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.

Ayurvedic Treatment ..click & see…>…….…(1) :....(2)

Home Remedies. click & see….>…....(1) :…(2) :.…...(3) :..

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
Ailmemts & Remedies

Foot order or Smelly foot

English: Grown male right foot (angle 1)
English: Grown male right foot (angle 1) (Photo credit: Wikipedia)

Description:
Our foot sometimes gives out an unpleasant smell which is very much embarrassing.         ( medical term bromohidrosis)

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It is a type of body odor that affects the feet of humans.The quality of foot odor is often reported as a thick smell. Some describe the smell like that of malt vinegar. However, it can also be ammonia-like. Brevibacteria are considered a major cause of foot odor because they ingest dead skin on the feet and, in the process, convert amino acid methionine into methanethiol, which has a sulfuric aroma. The dead skin that fuels this process is especially common on the soles and between the toes. The brevibacteria is also what gives cheeses such as Limburger, Bel Paese, Port du Salut, Pálpusztai and Munster their characteristic pungency.

Propionic acid (propanoic acid) is also present in many foot sweat samples. This acid is a breakdown product of amino acids by Propionibacteria, which thrive in the ducts of adolescent and adult sebaceous glands. The similarity in chemical structures between propionic acid and acetic acid, which share many physical characteristics such as odor, may account for foot odors identified as being vinegar-like. Isovaleric acid (3-methyl butanoic acid) is the other source of foot odor and is a result of actions of the bacteria Staphylococcus epidermidis which is also present in several strong cheese types.

Other implicated micro-organisms include Micrococcaceae, Corynebacterium and Pityrosporum.

Bart Knols, of Wageningen Agricultural University, the Netherlands, received an “IG Nobel” prize in 2006 for showing that the female malaria mosquito Anopheles gambiae “is attracted equally to the smell of limburger cheese and to the smell of human feet”. Fredros Okumu, of Ifakara Health Institute in Tanzania, received grants in 2009 and 2011 to develop mosquito attractants and traps to combat malaria. He uses a blend of eight chemicals, which is four times more effective than an actual human.

Causes;
The feet and hands contain more sweat glands than any other part of the body, with roughly 3,000 glands per square inch. Smelly feet are not only embarrassing, but can be physically uncomfortable as well.

Feet smell for two reasons: 1) shoe wear, and 2) sweating of the feet. The interaction between the perspiration and the bacteria that thrive in shoes and socks generates the odor.

Smelly feet or excessive sweating can also be caused by an inherited condition, called hyperhidrosis, which primarily affects men. Stress, some medications, fluid intake, and hormonal changes also can increase the amount of perspiration our bodies produce.

The main cause is foot sweat. Sweat itself is odorless, but it creates a beneficial environment for certain bacteria to grow and produce bad-smelling substances. These bacteria are naturally present on our skin as part of the human flora. Therefore, more smell is created with factors causing more sweating, such as wearing shoes and/or socks with inadequate air ventilation for many hours. Hair on the feet, especially on the toes, may contribute to the odor’s intensity by adding increased surface area in which the bacteria can thrive.

Given that socks directly contact the feet, their composition can have an impact on foot odor. Polyester and nylon are common materials used to make socks, but provide less ventilation than cotton or wool do when used for the same purpose. Wearing polyester or nylon socks may increase perspiration and therefore may intensify foot odor.[1] Because socks absorb varying amounts of perspiration from feet, wearing shoes without socks may increase the amount of perspiration contacting feet and thereby increase bacterial activities that cause odor

Treatments:
The best home remedy for foot odor is to soak feet in strong black tea for 30 minutes a day for a week. The acid in the tea kills the bacteria and closes the pores, keeping your feet dry longer. Use two tea bags per pint of water. Boil for 15 minutes, then add two quarts of cool water. Soak your feet in the cool solution. Alternately, you can soak your feet in a solution of one part vinegar and two parts water.

Persistent foot odor can indicate a low-grade infection or a severe case of hereditary sweating. In these cases, a prescription ointment may be required to treat the problem.

Treating Excessive Sweating:
A form of electrolysis, called iontophoresis, has been shown to reduce excessive sweating of the feet. However, it is more difficult to administer. In the worst cases of hyperhidrosis, a surgeon can cut the nerve that controls sweating. Recent advances in technology have made this surgery much safer, but may increase sweating in other areas of the body.

Prevention:
Methods of extinguishment may be used even before onset of the odor as prevention. However, a very effective and cheap way to prevent foot odor is with sodium bicarbonate (a mildly basic white salt also known as baking soda, bread soda, cooking soda, bicarbonate of soda, sodium bicarb, bicarb soda, or simply bicarb). Sodium bicarbonate

will create a hostile environment unsuitable for the bacteria responsible for the bad smell. Four pinches of it on each foot everyday are usually enough (two inside the sock and two on the insole of the shoe). Sometimes it might take one or two days before the shoes completely lose their old smell. Washing your feet and applying the sodium bicarbonate daily are also potentially useful solutions.

While there are a number of other remedies, sodium bicarbonate, if bought in a supermarket, costs approximately 20 times less than common odor-eaters or odor-killer powders.

Swabbing feet twice daily with isopropyl alcohol, found at your local drug store, for two weeks is a cheap and highly effective cure. One can also periodically remove their footwear, to reduce foot moisture and thereby reduce bacterial spawn.

Some types of powders and activated charcoal insoles, such as odor eaters, have been developed to prevent foot odor by keeping the feet dry. Special cedarsoles can be recommended for this purpose because of their antibacterial characteristics. Hygiene is considered important in avoiding odor, as is avoidance of synthetic shoes/socks, and rotation of the pairs of shoes worn

In general, smelly feet can be controlled with a few preventive measures:

•Always wear socks with closed shoes.
•Avoid wearing nylon socks or plastic shoes. Instead, wear shoes made of leather, canvas, mesh, or other materials that let your feet breathe.
•Bathe feet daily in lukewarm water, using a mild soap. Dry thoroughly.
•Change socks and shoes at least once a day.
•Check for fungal infections between toes and on the bottoms of your feet. If any redness or dry, patchy skin is observed, get treatment right away.
•Don’t wear the same pair of shoes two days in a row. If you frequently wear athletic shoes, alternate pairs so that the shoes can dry out. Give your shoes at least 24 hours to air out between wearings; if the odor doesn’t go away, discard the shoes.
•Dust your feet frequently with a nonmedicated baby powder or foot powder. Applying antibacterial ointment also may help.
•Practice good foot hygiene to keep bacteria levels at a minimum.
•Wear thick, soft socks to help draw moisture away from the feet. Cotton and other absorbent materials are best.

Extinguishment:

Once foot odor has begun, it can be extinguished, or at least alleviated, by either aromatic deodorants that neutralise the odor by their own smell, or by absorbers of the odor itself.

Among the earliest foot deodorants were aromatic herbs such as allspice, which nineteenth-century Russian soldiers would put in their boots.

Odor absorbers include activated charcoal foot insert wafers, such as Innofresh footwear odor absorbers.

General Tips: To tackle this problem, wash your feet with an antibacterial soap such as Neko and use a fresh pair of cotton socks daily. You can also apply deodorant to the soles of your feet. The best thing would be to buy another pair of work shoes and alternate wearing the two pairs so that the shoes have time to dry out.

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/Foot_odor
http://www.wolfpodiatry.com/library/1932/SmellyFeetandFootOdor.html

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Categories
Our body extricts

Sweat

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Defination:
Sweating (Perspiration, transpiration, or diaphoresis) is the production of a fluid consisting primarily of water as well as various dissolved solids (chiefly chlorides), that is excreted by the sweat glands in the skin of mammals. Sweat contains the chemicals or odorants 2-methylphenol (o-cresol) and 4-methylphenol (p-cresol), as well as a small amount of urea.
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In humans, sweating is primarily a means of thermoregulation, although it has been proposed that components of male sweat can act as pheromonal cues. There is widespread belief that sweating, for example, in a sauna, helps the body to remove toxins, but the belief is without scientific support. Evaporation of sweat from the skin surface has a cooling effect due to the latent heat of evaporation of water. Hence, in hot weather, or when the individual’s muscles heat up due to exertion, more sweat is produced. Sweating is increased by nervousness and nausea and decreased by cold. Animals with few sweat glands, such as dogs, accomplish similar temperature regulation results by panting, which evaporates water from the moist lining of the oral cavity and pharynx. Primates and horses have armpits that sweat like those of humans. Although sweating is found in a wide variety of mammals, relatively few, such as humans and horses, produce large amounts of sweat in order to cool down..

 

A study has discovered that men, on average, start perspiring much more quickly than women, then twice as much when they are in the middle of exercising.


Mechanism :

A man sweats after exercising.Sweating allows the body to regulate its temperature. Sweating is controlled from a center in the preoptic and anterior regions of the brain’s hypothalamus, where thermosensitive neurons are located. The heat-regulatory function of the hypothalamus is also affected by inputs from temperature receptors in the skin. High skin temperature reduces the hypothalamic set point for sweating and increases the gain of the hypothalamic feedback system in response to variations in core temperature. Overall, however, the sweating response to a rise in hypothalamic (‘core’) temperature is much larger than the response to the same increase in average skin temperature. The process of sweating decreases core temperature, whereas the process of evaporation decreases surface temperature.

There are two situations in which our nerves will stimulate sweat glands, making us sweat: during physical heat and emotional stress. In general, emotionally induced sweating is restricted to palms, soles, armpits, and sometimes the forehead, while physical heat-induced sweating occurs throughout the body.

Sweat is not pure water; it always contains a small amount (0.2–1%) of solute. When a person moves from a cold climate to a hot climate, adaptive changes occur in the sweating mechanisms of the person. This process is referred to as acclimatisation: the maximum rate of sweating increases and its solute composition decreases. The volume of water lost in sweat daily is highly variable, ranging from 100 to 8,000 mL/day. The solute loss can be as much as 350 mmol/day (or 90 mmol/day acclimatised) of sodium under the most extreme conditions. In a cool climate and in the absence of exercise, sodium loss can be very low (less than 5 mmols/day). Sodium concentration in sweat is 30-65 mmol/l, depending on the degree of acclimatisation.

Composition:
Sweat contains mainly water. It also contains minerals, lactate, and urea. Mineral composition varies with the individual, their acclimatisation to heat, exercise and sweating, the particular stress source (exercise, sauna, etc.), the duration of sweating, and the composition of minerals in the body. An indication of the minerals content is sodium 0.9 gram/liter, potassium 0.2 gram/liter, calcium 0.015 gram/liter, magnesium 0.0013 gram/liter. Also many other trace elements are excreted in sweat, again an indication of their concentration is (although measurements can vary fifteenfold) zinc (0.4 mg/l), copper (0.3–0.8 mg/l), iron (1 mg/l), chromium (0.1 mg/l), nickel (0.05 mg/l), lead (0.05 mg/l). Probably many other less-abundant trace minerals leave the body through sweating with correspondingly lower concentrations. Some exogenous organic compounds make their way into sweat as exemplified by an unidentified odiferous “maple syrup” scented compound in several of the species in the mushroom genus Lactarius.   In humans sweat is hypoosmotic relative to plasma

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You may also click and see:
*Diaphoresis
*Hyperhidrosis
*Anhidrosis
*Hyponatremia
*Hyperthermia
*Body odor
*Hidradenitis-Suppurativa
*Pheromones
*Sweat gland
*Sweat therapy
*Eccrine gland
*Apocrine gland

Click to see :

Sweat

What is Sweat?

Do you Sweat excessively? Here are the solutions

Source : http://en.wikipedia.org/wiki/Perspiration

Categories
Health & Fitness

How Can YOU Control Your Excessive Sweating and Odor?

The best way to stop excessive sweating is to find the cause. For example, if it only occurs when you are nervous or anxious, stress reduction techniques in combination with the proper use of an antiperspirant may go a long way toward getting this under control. However, if the perspiration affects multiple areas of your body no matter what the situation, you may have a form of excess sweating known as hyperhidrosis. As for the odor, it’s most likely caused by the bacteria on your skin as it comes in contact with the perspiration. But one thing is clear: The symptoms are affecting the quality of your life and it’s time to regain control with a visit to your physician.

…………...CLICK & SEE

Sweating the small stuff:
Sweating is a part of life. Normal sweating is usually caused by one or a combination of the following:

1.Your body is too hot and needs to cool off (from fever due to an illness, hot temperatures, too many layers of clothing)…….CLICK & SEE

2.You’re anxious and stressed…..CLICK & SEE

3.You’re performing strenuous exercise……..CLICK & SEE

The pattern of perspiration may be different depending upon the situation. For instance, when you’re nervous, the sweat often appears under the armpits, the hands and even on the forehead. In contrast, when you exercise, the sweat tends to occur throughout the body.

Needless to say, the location, amount, odor and frequency that the sweating occurs are unique to each individual. For some, it’s explainable and hardly noticeable. For others, the potential for embarrassment exists and can change life experiences. This makes it especially important to speak with your physician and provide the answers to the following questions:

*Where does your sweating occur (armpits, groin, whole body, hands, feet, face)?
*At what age did it begin (early to mid teenage years) and does heavy perspiration run in your family?
*How often does it occur (everyday, a few times per week, once a month)?
*When does it occur (during the daytime, wakes you up at night, day and night)?
*How often do you need to change your clothes (shirts, socks, others) due to excessive perspiration (once, twice or several times per day)?
*Do you get skin irritations or infections in the areas where you constantly sweat?
*How often do you need to shower during the day to get rid of the odor?
*Are you afraid to shake hands because of your sweaty palms? If so, how often do you find yourself drying them off due to excess perspiration?
*Are you afraid to wear certain colors because the sweat stains will show through?
*What products have you tried (deodorants, antiperspirants) and did they provide any relief?
*Do certain situations make your sweating worse (spicy foods, when you are anxious or upset, meeting a new person)?
*Have other symptoms occurred since your sweating problem began (fever, cough, joint pains, rash)
*Are you taking any prescription, non-prescription or herbal medications?
*Does your sweating or fear of sweating keep you from certain events or social activities?

Next, It is advised to encourage you to take a look at the information at the International Hyperhidrosis Society to see how you rate on the hyperhidrosis disease severity scale. A result of 3 or 4 means you’re sweating is life-altering and may clue your physician to check for the conditions known as primary focal or secondary generalized hyperhidrosis.

Techniques to decrease perspiration:
If excess perspiration occurs only when you are stressed or nervous, relaxation techniques learned through biofeedback, hypnotherapy, yoga and/or meditation might help to decrease your anxiety induced sweating. Acupuncture may even provide some relief. However, if your sweating is made worse by a multitude of factors including hyperhydrosis, other suggestions to consider include but aren’t limited to the following:

*Avoid or decrease the consumption of caffeinated products

*Bathe daily to limit the amount of bacteria contributing to the sweaty odor

*Eliminate odor-producing foods (onions, garlic, others) from your diet

*Wear loose fitting clothes containing materials such as cotton, wool and silk. These “breathable” fabrics allow for a better flow between your skin and the surrounding air.

*Use antiperspirants daily to stop the sweat and the odor, instead of deodorants, which stop the odor, but not the sweat.
*While these products are commonly applied to the armpits, they are also effective in other areas such as the hands and feet.

*Antiperspirants are available with and without a prescription. Look for the ingredient aluminum chloride hexahydrate, a very effective agent for problem sweating. Preparations containing 10-15 percent aluminum chloride hexahydrate work well for excessive perspiration in the armpits, while those containing 30 percent tend to work better for problem sweating of the hands and feet. Apply the antiperspirant after the area has been dried (use a towel or cool air from a blow dryer) once per night (works better than a morning application as it takes six to eight hours for the antiperspirant to plug the pores and block the flow of sweat) or twice per day (morning and night).

*Consider the use of iontophoresis for extreme and uncontrolled sweating of hands and/or feet. This technique uses very low levels of electric current applied during a 15 to 20 minute session over a period of time (days or weeks). It seems to slow or shut down the flow of perspiration through the sweat glands.

*Injection of botulinum toxin type A (Botox) to the affected areas (armpits, hands, feet and even the face) where sweating is not controlled by other methods. One treatment is very effective at stopping the flow of sweat for a period of four to seven months, sometimes longer.

Fortunately, much can be done to help prevent or minimize the discomfort and embarrassment caused by your drenching underarm sweating.  If you wish you may contact  Mayo Clinic to help you.

Therapeutic  treatment of   excessive sweating  is : IONOSPHERES

You may click to see:->Excessive Sweating – Red Hands

Prickly Heat: When Sweating Hurts
Night Sweats
Can Stress Cause Body Odor?

Sources:MSN Health & Fitness

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Categories
Health Quaries

Some Health Questions And Answers

Q: I attained menopause two years ago. My neighbour said that if I have sex, I will contract diseases. Is it true?

…………………………………………monopause.jpg
AGE NO BAR: Pregnancy can occur until menopause is attained

A: Menopause only marks the end of the reproductive phase of a woman’s life. The lack of hormones may cause the vagina to become dry. This may make penetration uncomfortable and cause irritation. Lubricating jellies such as KY jelly, vitamin E cream or an oestrogen cream can be used. Sex can be continued and without the fear of contracting diseases. Sexually transmitted infections (STIs), however, may occur if the relationship is not monogamous. But this has nothing to do with menopause.

Sweaty palms

Q: My son has excessive sweating on the soles and palms. The sweat smells of ammonia. Please advise.

A: About 1 per cent of the population suffers from excessive sweating (hyperhidrosis). This may be secondary to diabetes or thyroid dysfunction. In both cases, there may be a breakdown of muscles (protein) for energy, producing an ammonia smell in the sweat. These conditions need to be ruled out with appropriate blood tests. If the tests are normal, your son has primary hyperhidrosis. This can be treated with antiperspirant deodorants containing aluminum chloride (20-25 per cent). Apply it in the evenings, two or three times a week. Otherwise, ionotophoresis can be done. This is the application of low intensity electric current (15-18 mA) to the palms and soles while immersed in an electrolyte solution. Injections of botulinum toxin, surgical removal of the glands or the sympathetic nerve ganglia can be done in severe cases. There are no specific drugs available for the problem.

Goitre surgery


Q:
I have a swelling in my throat. Sometimes there is a rasping sound while breathing. My doctor says it is goitre and that surgery is needed, but my thyroid tests are normal.

A:
Goitre is a swelling of the thyroid gland. The gland may still be producing enough thyroid hormone to make the results of blood tests seem normal. The goitre could be due to cancer.

The swelling in your throat is large enough to press on the windpipe and cause the rasping sound. If you have been advised surgery, I think you should go for it.

Fall in libido

Q: I am a 46-year-old man who developed hypertension two years ago. I have been started on antihypertensives and since then have noticed decreased libido and impotence. Please help.

A:
Antihypertensives can have side effects like decreased libido, erectile dysfunction and premature ejaculation. This is particularly true of the older, less cardio selective medications. The effects are often dose-related. There are many groups of antihypertensive medications. Each person experiences different side effects, so treatment and dosage have to be individualised. Speak frankly to your doctor so that he can alter and adjust the medications.

Contraception

Q:
My husband and I have been using condoms for many years. I am now 51 years old. My husband says there is no need for contraception as I am too old to get pregnant.

A:
Women can become pregnant until they attain menopause, which occurs when menstruation has completely ceased for one year. You need to continue using condoms or some other form of contraception until then.

Juice is healthy

Q: I am a diabetic. I read that regular intake of orange juice controls cholesterol, blood sugar, body toxins, etc. Can I drink the sugar-free orange juice packaged by prominent companies and sold in supermarkets?

A: Around 240ml (1 cup) of unsweetened orange juice, marketed by the companies you mentioned, contains the following ingredients (expressed as a percentage of the daily requirement): 100 per cent of vitamin C, 35 per cent calcium, 4 per cent riboflavin, 6 per cent pyridoxine, 10 per cent thiamine, 15 per cent folic acid, 6 per cent magnesium, antioxidants, carotene and 100 calories.

Orange juice is recommended by the American Heart Association. It has zero fat and the trace elements, antioxidants and vitamins, have a cardio protective effect. Nothing compares to control of sugars with a sensible diet and exercise.

Controlling diabetes

Q: I am a 43-year-old man with unhealthy eating habits, not to mention alcohol and chewing tobacco. Recently, I checked my blood sugar and was shocked to see the results. The glucose level was 202 mg/dl (fasting) and 311 mg/dl two hours after food. I was afraid that medications would make me drug dependent. So I adopted a restricted diet and strict exercise schedule. I also stopped drinking and the tobacco. Within a week my glucose levels fell to 110mg/dl (fasting) and 186 mg/dl PP. Can I continue with the regimen and avoid medication?

A:
Congratulations on your success! You obviously are determined, motivated and dedicated. You can keep your sugars under control with diet and exercise. Buy a glucometer, check the sugars regularly and maintain a diary. If the sugar levels rise again, despite your strict regimen, you can consider medication.

All answers given by DR. GITA MATHAI

Source: The Telegraph (Kolkata, India)

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