About Piles

Swellings or swollen haemorrhoids that appear inside and around the anus and accompanying the anal canal are called Piles. Haemorrhoids are stockpile, clumps, bolster of tissue full of blood vessels, support tissue, muscle and elastic fibers in the anal canal. Everyone has haemorrhoids. However, when the haemorrhoids safeguard the anal passage begins to be too big due to inflammation so that the vein walls become elongated, less dense, thin, and troubled by passing a bowel motion that is when piles grow up.

They can be categorized by sizes, and they may be internal or external. Internal piles are commonly located between 2 and 4 centimeters (cm) on the top of the anus, and they are the more common type. External piles develop outside the edge of the anus.

Symptoms

Most cases of piles do not lead to overt symptoms however some may lead to bleeding and pain and alert the patient. Symptoms of piles may be outlined as:

A rocklike, possibly painful lump may be felt, nearby the anus. It may consist of blood clot. Piles that comprise of blood are called thrombosed external hemorrhoids.

• A person with piles may experience the feeling that the bowels are still full, after passing a stool.
• Passage of bright red blood is visible after a bowel movement.
• The area around the anus is itchy, red, and sore.
• Pain occurs during the passing of a stool.
• Piles can escalate into a more severe condition. This can include: excessive anal bleeding, also possibly leading to anemia
• infection
• fecal incontinence, or an inability to control bowel movements
• anal fistula, in which a new channel is created between the surface of the skin near the anus and the inside of the anus
• a strangulated hemorrhoid, in which the blood supply to the hemorrhoid is cut off, causing complications including infection or a blood clot
• Piles are classified into four grades:

  Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible.

  Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided.

  Grade III: These are also known as prolapsed hemorrhoids, and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted.

  Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

Causes

Piles are caused by increased pressure in the lower rectum.

The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

• chronic constipation
• chronic diarrhea
• lifting heavy weights
• pregnancy
• straining when passing a stool

The tendency to develop piles may also be inherited and increases with age.

Diagnosis

A doctor can usually diagnose piles after carrying out a physical examination. They will examine the anus of the person with suspected piles. The doctor may ask the following questions:

• Do any close relatives have piles?
• Has there been any blood or mucus in the stools?
• Has there been any recent weight loss?
• Have bowel movements changed recently?
• What color are the stools?

For internal piles, the doctor may perform a digital rectal examination (DRE) or use a proctoscope. A proctoscope is a hollow tube fitted with a light. It allows the doctor to see the anal canal up close. They can take a small tissue sample from inside the rectum. This can then be sent to the lab for analysis.

The physician may recommend a colonoscopy if the person with piles presents signs and symptoms that suggest another digestive system disease, or they are demonstrating any risk factors for colorectal cancer.

Treatment

Lifestyle Changes

A doctor will initially recommend some lifestyle changes to manage piles.

Diet

Piles can occur due to straining during bowel movements. Excessive straining is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals. A doctor may also advise the person with piles to increase their water consumption. It is best to avoid caffeine.

Body weight

Losing weight may help reduce the incidence and severity of piles. To prevent piles, doctors also advise exercising and avoiding straining to pass stools. Exercising is one of the main therapies for piles.

Homeopathic Treatments For Piles.

What is IBS?

Irritable bowel syndrome (IBS) is also known as spastic colon, irritable colon, mucous colitis, and spastic colitis. It is a separate condition from inflammatory bowel disease and isn’t related to other bowel conditions. IBS is a group of intestinal symptoms that typically occur together. The symptoms vary in severity and duration from person to person. However, they last at least three months for at least three days per month.IBS can cause intestinal damage in some cases. However, that is not common. IBS doesn’t increase your risk of gastrointestinal cancers, but it can still have a significant effect on your life.

IBS symptoms

The symptoms of IBS typically include:

• cramping
• abdominal pain
• bloating and gas
• constipation
• diarrhea

It’s not uncommon for people with IBS to have episodes of both constipation and diarrhea. Symptoms such as bloating and gas typically go away after you have a bowel movement. Symptoms of IBS aren’t always persistent. They can resolve, only to come back. However, some people do have continuous symptoms.

What causes IBS?

Although there are many ways to treat IBS, the exact cause of IBS is unknown. Possible causes include an overly sensitive colon or immune system. Postinfectious IBS is caused by a previous bacterial infection in the gastrointestinal tract. The varied possible causes make IBS difficult to prevent.

The physical processes involved in IBS can also vary, but may consist of:

• slowed or spastic movements of the colon, causing painful cramping
• abnormal serotonin levels in the colon, affecting motility and bowel movements
• mild celiac disease that damages the intestines, causing IBS symptoms

Home remedies for IBS

Certain home remedies or lifestyle changes may help to relieve your IBS symptoms without the use of medication. Examples of these lifestyle changes include:

Vitiligo occurs in about 1% or slightly more of the population throughout the world. Vitiligo affects all races and genders equally; however, it is more visible in people with darker skin. Although vitiligo can develop in anyone at any age, it most commonly appears in people ages 10 to 30 years. Vitiligo rarely appears in the very young or very old.

• participating in regular physical exercise
• cutting back on caffeinated beverages that stimulate the intestines
• eating smaller meals
• minimizing stress (talk therapy may help)
• taking probiotics (“good” bacteria normally found in the intestines) to help relieve gas and bloating
• avoiding deep-fried or spicy foods

MIGRAINE

A migraine is a powerful headache that often happens with nausea, vomiting, and sensitivity to light. Migraines can last from 4 hours to 3 days, and sometimes longer.

The American Migraine Foundation estimates that more than 36 million Americans get them, women 3 times more often than men. Most people start having migraine headaches between ages 10 and 40. But many women find that their migraines improve or disappear after age 50. They generally last between 4 and 72 hours.

SYMPTOMS

Migraine symptoms may begin one to two days before the headache itself. This is known as the prodrome stage. Symptoms during this stage can include:

Food cravings

Depression

Fatigue or low energy

Frequent yawning

Hyperactivity

Irritability

Neck stiffness

In migraine with aura, the aura occurs after the prodrome stage. During an aura, you may have problems with your vision, sensation, movement, and speech. Examples of these problems include:

Difficulty speaking clearly

Feeling a prickling or tingling sensation in your face, arms, or legs

Seeing shapes, light flashes, or bright spots

Temporarily losing your vision

The next phase is known as the attack phase. This is the most acute or severe of the phases when the actual migraine pain occurs. In some people, this can overlap or occur during an aura. Attack phase symptoms can last anywhere from hours to days. Symptoms of a migraine can vary from person to person. Some symptoms may include:

Increased sensitivity to light and sound

Nausea

Dizziness or feeling faint

Pain on one side of your head, either on the left side, right side, front, or back, or in your temples

Pulsing and throbbing head pain

Vomiting

After the attack phase, a person will often experience the postdrome phase. During this phase, there are usually changes in mood and feelings. These can range from feeling euphoric and extremely happy, to feeling very fatigued and apathetic. A mild, dull headache may persist.

The length and intensity of these phases can occur to different degrees in different people. Sometimes, a phase is skipped and it’s possible that a migraine attack occurs without causing a headache.

TYPES OF PAIN

People describe migraine pain as:

• Pulsating
• Throbbing
• Perforating
• Pounding
• Debilitating

It can also feel like a severe dull, steady ache. The pain may start out as mild, but without treatment will become moderate to severe.

Migraine pain most commonly affects the forehead area. It’s usually on one side of the head, but it can occur on both sides, or shift.

Most migraines last about 4 hours. If they’re not treated or don’t respond to treatment, they can last for as long as 72 hours to a week. In migraines with aura, pain may overlap with an aura or may never occur at all.

CAUSES

Researchers haven’t identified a definitive cause for migraines. However, they have found some contributing factors that can trigger the condition. This includes changes in brain chemicals, such as a decrease in levels of the brain chemical serotonin.

Other factors that may trigger a migraine include:

bright lights

severe heat, or other extremes in weather

dehydration

changes in barometric pressure

hormone changes in women, such as estrogen and progesterone fluctuations during menstruation, pregnancy, or menopause

excess stress

loud sounds

intense physical activity

skipping meals

changes in sleep patterns

use of certain medications, such as oral contraceptives or nitroglycerin

unusual smells

certain foods

smoking

alcohol use

traveling

HOME REMEDIES

You can try a few things at home that may also help remedy the pain from your migraines:

Lie down in a quiet, dark room.

Massage your scalp or temples.

Place a cold cloth over your forehead or behind your neck.

Sexual Dysfunction

What is sexual dysfunction?

Sexual dysfunction refers to a problem occurring during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle traditionally includes excitement, plateau, orgasm, and resolution. Desire and arousal are both part of the excitement phase of the sexual response.

A research from Health Organization suggests that sexual dysfunction is common (43 percent of women and 31 percent of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Because treatment options are available, it is important to share your concerns with your partner and healthcare provider.

What are the types of sexual dysfunction?

Sexual dysfunction generally is classified into four categories:

• Desire disorders —lack of sexual desire or interest in sex
• Arousal disorders —inability to become physically aroused or excited during sexual activity
• Orgasm disorders —delay or absence of orgasm (climax)
• Pain disorders — pain during intercourse

Who is affected by sexual dysfunction?

Sexual dysfunction can affect any age, although it is more common in those over 40 because it is often related to a decline in health associated with aging.

What are the symptoms of sexual dysfunction?

In men:

• Inability to achieve or maintain an erection suitable for intercourse (erectile dysfunction)
• Absent or delayed ejaculation despite adequate sexual stimulation (retarded ejaculation)
• Inability to control the timing of ejaculation (early or premature ejaculation)

In women:

• Inability to achieve orgasm
• Inadequate vaginal lubrication before and during intercourse
• Inability to relax the vaginal muscles enough to allow intercourse

In men and women:

• Lack of interest in or desire for sex
• Inability to become aroused
• Pain with intercourse

What causes sexual dysfunction?

Physical causes — Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of some medications, including some antidepressant drugs, can affect sexual function.

Psychological causes — These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, concerns about body image, and the effects of a past sexual trauma.

Allergic Rhintis

Allergic Rhintis also commonly known as Hay fever, It could be caused by an allergic reaction to an allergen that could be in a form of pollen, dust and certain animals. It prevail a condition where inner part of the nose becomes inflamed by all these external factors.We can also outline Allergic Rhintis as allergic disorder denoted by an amplified immune response to environmental triggers.

What are the Causes of Allergic Rhintis?

Allergic Rhintis is basically classified into two types:

• 1.Seasonal
• 2. Perennial

Seasonal Allergic Rhintis

This type of Rhintis occurs in the specific time of a year. As some of the people experience Hay fever during spring as probably they are allergic to tree pollens .Grass and weed pollens may causes allergy to someone during summers and in Autumn weeds and fungus spores can cause the reaction, That clearly shows that this type of Allergic reaction is just for the some sort of a season.

Perennial Allergic Rhintis

This Rhintis occurs with people all year-around, People may allergic to one or more allergen found indoors. It can be caused by small dust particles inside the house, carpets and mattresses. The tiny skin flakes which animals shed along with the fur (Animal dander) and Entering in damp areas such as bathrooms and basements could also be a reason behind allergic reaction.

What are the symptoms of Allergic Rhintis?

Symptoms of Allergic Rhintis can include:

• Runny nose
• Stuffy Nose or Nasal Congestion
• Watery, itchy nose and eyes
• Sneezing
• Cough
• Itchy nose, roof of mouth or throat
• Swollen, blue-colored skin under the eyes
• Postnasal drainage
• Fatigue

Symptoms can also be triggered by common irritants such as:

• Smoke of a Cigarette
• Strong Odors (perfumes, hair spray or fumes)
• Ozone also known as Air pollutants
• Air fresheners

Treatment and Management

The best way to treat Hay Fever is avoidance of allergens that triggers symptoms, This could be done as:

• When pollen count is high, avoid to open doors and windows.
• Prevent yourself from mowing the lawn during prone months.
• Splash your eyes with cool water on regular basis.
• Prevent yourself from mowing the lawns during prone seasons.
• Shower and change your clothes, once you enter the indoor after visiting outside.
• Wear a hat to prevent pollens falling on your hair and face.
• Flowers should be outside the home.
• Keep yourself away from smoke and quite smoking if you are a smoker.
• Use mite-proof bedding.
• Keep the carpets and floors as clean as possible.
• Apply Vaseline around and inside edges of your nostrils , so that pollens could be stopped getting through.
• Wash pets when the pets come inside or you can use damp cloth to smooth their fur down.

DEPRESSION

Overview

As per World Health Organization “WHO”, “Depression is a common illness worldwide, with more than 264 million people affected(1). Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life”. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.

Although there are known, effective treatments for mental disorders, between 76% and 85% of people in low- and middle-income countries receive no treatment for their disorder(2). Barriers to effective care include a lack of resources, lack of trained health-care providers and social stigma associated with mental disorders. Another barrier to effective care is inaccurate assessment. In countries of all income levels, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.The burden of depression and other mental health conditions is on the rise globally. A World Health Assembly resolution passed in May 2013 has called for a comprehensive, coordinated response to mental disorders at the country level.

Key facts

• Depression is a common mental disorder. Globally, more than 264 million people of all ages suffer from depression.
• Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.
• More women are affected by depression than men.
• Depression can lead to suicide.
• There are effective psychological and pharmacological treatments for moderate and severe depression.

Types and symptoms

Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate or severe.

A key distinction is also made between depression in people who have or do not have a history of manic episodes. Both types of depression can be chronic (i.e. over an extended period) with relapses, especially if they go untreated.

Recurrent depressive disorder: this disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment, and reduced energy leading to diminished activity for at least two weeks. Many people with depression also suffer from anxiety symptoms, disturbed sleep and appetite, and may have feelings of guilt or low self-worth, poor concentration and even symptoms that cannot be explained by a medical diagnosis.

Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities but will probably not cease to function completely. During a severe depressive episode, it is unlikely that the sufferer will be able to continue with social, work or domestic activities, except to a limited extent.

Bipolar affective disorder: this type of depression typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.

Contributing factors and prevention

Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.

There are interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention.

Diagnosis and treatment

There are effective treatments for moderate and severe depression. Health-care providers may offer psychological treatments such as behavioural activation, cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT), or antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists.

Psychosocial treatments are also effective for mild depression. Antidepressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with extra caution.

OSTEOPOROSIS

What is Osteoporosis?

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking or collapsing. The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

Symptoms of Osteoporosis

Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.

Fractures of the spine (vertebra) can cause severe "band-like" pain that radiates from the back to the sides of the body. Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height and/or curving of the spine due to collapse of the vertebrae. The collapse gives individuals a hunched-back appearance of the upper back, often called a "dowager hump" because it commonly is seen in elderly women.

A fracture that occurs during the course of normal activity is called a minimal trauma, or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial slip-and-fall accidents. Hip fractures also may heal slowly or poorly after surgical repair because of poor healing of the bone.

Causes of Osteoporosis

The following are factors that will increase the risk of developing osteoporosis:

• Female gender
• Caucasian or Asian race
• Thin and small body frame
• Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
• Personal history of fracture as an adult
• Cigarette smoking
• Excessive alcohol consumption
• Lack of exercise
• Diet low in calcium
• Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
• Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from bowel diseases, such as celiac sprue that can be associated with skin diseases, such as dermatitis herpetiformis
• Low estrogen levels in women (which may occur in menopause or with early surgical removal of both ovaries)
• Low testosterone levels in men (hypogonadism)
• Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
• Amenorrhea (loss of the menstrual period) in young women is associated with low estrogen and osteoporosis; amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat (for example, women with anorexia nervosa)
• Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
• Immobility, such as after a stroke, or from any condition that interferes with walking
• Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave's disease) or is ingested as thyroid hormone medication
• Hyperparathyroidism is a disease wherein there is excessive parathyroid hormone production by the parathyroid gland, a small gland located near or within the thyroid gland. Normally, parathyroid hormone maintains blood calcium levels by, in part, removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis.
• When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis. Vitamin D deficiency can result from dietary deficiency, lack of sunlight, or lack of intestinal absorption of the vitamin such as occurs in celiac sprue and primary biliary cirrhosis.

What is Asthma?

Asthma is a chronic lung disorder that can make breathing difficult. It features narrow, inflamed airways (bronchial tubes). "Asthma" is an ancient Greek word meaning "short breath," and as the name implies, it can leave you gasping for air. One of the telltale signs of an asthma attacks is wheezing with difficulty breathing. Other asthma symptoms include chest tightness, coughing, and shortness of breath.

When the breathing tubes of the lungs become chronically inflamed, they can become sensitive to inhaled environmental allergens and irritants that can trigger asthma. These environmental triggers include pollen, pollution, and tobacco smoke. Exercise can also be an asthma trigger for some.

Symptoms

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu.

Signs that your asthma is probably worsening include:

• Asthma signs and symptoms that are more frequent and bothersome
• Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
• The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

• Exercise-induced asthma, which may be worse when the air is cold and dry
• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
• Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander)

Causes

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

• Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
• Respiratory infections, such as the common cold
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants, such as smoke
• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Risk factors

A number of factors are thought to increase your chances of developing asthma. These include:

• Having a blood relative (such as a parent or sibling) with asthma
• Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
• Being overweight
• Being a smoker
• Exposure to secondhand smoke
• Exposure to exhaust fumes or other types of pollution
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
• Complications

Asthma complications include:

• Signs and symptoms that interfere with sleep, work or recreational activities
• Sick days from work or school during asthma flare-ups
• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma
• Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Prevention

While there's no way to prevent asthma, by working together, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

• Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.
• Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life in general.
• Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
• Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
• Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter.
• Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.
• When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed and immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.
• Take your medication as prescribed. Just because your asthma seems to be improving, don't change anything without first talking to your doctor. It's a good idea to bring your medications with you to each doctor visit, so your doctor can double-check that you're using your medications correctly and taking the right dose.
• Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.

PSORIASIS

What Is Psoriasis?

Psoriasis is a skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white scales. They can grow anywhere, but most appear on the scalp, elbows, knees, and lower back. Psoriasis can't be passed from person to person. It does sometimes happen in members of the same family.

Psoriasis usually appears in early adulthood. For most people, it affects just a few areas. In severe cases, psoriasis can cover large parts of the body. The patches can heal and then come back throughout a person's life

Symptoms

The symptoms of psoriasis vary depending on the type you have. Some common symptoms for plaque psoriasis -- the most common variety of the condition -- include:

• Plaques of red skin, often covered with silver-colored scales. These plaques may be itchy and painful, and they sometimes crack and bleed. In severe cases, the plaques will grow and merge, covering large areas.
• Disorders of the fingernails and toenails, including discoloration and pitting of the nails. The nails may also crumble or detach from the nail bed.
• Plaques of scales or crust on the scalp.
• People with psoriasis can also get a type of arthritis called psoriatic arthritis. It causes pain and swelling in the joints. The National Psoriasis Foundation estimates that between 10% to 30% of people with psoriasis also have psoriatic arthritis.

Types

Other types of psoriasis include:

• Pustular psoriasis , which causes red and scaly skin with tiny pustules on the palms of the hands and soles of the feet.
• Guttate psoriasis , which often starts in childhood or young adulthood, causes small, red spots, mainly on the torso and limbs. Triggers may be respiratory infections, strep throat, tonsillitis, stress, injury to the skin, and taking antimalarial and beta-blocker medications.
• Inverse psoriasis , which makes bright red, shiny lesions that appear in skin folds, such as the armpits, groin, and under the breasts.
• Erythrodermic psoriasis , which causes fiery redness of the skin and shedding of scales in sheets. It's triggered by severe sunburn, infections, certain medications, and stopping some kinds of psoriasis treatment. It needs to be treated immediately because it can lead to severe illness.

What Causes Psoriasis?

No one knows the exact cause of psoriasis, but experts believe that it’s a combination of things. Something wrong with the immune system causes inflammation, triggering new skin cells to form too quickly. Normally, skin cells are replaced every 10 to 30 days. With psoriasis, new cells grow every 3 to 4 days. The buildup of old cells being replaced by new ones creates those silver scales.

Psoriasis tends to run in families, but it may be skip generations. For instance, a grandfather and his grandson may be affected, but not the child's mother.

Things that can trigger an outbreak of psoriasis include:

• Cuts, scrapes, or surgery
• Emotional stress
• Strep infections
• Medications, including
• Blood pressure medications (like beta-blockers)
• Hydroxychloroquine, antimalarial medication

Diagnosis

Physical examination, It’s usually easy for your doctor to diagnose psoriasis, especially if you have plaques on areas such as your:

• Scalp
• Ears
• Elbows
• Knees
• Belly button
• Nails

Cervical Spondylosis

Cervical spondylosis is the natural wearing down of cartilage, disks, ligaments and bones in your neck. Main symptoms include neck pain or stiffness. Physical therapy; ice, heat, massage; soft collar and drugs are first-to-be-tried approaches. More severe cases, such as herniated disk, bone spurs or pinched nerves, are treated with injections or surgery.

What are the parts of the cervical spine?

Your entire spine is made up of 24 vertebrae (bones of the spine). The cervical spine consists of seven vertebrae that begin at the base of the skull. Running through an opening of the entire vertebral column are the spinal cord and its nerves. The spinal cord and nerves carry messages between the brain and rest of body, including muscles and organs. Between each vertebrae are disks. The disks act like the body’s shock absorbers. The disks are made of flexible but strong connective tissue filled with a gel-like material. Disks are like “jelly-filled, cushy doughnuts” between each vertebrae.

There are three joints between each pair of vertebrae. The front joint is called the intervertebral disk. Two joints in the back of the spine are called facet joints. Within every joint is cartilage, which cushions the ends of bones. Ligaments are soft bands of tissue that connect the vertebrae together.

Spondylosis is the natural wearing down of these parts of the spine. Cartilage wears out over time, disks lose their volume and become dried and cracked, ligaments may thicken and bone spurs may form where bones rub against each other in areas that are no longer covered with cartilage. All of these changes are defined as spondylosis.

How common is cervical spondylosis?

Changes in your spine are considered a normal part of aging. The spine likely begins this wearing-down process sometime in your 30s. By age 60, almost nine in 10 people have cervical spondylosis.

Who is most at risk for getting cervical spondylosis?

Older age is a risk factor for cervical spondylosis. In addition to age, you are more likely to experience neck pain or other symptoms related to cervical spondylosis if you:

• Smoke cigarettes or used to.
• Have one or more family members with this condition.
• Strain your neck often for your job, like looking overhead (for example, painters) or downward (plumbers or flooring installers) for many hours every day or keeping your head at an improper position for long periods of time (for example, staring at a computer screen that is too high or low).
• Have a previous neck injury, such as from a car accident.
• Do heavy lifting like construction workers.
• Are exposed to a lot of vibration like bus or truck drivers.

What causes cervical spondylosis?

As you get older, your spine undergoes changes due to decades of normal wear and tear. Starting in middle age, the disks between your vertebrae start to change. These changes can include:

• Degeneration: The spinal disks in your neck may slowly wear down (degenerate). With time, the disks become thinner, and the soft tissue has less elasticity. If you or your parents measure in a little shorter in height than you did years ago, this is normal collapsing or settling of your disks.
• Herniation: Normal aging can cause part of your spinal disk to tear or crack. This is called a herniated disk. The herniation can allow the disk to bulge out, pressing on nearby tissue or a spinal nerve. This pressure can cause pain, tingling or numbness.
• Osteoarthritis: Osteoarthritis is a progressive (ongoing) condition that causes cartilage in your joints to degenerate (wear down with time). With osteoarthritis, cartilage degenerates faster than with normal aging.
• Bone spurs: When cartilage in the joints of the vertebrae in your spine starts to degenerate and bone tissue rubs directly against other bone tissue, abnormal bone growths develop along the edges of vertebrae. These growths (called osteophytes or bone spurs) are common as you age. Often, they cause no symptoms.

What are the most common cervical spondylosis symptoms?

You may have cervical spondylosis and not even know it. It’s common to have no symptoms related to this condition.

If you do experience symptoms, symptoms typically include:

• Neck pain or stiffness. This may be the main symptom. Pain may get worse when you move your neck.
• A nagging soreness in the neck.
• Muscle spasms.
• A clicking, popping or grinding sound when you move your neck.
• Dizziness.
• Headaches.

What is cervical myelopathy?

As your vertebral disks wear away with time, your spinal cord can be put under increased pressure as the canal gets narrower from arthritis and disk protrusions. This compression can result in worsening neck pain and other symptoms. This condition is called cervical spondylotic myelopathy (CSM).

If you have CSM, you have the symptoms seen with cervical spondylosis, plus these additional symptoms:

• Weakness, tingling or numbness in one or both arms or legs.
• Loss of bladder and bowel control.
• Trouble walking (feeling unsteady on your feet).
• Loss of function in hands, like having problems writing.

Symptoms related to CSM may slowly get worse over time. If your symptoms don’t go away, or if they significantly affect your life, your healthcare provider may refer you to a spine surgeon who specializes in treating this condition.

RENAL STONE

Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.

Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones. Kidney stones can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.

SYMPTOMS

A kidney stone usually will not cause symptoms until it moves around within your kidney or passes into your ureters — the tubes connecting the kidneys and the bladder. If it becomes lodged in the ureters, it may block the flow of urine and cause the kidney to swell and the ureter to spasm, which can be very painful. At that point, you may experience these signs and symptoms:

• Severe, sharp pain in the side and back, below the ribs
• Pain that radiates to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Pain or burning sensation while urinating

Other signs and symptoms may include:

• Pink, red or brown urine
• Cloudy or foul-smelling urine
• A persistent need to urinate, urinating more often than usual or urinating in small amounts
• Nausea and vomiting
• Fever and chills if an infection is present

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

TYPES OF KIDNEY STONES

Knowing the type of kidney stone you have helps determine its cause, and may give clues on how to reduce your risk of getting more kidney stones. If possible, try to save your kidney stone if you pass one so that you can bring it to your doctor for analysis.

Types of kidney stones include:

• Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a substance made daily by your liver or absorbed from your diet. Certain fruits and vegetables, as well as nuts and chocolate, have high oxalate content.
• Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.
• Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain medications used to treat migraines or seizures, such as topiramate (Topamax, Trokendi XR, Qudexy XR).
• Struvite stones. Struvite stones form in response to a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.

Uric acid stones. Uric acid stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who eat a high-protein diet, and those with diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.

Cystine stones. These stones form in people with a hereditary disorder called cystinuria that causes the kidneys to excrete too much of a specific amino acid.

RISK FACTORS

• Family or personal history. If someone in your family has had kidney stones, you're more likely to develop stones, too. If you've already had one or more kidney stones, you're at increased risk of developing another.
• Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm, dry climates and those who sweat a lot may be at higher risk than others.
• Certain diets. Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.
• Obesity. High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.
• Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the amounts of stone-forming substances in your urine.
• Other medical conditions such as renal tubular acidosis, cystinuria, hyperparathyroidism and repeated urinary tract infections also can increase your risk of kidney stones.
• Certain supplements and medications, such as vitamin C, dietary supplements, laxatives (when used excessively), calcium-based antacids, and certain medications used to treat migraines or depression, can increase your risk of kidney stones.

DIAGNOSIS

If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as:

• Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
• Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
• Imaging. Imaging tests may show kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may reveal even tiny stones. Simple abdominal X-rays are used less frequently because this kind of imaging test can miss small kidney stones.
• Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.

ALLOPECIA

Hair loss is typically considered the domain of aging men, but this equal-opportunity condition — which has many causes — can affect virtually anyone.

Alopecia is the medical term for hair loss, and it doesn’t only happen on the scalp. Some illnesses and medications can trigger balding over the entire body, though genetics account for most cases on the head, according to the Cleveland Clinic.

Everyone sheds about 100 hairs each day as part of the normal hair growth cycle, but excess loss is usually a distressing development. Americans spend more than $3.5 billion each year trying to treat it, according to the American Hair Loss Association.

Symptoms & causes

Most people’s hair grows about a half-inch per month, and about 90% of your hair is actively growing at any given time, with the other 10% in dormant phase. After two or three months, this dormant hair falls out and its follicles begin growing new hair as other follicles begin a dormant phase.

Shedding hair is different from hair loss, when a hair falls out and doesn't grow back. People often shed hair during stressful events, such as childbirth, a breakup or divorce or during times of grief.

"It still doesn’t feel good, and it takes the hair [awhile] to reach a certain length where you perceive its presence," said Doris Day, a board-certified dermatologist New York City and an attending physician at Lenox Hill Hospital, also in New York. "So it feels like a hair loss, but it's not a hair loss."

Aside from heredity, noticeable hair loss can be caused by wide variety of factors, including:

Harsh hairstyles or treatments: Hairstyles that consistently use rubber bands, rollers or barrettes, or pull hair into tight styles such as cornrows, can inflame and scar hair follicles. So can incorrectly used chemical products such as dyes, bleaches, straighteners or permanent wave solutions. Depending on the degree of damage, resulting hair loss can be permanent.

Hormone imbalances: In women, hormonal shifts from birth control pills, pregnancy, childbirth, menopause or hysterectomy can induce more hair follicles than normal to enter the dormant phase.

Illness or surgery: The stress from sickness or surgery may prompt the body to temporarily cease nonessential tasks such as hair production. Specific conditions can also trigger it, including thyroid disorders, syphilis, iron deficiency, lupus or severe infection. An autoimmune condition called alopecia areata, which has no cure, causes rapid body-wide hair loss.

Medications and vitamins: Cancer chemotherapy, which attacks hair follicles in its attempt to kill all fast-growing cells around the body, is a well-known reason for hair loss. Other medications’ side effects include hair shedding as well, such as some that treat high blood pressure and gout (a painful joint condition caused by a buildup of uric acid). Excessive levels of vitamin A also contribute.

Nutritional deficits: Heavy dieting or eating disorders such as bulimia and anorexia can temporarily stun hair follicles to cease growth. This can also occur from insufficient protein, vitamin or mineral intake.

Aging: A natural effect of growing older is slowed hair growth.

Women usually don't go completely bald, but loss hair on the top of the head or the temples. Men tend to lose hair on their temples, and are more likely than women to go completely bald, Day said.

Diagnosis

Dermatologists will examine the person's scalp and take a history of medical or stressful events "to see what's been going on in their life and their world," Day said.

The dermatologist may take a biopsy — a small patch of skin that includes the hair follicle — and send it to a pathologist to determine if an autoimmune disease, such as lupus, is the cause of the hair loss.

Examining the hair and follicle can also determine whether someone has a bacterial or fungal infection, Day said.

Natural and alternative therapies

Treatments that reportedly improve alopecia areata include Chinese herbs, acupuncture, zinc and vitamin supplements, evening primrose oil and aroma therapy.

Viviscal, a natural supplement, has also shown more hair growth in men compared to those who took fish extract in clinical trials, Day said.

The NIAMSD recommends discussing any alternative treatments with physicians before use.

Atopic Dermatitis

Atopic dermatitis, also called Eczema, is a common allergic skin disease that usually starts in early childhood. It can be associated with infection (bacteria, fungi, yeast and viruses) of the skin. Atopy is a special type of allergic hypersensitivity that is associated with asthma, inhalant allergies (hay fever), and a chronic dermatitis. There is a known hereditary component of the disease, and it is more common in affected families. Criteria that enable a doctor to diagnose it include the typical appearance and distribution of the rash in a patient with a personal or family history of asthma and/or hay fever

Major and minor Characteristics of atopic dermatitis

Major characteristics

• Itching
• Characteristic rash in locations typical of the disease (arm folds and behind knees)
• Chronic or repeatedly occurring symptoms
• Personal or family history of atopic disorders (eczema, hay fever, asthma)

Minor Characteristics

• Early age of onset
• Dry, rough skin
• High levels of immunoglobulin E (IgE), an antibody, in the blood
• Ichthyosis
• Hyper linear palms
• Keratosis pilaris
• Hand or foot dermatitis
• Cheilitis (dry or irritated lips)
• Nipple eczema
• Susceptibility to skin infection
• Positive allergy skin tests

Is atopic dermatitis a common disease?

• Atopic dermatitis is very common worldwide and increasing in prevalence.
• It affects males and females equally and accounts for 10%-20% of all referrals to dermatologists (doctors who specialize in the care and treatment of skin diseases).
• Atopic dermatitis occurs most often in infants and children, and its onset decreases substantially with age.
• Of those affected, 65% of patients develop symptoms in the first year of life, and 90% develop symptoms before the age of 5.
• Onset after age 30 is uncommon and often occurs after exposure of the skin to harsh conditions.
• People who live in urban areas and in climates with low humidity seem to be at an increased risk for developing atopic dermatitis.
• About 10% of all infants and young children experience symptoms of the disease.
• Roughly 60% of these infants continue to have one or more symptoms of atopic dermatitis even after they reach adulthood.
• This means that more than 15 million people in the United States have symptoms of the disease.

Symptoms and signs of atopic dermatitis

• Symptoms and signs may vary from person to person; the most common symptoms are dry, itchy, red skin.
• Itch is the hallmark of the disease.
• Typically, affected skin areas include the folds of the arms, the back of the knees, wrists, face, and neck.
• The itchiness is an important factor in atopic dermatitis, because scratching and rubbing can worsen the skin inflammation that is characteristic of this disease.
• People with atopic dermatitis seem to be more sensitive to itching and feel the need to scratch longer in response.
• They develop what is referred to as the "itch-scratch" cycle.
• The extreme itchiness of the skin causes the person to scratch, which in turn worsens the itch, and so on. Itching is particularly a problem during sleep, when conscious control of scratching decreases and the absence of other outside stimuli makes the itchiness more noticeable.

Causes and risk factors of atopic dermatitis

The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors. There seems to be a basic cutaneous hypersensitivity and an increased tendency toward itching. Evidence suggests that the disease is associated with other so-called atopic disorders such as hay fever (seasonal allergies) and asthma, which many people with atopic dermatitis also have.

• In addition, many children who outgrow the symptoms of atopic dermatitis go on to develop hay fever or asthma.
• Although one disorder does not necessarily cause another, they may be related, thereby giving researchers clues to understanding atopic dermatitis.
• Many of those affected seem to have either a decreased quantity of or a defective form of a protein called filaggrin in their skin. This protein seems to be important in maintaining normal cutaneous hydration.
• It is important to understand that food sensitivities do not seem to be a major inciting factor for most cases of atopic dermatitis.
• This is an area of active research. Patients with atopic dermatitis seem to have mild immune system weakness.
• They are predisposed to develop fungal foot disease and cutaneous staphylococcal infections, and they can disseminate herpes simplex lip infections (eczema herpeticum) and smallpox vaccination (eczema vaccinatum) to large areas of skin.
• While emotional factors and stress may sometimes exacerbate the condition, they do not seem to be a primary or underlying cause for the disorder.

Skin features of atopic dermatitis

• Lichenification: thick, leathery skin resulting from constant scratching and rubbing
• Lichen simplex: refers to a thickened patch of raised skin that results from repeat rubbing and scratching of the same skin area
• Papules: small, raised bumps that may open when scratched, becoming crusty and infected
• Ichthyosis: dry, rectangular scales on the skin, commonly on the lower legs and shins
• Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs. These are also described as gooseflesh or chicken skin and may have a small coiled hair under each bump.
• Hyper-linear palms: increased number of skin creases on the palms
• Urticaria: hives (red, raised bumps), often after exposure to an allergen, at the beginning of flare-ups, or after exercise or a hot bath
• Cheilitis: inflammation of the skin on and around the lips
• Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
• Dark circles under the eyes: may result from allergies and atopy
• Hyperpigmented eyelids: scaling eyelids that have become darker in color from inflammation or hay fever
• Prurigo nodules also called "picker's warts" are not really warts at all. These are small thickened bumps of skin caused by repeated picking of the same skin site.

Stages of atopic dermatitis

• Atopic dermatitis seems to have a differing pattern of involvement depending on the age of a patient.
• In infants, atopic dermatitis typically begins around 6 to 12 weeks of age.
• It may first appear around the cheeks and chin as a patchy facial rash, which can progress to red, scaling, oozing skin.
• The skin may become infected.
• Once the infant becomes more mobile and begins crawling, exposed areas such as the knees and elbows may also be affected.
• An infant with atopic dermatitis may be restless and irritable because of the itching and discomfort.
• Many infants improve by 18 months of age, although they remain at greater than normal risk for dry skin or hand eczema later in life.
• In childhood, the rash tends to occur behind the knees and inside the elbows, on the sides of the neck, and on the wrists, ankles, and hands.
• Often, the rash begins with papules that become hard and scaly when scratched.
• The skin around the lips may be inflamed, and constant licking of the area may lead to small, painful cracks.
• Severe eczema cases may affect growth, and the child may be shorter than average.
• In those with more heavily pigmented skin, especially the face, areas of lighter skin color appear. This condition is called pityriasis alba. It is usually self-limited and the color will eventually normalize.
• The disease may go into remission (disease-free period) for months or even years.
• In most children, the disease disappears after puberty.
• Although a number of people who developed atopic dermatitis as children also experience symptoms as adults, it is less common for the disease to show up first in adulthood. The pattern in adults is similar to that seen in children; that is, the disease may be widespread or limited.
• In some adults, only the hands or feet may be affected and become dry, itchy, red, and cracked. Sleep patterns and work performance may be affected, and long-term use of medications to treat the condition may cause complications.
• Adults with atopic dermatitis also have a predisposition toward irritant contact dermatitis, especially if they are in occupations involving frequent hand wetting, hand washing, or exposure to chemicals.
• Some people develop a rash around their nipples.
• These localized symptoms are difficult to treat, and people often do not tell their doctor because of modesty or embarrassment.
• Adults may also develop cataracts that are difficult to detect because they cause no symptoms. Therefore, the doctor may recommend regular eye exams.

ECZEMA TREATMENT & MANAGEMENT

The major goal of treatment is an improvement in your quality of life. You should be able to participate in your school, work, social, and family activities. You should feel healthy and satisfied with your skin’s appearance. There should be no social stigma attached with the condition. You should have little to no side effects from the treatments for eczema. In addition, sleep should be restful and undisturbed by the need to scratch the skin.

Avoidance of Possible Triggers

Irritants: Irritants such as chemicals, soaps, detergents, fragrances, certain fabrics, and smoke can further irritate the skin in patients with eczema.

• The following are steps to perform to reduce irritant exposures:
• Wear comfortable clothing.
• Wash all new clothes prior to wearing them.
• Keep fingernails short and smooth to help prevent additional skin damage from scratching.
• Use broad-spectrum ultraviolet (UV) protective sunscreen (UV-A and UV-B with an SPF of 15 or higher).
• Bathe immediately after swimming to reduce and remove exposure to various chemicals found in swimming pools and beaches.

Inhaled Allergens: House dust mites are small, microscopic (you cannot see them with the naked eye) organisms. They are typically found indoors (mattresses, pillows, carpet), typically in areas of high humidity. These have been associated with eczema.

Foods: Common allergic foods have been associated with eczema. If you consistently notice worsening of your rash after ingesting certain foods, notify your allergist / immunologist for further evaluation. Of particular note, eliminating a variety of foods from the diet that you are not allergic to is rarely helpful in patients with eczema, so any evaluation of a possible food allergy should first be done with careful consultation with an allergist / immunologist.

Stress: Stress, including anger and frustration, can cause additional itching, thus potentially worsening the “itch-scratch cycle.”

Treatments

The following treatments may be used for both adults and children.

Basic Definitions

Topical Therapies: Topical means applying directly to your skin. There are many topical therapies

Ointments: Tends to have more oil than water, usually is more thick and greasy. These are the most common types of moisturizers used to treat eczema.

Creams: A mix of oil and water, it usually looks white and smooth.

Solutions: This is a more liquid form, feels like water.

Lotions: This is thicker than a solution.

Topical Moisturizers

Dry skin tends to worsen the itching and rash. Various environmental issues, such as exposure to low humidity and wind can further dry the skin. Therefore, moisturizing (hydrating, or adding water) your skin is an important component to eczema care. After soaking your skin in a bath or shower, pat dry the skin gently (pat the excess droplets of water). Then, immediately apply a moisturizer on the slightly wet skin to “lock” in the water and thus, improve dryness.

It is important to know that moisturizers are NOT steroids. It is also important to tell the difference between steroids or other anti-inflammatory medications and moisturizers. Your allergist / immunologist can help you differentiate between them.

Topical Steroids

Topical steroids are anti-inflammatory medications that are used on the rash areas (the red and inflamed areas of the skin, not just dry areas) of the skin. The steroids used for eczema are different from other types of steroids, such as testosterone and estrogen. When used properly as advised by your physician, topical steroids are safe. One topical steroid may be stronger (more potent) than another, and thus, may improve the rash more effectively than a weaker topical steroid. However, the stronger steroid also has potentially more severe side effects including thinning of the skin, and thus potent steroids should not be used on certain areas, such as the underarms, groin area, and face. Usually, topical steroids found over-the-counter are less strong than prescription ones. Bring all topical medications (they come in various forms, including creams, lotions, and ointments) to your allergist / immunologist, so the physician can differentiate between the various steroids and other topical medications.

Steroid pills or steroid injections (shots) are much stronger than topical steroids and can therefore cause more side-effects (including weight gain and bone problems). In general, they should be avoided, particularly in children.

Other Topical Anti-Inflammatory Medications

If topical steroids are not effective, other topical anti-inflammatory medications called topical immunomodulators might be tried. They are usually second-line agents used if steroids are unsuccessful. As they are not steroids, these medicines can be used on eyelid and other facial areas, as they do not normally thin the skin. As with any other medications, they have other potential side effects, so one must discuss them with an allergist / immunologist prior to use.

Wet-Wrap Therapy

Wet wrap therapy is usually used for people with severe and difficult to manage eczema. In this therapy, the skin is soaked in warm water for about 15-20 minutes and then, is patted dry. Topical medications (typically, steroids or other anti-inflammatory medications, as described above) are then placed on the “rash” areas of the skin. Then, a wet (not dripping) dressing (either gauze or clothing) is applied on top of the rash areas. This is followed by a dry wrap material, such as elastic bandage, pajamas, or sock, placed over the wet dressing. For patient comfort, a warm blanket may also be used. Wraps are used typically for 2-6 hours. The use of wet wrap therapy is individualized and should be performed under the close guidance of your allergist / immunologist.

Antihistamines

Oral, or pill, antihistamines do not reduce the itch associated with eczema, as it is not triggered by histamine. Sedative antihistamines are sometimes used to help encourage much needed sleep at night. However, there are potential side effects, including increased sleepiness, or sedation during the day, increased dryness, and difficulty urinating. Topical antihistamines should be avoided, as they may worsen your rash.

Therapies for Associated Infections

If your allergist / immunologist diagnoses an associated infection with the rash, an antibiotic may be prescribed. Your skin may be infected if there is oozing, crusting, your clothes start to stick to your skin, or you have the development of cold sores or fever blisters.

Bathing Strategies Including Dilute Bleach Baths

Very dilute bleach baths (typically, one quarter to one half cup of bleach mixed with 40 gallons of water bath) once to twice weekly may help improve the rash and may decrease the need for antibiotics.

Stress-Relieving Therapies

Stress reduction techniques, such as biofeedback and other techniques may be used to improve mood and decrease anxiety associated with eczema.

Vitamins

There has been a recent increase in studies associating vitamin D deficiency with eczema. If you have been diagnosed with vitamin D deficiency (low Vitamin D level) by your physician, Vitamin D supplements may be prescribed.

Biologic Medicines

Biologic medications are newer anti-inflammatory medications that have been approved for other allergic diseases, such as asthma, as well as for other skin conditions, such as psoriasis.

They have been studied in difficult to treat eczema patients, and one biologic agent has recently been approved for the treatment of very severe eczema. Your allergist / immunologist can discuss biological medications with you.

Probiotics

Despite a lot of media attention on probiotics, at present, there is no conclusive evidence showing that probiotic use improves or prevents eczema, and it is not currently recommended in routine eczema care.

Allergy Shots (Allergy Injections)

Allergy shots (giving injections of small doses of what you are allergic to, such as dust mites, under the skin in the arms) are currently approved for the treatment of asthma and allergic rhinitis (hay fever). Allergy shots can help some patients with eczema. Allergy shots are not the same as steroid shots, or steroid injections. Your allergist / immunologist can discuss whether allergy shots are appropriate for your eczema.

In summary, eczema is usually manageable, regardless of your age. There are many treatments currently available and future therapies are on the way. With careful evaluation and follow up with your allergist / immunologist, you can have a very high quality of life and enjoy all your activities.

WHAT IS PCOD?

PCOD (Poly Cystic Ovarian Disease) or PCOS (Poly Cystic Ovarian Syndrome) is a disease characterized by multiple (‘poly’) cysts (small sacs filled with fluid) in the ovaries.

Patients with PCOD have abnormal levels of hormones that result in irregular menses, infertility and certain masculine changes in the body.

What are the causes of PCOD?

PCOD problems are caused by hormone changes the hormonal imbalance. One hormone change triggers another, which changes another.

• Raised levels of Testosterone – Androgens or "male hormones," although all women make small amounts of androgens...Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle. Excess androgen produced by the theca cells of the ovaries, due either to hyperinsulinemia or increased luteinizing hormone (LH) levels.
• Raised levels of Luteinising Hormone (LH) – Due to increased production from the anterior pituitary. This stimulates ovulation but may have an abnormal effect on the ovaries if levels are too high.
• low levels of Sex Hormone-Binding Globulin (SHBG) – A protein in the blood, which binds to testosterone and reduces the effect of testosterone.
• Raised levels of Prolactin - Hormone that stimulates the breast glands to produce milk during pregnancy.

High levels of Insulin (a hormone that helps convert sugars and starches into energy) If you have insulin resistance, your ability to use insulin effectively is impaired, and also your pancreas has to secrete more insulin to make glucose available to cells (so, hyperinsulinaemia) Excess insulin might also affect the ovaries by increasing androgen production, which may interfere with the ovaries' ability to ovulate.

A significant hereditary component, if your mother or sister has PCOS, you're more likely to have it.If you're overweight, your chances of developing it are greater. As weight gain increases insulin resistance. Fatty tissues are hormonally active and they produce estrogen which disrupts ovulation.

What are the symptoms of PCOD?

Generally, the patient presents with the following symptoms:

Various hormones of the body operate in harmony to regularize smooth functioning of all systems including the reproductive system.

The disturbance of the hormonal mechanism makes the ovaries produce an excessive amount of the male reproductive hormones (androgens) and at the same time, there is a failure of egg formation. This excess of androgens with the absence of ovulation may cause infertility.

With this understanding, that the disturbed hormonal functioning of the body lies at the root of PCOD, it can be easily perceived that this constitutional disorder will require constitutional approach towards its rectification.

How is PCOD Diagnosed?

1. Typical medical history: Regular/ irregular menstrual cycles, heavy/scanty menstrual flow, the need to take hormonal tablets (progestins) to induce a period, etc.

2. Physical Signs: Often obese and may have hirsutism, (excessive facial and body hair) as a result of the high androgen levels.

3. Diagnosis can be confirmed by vaginal Ultrasound (USG pelvis): Shows that both the ovaries are enlarged; the bright central stroma is increased, and there are multiple small cysts in the ovaries. These cysts are usually arranged in the form of a necklace along the periphery of the ovary.

4. Blood levels of hormones:

• High LH (luteinizing hormone) level; and a Normal FSH level (follicle stimulating hormone) i.e. a reversal of the LH: FSH ratio, which is normally 1:1.
• Elevated levels of androgens (a high dehydroepiandrosterone sulfate (DHEA-S) level);
• Fasting cholesterol and triglyceride levels;
• Glucose tolerance test.

DO’s & DONT’S OF PCOD

• Diet should be dominated with lots of fruits and vegetables on a daily basis. Avoid dairy products as much as possible.
• Lean cuts of chicken and fish can be taken. But avoid red meat.
• Hydrate yourself well by having a minimum of 2-3 liters water/day, coconut water, buttermilk, vegetable soups, and smoothies. Avoid aerated drinks and sugary foods.
• Eat unsaturated fats and delete saturated and hydrogenated fats from your diet. Always check the label of the product while buying them.
• Binge on whole wheat products like wheat pasta, wheat poha and avoid maida, suji
• Brown rice in and white rice should be out of your diet. Red rice is also found to be rich in antioxidants which can be used as a substitute for white rice.
• Include natural herbs in your diet like flax seeds, methi seeds, coriander, cinnamon.
• Include millets like barley, ragi, quinoa, and oats. They are known to cool your body.
• Say Yes to walnuts, almonds and no to cashews
• Whole pulses like skinned green moong dal, chana dal, yellow moong dal, whole pulses to be included in various preparations.

Herniated Disc

What is a Herniated /slipped disc?

Your spinal column is made up of a series of bones (vertebrae) stacked onto each other. From top to bottom, the column includes seven bones in the cervical spine, 12 in the thoracic spine, and five in the lumbar spine, followed by the sacrum and the coccyx at the base. These bones are cushioned by discs. The discs protect the bones by absorbing the shocks from daily activities like walking, lifting, and twisting.

Each disc has two parts: a soft, gelatinous inner portion and a tough outer ring. Injury or weakness can cause the inner portion of the disc to protrude through the outer ring. This is known as a slipped, herniated, or prolapsed disc. This causes pain and discomfort. If the slipped disc compresses one of your spinal nerves, you may also experience numbness and pain along the affected nerve. In severe instances, you may require surgery to remove or repair the slipped disc.

What are the symptoms of a slipped disc?

You can have a slipped disc in any part of your spine, from your neck to your lower back. The lower back is one of the more common areas for slipped discs. Your spinal column is an intricate network of nerves and blood vessels. A slipped disc can place extra pressure on the nerves and muscles around it.

Symptoms of a slipped disc include:

• pain and numbness, most commonly on one side of the body
• pain that extends to your arms or legs
• pain that worsens at night or with certain movements
• pain that worsens after standing or sitting
• pain when walking short distances
• unexplained muscle weakness
• tingling, aching, or burning sensations in the affected area

The types of pain can vary from person to person. See your doctor if your pain results in numbness or tingling that affects your ability to control your muscles.

What causes slipped discs?

A slipped disc occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a slipped disc. A disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a slipped disc. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped discs.

Overweight individuals are also at increased risk for a slipped disc because their discs must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disc.

As you get older, you are more likely to experience a slipped disc. This is because your discs begin to lose some of their protective water content as you age. As a result, they can slip more easily out of place. They are more common in men than women.

Natural Treatments

It may not be possible to prevent a slipped disc, but you can take steps to reduce your risk of developing a slipped disc. These steps include:

• Use safe lifting techniques: Bend and lift from your knees, not your waist.
• Maintain a healthy weight.
• Do not remain seated for long periods; get up and stretch periodically.
• Do exercises to strengthen the muscles in your back, legs, and abdomen.