincristine). Some newer regimens include topoisomerase I inhibitors (topotecan and irinotecan) in induction which have been found to be effective against recurrent disease.

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Effective Treatment for Neuroblastoma

NEW HOPE FOR CHILDREN WITH HIGH-RISK NEUROBLASTOMA

Child’s Neuroblastoma Cancer Responds to Nutrition

Prognosis:
Between 20% and 50% of high-risk cases do not respond adequately to induction high-dose chemotherapy and are progressive or refractory. Relapse after completion of frontline therapy is also common. Further treatment is available in phase I and phase II clinical trials that test new agents and combinations of agents against neuroblastoma, but the outcome remains very poor for relapsed high-risk disease.

Most long-term survivors alive today had low or intermediate risk disease and milder courses of treatment compared to high-risk disease. The majority of survivors have long-term effects from the treatment. Survivors of intermediate and high-risk treatment often experience hearing loss. Growth reduction, thyroid function disorders, learning difficulties, and greater risk of secondary cancers affect survivors of high-risk disease. An estimated two of three survivors of childhood cancer will ultimately develop at least one chronic and sometimes life-threatening health problem within 20 to 30 years after the cancer diagnosis.

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:
https://en.wikipedia.org/wiki/Neuroblastoma
https://www.mayoclinic.org/diseases-conditions/neuroblastoma/symptoms-causes/syc-20351017

Diarrhea

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Description:

Diarrhea is one of the most common health complaints. It can range from a mild, temporary condition, to a potentially life-threatening one.

Globally, an estimated 2 billion cases of diarrheal disease occur each year, and 1.9 million children under the age of 5 years, mostly in developing countries, die from diarrhea.

Diarrhea occurs when a person suffers from repeated bowel movements which are loose and watery. It’s a very common condition and is not considered to be serious.Many people get diarrhea once or twice each year. It normally lasts 2 to 3 days, and you can treat it with over-the-counter medicines.

Some people frequently pass stools, but they are of normal consistency. This is not diarrhea. Similarly, breastfed babies often pass loose, pasty stools. This is normal. It is not diarrhea.

* Most cases of diarrhea are caused by bacteria, viruses, or parasites

* Inflammatory bowel diseases (IBD) including Crohn’s disease and ulcerative colitis can cause chronic diarrhea

* Antidiarrheal medications can reduce diarrheal output and zinc supplement is effective in children

* Some nutritional and probiotic interventions may help prevent diarrhea.

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Symptoms:

Some common symptoms of diarrhea include:

* Bloated stomach

* Cramps

* Thin or watery stools

* The constant feeling that you need to have a bowel movement

* Nausea

* Vomiting

More serious symptoms include:

* Blood or mucus in your stool

* Weight loss

* Fever

Causes:

Usually, diarrhea is caused by a virus that infects your gut. Diarrhea is also known as intestinal flu or stomach flu.

Some common causes of diarrhea include:

* Viruses. Viruses that can cause diarrhea include Norwalk virus, cytomegalovirus and viral hepatitis. Rotavirus is a common cause of acute childhood diarrhea.

* Contaminated food

* Alcohol abuse

* Diseases of the intestines (such as Crohn’s disease or ulcerative colitis)

* Eating foods that upset the digestive system

* Infection by bacteria (the cause of most types of food poisoning) or other organisms

* Laxative abuse

* Medications

* Allergies to certain foods

* Diabetes Mellitus Type 2

* Overactive thyroid (hyperthyroidism)

* Radiation therapy

* Some cancers

* Undergoing any surgery related to the digestive system

* Trouble absorbing certain nutrients also called “malabsorption”

* Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome (IBS)

Who is prone to diarrhea?

Some people could be more prone to diarrhea than others, such as:

* People suffering from illnesses like Crohn’s disease, ulcerative colitis, irritable bowel syndrome (IBS), Diabetes Mellitus Type 2

* People undergoing cancer treatments

* People who take certain medications such as laxatives, antacids, drugs that contain magnesium, NSAIDs (like aspirin and ibuprofen)* People who suffer from an intolerance of dairy products

* People suffering from gluten intolerance

* People who often take greasy fatty foods

* Older people (above 65 years) who suffer from several digestive disorders.

Diagnosis:

Besides conducting a physical exam and reviewing your medications, your doctor might order tests to determine what’s causing your diarrhea. They include:

* Blood test. A complete blood count test can help determine what’s causing your diarrhea.

* Stool test. Your doctor might recommend a stool test to determine whether a bacterium or parasite is causing your diarrhea.

* Flexible sigmoidoscopy or colonoscopy. Your doctor might recommend one of these procedures to look at the lining of your colon and provide biopsies if no cause is evident for persistent diarrhea.

* Both procedures involve using a thin, lighted tube with a lens on the end to look inside your colon.

Treatment:

In most normal cases no extra treatment is requred.The doctor may advice you to increase fluid intake and adjust food for one or two days and it goes away.

Water is a good way to replace fluids, but it doesn’t contain the salts and electrolytes — minerals such as sodium and potassium — you need to maintain the electric currents that keep your heart beating. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium. Certain fruit juices, such as apple juice, might make diarrhea worse.

For children, ask your doctor about using an oral rehydration solution, such as Pedialyte, to prevent dehydration or replace lost fluids.

Antibiotics:

Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won’t help.

Adjusting medications you’re taking:

If your doctor determines that an antibiotic caused your diarrhea, your doctor might lower your dose or switch to another medication.

Treating underlying conditions:

If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. You might be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you.

Lifestyle and home remedies:

Most diarrhea cases clear up on their own within a few days. To help you cope with your signs and symptoms until the diarrhea goes away, try to:

* Drink plenty of clear liquids, including water, broths and juices. Avoid caffeine and alcohol.

* Add semisolid and low-fiber foods gradually as your bowel movements return to normal. Try soda crackers, toast, eggs, rice or chicken.

* Avoid certain foods such as dairy products, fatty foods, high-fiber foods or highly seasoned foods for a few days.

* Ask about anti-diarrheal medications. Over-the-counter (OTC) anti-diarrheal medications, such as loperamide (Imodium A-D) and bismuth subsalicylate (Pepto-Bismol), might help reduce the number of watery bowel movements and control severe symptoms.

* Certain medical conditions and infections — bacterial and parasitic — can be worsened by these medications because they prevent your body from getting rid of what’s causing the diarrhea. Also, these drugs aren’t always safe for children. Check with your doctor before taking these medications or giving them to a child.

* Consider taking probiotics. These microorganisms help restore a healthy balance to the intestinal tract by boosting the level of good bacteria. Probiotics are available in capsule or liquid form and are also added to some foods, such as certain brands of yogurt.

Studies confirm that some probiotics might be helpful in treating antibiotic-associated diarrhea and infectious diarrhea. However, further research is needed to better understand which strains of bacteria are most helpful or what doses are needed.

Prevention:

Preventing viral diarrhea:

Wash your hands to prevent the spread of viral diarrhea. To ensure adequate hand-washing:

* Wash frequently. Wash your hands before and after preparing food. Wash your hands after handling uncooked meat, using the toilet, changing diapers, sneezing, coughing and blowing your nose.

* Lather with soap for at least 20 seconds. After putting soap on your hands, rub your hands together for at least 20 seconds. This is about as long as it takes to sing “Happy Birthday” twice through.

* Use hand sanitizer when washing isn’t possible. Use an alcohol-based hand sanitizer when you can’t get to a sink. Apply the hand sanitizer as you would hand lotion, making sure to cover the fronts and backs of both hands. Use a product that contains at least 60 percent alcohol.

Vaccination:

You can help protect your infant from rotavirus, the most common cause of viral diarrhea in children, with one of two approved vaccines. Ask your baby’s doctor about having your baby vaccinated.

Preventing traveler’s diarrhea:

Diarrhea commonly affects people who travel to countries where there’s inadequate sanitation and contaminated food. To reduce your risk:

* Watch what you eat. Eat hot, well-cooked foods. Avoid raw fruits and vegetables unless you can peel them yourself. Also avoid raw or undercooked meats and dairy foods.

* Watch what you drink. Drink bottled water, soda, beer or wine served in its original container. Avoid tap water and ice cubes. Use bottled water even for brushing your teeth. Keep your mouth closed while you shower.

* Beverages made with boiled water, such as coffee and tea, are probably safe. Remember that alcohol and caffeine can aggravate diarrhea and dehydration.

* Ask your doctor about antibiotics. If you’re traveling to a developing country for an extended time, ask your doctor about starting antibiotics before you go, especially if you have a weakened immune system. In certain cases, taking an antibiotic might reduce your risk of traveler’s diarrhea.

* Check for travel warnings. The Centers for Disease Control and Prevention maintains a travelers’ health website where disease warnings are posted for various countries. If you’re planning to travel outside of the United States, check there for warnings and tips for reducing your risk.

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:

https://www.practo.com/health-wiki/diarrhea-meaning-treatment-and-symptoms/69/article

https://www.medicalnewstoday.com/articles/158634.php

https://www.mayoclinic.org/diseases-conditions/diarrhea/symptoms-causes/syc-20352241 and 20352246