Categories
Ailmemts & Remedies

Palmar hyperhidrosis

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

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

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

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

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

Causes:
Hyperhidrosis is either primary focal or secondary generalized.

1. Primary Palmar  Hyperhidrosis

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

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

2. Secondary Palmar Hyperhidrosis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*Treatment should be directed at contributing factors.

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

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

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

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

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

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

Causes and Treatment of Palmar Hyperhidrosis – Sweaty Palms/Hands

Categories
Herbs & Plants

Linseed (Flax or Flaxseed)

Botanical Name :Linum usitatissimum
Family: Linaceae
Genus: Linum
Species: L. usitatissimum
Kingdom: Plantae
Order: Malpighiales

Synonyms:Linseed, flaxseed, common flax, lint bells, winterlien

Habitat: Common flax (Linum usitatissimum L.) was one of the first crops domesticated by man. Flax originated in India, and from its hardiness and usefulness, is generally diffused over the globe. Ancient centers of flax-growing are mountainous areas of India and China, In India flax was cultivated as a fiber crop earlier than cotton. As early as in the 4th or 5th millennium B.C. flax was cultivated for its fiber in Mesopotamia, Assyria and Egypt. Wild narrow-leaved flax and semi-cultured procumbent flaxes grow in Transcaucasia. Many monuments of Ancient Egypt reflect cultivation of flax and spinning and weaving of its fibers. In Russia flax has been cultivated since the birth of the Russian nation

Growing countries :The significant linseed producing countries are Canada ~34% and China ~25.5%, though there is also production in India ~9%, USA ~8%, and Ethiopia ~3.5% and throughout Europe.

Description:The flax plant is an annual herb, it grows   erect to 3 feet with slender stems and entire leaves. The leaves are glaucous green, slender lanceolate, 20-40 mm long and 3 mm broad. The flowers are pure pale blue, 15-25 mm diameter, with five petals. The fruit is a round, dry capsule 5-9 mm diameter, containing several glossy brown seeds shaped like an apple pip, 4-7 mm long, which is indehiscent. Linum is an erect annual herb with a glabrous stem and few branches, growing about 60cm in height and cultivated in most temperate and tropical regions. The stem bears alternate, sessile, simple entire lanceolate to oblong leaves. Each branch produces one or two violet-blue five-petalled flowers in a terminal cluster from June to August, and a globular capsule containing about ten seeds.In addition to the plant itself, flax may refer to the unspun fibres of the flax plant.

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Flax seeds come in two basic varieties: 1. brown; and 2. yellow or golden (also known as golden linseeds). Most types have similar nutritional characteristics and equal numbers of short-chain omega-3 fatty acids. The exception is a type of yellow flax called solin (trade name Linola), which has a completely different oil profile and is very low in omega-3 FAs. Flax seeds produce a vegetable oil known as flaxseed oil or linseed oil, which is one of the oldest commercial oils. It is an edible oil obtained by expeller pressing, sometimes followed by solvent extraction. Solvent-processed flax seed oil has been used for many centuries as a drying oil in painting and varnishing.

Although brown flax can be consumed as readily as yellow, and has been for thousands of years, its better-known uses are in paints, for fiber, and for cattle feed.

Parts used: ripe seeds and their expressed oil. Linseed oil, obtained from seed of the flax plant, is primarily used in industry; but some is used for edible purposes in eastern Europe.

Collection: when fully ripe in September.

Constituents: 30-40% fixed oil including linoleic, linolenic and oleic acids, mucilage (6%), protein (25%), the cyanogenic glycoside linamarine, bitter principle; the oil contains vitamins A, B, D and E, minerals and amino acids. The seeds contain around 35 to 44 percent of drying oil.

Use: Flax is grown both for its seed and for its fibres. Various parts of the plant have been used to make fabric, dye, paper, medicines, fishing nets and soap. It is also grown as an ornamental plant in gardens, as flax is one of the few plant species capable of producing truly blue flowers (most “blue” flowers are really shades of purple), although not all flax varieties produce blue flowers.

In eastern Europe, the seed is generally first cold pressed, the cold-press oil being used in foods. A later hot press yields additional industrial oil. In the U.S., oil extraction is generally hot press, followed by solvent extraction, and the oil is not used as food. The press cake from hot pressing is a valuable livestock feed. The flax seed contains a cyanogenic glucoside which forms hydrocyanic acid by enzyme action unless the enzyme is inactivated by heat. Flax seed for oil was grown in the U.S. on an average of about 2.7 million acres, 1964-66.
Flax fibers
Flax fibers are amongst the oldest fibre crops in the world. The use of flax for the production of linen goes back 5000 years. Pictures on tombs and temple walls at Thebes depict flowering flax plants. The use of flax fibre in the manufacturing of cloth in northern Europe dates back to Neolithic times. In North America, flax was introduced by the Puritans. Currently most flax produced in the USA and Canada are seed flax types for the production of linseed oil or flaxseeds for human nutrition.

Flax stem cross-section, showing locations of underlying tissues. Ep = epidermis; C = cortex; BF = bast fibres; P = phloem; X = xylem; Pi = pithFlax fibre is extracted from the bast or skin of the stem of flax plant. Flax fibre is soft, lustrous and flexible. It is stronger than cotton fibre but less elastic. The best grades are used for linen fabrics such as damasks, lace and sheeting. Coarser grades are used for the manufacturing of twine and rope. Flax fibre is also a raw material for the high-quality paper industry for the use of printed banknotes and rolling paper for cigarettes.

Medicinal Actions: demulcent, antitussive, gentle bulk laxative, emollient, anodyne, resolvent, relaxing expectorant, antiseptic, anti-inflammatory, locally drawing, soothing and healing, antitussive, pectoral

Indications: Respiratory catarrh, bronchitis, furunculosis, pleuritic pains

Therapeutics and Pharmacology: Linum may be used in all pulmonary infections, particularly where there is much catarrh, as in bronchitis. It is often applied as a poultice in pleurisy and other pulmonary conditions. A poultice may also be applied to boils and carbuncles, shingles, psoriasis and burns. Linum is also used in chronic or acute, atonic or spastic constipation. Whilst not a true laxative, it acts as a bulking and lubricating agent causing no irritation. Linseed oil is an valuable source of essential fatty acids which can help prevent the build-up of fatty deposits in the tissues. The oil has also been used to help the passage of gallstones.

Combinations: As a poultice for the chest Linum combines well with Sinapsis alba. For boils, localised swellings and inflammations it may be combined with Lobelia, Althaea root and Ulmus as a poultice.

The health benefits associated with flaxseed include:

Protecting against cancer:
Consuming flaxseed may help protect against prostate, colon, and breast cancers. Flaxseed is thought to prevent the growth of cancerous cells because its omega-3 fatty acids disrupt malignant cells from clinging onto other body cells. In addition, the lignans in flaxseed have antiangiogenic properties – they stop tumors from forming new blood vessels.

One US study presented at the 43rd annual meeting of the American Society of Clinical Oncology (ASCO) revealed that consuming flaxseed can stop prostate cancer tumors from growing. Dr Wendy Demark-Wahnefried, lead investigator of the study said that the team was “excited that this study showed that flaxseed is safe and associated with a protective effect on prostate cancer.”

Lowering cholesterol:
Researchers at the Iowa State University’s Nutrition and Wellness Research Center found that cholesterol levels lowered among men who included flaxseed in their diet. Suzanne Hendrich, lead author of the study, said that for “people who can’t take something like Lipitor, this could at least give you some of that cholesterol-lowering benefit.”

Preventing hot flashes:
A study published in the Journal of the Society for Integrative Oncology suggests that a dietary intake of flaxseed can decrease the risk of hot flashes among postmenopausal women. “Not only does flaxseed seem to alleviate hot flashes, but it appears to have overall health and psychological benefits as well,” concluded Dr. Pruthi.

Improving blood sugar:
There is strong evidence to suggest that consuming flaxseed every day improves glycemic control in obese men and women with pre-diabetes4, according to a study published in Nutrition Research.

Protecting against radiation:
A diet of flaxseed may protect skin tissue from being damaged by radiation, revealed researchers at the Perelman School of Medicine at the University of Pennsylvania. The investigators concluded that their “study demonstrates that dietary flaxseed, already known for its strong antioxidant and anti-inflammatory properties, works as both a mitigator and protector against radiation pneumonopathy.”

Caution: Only the ripe seeds should be used; immature seeds can cause poisoning as they contain traces of prussic acid. Linseed oil deteriorates rapidly. It is important to stress to anyone taking linseed that at least two glasses of water should be taken at the same time to ensure proper swelling of the linseed in the stomach. In many cases where linseed appears to fail, the reason is that not enough fluid has been taken.

Side effects and precautions:
Even though research on the safety of taking flaxseed during pregnancy is scarce, pregnant women should stay on the safe side and avoid consuming flaxseed because of its estrogen-like properties which doctors believe may affect pregnancy outcome. In addition, people suffering from a bowel obstruction should avoid flaxseed too (because of its high level of fiber), according to the University of Maryland Medical Center.5

Side effects associated with the consumption of flaxseed, include:
*Flatulence
*Stomach pains
*Nausea
*Constipation
*Diarrhea
*Bloating.

Preparation and Dosage:

Regulatory status GSL

Crushed or entire seeds: 3-6g or by infusion

Oil: 5-30ml, in vehicle, as a purgative

Additional Comments: As the source of linen fibre, Linum has been cultivated since at least 5000 BC; today it is mainly grown for its oil. It was used by the Egyptians to make cloth in which to wrap their mummies, and the Bible contains many references to the plant. The medicinal properties of the seeds were known to the Greeks and Hippocrates recommended them for inflammations of the mucous membranes. In 8th century France, Charlemagne passed laws requiring the seeds to be consumed to keep his subjects healthy. Linseed oil is used as a purgative for sheep and horses. Flax is obtained from the stem fibres. The oil has a number of uses in the paint and other industries. It is also used in cooking and has been recommended to help leach toxic heavy metals such as aluminium from the body.

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://www.purplesage.org.uk/profiles/linseed.htm
http://www.hort.purdue.edu/newcrop/Crops/Linseed_oil.html
http://en.wikipedia.org/wiki/Flax

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