Tag Archives: Loyola University Medical Center

Let’s Talk About Schizophrenia

People sometimes change inexplicably in their late teens – they behave bizarrely, argue unnecessarily with everyone, imagine events, become suspicious or withdraw into a shell. This is actually a disease called schizophrenia and these forms are classic, delusional, paranoid and catanonic. The word itself means “split mind ” in Greek as it was confused with a multiple personality disorder by earlier physicians. Today, these two illnesses are classified separately.
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Schizophrenia is a serious mental illness that is likely to affect one in 100 men and women (0.5-0.7 per cent respectively). It strikes people usually in their late teens and twenties. It is rare for schizophrenia to set in after the age of 40 and children are rarely diagnosed with it. They can, however, go on to develop it as adults if they have some other mental illness such as autism.

The onset of schizophrenia is so gradual that it mostly goes unrecognised and untreated, especially in developing countries with inadequate healthcare. In addition, people baulk at the idea of admitting they or a loved one is suffering from schizophrenia though no one has a problem saying they have an incurable chronic illness like diabetes or hypertension.

Schizophrenic patients may be delusional or hallucinate — that is see and hear things that are not real. Their speech may be disconnected, dressing and behaviour may be socially inappropriate and they may cry and laugh for no reason at all. Sometimes the person may be “catatonic” or unresponsive to any external stimulus.

Unreasonable behaviour and a quarrelsome nature may affect relations with friends, family and colleagues. The person may be unable to keep a job. Insomnia and morning drowsiness affect efficiency. The appetite may be poor.

The diagnosis of schizophrenia is difficult as the symptoms evolve gradually over a period of months or years. It is often difficult to pinpoint the exact date at which the changes were noticeable. The symptoms should be present for a month for schizophrenia to be suspected and remain for six months for the diagnosis to be established. The patient or a caretaker can report the symptoms. They should be substantiated by evaluation by a qualified medical professional.

PET scans also do not strictly conform to normal parameters. The brains in schizophrenics have smaller temporal and frontal lobes. The levels and ratios of certain brain chemicals like serotonin, dopamine and glutamine are altered.

The exact reason for these behaviour altering brain changes is not known. However, seven per cent of persons with schizophrenia have a family member who suffers from a similar disease. Many have been born to mothers who suffered several viral illnesses during pregnancy. Environmental factors also play a role — the incidence of the disease increases in persons who are financially insecure or from dysfunctional families with a history of childhood abuse.

Schizophrenics tend to gain weight because their lifestyle is sedentary. Patients also have a predilection for addiction — to tobacco products, alcohol and drugs like cannabis. They are often unwilling to check the addictions to control lifestyle diseases like diabetes or hypertension. Also, they do not adhere to diet modifications or medications needed to keep their disease in check; so this shortens lifespan. They eventually die 10-15 years earlier than their peers. They are also 15 per cent more likely to commit suicide.

Gone are the days when schizophrenics were locked up, immersed in cold baths or given electrical shock therapy. Today there are a plethora of drugs that can be used singly or in combination to control the symptoms of schizophrenia and help the person function fairly normally. These drugs act by correcting the enzyme and chemical imbalances in the brain. Response to medication may be slow and this may be frustrating for the patient as well as caregivers but medication can be increased only gradually to optimal levels. Drugs, combinations and dosages have to be individualised and vary from person to person.

The side effects of medication are weight gain, menstrual irregularities and drowsiness. Some people become very stiff and have abnormal smacking movements or grimaces but doctors are able to tackle this with other medications.

Rehabilitation is important. Once the symptoms are controlled, patients can function in society and even hold down jobs. They need to be trained to handle money and in personal care and hygiene. Medication needs to be continued even when the symptoms have disappeared. The involvement of the whole family helps as the person is then more likely to follow medical treatment and less likely to relapse.

People often ask for a “miracle drug” — a single tablet to treat all diseases. The only universal ingredient to improve health in all diseases (even mental problems) is physical exercise. So go take a walk.

Source : The Telegraph ( Kolkata, India)

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Umbilical Hernia

Definition :
An umbilical hernia is an outward bulging (protrusion) of the abdominal lining or part of the abdominal organ(s) through the area around the belly button

 

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An umbilical hernia is a protrusion of the peritoneum and fluid, omentum, or a portion of abdominal organ(s) through the umbilical ring. The umbilical ring is the fibrous and muscle tissue around the navel (belly-button). Small hernias usually close spontaneously without treatment by age 1 or 2. Umbilical hernias are usually painless and are common in infants.

UMBILICAL Hernias, and nearby hernias called “Paraumbilical Hernias” develop in and around the area of the umbilicus (belly button or navel). A Congenital (present since birth) weakness in the naval area exists. This was the area at which the vessels of the fetal and infant umbilical cord exited through the muscle of the abdominal wall. After birth, although the umbilical cord disappears (leaving just the dimpled belly-button scar), the weakness underneath may persist. Hernias can occur in this area of weakness at any time from birth through late adulthood. The signs and symptoms include pain at or near the navel area as well as the development of an associated bulge or navel deformity. This bulge pushes out upon the skin beneath or around the navel, distorting the normal contour and architecture in or around the navel (creating an ‘OUTIE’ instead of a normal ‘INNIE‘).
Although often appearing at or just after birth, these hernias can also occur at any time during later life. In INFANTS, these hernias may gradually close by age 3 or 4 and surgery can often be delayed until then, unless the hernias are causing problems or enlarging. This decision should be made after examination by a Pediatrician or skilled Surgeon. In ADULTS however, umbilical hernias cannot “heal”, and do gradually increase in size and often become problematic. Incarceration or Strangulation may occur….CLICK & SEE

Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. An Acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individuals.

Causes:

Children:
Umbilical hernias are fairly common. Such a hernia is obvious at birth, as it pushes the belly button outward. This is more obvious when the infant cries, becauses increased pressure results in more noticable bulging.

In infants, the defect is not usually treated surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment.

Umbilical hernia repair may be necessary for children for the following reasons:

*The herniated tissue is stuck in the protruding position, or if blood supply is affected
*The defect has not closed by age 3 or 4
*The defect is very large or unacceptable to parents for cosmetic reasons
*An umbilical hernia in an infant occurs when the muscle through which blood vessels pass to feed the developing fetus doesn’t close completely.

Adults:
Umbilical or para-umbilical hernias are relatively common in adults. They are more common in overweight people and in women, especially after pregnancy. Most surgeons recommend they be surgically repaired, as they tend to get bigger ov

Without surgery, there is a risk that some abdominal contents, typically a bit of fat or intestine, will get stuck (incarcerated) in the hernia defect and become impossible to push back in, which is typically painful. If the blood supply is compromised (strangulation), urgent surgery is needed.

Incarcerated abdominal tissue may cause nausea, vomiting, and abdominal distension.

Any patient with a hernia that cannot be reduced, or pushed back in, while lying down and relaxed should seek urgent medical attention.

Symptoms
A hernia can vary in width from less than 1 centimeter to more than 5 centimeters.

There is a soft swelling over the belly button that often bulges when the baby sits up, cries, or strains. The bulge may be flat when the infant lies on the back and is quiet.

Risks Factors:
Risks for any anesthesia include the following:
*Strangulation of bowel tissue is rare but serious, and needs immediate surgery.
*Reactions to medications
*Breathing problems, pneumonia
*Heart problems

Risks for any surgery include the following:
*Bleeding
*Infection
*Risks specific to umbilical hernia surgery include injury to bowel, which is rare.

Diagnosis:
The doctor can find the hernia during a physical exam.

Treatment
Usually, no treatment is needed unless the hernia continues past age 3 or 4. In very rare cases, bowel or other tissue can bulge out and lose its blood supply (become strangulated). This is an emergency needing surgery.

Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large. After surgery, the patient’s vital signs are monitored and he or she will remain in the recovery area until stable. Medication is supplied for pain as necessary. Patients, or parents if the patient is a child, are taught to care for the incision at home. Full activity can be resumed in 2-4 weeks.

Prognosis:

Most umbilical hernias get better without treatment by the time the child is 3 – 4 years old. Those that do not close may need surgery. Umbilical hernias are usually painless.

Expect successful repair of the hernia. The long-term prognosis is excellent. Very rarely the hernia will recur. Recurrence is more common if a larger hernia (more than 3 cm) is repaired without a mesh.

Recovery
Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large.

After surgery, the health care team will monitor the patient’s vital signs. The patient will stay in the recovery area until stable. Pain medication is prescribed as needed.

Patients, or parents if the patient is a child, are taught to care for the surgical cut at home. Full activity can be resumed in 2-4 weeks.

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://hernia.tripod.com/types.html
http://www.nlm.nih.gov/medlineplus/ency/article/000987.htm
http://www.nlm.nih.gov/medlineplus/ency/article/002935.htm
http://en.wikipedia.org/wiki/Umbilical_hernia

Vakrasana-1 (Yoga Exercise)

 

This is the advanced stage of Vakrasana-1. Here the spine is twisted with the support of the knee alongwith the shoulder, and hence it involves more strain.
Pre position Sitting Position.

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How to practice the Asana(Exercise)
1. Bend the left leg in the knee and place it near the thigh of left leg.
2. Place the right hand beyond the folded knee of the left leg and in front of the left hand. Keep the palms of both the hands in opposite direction. There should be a distance of one foot between the two hands.
3. Press the standing left knee with the right hand and shoulders, and twist the neck to the left. Turn the sight also in the same direction and continue normal breathing.

Position:
1. In this Asana (Exercise)the spine is to be kept straight.
2. The lower end of the spine and both the hips be placed well on the floor and stabilize them.
3. Then with the support of the neck and shoulders twist the upper vertebrae to the left. Alongwith the neck, the sight should also be turned to the left side and stabilize it in that direction.
4. In Vakrasana (Type 1) the spine is twisted only with the help of the shoulders. Here the shoulders, the knee and the hand are placed in such a way that there is more pressure on the spine.

Releasing :
1. Turn the neck and the sight to the front.
2. Restore the right hand to its place and set right the palm of the left hand.
3. Straighten the left leg and take the sitting position.

Note: Perform this Asana by taking up the right leg making relevant changes.
Duration It should be maintained for two minutes on each side to have the expected benefits. With practice, it can be maintained up to six minutes.

Benefits: The elasticity of the spine increases as it gets twisted in its erect position. Alongwith the spine the belly and other internal organs also get twisted and receive the desired strain. It also has very good effect on the spinal cord and its functioning is improved.
Precaution : One should avoid the temptation of attaining the ideal position if strain is unbearable.

Reference Book:– Yoga Pravesh