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Pseudotumor Cerebri

Tuesday, 28 December 2010



Pseudotumor Cerebri, also called benign intracranial hypertension or idiopathic intracranial hypertension, is a condition in which the pressure inside the skull increases without any obvious reason. Most commonly, it affects obese women of childbearing age.

Most of the symptoms are related to:
1. Increased intracranial pressure.
2. Papilledema: a swelling around the optic disc (the site of entry of the optic nerve to the eyeball). It occurs due to increase in the intracranial pressure.


Symptoms of pseudotumor cerebri include: 
  • Symptoms due to increased intracranial pressure:
    1. Headache, ranging from moderate to severe, that originates deep to the eye and that worsen with eye movements.
    2. Pulsatile tinnitus: ringing sound in the ears which are synchronous with the pulse.
    3. Double vision.
    4. Nausea and vomiting.
  • Symptoms due to papilledema:
    1. Dimming or black-out of vision in either eyes or both that lasts for seconds (visual obscurations).
    2. Blurring of vision.
    3. Having a difficulty to look to the sides.

How is pseudotumor cerebri diagnosed ?
- Fundus examination: a doctor will examine the patient's eye to confirm the presence of papilledema.

First aid measures for nosebleeds (epistaxis)

Sunday, 26 December 2010



Epistaxis or nosebleeds is defined as the bleeding from the nose and is classified as either anterior or posterior.
Anterior nosebleeds occur when the source of bleeding originates from Kiesselbach's plexus (Little's area) which is present in the anterior part of the nasal canal. Anterior epistaxis usually occurs in children and young adults.

(From Fleisher GR, Ludwig S: Textbook of Pediatric Emergency Medicine. Philadelphia, Lippincott, Williams & Wilkins, 1999.) 



However, posterior nosebleeds originates from the sphenopalatine artery which is present in the posterior part of the nasal canal. Posterior epistaxis usually presents in old individuals.

First aid measures for controlling epistaxis:
In most cases, the bleeding will be from Little's area. You must sit down and lean slightly forwards. You must breath through your mouth.
Pinch the nose so that the nostrils are closed between your thumb and forefinger for 10 minutes. Apply cold compresses to the bridge of the nose, if possible. Besides, you can suck on ice to achieve the same result. 
This is done so that vasoconstriction of vessels is obtained which will reduce the amount of blood supplying the nose.

10 easy effective tips for GERD (or heartburn) relief

Tuesday, 21 December 2010


Gastroesophageal reflux disease (GERD) is defined as the reflux of the gastroduodenal contents into the esophagus, larynx or lungs with or without resultant oesophageal inflammation. In other words, the stomach acid and/or bile flows, in the reverse direction, into the esophagus causing heartburn.



Here are 10 effective tips for treatment of GERD or heartburn:
  • Avoid foods that increase GERD symptoms as chocolate, peppermint, citrus, onions, spicy foods and fatty foods.
  • Avoid alcohol and caffeine.

Surgeries done in breast cancer management

Sunday, 19 December 2010


Breast cancer can be treated especially when discovered early. Mammogram is a very helpful imaging investigation that helps in the diagnosis of breast cancer.
The findings in mammography that are suggestive of malignancy include the presence of clustered micro-calcification and star shaped mass. The following mammogram belongs to a woman diagnosed with breast cancer:

Surgery has a great role in the management of breast cancer. Surgery can be done with or without radiotherapy. Early treatment can lead to cure. Besides, it helps in controlling the local malignancy and preventing the occurrence of metastatic lesions.


What are the surgeries done for treatment or management of breast cancer ?


  • Lumpectomy: as its name suggests, the surgeon removes only the malignant lump and a small portion of the surrounding tissues.

Mechanism and treatment of herniated disc (lumbar disc prolapse)

Saturday, 18 December 2010



Herniated disc can be the cause of intolerable back pain. Let's first clearly summarize the basic anatomy of the vertebral column. The vertebral column is made up of vertebrae (bones) that are separated by intervertebral discs. Here is a normal spine:


A normal intervertebral disc is shown below (seen from above).
The disc consists of a central soft area known as nucleus pulposus and a tough outer ring known as annulus fibrosus. Factors as trauma and degeneration may cause a tear in the annulus fibrosus which will lead to herniation of the nucleus pulposus outwards. This is simply the mechanism of a herniated (slipped) disc. 
The herniated disc will start to compress the nearby nerves causing back pain which is accompanied with a sharp lancinating leg pain (known as sciatica and femoralgia).

Causes and the treatment of bad breath (halitosis)

Friday, 17 December 2010

Foetor oris or halitosis are the medical terms that refer to bad breath. This can be an embarrassing problem that may lead to social problems. It is a common condition but many avoid to admit having it.

The causes of bad breath are:
  • Eating certain foods as garlic and onions.
  • Hunger and fasting for a prolonged period of time.
  • Tooth decay or dental caries.
  • Poor oral hygiene.
  • Gum disease as periodontitis.
  • Smoking, as it can cause periodontitis.
  • Unusual dryness of the mouth, which is known as xerostomia. This can normally occur during sleep. Some medications can cause dry mouth as antihistaminics, decongestants, high blood pressure medications, Parkinson's disease medications.

Symptoms of appendicitis

Friday, 10 December 2010



Acute appendicitis is defined as the acute inflammation of the appendix. It is the most common surgical emergency. Acute appendicitis can affect all age groups but the majority of cases occur between ages 11 and 20. 

Symptoms of acute appendicitis:
It starts with pain around the umbilicus or below the xiphisternum (the lowest part of the sternum) which is called the epigastrium. In the next 4-18 hours, the pain will migrate to the lower right quadrant of the abdomen. Pain can be present in back or the right flank. Pain of acute appendicitis increases in intensity with passage of time.



Vomiting and anorexia can occur after the feeling of pain. Besides, an elevated body temperature is a sign of an ongoing inflammation in the body. 

Causes of acute appendicitis:
The appendix contains a lumen in it. Anything that causes obstruction of the lumen will cause appendicitis. In adults, the lumen is commonly obstructed by fecaliths. Fecalith means hard fecal matter.


In teens and children, the lumen can be obstructed due to inflammation (submucosal lymphoid hyperplasia).

If symptoms are present, then the next step is to immediately go the nearest emergency room. The doctor will examine the patient and will order blood tests to check the white blood cells count. Besides, a CT scan can be done to confirm the diagnosis.

What is the treatment of acute appendicitis ?
Urgent appendectomy is the cure. It can be done either laparoscopic or open. This choice will be taken by the surgeon according to the general condition of the patient and the degree of inflammation.

Metabolic syndrome: diagnosis and prevention

Thursday, 9 December 2010



Let's start by defining metabolic syndrome. It is a common condition in which obesity, high blood glucose, high blood pressure and an abnormal cholesterol (lipid) profile cluster in one person.

How common is metabolic syndrome ?
Some researchers suspect that 35% of American adults have metabolic syndrome. 


What is the mechanism behind metabolic syndrome ?
There is no confirmed mechanism till now but many researchers think that any obese individual is liable to get insulin resistance. When the body is resistant to its own insulin, a lesser amount of glucose is taken by the body cells. This stimulates the pancreas to increase more and more insulin. This leads to high glucose levels and hyperinsulinemia and will also cause a high triglycerides and cholesterol levels.


What are the criteria needed for the diagnosis of metabolic syndrome ?
To be diagnosed as having metabolic syndrome, an adult must have three or more of the following:
  • Waist measurement of 40 inches or more in men and or 35 inches or more in women.
  • High triglycerides level (greater than or equal to 150 mg/dl) or being treated for high levels of triglycerides.
  • Low level of HDL (good cholesterol). In males, a low level means less than 40 mg/dl. In females, a low level means less than 50 mg/dl.
  • High blood pressure or being treated for hypertension.
  • High level of blood sugar when measured after fasting for about 8 hours.


What are the complications of metabolic syndrome ?
Metabolic syndrome increases the risk of having diabetes and cardiac diseases.


Can metabolic syndrome be prevented ?
Yes. Metabolic syndrome can be prevented by following these instructions:
  • Eat a well balanced diet. Avoid foods that contain a high amount of saturated fats. Eat more foods that are rich in fibres as green vegetables.
  • Maintain a normal body weight. As mentioned earlier that obesity plays a great role in the mechanism of metabolic syndrome.
  • Exercise regularly for at least 30 minutes daily.
  • Avoid alcohol intake. If you are a smoker, quit smoking.
  • Go for regular medical check-ups. You must regularly check your blood glucose level, blood pressure and cholesterol level. 

I hope you benefited from this article. Thank you for reading.

What are the banned drugs for athletes?

Wednesday, 8 December 2010

In sports, fair play involves treating all competitors equally and fairly. According to the International Olympic Committee, a list of drugs should not be used by athletes.



These drugs include:
  • Stimulants: as caffeine, ephedrine, amphetamines. These drugs will speed up and stimulate some areas in the brain which will make the athletes' reflexes faster.
  • B2-agonists: these are similar to stimulants in its action. Besides, these drugs have significant anabolic effects.
  • Anabolic steroids: as testosterone. They increase the muscles strength and weight. Besides, they improve an athlete's overall performance and acceleration.
  • Diuretics: as furosemide and mannitol. These drugs help in reducing the body weight by excreting more water out of the body. And this can have a positive effect on the athlete's performance.
  • Narcotics: as morphine and pethidine. They increase the pain threshold so the athlete will feel pain after a longer period of time. This is beneficial in sports in which aggression is required.
  • Hormones: as erythropoietin. Erythropoietin is secreted normally by the body. But it can be taken from external sources. It stimulates the bone marrow to produce more red blood cells. In turn, the athlete's blood will have a greater content of hemoglobin. 

All the above drugs can lead to the manipulation of a fair game. That's why all athletes are advised to avoid taking them because if the drug test came back positive, then this will have a negative effect on the athlete's reputation.

How can you prevent osteoporosis ?

Sunday, 5 December 2010


Osteoporosis is defined as the progressive decrease in the bone mass that results in increased bone fragility and a higher risk of a bone fracture from even a minor fall or with no trauma at all. Osteoporosis literally means "porous bone". 

Ways of preventing osteoporosis:

    • Diet: should contain the adequate amount of proteins, total calories, vitamin D and calcium. Daily intake of 700 -1000 mg of calcium is adequate. Adolescents, pregnant or breast-feeding women, post-menopausal women and adults over age of 65 are advised to have 1500 mg of calcium daily. Sources of calcium include milk, cheese, yogurt, green leafy vegetables,

      Brazil nuts, sardines and almonds. Daily intake of about 800 IU of vitamin D is recommended.       
    • Exercise: high-impact physical activity (as jogging) significantly increases the bone density in men and women. Gentle exercise in the elderly may reduce the risk of falls and improves the protective responses to falling.
    • Avoid smoking because smoking promotes bone loss.
    • Avoid alcohol intake.
    • Pharmacologic corticosteroid doses should be reduced or discontinued if possible.
    • For menopausal women: it is recommended that these women will take medications that promote bone growth and prevent bone loss. Bisphosphonates (as alendronate and risedronate) is a group of drug that inhibits bone loss.Besides, Raloxifene is used in the prevention and treatment of osteoporosis.
      Phytoestrogens are plant substances that are found in food, as soya, are helpful in preventing osteoporosis. 

    Systemic lupus erythematosus (SLE)

    Friday, 3 December 2010


    SLE is a chronic disease that causes inflammation of connective tissue. It is a multisystem autoimmune inflammatory disease. SLE is the commonest and the most serious type of lupus. 

    What causes SLE ?
    SLE is believed to be an autoimmune disease, which means that the body's immune system produce antibodies that attacks the own body's healthy organs. Besides, genetic predisposition can be one of the causes. 

    What are the risk factors for SLE ?
    Females are more likely to get SLE than males. Usually the age of the patient lies between 15-45 years old. SLE is more common in dark races. Besides certain drugs can trigger lupus.

    What are the drugs that are associated with lupus ?
    The following drugs had been associated with lupus only after long-term use. They are:
    Chlorpromazine, Hydralazine, Isoniazid, Methyldopa, Procainamide, Quinidine. 


    What are the symptoms of systemic lupus erythematosus (SLE) ?
    90% of patients will complain of joint symptoms and arthritis. This can be the earliest manifestation of the disease. Many patients will experience malar (butterfly-shaped) rash like this one:

    Eye affection can occur in the form of conjunctivitis, photophobia and blurring of vision. Systemic symptoms like fever, malaise, anorexia and weight loss/gain are usually present. Symptoms include:
    Shortness of breath, chest pains, mouth sores, kidney functions affection that can lead to renal failure. 

    How is SLE diagnosed ?


    To be diagnosed as having SLE, you must have at least 4  of the following 11 items:

    1. Malar rash
    2. Discoid rash
    3. Oral ulcers
    4. Photosensitivity
    5. Serositis
    6. Arthritis
    7. Neurologic disease
    8. Kidney disease
    9. Hematological abnormalities
    10. Immunologic abnormalities
    11. Positive antinuclear antibodies  


    What is the treatment of systemic lupus erythematosus ?
    There is no definitive cure for lupus till now. Drugs as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are used to reduce the pain and inflammation. Anti-malarial drugs, as Hydroxychloroquine, had proved to control the symptoms and signs of the disease and can prevent flares. 
    Immunosuppressive drugs, as cyclophosphamide, can be used especially when there is kidney affection. This group of drugs must be taken with extreme caution.
    A lot of clinical research is being conducted by the use of new emerging drugs that can help treat SLE. Epratuzumab, a humanised IgG1 monoclonal antibody, entered phase III trials after promising results in a smaller study. 


    General guidelines for SLE patients:
    - Avoid excessive exposure to sun by using sunscreens.
    - Exercise regularly.
    - Quit smoking and alcohol intake.
    - Avoid sulphonamide-containing antibiotics.
    - If you are taking immunosuppressive drug, then you must not take a live vaccine.
    - At any time, if you experience severe acute symptoms or fever or anginal pains or shortness of breath, immediately call your doctor.


    I hope this article was beneficial to you. And i hope you stay healthy and happy forever.Thank you for reading.


     
     

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