Monday, 21 July 2014

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome – Condition causing Pain/Numbness/Tingling Sensation

Carpal Tunnel Syndrome
Carpal tunnel syndrome or CTS, is a common condition causing pain, numbness and a tingling sensation in the fingers and hand which may affect the working of a person’s wrist. The word carpal is derived from the word carpus which means wrist and is taken from the Greek word karpos.

In medical terms, the carpus is referred to an assembly of eight small bones which lie side by side in the wrist, in two rows, that join the forearm to the hand and the tunnel is a narrow passageway for nine tendons and one nerve called the median nerve which lies in the middle of the forearm and the wrist passing from the forearm to the hand.

This passageway is on the carpal bones and roofed by a strong ligament, known as the flexor retinaculum. In CTS condition, a group of symptoms take place simultaneously and it is called a syndrome. The median nerve in the case of CTS get pressed or pinched within the narrow tunnel producing symptoms of pain, numbness and a sensation of pins and needles in the hand and these symptoms summed together is known as carpal tunnel syndrome.

Caused – Compression of the Nerve/Median Nerve

Usually this condition develops gradually and begins to get worse atnight which tends to affect the thumb, index finger, middle finger and part of the ring finger.

Besides these, other symptoms may include paraesthesia – pins and needles sensation, thumb weakness and dull ache in the hand or arm. As this condition progresses, the person may also experience a weakened grip in the affected hand and fingers together with a loss of muscle mass on the outer side of the hand and at time the pain may also affect beyond the wrist and the forearm.

Carpal tunnel syndrome is caused by compression of the nerve which controls the sensation and movement in the hand or the median nerve. It is not clear why the median nerve tends to get compressed though there are a few incidents which may increase the risk of developing CTS such as – a family history of CTS, strenuous, repetitive work with the hand, injuries to the wrist, pregnancy - up to around fifty percent of pregnant women tend to develop CTS and other health condition like diabetes and rheumatoid arthritis.

Durkan Test/Nerve Conduction Velocity Test

In some cases CTS disappear without any treatment or with some simple self-care measures. In other cases, for the treatment of CTS patient, the doctor will check the patient’s history and examine for signs of median nerve neuropath by performing the Durkan Test and check for presence of the Tinel’s sign, the pins and needles sensation which is a positive sign of CTS. A nerve conduction velocity test – NCV may also be recommended to confirm the diagnosis.

When the diagnosis is confirmed, there are various treatment options some of which are splints and braces which are advised especially at night in order to support the wrist. Physiotherapy and exercises are recommended where the patient is taught to exercise in order to tone the muscles of the upper limb together with specific exercises to treat CTS which can reduce the severity of the pain.

Surgical release of the carpal tunnel is also done where the retinaculum is divided to create more space for the nerve in case of patients for whom the conservative therapy does not give the desired result.

Friday, 18 July 2014

Eye Floater – Awareness

Eye Floater
Often we may not be aware of the different health issues that could affect our lives and it is best to have some information and knowledge on the various ailments where precaution could be undertaken that can help in the cure of the condition. Eye floaters are one such condition which may be ignored due to ignorance of the same.

These are tiny spots, flecks, specks or cobwebs that may be drifting aimlessly in one’s field of vision. Though annoying, these ordinary eye floaters and spots seem to be common but usually are not a cause for worry. They appear when tiny pieces of the eye’s gel like vitreous, break loose in the inner back of the eye. The vitreous is a gel like consistency right from birth and all through our youth which begins to dissolve as we age and liquefy creating a watery centre and some un-dissolved gel particles at times float around in the liquid centre of the vitreous.

 They tend to take on various shapes and sizes giving rise to the floaters that are seen. One will observe that these spots and floaters are particularly evident while looking at a bright clear area, like the computer screen or the sky and one will envisage tiny bits of debris floating loose within the eye. The shadows seen are actually shadows from these floaters which are cast on the retina as light passed through the eye giving rise to these spots that are seen floating aimlessly in one’s field of vision.

Eye Floaters, Sign of Retinal Tear/Detachment

These shadows of specks never seem to remain still when one tries to focus on them, on the contrary they tend to move when the eye moves, thus creating an impression that they are drifting in the air. In rare cases, eye floaters could be a sign of retinal tear or retinal detachment, where the retina tends to pull away from the blood vessels which supply the oxygen as well as the nutrients. Eye floaters cannot be prevented since it is a part of the natural ageing process.The need of a physician may arise when the person sees a shower of floaters and spots that are sometimes accompanied by light flashes which calls for immediate attention and treatment.

Posterior Vitreous Detachment - PVDs

The sudden appearance of these spots could mean that the vitreous is being pulled away from the retina or it could be that the retina itself is being dislodged from the inner back of the eyes which contains the nutrients, blood and oxygen which is essential for healthy function. If the retina is torn, vitreous may invade the opening pushing out the retina which could lead to the detachment of the retina. In the event of retinal tear or detachment, immediate care and treatment need to be taken in order to reattach the retina and thereby restore the normal function of the eye before its vision is lost permanently. More common than retinal detachments are Posterior vitreous detachments – PVDs and are not serious even when floaters appear all of a sudden though some vitreous detachment could also damage the retina while tugging on it which may lead to a tear or a detachment. For enriching information pertaining to health visit - Dream Health which will be beneficial to the viewer.

Wednesday, 16 July 2014

Lazy Eye

Lazy Eye
Lazy Eye – Amblyopia – In Early Childhood

Lazy Eye also known as amblyopia is an early childhood condition which occurs when the child’s vision in an eye does not develop properly, which means that the child’s eyesight in one eye does not develop the way it should.

The problem usually is in one eye though at times it may affect both the eyes. It is estimated that 1 out of 50 children may develop lazy eye and is diagnosed around the age of four. When one suffers from amblyopia or lazy eye, the brain focuses on one eye more than the other and tends to ignore the lazy eye and if the eye is not stimulated adequately, the visual brain cells do not mature properly.

The term `lazy eye’, does not seem to be accurate since the eye is not lazy though it may be more appropriate to use the term lazy brain since it seems to be a development problem in the brain and not an organic problem of the eye.

Unable to Focus Properly

There are usually no symptoms for a lazy eye and young children are often not aware that they are having vision problem and if they have the problem they are unable to explain it. Older children may relate that they cannot see in one of the eye.

In some cases, one eye may tend to look different from the other which is another condition that could lead to lazy eye like a squint. The person with lazy eye will be unable to focus properly with one of the eyes and while the other eye makes up for the problem, in the event the affected eye suffers as a result.

 The eye with impaired vision or amblyopia will not get clear images while the brain will not receive clear date ending in ignoring it. In several cases the brain and the good eye compensate for the shortfall so well that the child does not observe that they are facing any problem with their vision and a lazy eye is first detected only after a routine eye check-up.

Blurred/Double Vision/Squint

The symptom and signs of a lazy eye are blurred vision, double vision; eyes do not seem to work together, poor depth perception of vision, a squint which is either upwards, downwards, inwards or outwards. The eye which works like a camera has an image made up of light which comes through the lens of respective eye and beams on a light sensitive layer of tissue known as the retina.

The retina in turn conveys the image into nerve signals which are sent to the brain where it then combines the signals from each eye in a three dimensional image. Lazy eye is the result when the brain connection which is responsible for the vision does not function properly which is due to a reduction in the amount of light in the eye, confusion between eyes where two images are not same as in the case of a squint and lack of focus in the eye.

If the person suffering from amblyopia is neglected it can lead to the central vision of the eye not reaching normal levels. Do Visit Dream Health for information regarding health issues.

Saturday, 12 July 2014

Acromegaly – A Hormonal Condition

Acromegaly is a hormonal condition in which the body produces too much growth hormone which leads to excess growth of body tissues over a period of time and is mostly common in middle aged adults but extremely rare in children.

The name `acromegaly’ is derived from the Greek word `extremities – acro and `great’ – megaly due to the common symptom of this condition in abnormal growth of the hands and feet.It is a serious systemic condition which is caused in over 98% of cases by benign tumour – adenoma of the pituitary gland which secretes excessive growth hormone-GH. Growth hormone is produced and released by a pea sized gland just below the brain known as the pituitary gland and when growth hormone is released in the blood, it tends to stimulate the liver in producing another, hormone insulin like growth factor 1 – GF-1.

This is responsible for the growth of muscles, bones and the cartilage in the body, the process of which is essential for the growth as well as the repairs of the body tissues. Negligence on the treatment of acromegaly may result in marked bony and soft tissue changes including altered facial appearance, enlargement of the hands and feet, carpal tunnel syndrome, and sleep apnea.

Symptoms Vary and Differ Gradually

Besides this, other serious problems may occur like accelerated cardiovascular disease, diabetes mellitus hypertension and the possibility of a risk of colon cancer. If the tumour tends to develop before the completion of bone growth in adolescence, it may lead to gigantism due to the serious systemic changes resulting from growth hormone for which treatment need to be done with transsphenoidal surgery.

The symptom of acromegaly may vary and develop gradually and hence a diagnosis of this ailment may be difficult to detect. Some of the typical features may include large, prominent facial features, abnormally large hands and feet, tall height if it takes place before puberty and an enlarged tongue.

The diagnosis of this ailment is detected by demonstrating elevated levels of growth hormone and insulin like growth factor. Lack of suppression of growth hormone to oral glucose administration is mostly used to confirm excess GH production. On confirmation of the biochemical of acromegaly, a MRI of the pituitary needs to be performed to check the presence of pituitary adenoma.

Removal under General Anaesthesia

Acromegaly is treated to reduce excess growth hormone bringing it to normal levels, to relieve the pressure which the tumour exerts on the surrounding structures, to treat any hormone deficiencies and to improve the symptoms of acromegaly most of which is done through surgical removal of the tumour together with medication.

The possibility of surgery may be needed to remove the adenoma in the pituitary gland which helps to correct the excess growth hormone in the patient though at time the tumour may be too large to remove it entirely. Removal of the gland is done under general anaesthesia wherein an incision is made through the nose or inside the upper lip to access the gland.

The person experience prompt relieve of pressure on the surrounding structures on removal which leads to a rapid lowering of growth hormone levels.

Wednesday, 9 July 2014

Thrombophilia – Abnormality of Blood Coagulation

Thrombophilia is an abnormality of blood coagulation, where the blood has the tendency to clot thus increasing the risk of thrombosis or blood clots in the blood vessels. Individuals with thrombophilia are more prone to develop a deep vein thrombosis – DVT, a blood clot in one of the large veins in the legs and it is important to be alert for signs of DVT and consult the physician when faced with signs of this ailment like pain, swelling and a heave ache in the leg.

Thrombophilia are of different types most of which are inherited where the most common type of inherited thrombophilia is Factor V Leiden. Often, when one tends to bleed when injured, it can cause a reaction of different chemicals or clotting factors in the blood where these chemicals could cause the blood clot which then sticks to the injured area of the vessel along with blood particles known as platelets.

The natural chemical in the blood tend to act against these chemicals and stops the blood from clotting. In the case of thrombophilia, there is an imbalance in this function and the person either has too much clotting factor or too little of the prevention of clotting substance.

Risk of Developing Deep Vein Thrombosis - DVT

Thrombophilia is often mild and many do not envisage any health issues and thrombophilia symptoms only surface if one has a blood clot. People with thrombophilia are at risk of developing DVT and the warning signs are pain, heavy ache in a leg with swelling.

At times a part of the blood clot can break off and tend to travel through the blood stream through the circulation and lodge in the lungs resulting in pulmonary embolism- PE is a serious as well as a life threatening condition since it can prevent blood from reaching your lungs.

Some of the signs of pulmonary embolism are shortness of breath or chest pain and a person having these symptoms should visit their physician at the earliest. Cases of thrombophilia which are inherited have a tendency to form blood clots which runs in the family, which is passed on from parent to the child.

Precautions Need to be Taken 

Thrombophilia is diagnosed by blood tests which are done weeks or months after the blood clot is formed where these test check for deficiencies in the body’s natural anticoagulants or anti-clotting chemicals. If the diagnosis indicates that the person has thrombophilia then they are referred to a haematologist who specialises in diagnosing and treating blood disorders.

Thrombophilia people do not always require treatment since it can be mild without any problem though treatment will be necessary if one develops a blood clot and to prevent any further clots to develop. The treatment carried out, interferes with the clotting process and is used to treat as well as prevent a DVT or PE.

Person suffering from thrombophilia should be aware of the symptoms of blood clots and take precautions like losing weigh if they are overweight, quit smoking, if a smoker, avoid being inactive for prolonged intervals since this could cause DVT and follow a balanced diet with regular exercises. Tour Dream Health to get to know more on health issues and enjoy a healthy life.

Tuesday, 8 July 2014

Kwashiorkor – Malnutrition, Lack of Protein

Kwashiorkor is the most common form of malnutrition often found in children and is caused due to lack of protein, inspite of a reasonable amount of intake of calories. Every cell in the body contains protein and protein is essential in the diet for the body to repair cells and make new ones as well as for growth during pregnancy and during childhood.

Insufficient intake of protein could lead to this malnutrition. Healthy body regenerates cellsconstantly. Kwashiorkor is commonly seen in most developing countries of the world where there is a famine or a limited stock of food supply or seen in countries where the diet probably consist of mainly rice, beans and corn.

Kwashiorkor, like other forms of malnutrition can cause irritability, drowsiness and fatigue and if the person is still deprived of protein , they will tend to fail in putting weight or grow in height, develop swelling under the skin or oedema, develop a pot belly, lose muscle mass, have an enlarged fatty liver develop red, inflamed patches of skin which darkens and peel or split open, dry sparse, brittle hair which may turn reddish yellow or white, ridged nails and are vulnerable to infections due to poor immune system. Most of these malnourished kids tend to become intolerant to milk sugar- develop lactose intolerance.

Physical Appearance – Pot Belly

Kwashiorkor is diagnosed on physical appearance of the pot belly and oedema together with information about the person’s intake and the diagnosis can be confirmed with the help of blood and urine test which indicate the low blood protein levels, low blood sugar levels, the stress hormone cortisol and high levels of growth hormone, low levels of salt in the blood and on the waste product urea in the urine, iron deficiency anaemia and low blood pH. Besides these, other test may also include growth measurements, taking skin biopsy, analysing hair sample and calculating body mass index.

Recommended – 10 to 35 Calories of Protein

Kwashiorkorpatient need to have their blood and body fluid level rectified and any other infection treated. Thereafter small amount of food intake should be introduced gradually, like carbohydrate first, in order to provide sufficient energy, which could be followed by high protein food.

This could take over a week at which point of time the child should be consuming around 175 calories and 4 grams protein per kg of bodyweight while an adult around 60 calories and 2 grams protein per kg of bodyweight. Besides this, vitamin and mineral supplements can also be given.

Children with kwashiorkor condition may not grow or develop properly and is a serious problem which can also be life threatening if proper treatment is not rendered to the person. Treatment which begins in the initial stage of the ailment result in good recovery though they may not reach the full growth and height potential..

 If treatment is delayed, the condition may still improve but the mental and physical impairment may remain permanent. Kwashiorkor can be prevented on consumption of enough calories and protein rich food. It is recommended by the Centres for Disease Control and Prevention –CDC, that 10 to 35 percent of the daily calories should come from protein.

Friday, 4 July 2014

Devic’s Disease – Uncommon Neurological Ailment

Devic’s Disease
Devic’s disease or Neuromyelitis optica, NMO, is an uncommon neurological ailment, a heterogeneous condition consisting of recurrent and simultaneous inflammation and demyelination of the optic nerve or optic neuritis as well as the spinal cord or myelitis. 

It is caused by damage to the spinal cord, nerves or the brain. The optic nerves and the spinal cord which commonly gets affected, leads to inflammation of the nerve that leads from the eye to the brain or the optic neuritis, may cause loss of vision which could affect both the eyes simultaneously.

Other symptoms may include eye pain which tends to get worse on movement, reduced colour vision which may appear to be less vivid than usual or washed out. It could also lead to transverse myelitis or inflammation of the spinal cord resulting in weakness in the legs and arms which may range from a mild feeling in one limb to a complete paralysis in all the limbs.

Moreover it may even cause sensitivity to touch, cold, heat with numbness, tingling or burning sensation below the affected region of the spinal cord. Besides this, the individual may also experience tight and painful muscle contraction which is known as tonic muscle spasms.

Antibody – Aquaporin-4 (AQP4) 

NMO has an antibody known as aquaporin-4, AQP4, which is present in the blood and is a protein produced by the body to destroy disease carrying organism and toxins.

The person’s immune system which is the body’s natural defence against infection gets affected reacting abnormally and attacks tissues and organs in the body.

Presently two different causes are assumed based on the presence of auto antibodies against AQP4 along with NMO which is considered as an autoimmune disease or autoimmune astrocytopathy or autoimmune astrocytic channelopathy wherein a person’s immune system tends to attack the astrocytes of the optic nerves and the spinal cord though the cause of AQP4 variants in not known..

 This disease is a rare disorder resembling multiple sclerosis (MS) in many ways but needs various courses of treatment for optimal results and is also suggested to be a form of acute disseminated encephalomyelitis. Though inflammation affects the brain, the lesions tend to be different from those observed in the related condition of multiple sclerosis.

Devic’s connected to many Systemic Diseases

In some rare cases, parts of the brain may get affects and if the brain stem which is the lower part of the brain that is connected to the spinal cord, gets affected, it may cause symptoms like hiccups, vomiting and difficulties in speech and swallowing. In case a person experience only optic neuritis or myelitis, this condition is known as NMO spectrum disorder.

Devic’s disease has been connected with many systemic diseases which are based on anecdotal evidence of some Devic’s disease and patients having comorbid condition may include collagen vascular diseases, infection with varicella zoster virus, auto antibody syndrome, Epstein Barr virus and HIV together with exposure to clioquinol and anti-tuberculosis drugs.

The discovery of NMO-IgG has given rise to new way in research for the causes though it is yet unknown on the appearance of the antibodies against AQP4.