What Causes Bone Fractures?

Most people were introduced to the orthopedic surgeon at a young age when they were brought to the emergency room with their first broken bone. For me the memory of the event is now faint (something about a bicycle and pavement), but the cast that I was able to tote around the classroom is fondly recalled as one of my moments of youthful pride.

The first, and probably the most known cause for bone fractures is known as bone thinning or osteoporosis. Osteoporosis can lead to bone fractures because in time it makes the bones less dense by altering bone protein and other minerals. This increases the risk of bone fractures, because the bones become a lot more porous.

The ‘fatigue theory’ suggests that during repeated efforts (as in running), the muscles become unable to support the skeleton during impact as the foot strikes the ground. Instead of the muscles absorbing the shock, the load is transferred to the bone. As the loading surpasses the capacity of the bone to adapt, a fracture develops. The ‘overload theory’ suggests that certain muscle groups contract in such a way that they because the attached bones to bend. After repeated contractions and bending, the bone breaks.

Stress fractures are probably preceded by, causing bone pain and pain during exercise. Management of shin splints involves rest; if the symptoms still persist after two weeks, a stress fracture is suspected. When the pain has persisted for six weeks or more, a stress fracture is the likely cause.

The first step in describing a fracture is whether it is open or closed. If the skin over the break is disrupted, then an open fracture exists. The skin can be cut, torn, or abraded (scraped), but if the skin’s integrity is damaged, the potential for an infection to get into the bone exists. Since the fracture site in the bone communicates with the outside world, these injuries need to be cleaned out aggressively and many times require anesthesia in the operating room to do the job effectively.

Setting of bone through surgery. When surgery is needed, the procedure is called an open reduction. The doctor will give you local or general anesthesia. (General anesthesia will put you to sleep.) During the surgical procedure, the doctor may insert a rod, pin, plate, or screw into the injury to hold the bone in place. Advantages of surgery include: early mobility of injured bone and some use of the injured bone within weeks rather than months.

Impacted Fracture: An impacted fracture is similar to a compression fracture, yet it occurs within the same bone. It is a closed fracture which occurs when pressure is applied to both ends of the bone, causing it to split into two fragments that jam into each other. This type of fracture is common in car accidents and falls.

It may take a number of weeks or months for a fracture to heal. Your bone tissue will start growing new bone cells on the site of the fracture, creating new bone tissues until the fracture is closed. The healing process is usually painful, therefore you must strictly follow the doctor’s advice on handling the fracture so that you can recuperate faster and resume to normal activity. During rehabilitation, your activity may be limited to the extent of the pain threshold of the fracture. By the time the bone becomes strong again, you may have to undergo certain exercise to strengthen the muscles surrounding the bone fracture so that it can function again normally. The exercises will increase in activity over time until the fracture is completely healed, and normal skeletal activity is restored.

Acromioclavicular Joint Injuries – Part One

With its extreme mobility and limited stability and power, the shoulder joint is vulnerable to injuries in sport and activities, requiring expert management to recover entirely to normal. The shoulder joint proper is known as the glenohumeral joint and above this lies the acromioclavicular joint. Frequent reasons for injuring this joint are falls from skiing or bicycling and most contact sports. The joint is made up of the acromion, the end of the scapula, and the lateral end of the collar bone or clavicle and is vulnerable to forceful injuries.

There are a number of ligaments which strengthen the joint and they may be sprained or ruptured by an injury which may appear as an obvious disruption of the joint. Complications may occur in the presence of fractures at either side of the joint which can result in arthritic changes developing later in the joint. If athletic individuals consult a doctor for a shoulder injury then acromioclavicular joint injuries are the most likely cause with shoulder dislocations coming next. Smaller degrees of sprain with partial ligament tearing is much more common than complete joint separation, all occurring most frequently in young males.

The acromion and the lateral end of the clavicle make up the joint, which is held by four relatively small ligaments and surrounded by a fibrous bag called a joint capsule. These joint ligaments mostly stop the joint from being separated in a forwards and backwards direction while another ligament group adds to stability in an upwards and downwards direction. These ligaments pass from another part of the scapula and attach just inwards from the acromioclavicular joint. Depending which group of ligaments are torn will alter the picture of the injury sustained.

When someone falls onto the tip of their shoulder it is forced downwards compared to the remainder of the shoulder, making injury to the ligaments or a fracture a possibility as the collar bone stays where it was. The ligaments may be sprained or torn completely which makes the joint very unstable and loses its function. The severity of the injury is graded in the classification of these injuries. A type 1 sprain is the result of lesser trauma and may involve sprain of the joint ligaments, with the joint staying stable and appearing normal although a source of pain.

A type 2 sprain involves some disruption of the acromioclavicular ligaments but leaves the others which attach to the other part of the scapula uninjured. The far end of the clavicle or collar bone may now show a little prominently above the joint line as the supports have been damaged. In type 3 sprains both sets of ligaments are completely ruptured and the collar bone is obviously separated from the acromion, forming a visible and palpable lump towards the outside of the upper shoulder area. More severe injuries may involve fractures and complete disruption and malposition of the bony elements.

A patient with pain over the point of the shoulder should be suspected of having an acromioclavicular joint injury and be examined accordingly. Falling onto the tip of the shoulder is most common whilst the arm is close to the trunk. Many other ways of injuring this joint exist such as the frequently occurring fall on an outstretched hand. Patients may initially complain of rather generalised symptoms with pain and swelling around the area, with a few days needing to go by before local pressure over the joint confirms the diagnosis of an acromioclavicular joint sprain.

If injured, weight training athletes may find difficulty with exercises which stress the acromioclavicular joint such as bench pressing. Night pain is common as it is difficult to eliminate shoulder stresses during the night and patients may wake when they roll over onto the point of the shoulder. Examination reveals pain over the joint itself which is very localised, and if the injury is more severe there may be obvious deformity of the lateral end of the collar bone, it typically being prominent upwards. Patients will have limited movement in the shoulder and be unwilling to lift the arm beyond horizontal.

Types of Cerebral Palsy

There are several types of brain injuries at birth that may be called cerebral palsy. Cerebral palsy is caused by low oxygen to the brain during birth that can cause several different problems, depending on how severe the brain injury is.

The most common type of cerebral palsy identified is spastic cerebral palsy. This kind of cerebral palsy is known for causing jerky and rigid muscle behavior. There are three types of spastic cerebral palsy:

• Spastic diplegia – Characterized by tight leg and hip muscles, and legs crossed at the knee, making walking difficult

• Spastic hemiplegia – Characterized by stiffness on one side of the body. The affected side may not develop normally, and arms or hands may be more affected than legs

• Spastic quadriplegia – Characterized by affecting legs, arms and the body. It may be difficult for the child to walk and speak. The child may suffer seizures and mental retardation is a common occurrence

There are other kinds of brain injuries resulting at birth that may fall under the cerebral palsy umbrella. These include:

• Erb’s palsy – Can occur when the infant’s shoulder is stuck beneath the mother’s pelvis. Forcing the infant out may tear the brachial plexus, a nerve cluster running from the neck to the hand. This can cause paralysis in the shoulder area, arm, or hand

• Athetoid dyskinetic cerebral palsy – The child will have normal intelligence, but the body is affected by muscle problems. Drooling may occur due to lack of control of facial muscles, and speech may be difficult

• Ataxic cerebral palsy – Problems occur with fine motor skills, balance, and coordination. Intention tremors, or shaking that begins with voluntary movement, such as reaching out to pick something up are possible

• Hypotonic cerebral palsy – This causes control problems when child is still an infant. The child may have trouble keeping their head up and may not be able to control it when they are sitting up. Motor skill development may be delayed

Catastrophic Injuries: Paralysis, Amputation, Burns


A catastrophic injury or illness usually occurs suddenly and without warning. Injuries may be considered catastrophic when they disrupt a person’s life and livelihood, or ability to earn a living. Management of catastrophic injuries is complex and may require the expertise of a team of health care professionals as the injured person moves from hospital to rehabilitation, and return to home and community.

The financial fallout from a catastrophic injury makes essential the careful valuation of the claim by an experienced personal injury attorney working with economic and vocational specialists, life care planning specialists, and specialists in rehabilitation medicine.

The goal of an attorney handling these matters is simple: to secure for the client the Best Possible Future.


One type of catastrophic injury is paralysis.

Definition: “Complete loss of strength to an affected limb or muscle group.”

Normal muscle function requires unbroken nerve connection from the brain to a particular muscle. Damage at any point along this path reduces the brain’s ability to move a muscle and may cause muscle weakness. Complete loss of the nerve prevents movement and is called paralysis.

Weakness may sometimes lead to paralysis. Other times, strength may be restored to a paralyzed limb.

While paralysis may affect an individual muscle, it usually affects an entire body region. Some types of paralysis are:

Quadriplegia: where the arms, legs and chest are paralyzed;

Paraplegia: where both legs, and sometimes part of the chest, are paralyzed;

Hemiplegia: where one side of the body is paralyzed.

Paralysis may be caused by damage to the spinal cord or brain.

Damage to the brain may come from a stroke, tumor, certain diseases and a fall or blow to the head. – Damage to the spinal cord is most often caused by trauma, such as a fall or car accident. There may be other causes, such as a herniated disc or various diseases or conditions. The type of paralysis may give important clues to its origin. Paraplegia, or paralysis of the legs, occurs after damage to the lower spinal cord, and quadriplegia occurs after injury to the upper spinal cord, at the shoulders or higher. Spinal cord damage too high on the neck will affect the nerves serving the lungs and heart paralyzing the muscles that circulate blood and cause breathing, resulting in death.

Not all paralysis is treatable. But for non-permanent paralysis, the only way to treat paralysis is to repair its underlying cause. Rehabilitation may include: physical therapy to rebuild the muscles; occupational therapy to help restore the ability to perform daily activities, such as bathing, getting dressed; respiratory therapy to help breathing; vocational rehabilitation to retrain for a job; social worker to help adjust to one’s condition; speech-language pathologist; nutritionist and others.

Legal consequences: In a lawsuit from an accident causing paralysis, an injury attorney may have to consult many of these specialized experts, in addition to medical doctors, to best understand what the future holds for a paralyzed accident victim and how best to present that person’s claim to a jury.

Where the paralysis affects the injured person’s ability to earn a living, there may also be coordination with Medicare, Medicaid, private health and disability insurance, and other alternative sources of income or payment for medical care.


Another type of catastrophic injury is amputation.

Definition: “Loss of a body part.” Usually a finger, toe, arm or leg, due to an injury, accident or trauma.

Sometimes an amputated body part can be re-attached, especially when care is taken both of the body part and site of the amputation.

In a partial amputation, some tissue remains connected. Re-attachment may or may not be possible.

Complications common to this type of injury include bleeding, shock and infection.

50% to 80% of amputees experience the phenomenon of “phantom limbs.” This means that they feel as if the missing body part is still there. These phantom limbs can itch, ache and feel as if they are moving.

Some causes of amputation: factory, farm or power tool accidents or from motor vehicle accidents.

Amputees may require long-term care which may include a prosthesis and training in its use.

In a lawsuit from an accident causing amputation, an injury attorney will have to focus on rehabilitation and the injured client’s ability to earn a living. Vocational and occupational experts are frequently consulted. The question often arises about future expenses, such as future medical costs and care and replacement of the prosthesis.


From kids washing under a too-hot faucet to the accidental steam explosion from a car radiator, burns are a potential hazard. Babies and young children are especially susceptible to burns, as they are small and curious and have sensitive skin.

Common causes of burns are:

Scalding (from hot liquids or steam) – contact with open flame or heated objects (stove,fireplace, etc.) – chemical burns (bleach, battery acid, etc.) – electrical burns – sun burn Types of burns:

First-degree: Mildest. Limited to top layer of skin. Redness, pain minor swelling. No blisters.

Second-degree: More serious. Involve skin layers beneath the top layer.

Third-degree: Most serious. Involves all layers of skin and underlying tissue. Nerve damage may mean little pain.

What to do:

Seek medical assistance if:

Burned area is large or looks infected (swelling, pus, redness, etc.); Burn is from a fire, electrical or chemical source; Smoke was inhaled; – Burn is on the face, scalp, hands or genitals. A lawsuit for an accident involving burns can require sophisticated engineering assistance to show negligence, particularly in the cases of chemicals and/or defective products. An experienced legal team is essential.

Hernia – Causes, Symptoms , Treatment, Diagnosis

Hernia occurs when a part of an organ protrudes through the muscular fiber that has the role of keeping that organ in its place. This usually happens due to a weakness that appears in the muscles that are around the organ, and causes them to tear and let a part of it come out through the small opening that is created. That part of the organ that protudes will create a proeminent bulge that can usually be seen.

Hernia is a problem that is caused by the weakening of muscles of the abdominal wall. It is a painful disease that can be seen both in children and adults. The causes that may lead to hernia are genetic ones or poor lifting techniques.Because of the weakness of the abdominal wall some internal organs especially intestines bulge into the peritoneum. This type of hernia is an uncomplicated case because the organs can be manipulated back into the body. Even so no one can guarantee that these organs will stay in place without surgical help. This type of hernia is termed a reducible hernia.

Paraesophageal hernia may cause some incarcerations or more acute epigastric pain, because of a strangulation. This type of hernia is rare but it is dangerous, life threatening maybe. Sometimes complications like stomach strangulation appear but in most cases this does not happen.


Hernia symptoms are usually related to the bulge that hernia causes. In The early phases you only notice that small lump that does not hurt when it is touched. As the illness advances the bulge, or herniation as some specialists call it becomes painful and keeps swallowing. The lump becomes more visible when you cough or sneeze and in most cases it can be pushed back with your hand, but it will come out again in a couple of minutes. If it cannot be pushed back then it is possible that you are suffering from a strangulated hernia.

Hiatal hernia doesn’t cause any symptoms or trouble in the body, so in most cases people have it and they don’t even know about it, but they aren’t exposed to any risks. The only time when treatment is required is when strangulation occurs. In this case the patient needs surgery to put the stomach back in its normal position. Hiatal hernia surgery can be done with the help of the laparoscope, an instrument used in many types of surgeries, that enables the doctor to operate without making a large incision in the chest, but through a very small one.


Hiatus hernia is a condition usually diagnosed in later stages due to the lack of symptoms and the initial symptoms very assembling to other digestive diseases. Hiatal hernia is most common in persons of 55 years and more but can theoretically occur at any age. It is caused by a weakening of the diaphragm hiatus (esophageal opening) allowing the upper part of he stomach to turn up into the chest cavity. This condition is known as hiatus hernia and is responsible for the occurrence of gastric reflux.


Umbilical hernia is not surgically repaired in the small children’s case because usually until the child reaches the age of 3 the hernia shrinks and heals by itself. Some mothers try to increase the speed of the healing by tapping a coin to the bulge and forcing it to stay there and push it back, but this method is not medically tested or recommended. However, in some special cases umbilical hernia does require surgical intervention.

Femoral hernias can show no actual symptoms and may cause severe complications if left untreated. The actual surgical maneuver is pushing the hernial content back into the abdomen and repair the problem causing the weakening of the abdominal wall. If the hernia consists out of an intestinal fragment, it must return to its proper place to avoid complications such as a bowel obstruction.

The best treatment for primary inguinal hernias is considered to be the Lichtenstein repair. Not being a hard to do procedure this type of treatment may be used by non-specialist surgeons too. The results of this intervention are less pain and a smaller period of recovering. For bilateral hernias a laparoscopic repair is not only recommended, but necessary. There are some factors that influence the choice. One of them and one of the most important factors are the pores size. The mesh should not contain pores smaller than 10 um in diameter because these may develop bacteria that makes the pores inaccessible to leukocytes.

What do you know about kyphoplasty


Kyphoplasty is the surgery which helps the patient to recover from the spinal fracture.  Kyphoplasty treatment for spinal fracture increases the chances to recover from this specific frature and at pain management center you can get more guidance about it. It includes removing and finishing the back pain and stopmore damage to spinal cord. It also does not let any abnormality damage the spinal cord. This kyphoplasty treatment sustains the spinal cord healthy. This treatment  is not invasive and it helps you to recover from spinal fracture.  Khyphoplasty treatment is done in two sorts of anesthesia  local and general.  Both inpatient and outpatient procedures are available for kyphoplasty treatment. This treatment of kyphoplasty takes 30 to 45. Khyphoplasty sustains the height of vertebral body good and maintain the alignment of spine.  Immediate treatment of khyphoplasty may decline the hazardous effects of spinal fracture.

How is this treatment done?

At the operating table patient lays down and patient gets either general anesthesia or local anesthesia before this treatment takes place.  With the help of two tiny cuts on skin at the back tubes are entered  into the damaged vertebra.  Each tiny skin cut’s length is 1/6 or may be an inch longer. This procedure is done by the help of specialized X.RAY which helps the doctor to fix the tubes correctly into the damaged vertebra.  By the help of each tube a specific balloon is entered in the damaged vertebra.  Once the balloons reach into the damaged vertebra, they are filled up with a liquid with the guidance of X.RAY. This procedure aims to help the vertebra to recover from damage. Then the liquid is taken out of balloons and space is kept empty within bone that has beenwidened.  Adhesive bone cement is taken into damaged vertebra by tubes with the guidance of an X RAY and it is confirmed that there is no leakage of cement out of vertebra.  The cement then gets harder in minutes.

How does this kyphoplasty benefit the spinal fracture’s patients?

This treatment of kyphoplasty has many qualities to make a patient recover from spinal fracture. It decreases and finishes your back pain. It does not only make you recover from back pain but also it maintains height of vertebral body. The benefits of undergoing this kypholasty comprise of improvement in walking, sitting and laying down properly and it supports you to restart your activities of daily life as well. The risk of this treatment is very low compared to other surgical procedures.  Patient must consult his/her physician at pain management center to take a final decision to undergo this kyphoplasty procedure.


Two Types of Tmj

Temporomandibular Joint Disorder (TMJ) is a condition that may be suffered by more than 30 million Americans. Sometimes called “the Great Imposter” for its ability to masquerade as other conditions, TMJ can result in symptoms as diverse as sleep disorders, facial pain, back pain, tooth pain, ringing in the ears, and tingling or numbness in the extremities.

The temporomandibular joints are located on either side of the head, where the jaw (mandible) meets the skull. In itself it is composed of three parts, the articulating surface on the skull, described as a fossa, the articulating surface on the mandible, described as a condyle, and the disc of cartilage that acts as a cushion between them. TMJ can be caused by a condition in the joint itself, in which case it is described as being intracapsular, or by conditions outside the joint, in which case it is described as being extracapsular.

Intracapsular TMJ

Intracapsular TMJ is the result of some structural change in one of the three components and/or their relationship with one another. They can interfere with the function of the jaw and often produce pain, especially localized pain that is often easily traceable to jaw motion, although the actual diagnosis of TMJ can still be very difficult. There are four commonly recognized types of intracapsular TMJ.

Developmental disorders can lead to an abnormal development of the joint. These often appear in patients of a relatively young age and tend to be highly symptomatic.

Diseases such as degenerative arthritis, rheumatoid arthritis, and neoplasms (pre-cancerous growths) can attack the joint. Although neoplasms can be isolated, arthritic TMJ often develops along with other affected joints. These tend to appear in older patients.

Injuries can often lead to displacement of the joint. Although the trauma does not need to be directly to the jaw, the sudden onset of this type of TMJ makes it easy to trace back to its cause.

Internal derangements are TMJs that set in without any evidence of external influence. Instead, the relationship between the condyle, fossa, and disc is disrupted for no apparent reason.

Extracapsular TMJ

Extracapsular TMJ is caused not by damage to the joint itself, but by conditions outside the joint that exert displacing force on the joint. The most common cause of extracapsular TMJ is malocclusion, when teeth don’t fit together properly. Malocclusion can be congenital–related to poor dental development–or it can be the result of tooth loss, poor dental restorations, or dental trauma. Because this kind of extracapsular force places constant strain on the muscles and may displace or adversely affect important nerves in the area, extracapsular TMJ is more likely to create wide-ranging effects, such as headaches, ear pain, facial pain, and tooth wear and pain among other effects.

Trigeminal neuralgia :An enigma

Trigeminal neuralgia :An enigma


Dr. Altaf H Malik

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.

Co authors: 

Dr. Ajaz A Shah

Associate Professor and Head,

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.

Dr. Suhail Latoo


Department of Oral Pathology and Microbiology,

Govt. Dental College, Srinagar.

Dr. Manzoor Ahmad Malik

J & K Health Services, SDH Banipora

Dr. Rubeena Tabasum


C.D Hospital, Srinagar.

Dr. Shazia Qadir

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.


            Trigeminal neuralgia (TN — tic douloureux) is a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the nerve are distributed – lips, eyes, nose, scalp, forehead, upper jaw, and lower jaw.

Historical note

    • In 1900, in a landmark article, Cushing reported a method of total ablation of the gasserian ganglion to treat TN.
    • In 1912 Osler described TN as follows:
      • In patients with advanced TN, the paroxysms follow one another rapidly without any assignable cause, and in the intervals the patient may never be quite free from pain.
      • They are initiated by almost any form of external stimulus, for example by a draught of air; movement of the facial muscles or tongue while speaking; touching the skin, particularly over those points from which the pain seems to take its origin; and the act of swallowing, especially when the pain involves the mucous membrane field of distribution of the nerve.
      • It is not a self-limited disease. In some instances the neuralgia reaches such a frightful intensity that it renders the patient’s life unbearable. In earlier times suicide was not an uncommon consequence.


  • Usually no structural lesion is present, although many investigators agree that vascular compression, typically venous or arterial loops at the trigeminal nerve entry into the pons, is critical to the pathogenesis of the idiopathic variety. This compression results in focal trigeminal nerve demyelination.
  • Since the exact pathophysiology remains controversial, TN may have either a central and/or peripheral etiology.


It is not always possible to determine what causes trigeminal pain. However, several possibilities exist.

Compression of the nerve root. Compression of the nerve root is nowadays often considered to be the basic cause of classical trigeminal neuralgia. However, other opinions still exist. In this case a small blood vessel pinches the root of the trigeminal nerve. The spasms may be due to the pulsing of the blood vessel, which squeezes the nerve even more.

Damage to the myelin sheath. Damage to the myelin sheath can cause trigeminal pain. This type of damage occurs typically in connection with Multiple Sclerosis (MS). In a somewhat simple way the damage can be seen as a kind of short circuit, the way it is presented in picture 2 (not included here, as I have no scanner, sorry…). Normally, sensations of pain and heat are transmitted by different nerve routes. The myelin sheath of the nerves isolates these routes from each other. If the myelin sheath is damaged, different signals blend together and thus the nerve identifies as pain something that it would, for example, normally feel as a light touch.

Other nerve damage. Accidents, unsuccessful dental work, or various infections can damage the Trigeminal nerve. In this case the damage mechanism is probably similar to that in MS patients. The varicella virus, which causes herpes zoster, can sometimes also cause an intense pain in the trigeminal area. This pain is particularly difficult to treat.

Functional problems. Functional problems in the joints or the bones of the face are often believed to be the cause of atypical facial pain. The jaw bone may squeeze the nerve, and the squeezing is perceived as pain. This pain then causes tension in the muscles of the face, which causes the nerve to be squeezed even more tightly. It can be extremely difficult to break such a vicious circle.

Psychological reasons. ‘Psychological reasons’ are often mentioned as the underlying cause of atypical face pain. There is no doubt that psychological factors influence the patient’s tolerance of pain and how he or she relates to it. Regrettably, however, doctors often use these psychological reasons as a kind of weapon, and do not try to treat the real problem which causes the pain. Chronic pain certainly makes a person angry and depressed; on the other hand there is no reason to assume that anger and depression are the root cause of the pain.


  • In the US:
    • According to Penman in 1968, the prevalence of TN is approximately 107 men and 200 women per 1 million people. Mauskop states that approximately 40,000 patients in the US suffer from this condition at any particular time.
    • The incidence is 4-5/100,000.
    • Rushton and Olafson found that approximately 1% of patients with multiple sclerosis (MS) develop TN, whereas Jensen et al stated that 2% of patients with TN have MS.


  • TN is not associated with a shortened life. However, the morbidity associated with the chronic and recurrent facial pain can be considerable if the condition is not controlled adequately.
  • Individuals may choose to limit activities that precipitate pain, such as chewing, possibly losing weight in extreme circumstances.
  • TN may evolve into a chronic pain syndrome, and patients may suffer from depression and related loss of daily functioning.

Race: No racial risk factors have been identified.

Sex: The male-to-female ratio is 2:3.


  • Age of onset typically is 60-70 years; thus, advanced age is a major risk factor.
  • Patients who present with the disease when aged 20-40 years are more likely to suffer from a demyelinating lesion in the pons secondary to MS.
  • MS and hypertension are the 2 risk factors found in epidemiologic studies.

Criteria :

Classical trigeminal neuralgia fills certain, rather precisely defined criteria.

Spasmodic pain. The pain comes in short spasmodic attacks. It is often described as resembling electric shocks. A typical attack lasts only a few seconds. Several attacks can, however, follow each other within minutes. The pain is, at its worst, completely paralyzing.

Locality. The pain usually appears very locally within the area of the trigeminal nerve and does not radiate into other areas. The pain almost always appears on only one side of the face.

Trigger points. So-called trigger points are typical of trigeminal neuralgia. These are points in the face which, if touched even lightly, will trigger a pain attack. Such points can be located in the lips, on the side of the jaw, underneath the eye, in the eyelid, or anywhere where the trigeminal nerve reaches.

Trigger activities. If an activity causes a trigger-point to be touched, it may start an attack. For example, eating can become almost impossible. Loss of weight is common among those suffering from trigeminal neuralgia. Shaving, applying make-up, and even talking can become difficult. In some cases even a gust of wind can be enough to start an attack. An attack can, however, also start without provocation.

Remissions. So-called remissions, or painless periods, are typical of classical TN. Such a period can begin completely unpredictably and last from a few days to weeks or even months. In this case the pain is completely absent and life does not feel abnormal in any way. Without medical care the pain will, however, usually appear again sooner or later.




  • Clinical presentation
    • TN presents as a stabbing unilateral facial pain that is triggered by chewing or similar activities or by touching affected areas on the face.
    • Patients can localize their pain precisely. The pain is not confined exclusively to one of the 3 divisions of the nerve but more commonly runs along the line dividing either the mandibular and maxillary nerves or the mandibular and ophthalmic portions of the nerve.
      • Of patients, 60% complain of lancinating pain shooting from the corner of the mouth to the angle of the jaw.
      • Jolts of pain from the upper lip or canine teeth to the eye and eyebrow, sparing the orbit itself, are experienced by 30% of patients. This distribution falls between the division of the first and second portions of the nerve.
      • According to Patten, less than 5% of patients experience ophthalmic branch involvement.
    • Strictly unilateral, the disorder affects the right side of the face 5 times more frequently than the left.
    • Pain quality is characteristically severe, paroxysmal, and lancinating.
      • It commences with a sensation of electrical shocks in an affected area, then quickly crescendos in less than 20 seconds to an excruciating discomfort felt deep in the face, often contorting the patient’s expression.
      • The pain then begins to fade within seconds, only to give way to a burning ache lasting seconds to minutes.
    • During attacks, patients may grimace; hence the term “tic douloureux.”
    • The number of attacks may vary from less than one per day, to a dozen or more per hour, up to hundreds per day. Outbursts fully abate between attacks, even when they are severe and frequent.
    • Thus TN is an exception to the rule that nerve injuries typically produce symptoms of constant pain and allodynia. If the pain is particularly frequent, patients may be difficult to examine during the height of an attack.
    • A valuable clue to the diagnosis is the triggering of the pain with certain activities. Patients carefully avoid rubbing the face or shaving a trigger area, in contrast to other facial pain syndromes, in which they massage the face or apply heat or ice.
      • According to Sands, trigger zones, or areas of increased sensitivity, are present in one half of patients and often lie near the nose or mouth.
      • Chewing, talking, smiling, or drinking cold or hot fluids may initiate TN pain. Touching, shaving, brushing teeth, blowing the nose, or encountering cold air from an open automobile window also may elicit pain.
    • In contrast to migrainous pain, persons with TN rarely suffer attacks during sleep, which is a key point in the history.
    • Patients with MS and TN have similar complaints to those with the idiopathic variety, except that they present at a much younger age (often <40 y).
      • Some present with atypical facial pain, without trigger zones, and without the lancinating brief paroxysms of discomfort.
      • As previously noted, TN is not unusual in MS, but it is rarely the first manifestation. Typically it occurs in the advanced stages of MS.
  • Natural history and prognosis
    • After an initial attack, the disorder may remit for months or even years. Thereafter the attacks may become more frequent, more easily triggered, more disabling, and may require long-term medication.
    • Patients may find immediate and satisfying relief with one medication, typically carbamazepine. However, over the years, they may require a second or third drug to control breakthrough episodes and finally may need surgical intervention.
    • Simpler, less invasive procedures are well tolerated but usually provide only short-term relief.
      • At this point, further and perhaps more invasive operations may be required, and with these procedures the risk of the disabling adverse effect of anesthesia dolorosa increases.
      • Thus, the long-term prognosis of this disorder varies.
    • According to Fromm et al, some patients may present with pretrigeminal neuralgia syndrome for a period of weeks or even years before developing the customary symptoms of TN. They complain of an unrelenting sinus pain or toothache lasting for hours, triggered by moving the jaw or drinking fluids. Not surprisingly, they first seek dental care. Some find benefit from baclofen or carbamazepine.


  • In idiopathic TN, neurologic examination findings are normal.
    • Facial sensation, masseter bulk and strength, and corneal reflexes should be intact.
    • No sensory loss is found unless checked immediately after a burst of pain. Any permanent area of numbness excludes the diagnosis.
    • The corneal reflex also should be intact. Loss of this reflex also excludes the diagnosis of idiopathic TN, unless a previous trigeminal nerve section procedure has been performed.
    • The diagnosis of idiopathic TN is tenable only if no physical findings of fifth nerve dysfunction are present.
    • Any jaw or facial weakness or swallowing difficulties suggests another etiology.
    • In patients with MS or a structural lesion and TN, sensory loss often is found on examination.
  • Any objective abnormalities in the neurologic examination exclude the diagnosis of idiopathic TN.

Other diagnostic considerations are relevant with TN.

  • Other syndromes with paroxysmal lancinating head pain include the less common glossopharyngeal neuralgia (GN) and occipital neuralgia (ON) syndromes.
    • GN causes pain in the tonsillar fossa, posterior pharynx, and ear and may be initiated by coughing, yawning, or swallowing cold liquids.
      • During acute attacks of this disease, which frequently is associated with an underlying pathology, the patient may be unable to speak and tries to avoid moving the lips or tongue.
      • An involuntary startle during an attempt to touch the affected side of the face is diagnostic.
    • ON causes pain in the posterior head region.
      • Thus the distribution easily distinguishes it from TN.
      • Confusion arises only if the patient cannot provide a clear history.
  • According to Goadsby and Lipton, paroxysmal hemicrania syndromes typically last only seconds, similar to TN, but occur in and around one eye.
    • Intense unilateral conjunctival injection and lacrimation signal an autonomic component, which further distinguishes this condition.
    • This condition does not respond to carbamazepine.
  • Migraine and cluster headaches may produce severe unilateral pain but are not triggered by movement or contact with the face; nor do they respond promptly to carbamazepine.
  • According to Turp and Gobetti, atypical face pain usually extends beyond the distribution of the fifth cranial nerve, rarely is triggered, and presents with a steady unrelenting discomfo

The Pinched-Nerve Theory

For years, manual therapists have held firm to the belief that nerve root compression is the cause of pain arising from spinal misalignment. Pinched nerves are often blamed for unexplained neck and back pain. However, today most medical practitioners disregard the “pinched-nerve theory” due to the absence of neurological signs such as paresthesias, tingling, numbness, motor loss, etc.

Most researchers agree that pinched nerves do occur in extreme cases of trauma, muscle entrapments, and chronic degenerative disc disease. Some researchers dismiss the nerve root as a pain sensitive structure. To experience an example of nerve entrapment or ‘pinching’ of the nerve do this simple exercise: Lie on your side, place an arm above your head and rest on that arm for a few minutes. In a matter of time the arm will lose sensation as the nerve is stretched and compressed.

But, here’s the catch (no pun intended). Severe compression of a ‘healthy’ nerve may cause paresthesias, motor loss, sensory deficits, and loss of  normal reflexes…there will be no pain. But, if the compression continues and the nerve’s dural sheath has rubbed raw, become inflamed (intraneural edema) and then is compressed…pain will be felt.  This “silent nerve root compression syndrome” was first hypothesized by James E. Wilberger, MD in the Journal of Neurosurgery. His analysis  indicates that time is required before functional alterations create mechanical nerve fiber deformation and associated pain.

Prolonged pressure on an inflamed sensory nerve or its adjacent capillary beds can accelerate the experience of pain (nociception) in the brain. Compression of a tethered nerve causes muscle cell contraction which leads to protective spasm, altered firing order patterns, faulty posture, wasted energy, and pain. However, it is rare for long term pain to exist as a result of a compressed nerve.

A far more common occurrence is pain caused by oxygen deprivation of the sensitive nerve tissues. This particular condition can be extremely painful, yet is a harmless and reversible process. Although chronic back pain is most commonly blamed on pathologies such as herniated discs, bone spurs, etc., the pain often results from mechanical strain on joint related tissues such as spinal ligaments, joint capsules and muscles.

Some forms of manual therapy can effectively treat both types of problems; the reduction in nerve function (tingling and numbness) as seen in piriformis and thoracic outlet syndromes, and also pain due to nerve fiber irritation. Myoskeletal Alignment (R) Techniques aim to improve joint mechanics in the affected area to allow joint and soft tissue healing.

The Myoskeletal Therapist holds the joint in a specific position with one hand and stretches the surrounding soft tissues with the other. As resistance is met, the client/patient isometrically contracts to a count of 5 and relaxes. Following the isometric muscle contraction, a pin-and-stretch articular mobilization releases motion-fixated joints. Pain is often immediately alleviated once abnormal joint position is corrected thereby allowing better movement with diminished nerve pain.

It appears that there will always be a certain amount of controversy over what symptoms qualify to be called a pinched nerve. Many nerve compression specialists will continue believing that neurological tissue can be compressed by bone only. Others maintain that a herniated disc and osteoarthritis are the primary culprits leading to reduced nerve signal.

Dystonia Symptoms

Dystonia is not a new condition. It affects thousands of people every year. Contrary to popular belief, dystonia is not a normal consequence of growing older. As a matter of fact, the onset of dystonia can occur at any age. Dystonia is not a discriminatory condition, as it will affect men, women or children.

Symptoms can include disturbed sleep patterns, tiredness, depression, poor concentration, change in vision, and more. Normal activities can be more difficult to carry out. Sounds like other diseases as well, right? That’s why it is extremely important to not self-diagnose. Neurologists and Movement Disorder Specialists are physicians specializing in various areas such as dystonia and PD, with the ability to clearly differentiate the similarities of diseases with commonalities such as these.   

The clinical features of spastic cerebral palsy are those associated with damage to the cerebral cortex and corresponding pyramidal tracts. Symptoms and motor problems include paucity of movement, increased resistance to passive movement, muscle spasm, clonus (rapid contraction and relaxation of muscles), exaggerated deep tendon reflexes and absence of change in muscle tone associated with a change in posture, for example, moving from a supine to a sitting position.

People with this disorder can survive into adulthood. Patients with NPD type A have progressive neurodegeneration, and attainment of milestones does not progress beyond 10 months in any domain. Motor milestone attainment rarely progresses beyond the ability to sit with assistance. Progression with loss of previously achieved milestones ensues, and patients appear weak and hypotonic.

These are just some of the main symptoms of MS. There are many more in other areas but to list them all is well beyond the scope of this article. It is important, however, to realise that ignoring any of the above symptoms – particularly if they are tending to grow more severe or frequent – can lead to greater problems as the disease advances.

While the nerve-muscle connections cannot be repaired, selective denervation surgery is a peripheral way to treat this condition. Doctors perform a wide variety of tests to pinpoint the exact muscles that are contracting to cause you the majority of your dystonia issues. Once they have the locations of the misbehaving muscles, they carefully cut the nerves that supply these muscles.

These are slow twisting movements of the head, neck, trunk or proximal segments of the limbs, giving rise to grotesque movements of the body and distorted positions. Dystonia grossly resembles athetosis, but differes from it in its longer duration, persistence of the postural abnormality and affection of the axial muscles. ‘Torsion spasm’ is dystonia involving the lumbar and cervical muscles. I

Torticollis is a disorder where the neck muscles contract uncontrollably, causing the head to be twisted or turned in various positions. Sometimes a jerking of the head will also occur. This condition is usually painful and certain activities such as standing and walking can make spasms worse, making even simple tasks difficult. Severe headaches are not unusual with torticollis.

Voice Problems Among Call Center Agents

What do singers, lawyers, teachers, preachers, and call center agents have in common? All of them are professional voice users. This means that their voice is very important for them to earn a living. Being frequent voice users, however, also expose them to a greater chance of vocal abuse. With too much misuse and abuse behaviors, one’s voice may deteriorate and, eventually, he or she may even lose it. For those who use their voice professionally, losing their voice would mean losing their jobs as well. It is, therefore, important for them to take care of their voice by practicing vocal hygiene techniques to prevent from having vocal problems. For those who already have a vocal pathology, they can still undergo voice therapy for possible rehabilitation.

A lot of the activities or situations that call center agents are frequently involved in are detrimental for their voice. They continuously talk for five hours or more. Continuous voice use for two hours is the most length of time allowable. Going beyond that period of time will already cause a person’s vocal mechanism to feel strained and tensed. Call center offices are usually cold environments. Just like any muscle, a person’s vocal folds become tense in low temperature. The coldness can also cause the throat to feel dry. Another harmful habit of call center agents is that they often drink coffee, possibly to avoid feeling sleepy. Coffee, however, causes a person’s throat to feel dry and can also give a feeling of something lodged in the throat. This feeling leads to a person’s frequent throat-clearing which is also a vocal abuse behavior. Another situation they usually experience is lack of having enough rest and sleep. As a person’s whole body feels fatigued or tired, so does his or her vocal mechanism. The functioning of the larynx is, thus, compromised in this condition and makes it prone to overuse. Finally, call center agents experience a lot of stress from some of their clients. The stress, compounded with vocal overuse, will increase the level of strain and tension within the vocal mechanism. A person in this situation will be forced to exert more effort for vocal production which is not supposed to be done.

Because of the strain, tension, over-usage, and increased friction due to forced talking, it can cause the formation of scarring and nodules within the vocal folds. Vocal scarring and vocal nodules are among the most common vocal pathologies that professional voice users encounter. Because of the scarring and nodules, the voice can become hoarse and harsh-sounding. Pain in the throat area can also be felt. Instance of voice loss or aphonia will also be evident. Sometimes, pitch breaks also occur together with a general change in pitch. With a nodule in the vocal folds, total closure of the vocal folds during adduction may not be achieved resulting to an excess of air escaping. This will cause, then, cause the voice to sound breathy and compromise the loudness in vocal production.

To avoid reaching a situation where the voice has severely deteriorated, it is important for professional voice users to lessen or totally eliminate their vocal abuse and misuse behaviors. This means taking time to rest the vocal mechanism at least every 30 minutes. When in a cold environment, it will help to cover the throat or neck area with a muffler or a scarf. Frequently lubricate the throat area by drinking water to prevent it from straining because of dryness. Also avoid drinking coffee or smoking which will just increase the dryness of the throat. If possible, get enough rest after working. Performing relaxation techniques such as simultaneous contraction and release of the different muscles of the body, including those in the throat area, will also help. It is important to learn diaphragmatic breathing to lessen the tension in the neck area brought about by clavicular breathing. Also learn to decrease the feeling of stressfulness through stress management and relaxation. Constant practice of these behaviors will help any professional users, especially call center agents, avoid posing danger to their vocal mechanism. Otherwise, it will be an easy road for any person toward having vocal pathologies.

Fortunately, vocal problems such as abrasion or scarring and nodules can still be remediated with voice therapy. People who provide these services are called speech therapists or pathologists. Aside from managing voice problems, they also deal with speech and language problems as well as swallowing problems among young and old clients. In order to begin receiving voice therapy services, a person should initially obtain a referral from a doctor, preferably an otorhinolaryngologist. After being referred, a person with voice problem will be evaluated to determine the main reason or reasons causing his or her problem. Only after the evaluation will the therapy can then be started. During and after sessions, utmost cooperation from clients is required by therapists to make the voice management successful. Without a client’s cooperation as well as compliance to instructions, therapy sessions and therapy techniques provided will just be wasted. In the end, total rehabilitation actually depends on a person’s determination to be well.

How to Check for Throat Cancer Symptoms

Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are many different types of cell in the body, and there are many different types of cancer which arise from different types of cell. What all types of cancer have in common is that the cancer cells are abnormal and multiply ‘out of control’.

Cancer of the throat usually originates from cells which cover the mucous membrane lining the throat. As the tumour grows, it penetrates the mucous membrane and the muscle layers to surrounding tissues. The lymph nodes, neck, lungs and other organs can gradually become affected.

Throat cancer symptoms

Be aware. Pay close attention to a nagging cough, especially if it is producing blood.

Evaluate your health. If you have a sore throat for more than two weeks, have chronic neck pain or difficulty swallowing or a hoarse voice for an extended period of time, contact a doctor.

Pay attention to your breathing. Producing high-pitched or squeaky noises when breathing is not normal.

Throat cancer symptoms include: a sore throat that does not go away, painful swallowing, hoarseness, ear pains, and possible lumps in the neck region. Cancers above and below the vocal cords tend to spread more quickly than cancer of the vocal cords alone because there are more lymph vessels present in these areas, through which cancer cells spread quickly.

Talk to your doctor if you experience any coughing, nosebleeds, earaches or constant headaches. Your physician will most likely have to perform some blood tests on you at this point for further diagnosis.

If you are a heavy smoker or drinker it is highly recommended that you visit a doctor every now and then to perform regular tests. Especially if you encounter throat cancer symptoms like hoarseness or change in your voice tone for more than a week or two.

• Constant painful and tender throat.
• Roughness and Cough.
• Soreness or trouble while eating or swallowing.
• Inflated lymph glands in the neck.

Throat Cancer is also called as Larynx cancer, Vocal cord cancer or Cancer of the glottis.

Throat cancer is a specific type of cancer of the vocal cords, voice box (larynx), or other areas of the throat.

This may lead to severe ear ache as well and even paralysis of the face muscles since they are all interconnected with the throat. The person will feel excess mass in the face and he will not feel any sensations in the face. The neck will pain most of the time because of the sores or lumps which get enlarged day by day.

Due to the presence of the enlarged lump, a person can not eat through the mouth as swallowing becomes difficult and risky as well as painful. This condition leads the person to have excess weight loss. However the person is fixed with an Engi tube, which goes from the nasal area and directly to his stomach in order to pass liquid food.

The earlier throat cancer is diagnosed, the better the prospect of recovery. The symptoms of throat cancer are often confused with less serious conditions. The throat cancer symptoms or signs of throat cancer depend mainly on the size of the tumor and where it is in the larynx.

Tonsil Stones and Swollen Glands – Causes and Remedies

Swollen glands are very common type of symptoms of tonsillitis or tonsil stones.  Normally such types of conditions occur due to infections of various types and forms.  Swollen glands can also be called as swollen lymph nodes or swollen tonsils.  The lymph nodes are said to be the glands present in the body are responsible for playing a vital role in guarding the human body from various types of infections.

These lymph nodes can be located in particular body regions like behind ears, beneath jaw line and neck. But then swollen glands because of tonsil stones or tonsillitis can be seen in the neck area as they are situated in throat.  When the lymph size gets enlarged even by one centimeter in diameter than the actual size, then it is called as swelling of the glands due to tonsil stones.  Even though children are the most affected adults too can be affected.

There are various reasons for the cause of swollen glands but then some are rare and some very common.  Tonsil stones and tonsillitis, mononucleosis, strep throat, peritonsilar abscess, enlarged or swollen adenoids and scarlet fever are important among the various causes.  Sore throat is also found to be an important reason for the cause of enlarged glands.  The above causes can exhibit more than two common following symptoms like headache, pain experience when swallowing food, nausea and so on.  Bacterial or viral infections are main factors that the actual cause should be first found out to treat tonsil stones and swollen glands or tonsils properly.

Finding out the real cause for the problem might not be very hard but it can be tested at home or by the sufferer themselves.  They need to consult their family physician or reputed doctor regarding this problem.  Since the effectiveness of the treatment relies on the finding of the real problem or cause the physician might thoroughly examine the patient or sufferer thoroughly and might even take a few fluid samples from the throat’s back side.  The size of the lymph nodes too is taken into consideration for determining the actual cause and seriousness of the problem.

When the condition is not very serious or in the early stages, then just by gargling warm water with a pinch of Epsom salt can do wonders.  But if the health condition is a bit serious then they might be treated using antibiotics.  Viral infections on the other hand are treated using retroviral drugs and bacteria with antibiotics.  When the condition is very serious then there might be no other option but to get rid of tonsils using surgery.

Home Remedies for Curing Tonsil Stones
Tonsillectomy not only can lead to various health problems later but also does not come at a cheaper price.  The surgery can also hinder day to day activities for some time.  Hence, it is avoided most often. In fact, there are natural and scientifically proven ways to get rid of tonsil stones so they never return. It’s absolutely not necessary to go for a long, drawn out surgery or wasting your money on expensive nasal sprays and tablets. Follow a step-by-step program that will show you exactly how to get rid of your tonsil stones naturally and ensure they never come back! You can learn more about the program that promises a natural cure for tonsil stones from here

Diabetes Mellitus – Causes, Symptoms and Treatment

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (high blood sugar). Diabetes is a disease in which the body doesn’t produce or properly use insulin. Insulin is a hormone produced in the pancreas, an organ near the stomach. Insulin is needed to turn sugar and other food into energy. Three main forms of diabetes: type 1, type 2, and gestational diabetes (occurring during pregnancy),[1] which have similar signs, symptoms, and consequences, but different causes and population distributions. Ultimately, all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia.[2] Type 1 is usually due to autoimmune destruction of the pancreatic beta cells which produce insulin. Type 2 is characterized by tissue-wide insulin resistance and varies widely; it sometimes progresses to loss of beta cell function. Gestational diabetes is similar to type 2 diabetes, in that it involves insulin resistance; the hormones of pregnancy cause insulin resistance in those women genetically predisposed to developing this condition.

People with pre-diabetes are at increased risk for developing type 2 diabetes, heart disease and stroke. Gestational diabetes also involves a combination of inadequate insulin secretion and responsiveness, resembling type 2 diabetes in several respects. It develops during pregnancy and may improve or disappear after delivery. Insulin is called the “hunger hormone .

Causes of Diabetes Mellitus

Glucose into most cells from the blood (primarily muscle and fat cells, but not central nervous system cells), deficiency of insulin or the insensitivity of its receptors plays a central role in all forms of diabetes mellitus. Much of the carbohydrate in food is converted within a few hours to the monosaccharide glucose, the principal carbohydrate found in blood. Type 1 diabetes mellitus—formerly known as insulin-dependent diabetes (IDDM), childhood diabetes or also known as juvenile diabetes, is characterized by loss of the insulin-producing beta cells of the islets of Langerhans of the pancreas leading to a deficiency of insulin. The main cause of beta cell loss leading to type 1 diabetes is a T-cell mediated autoimmune attack. Type 2 diabetes mellitus—previously known as adult-onset diabetes, maturity-onset diabetes.

Symptoms of Diabetes Mellitus



3.Decreased endurance during exercise

Treatment of Diabetes Mellitus

Person with diabetes keeps blood sugar levels tightly controlled, complications are less likely to develop. People with diabetes should always carry or wear a medical identification bracelet or tag to alert health care professionals to the presence of diabetes. People with type 1 diabetes who are able to maintain a healthy weight may be able to avoid the need for large doses of insulin. People with diabetes also tend to have high levels of cholesterol in the blood, so limiting the amount of saturated fat in the diet is important. Drugs may also be needed to help control the level of cholesterol in the blood. Diet management is very important in people with both types of diabetes. Doctors recommend a healthy, balanced diet and efforts to maintain a healthy weight. Some people benefit from meeting with a dietitian to develop an optimal eating plan. Diabetic ketoacidosis is also a medical emergency, because it can cause coma and death. Oral medications are available to lower blood glucose in Type II diabetics include tolbutamide, tolazamide, acetohexamide, and chlorpropamide.

Diabetes – Causes And Home Remedies

Diabetes or diabetes mellitus is a metabolic disorder characterized by improper utilization of glucose by the body. The disorder forbids the body from using glucose either completely or partially. As a result, glucose builds up in blood and the person is diagnosed with high blood glucose or blood sugar levels. The hormone insulin produced by pancreas is the primary blood glucose regulator. If the pancreas does not produce enough insulin, blood glucose levels soar high, resulting in Type 1 diabetes.

The patient with Type 1 diabetes requires insulin injections. In other cases, the cells of the body become non-responsive to insulin, thereby causing glucose levels to rise. This is true in the case of Type 2 diabetes. Diabetes produces symptoms like increased thirst, increased hunger, frequent urination, skin infections, delayed healing of wounds, fatigue, weight loss/gain, irritability and erectile dysfunction. Some of the causes of diabetes may be listed as follows:

1. Heredity
2. High intake of carbohydrates
3. Inactivity or lack of exercise
4. Stress
5. Overeating habits
6. Insulin resistance
7. Inadequate insulin production
8. High cholesterol
9. High blood pressure
10. Surgery in pancreas
11. Disease of pancreas

Home Remedies for Diabetes

1. Boil 10-15 mango leaves in a glass of water. Leave overnight. The next morning, strain the liquid and drink it in empty stomach. This helps to cure diabetes.

2. Remove seeds and extract the juice of a bitter gourd and drink daily. This is an effective home remedy for diabetes.

3. Chew curry leaves twice daily to get rid of diabetes.

4. Drink the juice of crushed fish-berry early in the morning. This relieves diabetic conditions.

5. Pour 3 tablespoon cinnamon powder in 1 liter water and simmer for 20 minutes. Then strain and drink the solution regularly. This checks diabetes

6. Mix half teaspoon powdered bay leaf and half teaspoon turmeric powder. Add the mixture to aloe Vera gel and take before lunch and dinner. This is beneficial in treating diabetes.

7. Eat garlic regularly to keep glucose level under control.

8. Grind fenugreek seeds in to a fine powder and take 2 tablespoons every day. This prevents diabetes.

9. Feast on grapefruit to dismiss blood glucose.

10. Bean pod is the storehouse of natural insulin. Bean pod tea should be taken daily to do away with diabetes.

11. Mix 2 teaspoon of Greek clover seeds powder in to a glass of milk and drink daily. This is an effective diabetes cure.

12. Boil 4-5 leaves of sweet potato and 1 tablespoon ash gourd in water. Strain the contents and drink to ward off diabetes.