Sore Throat

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Pharyngitis is the term doctors use to describe sore throat and it accounts for 10-15 percent of all pediatric office visits. Group A beta-hemolytic streptococcal pharyngitis (GABHS), more commonly known as strep throat, is a primary concern of a person with a sore throat. GABHS is more common in children than adults. In both kids and adults viruses are the most common cause of sore throat.

The most important concern in the person with a sore throat is to rule out some serious conditions associated with sore throat, including, most commonly GABHS. Certain factors will help predict if the cause of the sore throat is GABHS or a viral infection. The factors are not perfect and the use of a throat culture is needed in many cases in order to rule out strep throat.

Important factors to know about strep include:

• It most commonly affects children between 5-15 years old.
• It does not commonly affect children under three years old.
• It has an incubation period of 2-5 days. This means that if you have been in contact with someone who is infected and are infected your disease may not show up for 2-5 days.
• Respiratory secretions spread the infection.

Causes of sore throat

Viruses cause the majority of sore throats. Bacteria cause 5-15% of sore throats, but those between the ages of 5-15 have a higher incidence of bacterial causes of sore throat. In this group, 15-30 percent of sore throats may be caused by GABHS.

Certain factors can help determine if the sore throat is caused by a bacteria or a virus. Viruses that cause sore throat are more commonly accompanied by cough, stuffy nose, red eyes and fatigue.

Possible diagnoses

• Viral sore throat – there are over 200 viruses that cause the common cold and each presentation may be a little different. Many of these viruses are linked to sore throat. Below some specific viruses that cause sore throat will be discussed.
• Hand-foot and mouth disease. This is caused by a virus that is called the Cocsackie virus. It causes blisters on the hands and feet as well as in the mouth or throat.
• Infectious mononucleosis can also cause sore throat. This sore throat is typically severe and associated with pus (white patches) in the throat. This disease is associated with swollen lymph nodes – particularly the glands on the back of the neck. It sometimes comes with stomach pain due to an enlarged liver or spleen. Those who are treated with penicillin will usually develop a rash (90% of the time). It is most common in those who are 10-25 years old and is accompanied by fatigue and a lingering sore throat.
• HIV is a rare cause of sore throat. Individuals who have risk factors for HIV (multiple sexual partners, men who have sex with men, intravenous drug users) who present with a sore throat should have this diagnosis considered.
• Bacterial sore throat. The most common cause of bacterial sore throat is GABHS. Other bacteria can sometimes cause sore throat.
• Fungal infections rarely cause sore throats. Candida infections are a common cause of fungal sore throat. The individual will have a sore throat with a white coat on the tongue and in the oral cavity that looks like cottage cheese. The white coating will bleed if it is scraped off.
• Diphtheria is a rare cause of sore throat. It presents with a sore throat, fever, tender lymph nodes in the front on the neck and serosanguineous nasal discharge. It can be prevented by routine vaccinations.
• Kawasaki disease rarely occurs but affects children under five and presents with sore throat, tender lymph nodes, fever, eye discharge, red oral mucosa, strawberry tongue, cracked red lips, swelling of the hands and feet and red rash on the hands and feet, followed by peeling of the palms.
• Peritonsillar abscess is a serious cause of sore throat and presents with fever, feeling wiped out, a hot potato voice, difficulty swallowing, painful swallowing, ear pain and difficulty opening the mouth.
• Miscellaneous causes of sore throat include: persistent cough, smoking, gastroesophageal reflux, postnasal drip secondary to runny nose, allergies, foreign body and thyroiditis (inflamed thyroid gland).

Complications

Most sore throats are caused by a virus and go away on their own. It is important that all health care consumers are aware of when sore throats can be serious and when they are likely self-limiting.

Death is a risk of life, but it is rarely related to sore throat. Throat abscess (pus filled infection in the throat) may lead to breathing problems as the swelling in the throat reduces the ability to breath. Diphtheria can lead to respiratory failure. Untreated GABHS can affect the heart valves and has the potential to lead to heart failure.

These serious complications are rare. Rheumatic fever is one of the most common preventable complication of sore throat. It occurs after GABHS goes untreated. The general population is not as greatly affected, as people commonly believe. In fact it takes treating 3000 to 4000 people with antibiotics with strep throat to prevent one case of rheumatic fever. The incidence of rheumatic fever is about one case per one million people. Treatment with antibiotics do not guarantee prevention of rheumatic fever.

Rheumatic fever occurs about 3 weeks after an untreated GABHS infection. It is characterized by joint pain and swelling, erythema marginatum (pink rings on the trunk, arms and legs), heart murmur or subcutaneous nodules (painless, firm nodes over the bones or tendons often seen on the wrist, elbow or knees). If this is suspected an immediate evaluation with a health care provider is essential.

Peritonsillar abscess (pus behind the tonsils) can cause sore throat or can be a complication of GABHS. It is not common but is characterized by worsening sore throat, ear pain, inability to open the mouth, fever, and a hot potato voice.

A rash that feels rough, like sandpaper, is red and fades when you push in on it is likely scarlet fever. This rash will last about a week and will result in peeling of the skin. This is a common manifestation of streptococcal infection

Streptococcal infections have the potential to attack the kidneys. It may present 10-14 days after a strep throat. It is characterized by bloody urine and swelling (especially around the eyes). It is unclear if treating with antibiotics reduces the risk of kidney problems after strep throat.

Red Flags

• High fever
• Unable to handle secretions – drooling
• Difficult time opening the mouth
• Hot potato voice (muffled voice, sounds like you have a mouthful of hot potatoes)
• Uvula (piece of tissue that hangs down in the back of the throat) deviating to one side
• One swollen tonsil
• Difficultly breathing

Diagnosing strep throat

Key features of the history and the physical exam will help the health care provider determine the likelihood of streptococcal infection. There are a few key features that are most predictive of strep throat.

Recent exposure to streptococcus and white patches in the throat or on the tonsils are the two most important factors in predicting strep throat. Tonsils that are free from swelling or pus and non-tender lymph nodes in the neck are the best criteria for ruling out strep throati.

Clinical prediction rules have been developed for helping the health care provider determine who has strep and who does not. None of these rules are perfect, and it usually requires the work of a throat culture to definitively determine who has strep throat. None-the less, these key features can be useful in helping patients determining their risk for strep throat.

The prediction rule has been based off of five key criteria.

1. Fever above 100.4 degrees Fahrenheit
2. Swelling of the tonsils or pus on the tonsils
3. Sore throat in the absence of cough
4. Tender lymph nodes in the front of the neck
5. Age – One point is given if the age is between 3 and 14, and one point is taken away if over the age of 45.

Based on the number of criteria that are present one can take a guess as to how likely GABHS is. The person is given a score of -1 to 5 and utilizing that point total one can predict the likelihood of strep throat.

For example, if we look at the case study presented in chapter 2: A 20 year-old female comes to her doctor with tonsillitis. “My nose has been stuffy for the last couple of days and I have been coughing. I woke up this morning and my throat hurt really badly. I looked in my throat and my tonsils were swollen and there were white dots on them.

It is also determined that she did not have a fever. When the doctor felt the front of her neck, he determined that her lymph nodes were swollen and tender.

This patient receives one point for swollen tonsils with pus and one point for swollen lymph nodes. She has a point total of 2. Therefore, her risk of strep is about 17%.

Table 1: Percent change of having GABHS based on number of clinical criteria

-1 or 0 – 1%
1 – 10%
2 – 17%
3 – 35%
4 or 5 – 51%

As you can see from the chart, it is impossible to rule in or rule out strep throat just by doing an interview and physical examination. The CDC recommends that antibiotics not be given unless GABHS is found on strep culture. When there is a score of 4 or 5 many health care providers will treat instead of doing a culture and some clinicians even choose to treat if there is a score of 3 or more.

One fact that is not well know is that strep throat will go away on its own. Well, that is not entirely true. The symptom of sore throat will remit, but the bacteria may still persist. It has the potential to go to the heart and cause rheumatic fever, it is therefore important to treat strep throat even though the sore throat will go away.

When sore throat persists beyond five days strep throat is not likely. It is more likely mononucleosis, a sinus infection, allergies or post-nasal drip.

Diagnostic Testing

Who is a candidate for diagnostic testing?

1. All children with a sore throat
2. Selected adults with a sore throat. This includes adults with at least one feature suggestive of strep throat (swollen tonsils, pus on the tonsils, fever above 100.4 degrees Fahrenheit, swollen lymph nodes, sore throat in the absence of a cough)

What type of testing should be done?

1. A rapid strep test is indicated for most patients with a sore throat with a back up throat culture

If the rapid test reads positive, it is quite reliable. If it reads negative it may not be that reliable. Because of the tests ability to miss the diagnosis, it is recommended that the health care provider get a back up culture that is sent to the lab to confirm every negative rapid strep test. Some experts suggest you do not need a back up culture in the adult, but my experience suggests that you should do a back up culture in the adult.

The rapid test should not be used in those who had a positive strep test in the last 30 days as there still may be strep antigen fragments hanging around that could give a false positive test.
Other testing for sore throat

When sore throat persists another diagnosis to consider is mononucleosis. This is most common in those 10-25 years-old. It can be testing by checking the blood for antibodies to the Epstein-bar virus. During the first week of the illness, the test may not pick up the disease but by the second week the test picks up the disease over 80% of the time.

Testing for HIV and other sexually transmitted diseases may be warranted in the high-risk individuals. Individuals who have oral sex may need the throat tested for gonorrhea.

Some cases of sore throat warrant a broad culture that looks for other causes of sore throat such as other bacteria.
Treatment

Most cases of sore throat are either caused by a virus or GABHS. If strep throat is present treatment with antibiotics is important and if it is not present treatment of the symptoms is all that is necessary. Treatment of strep throat will reduce rheumatic fever, abscess formation, transmission and improve comfort. It is always important to stay alert for other complications of sore throat – even though they are rare.

There is a nine-day window that the clinician has to treat strep throat to prevent rheumatic fever after GABHS. Treatment will also speed healing. After starting treatment you should be feeling much better in 24-48 hours. Ideally treatment should be started within 48-72 hours.

Some clinicians choose to treat patients while they wait for the return of the culture. Realizing that resolution will be faster and it will provide comfort to some patients.

This is not a wise strategy to implement for all patients. This requires some professional judgment of the treating health care provider. Those who are suspected of having strep are better candidates for this method of treatment. The goal is to avoid excessive exposure to antibiotics. When antibiotics are prescribed without a confirmed diagnosis the patient should be encouraged to stop antibiotics immediately if the culture comes back negative.

There is no resistance to penicillin in the United States, so it is the drug of choiceii. Ten days of pills or a shot is equally effective in its management. People who will not take all of their medication should receive a shot.

Amoxicillin, which is a type of penicillin, is often used in place of penicillin in children, as the suspension of penicillin does not taste good. Amoxicillin suspension has a pleasant tasting bubble gum flavor.

Individuals who do not have angioedema (swelling deep in the skin near the eyes and lips) or hives as their allergic reaction to penicillin can be treated with first or second-generation cephalosporins. If they are, they need to be watched closely as allergic reactions with penicillin sometime cross over to an allergic reaction to cephalosporins.

Erythromycin is recommended in patients with a severe penicillin allergy. Due to side effects – mainly gastrointestinal – azithromycin or clarithromycin is sometimes substituted.

Recurrent GABHS can be treated with amoxicillin-clavulanate (Augmentin). It is not usually picked as a first line medication as it is a more expensive and has a wider spectrum of activity. A wider spectrum of activity means that it is able to cover many other types of infections. The routine utilization of broad-spectrum antibiotics for simple infections has the potential to increase the risk of antibiotic resistance.

Penicillin should be used for 10 days in the treatment of GABHS to assure that all the bacteria are killed and no straggling bacteria remain.

The use of probiotics are one strategy that will significantly reduce the risk of Clostridium difficile and other complications of antibiotic use. When you are on antibiotic it is critical to take probiotics to reduce the risk of this complications. Always keep a supply of probiotics on hand because you never know when you will need to go on antibiotics.

Treating the symptoms

Sore throat pain can be quite debilitating and managing that pain is a critical part of treatment. Symptomatic treatment often involves a combination of systemic medications and local acting medications.

Systemic medications include medications that are taken by mouth that can help relieve the pain of the sore throat and may also help other symptoms that accompany sore throats such as headache, fever and body aches. Systemic medications include: ibuprofen, acetaminophen, naproxen or acetaminophen/codeine (in severe cases). The use of medications to reduce pain and fever, in addition to reducing symptoms, may help shorten the course of disease by one to two days.

Topical medications are available in many over the counter formulations and some can be made at home. A common home remedy is salt-water gargles, which can be made by adding one-fourth of a teaspoon of salt to 6-8 ounces of warm water. This concoction can be gargled and spit out every 3-4 hours. Sugar-free or regular Popsicles can help ease the discomfort of a sore throat.

Multiple over the counter medications are available for treating sore throat. They come in sprays and lozenges.

Certain foods can help the throat feel better. For example, warm or cool liquids soothe and moisturize the throat. Nasal saline can moisturize the nasal passages and clean mucus out of the nose. This will reduce the amount of post-nasal drip, which will help reduce throat discomfort. Herbal teas may be helpful in the treatment of sore throat. Throat coat – a herbal tea – has a demulcent that is more effective at providing relief than regular tea.

Certain prescription medications have the potential to aid a sore throat. Viscous lidocaine is a medications that comes as a thick liquid that the health care provider can prescribe that will numb the throat. It can also be mixed with other liquids such as liquid Benadryl and/or Maalox to ease the discomfort.

Steroids are used in some patients with sore throats. This is a prescription given by the doctor and can be given by mouth or as a shot. Steroids reduce the inflammation of a severely inflamed throat.

Home remedies for a sore throat:

• Salt water gargles as outlined above.
• A cool mist humidifier should be used. Many sore throats are caused by or exacerbated by dryness; the moisture that a cool mist humidifier provides can improve symptoms.
• Suck on a sour drop. Lemon drops or another type of drop will stimulate saliva and reduce throat pain
• Drink tea with honey as this will coat the throat.

Follow up

Improvement in the sore throat caused by a bacteria or virus is typically noted in 2-3 days. When there is no improvement or a worsening of symptoms noted a follow up with your health care provider should be attained to rule out a more serious (cellulitis or abscess) or another underlying condition (mononucleosis or chronic post-nasal drip).

Rarely, other bacteria can cause sore throat. This is much more common in the adult than the child. This may be considered when there is a non-response to antibiotics or a negative GABHS culture and the patient is getting worse. The health care provider will often take a more broad culture to look for other bacteria that may be causing the sore throat.

At times further testing is indicated. This is not common, but may occur in the sore throat that is not explained by other causes. It is most often carried out by an ear, nose and throat specialist. A laryngoscope will be used to look for cancer, a foreign body, acid reflux or another cause of sore throat.
Recurrent Disease

When disease returns within one week of completing antibiotic therapy it is considered treatment failure. The main causes of this are:

• Not taking the medication as directed
• Resistance to the antibiotic
• Repeat infections

For those who are thought to have a resistant strain, a different antibiotic may be considered such as a cephalosporin, macrolide or amoxicillin-clavulanate.

In cases where there is repeat infection, family members should be checked to see if they are carriers of strep. If they have a positive strep culture, they should be treated.

What is a carrier?

A surprising number of people – 10 to 25 percent – are colonized with GABHSviii. When one is colonized, it means that the strep is living in the throat with out causing the person to be sick. Generally, those who are colonized do not need to be treated, but sometimes they do. Treatment should ensue when there is:

• A personal or family history of rheumatic fever
• Recurrent transmission between close contacts
• Significant anxiety about GABHS
• Consideration of removal of the tonsils to eradicate the carrier state

Tonsillectomy and Adenoidectomy

Tonsils and adenoids are often removed, but the surgery may be done too often. The tonsils are there for a reason. The tonsils, while they often get infected, help fight infections in the throat and nose and keep the infection from spreading.

There are risks with this procedure. Bleeding is the most common complications and can occur up to eight days after surgery. Sore throat after the procedure is common. The voice sometimes changes after the procedure. The most worrisome complication is death, but this only occurs in one of every 250,000 operations.

The tonsils and/or adenoids can be removed for multiple reasons including:

• Recurrent GABHS: For two-year olds, more than 4 episodes a year; for three year-olds more than 3 episodes per year; and those over 3-years-old, greater than 6 episodes a year is an indication for the tonsils and adenoids to be removed.
• Obstructive sleep apnea
• A severe infection that does not respond to antibiotics
• Recurrent peritonsillar abscess
• Potential cancer
• Persistent mouth breathers may be a candidate for removal of the adenoids
• Persistent swallowing problems if they are caused by large tonsils or adenoids

What you need to know

If you are diagnosed with strep throat:

• Do not infect others. Do not come in close contact with others for 24 hours after starting antibiotics.
• Removable oral appliances (e.g. retainers) should be cleaned completely.
• A new toothbrush should be used after 24 hours.
• Complete the entire course of antibiotics or resistance to that antibiotic may occur.
• Symptoms that do not improve by 72 hours or get worse after 48 hours require a medical evaluation.
• Do not take any antibiotics that are lying around the house for a sore throat without visiting the health care provider. Antibiotics will invalidate a throat culture.

Questions to Ask Your Health Care Provider

1. Is my sore throat related to a virus or a bacterium?
2. Do I need a culture to determine if there is a bacterial infection?
3. Which medications do you recommend to manage my symptoms?
4. Do you recommend any home remedies?
5. Will an antibiotic help my infection?
6. Are there any potential interactions between the medications that you are recommending and the current medications that I am on or any other health problems I may have?
7. When should I expect an improvement in my condition?
8. What complications should I look out for and how will they show up?

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Source by Ray Lengel

Tonsillitis – How to Naturally Treat This?

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If your tonsils are white and swollen, your throat sore, your head achy and your body feverish, then you may have tonsillitis. This is a common condition that is classified as an inflammation of the tonsils.

It can generally be caused by a bacterial infection or a viral infection. If your tonsil inflammation is caused by a bacterial infection, then you will most like have to take a dose of antibiotics.

However, in about 85 percent of tonsillitis cases, the symptoms are caused by a viral infection. And, when it is a viral infection, there are natural, at home remedies to help treat this annoying illness. We have outlined some of the common treatments for viral tonsillitis below. All of these remedies can be easily found around the home.

Milk is a great treatment for swollen tonsils. Pure boiled milk combined with turmeric powder and pepper powder is the ultimate evening drink to kick your inflammation to the curb.

If boiled milk isn’t your thing, try freshly squeezed limes in warm water. Or, opt for a mixture of vegetable juices such as carrot, cucumber or beet juice. This will boost your immune system and sooth the throat.

Another option is to gargle with fenugreek seeds and water. You should allow the fenugreek seeds to simmer for a half an hour in the water and then set aside to cool before gargling with this mixture.

In many cases of tonsil inflammation, your problem may not be the result of a virus or a bacterial infection. Instead, it is caused by tonsilloliths.

If your tonsils feel swollen and there are white lumps in the back of your throat, but the rest of you feels okay, then you may have tonsilloliths. These are white balls of food, debris and mouth bacteria that get stuck in your tonsil cavities and cause bad breath and throat blockage.

For those tonsilloliths sufferers there are natural home remedies to treat your problem as well. And, the good news is, you don’t have to eat seeds. Instead you can try to cough the little balls out. Or, take a bobby pin or cotton swap and gently try to poke them out of place. If this doesn’t work, you can also try gargling with salt water to loosen the stones.

So whether you are suffering from a tonsillitis or tonsilloliths, there are home remedies to treat your problem the natural way.

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Source by Anna Watson

Diabetes Mellitus – A Metabolic Disorder

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Diabetes (diabetes mellitus) is no longer a new disorder for the generation of the present century. It prevails very frequently among the population of the modern world. Diabetes mellitus is basically termed as a metabolic disorder. Metabolism may be defined as the process of breakdown of food material for the generation of energy so that it can be utilized for growth and development. The end product of the food is glucose which is a sugar. The sugar glucose is present in our blood and is the chief source of energy our body needs. When the food we eat is digested, glucose enters our bloodstream and the cells utilize this glucose for growth and development. The cells cannot take directly glucose from the blood they require insulin for this task. Insulin makes the glucose readily available to the cells to be utilized. Actually insulin is a hormone that is secreted by pancreas. When food is eaten, pancreas secretes adequate quantity of insulin so that the glucose present in the bloodstream may enter the cells, so that the glucose level in the blood declines. An individual suffering from diabetes generally shows elevated levels of blood glucose and this condition is termed as hyperglycemia. This condition may arise when the body produces little or no insulin or the cells do not respond to the insulin produced by the pancreas resulting in higher blood glucose levels. The excess glucose leaves the body through urine. The body growth and development is hampered although plenty of glucose is present in the blood stream but the cells are not able to utilize it.

The word diabetes has got it origin from a Greek word meaning siphon. Aretus the Cappadocian was a Greek physician during the second century A.D. who the condition diabainein. The word became “diabetes” from the English adoption of the Medieval Latin diabetes. In 1675 Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means honey; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. In ancient China people found that ants were found to be attracted towards the urine of some people because it was sweet in taste so the term “Sweet Urine Disease” was coined. There exist three main forms of diabetes. The first type is called as Diabetes Type-I where no insulin is produced at all. The second type is called as Diabetes Type-II where either insulin is not produced in a sufficient quantity or the body insulin is not functioning properly. Both the diabetes Type-I, Type-II is chronic and persistent. The third type of diabetes is called gestational diabetes; it develops during pregnancy and resolves itself after child birth. The treatment for all the types of diabetes is available but Type-I and Type-II diabetes persists for lifetime with no known cure. The patient is administered regular doses of insulin which is available from 1921. The patient suffering from Type-I receives regular doses of insulin along with dietary as well as physical exercise. Patients suffering from Type-II are preferred tablets along with dietary as well as physical exercise but in some extreme cases the insulin injections are also administered to them. When the diabetes becomes uncontrollable the patient faces several complications which include hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. The longer complications comprise cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.

The individuals suffering from diabetes may be unaware of it sometimes as the earlier symptoms appear harmless. Regular medical checkup should be done in order to avoid the severe complications. The symptoms of diabetes include frequent urination where the blood glucose level is very high, the insulin is ineffective and the kidneys take more water in order to dilute glucose. This results in loss of blood glucose in the urine. Disproportionate thirst is another symptom where the patient drinks much more amount of water as compared to the normal person. Thirst is enhanced. Diabetes also results in the generation of intense hunger. This is because the cells are not able to utilize adequate amount of glucose for their growth and development they try to find sources of energy from wherever possible. This intense hunger results in weight gain. Patients suffering from Type-I are noticed with profuse weight loss because the cells are not getting energy, the fat stored in the body and the muscles breaks in order to provide energy. The depletion of body reserves leads to weight loss and increased fatigue along with increased irritability. Diabetes also leads to blurred vision and the wounds and the cuts take longer time to heal. The body becomes more prone to infections. The gums become red and swollen pulling away the teeth. Men suffering from diabetes generally show sexual dysfunction. Excessive amount of sugar in the blood also damages the nerves resulting in numbness or tingling of hands and feet. Diabetes can be diagnosed by carrying out the urine test which predicts excessive amount of blood glucose. Blood test also predicts the glucose level strengthening to the fact that the person is having diabetes.

The Type-I diabetes is an autoimmune disease where the person’s body has destroyed its own insulin producing beta cells of pancreas so no insulin is produced. Most people develop diabetes Type-I at the age of 40. Out of all the individuals suffering from diabetes 15% persons have Type-I. Type-I is basically fatal unless the patient receives regular doses of insulin. Pancreas transplant is also helpful for the patients suffering from Type-I as it can help in normal production of insulin so that the condition may be kept under control. Type-I may also occur at the age of 18. It is non-preventable. AC peptide is basically used to diagnose whether an individual is having Type-I or Type-II. The diet should be kept under control for a patient suffering from diabetes Type-I. Individuals are prescribed to eat food low in fat, little or no sugar in meals. The amount of cholesterol as well as carbohydrates should be maintained. Person’s suffering from Type-I diabetes have greater risks of heart disease, stroke, high blood pressure, blindness, kidney failure, gum disease and nerve damage, compared to a person who does not have any type of diabetes. Physical exercise helps to regulate the blood sugar level.

In diabetes Type-II the person either does not produce insulin or shows insulin resistance. The persons suffering from Type-II are overweight. This form usually occurs at a later age. In the early stages of Type 2 insulin sensitivity is the main abnormality – also there are elevated levels of insulin in the blood. There are medications which can improve insulin sensitivity and reduce glucose production by the liver. The risk factors of Type-II include cardiovascular attacks, development of gestational diabetes, impaired fasting glycaemia (IFG), impaired glucose tolerance (IGT), severe mental health problems.

Diabetes can be kept under control by keeping the blood sugar level under control by taking proper diet not very much rich in fats, carbohydrates, sugar and cholesterol. Smoking should be avoided. A health care professional can also take care of a patient suffering from diabetes as he or she can provide the patient a proper diet chart along with the type of exercise a patient requires. Now these days’ glucose meters are also available so that the patient can check his or her glucose level by himself.

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Source by Navodita Maurice

Diabetes – A Degenerative Disease

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Diabetes Disease:

In normal individuals food is broken down to glucose in the presence of insulin the glucose present in blood is utilized by body cells with the aid of insulin secreted by pancreas for getting energy to maintain optimal health. Diabetes is a condition which is signified by a higher concentration of glucose levels in the blood because person cannot utilize glucose due to deficiency of insulin secretion by the pancreas of the body.

Types of Diabetes:

Type 1 Diabetes: The Cells of Pancreas responsible for secretion of Insulin do not function properly or are completely damaged. This type of diabetes is found in children and young persons, hence it is also known as Juvenile Diabetes.

Type 2 Diabetes: In this type of Diabetes the pancreas cells do make some insulin but the body prevents the insulin to perform it’s function. This type is usually found in elderly obese patientsonly but now a days it is encountered in children and young persons also.

Diabetes is found in the pregnant women also, if it is not treated properly the mother and child can also develop many health disorders.

Diabetes Symptoms:

Diabetes is characterized by:

1. Feeling of exhaustion all the times.

2. Sensation of great thirst (Polydipsia)

3. frequent urination.

4. Blurring of the eyesight.

5. Felling of hunger all the times.

6. Sudden fall of body weight.

7. Non-healing of wounds.

8. Numbness of hands and feet.

Causes of Diabetes:

Definite causes of Diabetes are not known, possibly body lacks a gene which can provide protection at the time of onset of disease. Diabetic patients are usually obese with a sedentary life style, hiving higher levels of triglycerides in thir blood or suffering from hypertension and also having a diabetic hereditary family history

Diabetes a Warning Signal:

The health of the Diabetic patient is on the thresh hold of rapid worsening of the status of his health if not properly taken care of initially and maintaining of care through out his life.

Diabetes affects both rich and poor alike and for a considerable peiod remains undiagnosed, because for minor symptoms the patients donot take medical advise and the disease progresses to a stage when the symptoms become uncomfortable for the patient to bear. Because of this trend of accessing delayed medical advice, India has become the Diabetes World capital with more than 33 million people suffering from type 2 Diabetes representing about 20 % of World Diabetic Population. With the present progression rate it is estimated that by the year 2030, about 80 million Indian population shall be diabetic. A similar progression trend has been noticed in other Asian Countries also.

Diabetes a life long association:

Diabetes patients are destined to live their rest of their life with Diabetes with lot of care to keep the disease under control by regularly taking the advised medication and adjusting their food and lifestyle habits. Patients have to remain regularly under medical care

Diabetes & Future Onset of Serious Complications:

Diabetic patients carry a high risk of exposure to other serious complications, like hypertension, coronary heart disease, Degenerative vascular system and tissues of lower limbs. When there is continued high blood sugar level, the blood sugar generates certain substances, which are potentially harmful to the body cells, which damage delicate organs like heart, Blood Vessels, Kidneys, Nerves, Teeth and lower limbs. If with the passage of time treatment is not initiated serious complications start setting in.

Diabetic Disease Education to patients:

The Diabetic patients need to be educated about their disease and the necessary care and precautions they have to religiously follow in the true sense particularly about the lower limbs. The Diabetic patients are carrying a higher risk of degenerative vascular system of lower limbs resulting in Nerves and Tissues damage progression of which requires amputation of Toe, Foot depending upon the severity of the affected part. Thus they have to lead a life of dependency.

Diabetes & Heart Disease:

Diabetic Patients are 2 to 4 times more prone to suffer from heart attack as compared to normal persons. In the obstructructions developed in the arteries of heart and in the entire circulatory system there is slowing of blood supply resulting in pain in the Chest,difficulty in breathing, swelling of Heels, thickening of the blood vessels all these quickly lead to a Heart Attack

Protection of Heart & Blood Vessels:

The quick onset of serious complications can be reduced by:

1. Bringing down high blood glucose levels to normal.

2. Reducing intake of foods containing high quantities of Saturated fats, Trans Fats and High

Cholesterol foods.

3. Reduction in intake of Common Salt.

4. Keeping blood Pressure and blood Lipids in control.

5. No smoking and no consumption of tobacco.

6. Moderate Exercise.

Kidney Disease:

The filtration membrane gets thickened. The Protein metabolites excretion is reduced, which damages the kidney. The incidence of Renal failure due to Diabetes is in 45 % of the Renal failure cases. Special kidney function tests are performed to ascertain early involvement of kidney complications because no specific symptoms are witnessed in early stages of kidney complications.

Complications of Eyes:

Diabetes can damage the smaller capillaries of the eye. Diabetes can precipitate Glaucoma because of increase of internal pressure in the eye ball. There can be eyesight complication or even complete blindness due to the damage to retinal blood vessels and detachment of Retina.

Amputations of affected foot:

The complication of the foot can be loss of touch sensation, Pain or swelling of foot, Delayed or non-healing of foot, Change in the colour of skin to redness. As a precaution the foot should be protected from any cut, scratch or from any other injury. Wounds because of faulty blood circulation in the feet the Nerves and Tissues get damaged resulting ultimately gangrene development resulting into amputation of toe or foot in diabetic foot damage progression.

Gateway optimal health is with you on your journey to Disease free Healthy Life Styles

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Source by Jagmohan Chadha

The Difference Between High Altitude Pulmonary Edema and High Altitude Cerebral Edema

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High altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE) are two different forms of Acute Mountain Sickness (AMS). As per studies AMS affects about 40 percent travelers at an altitude of up to 10,000 feet and more than 50 percent on routes on higher altitudes which are mostly taken by trekkers.

High altitude pulmonary edema affects the lungs whereas High altitude Cerebral Edema affects the brain of the person. In HAPE an extra vascular fluid which is a fluid outside the blood vessels accumulates in the lungs of a person at high altitudes. This mostly happens when the person climbs the height very fast and this trek involves vigorous exercise. This leads to shortage of breath or dyspnoea as it is called, cough, fast heart rate and decreased oxygen levels in the arteries. On the other hand, High altitude cerebral edema is a form of AMS where the brain swells and ceases to function in the usual manner. This increases intracranial pressure and can lead to death. The major symptoms are vomiting and nausea, lethargy, confusion, loss of balance, seizure and this all can finally result in coma.

HACE is said to occur after the trekker ascends the altitude very fast whereas HAPE is usually said to occur on the second day after the person has ascended. HACE generally affects the people who continue to ascend with the symptoms of acute mountain sickness whereas HAPE affects young and healthy trekker. One major difference between HAPE and HACE is that HACE always is accompanied by the usual symptoms of AMS whereas HAPE it not related to the signs of AMS. The main symptoms of AMS are Loss of appetite, fatigue, weakness, dizziness etc.

HAPE can be treated by immediately starting to descend and go down 2000 feet to 4000 feet and this should be tried and done when the victim has the power to do it himself. It should also be tried that the victims are kept warm and oxygen should also be given if it available. For a victim of HACE, decent also should be started immediately irrespective of the time of the day and the victim should be brought down to the level where he felt well and was awake.

HACE can be prevented as it starts with the symptoms of AMS and if one continues to climb the altitude with the symptoms he is more susceptible to be a victim of the cerebral problem. On the other hand HAPE need not be accompanied by the usual AMS symptoms and thus, can at times be not avoided. As per studies a person affected by HACE may not be affected by HAPE but a person affected by HAPE can also develop HACE because of low levels of oxygen in the blood.

HAPE and HACE are too severe forms of acute mountain sickness which happens when people ascend to very high altitudes, for example, Mount Everest. One affects the lungs whereas the other affects the brain.

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Source by Colin Wallace

What is Prenatal Stroke?

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Meaning of prenatal stroke:

Strokes which occur in an infant 5 months before birth and 1 month after birth is known as prenatal stroke. Sometimes this may ensue in childhood epilepsy. Research is being conducted so that strokes in infants can be detected at an early stage which would make treatment possible and reduce the damage.

How is Prenatal Stroke connected to Epilepsy?

An enduring damage to the brain as an outcome of a stroke leads to repeated seizures which is known as epilepsy. 5 months before birth and 1 month after birth strokes is the most usual reason for prenatal seizures in infants. Around 17% of the infants who get prenatal raptures suffer from strokes.

Reasons of stroke prior to birth:

The different causes of stroke prior to birth are as follows:

o Pore cephalic vesicles:

Pore cephalic vesicles are uncommon liquid packed caves which can be seen in the brain of some babies. These cavities block the flow of blood to a particular region of the brain which results in stroke.

o Blood curdles:

Formation of blood curdles results when more than two or at least two babies carve up in the same womb, and one dies before birth. The dead baby turns out to form dead tissue and this is taken in again and moves inside the placenta resulting in a stroke to the unborn baby which is alive.

o Cramps of the blood vessels which helps in carrying blood to the baby’s brain:

If a to-be mother uses cocaine or amphetamines when she is carrying then cramps of blood vessels occurs in the baby.

o Exuberant hemorrhage in delivery:

When there is trouble in delivery and a huge quantity of blood is lost then the mother gets low blood pressure. The pressure becomes so low that the required of blood cannot be pumped to the brain of the baby. This results in ischemic stroke in the baby due to local anesthesia given to the mother.

Reasons of stroke after birth:

The different causes of stroke after birth are as follows:

o Irregularities in the composition of the heart:

When the composition of the heart is irregular then blood clots are formed. These clots are transmitted to the brain and results in stroke.

o Result of infective endocarditic:

A tiny pellet from bacteria which infects the valves of the heart gets transmitted to the brain resulting in strokes.

o Abnormal antibodies in mother:

Antiphospholipid in the mother influences the formation of blood clot resulting in stroke in the baby.

o Polygenic disorder in the mother can also induce stroke in the baby.

o Sufferings during birth also results in strokes.

o When an operation is conducted in the baby to set right a defect in its heart also may result in stroke in the baby.

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Source by Parmu Malika

Diabetes and Stroke

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Diabetics Suffer Greater Brain Damage From Stroke than non-Diabetics.

If you are diabetic, there will be higher than normal amounts of LDL cholesterol – the ‘bad’ cholesterol – in your blood vessels. This can cause narrowing of the arteries in the brain (the cerebral arteries) which will reduce the blood flow and lead to high blood pressure, the number one risk factor for stroke.

They are two main types of stroke you are likely to suffer.

  • Ischemic stroke.
  • Hemorrhagic stroke.

Ischemic stroke can occur when fatty deposits or a blood clot become wedged in an artery in the brain, blocking the blood flow. A piece of plaque from a partial blockage, which may be in the jugular or one of the larger arteries, can break off and make its way to smaller cerebral arteries which then becomes blocked. When this happens, the part of the brain which depended on the blocked vessel no longer receives any blood. Without a blood supply there is no oxygen getting to that brain tissue, and it will start to die within minutes. The death of brain tissue will result in a stroke and the area of the body controlled by that part of the brain will then become paralyzed

There are two types of stroke. The type caused by a burst artery,is known as hemorrhagic stroke, and the second type caused by blockage of an artery, is known as ischemic stroke.

With hemorrhagic stroke, a cerebral aneurysm burst open and the leaked blood increases the pressure on the surrounding brain tissue. This causes the death of those cells. Blood supply to any areas that depend on the burst artery is also reduced and that area of the brain will die as well.

After a stroke a healthy person’s blood supply is usually restored by using alternative routes through nearby blood vessels. This can either be done surgically or it may happen naturally. However, for persons with this disease, these other routes may not available because the nearby blood vessels may be blocked or damaged as well. This means that as a general rule, the brain tissue of diabetics who suffer from stroke, will be without oxygen for a longer time and therefore suffer greater damage than that of a healthy person.

An aneurysm is a bulge in a blood vessel resulting in a balloon like area filled with blood. If this occurs in the brain it is called a cerebral aneurysm.

Having diabetes also increases the risk of stroke in younger people. Type two sufferers in their thirties and forties have an increased risk of stroke because of the buildup of cholesterol and other fats in the arteries, which was going on even before the disease was diagnosed.

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Source by Timothy S Harris

Schizophrenia – The Games of the Mind

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Schizophrenia is a debilitating brain disorder affecting many Americans. It is often characterized by hallucinations, delusions, and inappropriate reactions to situations. It is a form of psychosis characterized by symptoms such as disordered thoughts, hallucinations, delusions, and social withdrawal. Schizophrenia is a mental disorder that alters sufferers’ perception of reality, producing delusions, hallucinations, and disordered thinking. Drugs can be effective in reducing or eliminating symptoms, such as delusions, hallucinations, and disorganized thinking. Medications may not completely eliminate hallucinations or delusions.

Behavior is influence by delusions, hallucinations, or incoherent or serious impairment in communication or judgment. Disorder is thought to mainly affect cognition, but it also usually contributes to chronic problems with behavior and emotion. Schizophrenia is the most common and severe form of psychosis or thought disorder. It is a complex mental disorder that is commonly misconstrued as a split personality disorder. It is a serious brain disorder.

Schizophrenia is a chronic, severe, and disabling brain disorder that has been recognized throughout recorded history. It is a chronic, severe and disabling brain disorder than affects over 50 million people worldwide. It is a devastating brain disorder – the most chronic and disabling of the severe mental illnesses. It is a chronic, severe, and disabling brain disease.

Schizophrenia is categorized as a brain disease, not a psychological disorder, and drug treatment is the primary therapy. Schizophrenia is a severe disorder that disrupts the function of multiple brain systems, resulting in impaired social and occupational functioning. It is one of the most serious mental disorder that affects one’s ability to function properly in society. It is a serious disorder which affects how a person thinks, feels or acts. Schizophrenia is a puzzling and disabling mental disorder that affects 1 percent of the population.

Schizophrenia is a disabling, chronic psychiatric disorder that poses numerous challenges in its management and consequences. It is a severe, persistent, debilitating, and poorly understood psychiatric disorder that probably consists of several separate illnesses. It is a very complicated mental disorder, with no single cause or cure. It is a severe, complicated illness. Schizophrenia is an illness, a medical condition.

Schizophrenia is a lifelong, severe psychotic condition. Schizophrenia is a serious mental health condition that causes disordered ideas, beliefs and experiences. It is not thought to be a ‘single’ condition but instead a label applied to a collection of disorders. It is also more common in people with seizure disorders. Schizophrenia is a disorder that most people know about but don’t know much about.

Treatment helps relieve many symptoms of schizophrenia, but most people who have the disorder cope with symptoms throughout their lives. Schizophrenia is usually classified according to the predominant symptoms or the specific course of the disease. It is a chronic disease, and you should plan for times of remission and times of relapse. It is a very serious mental illness and a major contributor to the global burden of disease. Schizophrenia is a serious mental illness.

Mental illness is an illness just like a physical illness. Schizophrenia is a complex and puzzling illness. Schizophrenia is a serious mental illness that affects 2.4 million American adults over the age of 18. Schizophrenia is rarely diagnosed, but possible, before age 10 or after age 40. Medication is highly effective in treating schizophrenia, however, it is difficult to keep individuals with schizophrenia on medication.

Schizophrenia is produced by problems with brain wiring in normal individuals. Schizophrenia is a biologic brain disorder that seriously impairs a person’s ability to think clearly and relate to others. Schizophrenia is a relatively common disorder, with a lifetime prevalence of about 1%. Schizophrenia is often confused with dissociative identity disorder, but the truth is that the two are completely different. Schizophrenia is more common than most people think.

Schizophrenia can cause people to do things that don’t make sense, repeat rhythmic gestures, or make ritualistic movements. Schizophrenia is known to be a major cause of disability. Schizophrenia is the 9th leading cause of disability worldwide. Schizophrenia is among the most damaging and least understood of all mental disorders. Schizophrenia is incredibly complex.

Schizophrenia is not a ‘very’ common disease. Schizophrenia is a complex disease, and environmental factors may also alter the timing of its onset and its progression afterwards. Schizophrenia is more common than Alzheimer’s disease and multiple sclerosis. Schizophrenia is not just one symptom, but a pattern of observable signs and symptoms. Schizophrenia is characterized by positive and negative symptoms.

Antipsychotics can be effective in alleviating some symptoms of schizophrenia. Schizophrenia is primarily treated with antipsychotic medications, which can effectively regulate the brain’s chemicals. Schizophrenia is also associated with abnormalities of the HPA axis R1602CHDHIDFE – R1602CHDFCEBE. Schizophrenia is also associated with changes in cognition. Schizophrenia is generally viewed as a disruption of normal functioning due to an underlying core illness.

Schizophrenia is NOT split personality or multiple personality. Schizophrenia is a literal mind boggling word in itself. Schizophrenia is not caused by bad parenting or personal weakness. Schizophrenia is generally divided into four types. Treatment is similar for all types of schizophrenia, however.

Treatment may be provided in-house or the resident may attend a treatment or rehabilitation program during the day. Treatment may involve psychotherapy, medication, skills training, or hospitalization. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy. Treatment may incorporate participation in Gamblers’ Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine. Treatment may be complicated further by the presence of alcohol or drug intoxication.

Therapy is one treatment option for antisocial personality disorder. Therapy is another important aspect of treatment. Therapy can also help you cope with stigma surrounding catatonic schizophrenia. Schizophrenia is known to run in families. Schizophrenia has long been known to be hereditary.

Schizophrenia can appear in children, though this is very rare. Schizophrenia has a strong hereditary component. Studies that employed nonschizophrenia psychiatric controls could reveal whether augmented interference is unique to schizophrenia. Studies are ongoing in attempts to better define the relationship of Toxoplasma infection to schizophrenia.

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Source by Shahid Syed Basha

Mental Illness in the Prison System

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Should the mentally ill be placed in the mainstream population of a prison?

Chances are you’ve never given much – if any – thought to this question. A paranoid schizophrenic kills someone because the voices in his head tell him that person is an alien trying to steal his brain. Is that schizophrenic safe in a prison? Are the other prisoners safe with him (or her) there?

A person suffering with severe bipolar disorder shoplifts an armload of clothing during an attack of acute mania. He or she is sent to prison, to co-exist with gangbangers, rapists, and murderers. Or, perhaps worse, to live in a solitary cell with no human interaction, for 23 out of 24 hours each day. The acute mania shifts to severe depression. What are the chances he or she will survive the prison term?

According to the U.S. Justice Department’s Bureau of Justice Statistics, in 1998 approximately 300,000 inmates had some form of mental illness. A decade later, that number rose to 1.25 million.

The National Alliance for the Mentally Ill (NAMI) states that 16 percent of the prison population can be classified as severely mentally ill. This means that they fit the psychiatric classification for illnesses such as schizophrenia, bipolar disorder, and major depression. However, the percentage skyrockets to as high as 50 percent when altered to include other mental illnesses, such as anti-social personality disorder, and borderline personality disorder.

Two major causes attribute to the rise of mentally ill inmates:

  • “Deinstitutionalization” – the process of closing down mental hospitals throughout the country. This began in the 1950s but gained strong momentum in the 1980s.

    In the 1950s, the U.S. had 600,000 state run hospital beds for those suffering from any form of mental illness. Because of deinstitutionalization and the subsequent cutting of state and federal funding, the U.S. now has just 40,000 beds for the mentally ill. The inability to get proper treatment left this segment of our population vulnerable and, consequently, many of them now land in prisons.

  • The second issue is the tougher sentencing laws implemented in the 1980s and 1990s. This is particularly true with the advent and pursuit of our “War on Drugs”. People with mental illness use and abuse drugs at a higher rate than the general population. They are also more likely to get caught, arrested, and imprisoned.
  • Deinstitutionalization hasn’t worked. All this has managed to do is to shift the mentally ill from hospitals to prisons – one institution to another. We have made it a crime to be mentally ill.

    The largest psychiatric facility in the U.S. isn’t a hospital; it’s a prison. At any given time, Rikers Island in New York City houses an estimated 3,000 mentally ill prisoners. The average inmate population at Rikers Island is 14,000. One out of every 4 to 5 inmates at this prison suffer from mental illness.

    Florida judge Steven Leifman, who chairs the Mental Health Committee for the Eleventh Judicial Circuit, states that, “The sad irony is we did not deinstitutionalize, we have reinstitutionalized-from horrible state mental hospitals to horrible state jails. We don’t even provide treatment for the mentally ill in jail. We’re just warehousing them.”

    What happens to the mentally ill in an overcrowded, violent prison system with little to no psychological counseling available?

    In state prisons, the mentally ill serve an average of 15 months longer than the average inmate. The very nature of most mental illnesses makes it difficult to follow prison rules. These inmates are more likely to be involved in prison fights and they tend to accumulate more conduct violations.

    Prison staff often punishes mentally ill inmates for being disruptive, refusing to comply with orders, and even for attempting suicide. In other words, these inmates are punished for exhibiting the symptoms of their illness.

    Gaining parole is also more difficult for the mentally ill. Their disciplinary records are often spotty, they may have no family willing or able to help, and community services are usually inadequate.

    In October 2003, Human Rights Watch released a report entitled Ill Equipped: U.S. Prisons and Offenders with Mental Illness. Following two years of in-depth research, this organization found that few prisons have adequate mental health care services. Furthermore, it found that the prison environment is dangerous and debilitating for the mentally ill.

    An excerpt from Ill Equipped:

    “Security staff typically view mentally ill prisoners as difficult and disruptive, and place them in barren high-security solitary confinement units. The lack of human interaction and the limited mental stimulus of twenty-four-hour-a-day life in small, sometimes windowless segregation cells, coupled with the absence of adequate mental health services, dramatically aggravates the suffering of the mentally ill. Some deteriorate so severely that they must be removed to hospitals for acute psychiatric care. But after being stabilized, they are then returned to the same segregation conditions where the cycle of decompensation begins again. The penal network is thus not only serving as a warehouse for the mentally ill, but, by relying on extremely restrictive housing for mentally ill prisoners, it is acting as an incubator for worse illness and psychiatric breakdowns.”

    According to Fred Osher, M.D., director of the Center for Behavioral Health, Justice and Public Policy at the University of Maryland, the majority of mentally ill inmates are arrested for misdemeanors and crimes of survival. He states, “That’s a whole host of folks who land in the criminal justice system because of their behavioral disorders.”

    Those on the fringe of society are primarily affected. These people are almost always impoverished and disabled by their illness. They have nowhere to turn, no one to help them, and so we toss them in prison. Even minor offenses keep them locked in prisons, since many cannot afford and/or do not know how to bond themselves out.

    The recidivism rate among the mentally ill is higher than that among the general prison population. Prison has become a revolving door system for dealing with mental illness. By default, prisons have become the new mental hospitals. However, they lack the funding and the training to deal with these patient-inmates.

    Ratan Bhavnani, executive director of the Ventura County chapter of the National Alliance on Mental Illness, states that, “In general, people with mental illness can recover when given the appropriate treatment rather than to be sent off to jail only to become more psychotic and come back and reoffend.”

    Michael Jung of Ventura, California suffers from bipolar and hears voices telling him that he is the devil. Over the past 10 years, Jung has been arrested a minimum of 15 times – all for relatively minor offenses. Earlier this year, Jung spent six weeks confined in G Quad, the unit where mentally ill inmates stay in their cells 23 out of the 24 hours in each day.

    Cells such as those in G Quad are referred to as the “rubber rooms” because the walls are padded. There is no furniture in these rooms. The “toilet” is a grate in the floor. They are stripped naked and monitored via video camera. Inmates who are paranoid, delusional, or otherwise difficult to manage are often placed in this type of cell, whether for their own protection, the safety of the other inmates, or just plain convenience.

    Susan Abril, a former inmate who suffers from bipolar disorder, was placed in this type of cell. During her confinement, Abril began hearing voices for the first time. “I didn’t sleep,” she said. “I mentally went insane being locked down 23 hours of 24.”

    We are essentially making the mentally ill inmates sicker, as well as ensuring their return to an already massively overcrowded prison system. Obviously our current system is not working. We cannot expect prison staff to function as psychiatrists. We also cannot expect the mentally ill to be “rehabilitated” in a mainstream prison system.

    The Taxpayer Action Board for Governor Pat Quinn of Illinois cited annual savings in the tens of millions of dollars that could be gained by releasing thousands of non-violent offenders, closely monitoring them and providing substance abuse treatment, mental health counseling, education, job training, and employment opportunities.

    For the most part, the mentally ill do not belong in prison. It would be cheaper (and smarter) for us as taxpayers to divert funding in order to provide adequate treatment programs to keep them out of prison.

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    Source by Darcia Helle

    Asking About a Friend’s Migraine

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    Let me start by saying that migraine patients have a much easier time accepting helpful tips from people who have proven to be supportive. Some people have earned the right to ask about our migraine health and to share what they have heard. We know these people care, want to learn, and have a sincere desire to see us healthy and migraine-free. It bothers us a lot more when strangers or unsupportive “friends” offer unsolicited advice. It’s a matter of personal boundaries.

    So, if your friend has migraines, chances are good that your comments and questions are welcome. However, we do have bad days when we just don’t feel like explaining, educating, advocating, etc. This especially goes for those of us who are more public about our condition. Sometimes we need to hide in the dark silence of our “migraine cave”.

    What can our supporters do or say? It depends on how our day is going, so the first thing I would suggest is to check in with us by asking, “How are you doing today?” and follow that up with, “Are migraines giving you trouble right now?” because you know our first response is likely to be, “I’m fine” even if we have a raging migraine attack with nausea and light sensitivity that’s been throbbing for hours.

    Assuming we are having a relatively good day, it’s probably safe to say things like:

    “I want to learn more about migraine. Is now a good time to ask some questions?”

    “I heard about that new migraine treatment on the news. What do you know about it?”

    “Dr. So-and-so says that migraines are caused by ________. Is that true? What do you know about this?”

    You see, most of us have been forced to become experts on our own condition. With a shortage of qualified headache specialists, only a lucky few are getting really good care. We seek each other out, subscribe to medical research journals, and scour the earth (and the Internet) for information. If you are just now hearing about a new treatment, chances are very good we’ve been following its development for many months, if not years. Take Cefaly, for example. I have friends who were buying it from Canada long before it was FDA approved in the U.S. I watched videos demonstrating the use of the device and explaining its pros and cons. My neurologist and I decided it wasn’t for me because most of my migraine attacks occur on the side and back of my head. Cefaly is applied only to the forehead, so I won’t be purchasing one.

    It was the same thing with Zecurity, Botox, GammaCore, and so many others. When it comes to getting news about migraine research, we don’t watch network news or read popular magazines. We subscribe to Medscape, The New England Journal of Medicine, Cephalalgia, and other medical journals.

    I bet you didn’t know that a few pharmaceutical companies are hard at work developing the first-ever migraine-specific preventive. Some have even made it to human trials. We still don’t have our own medicine though. For right now we are stuck with hand-me-downs from cardiology, other branches of neurology, and psychiatry. Every one of us is anxiously awaiting the arrival of our very own preventive treatment. Many of us will be lining up to volunteer for clinical trials as they are available in our area. We know you want to help. It’s just such a waste of time to constantly explain to people that we are much better educated about our condition than Dr. Oz, Oprah, or the 6 o’clock anchor. So, if you want to help, here are some ideas that will really make a difference in our lives:

    • Avoid wearing perfume or scented lotion when visiting with us.
    • Avoid smoking anywhere near us. Blowing your smoke in the other direction just isn’t enough.
    • Let us drive (so we can control the smells, volume, etc.)
    • If you smoke, use incense, or air fresheners please don’t be offended if we don’t visit your home. We love you and want to see you. We just don’t want to be sick for 3 days each time we visit. Please be willing to come to us or meet us somewhere else.
    • When cooking for us, please ask about food triggers. Most of us react poorly to MSG, artificial flavors, artificial colors, artificial sweeteners, artificial… you get the picture. We can also react to citrus fruits, bananas, hot dogs, lunch meat, sausages, cheeses, and certain spices. All-natural is your safest bet.
    • We may decline your offer to see a movie if it’s 3D or has lots of fast-moving scenes as these can trigger attacks.
    • Understand if we wear sunglasses indoors (especially at stores). The fluorescent lights really bother us even when we are not experiencing an attack. Some of us may also wear earplugs to dampen sounds.
    • Help us make a quick, graceful exit if we tell you that something is a trigger.
    • Plan for frequent breaks. We need to stay well-hydrated and keep our blood sugar up.
    • Recognize that we may appear to be taking a lot of medicines. It is unlikely that we are using narcotic pain medicines though, as they tend to make our condition worse. Most of us use a combination of prescription medicines and vitamin, mineral, and herbal supplements. We are not “junkies”. Each pill is carefully chosen. Most of us have discussed our treatment regimen with our doctor and have his/her approval.
    • Be flexible. Our lives are carried out in “maybes”, “ifs”, and “hopefullys”. Spending time with us means joining us in our world.
    • Believe us. If we say we are having a good day and take a few risks, then just go with it. We’ve been living with this condition long enough that we know when to push the limits and when to use caution.

    Thank you all for taking the time to care enough to learn more about what we need from our friends. We love each one of you!

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    Source by Tammy Rome

    Medical Treatment of Mycotic (Fungal) Nails

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    Fungal nail infections are ugly and embarrassing. They are common and easy to catch, but very hard to get rid of.

    Unfortunately most people ignore them considering fungal nails a cosmetic nuisance. Fungus could be a minor bother for a while, but if left untreated, the infection will get worse: nails may grow so thick, you will feel discomfort wearing closed toe shoes, nails may separate from toes (onycholysis), the matrix can get permanently damaged (onychodystrophy)… Long story short, onychomycosis is a serious disease, which requires medical attention and a comprehensive treatment.

    Nail fungus (Onychomycosis) is the most common nail disease, and over 30 million in the U.S. alone suffer from this condition. About 50% of the population over 45 years of age has nail infections. Some have battled fungi for decades. Treatment of Onychomycosis is challenging because the infection resides in the hard-to-reach area under the nail, called the nail bed.

    Topical anti-fungal solutions cannot get there. Oral medications cannot target this specific area and may be toxic and hard on the liver. New laser-assisted therapies are being developed and a growing number of foot doctors in the U.S. report excellent clinical results. To maximize the efficacy, laser treatments should be combined with a complete and comprehensive program.

    Typically at least two laser treatments of all toes with a focus on the badly infected ones are required. Patients need to use a UV shoe sanitizer (yes, we have to treat all shoes to kill fungus and bacteria), a strong topical medication as well as a care regimen for prevention of re-infection. This comprehensive course of treatment is safe, non-toxic, pain-free and highly effective.

    Thanks to its ability to pass through the nail and kill fungi in the nail bed, laser light is the only modality available today, which allows practitioners to address the very cause of the disease. While the high intensity light and thermal damage delivered to the target by the laser is lethal for the fungi, it is safe for the surrounding skin. In fact, these same lasers are used for new collagen growth in anti-aging aesthetic procedures and may stimulate the growth of new, healthy and fungus free nails, which will gradually replace the old ones.

    Patients with mycotic nails are very susceptible to re-infections. The fungus is everywhere in the environment of the people with Onychomycosis. Therefore, the complex decontamination and preventive care regimen are critical for the success of the treatment. To learn more about the use of lasers for fungus visit www.laserfortoe.com.

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    Source by Richard Miller III

    Hair Loss – 10 Diet Tips on How to Reduce Hair Loss

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    Almost all of the cases of permanent hair loss or balding is a result of hereditary influences. Temporary hair loss, on the other hand, can result from nutritional deficiency, among other causes. If the proper diet is maintained, poor nutrition will be avoided. Thus, this will help reduce hair thinning and loss. Here are a few facts that may help us determine what and what not to include in our diet:

    1. A high-fat and high-sodium diet contributes in hair loss. Such a diet harms our kidneys and increases the acidity of our blood, resulting in hair loss. Having a low-fat diet may help slow down the hair thinning process. According to some studies, male pattern baldness is connected to high testosterone levels, which may have resulted from consuming a high-fat and high-animal protein diet.

    2. Too little protein in one’s diet, on the other hand, can also lead to hair loss since it can make the hair go into a resting phase.

    3. Monosaturated fats, such as those found in nuts and extra virgin olive oil, encourages hair growth and revitalizes hair follicles.

    4. Avoid ingesting foods with large amounts of carbohydrates, such as rice, pasta, and potatoes. Carbohydrates are converted to glucose during the digestion process, and this raises the blood sugar level of the body. Cutting down our blood sugar level helps in reducing hair loss.

    5. Have no more than one drink of alcohol per day. Alcoholic drinks lower the zinc, vitamin B, vitamin C, and folic acid levels in our body. This would lead to a deficiency in vitamins that are important for the health of our hair. Moreover, alcohol contains a high level of sugar and calories.

    6. Limit your caffeine intake. Caffeine decreases the levels of vitamins B and C, potassium, and zinc in our body. This deficiency in vitamins would strain the adrenal glands and this would increase the levels of dihydrotestosterone (DHT) levels, a form of testosterone that induces hair loss and prostate growth.

    7. Soy protein stimulates hair growth. In one study, an increase of 15% in hair growth was observed. Good sources of soy protein include soy milk, tofu, fish, eggs, yogurt, and cheese.

    8. Anemia is one cause of hair thinning. In order to avoid this, eat a lot of iron-rich foods. Examples include dark green leafy vegetables, dried fruits, cherry juice, liver, eggs, raisins, dates, and whole grain cereals.

    9. Silica is another nutrient that helps improve the health of our hair. It reduces hair loss, promotes healthier hair regrowth, strengthens hair follicles, and gives shine and luster to our hair. Studies conducted in Europe have shown that silica intake slows down hair loss. An example of silica-rich food is raw oats.

    10. Incorporate iodine-rich foods into your diet as it is important in maintaining the health of your hair. Use sea salt to flavor your food. Eat vegetables such as spinach, carrots, turnips, and cabbage. Pine nuts, mustard, soybeans, millet, and cold-pressed seed oils such as pumpkin, walnut, and flax seed oil are also rich in the said nutrient.

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    Source by Wong Darren

    Treating Otitis Media (Middle Ear Inflammation) With Nasal Irrigation

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    In the evening of the Lantern Festival, the street outside the clinic was crowded with cheerful people and beautiful lanterns. Winnie, a five-year-old sat quietly on the clinic chair, her dad waited nervously for me to disclose the result. As always, I first checked Winnie’s ears with otoscope, both of her eardrums turned back to the normal gray color; I then picked up the otitis media checker to check her middle ear pressure, as the normal pressure green light turned on, the dad finally relaxed and said: “great! we are finally relieved.” Rest assured, I believe they will have a wonderful festive evening.

    Before Winnie came to the clinic, she had already been treated with antibiotics for her chronic sinusitis for over six months. In addition, she also had otitis media with effusion. Since her parents did not want her to have a ventilation tube placement surgery to treat the effusion, I suggested her to try pulsating nasal irrigation with warm saline and additional drugs to treat her chronic sinusitis and effusion. After one month of therapy treatment, her thick yellow-greenish pus symptoms of chronic sinusitis had shown great improvement. However, the progress of her middle ear effusion was not ideal. Her ear drums were still amberish and slightly depressed. The other two children who started the treatment about the same time had already been cured, so I jokingly told her that the others have graduated, and you still have to continue your effort. I suggested her to continue using nasal irrigation for two to three weeks before returning for diagnosis, and finally she graduated too.

    Whenever I saw middle ear effusion or acute otitis media patients, I would carefully examine their nose. In addition to taking the appropriate medication on time, I often recommend the patients not to blow their nose too hard, but to frequently use saline nasal spray or nasal irrigation to rinse the nose instead. Patients often feel strange, and some patients even reminded me that their children are here to examine their ears.

    In fact, otitis media in children is a complication of common cold and/or sinusitis. The complication has a very high probability of occurrence. According to research statistics, 1/3 of children at the age of three have had three or more otitis media. It is in fact the second most common complication (after upper respiratory tract infection) seen in the clinic. The main cause of otitis media is due to the nasal cavity bacteria travel through the eustachian tube (connecting the nasopharynx and middle ear cavity tube) to the middle ear cavity. Therefore, the real cause of the otitis media or otitis media with effusion is in the nasal cavity. If your rhinitis is treated, nasal passage is clear, eustachian tube is functioning well, then your middle ear effusion will be cured.

    After appropriate treatment of acute otitis media, most can be cured within two weeks, but there is still a small number of patients who show no sign of improvement; and the condition worsens and middle ear effusion pus becomes thicker. The color of the eardrum turns amber and depressed. If the child’s middle ear effusion lasts more than a month and pus thickens, it is usually caused by sinusitis or nasopharyngeal adenoidal thickening (adenoidalhypertrophy). At this time, one should be focusing on the sinusitis treatment, which often solves otitis media effusion subsequently. If the middle ear effusion continues after three months of treatment with no improvement, it is usually recommended to insert the ventilation tube to restore hearing and avoid affecting the children’s ability to learn and interact with others.

    Many patients often find it very strange, when a child obviously has ear pain, hearing issues, but the ENTs (otolaryngologists) keep asking if the child has nasal congestion, streaming yellow pus and spend a lot of time doing the local treatment of nasal and seemed to forget prescription of ear medications. In fact, for general acute otitis media, if the eardrum has no perforated hole and pus leaking out, using ear medication has no effect in treating otitis media (because the medication will only be in the ear canal but does not go through the eardrum into the middle ear intact.) So when I suggest patients with otitis media to use nasal spray to spray the nose, or use the pulsating nasal irrigation to rinse the nasal cavity, the patients often wonder if the saline water is going into the nose or to the ears. After a detailed explanation, many patients then realize that blowing your nose too hard may affect the middle ear, and using nasal irrigation with saline water is one way of treating otitis media with effusion.

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    Source by Hung Cheng Tseng M.D.

    Deaf/Mute Sign Language Awareness

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    The deaf, or the “deaf mute” or those suffering deaf mutism as is often described are just like any other person in the society. That they can not speak or hear words audibly does not exclude them from enjoying the basic necessities of life as well as achieve their ultimate desires in life. This piece is written to raise the level of awareness through asking the necessary questions that can have a positive impact in the way the ordinary person on the street relates to the concept of deaf and deafness.

    The deaf, in very simple terms communicate through sign language developed as a factor of necessity. This is because unable to communicate through hearing and speaking, they depend largely on signed language and body language communication. It is an established fact that there are hundreds of deaf sign language versions throughout the world. Also, these language versions were evolved wherever deaf people live. This seems natural since there has to be a way of communicating with the person who can neither hear nor speak using audible words.

    The need for greater awareness of the dilemma of the deaf is on the fact that through ignorance, many people are confused when confronted by the fact that they have a deaf child born to them and are unable to fully integrate with such people. There is little anybody can do at the moment beyond the scientific and technological inventions that have helped to develop special hearing aids.

    Among several attempts at promoting the development and use of the sign language is the development of sign language cultures in different countries, ‘Theatre of the Deaf’, signed interpretation of music – which provides a beautiful and expressive means of portraying musical lyrics, emotions’ and the rhythm for the ultimate enjoyment of both the deaf and hearing people. The impact of the signed interpretation of music alone has been proven to enable both types of the people to live together with better understanding and mutual delight.

    The challenge is to know how best to move such a success story to the next level. What can we do to creative a more inclusive and accommodating environment where understanding and appreciation of the deaf is more of a nom than an exception? Since deaf people are often surrounded by a larger majority of hearing and speaking people, they are often a minority. However when the society appreciate their unusual qualities and talents can we start to achieve a more inclusive attitude towards them.

    Learning the sign language and making it available in the curriculum of schools and colleges is a vital starting point. If a child grows up to realise that the deaf is no different to the rest of the human population other than the ability to speak and hear, the child’s attitude to the deaf would be totally different and more accommodating. This has been shown in homes where deafness affects a child, other children are known to be more accommodating to the idea than children who have never met or seen a deaf person. Siblings of deaf people are known to have acquired the skills of sign language more easily as they have been able to communicate with their deaf sibling through that medium. Besides, people travelling or visiting foreign countries have been shown to depend on sign language as the only means of expression.

    Summary and Conclusion: While learning the sign language may be seen as an added load to some people, the difference between having the knowledge and not having it can mean a lot when faced with some unforeseen reality. The sign language is fun to learn and anybody can and should endeavour to know the basics of how to communicate with the deaf or hearing people alike.

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    Source by Albert P Flowers

    Overcoming a Lisp Speech Impediment Fast

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    When you speak out loud, you are overcome by fear all of the time. You focus on just trying to get the words to come out clear and slush free, but you know those s sounds just don’t sound right. Then you hear people snicker and giggle around you because they think it is kind of funny. Little do they know how much this upsets you, little do they know that you’re constantly thinking about your lisp speech. You try so hard to speak clearly, but you can’t do it. All you want is for your lisp to go away so you can be normal.

    A lisp speech disorder is a big speech impediment that people all over the world have. If you have a lisp speech, then you know that life can be very difficult when talking, especially in public. It’s really hard meeting new people wherever it may be because you are nervous of your lisp, and when this happens, your lisp get worse. All you want is peace with the way you speak so that you can talk to people without being worried all the time.

    The good news is that there are steps that you can in the comfort of your own home to get rid of that lisp. For example, reading a script out loud can help to weaken your lisp. When you read out loud, you start to practice how words should roll off of your tongue. The more you read, the better your speech will become. Another way to overcome lisp is to not make direct eye contact with the person you are talking to. When you make direct eye contact, you get nervous so look at the bridge of their nose and you will be able to focus on your words.

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    Source by Jayden Webb