Wednesday, 20 August 2014

Macular Hole

Macular Hole

Macula -Focussing Area of the Eye 

The macula is a very small, central area of the retina, a thin layer of light sensitive tissue that lines the back area of the eye and is the focusing surface of the eye. Light rays are focused onto the retina where they get transmitted to the brain and identify the image which is seen. The macula is responsible in pinpointing vision, enabling to see the print while reading, sew or to recognise a person.It helps to see things directly in front as well as helps to see colour and other details.

The macular hole is a small break in the macula, the area which is responsible for details and the central vision of the eye. In the early stage, a macula hole could cause blank spots, blurring or distortion of the central vision. Straight lines may tend to be seen wavy or bowed and one may face discomfort while reading small print.

After some time, the persons may see small black patch or a missing patch in the centre of the vision. As we tend to age, the thick vitreous gel in the centre of the eyes shrinks, pulling always from the macula and the gel sticks to the macula and does not pull back, the macular tissues gets stretched eventually tears and a hole is formed.

The Amsler Grid Test

Macula hole is very common in people who have crossed the age of 60 and above and this condition may differ among individuals and a consultation with the physician is essential if faced with any of these symptoms. The macula often affects only the central vision and the peripheral or side vision is not affected but the person may have some difficulty in reading and with close vision and may notice grey or black spots or even blank area in their vision.

 It usually affects only one eye instead of both the eyes though there could be a possibility of both the eyes getting affected.It may develop over a period of time and one may fail to notice any symptoms till the vision gets affected.The initial stage starts with blurring and distorted images and the straight lines like the window frames, telegraph poles or lines of text may appear wavy or bent. A simple test, the Amsler Grid, will help to determine if the vision is distorted.

Virectomy for removal of the Vitreous Gel 

The location and the size of the macula hole can determine on how much the vision has been affected. There are three stages of this condition wherein the vision will tend to deteriorate as the condition progresses and worsens.

The treatment for macula hole is most effective if it is carried out in its initial stage of development of the condition. Surgery is usually essential to repair the hole and is often successful though one needs to be aware of the possibility of complication of treatment and that the vision may probably not return completely to its normal state. An operation known as vitrectomy is adopted to carefully remove the vitreous gel from the affected eye and replaced with a gas which helps in the healing of the macula hole

Monday, 18 August 2014

Hepatitis – Injury to Liver

Hepatitis – Injury to Liver/Inflammation of Liver cells 

The word `hepatitis’ is derived from the ancient Greek word `hepar’ meaning `liver and the Latin` itis’ means inflammation and Hepatitis means injury to the liver accompanied with inflammation of the liver cells. Hepatitis is used to describe the inflammation of the liver and can occur due to viral infection or if the liver has been exposed to harmful substance like alcohol. There are some types of hepatitis which do not cause any permanent damage to the liver while there are other types which may persist for several years causing scarring or cirrhosis of the liver.

 In serious cases, it could also lead to the loss of the liver function or liver failure or even liver cancer and that could be life threatening. These types of long lasting conditions are called chronic hepatitis. The liver which is the largest gland in the body weighs 1.36 kg and is reddish brown in colour. It has four lobes of different size and length and the largest internal organ of the body which lies below the diaphragm towards the right area in the thoracic region of the abdomen.

The blood travels to the liver through the hepatic artery and the portal vein carries blood containing digested food from the small intestine while the hepatic artery carries the oxygen rich blood from the aorta. The liver is the combination of thousands of lobule where each lobule comprises of many hepatic cells, which are the basic metabolic cells of the liver

Symptoms of Hepatitis

The symptoms of hepatitis in its initial stage are similar to flu and include muscle and joint pain, headache with high fever; feeling of sickness, with occasional yellowing of the eyes and skin, In the case of chronic hepatitis, symptoms may include unusual feeling of tiredness all the time, depression, jaundice and a general sense of not feeling well.

 In several cases, hepatitis does not cause any noticeable symptoms and when it occurs due to virus, many tend to be unaware of the ailment. Hepatitis normally heals on its own with no significant consequences or it could also progress and scar the liver and while acute hepatitis last less than six months, chronic hepatitis lasts much longer.

Three hepatitis viruses are the cause of liver damage namely hepatitis A, B and C though hepatitis may also be caused by other toxins and infections besides alcohol, as well as from our own autoimmune process within the body itself.

Autoimmune Hepatitis 

Autoimmune hepatitis is very rare cause of chronic or long term hepatitis wherein the white blood cells tend to attack the liver thereby causing chronic inflammation and damage to the liver. This could lead to more serious problems resulting in liver failure and the reason for this in not known.

Not all types of hepatitis are infectious and alcohol, chemical maybe unsafe for the liver and may cause inflammation. Obesity could be a cause of liver damage resulting in inflammation or a person may have some genetic problem, a metabolic disorder or an immune related injury all of which can be termed as non-infectious since this ailment does not spread from one person to another.

Saturday, 16 August 2014

Ebola Virus Disease

Ebola Virus Disease
Ebola Virus Disease – Fatal Hemorrhagic Fever 

Ebola virus is an important member of the Zaire ebolavirus species as well as the most dangerous of the five known virii in the genus ebolavirus. Out of the five ebolavirii, four of them are the cause of severe and at times fatal hemorrhagic fever among humans together with other pirmates which is known as ebola virus disease.

The Ebola virus disease – EVD is caused due to the virus from the Filoviridae family and is said to be transmitted from animals to humans wherein the virus tends to spread through direct contact with the body fluid of an infected individual or animals. The Ebola virus along with its species was earlier named Zaire which is now the Democratic Republic of Congo and the country where it was first described, was identified to be closely related Marburg virus excluding its species and given the name of `ebola virus’ in order to avoid confusion in the year 2010. It species is a virological taxon species which is included in the genus Ebolavirus, the Filoviridae family and whose members are called Filovirus, order Mononegavirales.

Natural Reservoir – Bats 

It is said that its natural reservoir is bats, especially the fruit bats and can be transmitted through close contact with the blood, secretions, organs or bodily fluids of the infected animals and in the case of humans it is transmitted when healthcare personnel may contract the said disease through contact with infected bodily fluid or through transmission, handling the meat of infected animals, contact with the bodily fluids of the infected person who has expired, besides coming in contact with the infected person’s blood, secretions, organs or other bodily fluids.

 Ebola virus was first discovered infecting humans in the African countries especially Sudan and is now presently bringing about a fear in the minds of the people due to its destructive capabilities drawing the infected individual to a fatal end. The Ebole hemorrhagic fever is a condition that can infect million and to be safe from this dreaded disease, utmost care and precaution needs to be taken.

Contagious Ailment

According to DrRattan Kumar Vaish, Senior Consultant of the Department of Internal Medicine, Rockland Group of Hospitals – NCR, Delhi, considers this conditionto be contagious and migratory populations are likely to get infected and transmit this virus. Those at a higher risk of infection could be individuals who are diabetics, immune-compromised patients, individuals with kidney and liver failure as well as HIV infected people.

It is also a hospital acquired infections wherein the hospital staff could also get affected with this virus. The incubation period which is the time when the infection occurs to the time when the persons understand the symptoms of this disease is around one week which is the early symptoms of this condition.

These symptoms include fever, headache, nausea, rashes, vomiting accompanied with stomach pain. Besides this, the affected person may also experience lower back pain, arthritis type of pain in the body, with diarrhoea and sore throat.

Know the Symptoms

As the condition progresses, symptoms like increased sensitivity to pain on the skin, genital swelling, conjunctivitis, bleeding from the mouth, ears, nose and ears,rashes over the body and redness on the roof of the mouth takes place.

The physician would be able to diagnose the ailment on checking the symptoms wherein test like Complete Blood count –CBC, a test to check the presence of the viral antigen – viral antigen testing and liver function test are prescribed. Once the symptoms are diagnosed, the treatment is to treat the symptoms and thus prevent secondary infection or complication such as liver failure and pneumonia since there is no definite treatment and the common anti-viral therapies are not effective on Ebola virus.

As per World Health Organisation reports, 80 percent of the people on an average infected with this ailment tend to die, the cause of which is the drop in their blood pressure and the failure of organs.

Basic Hygiene/Avoid Crowded Areas of Outbreak

As of date, there are no vaccinations available to eliminate this disease but basic hygiene could be adopted and followed in order to prevent the onset of this dreaded condition such as washing hands well, maintaining general hygiene, drinking of water from clean source, cooking food, especially meat, well. Besides this, crowded places should be avoided or the areas where there is an outbreak of this ailment. It is also advisable to take note of the early symptoms and consult a physician at the earliest.

The Ebola infected individual is placed in an enforced isolation area to avoid the spread of this virus. Government usually quarantine these areas where the disease occur or individuals who are infected. United States enables quarantine for those infected with Ebola virus. Liberia had closed schools during the 2014 outbreak.

One of the largest outbreaks till date is the 2014 West Africa Ebola virus outbreak which had affected Guinea, Sierra Leone, besides Liberia and as of August 2014, it has also been affecting Nigeria and at the end of July 2014, over 1320 cases had been surfaced.

Thursday, 14 August 2014


Gangrene – Serious and Life Threatening Ailment

Gangrene is a serious condition and potentially a life threatening ailment which arises due to the loss of blood supply causing the body tissue to die.It can affect any area of the body though it starts in the toes, feet, hands and fingers but can also occur inside the body, damaging muscles and organs. This may be the result of an injury or infection or in those suffering from chronic health problem which may affect the circulation of the blood.

Primary cause of gangrene is reduced supply of blood to the affected tissues which end up in cell death. Long term smoking and diabetes could increase the risk of suffering from gangrene. Gangrene are of different types with different symptoms like dry gangrene, wet gangrene, internal gangrene, gas gangrene and necrotizing fasciitis where the treatment options would include debridement or in extreme and severe cases would be amputation of the affected part of the body, antibiotics, maggot therapy, hyperbaric oxygen therapy and vascular surgery.

Some of the symptoms of this condition include redness and swelling in the affected part of the body, loss of sensation or severe pain, sores or blister in the affected areas which tend to bleed or produce foul smelling pus. The need to see a physician is extremely essential if faced with these symptoms.

Blood the Most Essential Element

Blood is the most essential element for health since it transports oxygen and nutrients to the entire body to feed cells, in delivering disease fighting antibodies which protects the body from various infection and when the blood circulation is not circulated effectively in the body, the cells are unable to survive resulting in infection and the tissue may die from gangrene.

Conditions affecting the blood stream flow could increase the risk of gangrene like atherosclerosis, peripheral arterial disease, trauma, Raynaud’s phenomenon, a condition wherein the blood vessels supplying the skin tends to get narrowed down, besides diabetes and smoking. The two major type of gangrene are the wet and dry gangrene where several cases of dry gangrene are not infected while all cases of wet gangrene are considered to be infected by bacteria.

Wet/Dry/Gas Gangrene

Wet gangrene occurs with the complication of an untreated infected wound, resulting in swelling from the infection of the bacteria due to sudden stoppage of circulation of the blood flow. Due to termination of the blood flow, the tissues tend to react to the presence of bacteria which multiply and the disease fighting cells - the white blood cells cannot reach the affected areas resulting in becoming moist and wet and breaking down causing death of the tissues.

Dry gangrene is the result of reduction of blood flow through the arteries and appears gradually and the process is slow. In most cases, the affected area is not infected and in this type of gangrene, the tissues tend to become black and cold and begin to dry off. This condition is common in people with blockage of arteries known as arteriosclerosis which results from high cholesterol levels, smoking, genetic, diabetes and other factors.

Gas gangrene is another type of wet gangrene caused by bacteria known as Clostridia which are a type of infection causing bacteria that grow only in the absence of oxygen and as they grow they produce poisonous toxins and gas. Regular check-up are essential and quitting smoking followed by adopting a healthy lifestyle with regular exercises and low fat diet should be maintained to reduce the risk of this ailment.

Tuesday, 12 August 2014

Acanthosis Nigricans

Acanthosis Nigricans
Acanthosis Nigricans – Darken/Thicken/Velvety Hyperpigmentation

Acanthosis nigricans, is a medical term for darkened, thickened patches of the skin, a brown to black, velvety hyperpigmentation of the skin that is usually found in body folds, like the lateral folds of the neck, armpits, groin, forehead, navel and other areas of the body. Though it is not a condition, it may be a sign of an internal or an underlying condition which is not really serious though the skin changes could be early signs of diabetes and rarely cancer. The only signs of acanthosis nigricans are the skin changes where one will notice thick, dark and velvety skin in the folds and creases of the body. These changes tend to appear slowly and at times over a period of years and the affected area may tend to smell or be itchy.

At times the skin over the joints of toes and fingers also tend to get affected together with the skin on lips, palms of the hand as well as the soles of the feet though this is usually common in the case of elderly people and acanthosis nigricans seems to be a sign of cancer which is known as acanthosis nigrican maligna and is quite rare. In rare cases of acanthosis nigricans which could be signs of cancer, the patches get very aggressive, spreading quickly in different areas of the body and tend to be more severe and extensive.

Tiny Finger like Growth - Papillomatosis

In these conditions, the mouth, tongue, throat, windpipe and nose could also get affected.One may also come across several tiny fingers like growth from the patches which are known as papillomatosis. Besides this, there could also be skin tags surrounding the areas that are affected which are small flesh coloured or pigmented growth which hangs off the skin looking somewhat like warts.

Acanthosis nigricans could be associated with insulin resistance wherein most people having this condition are prone to insulin resistant, which is a hormone secreted by the pancreas that enables the body to process sugar and insulin resistance is the cause of type 2 diabetes. People with acanthosis nigricans are overweight or obese and these are the risk factors in the development of insulin resistance. Besides this, hormonal disorder like ovarian cyst, problems with the adrenal glands or under active thyroids could also be associated with this condition.

Endoscopy or X-ray 

Medication like corticosteroid and oral contraceptive may also cause acanthosis nigricans as well as high doses of niacin. Cancerous tumours which tend to begin growing in internal organs like the stomach, liver or colon could also be the cause of acanthosis nigricans. The physician can suspect acanthosis nigricans by inspecting the skin and if the cause is not clear, blood test to check the count of sugar level and an endoscopy or x-ray would be essential.

Treatment is done to resolve the underlying cause of the condition of the skin that would depend on the cause, which would be to lose weight or opting to an alternate medication.Many cases of this condition tend to be harmless wherein the skin patches tend to fade away slowly as the condition is treated though in case of malignant acanthosis nigricans, with underlying cancer, the situation tends to get serious. If the tumour is successfully eliminated, this condition may disappear.

Sunday, 10 August 2014


Achalasia – Difficulty in Swallowing/Regurgitation

Achalasia is a failure or loss of ability to move food along and the valve at the end of the gullet fails to open to enable food to pass to the stomach. It is a failure of the smooth muscle fibres to relax causing a sphincter to remain closed, failing to open when needed. Achalasia can take place at several areas, along the gastrointestinal tract, achalasia of the rectum, for instance is known as Hirschsprung’s disease. Achalasia is an uncommon ailment which affects around 6000 people in Britain and is at times known as cardio spasm.

An esophageal motility disorder known as esophageal achalasia involves the smooth muscle layer of the esophagus and the lower esophageal sphincter – LES and is characterized by the in completion of the LES relaxation, increased LES tone and the lack of peristalsis of the esophagus, the inability of smooth muscles to move food down the esophagus. Achalasia is related to the difficulty in swallowing, regurgitation and at times connected with chest pain.

Due to Damage/Loss of Nerves in Gullet Wall

Symptoms of this condition could start at any point of time which tends to show up gradually. People with this ailment have dysphagia; a condition of difficulty and at times tends to get painfulwhile swallowing food and may get worse after some years. This may result in bringing up food which could have shortly been consumed after meals and some of the food brought up could have been held in the gullet for some time.

Vomit may also dribble out of the person’s mouth, occasionally and stain the pillow at night and should the same trickle down the windpipe it could result in repeated chest infection or even pneumonia. Achalasia is caused by loss or damage of the nerves in the gullet wall and the reason for this is not known though some believe that it could be the result of a viral infection which may have occurred in life.


Some diagnostic test are performed to diagnose the ailment like a barium swallow which involves drinking a white liquid containing barium chemical that enables the gullet to be seen and videoed through an X-ray. In the case of achalasia, the exit at the bottom end of the gullet does not open properly resulting in delay in passing of barium in the stomach and an ordinary chest x-ray would show a wide gullet.

An endoscope which is a flexible instrument is passed in the throat to enable the doctor to view directly at the gullet lining and stomach where trapped food can easily be visible. The endoscope being a flexible instrument can pass through the tight valve at the lower end of the gullet and in the stomach to check any disorder of the stomach. Manometry is also used to measure pressure waves in the gullet wherein a small plastic tube is passed in the gullet through the mouth or nose and the pressure at various points in the gullet is measured.

Treatment is carried out to disable the valve to enable the food to pass to the stomach with ease and though this condition cannot be cured, there are several ways to reduce the spasms at the end of the gullet and improve the symptoms.

Friday, 8 August 2014

Frozen shoulder

Frozen shoulder
Frozen Shoulder – Stiffness and Pain

Frozen shoulder is an ailment that leads to pain, together with stiffness of the shoulder whichis also known as adhesive capsulitis or shoulder contracture. It has a limited range of movement causing stiffness which could be due to an injury, strain, diabetes or a stroke. The stiffness may cause restriction and the inability to carry the daily functions and in more severe cases, the person may find it very difficult to even move the shoulder at all.

The tissues around the joint stiffen; scar tissue forms and shoulder movement tend to get difficult and painful. The symptoms gradually gets worse over a period of time and the person may experience shoulder pain for the first two to nine months which may later on lead to increasing stiffness. This ailment may improve over a period of time though it may take several years to get relieve from this condition.

Frozen shoulder could develop when one stops using the joint normally due to the pain, injury or due to chronic health condition and any shoulder pain could get worse if the frozen shoulder is not exercised well and not kept in motion. It could occur after an injury or a surgery, in people between the ages of 40 to 70 years old, in people suffering from chronic diseases and this condition is more common in women than men.

Known as Capsule- Gets Thicken and Inflamed

Frozen shoulder develops when the flexible tissue surrounding the shoulder joint also known as the capsule, gets thicken and inflamed. Frozen shoulder is diagnosed when the physician suspects limited shoulder movement and an x-ray is done to indicate symptoms if they are related to broken bone or arthritis.

Often the frozen shoulder eventually gets better without much treatment though proper treatment is necessary to eliminate the pain and misery of this condition, to improve the movement of the shoulder and be relieved from this condition. Possible treatments options could be painkillers, pain relieving injections, and shoulder exercises together with physiotherapy which could be helpful to the person to get some relieve though the treatment will depend on how severe the condition is and its progress.

Application of Heat to Affected Area

Besides this, application of heat to the painful area together with delicate, gentle stretching could prove to be helpful. Ice and medicine could also be used to reduce the pain and swelling. To increase the range of motion, physical therapy is a good option to the person with frozen shoulder. At times if the said treatment does not give much relief, a surgery may be suggested which is done to loosen some of the tight tissues around the shoulder and is often done with an arthroscope.

The causes of some of the cases of frozen shoulder is not known andthough it may not be possible to prevent them, efforts can be done to improve or reduce the pain experienced in this condition. Gentle progressive range of motion exercises, using the shoulder more often, stretching, together with patience and adhering to the instructions provided by the physicians, could all add to some relieve to the pain of frozen shoulder.