Tag Archives: Herpes simplex

Episcleritis

Definition:
Episcleritis is irritation and inflammation of the episclera, a thin layer of tissue covering the white part (sclera) of the eye. It occurs without an infection.
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Episcleritis is an inflammatory condition affecting the episcleral tissue between the conjunctiva (the clear mucous membrane lining the inner eyelids and sclera) and the sclera (the white part of the eye) that occurs in the absence of an infection. The red appearance caused by this condition looks similar to conjunctivitis, but there is no discharge. There is no apparent cause, but it can be associated with an underlying systemic inflammatory or rheumatologic condition such as rosacea, lupus or rheumatoid arthritis.

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It may also be associated with conditions such as gout and herpes simplex infection, so when episcleritis occurs it’s important to make sure these conditions aren’t a factor.

On rare occasions, it may become apparent that external substances, such as chemicals, are responsible for an attack.

Episcleritis is more likely to affect people in their 30s and 40s, and women are more likely to be affected than men.

Symptoms:
Typical symptoms include generalized or local redness of the eyes that may be accompanied by mild soreness or discomfort but no visual problems.

In general the symptoms are:
•A pink or purple color to the normally white part of the eye
•Eye pain
•Eye tenderness
•Sensitivity to light
•Tearing of the eye

When someone develops episcleritis, their eye (or eyes) appears red and may feel sore, tender and uncomfortable. In this respect, it’s similar to conjunctivitis (inflammation of the conjunctiva, which covers the episclera). But unlike conjunctivitis, episcleritis doesn’t cause a discharge, although watering may occur. Those affected may also find they become sensitive to bright light.

It comes in two forms: simple and nodular.

Simple episcleritis is characterised by intermittent bouts of inflammation that occur every couple of months and last between one and two weeks.

Some people report that these bouts are more likely to affect them in the spring and autumn, and although triggers often remain unidentified, some people find that stress or hormonal changes kick off the process.

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Nodular episcleritis causes longer bouts of inflammation that are more painful than simple episcleritis. This type is more often associated with underlying medical conditions such as rheumatoid arthritis.

Causes:
Episcleritis is a common condition that is usually mild.

The cause is usually unknown, but it may occur with certain diseases, such as:

*Herpes zoster
*Rheumatoid arthritis
*Gout
*Sjogren syndrome
*Syphilis
*Tuberculosis
*Herpes simplex infection
*Inflammatory bowel disease and Lupus.

Diagnosis:
Diagnosis of episcleritis is made clinically. A work-up may be needed in some cases to uncover a possible underlying medical condition.

Treatment:
The condition usually disappears without treatment in 1 – 2 weeks,  but topical or oral anti-inflammatory agents maybe prescribed to relieve pain or in chronic/recurrent cases. Corticosteroid eye drops may relieve the symptoms faster.
You may Click to see:Alternative Treatment of  Episcleritis

Prognosis: Episcleritis usually improves without treatment. However, treatment may make symptoms go away sooner.

Possible Completions:
In some cases, the condition may return. Rarely, irritation and inflammation of the white part of the eye may develop. This is called scleritis. Episcleritis, is associated with an underlying disorder about 70% of the time, and Scleritis can produce serious damage to the Eye; Episcleritis never does.

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/episcleritis1.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001019.htm
http://www.hopkinsmedicine.org/wilmer/conditions/episcleritis.html
http://lmk23.tripod.com/episcleritis.html

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Resources:
Nutrition and Healing November 2004
Medical Science Monitor 10(8):MT94-98; August 2004

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Halitosis

Other Names :Bad Breath, Breath odor, Mauvaise haleine (French), Mundgeruch (Deutsch), Slechte adem (Dutch), Mala respiración or Malo aliento (Spanish), Alito cattivo (Italiano) and more… Many names to one complicated situation, that has medical, dental and psychological aspects.

Definition:
Halitosis, or bad breath, is a term used to describe noticeably unpleasant odors exhaled in breathing—whether the smell is from an oral source due to bacteria or otherwise. Halitosis has a significant impact—personally and socially—on those who suffer from it or believe they do (halitophobia), and is estimated to be the third-most-frequent reason for seeking dental aid, following tooth decay and periodontal disease.

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Bad breath has a considerable impact on the lives of people who suffer from it or think they do, in all aspects of life – socially, professionally and personally.

Halitosis is considered to be the 3rd most frequent reason for seeking dental aid, but yet – many medical and dental professionals don’t have enough knowledge on the matter to offer the right treatment, not to talk of the layman knowledge on this problem.

In the past, bad breath was often considered to an incurable affliction, but in recent years it has become increasingly evident that bad breath is usually treatable, or at least its impact can be lessened once the causal factors are known.

Causes:
In most cases (85–90%), bad breath originates in the mouth itself.[2] The intensity of bad breath differs during the day, due to eating certain foods (such as garlic, onions, meat, fish, and cheese), obesity, smoking, and alcohol consumption.[3][4] Because the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening (“morning breath”). Bad breath may be transient, often disappearing following eating, brushing one’s teeth, flossing, or rinsing with specialized mouthwash.

Bad breath may also be persistent (chronic bad breath), which is a more serious condition, affecting some 25% of the population in varying degrees.[5] It can negatively affect the individual’s personal, social, and business relationships, leading to poor self-esteem and increased stress.

Listerine can lay claim to the origins of the word halitosis, which is a combination of the Latin halitus, meaning ‘breath’, and the Greek suffix osis often used to describe a medical condition, e.g., “cirrhosis of the liver“.

The term “halitosis” was introduced by Listerine in 1921, but bad breath is not a modern affliction. It has been causing embarrassment for thousands of years. Records mentioning bad breath have been discovered more than 3,000 years ago, all the way back in 1550 B.C. Back then, exactly what caused bad breath was not known, but a mouthwash of wine and herbs was one recommended way of solving the problem

Foul-smelling bacterial infection and chronic mouth inflammation are the most common causes of bad breath. Dental cavities and mouth, tongue, and gum infections top the list. Bronchiectasis, an infection and enlargement of the bronchial tubes, and lung abscess can also cause halitosis. It goes without saying that many smokers have bad breath which unrelated to mouth and lung infection but is simply a result of inhaling tobacco.

There are ,however, three serious illnesses which can all give specific mouth odours:
* Liver failure causes a fishy odour (fetor hepaticus)
* Kidney failure an ammonia odour, and
* Diabetic coma (ketoacidosis) a fruity odour.

Finally, many healthy individuals have persistent bad breath through poor digestion. (There is no research suggesting a connection with hormonal cycles although it is well known that menopausal symptoms can affect digestion and the functioning of the body organs mentioned above.)

Examination of the mouth will yield the diagnosis when dental infection is responsible. A history of cough, fever and weight loss may suggest bronchiectasis or lung abscess. Diabetic ketoacidosis, liver disease and kidney failure each have a characteristic constellation of symptoms and physical and laboratory abnormalities. It is for these reasons that a full consultation and diagnosis be sought to identify the cause of the problem.

Tongue

The most common location for mouth-related halitosis is the tongue. Tongue bacteria produce malodorous compounds and fatty acids, and account for 80 to 90 percent of all cases of mouth-related bad breath.[6] Large quantities of naturally-occurring bacteria are often found on the posterior dorsum of the tongue, where they are relatively undisturbed by normal activity. This part of the tongue is relatively dry and poorly cleansed, and bacterial populations can thrive on remnants of food deposits, dead epithelial cells, and postnasal drip. The convoluted microbial structure of the tongue dorsum provides an ideal habitat for anaerobic bacteria, which flourish under a continually-forming tongue coating of food debris, dead cells, postnasal drip and overlying bacteria, living and dead. When left on the tongue, the anaerobic respiration of such bacteria can yield either the putrescent smell of indole, skatole, polyamines, or the “rotten egg” smell of volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan, Allyl methyl sulfide, and dimethyl sulfide.

Cleaning the tongue
The most widely-known reason to clean the tongue is for the control of bad breath. Methods used against bad breath, such as mints, mouth sprays, mouthwash or gum, may only temporarily mask the odors created by the bacteria on the tongue, but cannot cure bad breath because they do not remove the source of the bad breath. In order to prevent the production of the sulfur-containing compounds mentioned above, the bacteria on the tongue must be removed, as must the decaying food debris present on the rear areas of the tongue. Most people who clean their tongue use a tongue cleaner (tongue scraper), or a toothbrush. Specially designed tongue cleaners are a lot more effective (collecting and removing the bacterial coating) than toothbrushes (which merely spread the bacterial accumulations on the tongue and in the mouth)[citation needed].

Mouth
There are over 600 types of bacteria found in the average mouth. Several dozen of these can produce high levels of foul odors when incubated in the laboratory. The odors are produced mainly due to the breakdown of proteins into individual amino acids, followed by the further breakdown of certain amino acids to produce detectable foul gases. For example, the breakdown of cysteine and methionine produce hydrogen sulfide and methyl mercaptan, respectively. Volatile sulfur compounds have been shown to be statistically associated with oral malodor levels, and usually decrease following successful treatment.

Other parts of the mouth may also contribute to the overall odor, but are not as common as the back of the tongue. These locations are, in order of descending prevalence: inter-dental and sub-gingival niches, faulty dental work, food-impaction areas in-between the teeth, abscesses, and unclean dentures. Oral based lesions caused by viral infections like Herpes Simplex and HPV may also contribute to bad breath.

Gum disease

There is some controversy over the role of periodontal diseases in causing bad breath. Whereas bacteria growing below the gumline (subgingival dental plaque) have a foul smell upon removal, several studies reported no statistical correlation between malodor and periodontal parameters.

Nose
The second major source of bad breath is the nose. In this occurrence, the air exiting the nostrils has a pungent odor that differs from the oral odor. Nasal odor may be due to sinus infections or foreign bodies.

Tonsils

In general, putrefaction from the tonsils is considered a minor cause of bad breath, contributing to some 3–5% of cases. Approximately 7% of the population suffer from small bits of calcified matter in tonsillar crypts called tonsilloliths that smell extremely foul when released and can cause bad breath.

Esophagus
The Cardia, which is the valve between the stomach and the esophagus, may not close properly due to a Hiatal Hernia or GERD, allowing acid to enter the esophagus and gases escape to the mouth. A Zenker’s diverticulum may also result in halitosis due to aging food retained in the esophagus.

Stomach
The stomach is considered by most researchers as a very uncommon source of bad breath (except in belching). The esophagus is a closed and collapsed tube, and continuous flow (as opposed to a simple burp) of gas or putrid substances from the stomach indicates a health problem—such as reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus—which will demonstrate more serious manifestations than just foul odor.

In the case of allyl methyl sulfide (the byproduct of garlic’s digestion), odor does not come from the stomach, since it does not get metabolized there.

Systemic diseases

There are a few systemic (non-oral) medical conditions that may cause foul breath odor, but these are extremely infrequent in the general population. Such conditions are:

1.Fetor hepaticus: an example of a rare type of bad breath caused by chronic liver failure.
2.Lower respiratory tract infections (bronchial and lung infections).
3.Renal infections and renal failure.
4.Carcinoma.
5.Trimethylaminuria (“fish odor syndrome”).
6.Diabetes mellitus.
7.Metabolic dysfunction.
Individuals afflicted by the above conditions often show additional, more diagnostically conclusive symptoms than bad breath. People troubled by bad breath should not conclude that they suffer from these conditions or disease.

Diagnosis
Self diagnosis

Scientists have long thought that smelling one’s own breath odor is often difficult due to acclimatization, although many people with bad breath are able to detect it in others. Research has suggested that self-evaluation of halitosis is not easy because of preconceived notions of how bad we think it should be. Some people assume that they have bad breath because of bad taste (metallic, sour, fecal, etc.), however bad taste is considered a poor indicator.

For these reasons, the simplest and most effective way to know whether one has bad breath is to ask a trusted adult family member or very close friend (“confidant”). If the confidant confirms that there is a breath problem, he or she can help determine whether it is coming from the mouth or the nose, and whether a particular treatment is effective or not.

One popular home method to determine the presence of bad breath is to lick the back of the wrist, let the saliva dry for a minute or two, and smell the result. This test results in overestimation, as concluded from research, and should be avoided. A better way would be to lightly scrape the posterior back of the tongue with a plastic disposable spoon and to smell the drying residue. Home tests that use a chemical reaction to test for the presence of polyamines and sulfur compounds on tongue swabs are now available, but there are few studies showing how well they actually detect the odor. Furthermore, since breath odor changes in intensity throughout the day depending on many factors, multiple testing sessions may be necessary.

Professional diagnosis:
If bad breath is persistent, and all other medical and dental factors have been ruled out, specialized testing and treatment is required. Hundreds of dental offices and commercial breath clinics now claim to diagnose and treat bad breath. They often use some of several laboratory methods for diagnosis of bad breath:

1.Halimeter: a portable sulfide monitor used to test for levels of sulfur emissions (to be specific, hydrogen sulfide) in the mouth air. When used properly, this device can be very effective at determining levels of certain VSC-producing bacteria. However, it has drawbacks in clinical applications. For example, other common sulfides (such as mercaptan) are not recorded as easily and can be misrepresented in test results. Certain foods such as garlic and onions produce sulfur in the breath for as long as 48 hours and can result in false readings. The Halimeter is also very sensitive to alcohol, so one should avoid drinking alcohol or using alcohol-containing mouthwashes for at least 12 hours prior to being tested. This analog machine loses sensitivity over time and requires periodic recalibration to remain accurate.

2.Gas chromatography: portable machines, such as the OralChroma, are currently being introduced. This technology is specifically designed to digitally measure molecular levels of the three major VSCs in a sample of mouth air (hydrogen sulfide, methyl mercaptan, and dimethyl sulfide). It is accurate in measuring the sulfur components of the breath and produces visual results in graph form via computer interface.
3.BANA test: this test is directed to find the salivary levels of an enzyme indicating the presence of certain halitosis-related bacteria.
4.?-galactosidase test: salivary levels of this enzyme were found to be correlated with oral malodor.
Although such instrumentation and examinations are widely used in breath clinics, the most important measurement of bad breath (the gold standard) is the actual sniffing and scoring of the level and type of the odor carried out by trained experts (“organoleptic measurements”). The level of odor is usually assessed on a six-point intensity scale


Treatment:

Teeth brushing, flossing, mouthwashes and breath mints are effective in many instances, but these yield only temporary, symptomatic relief. Although bad breath is a common complaint, identifying the cause and developing an appropriate treatment plan can be difficult. The underlying cause must be identified before the appropriate therapy/remedy can be chosen. In all cases, the first thing to do is to consult your dentist to check that the cause does not lie in the mouth.

Mouthwashes: – Remember, mouthwashes are only applicable when the source of the problem lies with bacteria in the mouth. Remember also that a mouthwash is symptomatic treatment and does not treat the underlying cause (eg. bacterial growth in a cavity).

A two-phase (ie. oil-water) mouthwash has recently been developed because many oral microorganisms possess hydrophobic outer surfaces and may therefore arequireoil/water base to remove such oral microorganisms.

In one study (1) olive oil and other essential oils was mixed with an aqueous phase including cetylpyridinium chloride, which is a disinfectant that promotes the adhesion of microorganisms to oil droplets. This study found that whereas a reduction of only 30% of sulfide was observed when a commercial mouthwash was used, this two-phase mouthwash led to approximately 80% reduction of sulfide. Furthermore, volatile sulfide and 2-ketobutyrate in saliva putrefaction system were completely inhibited by the two-phase mouthwash. It concluded that the two-phase mouthwash strongly inhibits the production of volatile sulfide and is therefore a valuable help in eliminating bad breath.

The mouthwash, Listerine, is a solution for washing the oral cavity consisting of essential oils (thymol, methanol, eukalyptol) and methyl salicylate. One study (2) found that Listerine inhibited the growth of microorganisms over a very broad range. The bactericidal action of Listerine against from bacteria isolated from saliva and dental plaque from 5 healthy normal subjects was tested. Listerine exhibited a potent bactericidal effect on bacteria in saliva and dental plaque. Most of the bacteria died after a 30 second exposure to Listerine. According to the results, Listerine therefore does appear to be effective as a solution used for cleansing the oral cavity and dentures.


At the current time, chronic halitosis is not very well understood by most physicians and dentists, so effective treatment is not always easy to find. Six strategies may be suggested:

1.Gently cleaning the tongue surface twice daily is the most effective way to keep bad breath in control; that can be achieved using a tongue cleaner or tongue brush/scraper to wipe off the bacterial biofilm, debris, and mucus. An inverted teaspoon may also do the job; a toothbrush should be avoided, as the bristles only spread the bacteria in the mouth, and grip the tongue, causing a gagging reflex. Scraping or otherwise damaging the tongue should be avoided, and scraping of the V-shaped row of taste buds found at the extreme back of the tongue should also be avoided. Brushing a small amount of antibacterial mouth rinse or tongue gel onto the tongue surface will further inhibit bacterial action.

2.Eating a healthy breakfast with rough foods helps clean the very back of the tongue.

3.Chewing gum: Since dry-mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. Chewing may help particularly when the mouth is dry, or when one cannot perform oral hygiene procedures after meals (especially those meals rich in protein). This aids in provision of saliva, which washes away oral bacteria, has antibacterial properties and promotes mechanical activity which helps cleanse the mouth. Some chewing gums contain special anti-odor ingredients. Chewing on fennel seeds, cinnamon sticks, mastic gum, or fresh parsley are common folk remedies.

4.Gargling right before bedtime with an effective mouthwash (see below). Several types of commercial mouthwashes have been shown to reduce malodor for hours in peer-reviewed scientific studies. Mouthwashes may contain active ingredients that are inactivated by the soap present in most toothpastes. Thus it is recommended to refrain from using mouthwash directly after toothbrushing with paste (also see mouthwashes, below).

5.Maintaining proper oral hygiene, including daily tongue cleaning, brushing, flossing, and periodic visits to dentists and hygienists. Flossing is particularly important in removing rotting food debris and bacterial plaque from between the teeth, especially at the gumline. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by your dentist).

Mouthwashes
Before discussing them, it is important to note that there has not been a single documented medical case of successfully cured chronic halitosis using any of the currently available mouthwashes. Mouthwashes often contain antibacterial agents including cetylpyridinium chloride, chlorhexidine, zinc gluconate, essential oils, and chlorine dioxide. Zinc and chlorhexidine provide strong synergistic effect. They may also contain alcohol, which is a drying agent. Rinses in this category include Scope and Listerine.

Other solutions rely on odor eliminators like oxidizers to eliminate existing bad breath on a short-term basis.

A relatively new approach for home-care of bad breath is by oil-containing mouthwashes. The use of essential oils has been studied, was found effective and is being used in several commercial mouthwashes, as well as the use of two-phase (oil:water) mouthwashes, which have been found to be effective in reducing oral malodor. also advances in oral science has made advice websites available world wide.

Traditional remedies
According to traditional Ayurvedic medicine, chewing areca nut and betel leaf is an excellent remedy against bad breath. In South Asia, it was a custom to chew areca or betel nut and betel leaf among lovers because of the breath-freshening and stimulant drug properties of the mixture. Both the nut and the leaf are mild stimulants and can be addictive with repeated use. The betel nut will also cause tooth decay and dye one’s teeth bright red when chewed.[34]

Society and culture
Bad breath often evokes a reaction characteristic of disgust among those who interact with bad breath sufferers. This is a natural defensive reaction designed to protect the body from potential sources of disease: The major chemical compounds of bad breath are the same as those emitted by rotting food (Putrescine), feces (Skatole), and even dead bodies (Cadaverine), all potential sources of disease and infection.

When the brain detects these compounds, it protects the body by forcing physical recoil (which moves the body away), scrunching up the nose (which constricts the nasal passages, and prevents further intake of noxious odors), and by causing gagging (which stops anything being swallowed). It may also produce nausea and vomiting, which ejects anything that has already been swallowed. Although these reactions are involuntary, they are often misinterpreted as a personal judgement on the sufferer, and can severely damage personal relationships.

Research
In 1996, the International Society for Breath Odor Research (ISBOR) was formed to promote multidisciplinary research on all aspects of breath odors. The eighth international conference on breath odor took place in 2009 in Dortmund, Germany.

You may click to see :-

*The Best Herbal Remedies For Halitosis :
*Home remedy for bad breath (Halitosis) :
* Natural remedies of Bad Breath        :
*Herbal Remedies for Bad Breath :

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://smellwell.com/bad+breath+causes/
http://www.internethealthlibrary.com/Health-problems/Halitosis.htm
http://en.wikipedia.org/wiki/Halitosis
http://www.whereincity.com/medical/topic/dental-health/diseases/halitosis-36.htm

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Bell’s Palsy

Definition:-
Bell’s palsy or idiopathic facial paralys  is a dysfunction of cranial nerve VII (the facial nerve) that results in inability to control facial muscles on the affected side. Several conditions can cause a facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell’s palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell’s palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis.

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Bell’s palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. The trademark is rapid onset of partial or complete palsy, usually in a single day. It can occur bilaterally resulting in total facial paralysis in around 1% of cases.

It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition, damage or death. No readily identifiable cause for Bell’s palsy has been found.

Corticosteroids have been found to improve outcomes while anti-viral drugs have not. Early treatment is necessary for steroids to be effective. Most people recover spontaneously and achieve near-normal to normal functions. Many show signs of improvement as early as 10 days after the onset, even without treatment.

Often the eye in the affected side cannot be closed. The eye must be protected from drying up, or the cornea may be permanently damaged resulting in impaired vision. In some cases denture wearers experience some discomfort.

Bell’s palsy occurs when the nerve that controls facial muscles on one side of your face becomes swollen or inflamed. As a result of Bell’s palsy, your face feels stiff. Half your face appears to droop, your smile is one-sided, and your eye resists closing.

Bell’s palsy can affect anyone, but rarely affects people under the age of 15 or over the age of 60.

For most people, Bell’s palsy symptoms improve within a few weeks, with complete recovery in three to six months. About 10 percent will experience a recurrence of Bell’s palsy, sometimes on the other side of the face. A small number of people continue to have some Bell’s palsy signs and symptoms for life.

Bell’s palsy occurs more often in people who:

*Are pregnant, especially during the third trimester, or who are in the first week after giving birth
*Have diabetes
*Have an upper respiratory infection, such as the flu or a cold

Also, some people who have recurrent attacks of Bell’s palsy, which is rare, have a family history of recurrent attacks. In those cases, there may be a genetic predisposition to Bell’s palsy.

Symptoms:
Bell’s palsy is characterized by facial drooping on the affected half, due to malfunction of the facial nerve (VII cranial nerve), which controls the muscles of the face. Facial palsy is typified by inability to control movement in the facial muscles. The paralysis is of the infranuclear/lower motor neuron type.

The facial nerves control a number of functions, such as blinking and closing the eyes, smiling, frowning, lacrimation, and salivation. They also innervate the stapedial (stapes) muscles of the middle ear and carry taste sensations from the anterior two thirds of the tongue.

Clinicians should determine whether the forehead muscles are spared. Due to an anatomical peculiarity, forehead muscles receive innervation from both sides of the brain. The forehead can therefore still be wrinkled by a patient whose facial palsy is caused by a problem in one of the hemispheres of the brain (central facial palsy). If the problem resides in the facial nerve itself (peripheral palsy) all nerve signals are lost on the ipsilateral (same side of the lesion) half side of the face, including to the forehead (contralateral forehead still wrinkles).

One disease that may be difficult to exclude in the differential diagnosis is involvement of the facial nerve in infections with the herpes zoster virus. The major differences in this condition are the presence of small blisters, or vesicles, on the external ear and hearing disturbances, but these findings may occasionally be lacking (zoster sine herpete).

Lyme disease may produce the typical palsy, and may be easily diagnosed by looking for Lyme-specific antibodies in the blood. In endemic areas Lyme disease may be the most common cause of facial palsy.

The main symptom of Bell’s palsy is a sudden weakness or paralysis in one side of your face that causes it to droop. This may make it hard for you to close your eye on that side of your face.

Other symptoms include:

*Drooling.
*Eye problems, such as excessive tearing or a dry eye.
*Loss of ability to taste.
*Pain in or behind your ear.
*Numbness in the affected side of your face.
*Increased sensitivity to sound.
*Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days — making it difficult to smile or close your eye on the affected side
*Facial droop and difficulty making facial expressions
*Pain around the jaw or in or behind your ear on the affected side
*Increased sensitivity to sound on the affected side
*Headache
*Changes in the amount of tears and saliva you produce

In rare cases, Bell’s palsy can affect the nerves on both sides of your face.


Cause
:-
Some viruses are thought to establish a persistent (or latent) infection without symptoms, e.g. the Zoster virus of the face and Epstein-Barr viruses, both of the herpes family. Reactivation of an existing (dormant) viral infection has been suggested as cause behind the acute Bell’s palsy. Studies suggest that this new activation could be preceded by trauma, environmental factors, and metabolic or emotional disorders, thus suggesting that stress – emotional stress, environmental stress (e.g. cold), physical stress (e.g. trauma) – in short, a host of different conditions, may trigger reactivation.

Other viruses that have been linked to Bell’s palsy include:

*The virus that causes chickenpox and shingles (herpes zoster)
*The virus that causes mononucleosis (Epstein-Barr)
*Another virus in the same family (cytomegalovirus)

With Bell’s palsy, the nerve that controls your facial muscles, which passes through a narrow corridor of bone on its way to your face, becomes inflamed and swollen — usually from a viral infection. Besides facial muscles, the nerve affects tears, saliva, taste and a small bone in the middle of your ear.

Pathology:
It is thought that as a result of inflammation of the facial nerve, pressure is produced on the nerve where it exits the skull within its bony canal, blocking the transmission of neural signals or damaging the nerve. Patients with facial palsy for which an underlying cause can be found are not considered to have Bell’s palsy per se. Possible causes include tumor, meningitis, stroke, diabetes mellitus, head trauma and inflammatory diseases of the cranial nerves (sarcoidosis, brucellosis, etc.). In these conditions, the neurologic findings are rarely restricted to the facial nerve. Babies can be born with facial palsy. In a few cases, bilateral facial palsy has been associated with acute HIV infection.

In some research the herpes simplex virus type 1 (HSV-1) was identified in a majority of cases diagnosed as Bell’s palsy. This has given hope for anti-inflammatory and anti-viral drug therapy (prednisone and acyclovir). Other research[5] however, identifies HSV-1 in only 31 cases (18 percent), herpes zoster (zoster sine herpete) in 45 cases (26 percent) in a total of 176 cases clinically diagnosed as Bell’s Palsy. That infection with herpes simplex virus should play a major role in cases diagnosed as Bell’s palsy therefore remains a hypothesis that requires further research.

In addition, the herpes simplex virus type 1 (HSV-1) infection is associated with demyelination of nerves. This nerve damage mechanism is different from the above mentioned – that oedema, swelling and compression of the nerve in the narrow bone canal is responsible for nerve damage. Demyelination may not even be directly caused by the virus, but by an unknown immune system response. The quote below captures this hypothesis and the implication for other types of treatment:

It is also possible that HSV-1 replication itself is not responsible for the damage to the facial nerves and that inhibition of HSV-1 replication by acyclovir does not prevent the progression of nerve dysfunction. Because the demyelination of facial nerves caused by HSV-1 reactivation, via an unknown immune response, is implicated in the pathogenesis of HSV-1-induced facial palsy, a new strategy of treatment to inhibit such an immune reaction may be also effective.

Diagnosis:-
Bell’s palsy is a diagnosis of exclusion; by elimination of other reasonable possibilities. Therefore, by definition, no specific cause can be ascertained. Bell’s palsy is commonly referred to as idiopathic or cryptogenic, meaning that it is due to unknown causes. Being a residual diagnostic category, the Bell’s Palsy diagnosis likely spans different conditions that our current level of medical knowledge cannot distinguish. This may inject fundamental uncertainty into the discussion below of etiology, treatment options, recovery patterns etc. See also the section below on Other symptoms. Studies   show that a large number of patients (45%) are not referred to a specialist, which suggests that Bell’s palsy is considered by physicians to be a straightforward diagnosis that is easy to manage. A significant number of cases are misdiagnosed (ibid.). This is unsurprising from a diagnosis of exclusion, which depends on a thorough investigation.

Risk Factors:
Although a mild case of Bell’s palsy normally disappears within a month, recovery from a case involving total paralysis varies. Complications may include:

*Irreversible damage to your facial nerve
*Misdirected regrowth of nerve fibers, resulting in involuntary contraction of certain muscles when you’re trying to move others (synkinesis) — for example, when you smile, the eye on the affected side may close
*Partial or complete blindness of the eye that won’t close, due to excessive dryness and scratching of the cornea, the clear protective covering of the eye.

Treatment:=
In patients presenting with incomplete facial palsy, where the prognosis for recovery is very good, treatment may be unnecessary. Patients presenting with complete paralysis, marked by an inability to close the eyes and mouth on the involved side, are usually treated. Early treatment (within 3 days after the onset) is necessary for therapy to be effective.[9] Steroids have been shown to be effective at improving recovery while antivirals have not.

Steroids
Corticosteroid such as prednisone significantly improves recovery at 6 months and are thus recommended.

Antivirals
Antivirals (such as acyclovir) are ineffective in improving recovery from Bell’s palsy beyond steroids alone. They were however commonly prescribed due to a theoretical link between Bell’s palsy and the herpes simplex and varicella zoster virus.

Physical therapy
Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.

Surgery
One way to relieve the pressure on the facial nerve is to surgically open the bony passage through which it passes. This decompression surgery is controversial and rarely recommended. In some cases, however, plastic surgery may be needed to make your face look and work better.

Home Remedy  & Lyfe Style:
Home treatment may include:
*Protecting the eye you can’t close. Using lubricating eyedrops during the day and an eye ointment at night will help keep your eye moist. Wearing glasses or goggles during the day and an eye patch at night can protect your eye from getting poked or scratched.

*Taking over-the-counter pain relievers. Aspirin, ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others) may help ease your pain.

*Applying moist heat. Putting a washcloth soaked in warm water on your face several times a day may help relieve pain.

*Doing your physical therapy exercises. Massaging and exercising your face according to your physical therapist’s advice may help relax your facial muscles.

Alternative medicine:
Although there’s little scientific evidence to support the use of alternative medicine for people with Bell’s palsy, some people with the condition may benefit from the following:

*Relaxation techniques, such as meditation and yoga, may relieve muscle tension and chronic pain.

*Acupuncture, placing thin needles into your skin to relieve pain, may stimulate nerves and muscles, offering some relief.(The efficacy of acupuncture remains unknown because the available studies are of low quality (poor primary study design or inadequate reporting practices).

*Biofeedback training, by teaching you to use your thoughts to control your body, may help you gain better control over your facial muscles.

*Vitamin therapy — specifically B-12, B-6 and zinc — may help nerve growth

Prognosis:
Even without any treatment, Bell’s palsy tends to carry a good prognosis. In a 1982 study, when no treatment was available, of 1,011 patients, 85% showed first signs of recovery within 3 weeks after onset. For the other 15%, recovery occurred 3–6 months later. After a follow-up of at least 1 year or until restoration, complete recovery had occurred in more than two thirds (71%) of all patients. Recovery was judged moderate in 12% and poor in only 4% of patients. Another study found that incomplete palsies disappear entirely, nearly always in the course of one month. The patients who regain movement within the first two weeks nearly always remit entirely. When remission does not occur until the third week or later, a significantly greater part of the patients develop sequelae. A third study found a better prognosis for young patients, aged below 10 years old, while the patients over 61 years old presented a worse prognosis.

Major complications of the condition are chronic loss of taste (ageusia), chronic facial spasm and corneal infections. To prevent the latter, the eyes may be protected by covers, or taped shut during sleep and for rest periods, and tear-like eye drops or eye ointments may be recommended, especially for cases with complete paralysis. Where the eye does not close completely, the blink reflex is also affected, and care must be taken to protect the eye from injury.

Another complication can occur in case of incomplete or erroneous regeneration of the damaged facial nerve. The nerve can be thought of as a bundle of smaller individual nerve connections that branch out to their proper destinations. During regrowth, nerves are generally able to track the original path to the right destination – but some nerves may sidetrack leading to a condition known as synkinesis. For instance, regrowth of nerves controlling muscles attached to the eye may sidetrack and also regrow connections reaching the muscles of the mouth. In this way, movement of one also affects the other. For example, when the person closes the eye, the corner of the mouth lifts involuntarily.

In addition, around 6%[citation needed] of patients exhibit crocodile tear syndrome, also called gustatolacrimal reflex or Bogorad’s Syndrome, on recovery, where they will shed tears while eating. This is thought to be due to faulty regeneration of the facial nerve, a branch of which controls the lacrimal and salivary glands. Gustatorial sweating can also occur.

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

Resources:
http://en.wikipedia.org/wiki/Bell’s_palsy
http://www.mayoclinic.com/health/bells-palsy/DS00168
http://www.webmd.com/brain/tc/bells-palsy-treatment-overview

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Some Health Quaries & Answers

 

Q: My husband and I both have corns on our feet. His corns fell off after he applied corn caps. Mine did not even though I used the same caps. The caps keep falling off instead.

CORNY REMEDY :-

A: If the corn caps worked for your husband, trying the same brand makes sense. For self-treatment to be successful, the foot has to be dry when you apply the caps. Also, do not walk barefoot even in the house. When you have a bath, tie your leg in a plastic bag so that the caps do not get wet. You need to leave them on as long as possible.

Even though the lesions appear similar, in your case the diagnosis may be something else like warts. If they are still present after three months of self-treatment with corn plasters, consult a dermatologist and consider having them surgically removed.

HIS  FACE WAS PARALYZED :-

Q: My uncle was travelling in a car sitting next to the window. After he reached home he found that he could not move the right side of his face, or even close the eye. Is this a stroke?


A: This sounds more like “Bell’s palsy” than a stroke. It is an isolated paralysis of the facial nerve. It is common in persons between 15-60 years of age and in diabetics. It occurs because the facial nerve passes through a narrow bony canal in the ear before its branches enter the facial muscles. Exposure to cold can cause the nerve to swell up. It then becomes compressed. The pressure causes the paralysis. This can also occur as a result of an infection with the Herpes Simplex virus.

Treatment is with antiviral agents, steroids and physiotherapy. Recovery is usually complete.

POTTY TRAINING

Q: My six-year-old son has no control over his bowel movement. His pants and underwear are constantly soiled because part of the motion leaks out. It is not diarrhoea. This happens in school too, and it is becoming a problem.


A: If your son had control of his motion initially and has now lost it, he probably suffers from a condition called “encopresis”. It occurs when the child does not go to the toilet when he feels the urge. This results in chronic constipation. Once the rectum is full of impacted stools, liquid motion from above can leak out of the anus causing this problem.

Treatment of encopresis focuses on clearing the colon of retained, impacted stool and encouraging healthy bowel movement. This means training your son to go to the toilet as soon as the urge to defecate occurs. Also, try to send him to the toilet every day at a fixed time.

The diet should contain dietary fibre in the form of four to five helpings of fruits or vegetables a day.

DARK PATCHES

Q: I developed dark patches on my arms and legs. I went to one of the clinics advertised on television and they diagnosed macular amyloidosis (I don’t know what that is) and advised laser treatment. I am a bit nervous about this.


A: Macular amyloidosis is a skin condition in which itchy lesions appear as flat dusky-brown or greyish spots that may eventually form patches of darkened skin. It is found symmetrically distributed over the upper back between the shoulder blades, on the chest, sometimes on the arms, and rarely on the legs.

The diagnosis has to be made after a biopsy. All dark patches are not macular amyloidosis (yours seem non-itchy) nor do they require expensive treatment like laser therapy. Go to a dermatologist, confirm the diagnosis and then start treatment. Usually anti histamines and topical steroids are tried initially. Do not believe everything said in advertisements on television.

CURE  FOR  PCOS

Q: My daughter has polycystic ovarian syndrome (PCOS). Each time the doctor puts her on tablets, and she is alright for a few months. As soon as the treatment is discontinued, her periods become irregular.


A: PCOS occurs because of an inherited abnormal gene for food metabolism. As a result the sufferer tends to become obese, develop acne and have irregular periods. The gene will always be present. The tendency to manifest the gene can be controlled if —

* Your daughter jogs 40 minutes a day

* She maintains her BMI at 23 (BMI is weight divided by height in metre squared).

Pills or exercise — the choice is hers.

ATTEMPTED  RAPE

Q: A relative tried to rape me during my childhood. Now I have abdominal pain all the time. I think I have an infection.


A: Since you are worried, and with reason, test your blood for VDRL, HIV and HbAg. Also, do an ultrasound of the abdomen and pelvis. If all these are normal, you have nothing to worry about.

Move on with your life and forget the past. Almost 95 per cent women face unwelcome unwanted sexual advances at some time in their life. Take lessons in karate, Kung Fu or some other martial art. It will make you more confident and ensure nothing like that happens again.

Source: The Telegraph ( Kolkata, India)

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