Lissencephaly

Lissencephaly
Lissencephaly, the literal meaning of which is ‘smooth brain’, is an uncommon, genetically-associated brain mal-development disorder marked by nil folds or convolutions in the cerebral cortex as well as microcephaly, i.e., an unusually small head. Lissencephaly is considered as a type of cephalic disorder. Terms like “pachygyria,” i.e., wide gyri or folds, or agyria, i.e., absence of gyri, are used by medical experts to define the appearance of brain surface in patients.

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Children affected by lissencephaly typically elicit considerable developmental delays, which in turn may vary from one affected child to another as per the severity of brain deformity and regulation of seizures. The life expectancy of the patients may be shortened, often because of underlying respiratory anomalies.

Lissencephaly is a very rare condition. In the US, it affects 11.7 children in every 1 million births.

Symptoms

Most children with lissencephaly tend to have a head which is of the normal size. However, some patients may be born with an abnormally small head, and the combination of the two brain-skull abnormalities is referred to as microlissencephaly.

Some of the additional common signs and symptoms of lissencephaly are listed below:

• Feeding difficulties


• Intellectual deficits


• Failure to flourish and thrive


• Irregular appearance of the face


• Swallowing problems


• Malformed toes, fingers, and/or hands.


• Severe psychomotor retardation


• Hypotonia or muscle spasms


• Seizures

Couples with a family history of lissencephaly can check for the presence of the condition via imaging tests. The brain normally develops folds during weeks 25 to 30 of pregnancy. This is when doctors will perform an ultrasound.

 Lissencephaly Types

Advancements in the field of genetics and neuroimaging has facilitated better understanding of migration disorders, thereby allowing a better definition of the spectrum of lissencephaly. The spectrum is classified into nearly 20 different forms. Many more may be added after the respective causative factors have been discovered.

Lissencephaly is categorized as per varied systems. One of the major forms of classification is Classic/Type I vs. Cobblestone/Type II. However, certain systems and additional types cannot be added to any of these classifications.

A few types of lissencephaly are listed below, along with their OMM numbers:

1. Classic/Type I lissencephaly – 607432

• L1S1:This type of lissencephaly occurs due to mutation of PAFAH1B1 gene. It is further subdivided into:
  
  
  
  • Miller–Dieker syndrome – 247200
  
  
  • Type 1 isolated lissencephaly – 601545
  
  
  • LISX1 – 300121:This type of lissencephaly occurs due to mutation of DCX/doublecortin gene. It is further subdivided into:
    
    
    
    • Lissencephaly, isolated, type 1, without the occurrence of other known genetic errors.
    
    
    
    
  
  
  
  

2. Cobblestone/Type II lissencephaly

• Fukuyama syndrome – 253800


• Walker–Warburg syndrome, also known as HARD(E) syndrome – 236670


• MEB/Muscle-eye-brain disease – 253280

3. Other types of lissencephaly

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• Microlissencephaly, i.e., microcephaly and lissencephaly


• LIS3: TUBA1A – 611603


• LIS2: Norman-Roberts syndrome. It occurs due to RELN gene defects – 257320


• LISX2: ARX, 300215

Causes of lissencephaly

Lissencephaly is thought to be mainly caused due to certain genetic mutations. It can also occur due to inadequate blood flow to the brain of the unborn child during early pregnancy, or due to viral infections of the fetus or the uterus during the first trimester.

Any of the above listed factors can result in neural migration deficits at the time of embryo development. Neural migration is a process marked by movement of the nerve cells from their original place to the permanent area inside the gray matter of the cerebral cortex. Such migration or movement typically occurs between 12 and 14 weeks of fetal development. Lissencephaly develops because such movement of the nerve cells does not occur, eventually affecting the development of brain.

Studies have successfully found out that defects in the LIS1, DCX, 14-3-3ε, ARX, and RELN genes contribute towards the development of lissencephaly. The severity of the brain formation varies as per the type of gene that suffer from mutation.

Lissencephaly may occur on its own. It can also develop along with varied related conditions such as Walker-Warburg syndrome Miller-Dieker syndrome, isolated lissencephaly sequence, and Walker-Warburg syndrome. Specialists may be needed to differentiate between these varied disorders.

Couples at increased risk to conceiving a child with lissencephaly must go for genetic testing as well as genetic counselling before opting for parenthood.

Diagnosis

The brain surface of the fetus is usually smooth till week 25 to 30 of pregnancy. If routine complex ultrasound examinations performed after this period detect any cerebral abnormality, then doctors may recommend further testing such as NMR and genetic studies, especially if the unborn child has a family history of lissencephaly or other brain conditions, or if the doctor suspects the occurrence of brain defects. Chorionic villus sampling may also be performed to check the presence of certain variants of lissencephaly, if genetic mutations are detected.

After birth, if the baby shows signs and symptoms of brain malformation, then doctors may recommend varied diagnostic tests such as CT scans, MRI scans, and/or ultrasound. In case of lissencephaly, specialists will be needed to carefully grade the severity of brain malformation. A grade 1 lissencephaly diagnosis means that a large section of the brain is affected; it is extremely rare. Most lissencephaly patients suffer from grade 3 form of the disorder.

Treatment

Currently, there are no ways to medically correct the brain defects associated with lissencephaly. Treatment is dependent on the severity of the accompanying symptoms; it is aimed at managing the symptoms and preventing complications.

• Swallowing and feeding difficulties may need the use of a gastrostomy tube.


• Hydrocephalus is treated via shunting which helps remove excess cerebrospinal fluids.


• Seizures can be controlled with anticonvulsants and other anti-seizure medications.

Lissencephaly life expectancy

Life expectancy and prognosis of lissencephaly is dependent on the severity of the condition. The mental function in children with severe lissencephaly may not develop beyond that of a 3 to 5 months old baby. In the years gone by, such children did not live beyond 2 years. Now, the life expectancy has gone up to nearly ten years. Respiratory diseases, choking or aspiration on fluids or foods, and/or seizures are the main causes of death.

Child with mild instances of lissencephaly may feature near normal brain function and development.

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Warts on Tongue

Warts on Tongue Warts are small lesions or bumps that can develop anywhere in the body and even inside the mouth. It can develop on the lips and tongue also but often they are painless and harmless. Tongue warts occur either as single or in groups. They are irregular in shape, size and texture. Warts are tiny and discrete bumps which are rough in shape and white or red in color. Warts on tongue are caused by viral infection and often they are transmitted through oral sex. Treatment is available in various forms from topical creams to laser therapy.

Risk Factors :

Oral warts are at high risk of developing in people who have sexually transmitted diseases. People with weak immunity are more prone to develop warts on tongue than others. Certain ethnic groups like Asians and black people are at high risk of developing oral warts. Those who are involved in meat industry like handling and processing meat are at high risk of developing oral warts. Oral warts are common in any age group but are high in young adults.

Causes :

It is the HPV virus that causes warts on tongue. There are hundreds of strains of human papilloma virus causing oral warts and genital warts. Among them HPV2, HPV13 and HPV32 are identified causing warts on tongue. The main method of spreading is through kissing the genitals. A person having poor genital hygiene can easily transmit the virus to their partners.

Symptoms :

When a person develops warts on tongue he would develop irritation while eating food and there can be difficulty in chewing food. It can cause painful sores on the tongue varying in shape and size. The presence of warts on tongue can cause discomfort and pain to the person. Some people will have problems in speaking due to irritation and discomfort. Warts appear as lesions or raised tiny section on the tongue.

Diagnosis :

No special test is required for detecting oral warts. It can be identified on physical exam.

Treatment :

Treatment of warts on tongue can be difficult due to its tiny size and location on the tongue. Topical creams and antiviral ointments can be applied on the warts which would destroy the virus and prevent further development of warts. Oral medications are given for managing pain and irritation. Some people believe that applying tea tree oil with cotton swab on the wart will destroy the virus gradually. Similarly you can get remedy by rubbing the banana peel or crushed potatoes on the warts for getting relief from irritation. Garlic is considered to have antiseptic properties and hence you can smash some garlic or use garlic paste on the warts to destroy them.

Surgical methods of removing warts include cryotherapy (by freezing the wart with liquid nitrogen), laser therapy (destroying it with laser beam), and injection (by injecting interpheron alpha) and gently cutting and removing it using specially sterilized instruments. Often the warts on tongue would recur on the same person. Avoid pricking or cutting the warts on your own since this can lead to complications of bleeding. Eat only soft and crushed foods that are soothing to the tongue.

Prevention :

You can prevent developing warts on tongue by wearing condoms while doing oral sex. Alternatively you can apply dental dams to prevent such infection. But even the above methods cannot guarantee total protection. You need to avoid having any type of sexual contact with the person having infection.

Excessive Burping

Excessive Burping Belching is the process of expelling air through the mouth. It occurs normally for all people irrespective of their age and health condition. But for some people it occurs repeatedly in the same day causing embarrassment. When a person swallows too much of air unintentionally the stomach expands for accumulating the air. Eventually excess of air is sent out from the stomach through the mouth causing belching or burping.

Causes :

Number of factors can cause excessive belching. Some people may swallow more air particles while eating quickly or drinking fast. Taking too much of carbonated drinks can also cause belching. Sometimes anxiety can trigger belching when too much of gas is released from the stomach. Newborns and infants are allowed to burp shortly after they finished with feeding since they always drink quickly taking in large amounts of air. They feel comfortable only after expelling excess of air from the stomach.

Some people belch frequently as a habit. For some people it can be due to medical issues like inflammation of the stomach or due to Gastro Esophageal Reflux Disorder (GERD). There are various factors and medical conditions that cause excessive belching. Aerophagia is the process of taking in lots of air involuntarily. Without their knowledge some people swallow excess of air while eating or drinking.

People who talk frequently while eating are prone to more belching than others. People who use chewing gum or candy regularly are likely to swallow excess of air. Drinking beverages that contain carbon, smoking, ill fit dentures and anxiety attack can trigger excessive belching. Having too much of alcohol, carbonated drinks, sugary foods, items rich in starch or fiber can also produce excess of gas causing belching.

Certain foods like cabbage, bananas, broccoli, peas, beans, onions, garlic and cauliflower can cause more gas. Certain drugs given for Type 2 diabetes like acarbose, pain killers like Ibuprofen or naproxen or aspirin and laxatives like sorbitol can cause more gas leading to belching. Certain medical conditions like gastroparesis, gastritis, peptic ulcer, malabsorption, lactose intolerance and certain stomach infections can cause gas and belching. Helicobacter pylori are the bacterium causing inflammation of the soft lining of the stomach which can irritate the cells causing more gas formation. Any ulcers or sores on the stomach or intestine, or on the throat can cause gas.

When to see a doctor? :

Belching is a normal process if it happens occasionally. But people who belch or burp frequently due to heartburn accompanied with abdominal pain should seek medical guidance.

Diagnosis :

Your doctor would order some testing procedures based on your symptoms. If there is abdominal pain while belching he may ask you to undergo ultrasound scan of the stomach and intestine. He would analyze the cause for excessive belching and accordingly proceed with testing process. He may request for abdominal scan, X-ray and CT/MRI scan if necessary to rule out any anomalies.

Treatment :

Your doctor will consider factors like your age, health and list of medications you are currently taking before treating excessive belching. The method of treatment depends on the underlying medical cause or other factors.

Home Remedies :

• You should start eating and drinking slowly. Don’t talk while eating.


• A small walk after eating can help you to expel air easily.


• Lying on your side can help to relieve the excess of gas from the stomach.


• Sit down by bending your knees together and keeping it close to your chest. This position will help you to expel the gas with ease.


• Avoid using chewing gum or candies frequently.

Medical Treatment :

Your doctor will ask you series of questions about your symptoms, eating habits and drinking. He would ask you to maintain a food chart for few days to know the exact reason. If certain foods are causing excessive belching you will have to avoid it in future. If drinking alcohol is the major cause for belching try to reduce your intake. In case if there is inflammation of the stomach he would prescribe suitable medications to treat swelling.

For occasional belching and acidity over the counter antacids can give relief. But for repeated belching you can consult your doctor. If the cause is due to GERD suitable drugs are to be taken regularly and you will be instructed to avoid certain foods that are more acidic. Prolonged belching can affect the normal functions of your digestive system and intestine. Hence you need to know the reason and triggering factors for belching.

Amblyopia

Amblyopia Amblyopia also known as lazy eye is abnormal vision seen in infancy and childhood. Lazy vision is reduced vision that can affect the visual perception of the child. Actually amblyopia is seen in only one eye, but left untreated it can affect total vision also. Amblyopia can cause loss of vision from mild to severe. It is caused due to reduced neuromuscular communication between the brain and the eyes. The brain receives signal from only one eye and reduced weak signal from the other eye. It ignores the weak signal of the affected eye causing lazy eye. Amblyopia can be corrected with eye patches, eyeglasses or lenses. About 2-3% of American children have amblyopia.

Symptoms :

Since amblyopia begins in infancy or childhood, it is difficult to identify. The baby may have wandering eye that moves either inward or outward. If you grab the attention of the infant by showing some objects, the eyes may not focus together. The baby may have reduced perception in one eye.

If you observe any of the above symptoms in your baby you need to consult your doctor immediately. The child may have blurred vision or turned out vision due to crossed eyes. If there is wandering of eyes after few weeks of birth, you can report it to your primary care physician.

Causes :

The major cause of amblyopia is strabismus or crossed eyes. Babies or children having crossed eyes are likely to develop amblyopia. Misalignment of eyes or reduced communication between the brain and eye muscles can be the cause of amblyopia. Imbalanced muscle would prevent the eyes to track the object together.

You can detect this problem by simply closing one eye of the baby with your hand and check if he/she is comfortable in indentifying favorite toy. If the child cries or fusses and not able to complete the task it can be due to amblyopia. Hereditary is another factor for amblyopia which tends to run in families. Deprivation can block the clear vision of the child causing cloudy or blurred vision. Some children can have astigmatism right from birth which is a refractive error. This can cause vision problems.

Risk Factors :

Children born to parents with vision problems are more prone to develop amblyopia than others. Children with low birth weight and those with a family history of vision problem can develop lazy eye. Amblyopia should be treated without any delay; else it can cause permanent loss of vision.

Diagnosis :

Routine physical exam at primary health care center would reveal any abnormality in the eyes of the infant. Wandering eyes is the strong indication of amblyopia. Your ophthalmologist will examine the baby’s eye through a special device or test his eyes by red reflex test. She would check whether the child has strabismus or crossed eyes. Depending on the age of your child, your doctor may conduct suitable test. Infants are tested using moving object, toddlers by reflex test and preschoolers will be asked to read some letters and identify pictures.

Treatment :

Treatment for amblyopia or lazy eye should begin in early childhood depending on the intensity of the problem. For mild vision abnormality, your doctor may suggest corrective eyewear like eyeglasses or contact lenses, if the problem is due to astigmatism. For some children the doctor may recommend eye patches. The child will have to cover the normal (strong) eye with a patch so that weak eye would outgrow the problem of reduced vision gradually. Children above 4 or 5 years can use this method of treatment.

Eye-drops like atropine can be applied on the strong eye which can cause temporary blurring of vision. The weak eye will be stimulated eventually to focus the object correctly. In severe cases, surgery has to be done for correcting lazy eye or amblyopia. Children having cataracts or droopy eyelid are to be surgically operated for correcting the vision. In some cases, combination of two methods would give the best output in few weeks. Any type of treatment will yield positive results, if started in early childhood.

Peritonitis

Peritonitis Peritonitis is a type of fungal infection of the abdominal wall caused by swelling of peritoneum (a soft membrane lining of the stomach). It would cause bloated feeling and abdominal cramps. Peritonitis needs to be treated immediately failing which it can cause complications like organ failure and even death. To prevent any serious complications, it should be treated promptly. It can be treated and controlled by antibiotics and in severe cases it has to be surgically operated.

Symptoms :

Some of the common signs of peritonitis are moderate to severe abdominal pain, tenderness, nausea, vomiting, fever, bloating sensation, diarrhea or inability to pass stool and extreme tiredness. For people who are doing peritoneal dialysis it can cause cloudy fluid and white strands of fibrin during dialysis. If you have severe abdominal pain with problems in passing urine or stool, then you need to seek immediate medical advice.

Causes :

• Any sudden perforation (rupture) of the abdominal wall can cause peritonitis. The soft membrane of the abdomen peritoneum can get broken due to several factors.


• Certain type of medical procedures like peritoneal dialysis can cause perforation in peritoneum. Using poor hygienic instruments during dialysis can cause infection of peritoneum leading to peritonitis.


• It can occur during the process of gastrointestinal surgery.


• Bacteria can easily enter into the peritoneum during the above procedures.


• Pancreatitis can also lead to peritonitis if the bacteria could migrate outside pancreas.


• Any infection in the digestive tract can cause rupture of the abdominal wall causing peritonitis. Any sudden injury to the stomach can cause this condition.


• Certain types of liver disease can cause peritonitis.


• Primary peritonitis is caused by liver cirrhosis and kidney failure.


• Secondary peritonitis can be caused due to pelvic inflammatory disease, Crohn’s disease, diverticulitis, any surgical procedure and trauma.

Risk Factors :

Peritonitis infection can occur to people who undergo peritoneal dialysis. Hence it is necessary to use sterile surgical instruments during dialysis. If left untreated, it can cause sepsis (internal infection) which can lead to organ failure.

Diagnosis :

Your doctor will complete the physical exam and look for the above symptoms. He will collect your medical history and check for cloudy fluid during dialysis in case you are a patient of dialysis therapy. He may order for series of tests including blood profile, peritoneal fluid analysis, and imaging tests like X-ray or CT scan to check the condition of your abdomen.

Treatment :

• Depending on the condition of the patient, he/she may be hospitalized for treating peritonitis infection.


• The doctor will start Intravenous fluids and give suitable antibiotics to prevent the bacterial infection.


• If the condition is critical surgery is done to remove the infected or dead tissue from the abdomen.


• For people who undergo peritoneal dialysis extreme care should be taken to prevent any infection.


• Until the infection heals completely, the dialysis therapy is given through alternative methods.

Prevention :

Take enough steps while doing peritoneal dialysis to maintain proper hygiene. The nurse and surgeon should thoroughly wash their hands before using any catheters. The skin area around the catheter should be cleaned with antiseptic solution. The entire team should use proper sterile instruments during the procedure. It is necessary to take antibiotics prescribed by your doctor in case you have spontaneous peritonitis before due to underlying medical conditions.

Neurosarcoidosis

Neurosarcoidosis Sarcoidosis is described as a peculiar inflammatory disorder affecting the lungs and it occurs mostly between 20-40 years. It can affect many organs in the body since it is caused due to deposits of plaque like substance in the nervous system. Neuro-sarcoidosis is the term given to sarcoidosis that affects the nervous system. Often it affects the facial nerves and cranial nerves like pituitary gland and the hypothalamus.

People who have sarcoidosis have increased risk for developing neurosarcoidosis. Initial symptom of this disease is the Bell’s palsy causing weakness of optical (pertaining to eye) and auditory (ear) nerves. It can develop suddenly and also a slow process. Swelling of nerves can occur in any part of the body like brain or spinal cord or any other part of the nerves. The effects of this disease can be managed by taking corticosteroid drugs.

Causes :

Neurosarcoidosis is a chronic (long term) disorder affecting many organs and system of the body. It can affect particular area of nerves or the spinal cord as a whole. This disease develops due to the deposit of dead cells in the nerves thus disrupting its normal function.

Symptoms :

Muscle weakness in your face is the first symptom of neurosarcoidosis. The nerves of the face muscles can get affected causing intense pain or numbness in these areas. It can cause reduced vision, trouble in hearing and loss of smell and taste if the auditory and optical nerves gets affected. In case if the nervous system of the pituitary gland gets affected it can cause symptoms like excess of thirst, extreme tiredness, changes in menstrual cycle (for women) and increased urine output.

For some people it can cause symptoms like confusion, loss of memory, delirium, dizziness, blurred vision, headache, loss of taste or smell, seizures and stroke. If the peripheral nerves get affected due to this disorder, it can cause loss of sensation or abnormal sensation and reduced movement in particular part of the body.

Diagnosis :

Your doctor will complete physical exam after listening to your symptoms. He may then gather complete medical information and order for series of tests like blood profile, imaging tests like X-ray, CT or MRI scan of the brain. He may also perform lumbar puncture to collect cerebrospinal fluid inside and testing it in the lab. In case of inflammation of nerves the results would show increased levels of angiotensin converting enzyme.

Treatment :

• No clear treatment is available for neurosarcoidosis. The intensity of symptoms can be managed by effective drugs and therapies.


• Drugs that contain corticosteroid are prescribed for controlling swelling of nerves.


• Immunosuppressant drugs are also given for managing the symptoms.


• For people who have muscle weakness in particular part like hands or legs, physiotherapy is given for muscle relaxation.


• TNF alpha inhibitors are given to reduce inflammation of arthritis is effective in treating neurosarcoidosis.

Prognosis :

The outlook of this disease varies from one person to another. Age, health condition and intensity of nerves affected determine the prognosis. For some people the symptoms can be managed with effective doses of medications but for others the disease may progress repeatedly. For severe cases, it can cause permanent disability and even death. With progressive damage done to the brain nerves, there would be increased complications that can be serious.

Prevention :

You cannot totally prevent getting neurosarcoidosis. But if you are diagnosed with sarcoidosis, you need to get intense treatment for the disease so that it does not affect your nerves anymore.

Achilles Tendonitis

Achilles Tendonitis The term ‘Achilles’ refers to the bone surrounded by group of tissues connecting the muscles of the lower leg to your heel. Any injury to the tendon of Achilles can cause inflammation leading to Achilles tendonitis. It is a common phenomenon that occurs in adults who over use this tendon tissues only for a day or two of the week. There are people who play basketball or any kind of sports only on Sundays or weekends. This can cause swelling of tendon causing intense pain. Often the pain can be managed by self care methods but in severe cases the tendon may get rupture inside requiring surgery.

Causes :

• Vigorous practice of sports activities like running or jumping can cause injury of Achilles tendon muscles.


• Participating in a marathon race without any practice can cause injury to the soft muscles and tissues that surrounds the tendon.


• Using poorly fitting shoes and footwear and putting extra tension on the foot muscles can cause inflammation of Achilles tendon.


• Using certain antibiotics like ciprofloxacin can affect the tendon muscles leading to easy rupture of tendon.


• Increasing age can also contribute for Achilles tendonitis since the tendon would become weak with age.

Symptoms :

• Mild to moderate injury of Achilles tendon can cause stiffness and pain. Often the pain reduces when you start walking but sometimes the pain can increase if you perform any vigorous action involving foot muscles.


• It can cause tenderness and swelling of tendon. Palpitation can be felt on the tendon. There would be intense pain while you move the ankle joint.


• Achilles tendonitis can cause mild pain in the lower leg just above the heel portion after you have completed running or any sports activity.


• Some people can feel intense pain after climbing stairs. Morning stiffness is common with this problem which would improve after you start walking.

Who are at risk?

For reasons unknown, men are more prone to develop Achilles tendonitis than women. Elderly people, people with physical problems in their foot, obese people, people who use ill fitting shoes, people who suddenly take part in any sports events, people with certain medical issues like hypertension or diabetes and prolonged use of antibiotics like fluoroquinone can get Achilles tendonitis. In rare cases the tendon can become weak causing internal rupture leading to severe pain that demands surgical correction.

Diagnosis :

Any intense pain on the back of your heel area can be Achilles tendonitis. Your doctor will apply little pressure on the area to feel any swelling or tenderness. He may request for X-ray of tendon or imaging tests like CT/MRI scanning to get accurate picture of the tendon.

Treatment :

Mild form of Achilles tendonitis does not require any treatment. Applying hot pack on the area can give relief from pain and swelling. You can get comfort by taking pain killers like Ibuprofen or naproxen for few days. Your doctor may prescribe strong doses of anti-inflammatory agents and pain killers depending on the symptoms. Physiotherapy exercises like stretching can facilitate healing of muscles and give strength to the injured tendon. Using orthotic instruments like wedge or shoe insert can reduce inflammation of the tendon and relieve extra pressure on it.

Surgery is the option if there is rupture of tendon. Rupture/tear of tendon can occur in any age group but is more particular in old age people. Sports personalities who are taking part in football or running events can develop rupture of tendon. Any injury or sudden fall can cause sudden stretching of tendon leading to rupture. Your surgeon will repair/correct the tendon and you need to take complete rest until the injury heals.

Home Remedies :

• For managing mild pain on the tendon or lower foot area you can try any of the following techniques.


• Avoid doing any exercises for few days so that the inflammation completely heals.


• Apply ice pack on the area for few minutes and this can be repeated soon after you complete exercise or sports.


• Wearing compression bandage on your foot can reduce tension.


• Keep the foot well elevated to reduce swelling.

Prevention :

Don’t start vigorous practice on the very first day. Always increase the duration of activity gradually to prevent sudden inflammation of the tendon. Avoid running in rugged terrain and wear shoes that are comfortable to your heels giving extra cushion. Practice stretching exercises regularly to strengthen your calf muscles.

Social Anxiety Disorder

Social Anxiety Disorder Social anxiety disorder is a problem that originates from the fear of making mistakes. The person with SA disorder will have unreasonable fear that he/she is being watched by others and will develop irrational fear of social situations. These people are always self conscious and worried about being criticized by others. People with SA disorder will often avoid being in social situations and if conditions compel them to take part in social events, they would develop an “anticipatory anxiety” probably weeks or even months before the occasion. They live in the fear of something wrong is going to happen. Many people are fully aware of their irrational fear (which is meaningless) but they don’t have the courage to overcome it.

SA disorder is called as “social phobia” which is linked with other type of mental issues like panic disorder or obsessive compulsive disorder. People with social phobia will have problems in interacting with people, and working in front of others. The fear becomes so intense that it seriously interferes with their routine activities and creates problems in relationships. These people are afraid to do even common things like using public toilet or eating in a restaurant etc. They imagine that somebody would criticize them for their behavior or mistakes and avoid such situations.

Causes :

No one factor can be limited to cause social anxiety disorder. It is caused by multiple factors like psychological, social and biological factors. For some people, SA disorder is hereditary and runs in families. It is believed to occur due to abnormal functions in the brain that is responsible for fear or stressful events.

For some people, SA disorder can develop due to embarrassing events in childhood and humiliating events in society during adolescence. Children with this disorder would have suffered and neglected by peers or bullied by others. Children who are over-protected may not have the opportunity to learn proper social skills and in later stage can develop this disorder.

Symptoms :

Some of the signs and symptoms of SA disorder are given below:-

• Developing intense anxiety while taking part in social situations


• Feeling very self conscious in front of others


• Worried and anxious about particular event even days or weeks before


• Avoid taking part in social events


• Having unreasonable fear of getting criticized


• Having hard time to maintain friendship


• Developing physiological problems like trembling, sweating and blushing, shaking while attending social situations

Social anxiety disorder is ranked 2nd in general anxiety disorders and is ranked 3rd among various types of mental disorders. More than 15 million Americans are believed to have SA disorder. It begins during early childhood or adolescence mostly, but it can develop during adulthood also. More women develop SA disorder than men.

Diagnosis :

A person is said to have SA disorder if he/she has any of the above symptoms in the past 6 months. Parents can observe the behavior of their children in social situations and detect any such activities. Your doctor may conduct some physical tests to rule out any other physical problem. He may refer your child to psychiatrist who will evaluate SA disorder based on designed interview and various assessment tools.

Treatment :

Social Anxiety disorder can be fully treated and cured. But the rate of recovery will be fast if diagnosed in early stages. Your therapist would use a specialized method called cognitive behavior therapy for treating the symptoms. The person will be able to slowly overcome the fear and anxiety with regard to social events and situations. He would create artificial conditions resembling social setup and teach different ways of overcoming his fear. The therapist will also make your child learn social skills.

Medications are recommended to treat people with intense anxiety or depression associated with SA disorder. But you cannot expect results overnight and it may take several months or years to cope with anxiety prone situations. Social phobia can also be treated with monoamine oxidase inhibitor kind of drugs. These drugs can cause side effects and hence you have to visit your doctor regularly to report any changes.

Prognosis :

The outlook for SA disorder is satisfactory. Many people are able to live normal life and take part in social situations after therapy.

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder Post traumatic stress disorder was earlier known as “shell shock” is a serious mental condition that occurs to a person who undergoes or witness a traumatic event. People who experience terrifying event in their life would take some time to overgrow the trauma. But for few people, the symptoms of helplessness, intense fear, flashbacks, nightmares, negative feelings and avoiding social life would continue for years after the event.

Actual cause of PTSD is not known clearly, since not all the people who witness traumatic events in their life are developing this disorder. It is believed to occur due to certain changes in chemical reaction in the brain. The symptoms can be managed with effective medications and therapy. Report indicates that 3.5-4% of Americans have PTSD (about 7.8 million Americans). This disorder can occur to anyone at any age and more women than men suffer from this anxiety disorder.

Symptoms :

Initial symptoms would start anytime after a person experiences traumatic event. The signs and symptoms can be broadly categorized into 4 main streams namely disturbed memories, avoidance, having negative changes in mood and finally change in emotions. Disturbed memories can cause recurrent thoughts about traumatic event, flashbacks, nightmares, upsetting dreams and intense emotional disturbance.

Symptoms of avoidance include avoiding people, avoiding certain places and avoiding thinking or talking about the stressful event. Negative changes in mood and thought can cause guilt feeling, low self esteem, hopelessness, lack of interest and inability to maintain relationships. The person may not remember certain aspects of the event and he may lose interest in important activities.

Changes in emotions can cause difficulty in sleeping, concentrating, guilt feeling, and trouble in remembering and concentrating, always expecting some danger and engaging in self destructive behavior. The person may get frightened easily even by small events. The intensity of symptoms may not be the same for all. The memories would become severe when the person is stressed or witness certain events that remind them about the past. Children with PTSD at young ages can have delayed development of motor skills.

Causes :

PTSD is classified as an anxiety disorder affecting certain people who witness terrifying event or undergo increased stress. A child who is sexually abused for prolonged period may develop PTSD. An individual who witness gruesome accident, who is in part of personal assault, who sees violent deaths of loved ones and military combat can develop this disorder.

People who are held as captives by terrorists and those who are part of natural disasters can have high risk of developing traumatic disorder. Symptoms can begin shortly within weeks but for some people it might take months or years also. PTSD is believed to occur due to inherited mental aspects of your personality and the response of your body to stressful events and changes in chemical reaction in your brain.

Who are at Risk?

• Military personnel and people facing prolonged physical or mental abuse are at high risk of developing PTSD.


• People who lack good family system and grow up in neglected childhood have increased chance of getting this disorder.


• You are at risk of getting this problem if you have family history of anxiety disorder or other mental health problem.


• People who are involved in natural disasters like flood, earthquake and who witness’s accident or plane crash may develop PTSD.


• As such PTSD can cause complications like depression, anxiety and emotional disturbance if not treated. It can cause complications like developing addiction to alcohol or substance and increased suicidal thoughts.

Diagnosis :

PTSD can be detected based on symptoms. Your doctor will refer the case to a psychologist who will evaluate the disorder by asking series of questions. She would ask you about the traumatic events in your life. According to the Diagnostic and Statistical Manual of psychiatric disorders, a person is said to have PTSD if he/she has some of the above mentioned symptoms for more than a month or two. For some people it can cause great distress and make them unable to carry on with daily tasks.

Treatment :

The main purpose of treating PTSD is to help the person to overcome the stress caused by traumatic event or experience. Based on the severity of the symptoms, the person will be given psychotherapy and medications.

• Psychotherapy :

Cognitive behavior therapy can help the person to change his thought patterns and manage his feelings and emotions caused by trauma. Exposure therapy is one in which the therapist will take the person through artificially created traumatic experience and teach him to confront the fear. Many approaches like psychodynamic therapy, family and group therapy are used to change the behavior of the person effectively and to remove the distress caused by traumatic experience.

• Medications :

Antidepressants like sertraline or paroxetine are prescribed for relieving symptoms of anxiety and depression. Anti anxiety drugs can help the person to overcome stress and improve his sleeping pattern. Prazosin is an effective drug used to control nightmares and relieve the symptoms of PTSD. You need to consult your doctor about the side effects of these medications and follow his instructions and usage and dose.

Discuss with your doctor and therapist freely about PTSD. Stick on to your treatment plan even if you feel better and continue taking medications till your doctor says to stop them. Do regular exercise and eat healthy diet. Get in touch with your family and friends and share your feelings. You can also join a support group to get ideas about their coping strategies.

Many of us would confront with traumatic experience in life, but not all of us develop symptoms of PTSD. You will be able to come out of it within few days. Do not delay in getting treatment if you feel that you are not able to overcome the stress caused by traumatic experience. The more you delay the treatment, the more will be the severity of symptoms of PTSD.

Prognosis :

In most of the cases, recovery is possible but it can take some time since it is a gradual process. You cannot totally forget the event but you can manage to carry on with life with well developed coping methods.

Stuttering

Stuttering Stuttering is a disorder that affects the quality of speech. It is a speech disorder that causes significant problems with the delivery of speech. People with stuttering disorder may repeat the same word or prolong a word or phrase during their speech. Stuttering problem is common among young children when they learn to speak. With proper training it can be overgrown during the course of development.

Stammering or stuttering disorder can become chronic (lifelong) for some people and it can affect their self esteem also. Stress or anxiety can worsen the stuttering symptoms. Stuttering can be managed by speech language therapy and individual counseling and behavior therapy. Stuttering can be related to social anxiety disorder also.

Symptoms :

Children or adults affected with stuttering disorder will have difficulty in starting a word or sentence. They would repeat particular syllable or word frequently. They would prolong a word or sound for few seconds. Some people would abruptly stop while talking and others would add extra words before moving to next word. It may cause tightness of muscle on the face, facial tics, rapid blinking of eye and mild tremors on their lips. These symptoms may worsen if they are stressed or tired. Due to stuttering some people may develop anxiety while talking and avoid situations that warrant talking to strangers. Casual talking on the phone can cause significant problem for them.

Causes :

Exact cause of stuttering disorder is not known. It is believed to be caused by various factors like genetics (due to abnormalities in genes), defect in speech motor control, and certain medical conditions like stroke or trauma and due to rare mental health issues.

Risk Factors :

A person having close relatives who stutter, a child with delayed development increases the risk factor for stuttering. Males are more prone to develop stuttering than females, for reasons unknown.

Diagnosis :

Parents can observe their children while talking to check if they are stuttering. You can ask him to read aloud to detect any difference in speech. Young children would have problems in talking during the stage of learning to speak and you need to worry only if it is long term. Doctors would ask series of questions about their relationships, work and attitude for adults who stutter. They would find out if there is any mental health issues involved.

Treatment :

Combination of various methods is used for treating stuttering disorder. One method may be effective for one person and not for others. Experts would give therapy to talk slowly using controlled fluency method. You can make use of electronic devices while speaking that would help in slowing your speech to prevent stuttering. Cognitive behavior therapy CBT is helpful to change the way you think and behave. This is very useful in resolving situations of stress and anxiety.

Parents can identify which method is suitable for their child and follow it effectively to improve his speech. Encourage your child and praise him which helps in growing his self esteem. Don’t criticize your child because he stutters while talking since this would affect his overall development. You try to accept what he is and find out ways to improve his performance.

Narcolepsy

Narcolepsy Narcolepsy is a long-term neurological disorder that affects your quality of sleep. It can interrupt with wakefulness and control of sleep causing daytime drowsiness. People with narcolepsy disorder may find it difficult to stay awake for long periods during day time. Severe cases of narcolepsy can interfere with your normal routine. Narcolepsy is not related to depression, fainting or lack of sleep but it is a sleep disorder that causes sudden spells of sleep, irrespective of circumstances.

Some people may fall asleep suddenly during any time of the day and they would not have control over it. They go to sleep even during work-time while doing any activity or urgent task. Narcolepsy cannot be cured and often it is chronic. Medications and lifestyle modifications can help you overcome daytime sleepiness.

Causes :

Narcolepsy is believed to be caused by genetic factors. Certain genes are responsible for managing the release of chemicals in the brain that induces sleep. Low level of hypocretin (neuro chemical) in the brain can cause narcolepsy disorder. Certain abnormalities in the brain can affect the normal sleeping pattern. Under normal conditions, people fall asleep with NREM pattern during which there will not be rapid eye movement.

This is followed by deep sleep and finally it ends with REM (rapid eye movement) phase. It is during this phase, one would get dreams and makes muscle movement. However, people with narcolepsy would directly go into REM sleep without having NREM stage. This process occurs at any time of the day or night.

Symptoms :

People with narcolepsy would fall asleep at any time, irrespective of the time and circumstances. It can cause excessive daytime sleepiness which can interfere with routine activities. Daytime sleepiness (excessive) is the first symptom of narcolepsy which may be misunderstood for other illnesses. They may experience lack of concentration, confusion, lapse of memory and fatigue. In some people, it can cause cataplexy, a condition of loss of muscle control. Sudden lapse might occur in muscle tone causing slurred speech, imbalance while walking and sometimes body collapse. Strong emotions may trigger cataplexy condition causing abrupt loss of muscle control.

They might have delusions (seeing objects that are non-existing) and it differs widely from one person to the other. Narcolepsy can cause sleep paralysis for short time making them unable to speak or move suddenly. This condition occurs during the stage of falling asleep or while waking up from sleep. But this may last only for few seconds to minutes and soon they will recover fully. Narcolepsy may occur at any age, but it often begins between 10-25 years. People with narcolepsy disorder may have related sleep problems like sleep apnea, insomnia and restless leg syndrome.

Diagnosis :

Your doctor would observe for sudden loss of control on muscle tone and excess of daytime sleepiness. He may request for special tests for assessing your sleep history for which you may have to stay at sleep center overnight. Team of trained professionals would observe your sleeping pattern. Polysomnogram test would be done for studying the electrical activity of the brain when you are asleep. If necessary, sleep latency test and hypocretin test would be done to measure hypocretin.

Treatment :

Narcolepsy cannot be cured and in most of the cases it is chronic (long term) disorder. Medications are given to manage the intensity of symptoms. For people who have problems in staying awake during daytime, stimulants like Provigil or Nuvigil are given. It acts directly on the central nervous system helping them to reduce the episodes of daytime sleepiness.

Amphetamines like concerta or Ritalin are effective in treating the symptoms of narcolepsy. But it can cause adverse effects. SSRI inhibitors like fluoxetine or venlafaxine are prescribed to suppress the sudden REM (rapid eye movement) sleep. Antidepressants like imipramine or protiptyline are given to control the effects of cataplexy, but it may cause side effects. Some doctors prescribe xyrem for managing daytime sleepiness and to improve quality sleep during night. You need to consult your doctor if you observe any changes since it can interfere with other medications also.

Home Remedies :

You need to stick on to your schedule on all the days by going to sleep at the same time and waking up at fixed time. You can explain your condition to your office and take short naps during the course of the day. This would considerably reduce your daytime sleepiness. Avoid using alcohol since it may worsen your symptoms and intensify drowsiness.

Do regular exercise which can help you to stay awake during daytime. If you are planning to drive long, it is better to have your friend by your side since in spite of taking medications you may feel sleepy. Stop driving if you are feeling sleepy or drowsy by taking a break for half-an-hour. By discussing your problem with your friends and family you can carry out your daily routine.

Couvade Syndrome

Couvade Syndrome Couvade syndrome is a strange condition in which the would-be father experience some of the symptoms associated with pregnancy. It is also known as sympathetic pregnancy wherein the husband would have the feelings of expectant mother and experience similar symptoms and behavior. Some of the common symptoms of this syndrome are alteration in hormone levels, vomiting, morning sickness and increase in weight. In reality Couvade syndrome is not a medical condition but is considered to be psychosomatic disorder.

Symptoms :

The signs and symptoms of Couvade syndrome is typical of the symptoms experienced by pregnant women during her pregnancy. The expectant father would show signs of nausea, morning sickness, heartburn, weight gain, bloating, abdominal cramps, backaches and leg pain. He may also experience genital irritations that are common during the term of pregnancy. In addition he may also have disturbance in sleep, anxiety and depression feelings and reduced sex drive.

It would be exciting to know for a man that he would father a child very soon. These feelings would induce emotions and bring changes in certain enzymes causing hormonal imbalance. These symptoms can be attributed to the stress that is caused due to fatherhood. There are men who had developed cravings for food and even breast augmentation like pregnant women.

Causes :

• Some expectant fathers are so anxious of becoming father which may induce physiological symptoms mentioned above.


• They are worried about the expected life change and start eating more gaining more weight.


• Psychological theory explains Couvade syndrome as feeling empathetic for the expectant mother. Mood swings can occur due to hormonal changes when a man starts secreting more of estrogen than testosterone.


• Till now, there is no medical theory to explain this phenomenon.


• Increased stress and anxiety may produce chemicals in the body causing sympathetic pregnancy.

Who are at risk?

Any man who is more concerned for his wife and developing fetus may develop Couvade syndrome. But this is more common in men who have come a long way facing fertility problems and pregnancy loss than others.

Diagnosis :

No special tests are needed to detect Couvade syndrome. It can develop in men who are expecting fatherhood and have more concerns about wife and child.

Treatment :

Couvade syndrome needs no treatment and is only temporary. Once the expecting mother delivers the child all the symptoms of the father would resolve spontaneously. Only in rare cases symptoms of fatigue and bloated stomach may continue after child-birth. This can be due to change in hormone levels and can be dealt with medical help. Counseling for the couple will help to reduce anxiety during the term of pregnancy.

Dubowitz Syndrome

Dubowitz Syndrome Dubowitz syndrome was first identified by Dr. Victor Dubowitz which is a rare genetic disorder. Only few hundred people have developed this syndrome around the globe. This disorder is related to retarded development and stunted growth of the child both before and after birth. It is marked with distinct features of short stature, unusual facial features and small head. Children with Dubowitz syndrome are likely to have some extent of mental retardation. Only certain traits of this disorder can be treated and other features cannot be repaired.

Symptoms :

Children born with Dubowitz syndrome have retarded growth and are short in stature. Their muscles and bone will not grow normally and they have distinct facial features with small head (microcephaly). Such children may develop various skin problems including eczema and their mental growth can also be affected due to this syndrome.

Initial symptoms can be detected in the fetus and also after birth. These children would have under-developed bones, drooping eyelids, lateral eyebrows with long distance between the eyes. They might also have some behavioral problems and they are often shy and stubborn in character. The growth of multiple organs can be affected. Such children have low birth weight and short attention span. Having eye abnormalities are quite common in children with this disorder.

Causes :

Dubowitz syndrome is genetic and caused by autosomal recessive pattern of genes inherited by birth. Both the parents should have mutated genes in them to pass it on to their child. Parents with one child having this syndrome have increased chance to have their next child also affected. Dubowitz syndrome is a rare disorder in which children are born with defective genes affecting normal growth.

Diagnosis :

The doctor can identify children with this syndrome by mere physical examination. Diagnosis can be made even during prenatal scanning.

Treatment :

• Since it is a genetic problem nothing can be done for marked facial features and stunted growth.


• Certain problems like skin itching, chronic constipation and allergies can be controlled using effective medications.


• Experts from various medical fields should work together to manage and repair the obvious symptoms.


• For instance cardiovascular problems and optical issues can be repaired and corrected by surgery.


• Lifespan of affected child would be normal.


• Prognosis of each case is different and depends on the severity of the congenital abnormalities inherited by birth.

Adenocarcinoma

Adenocarcinoma Adenocarcinoma is the cancer that affects the glandular tissue of your body. The term “adeno” refers to gland and “carcinoma” means cancer. The cells of the body would multiply in disciplined manner. Old cells would die after some days which are replenished with newer cells. But in some cases, old cells will not die and more and more new cells are formed. This abnormal cell formation leads to cancer.

Glandular tissue is present throughout the body and very often adenocarcinoma affects the epithelial cells, interfering with its normal secretion. Though adenocarcinoma can occur anywhere on the body, it commonly occurs in lungs and colon. Other organs like cervix, stomach, pancreas and thyroid gland can also develop adenocarcinoma. Some types of gland tumors like insulinoma or vipoma are not considered as adenocarcinoma but they are neuroendocrine tumors.

Types :

• Mucus secreting glands are affected with adenocarcinoma.


• Among all other types of lung cancer, adenocarcinoma is the most common one.


• Adeonocarcinoma can develop in prostate glands and almost all the prostate cancers arise due to adenocarcinoma.


• Cancer that occurs in exocrine pancreas is of adenocarcinomas type. Often they develop in pancreatic ducts.


• Esophagus has number of glandular cells that are prone to develop adenocarcinoma.


• Similarly cancers that occur in the colon or rectum belong to adenocarcinoma type.

Causes :

Exact cause of adenocarcinoma is not known. But it develops due to overcrowding of older cells upon which newer cells start growing forming a mass or tumor.

Diagnosis :

Your doctor will use different set of diagnostic procedures for detecting adenocarcinoma based on the part that is affected. Some of the common tests used for detecting adenocarcinoma are CT scan, MRI scan and biopsy.

Treatment :

Treatment approach differs in accordance with the size and location of cancer in the body. Surgical removal of the tumor from the glandular tissue is done in many cases. In this process some part of healthy tissues are also removed. At present non-invasive surgeries are used to reduce the chance of infection and to speed up the process of healing.

Chemotherapy is given either through medications or injection to destroy cancer causing cells. Often chemo is combined with surgery or radiation therapy. Radiation therapy is typically combined before or after surgery or along with chemotherapy.

Lupus Rash

Lupus Rash Lupus rash is a type of autoimmune disorder in which the body’s own immune system will attack and destroy tissues and organs. Inflammation of the skin occurs in many parts of the body affecting every joint. Lupus rash is characterized by the presence of distinctive rashes on the face resembling a butterfly. The shape of the rash may be similar to that of the wings of the butterfly and is present on both the cheeks.

Most of the cases diagnosed with lupus will not have any major problem except for minor discomfort. In rare cases, lupus can affect vital organs significantly causing lifelong disability. It can impair the functions of kidneys, brain and even the heart making life more serious. There is no specific treatment for lupus rash but the symptoms can be managed by effective medications.

Types :

Two kinds of lupus rash are being recognized :

One is discoid lupus DLE and it affects the skin that is overly exposed to powerful ultra violet rays of the sun. It causes skin lesions and leaves scars on the surface of the skin after it has healed completely.

Second type of lupus is systemic lupus erythematosus which is very serious. It can affect the functions of internal organs and it produces the distinctive symptom of butterfly shaped rashes on the cheeks. The connective tissues of the various joints and muscles are badly damaged and in some cases it can also affect the membranes of the lungs and heart and even the brain. It will not spare blood vessels also. This type can cause painful lesions on the skin more on the fingers. The normal blood flow to the extremities can get seriously affected causing numbness on the toes and fingers.

Symptoms :

An individual affected with lupus rash may not have the same signs like that of other person. The symptoms may flare on certain periods and remission follows immediately. The intensity of the symptom can vary certainly on the extent of weakened immunity and also on the part of the body which has been affected.

Some of the common signs of lupus rash are fever, joint pain, stiffness on the joints, butterfly shaped rashes on the cheeks, lesions on the skin, pain on the fingers and toes (more during winter time) and fatigue. They become extremely sensitive to sunlight and can cause unexplained weight loss. It can cause chest pain, painful sores on the mouth and throat and enlargement of lymph nodes on the throat and mouth. Some people may get severe headache, loss of memory and confusion of thoughts if the brain tissues are affected by lupus.

Causes :

Exact cause of lupus remains a mystery. It is an autoimmune disease in which the body’s immune system will attack its own tissues and muscles. It can be due to hormone imbalance, genetic factor and also due to environmental factor. An individual with a history of lupus rash from his parents is predisposed for inheriting this disorder.

A person who is overly exposed to sunlight can develop lupus rash. Similarly a person who is consuming neurological medications for managing seizure can also get lupus. Lupus affects more number of women than men for reasons unknown. People who are in the age group of 15-40 years have increased risk for developing lupus. This disease is common in certain race like Hispanics, African American and Asians.

Complications :

In severe cases, lupus can infect the kidneys leading to renal failure. In some cases, the tissues surrounding the brain are affected causing various brain related problems. Lung inflammation is common among people who have lupus rash for long period. Having lupus rash for long time puts you under high risk for getting various infectious diseases and even cancer. Pregnant women suffering from lupus can develop complications of preterm birth.

Diagnosis :

It is difficult to diagnose lupus rash since the symptoms are vague and similar to other diseases. After considering the symptoms of the patient, the doctor may order for complete blood test for measuring the RBC, WBC and platelets. It is useful for find the erythrocyte sedimentation rate.

He would also check whether the kidney and liver functions are normal to ensure that lupus has not affected any vital organ. Increased level of protein in urine indicates lupus has affected kidneys. Your doctor may also ask for imaging tests like X-ray of the chest to rule out lung inflammation and for Echo to assess the function of the heart.

Treatment :

The mode of treatment is not the same for all people affected with lupus rash. Your doctor will decide the course of treatment depending on the intensity of the symptoms and your health condition. Anti-inflammatory medications (non-steroid) like Ibuprofen or naproxen is prescribed for getting relief from pain and fever. Hydroxychloroquine is also a good medicine for controlling lupus.

For more severe cases, corticosteroids are prescribed but this would produce some undesirable effects if continued for long term. Since the disease is caused by weakened immunity immunosuppressant like cytoxan, imuran and arava are prescribed.

Pictures of Lupus Rash :

Images, Pics, Pictures and Photos of Lupus Rash

Lifestyle Changes :

Lupus rash is not a simple disease that can be managed overnight. It takes enough time for the medications to control the symptoms. Flaring and remissions are common with lupus and hence one has to bear with it. Get enough rest as and when you require it since you may become extremely tired due to weakened immunity. Avoid going out in hot sun since it can worsen your skin condition. Eat a well balanced diet and do regular exercises to get enough strength to fight the disease.

Some people are using alternative medicine like flaxseed, fish-oil and dehydro-epiandro-sterone for managing flare-ups. It may be a shock to know that you have lupus, but try to understand that you are not alone. Know more information about the disease and identify the period of remissions and flare-ups. Find a support group and stay connected with them.

Fissured Tongue

Fissured Tongue Fissured tongue is characterized by the presence of cracks or grooves on the upper portion of the tongue. This is called lingua plicata or scrotal tongue in medical terms and this condition is harmless. Often, the cracks are seen on the top of the tongue and sometimes on the sides. These grooves can vary in depth and length and some may be very deep and others may be elongated in shape. In some people there can be various partitions on the grooves thus dividing the entire tongue into many grooves and lobes. Fissures on the tongue are usually harmless and in rare cases it can get infected if debris builds on it.

Who are at risk?

About 5% of the people may develop a fissured tongue. Men are more likely to have fissured tongue than women. It is believed to run in families and can be genetic.

Causes :

Exact cause of fissured tongue is not known. But it is considered to develop due to certain conditions or diseases like Down’s syndrome or Melkersson Rosenthal syndrome. In both these cases, the children will have fissured tongue along with facial swelling or paralysis on the face. In children with benign migratory glossitis this condition can develop.

It can occur due to injury or trauma to the tongue or due to teeth grinding. Swelling or inflammation on the tongue can cause mild cracks on the tongue. The tongue can get irritated due to repeated consumption of tobacco or alcohol and develops fissures gradually. It can occur due to allergic reactions, reflux disease or in rare cases due to tongue cancer.

Symptoms :

Presence of grooves or cracks on the tongue is characteristic marks of fissured tongue. The tongue may be separated into many sections or lobes by fissured tongue. Individuals with geographic tongue may not have the regular papillae or raised bumps on the tongue. Their tongue will resemble the geographic map having contours.

Diagnosis :

Your doctor can easily detect fissured tongue by mere examination of the tongue.

Pictures of Fissured Tongue :

Images, Pics, Pictures and Photos of Fissured Tongue

Treatment :

No treatment is required in most of the cases having fissured tongue. You can gently brush the tongue using soft toothbrush for removing the built-in debris. In case there is pain in the cracks, you can visit your dentist. Over the counter pain-killers are effective in giving relief from pain. Avoid eating spicy or hot foods which may worsen the grooves and inflammation.

Brush your tongue properly and practice good hygiene. Bacteria can accumulate on the cracks causing infection and hence remove the leftover food particles on the fissured tongue by cleaning it regularly. Fissured tongue is harmless and may not cause any problem unless it is attacked by bacteria.

Reactive Arthritis

Reactive Arthritis Arthritis refers to swollen joints. Reactive arthritis is the condition in which inflammation of genital parts or gastro intestinal systems take place. It often develops after a person had genital infection or problems in bowel movement. The symptoms of reactive arthritis are similar to that of psoriatic arthritis and ulcerative colitis. This condition can occur in any part of the joint but often affects the eyes, mouth and the urinary tract. In rare cases it can infect the heart. Treatment is given for reducing the intensity of stiffness in the joints.

Reactive arthritis is marked by three conditions namely :

• Inflammation of joints


• Swelling of eyes or conjunctivitis


• Inflammation of urinary and genitals and gastrointestine

This disease was also known as ‘Reiter’s syndrome’ in olden days. This type of chronic arthritis affects the people of age group 30-40 years largely but can occur in any age group.

Symptoms :

The signs of reactive arthritis occur often after an infection. The initial symptoms can occur anywhere from 1-3 weeks of urinary or eye infection. There will be intense joint pain due to swelling of joints in the knees and ankles. Some people may develop joint inflammation on the lower back. Swelling of eyes is common in reactive arthritis. Many people will develop urinary problems and there will be compulsive urge for urinating frequently. The extremities are swollen and there will be difficulty in writing and walking.

Causes :

Exact cause of arthritis is unknown. It is believed to be autoimmune disorder. People who are frequently infected have increased chance of getting reactive arthritis. Genetics play a role in causing this disease. The presence of HLA B27 genes is indicative of developing this disease in later ages. Bacterial infection can cause reactive arthritis. It can be caused by Chalmydia, shigella or salmonella bacterium.

Though this disease is not contagious still there is every chance for contacting it through unsafe sex. Chlamydia trachomatis is the bacterium causing venereal infections which is followed by reactive arthritis in many cases. An individual with infectious dysentery can develop this problem after few weeks of infection.

Risk Factors :

For reasons not known, men are more prone to develop reactive arthritis than women. People with HLA B27 genes inherited from parents have increased risk. A person having sex with multiple partners and having dysentery infection often have more chance for getting reactive arthritis.

Diagnosis :

The doctor may physically examine the body to check the signs of warmth and swelling. He may request for blood test and joint fluid test for confirming his diagnoses. A thin needle is inserted to the inflamed joint to draw sample of fluid for testing the WBC and infectious organisms.

Treatment :

No specific medications are available for treating reactive arthritis. But drugs are helpful to manage joint pain and further inflammation. Antibiotics are prescribed for controlling bacterial infection. Nonsteroidal anti inflammatory drugs like Indocin is given for getting quick relief from joint pain. For severe pain corticosteroid is injected directly into the joints which will considerably reduce swelling.

Stiffness of joint can be reduced by rheumatoid arthritis medications like sulfasalazine or methotrexate drugs. Regular physiotherapy can make mobility easier for people affected with joint pain. Practicing strengthening exercise will give flexibility to joint muscles and reduce stiffness. People with autoimmune disorder like AIDS and severe viral infections have to be more precautious than others. Eye inflammation or conjunctivitis is treated with suitable anti-inflammatory eye drops.

Prevention :

You cannot do anything to prevent reactive arthritis. But you can always reduce the chance of getting bacterial and viral infection. Practice safe sex and always wear condoms while having sex with strangers. Eat healthy foods and fully cooked stuff to prevent bacterial infection. Do not send your child to school or day care center if he has developed dysentery since infection can spread to other children.

Astigmatism

Astigmatism Astigmatism is a mild imperfection in your eyes that can cause mild vision problems. It can easily be corrected by wearing contact lenses, eyeglasses or through surgery. It occurs due to minor imperfection in the curvature of the eyes. A person having astigmatism will have slightly different curvature in one or both of his eyes. The curvature may not be smooth in all the sides in the cornea. For some people it occurs if the eye is not fully in round shape having slight difference in corners or on one side.

How it occurs?

Eyes are normally round shaped resembling a sphere. On seeing an object, the light enters the eye and by reflection it creates an image of the object in the lens thus giving clear view of the object. But a person with astigmatism the reflection may not be even causing blurry images or wavy images of the object.

Symptoms :

Blurred vision, trouble in seeing distant objects, strain on the affect eye/eyes, and headaches are some of the indicators of astigmatism. If you have any of the above symptoms or if your vision is not clear as before or if you have trouble reading/writing then it is time for you to get your eyes tested with the doctor.

Risk Factors :

People who are above 50 years, people with diabetes (for long period), and people with high blood pressure are more prone to develop astigmatism than others. There will be some degree of astigmatism for all the persons who have crossed 40 years.

Causes :

Astigmatism occurs when the cornea is not evenly shaped leading to refractive error. When there is smooth curvature then the image will be perfectly shaped. But if the surface curvature is not smooth or bent on one side then it produces distortive image. An individual with astigmatism will have cornea that is not smoothly curved causing uneven focus producing refractive error.

Astigmatism can occur along with other errors like myopia and hyperopia. In the case of myopia (nearsightedness) the cornea is curved in excess which causes the light to be focused in front portion of the retina (not exactly on the retina) causing blurry vision. In the case of hyperopia (farsightedness) the cornea is curved very little causing focus on the back of the eyes. In most of the cases astigmatism is present from birth and not caused by watching television (for long periods) or by reading in poor light.

Diagnosis :

Your ophthalmologist will check for the above symptoms and conduct simple vision test or examine your eyes in special device called keratometer. She will study the nature of curvature of the cornea or the lens thoroughly. Retinoscopy is done to measure the extent of focusing light by the eyes and to assess the degree of refractive error in your eyes.

Treatment :

Depending on the nature of refractive error special eyeglasses or corrective lenses are prescribed. By wearing lenses the improper focus is corrected thereby giving a clear image of the object. Eyeglasses made of special lenses are given for correcting the uneven shape of the cornea. This would also help in correcting the refractive error.

Many people prefer to wear contact lenses in the place of eyeglasses and it comes in wide range of options. You can discuss with your doctor about the benefits of wearing contact lenses. But using lenses for long periods can makes one prone to eye infection.

Surgery :

Refractive surgery is done for reshaping the cornea of the eyes. Lasik surgery is done using a special instrument for making a small round shaped hinge is made in the cornea. The surgeon will gently resize the shape of the cornea in this procedure. Not all the people having astigmatism will have to undergo surgery. Your doctor will try different options for correcting the cornea shape before deciding on refractive surgery.

Spinal Meningitis

Spinal Meningitis The brain and the spinal cord are surrounded by soft membranes to protect the inner tissues. Spinal meningitis occurs when these membranes get swollen due to some reason and develops inflammation. An important feature of meningitis is high fever with a stiff neck. Meningitis is caused by viral infection or fungal infection. The disease can be treated by medications and early intervention but sometimes it can be serious and life threatening.

Symptoms :

Early signs of meningitis will be high fever or flu like symptoms. For this reason many people fail to recognize the disease leading to complications. Meningitis symptoms can develop within hours or few days depending on the intensity of infection.

Some of the important signs of spinal meningitis are:

• Stiffness in neck region


• High fever (occurs suddenly)


• Muscle spasm, joint pain and more intense pain in spine region


• Difficulty in concentrating or confusion of thoughts


• Extreme tiredness


• Severe headache/nausea/vomiting


• Trouble in getting quality sleep and difficulty in waking up

In some cases, the affected person may get sudden seizures or skin rashes and he becomes sensitive to light.Spinal meningitis may develop in infants and newborns also. If the infant develops sudden high fever accompanied with stiff neck then you must rush to the doctor immediately.

Some infants will have symptoms like excess of sleepiness, inactivity, trouble in feeding and constant crying with irritation. In some cases a soft bulging may appear on the baby’s head and it has great discomfort.When compared with bacterial meningitis, viral meningitis is better since the symptoms can improve even without treatment. Delay in taking treatment can cause complications or severe brain damage. In severe cases meningitis can cause death.

Causes :

Meningitis can be caused by viral or bacterial infection. Bacterial infection is more serious and life threatening than viral infection.

Bacterial Infection :

Bacteria can enter the bloodstream through ear/sinus infection or sometimes it can directly attack the meninges (membranes that envelops the brain/spinal cord) causing infection. Streptococcus pneumoniae (which causes ear infection/throat infection), Neisseria meningitides (that cause respiratory infection), Haemophilus influenzae Type B and Listeria monocytogenes (present in hot dogs and cheese) are some of the bacterium that causes spinal meningitis.

Viral Meningitis :

Viral meningitis is often mild and symptoms can improve on their own. Enteroviruses are often responsible for causing spinal infection. Herpes simplex virus, West Nile virus and mumps are some of the viral infections that cause meningitis. Chronic meningitis can develop when the organisms invade the cerebrospinal fluid. Acute form of meningitis can develop suddenly but chronic form may take weeks together. In rare cases fungus can cause meningitis. Sometimes strong drug allergy, chemical reactions and other infectious diseases can cause spinal meningitis.

Who are at risk?

A child who skips his scheduled vaccine may develop meningitis in later ages. Infants and newborns are prone to bacterial infections at high rate. Individual living in community setting like that of military camps, dormitories, boarding schools or colleges have increased risk of developing contagious meningococcal meningitis. Pregnant women (with weakened immunity) have risk of developing listeriosis leading to meningitis.

In general, people with weakened immunity are vulnerable to many diseases including meningitis. Meningitis can cause various complications if not given proper treatment in time. Some of them may develop hearing loss, brain damage, learning disability, seizure and various other brain damage.

Diagnosis :

The doctor will look for the above symptoms and check for ear/nose/throat infections and skin rashes. Since the symptoms of meningitis are confusing it is difficult to detect spinal meningitis. He may order for blood profile to detect growth of micro-organisms, imaging tests (like X-ray, CT scan), and lumbar puncture. He would collect small amount of cerebrospinal fluid from the spine using spinal tap procedure and test it in the laboratory. Any abnormal increase in the WBC count can be due to meningitis. To diagnose viral meningitis your doctor may request for polymerase chain reaction test.

Treatment :

Firstly the doctor should make sure about the type of microorganisms that has caused meningitis. The treatment may vary depending on the infection the person/child has. Antibiotics are prescribed for treating bacterial meningitis. In severe infection, your doctor may give steroid medications (in high doses) and taper it slowly. The root cause of bacterial infection like ear infection or sinus should be treated.

Viral infections cannot be treated with antibiotics and the symptoms will improve within a week. Simple home remedies like drinking plenty of fluids and taking complete rest can give some relief. In severe cases, antiviral medications are prescribed. Antifungal drugs are given for meningitis caused by fungus.

Prevention :

Meningitis develops through infections and hence one should always practice good hygiene both at home and at workplace. Children should be instructed to wash the hands thoroughly before they eat and after using toilet. Avoid sharing foods and personal items with others. Cover your mouth while sneezing.

Vaccinations are available to prevent bacterial meningitis. Do not skip the doses of vaccination and follow instructions of your pediatrician for your children. Meningococcal conjugate vaccine is given in single dose for children of 11-12 years followed by booster shot at 16 years.

Psoriatic Arthritis

Psoriatic Arthritis Psoriatic arthritis is a condition associated with arthritis (inflammation of joints) where people will develop small red patches on the skin causing stiffness and swelling of joints. Often psoriasis develops first and after few days arthritis may develop but for some people initially they develop arthritis, a chronic inflammatory condition of joints and later they develop skin rashes on it.

This condition can affect any joints and even the fingertips causing severe pain. This disease will have remission period followed by flares. Treatment can be given for managing the symptoms but the disease cannot be cured completely.

Symptoms :

Psoriatic arthritis is a chronic disease where people may have flare-ups (symptoms worsen) and remission (symptoms disappear). Very often the joints on one side of your body get affected. It can affect any joints of the body causing inflammation and pain. This disease is characterized by swollen extremities. The fingers and toes become swollen causing severe pain. The affected person will have difficulty in lifting objects using fingers and may have problems with simple task of writing their names.

For some people there will be back pain (inflammation of joints of the spine) and foot pain affecting the ligaments of the heel and soles of the foot. Due to this the mobility of the person gets affected. The joints become rigid and stiff due to swelling giving intense pain while movement. In many cases, the stiffness is very severe in the mornings which may reduce in the afternoon. The symptoms can be mild to severe depending on the intensity of the disease. For some people it may take months together for showing initial symptoms but for others it can be quick and severe.

Causes :

The main cause for psoriatic arthritis is weakened immunity. The body’s immune system will attack the joints and tendons by mistake causing inflammation and pain. However it is still not clear what exactly triggers the immune system for self-attack. People with family history of psoriasis or rheumatoid arthritis are likely to develop this disease. It is possible that physical injury on the joints or bacterial infection (left untreated) can trigger this condition.

Risk Factors :

People having family history of psoriatic arthritis, people having psoriasis with weakened immunity, and people who are in the middle age are prone to develop this disease.

Diagnosis :

Your doctor will look for the symptoms and check the joints for inflammation. He may do a biopsy by removing a small tissue from the joints and testing it in the lab.

Treatment :

There is no cure for psoriatic arthritis and it is a chronic condition. Medications are given to lessen the joint pain and for facilitating the mobility problem. NSAID drugs like Advil or naproxen sodium are given to reduce inflammation of the joints. But long term use of these drugs can cause side effects. Anti-rheumatic drugs are highly effective in slowing down the process of tissue damage on the joints. Some of the common drugs of this category are methotrexate, leflunomide and sulfasalazine.

Since this disease is an autoimmune disorder immune-suppressant drugs like azathioprine or cyclosporine are prescribed for suppressing the immune system. Alpha inhibitors like Enbrel, Remicade and Humira of tumor necrosis factor TNF is given for controlling pain and stuffiness in the joints. In severe cases, the person is given steroid injection for getting quick relief from pain. Surgery is done if the joints are severely damaged by the disease making movement impossible.

Pictures of Psoriatic Arthritis :

Images, Pics, Pictures and Photos of Psoriatic Arthritis

Home Remedies :

Minimize the use of your fingers. Avoid opening the containers using fingers instead you can use tools or gadgets for opening the jars. Maintain your weight since obesity can give rise to joint pain and inflammation. Make it a practice to go for a walk daily. Walking and jogging can increase blood circulation and improves muscle flexibility. If you have severe pain due to swelling of joints, you can apply cold/hot packs alternatively to get some relief and to reduce stiffness. Reduce your stress by joining yoga class and meditation.