Friday, 28 November 2014


Image Credit: Janelle Aby, MD,
Hypotonia – Decrease Muscle Tone

Hypotonia is a medical term for decreased muscle tone which is the amount of tension or resistance to stretch in a muscle and is felt as resistance to movement. It is not the same as muscles weakness and it can be difficult to use the muscle which has been affected. Muscle weakness could at times develop in hypotonia based on the cause of the ailment.

This ailment is often identified in babies’, immediately after birth or at a very tender age though it could also develop in the later stage of life. Hypotonia is not a medical disorder; it is a potential manifestation of several other diseases and disorders which can affect the motor never that is controlled by the brain or muscle strength.

Recognizing the symptoms of hypotonia in early infancy is quite straightforward though diagnosing the cause could be difficult and not very successful. The effects of hypotonia on the development of a child on long term would depend mainly on the seriousness of the muscle weakness as well as the nature of the cause. While some disorder tends to have a specific treatment, the principle treatment for most hypotonia of neurologic or idiopathic cause is physical therapy and occupational therapy for remediation and probably music therapy.

Symptoms - Children

Hypotonia is presumed to be associated with the disruption of afferent input from stretch receptors or/and lack of the cerebellum’s facilitatory efferent influence on the fusimotor system which is the system that innervates intrafusal muscle fibres in controlling muscle spindle sensitivity.

Hypotonia when present at birth is detected when the child is six months old in infants and young children, if not earlier. Some of the symptoms may include: the child may have little or no control of their neck muscles and hence their head tend to flop, feel limp when held as though they would slip easily through the hands, unable to place any weight on their leg of shoulder muscles, arms and legs tend to hang straight down from their sides instead of bending at the elbows, hips and knees, would be finding sucking and swallowing difficult and may have a weak cry.

Besides this, the child may also take a longer time to reach development like crawling, sitting up, walking, talking and feed themselves.

Symptoms - Adults

An adult suffering from hypotonia may envisage the following problems:
  • Would tend to be clumsy and fall frequently 
  • Have an unusual degree of flexibility in the hips, knees and elbows 
  • Have difficulty in rising up from a lying or sitting position 
  • Difficulty is reaching for or lifting objects
Based on the cause, this disorder may either improve or stay on or may get worse over a period of time while babies with hypotonia caused by premature birth usually improve as they grow up while hypotonia caused by infection or any other condition would improve if the underlying condition is treated successfully though often it is not possible to cure the underlying cause of this disorder. 
If the ailment is inherited, it could persist all through the person’s life while treatment could improve activities like mobility and speech. Treatment may involve physiotherapy, occupational therapy as well as speech and language therapy.

Monday, 24 November 2014

Graves’ Disease

Graves’ Disease
Graves’ Disease – Autoimmune Disease

Graves’ disease is an autoimmune disease which affects the thyroid which is a small gland in the front area of the neck. It creates hormones known as T3 and T4 which regulates how the body utilises the energy and the thyroid hormone levels are controlled by the pituitary.

 This is a pea sized gland in the brain which makes thyroid stimulating hormone – TSH that enables the thyroid to make thyroid hormone. With Graves’ disease, the immune system tends to make antibodies which act like TSH making the thyroid to produce more thyroid hormone than what is needed by the body.

This is known as an overactive thyroid or hyperthyroidism and an overactive thyroid affects every function of the body in speeding up like the heart rate as well as the rate wherein the body turns food into energy.

This disease is the result of overactive thyroid and is closely related to Hashimoto’s disease which is another autoimmune disease that affects the thyroid.It could run in families and can occur at any age though it is most common in women in the age group of 20 – 40.

 Smokers are more likely to develop this disease. Being an autoimmune condition, the immune system tends to mistake something in the body for a toxic substance and attacks it.

Overproduction of the Thyroid Hormones

In this condition, it attacks the thyroid gland leading to an overproduction of the thyroid hormones. What triggers the immune system to do this is not known and like several autoimmune conditions it is presumed that a combination of both genetic as well as environmental factors would be responsible.

Some people suffering from Graves’ disease may also have their eyes affected where the tissue behind the eyes tends to get inflamed and swollen causing them discomfort and bulging in one or both the eyes.

At times it could also cause double vision which is known as Graves’ ophthmopathy and these symptoms could occur before or at the same time or after the other symptoms of the disease begins to show up. Eye problem often tends to get better without much treatment.

Factors Responsible for Graves’ Disease

Factors responsible for this disease may include Genes wherein some people are prone to this disease due to their genes. Emotional stress or trauma could also trigger this disease, pregnancy also affects the thyroid where 30% of young women who suffer from Graves’ disease have been pregnant in the 12 months prior to the onset of the symptoms which indicates that pregnancy could trigger Graves’ disease in some women.

Sex hormones also play a role which could explain why Graves’ disease affects women more than men. Infection too is responsible in the onset of Graves’ disease though no studies have shown it to be directly the cause of this disease. Graves’ disease can be treated through drugs which helps the thyroid from making too much thyroid hormone.

Radioactive iodine – RAI, treatment can be helpful wherein a pill which contains RAI is swallowed which is a form of iodine that damages the thyroid by giving it radiation and destroys thyroid cells where less thyroid hormone is produced.

Through surgery where most or the entire thyroid is removed though one would need to take thyroid hormones to replace the needed thyroid hormone which the body no longer produces.

Saturday, 22 November 2014


Asbestosis – Lung Tissue Scarring 

Asbestosis is a process of lung tissue scarring which is caused by prolonged exposures to asbestos fibres. Asbestos is a term for a group of minerals which are made of microscopic fibres and in the past was extensively used in construction.

Patients with x-ray findings or biopsy results could also have remote history of asbestos exposure and delayed development of this condition. Smoking too could increase the frequency or the rate of progress of asbestosis by preventing the efficient elimination of inhaled fibres through the airways. Asbestos could be very dangerous though not considered as a health hazard if undisturbed.

However if the material with asbestos is drilled, broken, chipped or allowed to deteriorate, it could give out some fine dust containing asbestos fibres and when the same is breathed in, it could enter the lungs and gradually cause damage over a period of time.

Breathing in the asbestos fibres could scar the lungs with a number of symptoms like shortness of breath which may take place after physical activity in the initial stage and eventually tends to be a constant problem. A person may suffer from persistent cough, wheezing, extreme tiredness, chest pain, and in more advantaged situations, clubbed or swollen fingertips.

PFT/Exercise Test/CT Scan

Exposure to Asbestos is divided into three forms, namely asbestosis – lung scarring due to asbestos fibres, disease of the lining of the lung – pleural plaques, scarring or fluid accumulation and lung cancer. Cancer of the lining of the lung due to asbestos exposure is Mesothelioma while cancer of the larynx, throat, kidney, oesophagus and gallbladder is linked to asbestos exposure which is treated based on the kind of condition of asbestosis.

The abnormalities in breathing can be identified with function test like pulmonary function tests – PFT or exercise test which is performed at specialized laboratories since asbestosis could obstruct the airflow and restriction of lung inflation.

Besides, this condition could also affect the ability of transferring oxygen to the blood. In advanced cases, the person could have reduced blood oxygen and would be in needof supplementary oxygen. The abnormalities in the x-ray include thickening of the lining of the lungs with tiny lines marking the lower portions of the lungs. CT scans could be very helpful in separating asbestosis from other conditions which may have similar reports but even a CT scan may not identify the disease of lining of the lung- pleural disease in people with asbestosis.

Biopsy & Microscopic Examination

At times a biopsy and microscopic examination of the lung could help in diagnosing asbestosis where under microscopic examination; some coated fibres are seen with pattern of scarring. The content of coated as well as uncoated asbestos is linked to the severity of this disease and since other particles could resemble asbestos, a clear identification would require scanning electron microscopy.

 Presently, to detect asbestos fibres in the lung tissues and fluid, secretion or sputum could be used to diagnose together with the history of asbestos exposure as well as the characteristic x-ray or the results of the CT.

Since there is not cure for asbestosis once it has progressed and the damage has already been caused to the lungs, it is most important to quit smoking if the person has a tendency to smoke to prevent further damage to the lungs and smoking could also increase the chances of lung cancer to the person with this ailment. Some treatment like oxygen therapy could bring about some improvement and quality of life to these patients.

Wednesday, 19 November 2014


Cellulitis – Bacterial Infection of the Skin 

Cellulitis is a bacterial infection of the skin and tissues beneath the skin and unlike impetigo, a very superficial skin infection, cellulitis is a kind of aninfection that involves the skin’s deep layers, which is the dermis and subcutaneous tissue. Its main bacteria responsible for cellulitis are Streptococcus and Staphylococcus, which are the same bacterial that could cause impetigo.

MRSA- methicillin-resistant Staph aureus could also cause cellulitis while at other times, bacteria such as Hemophilus influenzae, Pneumococcus and Clostridium species could also be the result of cellulitis. This disease is quite common and can affect people of all ages and races, men and women alike.

Cellulitis is not contagious and sometimes it tends to appear in areas where the skin could be broken open like the skin near ulcers or surgical wounds. Cellulitis is often treated with oral or intravenous antibiotics.

It appears as a swollen, red appearance on the skin which feels hot and tender and could spread rapidly to other areas. The skin on lower areas of the legs commonly tends to get affected though it could affect any area of the body or face. It could also affect only the skin’s surface or also affect underlying tissues of the skin and spread to lymph nodes as well as the bloodstream.

Symptoms of Cellulitis

Cellulitis tends to begin with small areas of tenderness, redness and swelling which may spread to the adjacent skin that would feel warm to the touch and as the red area begins to get large, the person may have fever which at times may accompany with chills and sweats, tenderness and swollen lymph nodes near the area of infected skin.

 Sometimes small blisters may also form and burst. This condition may appear when one or more types of bacteria may enter through a crack or break in your skin. Bacteria is more likely to enter these areas of skin when a person may have had a recent surgery, cuts, puncture wounds, athlete’s foot or dermatitis, besides ulcers.

There could also be certain kinds of insects or spider bites which could transmit the bacteria to begin the infection of cellulitis. Moreover areas of dry flaky skin could also be at risk for entry point for the bacteria.

Treated with Antibiotics – Oral/Intravenous 

When faced with the symptoms mentioned, the person should consult the physician who could distinguish if the inflammation is due to an infection and diagnose the ailment. Cellulitis is often treated with antibiotics which are designed to eradicate the likely bacteria that could be the cause of cellulitis.

At times the treatment may need the administration of intravenous antibiotics in the hospital since oral antibiotics may not provide sufficient penetration of the inflamed tissues to be effective or it could also be administered at home.

Physician is the best judge in choosing a treatment based on the several factors which include the extent and location of the infection, the kind of bacteria responsible for the infection and the overall condition of the person suffering from cellulitis.

If this condition is not treated it could spread the infection rapidly and could be dangerous to the person and hence it is necessary to seek timely treatment.

Saturday, 15 November 2014

Gilbert’s Syndrome

Gilbert’s Syndrome
Gilbert Syndrome – Common Harmless Genetic Liver Disorder

GilbertSyndrome also called Gilbert Meulengracht syndrome is a common harmless genetic liver disorder caused due to increased bilirubin, a chemical which results from the normal breakdown of haemoglobin from red blood cells. It is a condition where high levels of bilirubin tend to build up in the blood. Bilirubin is the yellow pigment which is found naturally in the blood that forms when the red blood cells are broken down.

This disorder is also referred as constitutional hepatic dysfunction and familial nonhemolytic jaundice. The abnormality results in mild elevation of bilirubin in the blood especially after starvation or dehydration. Gilbert syndrome is the outcome of a genetic mutation in promoter region of a gene and the gene is on chromosome 2 while other types of mutation in the same gene could cause Crigler-Najjar syndrome which appears to be more severe as well as a dangerous type of hyperbilirubinemia – high bilirubin in the blood.

The cause of hyperbilirubinemia is the outcome of reduced activity of the enzyme glucuronyltransferase that binds bilirubin with other lipophilic molecules rendering the bilirubin water soluble which is then excreted in bile into the duodenum.

Short Lived Incidents of Jaundice

Persons suffering from Gilbert’s syndrome may experience occasional and short lived incidents of jaundice and the skin and the white area of the eyes may turn slightly yellow while others may have problems during episodes of jaundice like abdominal pain, loss of appetite, feel tired or sick, dizziness, irritable bowel syndrome – IBS, which is a common condition causing stomach cramps, bloating, constipation and diarrhoea and problems on focusing and thinking clearly.

These symptoms may not be directly related to increased bilirubin levels and could also be the result of other disorder, than Gilbert’s syndrome. This disorder produces an increased level of unconjugated bilirubin in the bloodstream though it does not cause any serious consequences. Mild instances of jaundice may occur under conditions of stress, fasting, exertion and infection while severe cases will be yellowing of the skin tone as well as the sclera in the eye.

Faulty Gene

In the case of Gilbert’s syndrome, the person has faulty gene which means that their liver has problems in removing the bilirubin in the blood. In normal situation, when red blood cells reach the end of their life which is about 120 days, the red pigment, haemoglobin that carries oxygen in the blood breaks down into bilirubin where the liver converts it into water soluble form and thereafter it passes into bile and eventually removed from the body through urine or stools.

Bilirubin gives the urine its light yellow colour and stools their dark brown colour. In this disorder, the faulty gene which means the bilirubin does not pass into the bile normally and instead it builds up in the bloodstream causing the skin and eyes with the yellowish tinge. Besides inheriting the faulty gene, there are no known factors for the development of this disorder and are not related to any environmental factors, lifestyle habits or serious underlying liver problems like cirrhosis or hepatitis C.

Though it is a long term condition, it does not require any treatment and is not a threat to health. Episodes of jaundice with any associated symptoms are short term and will gradually pass off.

Thursday, 13 November 2014

Anger Management

Anger Management
Anger – Learning to Control Anger

It is normal to get angry when one may be ill-treated or misunderstood but just like all things has its limitation; anger too should be within its limits. When one tends to get angry, the actions and its reaction could have an impact on the individual and the one to whom it may be targeted to.

 If a person tends to have a hot temper, it could pose as a problem when it harms the person or others. But managing anger could also be a problem for several people who may find it difficult to keep their temper under control. There could also be health issues related to unresolved anger like high blood pressure, depression, heart attack, anxiety, problems with digestion, etc.

Such a kind of a person need to take control of themselves when angry and learn to master the art of anger management which could be helpful when faced with it. Learning to control anger and expressing it rightly could help to build a better relationship, lead a healthy and satisfying life as well as help in reaching their goals.

Every individual tends to have physical reaction to anger and one could try to keep a reign on their temper and prevent regretting the outcome of it at a later stage.

Recognize Anger Signs

Individuals need to recognize the anger signs when angry like the heart beats faster and breathing tends to get quicker thus leading the person to react. Other signs could also be like tension in the shoulders or the clenching of the fists. Should the person have a history of losing control and comes across these kinds of signs, the best option would be to move away from that situation.

This would help in easing the atmosphere as well as give the person time to cool off the heat. Another option would be counting to ten which can give the person sufficient time to cool and sober down and thus overcome the urge to lash out when angry.

Besides counting, breathing out for a longer time than breathing in and relaxing as you breathe out also helps in the most amazing way since the person automatically breathes in more than out, when angry and this trick is to get the person to breathe out more than in, which helps to calm and sober down, enabling them to think clearly.

Exercises and Relaxation

To manage anger in the long term, one could bring down the general stress level with the help of exercise and relaxation while running, walking, yoga, swimming and meditation could be some of the activities which could be beneficial in reducing stress.

Regular exercise could be a daily routine to eliminate anger and irritation with regular hours for relaxing and making sure that one receives sufficient sleep should be taken into consideration. Other ways could be by getting engaged in creative hobbies like writing, dancing or painting which could release the tension and reduce the feeling of anger within.

Discussion with a trusted person could also be helpful wherein with the exchange on discussions, one could come across several things which otherwise could have been overlooked and get a different perspective on that situation.

Wednesday, 12 November 2014


Gout – Crystals of Uric Acid Deposited in Joints

Gout is a kind of arthritis wherein crystals of uric acid tend to get deposited in the joints. It could cause sudden joint inflammation in one joint and severe gout could at times affect several other joints at the same time. This is known as polyarticular gout.

The most common symptom is severe and sudden pain in the joint together with swelling and redness. It is the toe which is commonly affected though it could develop in any other joint. The symptoms develop rapidly and are at its worst within 6 to 24 hours and usually last for around 3 to 10 days. Thereafter, the joint tends to look and feel normal again and the pain also disappears completely.

Gout is the cause of the accumulation of crystals of by-product chemical of metabolism in the joint which is the uric acid and when it tends to accumulate it could cause inflammation in the joint. Elevated level of uric acid in the bloodstream could lead the uric acid accumulation in the tissue of a joint which is found in the body and a normal by-product of the body breaks down on certain proteins known as purines.

Causes of Gout

If too much uric acid is produced or too little is excreted while urinating, the uric acid accumulates and may cause tiny crystals of sodium urate to form in and around the joints.

These tend to gradually build up over the years which are like hard needle shaped crystals and when it reaches a high concentration level crystals in the joint, they tend to cause two types of problems such as, some may spill over from the joint cartilage inflaming the soft lining of the joint resulting in pain with inflammation of an attack of gout while some pack together forming hard slowly expanding lumps of crystals or tophi which could cause progressive damage to the cartilage joint as well as the nearby bone and eventually results in irreversible joint damage causing stiffness and pain on movement.

Some of the common factors of gout is age and gender and may affect a person as they grow old andit is three to four times more likely in men, person having high blood pressure or diabetes, having close relatives who have been suffering from gout, a diet rich in purines like eating sardines and liver frequently and drinking too much of beer or spirits since alcoholic drinks contain high level of purines and being overweight.

Treatment and Relief for Gout 

Gout can be treated by relieving the symptoms which can be done by using ice packs and taking painkillers while in some cases, alternative medication may also be required. Preventing gout attacks in the future through a change in lifestyle which could involve losing weight if found to be overweight and taking medication which could lower the level of uric acids.

It is essential to follow the prescribed medication given by the physician and adhere to any recommended changes in lifestyle. Some complications may also arise which though uncommon may include kidney stones wherein high level of uric acid could lead to stone developing in the kidneys, permanent joint damage due to on-going joint inflammation between attacks and due to formation of tophi in the joint which damages the cartilage and bone if not treated for several years, tophus formation that are tophi of small and large lumps which at times are visible and felt easily under the skin.