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Dr Manjusha Agarwal

Senior Consultant

MBBS,MD (Medicine)

Experience: 28 Years

General Medicine
Mumbai, Parel
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Dr Vivekananda Reddy N

Consultant

MBBS, MD (General Medicine)

Experience: 15 years

General Medicine
Hyderabad, LB Nagar
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BRINGING THE LATEST TECHNOLOGIES FROM AROUND THE GLOBE FOR ACCURATE DIAGNOSIS AND TREATMENT OF DISEASES

The Department of General Medicine at Gleneagles Hospitals is an all-encompassing speciality that offers consultation and advanced diagnostics to ascertain a patient’s condition before referring an individual to a specialist if required. The department employs some of the finest general medicine practitioners and undertakes consultation and care for managing, preventing, treating and diagnosing all adult health conditions. A multi-disciplinary approach to providing a holistic and comprehensive management of diseases is a key facet of the department. The Department of General Medicine caters to the following diseases and disorders.

Types of Abscesses

The type of Abscess depends on the area where the Abscess is formed. The common ones include:

Anal Abscess
Breast Abscess
Dental Abscess
Gluteal Abscess
Ischiorectal Abscess
Perianal Abscess
Perineal Abscess
Periodontal Abscess
Perirectal Abscess
Pilonidal Abscess
Tooth Abscess

Signs and symptoms

Redness and swelling
Tenderness
Fever and chills
Loss of function of affected body part
In the case of a deep skin Abscess, high temperature, pain in the affected area, and general weakness can help to identify the Abscess.

Causes

An Abscess develops when the bacteria invade the sebaceous or sweat glands, and hair follicles, or enter through the cuts, incisions, or punctures of the skin - leading to inflammatory responses.

Abscess also develops after a surgical procedure. Internal Abscesses develop as a complication of the existing condition. For example, there may be a chance of development of Abscess due to Appendicitis.

Risk factors

The factors that increase your risk of developing Abscess include:

Intravenous drug use - Through frequent penetration of the needle, there will be skin damage leading to an increased risk of infections.

High Blood Sugar levels – People with Diabetes or who have a diet rich in sugars are more prone to infections.

Weak Immune System – The Immune System may weaken because of other illnesses or the use of immunosuppressive drugs increasing the risk of infections.

When to seek medical advice?

Usually, most Abscesses will heal within two weeks. Uncomplicated skin Abscesses shrink and drain by applying heat with the help of a warm compress. Do not squeeze or puncture an Abscess as it can make the infection deeper and thus worsen the condition.

Consult a doctor in the following situations:

If the Abscess is larger than 1cm
If the Abscess fails to heal
If you have an underlying disease condition such as HIV, Cancer, or peripheral vascular disease
If you are a drug abuser
If you are on Steroid Therapy, Chemotherapy, or Immunosuppressive Therapy
If you are pregnant
If you have recurrent Abscesses
If your body temperature is 100.4 F or higher

Diagnosis

Your doctor will review your medical history and ask for information about the time of onset of Abscess, Allergies, use of prescription and non-prescription medicines, and co-existing conditions.

Depending on the location and extent of the Abscess, your doctor may recommend blood tests, wound culture tests, or imaging studies.

Abscess is structurally similar to Cysts and boils. Cysts are painless unless they are irritated by rupture and they usually resolve on their own, unlike Abscess. Boils and Carbuncles are types of Abscesses that involve hair follicles.

Treatment

The standard therapy is incision and drainage of the Abscess. Your doctor will numb the area by administering local Anaesthesia and applying the antiseptic lotion on the affected area. Then the Abscess is cut open to drain the pus and debris. After draining, the wound is left open for one or two days. Later, the wound is dressed with a bandage. The pain subsides as the Abscess heals.

Antibiotics are prescribed to patients with severe Abscesses such as an Abscess on the face, the presence of more than one Abscess, and a compromised Immune System. Dicloxacillin or cephalexin are commonly prescribed antibiotics.

Self-Management

To prevent the development of new or recurrent Abscess:

Examine your skin regularly, particularly high-risk areas for any minor cuts.
Clean the cuts and scrapes thoroughly and apply an antibacterial ointment.
Perform home care carefully as per your doctor’s instructions. Report immediately if there is any illness, fever, increased pain, redness or swelling.
If you are Diabetic, follow your Diabetes treatment plan without failing to control your blood glucose levels.

An Abscess is a collection of pus that appears as a pink to dark red coloured bump, within or below the skin surface. There will be tenderness, and in most cases, swelling and inflammation can be seen. It occurs due to bacterial infection (mostly Staphylococcus Aureus) on any part of the body. However, the face, neck, chest, base of the spine and tooth are the commonly affected parts. Areas of hair growth such as armpits and groin are also commonly affected. There may be deep skin or internal Abscesses that form in the Lungs, Brain, Kidney, and Teeth. Deep skin Abscesses are difficult to diagnose.

Warning signs of Anorexia

The signs and symptoms of Anorexia Nervosa include:

Extreme loss of weight with less intake and compulsive exercise
Perception of being over-weight and in bad shape
Fear of gaining weight
Dry, pale and yellow skin with thin hair
Cold or swollen hands and feet, weak bones and fatigue
Low Blood Pressure and rhythm disturbances in the Heart
Poor concentration and memory
Refusal to eat in public
Self-induced vomiting or purging
Use of diet pills or pills that increase urination
Secondary amenorrhea

Anorexia is a potential cause of many problems like growth arrest, excessive hair fall, and malnutrition. It may lead to weak and brittle bones and problems in the Heart, Thyroid, and Kidneys. Infertility is the most feared consequence. Repeated vomiting of the acidic content from the Stomach can cause tooth decay. Depression, mood swings, decreased mental abilities and suicidal thoughts are the dreaded psychological consequences. Anorexia Nervosa is a serious disorder and can cause death in 10% of cases.

Treating Anorexia Nervosa

Treatment of Anorexia is challenging. The patient has to be made to realize that she or he is suffering from the disorder. Anorexia Nervosa treatment begins with counseling and the first goal is to help the patient gain weight. The doctor may help the patient to follow an eating schedule, decrease physical exercises and increase social activity. Rarely, hospitalization may be required if there are medical complications. If the patient has severe mood problems, medicines like antidepressants, anti-anxiety drugs and mood stabilizers may be needed.

Anorexia Nervosa and Bulimia

Both Anorexia and Bulimia are eating disorders. Both share similarities in that the patient fears weight gain and has a distorted perception of weight and shape. Unlike Anorexia, Bulimia is characterized by excessive eating. Such people adopt irrational methods after eating like using laxatives to purge or mechanically stimulating the throat to cause vomiting. Some may use enemas or pills to stimulate urination. They are involved in heavy exercising and avoid socializing to escape eating. People with Bulimia may be either normal or more in weight than the underweight people with Anorexia. Binging and purging are regular features of Bulimia and the frequency of such practice may be at least twice a week and prevalent for at least three months.

Seek help

Family and friends should support the anorexic patient. A comfortable time and place should be chosen to talk to the patient. Conflicts should be avoided. No blame, shame, guilt or fear should be thrown on the affected person. Help the patient meet the stress in life. Offer moral support. Participate in healthy eating. Offer simple solutions to all situations and persuade them to consult a therapist for help. Offer patient hearing and supportive concern. Let them know you care.

Love yourself!

Anorexia Nervosa is a dreadful disorder, especially among young women who are too inclined to keep themselves in the best shape. It is treatable but may return. Weight management is an elaborate and long affair. Patience, support, positive attitude and sensitivity can go a long way to fight this disorder. Help yourself and help others to eat healthy, and maintain a good body weight.

Anorexia Nervosa is a mental disorder where a person, more often a woman, has an intense fear of gaining weight. These people are usually thin and fear food, but are yet not satisfied with their body image. The disorder is much beyond a food or eating problem. It is a means to ease some hidden tensions, anger, and anxiety. Anorexia Nervosa is most commonly seen in adolescent girls and young women, though it can affect men and children. Such people weigh at least 15% less than the normal weight expected for their heights. Why people can become anorexic is not exactly known. Many factors like social attitudes, genetics, hormones, obsession, over concerned parents, personality traits like being a perfectionist and an intense concern for weight and shape are believed to lead to this disorder. Many people may be facing a stressful event in life like a family conflict, loss of a loved one, change in job, rape or abuse. They have a generally negative attitude in life and a negative self-image.

Symptoms

Symptoms usually begin four to nine days after you start taking antibiotic medication. Diarrhoea is the most common symptom of AAD. You may suffer from loose stools or more frequent Bowel movements. In some cases, after finishing your antibiotic treatment, Clostridium Difficile, a toxin-producing bacterium causes antibiotic-associated colitis (inflammation of the colon). This is due to the imbalance of the type of bacteria in your Intestinal Tract.

In such conditions, you may experience:

Foul smelling Diarrhoea
Abdominal cramps
Nausea and vomiting
Low-grade fever
Loss of appetite
Pus or blood in the stools

Antibiotic-associated Diarrhoea often begins about a week after you start taking an antibiotic. Sometimes, Diarrhoea and other symptoms don’t appear until days or weeks after you have finished antibiotics treatment.

Causes

The exact cause of AAD is still not known. It is believed to be developed when antimicrobial medications upset the balance of “good” and “bad” bacteria in your Gastrointestinal Tract. AAD is also caused by bacteria called Clostridium Difficile, which rapidly grows and releases toxins that damage the Intestinal wall. Many people get this infection after a prolonged stay in a hospital or nursing facility.

Almost all antibiotics can cause AAD, but cephalosporins, penicillins, fluoroquinolones, and clindamycin are the most commonly involved antibiotics.

AAD can occur in anyone who takes antibiotics, but the risk increases if you:

Are over the age of 65
Have had surgery on the Intestinal Tract
Have taken antibiotics for an extended period
Have taken more than one antibiotic medication

Complications

Dehydration (loss of fluids and electrolytes) is the most common complication. If you do not treat the condition in the early stages, it may become severe and can be life-threatening. You may have a dry mouth, intense thirst, little or no urination, and weakness. Other complications include:

Bowel perforation- A hole in the Bowel lining
Toxic megacolon- A severe condition that leads to Bowels being unable to expel gases
Death

Diagnosis

In most cases, the doctor diagnoses AAD based on your symptoms, history of antibiotic treatment and the results of physical examination. The diagnosis helps to decide the treatment for Diarrhoea. The doctor would perform an endoscopy to confirm the disease by taking a sample from your intestinal tract using an endoscope which is a thin flexible tube with a fiber-optic video camera that is passed down your throat, into your esophagus and Stomach.

Treatment for Antibiotic-induced Diarrhoea

Treatment for AAD depends on the severity of your signs and symptoms. Mild to moderate AAD can be managed by following these tips.

Drink plenty of fluids such as oral rehydration fluids, fruit juices, soft drinks, and sports drinks to replace the lost body water or overcome rehydration.
Avoid milk and milk foods, fibre-rich foods such as corn and bran and foods containing wheat flour as it may trigger a Bowel movement.

If you have more severe Diarrhoea or C. difficile infection, then your doctor may ask you to discontinue the antibiotic and replace it with other antibiotics with a lower risk of inducing Diarrhoea.

Nearly 22% of patients with C. difficile-associated AAD have managed the clinical signs and symptoms just within 3 days of drug withdrawal.

Your doctor may recommend a faecal transplant if the symptoms persist. In this technique, fresh stool from the donor is mixed and blended with a salt solution to make the slurry. This is passed through gauze to remove undigested food particles and is transferred into the recipient’s intestine through a colonoscopy or an enema.

If the patient develops serious complications like developing a hole or leak, then the doctor would recommend emergency surgery to remove the affected portion of the colon.

When to seek medical advice?

Report to your health care professional if you are taking any antibiotics and experience symptoms like:

More than five stools per day
High volume or watery Diarrhoea
Fever
Abdominal pain
Blood or pus in the stool

Prevention

The key measure for preventing AAD is to limit antibiotic use. Take antibiotics only when your doctor suggests and take them exactly as prescribed. Remember!!! Don’t stop the antibiotic medication without consulting your doctor. If you have C. difficile-related Diarrhoea, maintain good hygiene conditions like using gloves, and washing hands to prevent transmission and dissemination of bacteria.

Many different bacterial species live inside the Bowel. Most of them are harmless or even helpful to the body, but few of them may have the potential to be aggressive troublemakers. If you are taking an antibiotic, the medication may cause a mild change in the population of Intestinal bacteria resulting in loose stools or mild Diarrhoea for a few days. This condition is called antibiotic-associated Diarrhoea (AAD) and occurs in nearly 5% to 30% of people under antibiotic therapy. In most cases, this condition is mild and requires no treatment as the symptoms stop once your antibiotic treatment ends. The severe condition requires treatment with other medications.

Causes

The problems associated with any component of the back may lead to back pain. The pain may be acute (sudden pain and lasts for less than six weeks) or chronic (lasts for more than three months). The common causes of back pain are listed below:

Muscle strain: Repeated lifting of something improperly or lifting too heavy weights may strain the muscles of the back. Constant strain on your back may result in muscle spasms.
Structural problems: The structural problems that lead to back pain involve:

Ruptured discs – These discs cushion each vertebra present in the spine. If there is a rupture in the disc, then the nerves are pressurized leading to back pain.
Bulging discs – The bulged discs apply more pressure on the nerves leading to back pain.
Sciatica – The compression of the spinal nerve by the Herniated Disc may result in lower back pain.
Abnormal curvature of the spine – Conditions such as Scoliosis and Kyphosis involves curve in the spine leading to back pain.
Osteoporosis – If the spinal vertebrae become brittle and porous, then it may lead to back pain and may result in compression fractures.

Day-to-day activities: The activities you do in your everyday life such as bending awkwardly, pushing or pulling something, standing for a longer duration, twisting, and overstretching may cause back pain.

Symptoms

The primary symptom of back pain is an ache or persistent pain in your back. The other symptoms include:

Muscle pain
Shooting or stabbing pain
Pain radiating to the buttocks and the legs
Limited flexibility of the back

Risk factors

The factors that increase your risk of developing back pain include the following:

Age: The risk of back pain increases as you get older, and it is more common in people aged 30 to 40 years.
Physical inactivity: A sedentary lifestyle or physical inactivity makes your bones and muscles rigid leading to pain.
Smoking: The habit of smoking prevents enough nutrients reaching from the discs and weakens them. This results in back pain.
Medical conditions: Certain medical conditions such as cauda equina syndrome, Cancer of the spine, infection of the spine, sleep disorders, Shingles, and other infections such as pelvic inflammatory diseases and Kidney infections result in back pain.

Complications

Prolonged back pain can lead to the following complications:

Weight gain: Due to the restriction in the activities and movement in a person with back pain, there is an increased risk of weight gain.
Disability: Back pain is one common cause of absence from work due to the person’s disability.
Nerve damage: Back pain resulting from a Herniated Disc can result in nerve damage. This can lead to numbness of the legs and severe shooting pain in the back of the legs.
Depression: If the back pain lasts for several days, it can lead to depression of the person due to a disruption in the sleeping, and eating patterns, and a loss of motility.

Diagnosis

Your doctor diagnoses the back pain by assessing your ability to sit, stand, and walk. A pain assessment is also performed where you will be asked to rate your severity of pain on a scale of zero to ten. This helps your doctor to determine the origin of pain and also the presence of muscle spasms. Sometimes, to rule out other causative factors, your doctor may suggest any of the following tests:

X-ray: The X-ray helps to determine the proper alignment of your bones and also conditions such as Arthritis or broken bones.
Magnetic Resonance Imaging (MRI) Scan: The MRI Scan is beneficial to obtain more detailed images of the structures in the back. This scan reveals the presence of any Herniated Disc or other conditions related to muscles, bones, nerves, tendons, and ligaments.
Blood tests: Blood tests are performed to determine the presence of any infection that is leading to back pain.

If your doctor suspects Bone Tumours, Osteoporosis, or Spinal Stenosis, then bone scans and nerve studies are suggested.

Treatment

In the majority of individuals, back pain resolves itself without any medical help. Depending on the type, whether acute or chronic back pain, your doctor might prescribe the following:

Medication

Over-the-counter analgesics: Drugs such as acetaminophen and aspirin might relieve acute back pain. If these drugs do not relieve the pain, then your doctor may suggest nonsteroidal anti-inflammatory drugs such as ibuprofen, ketoprofen, and naproxen.
Topical analgesics: Certain topical analgesics that include creams and ointments are applied to the skin over the site of pain.
Injections: Your doctor may prescribe steroid or anaesthetic injections to reduce your pain.
Muscle relaxants, anti-depressants, and narcotics may be given in rare conditions.

Surgery

Your doctor may recommend surgery only if you suffer from chronic back pain which was not relieved by any other therapy. You may require surgery if you have a Herniated Disc, Spinal Stenosis, Vertebral Fractures, or Degenerative Disk Disease.

Complementary and Alternative Therapy

Several Alternative Therapies may resolve your back pain, and those include Chiropractic, Osteopathy, Shiatsu, and Acupressure.

An Osteopath treats and strengthens your musculoskeletal framework with drug-free non-invasive manual medicine.
A Chiropractor focuses on neuromuscular causes and relieves your back pain.

Back pain is one of the most common conditions that affect the individual at some point in their life. It is also considered a leading cause of disability worldwide. Your back pain can be healed with proper body mechanics and home treatment. But, if you experience severe pain, you may have to visit your doctor. The human back consists of a complex structure of muscles, ligaments, tendons, bones, and discs. Back pain ranges from dull, continuous pain to sharp and severe pain. It can originate from muscles, nerves, bones, joints, or spine. It is estimated that nine out of ten individuals suffer from mild to severe back pain. However, the condition may rarely cause disability.

Breast Cyst Aspiration

Breast Cyst Aspiration is a procedure in which the doctor removes the fluid from the Breast Cyst by using a small needle. Breast Cyst Aspiration aims to confirm the diagnosis and drain the fluid from the Cyst.

The lump in your Breast may cause pain and you may worry whether it is because of Breast Cancer. Breast Aspiration helps your doctor to find out whether the lump in your Breast is a Tumour or Cyst. Breast Aspiration provides the results immediately so that you do not have to wait for specific tests to be carried out.

Breast Cyst Aspiration Procedure

Before the Cyst aspiration, your doctor may conduct an ultrasound procedure to have a better picture of your lump. Then your doctor may cause numbness of the skin of your Breast by giving local anaesthesia (medicine causing local numbness) and inserting a needle into your lump and draining out the fluid. If the fluid does not contain any blood and the lump disappears, then no further tests are necessary. If there is blood in the fluid and if the lump continues, then your doctor may recommend you to a Breast surgeon for further tests. If there is no fluid drawn during aspiration, then your doctor may recommend you undergo further tests to evaluate your lump.

Benefits

The doctor can diagnose the lump in your Breast immediately on the same day after the Cyst aspiration. If the lump you have is a Cyst, you can know right away and no further tests are required.

Risks

Before you undergo Breast Cyst Aspiration, your doctor informs you of the procedure and keeps you informed about the possible problems. You may feel slight pain when the needle goes inside your Cyst and there can be a small bruise on the Breast. At times the place where the needle is inserted may become infected.

Need to see the doctor after Breast Cyst Aspiration

After Breast Cyst Aspiration, you need to see your doctor again after a period of 4 to 6 weeks. The doctor examines whether the Cyst which was drained has developed into a lump again. A recurring Cyst is a problem. If you feel that the Cyst that was aspirated has filled up again with fluid, call your doctor.

A Breast Cyst is a non-cancerous (benign) fluid-filled sac in the Breast. Breast Cysts are lumps found with distinct edges and shapes, circular or elliptical. At times, a Breast Cyst can also be firm. Breast Cysts generally occur in females between the ages of 30 and 40 and disappear after menopause (the age at which ovaries stop functioning) unless they are on hormone therapy. Sometimes, the Cysts may cause mild pain. In some women, the Cyst comes and goes with the menstrual cycle, but if it persists, then it may need evaluation. It is difficult to differentiate between a solid mass and a fluid-filled Cyst through physical examination and palpation. Breast Cysts can be diagnosed only through Mammograms and ultrasounds.

Causes of Breast Pain

There are many possible causes of Mastalgia. It may be related to many factors such as

Pregnancy and menstruation
Hormonal changes during menstruation
Menopause
Pregnancy may cause Breast tenderness to some extent
Breast pain may occur in teenagers undergoing puberty
Breastfeeding may also cause pain in the Breast

Pain, swelling and tenderness a few days before periods are usually normal but abnormal pain for no reason that persists for many weeks or months is for sure a reason to worry.

Other causes of Breast pain are:

Infection or injury to Breast tissues
Fibrocystic Breast changes (painful and lumpy Breast just before your period)
Shingles caused by Chickenpox virus (painful, blistering skin rashes on one of your Breast, months or years after you were affected with Chickenpox)
Breast Cancer can also cause Breast pain (in rare cases)

Types of Breast Pain

There are two types of Breast pain in women-cyclic and non-cyclic.

Cyclic Mastalgia: About 40% of women experience cyclic Mastalgia a week or a few days before having periods. It is related to the menstrual cycle. During a cyclic Mastalgia, you may experience a burning, stabbing, pricking pain in one or both the Breasts. This may also cause pain in the armpits, arms, and shoulders. During the menstrual cycle change in the hormone level increases the sensitivity of Breast tissues. There is fluid retention in the Breast before your periods, as the Breasts are prepared for changes during pregnancy. This fluid retention results in swollen, enlarged, and painful Breasts that resolve during menstruation. Still, no particular hormone has been identified as a contributor to cyclic Mastalgia.

Non-cyclic Breast pain is common in older women. Non-cyclic Breast pain may be in turn divided into two types. First, the pain that originates in the Breast but is completely not related to the menstrual cycle. This is common in older women before and after menopause. The sharp and stabbing pain is confined to a single spot. If you experience sudden, continuous pain it is better to consult your doctor. The second type of non-cyclic Mastalgia originates elsewhere but the pain is felt in the Breast. The pain usually originates in the bones, joints, and muscles called Musculoskeletal Pain. Pain in the chest wall and spine may also result in non-cyclic Mastalgia

Diagnosis

During your visit to the doctor, he may ask about your previous medical history and family history. The doctor will tell you to describe your pain and the area where you exactly feel it.

Visual and manual examination of your Breast will be done to check for any lumps, skin rashes or any other abnormality. Lymph nodes located in your underarms and lower neck will also be examined. Your doctor will listen to your Heart and Lungs; and check your chest wall and abdomen to be sure that the pain originated from your Breast and not from any other source.

If you are less than 35 years of age and your physical examination and medical history don’t show any abnormal results then no additional tests are needed. But if you are above 35 years old, and your physical examination is normal, your doctor may still want you to get a Mammogram done.

If any lump or unusual thickening of the Breast tissue is detected your doctor may ask you to do a Mammogram. This is an X-ray examination of your Breast tissue. An ultrasound may be needed. If lumps are detected on your Breast, then your doctor might suggest a Breast Biopsy, where a small piece of your Breast tissue will be taken and examined under the microscope.

Treatment

There are many treatment options for reducing Breast pain. Depending on what exactly is causing the pain your doctor may decide on one of the treatment options.

Wearing comfortable underwear and clothing that fits you properly may reduce pain in some women
A non-steroid anti-inflammatory medicine for non-cyclic Breast pain
An oral contraceptive can help, if you are already taking contraceptives then your doctor may change the dose accordingly
Adjust the dosage of your hormone replacement therapy, either by reducing it or by completely stopping it, which your doctor will decide
The only approved medicine for treating Breast pain and Breast tenderness is Danazol, but it has many androgenic (male characteristic) side-effects like acne, weight gain, and change in voice, thereby limiting its use. Another drug Tamoxifen used for treating Breast Cancer is prescribed for some women but it also has many potential side effects that are even more troublesome than Breast pain
Change your diet as being over-weight produces an excess amount of estrogen hormone causing Breast pain
Cyclic Mastalgia: Some say reducing salt consumption may help, but many times this doesn’t help as cyclic Mastalgia is associated with hormonal change and not fluid retention.
Exercise regularly as physical activity produces endorphin, a natural pain-killer produced in our body

Home remedies

Though there is minimal research supporting these home remedies, they may help a few women to manage their Breast pain. Some tips are worth trying

Try hot and cold compresses on your Breast
Wear proper fitting clothing and inner-wear
If anxiety is the cause of pain try some relaxation therapy at home
Make changes in your diet and try to shed a few kilos
Try a pain reliever
Limit consumption of caffeine

Conclusion

Mastalgia is caused by various factors; it can be Cyclic or Non-cyclic. Generally, Cyclic Mastalgia is more effectively treated than Non-cyclic Mastalgia. Many patients worry more about Breast Cancer than the actual pain caused by Mastalgia. Remember that Breast Cancer is very rarely related to Breast pain. However, it is very important that Breast pain needs to be checked to make sure and rule out the presence of Cancer. Any pain that lasts longer is difficult to deal with therefore consult your doctor and learn ways to manage your pain in addition to the doctor’s plan.

Pain in the Breast or Mammary Gland, which is medically termed Mastalgia or mastodynia is a common problem faced by young women, though it affects women of all ages. Because of increased awareness about Breast Cancer, women with Mastalgia get panicked easily that pain in the Breast may be due to Breast Cancer, and seek medical advice. Less than 10% of women with Breast Cancer have pain. It is estimated that about 2/3rd of women experience some sort of pain in their Breasts at various stages of their lives, which range from mild to extreme pain. However, all Breast pain must be checked with a doctor to find out the exact cause of the pain. You may experience pain either in one or in both the Breasts. Mastalgia may come and go or it may persist for several weeks or months.

Signs and symptoms

In most cases, Carpal Tunnel symptoms develop gradually without any specific reason. Usually, the symptoms come and go but, if the condition gets severe, the symptoms may occur more frequently and persist for a longer duration.

The first symptom is numbness or tingling in your thumb, index and middle fingers that awakens you at night. You may also feel discomfort in the wrist and hand.

Pinching and needle-like sensation or pain in the hand
Your fingers may feel stiff when you wake up
You may also experience weakness in your hand and tend to drop objects very often. This is due to the numbness in your hand or weakness of the thumb’s pinching muscles that are controlled by the median nerve.
With moderate pain, you may not be able to brush your hair or hold a fork, pinch an object and open a jar using a screwdriver.

Not all pain in the hands is caused by Carpal Tunnel Syndrome. It may also be due to an injury to the muscles, ligaments and tendons, or nerve problems and inflammation in the thumb joint or wrist.

When to seek medical advice?

Consult the doctor immediately when you have the symptoms mentioned above and if the symptoms interfere with normal activities. Remember!! If you ignore the condition, you may end up with permanent nerve damage.

Causes

This condition is caused by the compression of the median nerve that runs from your forearm in your wrist (Carpal Tunnel) to your hand. Other carpel tunnel syndrome causes include:

Reduced blood flow to the hands
Obesity
Conditions such as Rheumatoid Arthritis, Gout, Diabetes, and Hypothyroidism
Repeated hand movements
Bone spurs; take up space in the Carpal Tunnel and put more pressure on the median nerve

Carpal Tunnel Syndrome is a work-related condition caused by:

Forceful hand movements
Hand-arm vibration
Working for long hours in the same position (on hand)

Risk factors

Risk factors include:

Gender - Women and older people are more likely to develop the condition.
Heredity
Repetitive hand use
Pregnancy
Health conditions; such as menopause, Obesity, and Thyroid gland imbalance
Alterations in the balance of body fluids
Inflammatory conditions such as Rheumatoid Arthritis

Diagnosis

Your doctor will talk to you about general health, and ask about the symptoms and medical history. Then he or she would perform a physical examination to test the feeling of the fingers and muscle strength in your hand.

The doctor would bend the wrist, and tap or press on the nerve to put pressure on the median nerve.

Other tests are also recommended such as:

Electromyogram - to determine if muscle damage has occurred
Nerve conduction study - to diagnose the condition and to determine other conditions
MRI Scans, X-rays, and CT Scan tests are also performed to determine if there are problems with the nerve itself and to determine the causes of your symptoms

Treatment

As mentioned above, the condition should be treated as early as possible once you start experiencing the symptoms to prevent complications. The Carpal Tunnel Syndrome treatment depends on how severe your pain and symptoms are, and if there is a weakness.

Non-surgical treatment

If you get diagnosed with the condition in the early stages, the symptoms can be relieved without surgery. These treatment options include:

Braces or splints

Also called Carpal Tunnel splints; wearing these at night keeps your wrist from refraining from bending during the night. You can also wear them during the day while doing the activities that aggravate the symptoms.

NSAIDs

Over-the-counter drugs such as ibuprofen and naproxen can help relieve pain and inflammation.

Activity changes

Check for the activities that aggravate the symptoms and prevent them from happening very often.

Nerve gliding exercises

These Carpel Tunnel Syndrome exercises make your nerve move freely and help to slow down or stop disease progression.

Steroid injection

These powerful agents are injected directly into the Carpal Tunnel to relieve pain and other symptoms.

Surgery

If the non-surgical options do not manage the symptoms, the doctors would suggest you go for the Carpal Tunnel surgery. Before that, discuss with your doctor regarding the risks and complications associated with the surgery. There are two different surgical techniques, but the goal is common; to manage the symptoms.

Open Carpal Tunnel Release – A large incision is made on the palm over the Carpal Tunnel and cuts the ligament to free the nerve.

Endoscopic Carpal Tunnel Release – The ligament is cut through one or small incisions in your hand. This technique results in less pain compared to the open technique.

It may take a few weeks to resolve the condition.

Self-management

Follow these tips to get temporary relief from the symptoms:

Take regular breaks from repetitive activities that involve hand usage.
Rotate your wrists and stretch your palms and fingers.
Take OTC drugs such as aspirin and ibuprofen if the pain is severe.
Avoid sleeping on your hands.

Carpal Tunnel Syndrome is a common condition causing pain, numbness, and tingling in the hand and arm that is caused by compression of the median nerve (the major nerve of the hand). It should be diagnosed and treated in the early stages as it may get worse over time. Evidence has proved that 3% of women and 2% of men will be diagnosed with Carpal Tunnel Syndrome at least once in their lifetime. The incidence is high in women older than 55 years of age.

Symptoms

The classic symptom of Chickenpox is an itchy rash. Other Chickenpox symptoms include:

Fever
Headache
Loss of appetite
Fatigue

The rash goes through three phases, raised bump, fluid-filled blister, and crusts or scabs. The rashes can appear anywhere on the body.

The symptoms appear after 10 to 21 days of exposure to the virus, and these symptoms are seen up to five to ten days.

Causes

There are different causes of Chickenpox; it is mainly caused by the varicella-zoster virus. The infection occurs through airborne transmission and when coming in contact with the infected person. It can spread through saliva (by coughing or sneezing) and contact with blisters.

Risk factors

The risk of Chickenpox infection increases if you haven’t had Chickenpox infection before. The risk also increases if you are not vaccinated. In rare cases, few people can get this infection more than once.

Complications

Often, Chickenpox is a mild disease. However, in a few cases, it can be severe and may lead to death. The complications that can be seen are Dehydration, Pneumonia, bacterial infections of the skin, bones, or bloodstream, Toxic Shock Syndrome, and Reye’s Syndrome. Reye’s Syndrome can occur if you take aspirin during Chickenpox.

If pregnant women get Chickenpox, birth defects may occur such as growth impairment, vision problems, and intellectual disabilities.

The infection may recur in some cases such as Shingles.

Diagnosis

Your doctor diagnoses Chickenpox by physical examination of the blisters. Blood tests or a culture of lesion samples are also performed to confirm the diagnosis.

Treatment

Mostly, your doctor may advise you to manage the symptoms in healthy children. Your doctor may prescribe an antihistamine to treat itching.

The doctor may give appropriate treatment to reduce the risk of complications. Chickenpox treatment for kids includes an anti-viral drug or immune globulin. These medications shorten the duration of infection and reduce the severity.

Self-management

Taking lukewarm baths and wearing protective, lightweight, and cotton clothing can soothe the symptoms. Instruct your child not to scratch, as infection gets into the skin. Keep your children out of school and daycare to prevent the spread of the infection.

Prevention

Vaccination is the best and safest way for Chickenpox prevention. In most cases, the infection is mild. However, it is better to get vaccinated to prevent the infection. The first shot of the Chickenpox vaccine is given at 12 and 15 months of age, and a booster dose is given between 4 and 6 years of age.

Avoiding contact with infected people can also prevent infection.

Chickenpox is the most common infection in children of age below 12 years. However, the infection can occur at any age. It is a contagious infection and is characterized by fluid-filled busters on the skin that are itchy, red, and small.

Signs and symptoms

The symptoms of Chikungunya show up between 3-10 days after being bitten by the infected mosquito. They are as follows:

Sudden high fever without any prior underlying infection and can go as high as 103-104.
The rash can appear within 48 hours mainly on the face and limbs.
Severe headache
Pain behind the eye increases with eye movement
Nausea
Vomiting
Low Blood Pressure
Difficulty in breathing

Causes

The female Aedes mosquito is responsible for causing Chikungunya.

Diagnosis

Only a blood test can definitively diagnose Chikungunya as symptoms are not always easy to tell apart from other conditions.

Treatment

Rest in the acute stage of the disease. The patients are prone to Dehydration and therefore, are advised to increase their fluid intake
Relief of pain and fever by acetaminophen (paracetamol) or ibuprofen, but not in the first three days
Home remedies that can be tried for treating Chikungunya
Consuming ginger tea and green tea can help relieve inflammation.
Applying an ice pack on the joint for a while will help reduce inflammation and pain.

Self-Management/Prevention

If you already have Chikungunya, avoiding getting bitten is still important because the mosquito will transmit the disease from you (infected person) to another non-infected person.
Use insect repellents with any of the following ingredients: Picaridin, DEET or oil of lemon eucalyptus, to avoid mosquito bites.
For example: Odomos, a popularly available mosquito repellent cream.
Don’t leave open water spaces in and around your house since the Aedes mosquito often breeds in dark, enclosed spaces. Within your personal space, consider covering overhead tanks or even bathtubs and flower pots where water may stagnate.

Chikungunya is a viral disease caused by the Chikungunya virus (CHIKV). It is transmitted from an infected person to a healthy person through the female Aedes mosquito which is also responsible for transmitting Dengue. While it is similar to Dengue in a lot of ways, the complications arising from it are less severe. The disease usually manifests with symptoms like fever and joint pain. The joint pain can be quite incapacitating and may be accompanied by muscle pain. Other prominent symptoms include skin rashes, headaches, and fatigue. While this is a relatively controllable disease, it can result in Liver Damage and internal bleeding.

Symptoms

The primary chronic fatigue syndrome symptom is severe tiredness which can last for as long as 6 months or even more in some patients. Additionally, you may have at least four of the below symptoms:

Headache
Sore throat
Joint pain (involving many joints)
Muscle pain
Sleep disorders
Feeling uneasy for at least 24 hours after physical activity
Memory problems
Tender lymph nodes

Based on the severity of your symptoms, CFS is classified as below:

Mild: You can take care of yourself but may need some rest frequently

Moderate: You will have difficulty in moving and may need an afternoon nap

Severe: You will have difficulty concentrating and a drastic decrease in mobility

Causes

The exact cause of chronic fatigue syndrome is not known. The possible causes could be hypotension (low Blood Pressure), viral or bacterial attacks, weak Immune System, stress, and hormonal imbalances. CFS can also occur in people with genetic predisposure.

Risk factors

Below are the risk factors for chronic fatigue syndrome:

Elderly: CFS can occur in people of any age group. However, it is more common in people aged 40’s and 50’s.

Gender: Women outnumber men by nearly four times in getting CFS as per the statistics provided by the CDC (Center for Disease Control and Prevention).

Other factors include genetic predisposition, stress, allergies and environmental factors.

Complications

Chronic fatigue syndrome if not addressed timely can lead to certain complications such as:

Depression
Regular absenteeism at work
Social withdrawal

Lifestyle restrictions

Diagnosis

As the symptoms of CFS are similar to the other conditions, it is advisable not to self-diagnose but to consult a doctor instead. Even for a physician, it is challenging to diagnose CFS as the symptoms are common with many other medical conditions.

There are no laboratory tests available for diagnosing CFS. If you have at least four of the above symptoms in addition to severe fatigue for more than 6 months, then you might be diagnosed with CFS. Further assessments include:

Review of medical history including those causing fatigue and other related symptoms
A thorough physical and mental state examination
A battery of laboratory tests to rule out other possible conditions for the symptoms

Treatment

A complete cure is not possible but chronic fatigue syndrome treatment involves management of the condition and its symptoms. Your doctor chooses the best treatment plan for you from the main treatments detailed below:

Medications

Antidepressants are given to cope with your illness. Low doses can also help in improving sleep.
Sleeping pills may be recommended when other home remedies are not effective.

Exercise

A structured exercise program called graded exercise therapy is suggested by your physiotherapist. It begins with stretches and range-of-motion exercises for a few days. Follow these specific exercises without fail.

Psychological counselling

A psychological counsellor can help you find ways to overcome the limitations of CFS.

Self-management

By taking certain steps, you can overcome the trouble with the symptoms of chronic fatigue syndrome:

Make the best during your peak energy hours: Do your routines when your energy levels are high. If possible maintain a diary and note down the timings of your high energy. If you notice a pattern in this, plan your work accordingly.

Do not overdo: Take charge as per your energy levels. However, do not work too hard as you may become overtired and it may become difficult for you to recover.

Improve your sleep: Follow a regular schedule of going to bed and getting up in the morning. This helps you to have a better sleep. It is advisable to avoid caffeine, alcohol, nicotine, etc. which can affect your night’s sleep.

Stretch every day: Regular gentle exercise is quite helpful. You may perform stretches instead of vigorous exercises.

Take care with medications: If you have joint or muscle pain, you may take non-prescription medicines such as acetaminophen, naproxen or ibuprofen.

Eat a balanced diet: Eat fruits, vegetables, cereals, legumes, grains, fish, low-fat dairy and lean meat such as skinless chicken, red meat, etc. regularly.

Reduce stress: Adopt the best techniques which are more suitable for you to overcome stress. Follow relaxation techniques such as breathing, listening to music, dancing, playing your favourite simple games, etc.

Do you always feel tired despite taking adequate rest? Is it troubling you over weeks to several months? Then do not neglect as you might be having chronic fatigue syndrome (CFS). Chronic fatigue syndrome is an extreme state of tiredness which does not go away even after satisfactory sleep or rest. It is a debilitating disorder which lasts for a long time and interferes with your daily activities.

Symptoms

Early Dehydration symptoms include:

Excess thirst and dry mouth
Dizziness and lightheadedness
Tiredness
Amber-coloured urine with a strong smell
Reduced tears while crying
Feeling drowsy or sleepy

As the severity of Dehydration increases, the following symptoms of Dehydration will appear:

Sunken soft spot on the head and sunken eyes
Low Blood Pressure and increased Heart rate
Rapid breathing
Decreased urine output
Withering of skin

If you have severe symptoms, you need immediate medical help as it can lead to shock.

Causes

The main cause of Dehydration is not taking adequate amounts of water to replace the lost fluids. The other causes include:

Excessive sweating: If you sweat excessively, you can get dehydrated as you lose more amount of fluids. This is more common during hot climatic conditions such as extreme summers.

Illnesses: Certain illnesses also can cause Dehydration due to continuous vomiting and Diarrhoea.

Fever: In an attempt to reduce your body temperature which is high during fever, excess fluids are lost. If the fluids lost are not replenished with adequate fluid intake, it can lead to Dehydration.

Excessive urination: Certain medical conditions cause chemical imbalances which increase urine output leading to Dehydration.

Risk factors

The risk of Dehydration is high in certain populations including:

Athletes, especially bodybuilders and swimmers who are regularly exposed to direct sun
Seniors, infants, and young children
People with chronic illnesses
People who stay at high altitudes
Workers exposed to extreme sun rays (e.g. welders, construction workers, landscapers, etc.)

Diagnosis

When you report the symptoms of Dehydration, your doctor checks the vital signs and if there is a low Blood Pressure, increased Heart rate, fever and fast breathing, an initial clue of Dehydration is obtained. Further to determine the underlying cause of Dehydration, blood and urine tests are performed.

Urine analysis shows high specific gravity and ketone bodies, the degree of which indicates the severity of Dehydration.

The amount of sodium and potassium in the blood and the indicators of Kidney function such as BUN and creatinine also indicate the degree of Dehydration.

Complications

If Dehydration is not treated, it can lead to life-threatening complications such as:

HeatStroke
Seizures (due to excess electrolyte loss)
Heat cramps
Heat exhaustion
Kidney Failure
Low blood volume
Coma

Treatment

The strategies for treating Dehydration are given below:

Rehydration: The first focus of Dehydration treatment is fluid replacement. In this method, fluids are replaced either through drinking (mild cases) or through IV injections (severe cases). The solutions are often a mix of water and electrolytes.

Medications: Based on the cause of Dehydration, you may be given medicines such as acetaminophen (to treat fever). It is advisable to avoid salt medications as they can lead to serious complications.

Self-management

Follow these steps to reduce the severity of Dehydration:

Keep sipping small amounts of water regularly. Do not drink soda, coffee or sweet drinks.
Take drinks containing carbohydrates and electrolytes. You may prepare rehydration fluids by adding half a teaspoon of salt, and six spoons of sugar to one-litre water.
If heat exposure is the reason, the person should be cooled down by removing excess clothing and providing air conditioning. However, exposure to excess colds such as ice packs should be avoided.

Dehydration occurs due to the excess loss of fluids from your body over the fluids you take. A reduction in the water content of your body causes an imbalance in the minerals affecting your overall body functioning. Based on the extent of the fluid loss, Dehydration can range from mild to severe. If severe Dehydration is not treated immediately, it can lead to shock.

Types of Dengue

Dengue fever can be classified into different severities such as:

Mild Dengue Fever: This stage hardly leads to fatal complications. At this stage, the symptoms will disappear after seven days. The symptoms of mild Dengue fever include high fever, body rashes, muscle and joint aches, intense headache, nausea, and vomiting.

Dengue Hemorrhagic Fever (DHF): The symptoms of DHF may be mild on the onset but worsen gradually. Mild Dengue symptoms along with some severe symptoms such as a bleeding nose, bleeding gums, blood spots under the skin, clammy skin, and sensitive skin are observed. DHF can result in damaged lymph and blood vessels, decreased platelet count, internal bleeding, and weak pulse rate. DHF can result in death if untreated.

Dengue Shock Syndrome: The progression of DHF symptoms can lead to massive bleeding, shock, and death which is referred to as Dengue sock syndrome. The symptoms include mild Dengue fever, DHF, and additionally sudden Hypotension, heavy bleeding, regular vomiting, intense Stomach pain, and disorientation.

Symptoms of Dengue fever

Febrile Phase

Sudden onset of fever
Rashes
Headache
Bleeding nose and mouth
Vomiting
Diarrhoea
Joint and muscle pains

Critical Phase

Hypotension
Pleural effusion
Ascites
Gastrointestinal bleeding

Recovery Phase

Itching
Seizures
Slow Heart rate

Diagnosis

Accurate diagnosis is essential to diagnose Dengue fever as most of the symptoms are similar to Malaria and typhoid. The laboratory tests that are performed for the diagnosis of Dengue fever include:

Complete Blood Count test (CBC): It is performed to measure the concentration of white blood cell count, red blood cell count and platelets in the body.

Reverse Transcriptase-polymerase Chain Reaction (RT-PCR) Test: It is performed to identify the Dengue virus.

Enzyme-linked Immunosorbent Assay (ELISA) Test: It is performed to identify the count of antibodies that are present in the blood.

Hemagglutination Inhibition Assay (HI Assay): It is performed to identify the serum antibodies.

Liver Function Tests: These are carried out to determine the elevations in serum albumin and transaminases.

Dengue Fever Treatment

There is no specific Dengue fever treatment. Depending on the severity of the condition, rehydrating fluids and salts are given to the patients. Tylenol (Paracetamol) can be used to treat pains and high fever. Non-steroidal Anti-inflammatory Agents such as aspirin and ibuprofen can cause severe internal bleeding if used in the treatment of Dengue. So, medicine for Dengue should be given only under the supervision of a doctor.

In case of severe Dengue forms, intravenous fluid supplementation, and blood transfusions are given.

Immunization

In early 2016, the first Dengue vaccine (Dengvaxia) by Sanofi Pasteur was registered.

Dengue Prevention

Protecting from mosquito bites can help in preventing Dengue fever. The best prevention methods include:

Preventing the multiplication of mosquitoes by removing stagnant waters
Proper disposal of solid wastes
Cleaning and emptying of domestic water storage every week
Usage of appropriate insecticides in water storage containers
Using window screens for household protection
Wearing long-sleeved clothes
Use of mosquito traps, insecticide-treated materials, coils and vaporizer
Applying insecticides as sprays during outbreaks to control vectors
Monitoring and surveillance of vectors to determine the effectiveness of control interventions

Dengue fever is also called “breakbone fever” or “dandy fever”. It is a mosquito-borne viral infection. transmitted by “Aedes Mosquito” which is infected by the Dengue virus. It is found in tropical and subtropical areas. Dengue is the most prevalent disease condition in India with an increasing number of cases year by year. Studies say that almost greater than 300 times of cases have been reported from the year 2012 to 2015. The Dengue virus is not contagious and cannot be spread from one person to another person. It can be contracted from the bite of a mosquito that has previously bitten an infected person. The incubation period for the Dengue virus usually ranges from 3 to 15 days before the symptoms appear in the infected person.

Causes

Diarrhoea is called Stomach flu or Intestinal Flu. It is a viral infection that infects your gut. It also occurs if you:

Take laxatives regularly (laxative abuse)
Consume more amounts of alcohol (alcohol abuse)
Drink contaminated water or eat contaminated food
Get infected by certain viruses (rotavirus, norovirus, and flu)
Have diseases that affect the small intestine, or colon, such as Crohn’s disease, irritable Bowel syndrome

Some people also get Diarrhoea post-stomach surgery. After the surgery, there are chances that the food moves through the digestive tract more quickly than normal.

Symptoms of Diarrhoea

You may have symptoms such as:

Fever
Loose stools
Watery stools
Abdominal cramps
Nausea and vomiting
Bloating in the Stomach
The feeling of urge to defecate

More serious Diarrhoea symptoms include:

Bloody stools
Mucus in stools
Unusual weight loss

Continuous watery stools that occur more than thrice a day are dangerous and you may get dehydrated. To avoid this, you must drink enough fluids.

When should I call a doctor?

You must call your doctor immediately if you have:

Dry and scaly skin
Dark-coloured urine
Dark blackish stools
Fever that is 101˚F or above
Noticed blood in your stools
Severe pain in the abdomen
Severe nausea and vomiting
Fast Heart rate (tachycardia)
Diarrhoea lasting for more than two days

Diagnosis

To find out the underlying cause of Diarrhoea your doctor may take a medication history, and perform a thorough physical examination. Stool or blood may be tested to know about the type of bacteria, parasites or viruses. If you have Chronic Diarrhoea, your doctor would ask you to go for other tests to look for the signs of the disease. You should avoid certain foods that may trigger your Diarrhoea.

Treatment of Diarrhoea

In Diarrhoea, you will feel exhausted due to the loss of body fluids. So, to rehydrate, your doctor would replace the lost fluids and electrolytes to prevent Dehydration. Your doctor would choose an appropriate treatment option based on the underlying cause.

If you are suffering from Diarrhoea, then you must drink plenty of water, and fruit juices and eat a soft and bland diet. You must avoid taking foods that contain caffeine and salty broths. In the case of Diarrhoea in children, you must give oral rehydration solutions to replace the lost fluids and electrolytes.

Prevention

Yes, prevention is always better than cure. Only two types of Diarrhoea can be prevented - rotavirus Diarrhoea and traveler’s Diarrhoea. There are immunization schedules for rotavirus Diarrhoea; these vaccines are given in two to three doses for infants.

When travelling to developing countries, you can prevent the risk of a Traveler’s Diarrhoea by:

You must drink only boiled or purified water
You must make sure that the food is cooked properly
You must avoid eating unwashed or unpeeled raw fruits and vegetables

Diarrhoea is the most commonly heard condition that may affect people of all ages. Diarrhoea is loose, watery stools which occur more than three times a day. Acute Diarrhoea lasts only for one or two days. Chronic Diarrhoea that lasts for more than four weeks is considered a sign of a more complicated problem.

Dizziness has no particular medical meaning. Four different conditions are referred to as the types of dizziness:

Vertigo: you may feel that you are in motion when there is no motion. It would be like the environment around you is spinning round and round.
Lightheadedness: this is also called Syncope. If you feel like fainting, then it is said to be lightheadedness. This happens when you stand up quickly or when you take deep breaths.
Disequilibrium: you may feel unsteady on your feet while walking and you may also feel like falling if you have disequilibrium.
Anxiety: some people may use the word “dizzy” if they are panicky, depressed, or anxious.

Causes

Many causes make you feel dizzy, which include:

Infection: In case you have any infections such as ear infections, or common cold or Diarrhoea. These conditions can cause temporary Vertigo.
Meniere’s Disease: this is characterized by episodes of long-lasting severe Vertigo. Other symptoms of this condition may include ringing in the ears (Tinnitus), hearing loss, or fullness in the ears.
Dandy’s Syndrome: in this condition, you may feel that everything is jumping up and down. This happens when you take any antibiotic that is toxic to your ear. However, it may get set over time.
Tumours or Stroke: these conditions can also trigger the state of dizziness, but rarely.
Parkinson’s Disease: this disorder can also make you stoop forward due to dizziness.
Low blood sugar levels: if you are diabetic, you may feel dizzy due to the low sugar levels in the blood.
Dehydration: you may feel dizzy if you have heat exhaustion due to fever, Diarrhoea, etc.,
Migraine: you may feel dizzy before and after you have an episode of a headache.

Symptoms of Vertigo

Often dizziness symptoms are accompanied by:

Headache
Confusion
Disorientation
Feeling off balance
Chest tightness
Nausea or vomiting
Weakness or tiredness

Diagnosis

Your doctor would evaluate and treat the underlying serious cause of dizziness. Your doctor may ask you about the history of dizziness and the type of dizziness that you are experiencing. Depending on your health history, your doctor would order some diagnostic tests.

The tests may include:

CT Scan
Blood tests
Eye examination
Dox-Hallpike Test
Cardiac Stress Test
Electrocardiogram (ECG)
Bleeding and clotting time

Treatment

The medical treatment for dizziness is purely based on the underlying cause or disease.

Dizziness may be a symptom of something dangerous and must always be discussed with the doctor. It can also be drug-induced, so if you discuss it with your doctor, he or she may change the medication that you are using for any other underlying condition.

Here are some of the home remedies that work well for you if you are dizzy:

Avoid stress and anxiety; this can help you keep dizziness at its Bay
You must take plenty of fluids and food and an ample amount of rest.
You must not stand up suddenly, and must not change the positions suddenly.
You must make sure that there are no rugs or carpeting that may make you fall if you are dizzy

Medical treatment

Treatment varies depending on the cause. Some of the common treatments for conditions that cause dizziness include:

If a Heart Attack or Stroke is the cause of your dizziness, then an emergency blood transfusion or surgery would be beneficial
If Dehydration is the cause of your dizziness, then intravenous fluid administration can be useful.
If the underlying cause for dizziness is shortness of breath, then the oxygen supply would correct the dizziness.

Medications such as benzodiazepines are used to control fainting or spinning around feelings.

Dizziness is the most common complaint that every one of us has experienced. What does dizziness mean? This term is used to describe different things. For example, some of us say “It’s so dizzy today,” this refers to either being light-headed, or lack of balance while walking, unsteadiness or feeling of fainting. We also use the word “dizzy” when we are emotional or feeling confused.

Causes

The exact cause of (ET) and (MPNs) is unknown. These conditions are not genetically inherited ones. However, there is a chance of familial predisposition to the disease in a few patients.

It is believed that mutation in the genes modifies the activity of the proteins that control the pathways in patients with ET because signalling pathways play a vital role in cell regulation, growth, and development.

Risk factors

The most common risk factors associated with ET are:

The foremost prominent symptom would be extreme fatigue; other Ebola Virus symptoms would include:

Gender
Women are at a higher risk for developing ET
JAK2 mutation
Mutation to these genes makes the body produce an abnormal or increased number of cells
Age
If you are older than 50 years, then the risk of developing ET is high, but there is still evidence that people below 40 years have also suffered from the condition.

Symptoms

In the early stages, ET is asymptomatic. If the symptoms are present they may commonly include the symptoms related to small vessel damage such as:

Headache
Blurred vision
Bluish colouration of fingers and toes
Burning sensation, and pain in the hands and feet
Nosebleed or heavy menstruation
Gastrointestinal bleeding
Blood in urine

Complications

There may be chances of thrombotic complications that result in Stroke, Transient Ischemia Attack, Heart Attack, Deep Vein Thrombosis (DVT), and blood clotting in the abdominal veins.

Diagnosis

Your doctor might order the following tests to detect ET in you:

Blood test: A routine blood test may show a high count of platelets. This is also performed to exclude other causes such as Iron Deficiency Anaemia and inflammation in the body.

Bone Marrow Biopsy: To look for the classical signs of ET or to rule out the early phase of Myeloproliferative Neoplasm a Bone Marrow Biopsy is performed.

Gene mutation studies: Your doctor would recommend a gene mutation test that studies JAK2 mutations, CALR or MPL mutations.

Treatment

If you are asymptomatic, you may not require any medication for ET. Others may require several treatments and therapies, to get symptomatic relief.

Available treatment options include:

Low-Dose Aspirin: Your doctor might prescribe you a low dose of aspirin to reduce the risk of blood clots and to relieve you from the burning sensation in the hands and feet that are caused due to ET.

Hydroxyurea: If you are in the category of patients who require treatment with drugs, your doctor will prescribe you hydroxyurea as a first-line agent. It reduces the risk of blood clotting.

Anagrelide: If you are the one who is intolerant to hydroxyurea, then your doctor would prescribe a platelet-lowering drug called Anagrelide.

Interferon: If you are a pregnant woman with ET, then your doctor would prescribe interferon for treating ET.

Lifestyle modifications

Apart from taking regular medications, you must also try to inculcate certain healthy habits into your daily routine, such as the following tips:

You must eat healthy foods that should include whole grains, fresh fruits, and vegetables. Your diet should be low in saturated fats. You must avoid trans fats.
You must increase your physical activity. Try to take a brisk walk ride your bike or swim.
You must keep your weight in control because being obese increases the pressure on the pelvic veins and legs, which can be the risk factor for High Blood Pressure.
You must quit smoking and avoid alcohol consumption

Platelets are also called Thrombocytes. These are some of the vital components of the blood which function to stop bleeding and help in clotting blood vessels in case of any injury. The normal range of platelets in our body is— 150, 000 to 450, 000 per micro liter. If the count is less than 150, 000 per micro liter, then it is termed as ‘Thrombocytopenia’. But in Essential Thrombocythemia (ET) the number of platelets is increased. Essential Thrombocythemia is a Chronic Myeloproliferative Neoplasm (MPN). It is commonly seen in women over 50 years of age.

Signs and symptoms

The Mediterranean Fever symptoms usually occur during childhood and they occur as attacks or bouts that last for one to three days. Signs and symptoms include:

Fever
Pain in the abdomen, joints, chest, and muscles
A red rash on the lower limbs, especially around the knee or ankle
Painful scrotum
Deposits of an abnormal protein (amyloidosis) can also occur in organs such as Kidneys, Liver, Thyroid Gland, Heart.

Causes

FMF is a familial genetic disease, caused by an abnormality in the MEFV (Mediterranean Fever) gene. Parents having this abnormal gene can inherit it from their progeny, and hence the offspring is born with the illness. For a child to acquire FMF, he/she should inherit two abnormal copies of the gene - one from each parent.

The abnormal MEFV gene reduces the activity of pyrin – a protein responsible for controlling inflammation in the body. Derangement of pyrin causes uncontrolled inflammation, leading to fever and pain in the affected areas.

Risk factors

Having any one of the following may increase your risk of developing FMF.

Descendent of the Mediterranean region
Family history of the disease

Complications

In the long run, patients with FMF can develop Arthritis, Renal Failure, and infertility in women, as abnormal clusters of protein accumulate in various body tissues.

Diagnosis

FMF is diagnosed by genetic testing/ DNA test. But, the need for diagnosis is felt only if the person has periodic episodes of fever associated with severe abdominal pain, and/or chest pain, and/or joint pain lasting for more than 2 days.

However, few laboratory findings such as an increase in the number of white blood cells, high Erythrocyte Sedimentation Rate (ESR), and elevated serum levels of fibrinogen are characteristics of FMF.

Treatment

FMF is incurable. But few Mediterranean Fever treatment options can prevent signs and symptoms.

Prophylaxis (prevention) of FMF is done by taking colchicine. Regular consumption reduces the recurrence of fever and other symptoms.

However, an already-started episode of FMF can be managed by taking pain relievers such as paracetamol or dipyrone to control pain and discomfort.

Evaluation of close-ones

Irrespective of the symptoms, all the first-degree relatives of the patient should take a genetic test, to detect the presence of p.Met694Val Allele. The presence of a mutant form of this gene may result in amyloidosis. For such individuals, colchicine can be given as it prevents Renal Amyloidosis.

Familial Mediterranean Fever (FMF) is a hereditary inflammatory disorder characterized by recurrent episodes of fever and inflammation of the Lungs, abdomen, and joints. Occasionally, other organs like the Heart, the membrane enveloping the Brain and Spinal Cord, and the testicles of the males are affected. As the name indicates, this disorder is commonly seen in people of Mediterranean origin (Sephardic Jews, Turks, Arabs, and Armenians) and less common in the population of other ethnic groups. The initial attack of FMF is seen in early childhood or during teenage, and infrequently seen in later stages of life.

Benefits of Folic Acid

Folic acid has several benefits. A few of them are mentioned below:

Preventing and treating low blood levels
Used for memory loss
Use to prevent Heart Disease
Prevent miscarriage and birth defects
Prevent hearing loss
Prevents depression
Treats Anaemia
Used for Kidney Diseases
Used in the treatment of iron deficiency

Folic acid side-effects

Folic acid also has a few side-effects which are mentioned below. High folic acid dosage causes:

Abdominal cramps
Diarrhoea
Rash
Sleep disorders
Irritability
Confusion
Nausea
Upset Stomach
Behavioural changes
Seizures

Signs and symptoms

Due to Anaemia, you may have weakness and fatigue. Other folic acid deficiency symptoms are:

Loss of appetite
Weight loss
Grey hair
Depression
Diarrhoea
Poor growth
Headache
Irritability

Causes and risk factors

The primary cause of folic acid deficiency Anaemia is malnutrition. Malnutrition occurs due to having a diet low in vitamins and having overcooked foods. The inability to absorb folic acid in the body by the Intestine (malabsorption) can also lead to folic acid deficiency Anaemia. In women, pregnancy also causes folate deficiency Anaemia.

Excessive alcohol intake and a history of Sickle Cell Disease also increase the risk of Folate Deficiency Anaemia. Alcohol interferes with the folate absorption in the body.

Complications

If you have folate deficiency Anaemia during pregnancy, your baby may develop Congenital Birth Defects such as Spina Bifida. Spina Bifida is a condition in which the backbone and membranes around the spinal cord are closed.

Diagnosis

Other conditions of blood also have similar symptoms. So, your doctors recommend for few diagnostic tests to rule out other conditions and confirm the diagnosis. The diagnosis of folate deficiency Anaemia includes:

Complete Blood Count to determine Red Blood Cell count
Red Blood Cell folate level test to determine folic acid levels

Your doctor may also question your eating habits to determine whether malnutrition is a cause of Anaemia. If you are of childbearing age, your doctor orders a pregnancy test to determine whether the pregnancy is the cause.

Treatment

The goal of the treatment is to treat the underlying cause and increase folic acid levels.

Your doctor prescribes folic acid tablets to be taken every day till the folic acid levels reach the normal range. If the levels are too low, your doctor prefers administration of folic acid intravenously. If your intestine is failing to absorb folic acid, you may need folic acid supplements for a lifetime.

If the cause is malnutrition, your doctor advises you to make dietary changes to increase the intake of folic acid. Consuming green leafy vegetables, citrus fruits, yeast, Liver, beetroot, and sprouts may help you to recover from folate deficiency. Consume fresh foods and avoid processed or overcooked foods. Your doctor may refer you to a dietitian to make a proper diet plan.

You will recover from this condition after the treatment with no chronic side effects.

Self-management

Taking folic acid supplements if your folic acid levels are low can reduce the risk of developing Anaemia. During pregnancy, take folic acid supplements as per your doctor’s advice.

Consume dark green leafy vegetables as these foods are rich in folic acid.

Folic acid is vitamin B9, and you require this vitamin daily as your body can’t store it. Its deficiency (decreased blood levels of folate) causes Folate Deficiency anaemia. Folate is necessary for the formation of red blood cells and due to its deficiency, red blood cell count decreases causing Anaemia.

Types of Gangrene

Dry Gangrene: Dry Gangrene is caused when your body part does not get sufficient oxygen, this makes the part deteriorate and finally die. Dry Gangrene does not have a chance of infection.

Wet Gangrene: When bacteria invade the organ, wet Gangrene occurs; there can be moisture due to the presence of bacteria which makes the tissue die. Wet Gangrene is considered more serious than dry Gangrene because of the chances of spreading the infection to other parts of the body.

Shortness of breath, feeling of vomiting, and a sudden episode of heavy cold sweating are the other coronary artery disease symptoms.

Gas Gangrene: Clostridium perfringenis bacterium is the main cause of gas Gangrene. The bacteria cause gas bubbles and toxins inside the affected area and the toxic gasses cause tissue death. This is a fatal type of Gangrene.

Causes and Risk Factors

The following conditions are the risk factors that can cause Gangrene

Habits such as smoking
Infection to the wounds
Conditions such as Obesity
Certain drugs such as warfarin
Diseases such as Raynaud’s Syndrome, and Diabetes
Injuries such as crash injury, frostbite or severe burns
Certain diseases that affect blood circulation (Arteriosclerosis)

Symptoms

The signs and symptoms of Gangrene may include:

Discoloration of skin
Foul-smelling discharge from the sores
Partition between healthy and damaged skin

If the Gangrene affects your internal organs, then you are likely to experience the following symptoms:

High body temperature
Swelling and pain near the site

If there is any bacterial infection near the gangrenous tissue, you may experience shock; the signs and symptoms of shock include:

Low Blood Pressure
Confusion
Lightheadedness
Increased Heart rate
Difficulty in breathing

Notify your doctor immediately when you experience symptoms such as persistent fever, skin discolouration, numbness or hard feeling near the skin, or sudden, sharp pain at the surgery or trauma site.

Complications

Gangrene is a medical emergency if the Gangrene is infected with bacteria. The bacterial infection spreads to other organs and can cause serious complications if left untreated.

Gangrene may lead to scarring and may require the need for reconstructive surgery. At times when tissue death (necrosis) occurs, the body part such as the foot may need amputation.

Diagnosis

Your doctor may order a routine blood test to evaluate your White Blood Cells (WBC), if the WBC is found elevated, it indicates the presence of infection.

Your doctor would order imaging tests such as X-ray, (CT) Computerized Tomography Scans or (MRI) Magnetic Resonance Imaging Scan to view the interior body structures and to analyze the severity of Gangrene.

Your doctor may order for an Angiogram to view your arteries, this test helps to evaluate the presence of any blockage in your arteries.

Your doctor may order for tissue culture, this involves the extraction of fluid from the blister present on your skin and is then examined for the presence of Clostridium perfringens.

Treatment

The treatment for Gangrene depends upon the type and severity of Gangrene. Your doctor would choose the best treatment strategy for you; the main goal of the treatment is to prevent further complications such as amputation. The following treatment options are considered:

An intravenous antibiotic - if there is any evidence of bacterial infection

Vascular Surgery is if you have improper blood flow due to the blocks in the arteries. This surgery helps in improving the blood flow through the veins to the tissues.

Hyperbaric oxygen chamber - this is considered if the type of Gangrene is Gas Gangrene. It helps in halting or slowing down bacterial growth due to the presence of an oxygen-rich environment. This fastens the tissue healing and also provides oxygen supply to the damaged tissue and promotes healing.

Tissue debridement - to remove the dead tissue. It is performed with surgical tools and chemicals. The benefit of this treatment option is that it removes the infected tissue and prevents further spread.

Skin graft - to replace your damaged tissue in the case of severe Gangrene. In many cases, amputation of the affected limbs such as the toe, and the finger is necessary. In essential cases, the parts may be fitted with a prosthesis, or with artificial limbs to replace the removed body part.

Any body part which is devoid of blood supply may die and eventually result in Gangrene. Gangrene affects the organs that are distant from the Heart, which includes toes and fingers. It can affect many other body parts as well, including the vital internal organs. It is considered to be a medical emergency because it may lead to amputations and death. If Gangrene is left untreated it can cause shock. It can be life-threatening and requires immediate medical attention. Early recognition and treatment help to reduce complications.

Symptoms

The symptoms of Swine Flu develop 3 days to 5 days after the person has been exposed to the H1N1 Virus. The affected person has the following H1N1 symptoms:

Sore throat
Cough along with high fever and chills
Body ache
Headache
Vomiting
Diarrhoea
Fatigue

One must consult the doctor immediately if one experiences these signs:

Shortness of breath
Feeling of confusion

In children, the parents must look out for warning symptoms like,

Fever associated with rash
Extreme irritability
Symptoms of flu that keep appearing and disappearing
Inability to drink fluids
Difficulty in waking up from sleep

In case of Swine Flu during pregnancy or any underlying health condition like Heart Disease or Eemphysema, one needs to consult the doctor.

Difference between H1N1 Flu and Seasonal Flu

Seasonal flu is also caused by viruses like Swine Flu but it appears during December, January and February, unlike Swine Flu which appears in spring.

Seasonal flu infects people who are 65 years of age and above as HINI flu occurs in people who are below 25 years of age.

Diagnosis

For diagnosing Swine Flu, a respiratory mucus sample is collected from the patient within 4 to 5 days of illness. This is the time when the patient sheds the virus.

In children, however, the shedding of the virus continues for more than 10 days. This sample is sent to the laboratory for testing.

Treatment

Treatment is not necessary for most of the H1N1 cases as they decrease on their own, but in case the patient has a chronic respiratory disease, medications are prescribed to clear Lung secretions, open the airways and decrease swelling.

In case of fever and body aches, medications like acetaminophen (Tylenol), Ibuprofen(Advil, Motrin) and Naproxen(Aleve) are taken. Anti-viral drugs like zanamivir (Relenza) and Oseltamir (Tamiflu) are prescribed only for people who have a high risk for complications to develop.

The high-risk group includes:

Women who are pregnant
Children younger than 5 years of age
People 65 years and above age group
Severe shortness of breath
People who are hospitalized
People with underlying medical conditions like asthma, Heart Disease, Diabetes, Kidney Disease, Liver problems, Blood Disease, Emphysema and Neuromuscular Disease, HIV infection
Patients younger than 19 years of age who are taking long-term aspirin therapy

Vaccination

The H1N1 vaccination not only protects against Swine Flu but also against two strains of seasonal flu. The Centre for Disease Control And Prevention recommends the vaccination for high-risk groups that include,

Pregnant women
People who live and take care of children who are below 6 months
People between the age groups of 6 months to 24 years of age
People with chronic health problems and immune diseases
People who work in hospitals and emergency services.

However, the H1N1 Swine Flu vaccine can be taken by anyone above 6 months of age for protection against the H1N1 Virus. Some people have however experienced allergic reactions after taking the vaccination.

Preventive measures

To prevent getting infected with the H1N1 Virus, one must always wash hands with an antiseptic soap or a hand sanitiser before eating meals.

The flu virus is said to survive on door knobs and countertops for nearly 2 hours. Washing of the hands is essential.

If a person has Swine Flu he or she should stay at home as the flu spreads to others easily.

While coughing or sneezing, the affected person should use a tissue to prevent contaminating surfaces with the infected droplets from the nose and mouth.

The affected person’s glasses and utensils have to be kept separately.

H1NI Influenza or Swine Flu first occurred in the spring of 2009 in the United States. It is caused by the H1N1 Virus which spreads quickly. It is also known as Swine Flu as it is known to be transmitted from pigs to humans. The virus infects the cells in the lining of the throat, nose and Lungs by inhaling contaminated droplets in the air or by coming into contact with a surface contaminated by the virus. The H1N1 Virus has spread to all parts of the world since its first appearance affecting millions of people worldwide due to which the World Health Organization (WHO) has declared Swine Flu a global pandemic.

Regulation of body temperature

In human beings, it is vital to maintain body temperature within the range of 36.50C to 37.50C for normal functioning of the cells, and enzymes in the body even in unfavourable environmental conditions. The Autonomic Nervous System, the network of nerves that control certain bodily functions automatically independent of the Brain, regulates the body temperature.

The Hypothalamus, a part of the Brain, receives messages from the thermal receptors sensitive to the changes in the environmental heat via the Central Nervous System (Brain and Spinal Cord) and subsequently Hypothalamus responds to these changes by sending proper signals to the peripheral nerves (nerves outside Brain and spinal cord) for suitable action to be taken such as to conserve heat or to dissipate heat so that the body temperature is maintained within the “set-point” (36.50C to 37.50C).

Heat index

When it is hot outside and the presence of water vapour is also high (relative humidity) in the atmosphere, your body cannot sweat and cannot dissipate the heat which may lead to Heat Stroke.

The air temperature when taken along with the relative humidity is called the heat index which in simple terms indicates how hot it feels in the shade. A heat index of 900F or above is considered as dangerous.

Medicines that Affect Heat Stroke

Some of the medications affect the way your body responds to heat and may cause Heat Stroke.

Antihistamines increase the susceptibility to Heat Stroke as they cause constriction of blood vessels, reduce sweating and may restrict the dissipation of heat
The anti-stress hormone medicines (beta blockers) block the production of stress hormones leading to the constriction of blood vessels and thus may interfere with the regulation of heat in the body.
Illegal drugs and diet pills can dehydrate the body and/or increase metabolism and heat production increasing the risk of Heat Stroke.
Laxatives may cause excessive Bowel movement resulting in Dehydration and increased Heat Stroke risk.
Medications for mental illnesses interfere with the regulation of the temperature and may restrict sweating leading to a rise in body temperature leading to Heat Stroke.
Water pills cause the body to lose water and as such may cause Heat Stroke.

Your doctor shall be able to guide you accurately as to which medications you should avoid so that there is no increased risk of suffering from Heat Stroke.

Signs and symptoms

You should suspect heat exhaustion if you have normal or above normal body temperature but not more than 1040F with a headache, and a feeling of exhaustion, tiredness and weakness the skin may feel moist, sweaty and dank.

You may feel irritated and have an uneasy and unpleasant feeling in the Stomach. Your urine output may be reduced.

You may feel giddy due to decreased Blood Pressure while standing. Heat exhaustion may cause abnormal sweating, enlarged pupils, abnormal breathing patterns, and irregular Heartbeat.

The Heat Stroke symptom may be different in a Heat Stroke. The symptoms include:

Body temperature may rise above 1060F in a very short time
Dry and hot skin
Narrowed pupils
Deep and shallow breathing
Rapid and strong/weak Heartbeat
Initially High Blood Pressure subsequently lower than normal
The sensation of the head swirling and the uneasy sensation of vomit
Disorientation
Painful muscle contractions

Things to do in a Heat Stroke situation

Following are the things to be done when faced with a situation of Heat Stroke.

Call for medical emergency personnel
Keep the person who had Heat Stroke in a cool place away from sunlight or from the source of heat such as in an air-conditioned room or shade.
Remove unnecessary clothing from the body of the person with Heat Stroke and increase ventilation. Wet the skin of the person with cool water.
If possible, arrange for ice packs and keep them in the areas where blood vessels are closer to the skin such as armpits, groin, neck and back.
Monitor the temperature

Get medical help immediately if you observe any of the following emergency signs:

Hot and dry but not sweaty skin
Unconscious
Severe vomiting
Breathing problems such as difficulty in breathing or shortness of breath

If you are treated for heat exhaustion or Heat Stroke you will probably recover in a few hours to a few days respectively. You may become more sensitive to heat after heat exhaustion or Heat Stroke. Try to avoid further exposure to heat and follow the advice of your doctor till return to your normal activities.

Preventing heat-related illnesses

If the heat index is high, then it is advisable to stay indoors to prevent yourself from Heat Stroke. Engage in outdoor activities during the cooler part of the day. If you need to go outside, then avoid heavy, tight-fitting and dark-coloured clothes. Do not expose yourself to direct sunlight. Maybe you can wear a hat or umbrella. If possible, use a suitable sunscreen.

Ensure to take plenty of water as often as possible to avoid any loss of fluids. Try to avoid drinks that contain caffeine or other stimulants such as alcohol. While you carry out the outdoor activities, ensure to take water more often, say for every 15 minutes. Ensure to keep yourself properly hydrated all the time.

In case you have any other medical conditions and take medicines, discuss with your doctor how you can cope with the high heat index and what steps you need to take.

Cool it off!

Heat exhaustion and Heat Stroke are the two heat illnesses. Both need immediate medical attention. Though both are similar their symptoms differ. Heat exhaustion is the body’s inability to retain body fluids and salts. Heat Stroke, a bit different from heat exhaustion, is the body’s inability to maintain the temperature regulatory mechanism.

If proper precautions are taken heat illnesses can be prevented. When this occurs, immediate attention is required and both can be treated effectively. Recovery may take from hours to days depending on the severity of the heat illness.

Heat Exhaustion and Heat Stroke are both heat-related illnesses which can be caused by excessive heat and humidity. Though they are similar, the symptoms they show differ. As the outside temperature rises, your body tries to keep cool by sweating, resulting in loss of water and salts. If this loss is not replenished, then it may result in high temperature, and eventually, you become sick. When you are exposed to excessive heat lose water and electrolytes and become weak with frequent uneasy feelings in the throat and Stomach and vomiting, then you are said to suffer from heat exhaustion. When the outside temperature is higher than your body’s temperature, your body responds with sweating as evaporation causes cooling. Along with water, electrolytes are also lost resulting in Dehydration and salt depletion. The core body’s temperature may or may not be elevated. Heat exhaustion may be caused due to the failure of the body’s cooling mechanism; depletion of body salts, replacement of only water but not salts and exposure to heat for a long time. The other causes could be alcohol consumption which can affect the body’s ability to regulate temperature, and over-dressing which may not allow proper sweating. Another condition called Heat Stroke, occurs when the body’s mechanism to control temperature fails. The body’s temperature rises dangerously above 104F or 400C and is manifested by dry and hot skin and abnormalities of the central nervous system such as convulsions, confusion and coma. The cause of Heat Stroke may be exposure to heat for too long a period and overexercising or indulging in exercise not suitable for the age and condition.

What is Cholesterol?

Cholesterol, a kind of lipid (fat), is a waxy fat substance found in all the cells of your body. Cholesterol is required by the body for proper growth and development, and to produce hormones. 25% of the cholesterol in your body comes from your diet and the remaining 75% is made by the Liver and other cells. Cholesterol enters your body when you eat foods rich in saturated fats such as eggs, milk and milk products, red meat and tropical oils such as coconut oil.

Types of cholesterol

Cholesterol is of two types. Cholesterol is carried in your blood in bundles of lipoproteins. As lipids are insoluble in blood, they are transported to the destination by lipoproteins which are complexes of proteins and lipids.

The good cholesterol is called high-density lipoprotein (HDL) and the bad cholesterol is termed low-density lipoprotein (LDL). HDL removes cholesterol from the blood and carries it to the Liver, and LDL carries cholesterol to various cells in your body. Too much LDL is bad for your body, whereas a high level of HDL is good for your body because it decreases the cholesterol level in the blood.

High cholesterol is unhealthy

A healthy body requires a healthy level of cholesterol, for many functions in the body. The body uses cholesterol for proper growth and development of nerves, tissues and secretion of hormones. However, too much cholesterol in the blood can lead to the deposition of fats in the form of plaques in the blood vessels that carry oxygen to various parts of the body (arteries) causing them to become narrow (atherosclerosis). These plaques can become large and block the flow of blood in the arteries.

When these plaques split up, they can cause blood clots which again obstruct the blood flow. If the arteries supplying the blood to the Heart are jammed, it may result in a Heart Attack. If the arteries that supply blood to the Brain are involved, then it may lead to a Stroke.

Causes of high cholesterol

High cholesterol is a major risk to Cardiovascular Diseases which causes a lot of health problems. Below mentioned are a few causes of high cholesterol. They are:

High intake of saturated fat (deep-fried foods, dairy products, chocolate, meat)
High intake of trans fat (some fried or processed foods)
High cholesterol (meat, cheese, egg yolks)
Overweight

The reason for abnormal levels of cholesterol can also be because of

Diabetes
Polycystic Ovarian Syndrome
Liver or Kidney Disease
Women during pregnancy develop high cholesterol levels
Underactive Thyroid gland
Drugs like progestins or steroids also increase cholesterol levels

Symptoms

People suffering from high cholesterol do not show any symptoms unless routine screening is performed. Routine screening includes regular blood tests. High cholesterol levels are not observed but eventually cause a threat of Stroke to the individual.

Checking cholesterol levels

You can undergo a blood test known as a lipid profile to check the levels of cholesterol in your blood. If you are a man and above the age of 35 yrs or if you are a woman above the age of 45yrs and having risk factors for other Heart Diseases, then you must check your cholesterol levels every 5 years. Otherwise, if you have any of the risk factors for Heart Disease, then you need to check your cholesterol level more frequently.

Elevated levels of cholesterol in the blood increase the risk of getting Heart Disease and or having Heart Attacks. Since there are no symptoms associated with high blood cholesterol or hypercholesterolemia, most people are not aware of this condition.

Total cholesterol level is the combination of various types of cholesterol and is measured in milligrams per deciliter (mg/dl) of blood. Total cholesterol of less than 200 mg/dl is considered normal, between 200 to 239 mg/dl is considered a borderline risk of cholesterol and 240 mg/dl and above is treated as a high cholesterol level and has double the risk of coronary Heart Disease than someone with less than 200 mg/dl.

An elevated level of LDL increases the risk of Heart Disease. LDL levels

< 100 mg/dl is considered as most favourable
100 to 129 mg/dl is favourable
130 to 159 mg/dl is bad
> 159 mg/dl means a very high risk of developing Heart Disease.

While a high level of HDL is considered safe and desirable,

A low level of HDL offers no protection against build-up of plaques and clogging of arteries.
> 60 mg/dl is most favourable,
40 to 60 mg/dl is favourable
< 40 mg/dl is undesirable and has a higher risk of Heart Disease.

Improving your cholesterol level

Eat foods which are low in saturated fats so that you can reduce your LDL cholesterol. You can raise your HDL cholesterol by not smoking, and losing weight through exercises if you are obese or overweight. Besides resorting to healthy food habits, you have to make changes in your lifestyle by engaging yourself in regular exercise. If these do not work within six months to one year, you may have to consult your doctor for required cholesterol-reducing medications.

If your cholesterol levels are not controlled despite lifestyle changes from six months to one year, your doctor may prescribe some of the following medications.

Statins: These drugs slow down the production of cholesterol and restrict the build-up of cholesterol in your arteries.
Resins: The Liver uses cholesterol to produce bile acid for digestion. These drugs bind to the bile acid blocking its absorption and the unabsorbed bile acid is finally eliminated from the body. This makes the Liver produce more bile acid using more cholesterol finally resulting in the lowering of blood LDL cholesterol.
Cholesterol inhibitors: These medicines block the absorption of cholesterol in the intestines and are given along with statins so that total blood cholesterol is maintained within limits.
Niacin: This is a B vitamin and when given in large doses, increases HDL cholesterol and decreases LDL cholesterol. Follow the instructions from your doctor.

Manage cholesterol

High levels of cholesterol in the blood, mean a higher risk of Heart Disease. As you become old, cholesterol levels in your blood tend to rise together with associated risks. Generally, no signs or symptoms are manifested to warn you of high cholesterol. Hence, make it a point to undergo tests once every 5 years so that high cholesterol if any could be detected in time. Most importantly if any one of your family members already has a Heart Disease or high cholesterol or is obese or overweight.

Cholesterol can be reduced if you adopt a healthy lifestyle and healthy eating habits. Sometimes you may have to take appropriate medications to reduce your cholesterol.

Cholesterol is not the culprit, but the excess of it is. Like any other nutrient, cholesterol is an important constituent of our body and is essential for staying healthy. The problem occurs when we consume it in excess, which our body is unable to use. Unused cholesterol is bad for health and is responsible for a gamut of disease conditions.

Symptoms

Signs and symptoms of infectious diseases depend on the causative organism and differ for each infection.

Fever and chills
Diarrhoea
Fatigue
Muscle aches
Weight loss
Coughing
Skin rashes

Causes

Bacteria cause infectious diseases such as Tuberculosis, Pneumonia, and Meningitis. Viruses cause illnesses ranging from the common cold to dreadful HIV. Examples of fungal infections are athlete’s foot, candidiasis, etc. Parasitic infections can occur due to protozoa, helminths, or ectoparasites. Trichomoniasis and giardiasis are examples of parasitic infections.

After the invasion of the organism, the protective mechanisms of the body fight against the organism. The disease occurs when these mechanisms are compromised, and the damage to the body by the organism begins. The organisms damage the tissues of the host by releasing some chemical toxins. The type and effect produced by the toxins in the body vary depending on the organism.

Infectious diseases can be transmitted through direct or indirect contact. Direct contact can be from person to person, animal to person, and mother to fetus. Indirect contact can be through carriers or vectors and food contamination.

The routes of transmission can be through droplet, sexual, oral, fecal-oral, iatrogenic, vertical, or vector-borne.

Risk factors

Anyone of us can get infectious diseases. But the chances increase if your Immune System is weakened or compromised. This may be due to conditions such as HIV or Cancer and the use of medications such as steroids that suppress the Immune System. Elderly people are more likely to develop infections as they suffer from comorbidities.

Diagnosis

Your doctor gives a provisional diagnosis based on your symptoms. Body fluids are analyzed to reveal the presence and type of organism present. Samples for laboratory tests include blood, urine, stool, throat swab, and spinal fluid. Spinal fluid is obtained through lumbar puncture. Your doctor would recommend one or more of these tests based on your symptoms. A microbial culture test is performed with the sample obtained to detect the organism.

Imaging tests such as X-rays help to rule out conditions that have similar symptoms. In a few cases, your doctor may also recommend a Biopsy to confirm the diagnosis.

Treatment

Your doctor chooses an appropriate treatment based on the causative organism.

Antibiotics are prescribed if the infection is caused by bacteria. Few exceptions such as Tuberculosis, anti-tubercular drugs are given rather than antibiotics. These medications can be bacteriostatic or bactericidal. Your doctor may prescribe oral, topical, or intravenous antibiotics based on the type and severity of the infection.

Antivirals are given to treat some, but not all viral infections. Antivirals are prescribed to treat conditions such as HIV, herpes, Influenza, and hepatitis. Antifungals are given for fungal infections and anti-parasitics are given for parasitic infections.

Self-management

All infections don’t require treatment, as some of the conditions are self-limiting. So, drink plenty of fluids and have adequate rest when you are ill. Follow some measures to prevent new or recurrent infections.

Wash hands thoroughly before preparing food, eating, and after using the toilet.
If you are caring for an infected person, wear masks and apply antiseptic lotion before and after coming in contact with the person.
Use antimicrobial substances such as antiseptics for use on the skin and disinfectants for use on non-living objects. Keep your kitchen and the eating area very clean.
Get vaccinated as immunization can reduce the risk of infection.
Practice safe sex by using contraceptives like condoms during sexual intercourse.
Don’t share personal items such as toothbrushes or razors.
Adopt methods such as pest control to prevent vector-borne transmission.
If you are travelling to an area where an epidemic disease is present, consult your doctor and ask for measures to prevent the infection.
Long-term use of antibiotics can also cause opportunistic infections. So, use antibiotics for a duration recommended by your doctor.

Infection occurs due to the invasion of organisms or disease-causing agents such as bacteria, viruses, fungi, or parasites. Infectious disease is an illness that occurs due to infection. Infectious disease is also known as transmissible or communicable disease. Infection is not the same as an infectious disease as all infections don't cause illness in the host. Some organisms invade the host but remain asymptomatic. Some infections are life-threatening (e.g. Pneumonia and Meningitis) whereas some infections cure and may cause complications in later stages (Chickenpox leading to Shingles). Infectious diseases, if they are chronic and persistent, are resulting in millions of deaths globally every year.

Difference between cold and flu

It may be difficult to distinguish between the common cold and flu as both affect the upper respiratory structures and cause similar symptoms. The onset and severity of symptoms in the two conditions are however different. Compared to the cold, flu has a sudden onset and the symptoms are more severe.

Causes

Influenza is an airborne disease and it is contagious. This flu travels in air droplets when a person infected with this virus coughs, sneezes or talks. It enters through the mouth, nose or eyes and affects the healthy individual.

A person with a weak Immune System is easily prone to the disease.

Symptoms

The symptoms of Influenza may vary according to the stage of the illness.

High fever
Exhaustion
Chills
Fatigue
Frequent body aches
Headaches
Poor diet
Difficult to feed small babies

No stuffy or running nose should be casually taken to just another episode of the common cold. Several bacteria can cause similar symptoms which may ultimately progress to affect and destroy the Lung tissues to cause Pneumonia.

Most colds and flu last a few days to a week to ultimately resolve without any specific treatment. This is not of much concern and can be managed at home. However, one should be watchful for any signs of worsening disease.

If the child develops uneasy, noisy, or laboured breathing, very high fever, or distressing cough, one should seek medical help.

Caring for your child

The child can be made to feel better by comforting care. The child should be allowed plenty of rest.
It is good to not send the child to school or daycare.
Small babies should be held upright to allow them easy breathing while at rest or sleep. The babies should be given Breast feeds and the elder children may be offered frequent sips of water or their favorite juice or popsicles.
The child should be given a healthy and balanced diet.
A comfortable temperature should be maintained in the child’s room and the humidity levels should be controlled to avoid too dry air.
Humidifiers or mist may be used to moisten the air; this may relieve the symptoms of congestion and stuffiness and make breathing easier.
The child may be given a relaxing warm water bath or maybe sponged with a warm towel.
Saline nasal drops may be instilled into each nostril to clear away the blockade.
The child may be encouraged to blow out the nose into a clean handkerchief.
A suction bulb may be used to clear the nose in very small babies. The nozzle should not be pushed too deep inside.

Medications

Syrups containing medicines like paracetamol or ibuprofen are available over the counter. These may be given to a sick child who develops fever or distressing body aches. These medicines may be used strictly according to the dosing instructions.
Some are dosed according to the weight of the children. In that case, it is better to know the weight of the child. These are best used in children above 2 years. Babies less than 2 years of age should be given any medicine only after consultation with a doctor.
Other medicines that may be prescribed for cold and flu include those like diphenhydramine, and chlorphenamine which are antihistaminics that oppose the action of histamine, a chemical signal that causes runny nose and itching in the throat and ears.
If dry cough is a problem, cough suppressants may be used to provide relief. Expectorants are medicines that make the secretions less viscous and allow the child to cough them out easily.
Nasal decongestant medicines like pseudoephedrine and phenylephrine help to relieve a blocked nose.
Aspirin is one medicine that should be avoided in children. This can cause Reye’s syndrome, a life-threatening disorder that affects the Brain, Liver, and other organs.

Visiting the doctor

Most cases of common cold and flu resolve after a few days with proper care at home. However, it may be important to see the doctor if the child develops a high fever, the cough lasts many days and is accompanied by sputum which is coloured green or yellow, develops difficult and laboured breathing, the nasal discharge becomes yellow or green, the child complains of pain in ears or nose, the throat is intensely inflamed and pitch of the voice changes, chest wall shows retractions with breathing movements, and the child refuses to feed persistently, and the urine becomes dark and scanty.

Preventing cold and flu

Common colds and flu are contagious and spread from one person to another. The child should be isolated from any person who has an illness. Frequently, children catch an infection in the daycare or nursery.
A sick child should be allowed to rest at home. Frequent and proper hand washing should be encouraged. Hands should be washed before and after meals and after every use of the toilet. Hands should be washed with soap and lukewarm after and should be thoroughly scrubbed on both surfaces, between fingers and along nails for about 20 seconds before being rinsed.
The tissues used to wipe the child’s face and nose should never be reused. These should be carefully disposed of in the dustbin and other children should not be allowed to access them.
Hands should be washed after every diaper change.
Anybody who has a cold should cough or sneeze by covering the nose and mouth with a clean handkerchief to avoid spreading it to children and others at home.
The house should be kept clean and well-ventilated.
Seasonal vaccination is recommended every year for the most prevalent strain of virus causing the illness.
Anybody 6 months and older should get the vaccine.
People caring for babies less than 6 months of age should be vaccinated. The 2010-2011 flu vaccine protects against an Influenza A H3N2 strain.
Healthcare workers and children who are at high risk either due to an underlying medical condition or because they are too frequently exposed to an infection need vaccination.

The common cold and flu are both infections of the upper respiratory tract that affect the ears, nose, throat, and sinuses. Both cold and flu are contagious infections caused by viruses. There are many different types of viruses causing the common cold and the flu is caused by the Influenza viruses of which three strains have been described: Type A Type B Type C These viruses constantly change structure to make new strains. This is why common colds and flu are characterized by repeated episodes in both children and adults.

Causes

Acute Laryngitis is temporary and is caused by overuse or due to any underlying infection. Chronic Laryngitis can be caused due to long-term exposure to harmful chemicals.

The major causes of acute Laryngitis are viral infections, the strain on vocal cords, or may be due to bacterial infections.

The major causes of chronic Laryngitis are acid refluxes, overusing of voice, infections such as sinusitis, smoking and frequent exposure to harmful allergens.

Symptoms

The common symptoms of Laryngitis may include dry cough, loss of voice, throat irritation, weakened voice, and hoarseness in voice.

Croup is a symptom that occurs in infants and small children who are attacked with a bacterial form of Laryngitis. Croup is an inflammation of the throat which may develop into epiglottitis. Epiglottitis can become fatal if left untreated.

When to call the doctor?

You must call your doctor immediately if there is:

Hypersalivation
Trouble swallowing
Difficulty in breathing
Fever over 103 degrees Fahrenheit

Complications

In most severe cases of Laryngitis, which is caused by infection, the infection may spread to other parts of the respiratory tract and cause severe respiratory tract infections.

Diagnosis

Hoarseness of voice is the most common sign of Laryngitis. This can vary on the degree of infection. Your doctor may examine your vocal cords. Later he/she would order diagnostic tests such as:

Laryngoscopy: this technique helps your doctor to visually examine your vocal cords, for this a light and a tiny mirror are required. Your doctor may rather use a fibre-optic Laryngoscopy by inserting a flexible tube which has a tiny camera; this helps your doctor visualize the motion of your vocal cords.

Biopsy: if your doctor finds anything suspicious your doctor may take a sample of the tissue for Biopsy.

Treatment

Acute Laryngitis is self-limiting and gets better within a week or two. Following certain self-care measures would also speed the recovery and improve symptoms.

The goal of treatment for chronic Laryngitis is to treat the underlying causes, such as Heartburn, smoking or alcohol addiction.

Your doctor prescribes certain medications which include:

Antibiotics cannot work well because the major cause would be viral. If there is any evidence of bacterial infection, then your doctor will recommend the most suitable antibiotics for you.

Corticosteroids help reduce the inflammation in your vocal cords. But these drugs are reserved only for urgent needs in treating Laryngitis mainly in cases that have symptoms such as croup.

Lifestyle changes

Some home treatments and self-care remedies would help in alleviating the symptoms of Laryngitis:

Breathing in moist air and inhaling steam would help clear the airway.
Resting the voice as much as possible, by talking less and avoiding overuse of the voice
Drinking plenty of fluids to prevent Dehydration
Sucking on lozenges or gargling with warm salt water, or chewing on a gum
Avoiding overuse of decongestants which dries your throat

Prevention

To prevent the irritation in your throat, you can follow the measures given below:

Avoid smoking
Limit alcohol consumption
Avoid eating spicy foods
Drink lots of fluids
Eat more fruits and vegetables

The larynx is called the “voice box”. It is the vital part of the respiratory tract which allows the air to pass through it and keeps the food and drink from blocking the airways. The main function of the larynx is to produce sounds while you talk and sing. When the larynx is inflamed, the condition is referred to as Laryngitis. Inflammation can be a result of overuse, irritation or infection. The two main types of Laryngitis are chronic type and acute type.

Signs and symptoms

After the infected mosquito (female Anopheles) bites us and releases the parasite into the bloodstream, it takes between seven and 30 days (an average of 15 days) for the symptoms to develop. This period is known as the incubation period. In some people, symptoms may not develop for several months after infection as these parasites will be dormant.

Symptoms of Malaria can be divided into uncomplicated or complicated (severe).

The most common symptoms of uncomplicated Malaria are

Fever and chills
Headaches
Nausea and vomiting
General weakness and body aches

The most common symptoms (when different body systems are affected by Malaria) of complicated or severe Malaria are:

Severe Anaemia (due to destruction of RBCs)
Kidney Failure
Cerebral Malaria (characterized by seizures, unconsciousness, abnormal behaviour, confusion)
Cardiovascular collapse
Low blood sugar (after treatment with quinine in pregnant women)

Causes

The primary and major cause of Malaria is the transmission of the parasite into the bloodstream through the infected female Anopheles mosquito. Malaria is congenital; which means an infected mother can also pass the disease to the baby at birth. This disease is also transmitted by blood, so it can also be transmitted through an organ transplant, a transfusion, and the use of shared needles or syringes.

Risk Factors

The biggest risk factor is visiting the place where Malaria is endemic.

People who are at risk of serious disease include:

Children and infants
Travelers from areas where Malaria is uncommon
Pregnant women and unborn children

Complications

Malaria can be lethal. In most cases, deaths due to Malaria are related to one or more serious complications, which include:

Cerebral Malaria is caused when the parasite-filled blood cells block small blood vessels in the Brain, causing swelling and damage to the Brain. Cerebral Malaria may cause coma.
Breathing problem is due to accumulated fluid in the Lungs known as pulmonary Edema due to Malaria.
Organ failure mainly Kidneys Liver or spleen failure due to Malaria and these conditions can be life-threatening.
Anaemia is due to the destruction of red blood cells by the parasites.
Low blood sugar is due to severe forms of Malaria itself and the drugs used for Malaria treatment such as quinine. Very low blood sugar may lead to coma or death.

Diagnosis

Malaria is diagnosed with the help of different types of blood tests which can show the presence of the parasite.

Your doctor may recommend you take the blood smear test mainly to determine

if you have Malaria
the type of Malaria parasite causing symptoms
if the infection-causing parasite is resistant to certain drugs
whether the disease is affecting any of your vital organs

Some blood tests take several days to complete, while others can produce results in less than 15 minutes. One such is a rapid diagnostic test also known as antigen test which can give the diagnosis in a few minutes. It is recommended that a positive test be followed with a blood smear examination.

Treatment

Your doctor will prescribe medications based on the type of parasite responsible for your infection. Medications may not always clear you from infections as few parasites are resistant to drugs. If this condition occurs, your doctor uses more than one drug or changes medications altogether to treat you.

The medications or antibiotics prescribed depend on the specific species of parasite identified, the severity of symptoms, and the determination of drug resistance species. Medications can be given in the pill form or the intravenous form depending on the above factors.

Prevention or self-management

There is no vaccine for Malaria, and no medication is 100% effective. Therefore the prevention of mosquito bites is of great importance. Prevent mosquito bites by sleeping under bed nets; use clothing that covers most of the exposed skin to reduce the risk of bites. Also, treating clothes and bed nets with insecticides can prevent bites even further.

In case you are travelling to places where Malaria is common, talk to your doctor and take preventive medication before, during, and after your trip.

Malaria is an infectious disease caused by a parasite known as Plasmodium and is transmitted by infected mosquitoes. Malaria is characterized by chills, fever, fatigue, and headaches, and can sometimes be life-threatening. Malaria is highly prevalent in tropical and subtropical countries, while it is uncommon in temperate climates. As per the reports, nearly 660,000 people die due to Malaria each year. As there is no vaccine for Malaria, people are advised to take preventive medication before, after, and during their travel to locations where Malaria is common. Another reason for Malaria being more prevalent is many Malaria parasites are immune to the common drugs used in the treatment of Malaria.

Signs and symptoms

Common signs and symptoms of POEMS Syndrome include:

Weakness of nerves in the upper and lower limbs
Darkening of the skin (hyperpigmentation)
Thickening of the skin
Abnormal fluid retention
Increased hair growth (hypertrichosis)
Elevated platelet count
Shortness of breath
Fluid accumulation around the Lungs (i.e. pleural effusion)

Causes

POEMS syndrome occurs due to the uncontrolled growth of monoclonal cells (plasma cells) leading to the accumulation of M-proteins (which fight infections) in the blood. A protein called Vascular Endothelial Growth Factor (VEGF) also causes angiogenesis leading to POEMS Syndrome.

Diagnosis

To diagnose POEMS Syndrome, your doctor may prescribe a few blood tests which include measuring vitamin B12 levels, VEGF levels, and haemoglobin levels.

POEMS syndrome diagnosis may be confirmed if your blood tests show:

Low vitamin B12 levels
Elevated VEGF levels
Decreased haemoglobin levels

A Lumbar Puncture is performed to determine protein levels in Cerebrospinal Fluid (CSF).

Your doctor may also recommend Electromyography (EMG) for Neuropathy, Computed Tomography (CT) Scan and Bone Marrow Biopsy to diagnose the condition.

Treatment

The treatment for POEMS helps to relieve the symptoms but may not cure the condition. The treatment depends on the underlying plasma cell disorder. The treatment usually involves a combination of medical, surgical, and adjuvant therapies. Treatment options may also include Radiation Therapy, Chemotherapy, and Peripheral Blood Stem Cell Transplant.

Corticosteroids and low-dose alkylating agents are given followed by Chemotherapy. Systemic therapy can be given in the case of widespread osteosclerotic lesions.

If VEGF is the underlying cause, a monoclonal antibody such as bevacizumab may be prescribed by your doctor.

POEMS syndrome is a rare disease and research is still ongoing to identify the appropriate treatment for it.

Prevention

Early diagnosis of POEMS syndrome is very important as it progresses rapidly and may be life-threatening at times. This condition is often misdiagnosed as it mimics the symptoms of other conditions as well.

POEMS Syndrome is a rare disorder. POEMS stand for Polyneuropathy – numbness, weakness of lower limbs, and tingling sensation Organomegaly – enlarged Liver, spleen, or lymph nodes Endocrinopathy – abnormal levels of hormone leading to Diabetes, fatigue, Hypothyroidism, and metabolism problems Monoclonal protein – abnormal bone marrow cells that produce a monoclonal protein leading to monoclonal plasma-proliferative disorder Skin abnormalities – increased thickness of skin; increased hair growth on legs and face This syndrome is seen mostly in men and elderly people. It is also known as Shimpo Syndrome, Crow-Fukase Syndrome, or Takatsuki Syndrome.

Raynaud’s Disease can occur due to various conditions at the workplace. The repeated actions that can lead to Raynaud’s Disease are the use of tools that vibrate at work, playing the piano and typing for a long time. The chemicals that lead to this disorder are nicotine in cigarette smoke aids in the narrowing of blood vessels and exposure to vinyl chloride in the plastic industry. The causes can be damage to the nerves of the feet and hands due to working repeatedly over them. Diseases that cause Raynaud’s Disease are:

Scleroderma - a skin disease caused by a disordered Immune System.
Sjogren’s Syndrome - a disease that causes dryness of skin and mouth.
Rheumatoid Arthritis - a disease affecting the joints caused by a disordered Immune System.
Atherosclerosis - a condition that involves the deposition of fats in the walls of the blood vessels
Buerger's Disease - inflammation of the blood vessels
Dermatomyositis - a disease that causes inflammation of muscles and skin
Carpal Tunnel Syndrome - a condition caused by the compression of the nerve that controls muscles of the wrist and palm
Thyroid problems
High Blood Pressure

In all these diseases, the blood vessels narrow down resulting in a lack of blood supply to the extremities. In severe cases of Raynaud’s Disease, permanent death of tissue occurs due to lack of blood supply which is known as Gangrene.

Raynaud’s Disease may also be the result of certain medications used in the treatment of Cancer, High Blood Pressure, cold and migraine, and contraceptive pills. Frostbite and injury caused due to certain surgeries of the extremities also cause Raynaud’s Disease.

Risk factors for Raynaud’s Disease

Raynaud’s Disease is commonly seen in women between 15 to 40 years of age, the reason is unknown. People having a family history of the disease and those who are living in colder climates are at higher risk.

People in occupations that involve repeated trauma to extremities due to the use of any tool that vibrates have a high risk of developing Secondary Raynaud’s Disease.

Other risk factors are diseases like Lupus and Scleroderma, exposure to chemicals like vinyl chloride in plastic industries and smoking.

Diagnosing Raynaud’s Disease

Raynaud’s Disease can be identified by the colour change of toes and fingers from the normal healthy pink to bluish purple colour on exposure to extreme cold or psychological stress.

Tests are conducted by the Rheumatologist (Doctor who treats disease of muscle, bone and joints) to diagnose Raynaud’s Disease. In the test known as the cold simulation test, the patient’s fingers are taped with cold sensors and then dipped in ice-cold water for some time. Then the fingers are removed from the ice water and observed for color change. If the patient has Raynaud’s Disease, it will take longer time than normal for the colour to change from bluish-purple to healthy pink.

In a test called nail fold capillaroscopy, the fingernails are observed under a microscope after putting a drop of oil at the base of the fingernail. If there is any disorder, then the blood vessels look inflamed under the microscope.

Blood tests are also conducted to check for any conditions of inflammation.

Treating Raynaud’s Disease

A permanent cure for Raynaud’s Disease is not there, but you can avoid trigger factors to a large extent. When you go out in cold weather, you must wear warm gloves, scarf, coat, hat and mittens.
Make sure the car is warmed when you drive out in chill weather.
When you have to handle cold foods from the refrigerator, do so wearing warm gloves.
Avoid air-conditioned places and keep yourself warm by wearing protective warm clothes.
If you are working in industries in which you are exposed to chemicals, do wear protective gloves.
The use of tools that vibrate in your workplace should be limited.
Do consult your doctor when you need to take medicines for any other illness as certain medicines can trigger
Raynaud’s Disease due to their blood vessel constricting nature. Similarly, psychological stress leads to the release of hormones that constrict blood vessels leading to Raynaud’s Disease.
Keep away from stressful situations and practice relaxation and deep breathing techniques.
When you find that your fingers and toes have started to become cold and blue, start rubbing them, put your hands under your armpit or place your fingers in warm water. You can shake and move your hands and legs in circles. This will generate heat.
In severe cases, the tissue becomes dead which is also known as Gangrene. In such cases, surgery involving amputation of the affected part followed by antibiotic therapy is a must.

Life with Raynaud’s Disease

Life with Raynaud’s Disease can be easy if you know how to avoid the trigger factors. By taking all the precautionary measures, keeping stress at bay, and following the doctor’s advice, you can lead a normal healthy life.

Raynaud’s Disease is a disease that affects the blood vessels of the toes, fingers, tip of nose, nipples, lips, and ears when the blood vessels become narrow, and blood does not reach these areas, making them turn blue and white. The fingers and toes get back their natural pink colour when the blood starts flowing to those areas again. In some extreme cases, there is permanent death of tissue due to a lack of blood flow in the area for a long time. Stressful emotional situations and extremely cold temperatures trigger the disorder during which the blood vessels narrow down cutting away blood supply to the area. In stressful emotional conditions, the body releases hormones that narrow the blood vessels which cut off the blood supply to the extremities causing Raynaud’s Disease. In people suffering from Raynaud’s Disease, the narrowing of blood vessels as a result of stress or extreme cold is more than that which occurs in people without the disorder.

Causes

Many causes contribute to the development of secondary hypertension which include:

Kidney Disease: Damage to the Kidneys results in the narrowing of renal arteries causing an increase in Blood Pressure.

Abnormalities of the adrenal gland: Adrenal glands secrete various hormones that regulate Blood Pressure. Adrenal Diseases such as Pheochromocytoma, Hyperaldosteronism, and hypercortisolism can alter Blood Pressure.

Diabetes complications: In the case of diabetic nephropathy, damage to Kidneys occurs leading to secondary hypertension.

HyperparaThyroidism: Parathyroid hormone regulates calcium and phosphorous levels in the body. If the hormone levels in the body increase, calcium levels also rise triggering High Blood Pressure.

Sleep apnea: In this condition, inhalation of oxygen decreases leading to damage of blood vessel linings. This damage ultimately causes a rise in Blood Pressure.

Obesity: The amount of blood circulation increases putting pressure on the arteries. This causes a rise in Blood Pressure leading to secondary hypertension.

Pregnancy: Women during pregnancy are also at risk of secondary hypertension.

Symptoms

Symptoms of secondary hypertension include:

Persistent rise in Blood Pressure (systolic Blood Pressure > 180 mmHg; diastolic Blood Pressure >120 mmHg) even after using medications
Sudden onset of High Blood Pressure before the age of 30 and after 55
No family history of hypertension

Complications

The complications of secondary hypertension are damage to the arteries, formation of an aneurysm, weakened blood vessels in the eyes and Kidneys, Heart Failure, impairment of memory, and metabolic syndrome.

Diagnosis

Your doctor initially measures your Blood Pressure six to seven times at different visits. If the Blood Pressure is persistently high during all the measurements, your doctor may give the provisional diagnosis as secondary hypertension. Your doctor may also recommend following tests to confirm the diagnosis.

Blood test – to check levels of electrolytes (sodium, potassium, calcium, and chloride), creatinine, blood urea nitrogen (BUN), blood glucose, cholesterol
Urine test - to check for the markers of High Blood Pressure
Ultrasound of Kidneys – to know whether the underlying cause is Kidney damage
Electrocardiogram – to evaluate whether the underlying cause is a Heart problem
Magnetic Resonance Angiography – in cases of renal stenosis

Treatment

The primary goal of the treatment of secondary hypertension is to treat the underlying cause. After diagnosis, your doctor recommends appropriate treatment for the cause (maybe adrenal gland abnormalities, Kidney Disease, Diabetes, or sleep apnea). Your doctor also prescribes antihypertensive medications such as diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, or calcium channel blockers.

If there is damage or narrowing of the arteries, your doctor may recommend surgery to correct the problem. If the secondary hypertension is drug-induced (caused by the use of any medication), then your doctor suggests to stop taking the medication decrease the dose of the medication or try to give any alternative medication.

Lifestyle modifications

To keep your Blood Pressure, adopt some measures:

Eat healthy foods.
Maintain a healthy weight.
Perform regular physical activity.
Reduce the intake of sodium in your diet.
Stop smoking and alcohol consumption.
Take Blood Pressure medication as prescribed.

Blood Pressure which is measured as 120/80 mmHg is said to be a normal reading. If the reading is above the normal levels, it is termed High Blood Pressure. In the majority of people, High Blood Pressure is caused by any other underlying diseases, such as Kidney damage, damage to arteries or Heart problems. This kind of Blood Pressure is called secondary hypertension. On the other hand, if the cause of hypertension is idiopathic (of unknown cause), then it is called primary hypertension The incidence of secondary hypertension is less when compared to primary hypertension.

Common STDs

There is a wide range of the Sexually Transmitted Diseases list.

Chlamydia is caused by the bacteria Chlamydia Trachomatis, which infects the urinary tract in both men and women. Symptoms include painful urination and pain in the lower abdomen. In women, Chlamydia can cause pain during intercourse and vaginal discharge. Men have a discharge from the penis and testicular pain.

Gonorrhea is caused by the bacteria Neisseria Gonorrhoea and can infect the genital tract, mouth, and rectum of both men and women. Symptoms include a thick, cloudy, or bloody discharge from the penis or vagina, pain or burning sensations when urinating, frequent urination, and pain during sexual intercourse.

Syphilis comes from a spiral-shaped bacteria called Treponema pallidum. It appears with one or more lesions or ulcers around the genital area. Syphilis can be dormant for up to seven years between active outbreaks. Taking penicillin or a similar antibiotic can cure Syphilis, however, if left untreated Syphilis can cause severe complications including death.

Trichomoniasis is caused by the single-cell protozoa Trichomonas vaginalis. This disease affects both men and women, but most symptoms are found in women and include vaginal discharge, itching or irritation, pain during sexual intercourse, painful urination, and light vaginal bleeding.

Genital Herpes is a result of the Herpes Simplex virus. The signs of infection appear as one or more blisters on or around the genitals or rectum. These blisters form small, fluid-filled clusters that break open, leaving painful sores.

Human Papillomavirus, or HPV, is a viral infection that can appear in the mouth, throat, or genital areas of both men and women. In ninety per cent of cases, there are no outward symptoms. However, the disease can also manifest itself as warts on the genitals, or more rarely, in the throat. Certain strains of HPV can result in potentially life-threatening Cancers.

Hepatitis B is a Liver infection caused by the Hepatitis B virus. It is considered life-threatening, and, if untreated, can cause chronic Liver disease. Common symptoms include fever, fatigue, muscle or joint pain, loss of appetite, and mild nausea and vomiting. Serious symptoms that require immediate medical attention and possibly hospitalization include severe nausea and vomiting, yellow eyes and skin ("jaundice"), and a bloated or swollen Stomach.

Acquired Immune Deficiency Syndrome (AIDS) is caused by Human Immunodeficiency Virus (HIV) which progressively damages the Immune System and makes the body vulnerable to infections. It might take years for HIV to permanently damage the Immune System and develop into full-blown AIDS. Early symptoms include fever, headache, sore throat, swollen lymph glands, rashes, and fatigue. Once these early signs disappear, chronic symptoms may appear, such as Diarrhoea, weight loss, fever, cough, and shortness of breath. Symptoms in the later stages of HIV include fatigue, sweating at night, continued chills or fever, swelling of the lymph nodes for more than three months, Chronic Diarrhoea, and continued headaches. There is no cure for AIDS, however, there are ways to manage the disease so people stay healthier and live longer.

Symptoms

A few STD symptoms in men are:

Painful urination
Testicular pain in men
Discharge from the penis

A few signs of STD in women are:

Lower abdominal pain
Vaginal discharge
Bleeding between periods
Pain during intercourse

Treatment of STDs

If you are concerned that you might have an STD, consult with your doctor immediately. Be honest and direct with your doctor. While this may be an unpleasant or awkward conversation to have, there are serious risks and consequences to delaying the treatment of an STD.

Causes for concern might include any of the symptoms listed above, a personal history of sexual encounters that could be considered high risk, or partners who have displayed any symptoms of having a Sexually Transmitted Disease. A doctor will be able to give a specific diagnosis and treatment, as well as provide support options for dealing with the disease.

The doctor or healthcare provider may order some laboratory tests to help diagnose the cause of any symptoms or infections. Most tests will collect blood samples, but sometimes testing fluids from active sores or scrapings may be necessary. Testing discharge may also be required for a confirmed diagnosis.

Most infections from bacteria or parasites will need antibiotic treatments. Viral STD infections are not curable but can be effectively controlled through vaccines. HIV infections are managed through antiviral and antiretroviral drugs which can lead to an improved quality of life.

Preventing STDs

Each year, millions of new cases of Sexually Transmitted Diseases are reported, yet STDs can easily be avoided. Some lifestyles can increase the odds of being exposed to an STD. These include being sexually active at an early age, lowering inhibitions by abusing alcohol and illegal drugs, and living in a community with a high rate of STDs because your risk of exposure goes up.

Safety tips include avoiding unprotected sex, not engaging in sex with multiple partners, and staying away from risky sexual practices. Of course, the only sure way to avoid an STD is to not have sex.

When engaging in oral, vaginal, or anal sex, always use latex condoms. Avoid condoms lubricated with spermicides because frequent use of some spermicides can increase the risk of HIV. And be aware that you can take vaccines to prevent STD infections such as hepatitis B and Human Papillomavirus, or HPV.

Sexually Transmitted Diseases, also called STDs or Sexually Transmitted Infections, are infections caused by viruses, bacteria, or parasites transmitted through sexual encounters. Today, there are more than 20 types of known STDs, some with a long list of serious symptoms and consequences, including Cancer, infertility in women, and even the possibility of death.

Signs and symptoms

Tetanus symptoms usually occur within 4 to 21 days (an average of 10 days) after infection. The main symptoms of Tetanus include:

stiffness in jaw and neck muscles which makes it difficult to open your mouth
painful muscle spasms that cause difficulty in swallowing and breathing
unusual sweating
a rapid Heartbeat (tachycardia)
a high body temperature of 38oC (100.4oF) or above

Causes

The bacterium which causes Tetanus is Clostridium tetani. It is commonly found in soil and the faecal excreta of cows and horses. It can stay alive for a long time outside the body. If you’re infected, the bacteria enter your bloodstream through the wound and multiply quickly. The toxins released by these bacteria affect the nerves, producing symptoms such as muscle stiffness and spasms.

Tetanus infection can occur when there are

burns
cuts and scrapes
tears or splits in the skin
eye injuries
injection of contaminated drugs
insect or animal bites

Tetanus is not contagious, i.e. it does not spread from person to person.

Risk factors

Most of the cases of Tetanus are recorded in people who do not get vaccinated. Missing either an initial immunization or a booster dose can increase the risk.

You are also more likely to have Tetanus if you have an injury that paves the way for the entry of the bacterial spores. The use of illegal drugs is another risk factor for Tetanus infection.

Diagnosis

Based on your symptoms, your physician will ask about your medical history and perform a physical examination. A laboratory test may not help to diagnose Tetanus. But to rule out other conditions with similar symptoms, lab tests may be performed.

Treatment

If you are at risk of developing Tetanus but do not have any associated symptoms, then your doctor will clean the wounds and give you a Tetanus immunoglobulin injection. Also, a dose of the Tetanus vaccine will be given if you haven’t taken one in the past.

If your doctor suspects Tetanus, then you will be admitted to the intensive care unit (ICU) and the following Tetanus treatment is provided:

antibiotics such as penicillin to kill the bacteria
Tetanus injection containing immune globulin to neutralize the bacterial toxins
muscle relaxants to relieve muscle spasms and stiffness
a ventilator to support breathing

Complications

The serious health complications that can result from severe muscle spasms associated with Tetanus are:

breathing problems as a result of spasms of the vocal cords
Abnormal Heart rhythms
Brain damage due to poor oxygen supply
secondary infections due to extended stay in the hospital
Pneumonia (an infection of the Lungs)
bone fractures

Self-management

You may take some steps for the prevention of Tetanus infection when you have a wound, such as:

Applying pressure to control bleeding
Keeping the wound clean
Using antibiotics
Covering the wound
Regularly changing the dressing

Prevention

Vaccination is the only way to prevent Tetanus infection. The Tetanus vaccine in children is administered along with diphtheria and acellular pertussis (DTaP) vaccine. It is administered at the ages of two months, four months, six months, 15 to 18 months, and four to six years.

The booster shots of the Tetanus vaccine are given in combination with the diphtheria vaccine (Td). It is administered at the ages of 11 and 12, and then a TD booster after 10 years.

Tetanus is a rare but serious condition which is caused by a type of bacteria that gets into wounds. It can become fatal if treatment is not taken on time. It primarily affects your nervous system leading to painful muscle contractions. In India, it is estimated that fewer than one million people are affected by Tetanus. Tetanus is a medical emergency and requires aggressive treatment. Thankfully, Tetanus can be prevented by the use of a vaccine called Tetanus toxoid. However, the effect of the vaccine does not last permanently, you may require booster shots for every 10 years.

Frequently Asked Questions

What is the best treatment for Dengue fever?

Depending on the severity of the condition, rehydrating fluids and salts are given to the patients. Tylenol (Paracetamol) can be used to treat pains and high fever. intravenous fluid supplementation and blood transfusions are given in case of severe Dengue.
Is paracetamol safe for Dengue fever?

Medicine for Dengue should be taken only under the supervision of a doctor. Tylenol (Paracetamol) can be used to treat pains and high fever. Non-steroidal anti-inflammatory agents such as aspirin and ibuprofen can cause severe internal bleeding if used in the treatment of Dengue.

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