Sepsis

Sepsis Elderly people and people with weak immunity may develop potentially dangerous infection known as sepsis. One out of 4 people developing septic shock are likely to die due to severe infection. Each year millions of people develop this infection which can damage multiple organs like kidney and liver. Once the infection develops in the body, it releases poisonous chemicals into the bloodstream. This in turn would cause inflammation over the entire body.

If the sepsis proceeds to septic shock, it produces number of blood clots thus blocking vital oxygen supply to the organs leading to organ failure. Blood pressure would drop drastically causing death. Serious types of infection are the major cause of sepsis and early diagnosis and prompt treatment only could save the life of the affected person.

Symptoms :

Sepsis begins with inflammation of the body, proceeds to severe sepsis and finally causing septic shock. It can be life threatening if not treated at the early stages.

Symptoms of 3 stages of sepsis are given below :

• Sepsis :

A person should have severe infection for developing sepsis. He may develop drastic changes in body temperature either too high or too low. The temperature of the body can fall below 96 F or go above 101 F, depending on the case. It can cause irregular heartbeat (above 90 beats per minute) and difficulty in breathing.

• Severe form of sepsis (second stage) :

People having severe sepsis may show symptoms including shortness of breath, mental confusion, disorientation, discoloration of skin, very low urine outflow and abnormal heartbeat. All the above signs indicate organ failure and platelet count drops down below normal level. Due to reduced oxygen supply to the brain, the individual may collapse.

• Final Stage (septic shock) :

In addition to the above symptoms, the affected individual would develop sudden decrease in blood pressure leading to death. His skin would be very cold and death occurs mostly due to organ failure. Unless the patient is hospitalized and treated with vital intravenous fluids the chances of survival are low.

Complications :

Sepsis is a serious life threatening condition requiring immediate medical care. It can lead to multiple organ failure, death of tissue, clotting of blood in various parts of the body and reduced blood supply to brain and heart. You may recover from mild sepsis (in the first stage) but the rate of mortality is high in second and final stages.

Causes :

Any type of severe infection caused by bacteria or virus can cause sepsis. Some of such infectious diseases are pneumonia (lung infection), kidney infection, and abdominal infection. Some people may develop bacteremia causing blood infection. Weakened immunity and very old age are also the causes of getting severe infection leading to sepsis.

Who are at risk?

Elderly people, people with weak immune system, people who are in ICU for long term and people with severe skin infection may develop sepsis.

Tests :

Since the symptoms of initial sepsis are often confused for side effects of infection, it is difficult to diagnose sepsis. Your doctor may order for complete blood test, blood clotting test and kidney function test. To check the level of electrolytes, he may order for urine analysis, sputum test (to diagnose pneumonia) and imaging tests like X-ray, CT and MRI scan.

Treatment :

Early intervention can make one fully recover from sepsis. Right diagnosis and vital treatment is necessary for sepsis. If the person has developed sepsis shock he has to be put on lifesaving machines to boost heart function. Depending on the health condition of the patient, necessary treatment is to be provided promptly. Antibiotics are given through IV supply for killing infectious bacteria or virus. Broad spectrum antibiotics are administered even before the test results have come.

For managing blood pressure, vasopressor drugs are given which can constrict blood vessels interrupting blood clots. Medications for triggering immune system are given intravenously. The patient will continue to remain on the supportive care of oxygen supply until he is out of danger. In case the kidney function is impaired dialysis is done promptly.

Systemic Inflammatory Response Syndrome

Systemic Inflammatory Response Syndrome SIRS is the short form of systemic inflammatory response syndrome. As the name indicates, this syndrome is caused by systemic response of the body due to severe inflammation or infection. This is characterized with high fever and rapid heartbeat and abnormal level of white blood cells in blood.

Symptoms :

Symptoms of SIRS may vary widely depending on the triggering factor of infection. Some of the common signs include high fever, chills and localized pain based on inflammation.

Criteria for diagnosing SIRS are as follows:-

• Very high or very low level of white blood cells in blood. It may go up to 12,000 per liter or below 4,000 also.


• High fever and chills. The temperature may shoot up to 100.4 F or can go below 96 F also.


• Rapid heartbeat


• Fast respiratory rate

Causes :

SIRS can be caused due to severe infection, ischemia or after effects of surgery. Infection can occur due to bacteria, virus and other micro organisms. It can be anything ranging from sepsis, cellulitis to diabetic foot infection. SIRS can develop due to non-infectious conditions like dehydration, burns, cirrhosis, autoimmune disorders, acute ischemia, and myocardial infarction and due to hemorrhagic shock.

Complications :

In rare cases, SIRS can cause potential complications like anemia, renal failure, respiratory failure, gastritis and abnormal levels of electrolytes.

Tests :

The doctor would look for the above symptoms and would complete his physical examination. He would look for possible site for infections in his routine screening. He may order for blood profile, urine analysis, liver function test and analysis of cerebrospinal fluid.

Treatment :

The method of treatment given is based on symptoms and health condition of the patient. Some patients may show signs of sepsis due to severe rate of infection without having any sign of SIRS. Your doctor will consider the causative factor of SIRS before starting any treatment. In case of myocardial infarction or respiratory failure emergency treatment will be given on ICU.

Blood pressure of the patient will be restored to normal by injecting vasopressor or similar drugs intravenously. If SIRS has developed due to surgical conditions like cholecystitis or ruptured appendix suitable surgical measures are initiated. Antibiotics are given if the root cause of infection is bacteria. Similarly antiviral medications are injected through vein if the doctor confirms the cause is viral infection. Blood glucose level is monitored carefully and if required, insulin therapy is given to stabilize the level of blood glucose.

Outlook :

Recovery from SIRS depends on factors like severity of infection and overall health condition. When compared with sepsis and septic shock recovery rate is high.

Testicular Cancer

Testicular Cancer Testicles are a pair of reproductive organs that secretes testosterone and sperm. They are found well inside the scrotum which looks like a loose bag below the penis. Testicular cancer is the type of cancer that develops in the testes. Testicular cancer is very rare in occurrence but there are few such cases in the USA and often it develops in the age group of 15-35. This cancer can be fully cured unlike other cancer. Men can prevent testicular cancer by regular self examination of reproductive organs.

Symptoms :

It can cause heaviness in the scrotal bag region and lump can be formed in one of the testicles. The affected male can feel accumulation of fluid accompanied with mild pain in the scrotum. It can also cause dull pain in the groin. Lumps can be formed in both the testicles in some men. There can be discomfort or pain while having sex. For some men the breast may get enlarged and become tender due to testicular cancer. You should not delay in consulting your health care physician if you feel lumps and discomfort in the scrotum.

Causes :

Exact cause of testicular cancer is still not clear. Like many other types of cancer, this cancer also occurs due to uncontrolled growth of new cells when old cells do not die. There will not be enough space for the additional cells which forms a mass or lump inside the testes causing testicular cancer. There is no specific reason why some men develop testicular cancer and others not.

Risk Factors :

Men with abnormal growth of testicles (Klinefelter syndrome) and men with family history of testicular cancer and men with testicles that are not properly descended are at high risk of developing testicular cancer. Normally testicles would descend well inside the scrotum before the birth of the child but some men are born with undescended testicles. They are more prone to get this cancer than others. Men who are in the age group of 13-35 are at risk of getting testicular cancer and certain ethnic group like black men have increased chance for developing this cancer.

Tests :

Testicular cancer can be easily diagnosed by self examination of the genitals. Your doctor may check the reproductive organs for any lumps or abnormal growth of the scrotum. He may order for ultrasound scan to get clear image of the testicles. He may also request for blood profile to know the level of tumor markers.

Types :

• Seminoma is a type of testicular cancer that occurs in elderly men.


• Nonseminoma cancer type develops in young men and it may spread quickly.

Stages :

• In the first stage of testicular cancer, the cancer cells are confined to testicles.


• In the second stage it may spread to the nearby lymph nodes.


• In the final stage cancerous cells may move to other parts through bloodstream.

Treatment :

Treatment methods depend on your age, health condition and staging of cancer. Various approaches for treating testicular cancer are surgery, chemo and radiation therapy. Surgical methods include orchiectomy and retroperitoneal dissection of lymph nodes. In the first procedure, the entire testicles are removed from the body. Your surgeon may add an artificial saline filled testicle on that portion.

In the second approach wherein the cancer is in the second stage, the nearby lymph nodes that contain cancer cells are also removed along with affected testicle. Sometime, the nerves can get damaged during this surgery which can cause pain and discomfort while having sex.

• Radiation Treatment :

In this method, high energy beam of light is used to destroy cancer cells. This method is combined with other approaches or sometimes done after surgery.

• Chemotherapy :

Medications are used to destroy cancerous cells. It is given in the form of injection or as oral pills depending on the case. Both the methods have side effects which you can discuss with your doctor.

Prevention :

You cannot do anything to prevent testicular cancer, since its cause is not defined. But you can always identify when something goes wrong by doing regular self examination to feel the presence of lump in the scrotum.

Essential Tremor

Essential Tremor Essential tremor is a disorder that causes uncontrollable tremors or “shaking” in the body and often it affects people who are above 40 years. It is believed to be caused by abnormal electrical activity in the brain and it produces rhythmic shaking of fingers or any part of your body. Trembling of hands can cause difficulty in tying the shoelaces or drinking a glass of water etc for the affected person. It may affect your hands, legs, head and voice box and other parts also. If left untreated, essential tremor may get worse making daily routine miserable for affected people. Medications and therapy are available for managing the symptoms of essential tremor.

Symptoms :

Signs of this neurological disorder differ on the part of the body that has been affected. Often the nerves of hands or arms are affected and for some people head can also get affected. The symptoms of essential tremor will not appear suddenly but is a slow process. Shaking of fingers may get worse gradually and when the person tries to use his fingers tremor may increase. Shaking or trembling of fingers occurs in one hand initially and slowly it progresses to both the hands.

Some people may have tremor in their head which may cause uncontrollable movement of their head either vertically or horizontally. Any type of tremor may worsen due to fatigue or emotional stress. Increased alcohol intake and extreme heat or cold climate may increase the symptoms.

Parkinson’s disease .Vs. Essential Tremor :

Parkinson’s disease is closely related with essential tremor in the aspect of many symptoms. But there exist some difference between the two disorders. Trembling of hands due to Parkinson’s disease occurs while the individual is resting his hands on his lap whereas essential tremor occurs while doing some work with hands. Parkinson’s disease can cause other health issues but tremor will not cause any other problem. And tremor neurological disorder involves only certain parts of the body like hands and head but Parkinson’s disorder may affect all parts of your body.

Causes :

• Exact cause of essential tremor is unknown, but is believed to be caused due to defective gene mutation.


• Abnormal electrical impulse in the brain can cause trembling of hands and legs.


• People with family history of essential tremor may develop this disorder likely.

Who are at risk?

A person with either of parents (having essential tremor) have 50% chance of developing this disorder. Often defective gene mutation is passed on to the children by the parents. People who are more than 40 years and having nervous problem are prone to develop ET.

Tremor can get worsen over time and make life difficult for the affected person. The person may not be able to eat normally and hold a glass of water for a while. He may have difficulty in shaving or applying makeup. Some people may develop voice problems and may face writing difficulty which can create problem at workplace.

Tests :

Your doctor will complete the physical examination and may order for complete neurological testing to check the muscle tone and strength. He may refer your case to a neurologist who may do certain tests to study tendon reflexes. Blood and urine test will be done to rule out any other abnormalities like thyroid problem and imbalance of ions. Finally he may ask you to perform certain simple tasks like drink a glass of water, write on a paper and draw some figures etc.

Treatment :

Not all the people with this disorder need treatment. No vigorous treatment is required for people with mild symptoms. For severe cases and people who have difficulty in carrying out routine activities, medications are prescribed. Beta blockers like atenolol, nadolol or sotalol that are prescribed for managing blood pressure are effective in controlling essential tremors.

Drugs like primidone or topamax or neurontin that are given for treating seizures are useful in managing the symptoms of tremor. It may cause adverse effect initially which you can discuss with your doctor. Tranquilizing agents like alprazolam or clonazepam are prescribed for severe cases. Mild to moderate symptoms of tremors can be controlled by taking a shot of Botox injection. You can repeat the injection after 4 months depending on the symptoms. Voice tremors can also be managed using Botox injection.

Physiotherapy is very effective in improving the symptoms of essential tremor. Your therapist will teach you about the effective usage of your hands with apt physical movements that can improve the muscle coordination in long term. You can make certain lifestyle changes like using heavier glasses and using heavy writing tools for controlling the symptoms of shaking.

• Surgery :

Surgery is the last choice for patients who are not responding with medications and have severe disabling problem due to ET. Deep brain stimulation is done by inserting electrodes into the thalamus portion of the brain which would emit electrical pulses that blocks the signals causing essential tremor. But your doctor will decide whether you are right candidate for surgery.

Prognosis :

Essential tremor cannot be fully cured but most of the symptoms can be managed for achieving quality life. You cannot prevent ET since the cause of tremor is not known. Follow the instructions of your doctor in taking medications and therapy and avoid alcohol and coffee/tea since it may worsen the symptoms. Practice relaxation exercises to reduce stress.

Umbilical Hernia

Umbilical Hernia If any of the fatty muscles protrudes through a hole from the connective tissue, it is called hernia. Hernia can occur in many places. If it occurs in the inner groin it is known as inguinal hernia, if it develops from the umbilical cord or navel it is called as umbilical hernia. In case the hernia is seen developing from the upper abdomen it is known as hiatal hernia and if fatty tissue is seen developing from the outer groin it is called as femoral hernia.

Umbilical hernia is one in which part of intestine pierces through a hole of abdominal muscles and is most common among infants. Bellybutton of the baby can protrude out of the navel for infants and often it may close gradually when the infant grows. Umbilical hernia that does not resolve promptly before the completion of 3 years of age needs treatment.

Symptoms :

Infants would have a small swelling near the umbilical cord (navel). The bulging can be clearly noticed when the baby cries or coughs. And it may not be seen when the baby says calm and sleeps. Often, umbilical hernia is painless and do not cause any discomfort. In rare cases it might cause abdominal discomfort.

In most of the infants, umbilical hernia would close on its own when the child turns 1 year. In rare cases surgery is to be done to close the hole. In adults umbilical hernia might develop in some cases. People with problems in their belly or those who are obese can develop this problem. In rare certain health issues like persistent cough and constipation can create umbilical hernia.

Causes :

It is the umbilical cord that connects the fetus with the mother and through which food is served to the growing child. The umbilical cord of the mother gets connected with the baby’s abdominal muscles and normally the small opening would close automatically after childbirth. In some cases the abdominal muscles would not fuse together completely and creates a small hole in the navel region. Over time, this would make the abdominal wall weak causing umbilical hernia.

In adults, umbilical hernia is rare. Excess of pressure put on the abdominal muscles like obesity and multiple pregnancies can cause umbilical hernia. Fluid accumulation in excess on the abdominal cavity and undergoing abdominal surgery can also cause this problem. Sudden lifting of heavy objects can weaken the abdominal muscles leading to hernia. Poor nutrition and constant smoking can also cause hernia.

Complications :

Umbilical hernia would not cause any complications. In rare cases, some part of abdominal tissue gets trapped outside which cannot be pushed inside the abdominal cavity. This in turn can block the blood flow to this section causing tissue damage. In severe cases if no blood supply is restored it can cause death of tissues (gangrene) that has to be operated immediately.

Tests :

Umbilical hernia can be diagnosed easily by mere physical exam. No additional tests are needed. For some babies the hernia becomes visible only if the baby stands up. Ultrasound scanning is done in such cases to get accurate picture.

Images, Pics, Photos and Pictures of Umbilical Hernia :

Treatment :

Often no treatment is needed for umbilical hernia, since the hernia would close automatically when the baby grows. Never attempt to push back the bulging tissue into the abdominal cavity on your own. And some people believe that fixing a coin on the hernia and closing it down by a tape can help in solving the problem. But this can cause infection. Sometime, doctor would gently push back the tissue into the cavity. Surgery is to be done for hernias that are bigger in size (more than 1.5 cm) and are painful and does not go away even when the child reaches 3 years.

Even for adults, surgery is the only option for treating umbilical hernia. The surgeon would make a small incision at the base of navel region and gently pushes the herniated tissue muscles into the abdominal cavity. The tiny opening will then be stitched. Developing gangrene and infection is quite possible for adults due to hernia. You can get back to work probably in a week or so and follow your doctor’s instructions so that you are not getting hernia again.

Cushing Syndrome

Cushing Syndrome Cushing syndrome is a rare type of hormonal disorder that develops when the body’s tissues are exposed to cortisol for long period. It is also known as hypercortisolism in medical terms. It can cause increase in weight, increase volumes of fat around the face and neck, and thinning of arms and legs. It can also cause mood swings and hypertension.

Cushing syndrome is caused by pituitary adenomas and prolonged intake of corticosteroid drugs and other immune suppressant drugs. Excess secretion of cortisol can also cause this disorder. Symptoms of Cushing syndrome can be managed with applicable treatment after diagnosing the root cause. This disorder develops mostly in the age group of 20-50 years.

Symptoms :

Due to increased production of cortisol hormone several changes can occur in the body. The affected person becomes obese and his face becomes round due to excess deposition of fat. The same effect is also found around the neck region but in contrary his legs and arms would be thin. The skin becomes fragile and vulnerable for wounds and puncture.

The individual may develop pink marks on the thighs, abdomen and buttocks. His bone become weak and makes it difficult for him to carry on simple tasks like lifting an object or getting up from a chair. It can lead to increased blood sugar and blood pressure adding more complications. Women may develop hair growth (overly) on the face and chest region and even on their abdomen. This disorder can also affect the normal menstrual cycle in women and can cause decreased libido and erectile dysfunction in men. In addition to the above, the individual may also feel excess of tiredness. He may lose control of his emotions and can develop anxiety and depression problems.

Causes :

Over production of cortisol hormone in the body is the main cause for Cushing syndrome. It is the adrenal glands that secrete plenty of hormones which include cortisol also. This particular hormone is vital for keeping your blood pressure under control and also helps in regulating the function of cardiovascular system. It prepares the body to face stressful events and also helps in metabolize nutrition accepted by the body and convert them into energy.

• External Causes :

Prolonged use of steroid drugs like prednisone and other corticosteroids for immune disorders like lupus and arthritis can cause increase in the level of cortisol hormone. Asthma patients may also use steroids in the form of spray and injection which can lead to this disorder.

• Internal Causes :

Adrenal glands can produce excess of cortisol hormone due to variety of diseases and disorders. Development of tumor (non-cancerous) in the pituitary gland can cause pituitary adenoma leading to over production of cortisol. An ectopic tumor in any other part of the body can also cause ACTH leading to Cushing syndrome. Any disorder in the adrenal glands can cause Cushing syndrome. In rare cases it can be due to family history.

Complications :

If left untreated, Cushing syndrome symptoms can cause complications like osteoporosis (bone loss), hypertension, loss of muscle strength, diabetes and other infections.

Tests :

Based on change in physical appearance your doctor may suspect Cushing syndrome. She would collect complete medical history to know whether you have been using steroid drugs for long term. She may order for blood profile and urine analysis to check the level of cortisol. Saliva test will also be done at various time intervals of day and night to confirm increase in the level of cortisol. To detect any tumors she may order for imaging tests like CT scan.

Treatment :

Your doctor will have to find out the exact causative factor and accordingly design the treatment for Cushing syndrome. If you are an individual who is using corticosteroid drugs for long period, your doctor would reduce the dosage and see whether the symptoms of Cushing syndrome improves. But remember you should not try stopping these drugs abruptly since it can cause complications. Your doctor would slowly taper off the drugs.

For people whom presence of tumor is the root cause for Cushing syndrome, your doctor would recommend surgery to remove it. Any abscess in the adrenal glands or elsewhere in the body can lead to increased cortisol secretion. Your doctor will monitor the level of cortisol regularly after the surgery and supplement with cortisol injection, if necessary.

Radiation treatment is effective for removing pituitary tumor which can be given in break-ups or as a single dose, depending on factors like size and intensity of tumor. Drugs are given to reduce cortisol hormone for some people who are severely affected with Cushing syndrome. Combination of drug treatment with radiation and surgical approach are also common in practice. Medications like Nizoral, Lysodren and Metopirone are prescribed.

Images, Pics, Photos and Pictures of Cushing Syndrome :

Lifestyle Changes :

It is quite common to experience tiredness after surgery or any other therapy. You need to follow the instructions of your doctor and slowly increase the activities. Eat healthy balanced diet and include enough calcium and vitamins in your food. Cushing syndrome can cause depression disorder and hence do not avoid or ignore your symptoms. Consult your doctor if you have doubt that you are having disturbed mental health.

Delirium

Delirium Delirium is a state of confused thinking and losing mental balance. It is a type of mental disorder that interferes with the normal functions of your brain. The individual may forget daily routine and lose contact with the environment. He/she may in a state of confusion seeing and hearing unnatural things that does not exist.

Delirium can occur due to many causes like head injury, brain infection, drug toxicity and sudden metabolic changes. Intake of certain medications, certain type of chronic diseases and overuse of alcohol or drug can cause delirium. Delirium symptoms can be managed by combined approach of medications and supportive care.

Symptoms :

The signs of delirium may not last long and in most of the cases it occurs only for short period. For some people, it may last for few hours only and for some others it can continue for few days. There will be fluctuation of symptoms throughout the day. The affected person may have reduced awareness which can cause poor concentration, confused thinking and easy distraction over things. He may appear withdrawn paying no attention to the happenings and gives little or no response to the environment.

Delirium can cause symptoms like poor memory, disorientation (inability to identify the place or time of the day) and difficulty in understanding conversation. He may talk nonsense and may not respond to the questions in normal way. Delirium can also cause restlessness, irritability and aggression. The person may see and hear non-existent things. He may not sleep properly and may express strong emotions.

Causes :

Under normal conditions, brain sends and receives signals promptly. But delirium occurs when there is abnormality in the brain which would impair the route of signals. Brain’s activity may get disturbed by various factors. Severe infectious diseases, dehydration and intense skin problem can trigger the brain signals and block them. Prolonged stay in the hospital can make vulnerable to develop delirium.

Old age, dementia, any type of acute infection, visual disturbance and poor nutrition can trigger impulses in the brain leading to delirium. Chronic illnesses like lupus or arthritis and severe immune disorders and intake of several drugs for long term and alcohol abuse can cause delirium. Drugs given for inducing sleep, pain-killers, drugs given for stabilizing mood and medicines given for treating Parkinson’s disease can induce delirium. Delirium can occur in people who suffer from anxiety and depression.

Complications :

Delirium is not a disease and often the symptoms would vanish within few hours. But for some people it may last for several weeks. Once the root cause of delirium is found and treated, the patient can recover quickly. If delirium develops in terminally ill patients or people with mental disorders it may permanently damage their thinking skills and impair the normal functions of the brain.

Tests :

The doctor would listen to the patient’s family and close friends and collect complete medical records of the affected person. He would give suitable questionnaire to assess his mental status. He would check his mental awareness and his thinking ability by asking a series of questions. He would also identify about his perception ability.

He may order for neurological tests to find out the root cause of delirium. Neurologist would evaluate his ability of vision and motor balance and reflexes. He may also order for imaging tests like CT or MRI scan of the brain to get accurate picture.

Treatment :

Before starting any treatment the doctor would identify the factors that trigger the delirium. He would analyze the list of medications taken by the patient, to find if that can be the factor for inducing imbalance in brain. If necessary he might reduce the strength of doses or give suitable alternate medications. There are certain drugs that can interfere with normal thinking ability of the person. Sometimes it may endanger the person’s mental status or create danger for society.

Coping Techniques :

Coping and supportive care are vital in treating the person affected with delirium. Family people can attend to the immediate need of the affected person by providing wall clocks and calendar in every room. The atmosphere of the home should be calm and cool. Nowadays many electronic devices are available to remember important events of the day.

The person should be in close contact with his family and friends. Needless to say, he should have quality sleep which can help considerably in keeping his brain calm. Going for brisk walk or doing aerobic exercises will promote quality sleep. Taking healthy diet and supplementing with fluids is effective in preventing dehydration. Attending yoga classes and practicing relaxation techniques can reduce agitation and stress.

Prevention :

You cannot totally prevent getting delirium. You can reduce the risk factors that can be inducing an episode.