Health Problems-Autoimmune conditions weaken the immune system and make it easier to develop infections, colds, and flu. People with chronic immune conditions tend to feel sick more often and may take longer to recover from illnesses. More than 23.5 million Americans live with an autoimmune condition.
HEALTH PROBLEMS PILES (Hemorrhoids)
Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.
Depending upon the situation there are two types of piles.
1) External piles. 2) Internal piles.
1) External piles:-
This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.
2) Internal piles:-
It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.
Some times internal and external piles occure in same individual.
Factors responsible for piles:–
1) This is a familial disease.
2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.
3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.
4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.
5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.
6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.
Signs and symptoms of piles:–
1) Pain:-
Pain is common in external piles which will be worse while straining at stool.
2) Bleeding:-
Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.
3) Protruding mass:-
In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.
4) In some cases there will be discharge of mucus with itching around the anal orifice.
Complications of piles:–
1,Infection: The infection can spread to deep veins resulting in septicaemia.
2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.
3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.
4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.
5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.
Treatment of piles:–
Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.
1) The thrombosed external pile is excised under local anaesthesia.
2) Sclerosant injection therapy can reduce the size of piles.
3) Rubber band ligation around the neck of piles is useful in some cases.
4) Cryosurgery is very effective.
5) Anal dilatation can reduce constipation and pain.
6) Haemorrhoidectomy is the surgical removal of piles.
How to prevent piles?
1) Eat plenty of fruits and vegetables.
2) Take fibrous food.
3) Avoid excess intake of meat,prawns,crabs ect.
4) Keep a regular timing for food.
6) Drink sufficient quantity of water.
7) Keep a regularity in bowel habits.
8) Take treatment for constipation.
HEALTH PROBLEMS PROSTATE CANCER
Prostate is a glandular organ present only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This is the inflamation of the prostate gland due to bacterial infection.
2) Benign enlargement of the prostate:-
This is a non cancerous tumour of the prostate seen after the age of 50. 3,Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.
Cancer of the prostate.
Cancer of the prostate is directly linked with the male sex hormones(androgens).If the levels of sex hormone increases the growth rate of cancer also increases.It is found that after the removel of testes there is marked reduction in the size of tumour.
Site of tumour:-
Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.
Changes in the gland in cancer:-
The gland becomes hard with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)
Growth :-
Growth rate is very fast in prostate cancer .The tumour compresses the urethra and produce difficulty in urination.
Spread of tumour:-
Metastasis in cancer of prostate is very early.
1) Local spread:-
From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.
2) Lymphatic spread:-
Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)
3) Spread through the blood:-
Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:–
Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen.
1) No symptoms:-
Tumour is small and only in the posterior lobe. This is diagnosed accidentely.
2) Slight difficulty in urination:-
Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.
3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.
4) Retention of urine:-
When the urethra is completely compressed there will be retention of urine.This can lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and finally coma.
5) Signs of metastasis:-
Some patients come with the signs and symptoms of metastasis.
a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.
b) Fracture of spine due to cancerous growth in the spine.
c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.
d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.
e) General weakness due to spread of cancer to different parts of the body.
f) Anaemia due to involment of bone marrow and increased destruction of RBCs.
Clinical examination :-
Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.
Investigations:-
1) Complete blood investigations;-
RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.
2) Urine analysis:-
Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.
3) Renal function tests:-
Blood urea level,serum creatinine level,electrolyte level ect.
4) Serum acid phosphatase:-
Increased in cancer of prostate.
5) x-ray of the spine:-
To detect any tumour or fracture.
6) Ultra sonography;-
Gives idea about prostate,bladder,kidney ect.
7) C T scan:-
More detailed information about organs and tumour.
8) MRI of the spine:-
Gives detailed information about spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Gives idea about lymphatic spread of cancer.
10) Biopsy to confirm cancer:-
Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This will detect the presence of cancer cells.
Treatment:-
1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)
Partial prostatectomy :-
Here only the affected lobe is removed.
Radical prostatectomy :-
Total removal of prostate along with nearby lymphnodes.
5, Hormone therapy :-
Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.
6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.
7) Radiotherapy is also done for some cases.
8) Homoeopathy:-
Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms.Constitutional homoeopathic medicine will give great relief and can increase the life span.
9) Yoga and meditation is also healpful.
THE GROWTH AND POWER OF APPETITE HEALTH PROBLEMS
One fact attendant on habitual drinking stands out so prominently that none can call it in question. It is that of the steady growth of appetite. There are exceptions, as in the action of nearly every rule; but the almost invariable result of the habit we have mentioned, is, as we have said, a steady growth of appetite for the stimulant imbibed. That this is in consequence of certain morbid changes in the physical condition produced by the alcohol itself, will hardly be questioned by any one who has made himself acquainted with the various functional and organic derangements which invariably follow the continued introduction of this substance into the body.
But it is to the fact itself, not to its cause, that we now wish to direct your attention. The man who is satisfied at first with a single glass of wine at dinner, finds, after awhile, that appetite asks for a little more; and, in time, a second glass is conceded. The increase of desire may be very slow, but it goes on surely until, in the end, a whole bottle will scarcely suffice, with far too many, to meet its imperious demands. It is the same in regard to the use of every other form of alcoholic drink.
Now, there are men so constituted that they are able, for a long series of years, or even for a whole lifetime, to hold this appetite within a certain limit of indulgence. To say “So far, and no farther.” They suffer ultimately from physical ailments, which surely follow the prolonged contact of alcoholic poison with the delicate structures of the body, many of a painful character, and shorten the term of their natural lives; but still they are able to drink without an increase of appetite so great as to reach an overmastering degree. They do not become abandoned drunkards.
No man safe who drinks.
But no man who begins the use of alcohol in any form can tell what, in the end, is going to be its effect on his body or mind. Thousands and tens of thousands, once wholly unconscious of danger from this source, go down yearly into drunkards’ graves. There is no standard by which any one can measure the latent evil forces in his inherited nature. He may have from ancestors, near or remote, an unhealthy moral tendency, or physical diathesis, to which the peculiarly disturbing influence of alcohol will give the morbid condition in which it will find its disastrous life. That such results follow the use of alcohol in a large number of cases, is now a well-known fact in the history of inebriation. The subject of alcoholism, with the mental and moral causes leading thereto, have attracted a great deal of earnest attention. Physicians, superintendents of inebriate and lunatic asylums, prison-keepers, legislators and philanthropists have been observing and studying its many sad and terrible phases, and recording results and opinions. While differences are held on some points, as, for instance, whether drunkenness is a disease for which, after it has been established, the individual ceases to be responsible, and should be subject to restraint and treatment, as for lunacy or fever; a crime to be punished; or a sin to be repented of and healed by the Physician of souls, all agree that there is an inherited or acquired mental and nervous condition with many, which renders any use of alcohol exceedingly dangerous.
The point we wish to make with you is, that no man can possibly know, until he has used alcoholic drinks for a certain period of time, whether he has or has not this hereditary or acquired physical or mental condition; and that, if it should exist, a discovery of the fact may come too late.
Dr. D.G. Dodge, late Superintendent of the New York State Inebriate Asylum, speaking of the causes leading to intemperance, after stating his belief that it is a transmissible disease, like “scrofula, gout or consumption,” says:
“There are men who have an organization, which may be termed an alcoholic idiosyncrasy; with them the latent desire for stimulants, if indulged, soon leads to habits of intemperance, and eventually to a morbid appetite, which has all the characteristics of a diseased condition of the system, which the patient, unassisted, is powerless to relieve since the weakness of the will that led to the disease obstructs its removal.
“Again, we find in another class of persons, those who have had healthy parents, and have been educated and accustomed to good social influences, moral and social, but whose temperament and physical constitution are such, that, when they once indulge in the use of stimulants, which they find pleasurable, they continue to habitually indulge till they cease to be moderate, and become excessive drinkers. A depraved appetite is established, that leads them on slowly, but surely, to destruction.”
TONGUE IN DISEASE DIAGNOSIS
Introduction:
Tongue is a muscular organ associated with the function of deglutition,taste and speech.It acts as an easily accessible organ for the assessment of health of an individual and shows the state of hydration of the body.It is said that tongue is the mirror of the gastrointestinal system and any abnormal functioning of the stomach and intestines will be reflected on the tongue.
Some characteristic changes occur in the tongue in some particular diseases.That is why the examination of the tongue is very essential and will give some clues for diagnosis.All doctors examine the tongue and they consider the changes in size,shape,,colour,moisture,coating,nature of papillae and movements ect.
Appearance of tongue in some abnormal conditions:-
1) Movements of the tongue:-
a) In one sided paralysis of the body(hemiplegia)tongue moves towards the parylised side when protruded.
b) Tremulus movement of the tongue is seen in diseases like thyrotoxicosis,delirium tremens and parkinsonisum.Tremor is also seen in nervous patients.
c) In progressive bulbar palsy there will be wasting and paralysis of the tongue with fibrillation.Eventually the tongue gets shrivelled and lies functionless in the floor of the mouth.This condition is associated with dribbling of saliva and loss of speech.
d) In chorea(involuntary rhythmic movements) the patient may not be able to keep the protruded tongue in rest,it will be moving involuntarily.
2) Moistness of the tongue:-
The moistness of the tongue gives some indication about the state of hydration of the body.Water volume depletion leads to peripheral circulatory failure characterised by weakness,thirst,restlessness,anorexia,nausea,vomiting ,dry and parched tongue.
Dryness of the tongue is seen in following conditions.
a) Diarrhoea
b) Later stages of severe illness
c) Advanced uraemia
d) Hypovolumic shock
e) Heat exhaustion
f) Hyponatraemia
g) Acute intestinal obstruction
h) Starvation
i) Prlonged fasting.
3) Change in colour of tongue:-
a) Central cyanosis:-
Cyanosis is the bluish discolouration of the mucus membrane due to decrease in the amount of oxygen in the blood.This is seen in heart failure,respiratory failure and in anoxia.In cyanosis tongue,lips ect becomes pale bluish.
b) Jaundice:-
This is the yellowish discolouration of all mucus surfaces of the body (including tongue)due to increase of bilirubin in the blood.Jaundice is seen in hepatitis,bile duct obstruction,increased destruction of RBCs and ect…
c) Advanced uremia:-
This is the increase of urea and other nitrogenous waste products in the blood due to kidney failure.Here the tongue become brown in colour.
d) Keto acidosis:-
This is the acidosis with accumulation of ketone bodies seen mainly in diabetes mellitus.Here the tongue become brown with a typical ketone smell from the mouth.
e) Riboflavin deficiency:-
Deficiency of this vitamin (vitamin B2) produces megenta colour of the tongue with soreness and fissures of lips.
f) Niacin deficiency:-
Deficiency of niacin (vitamin B3)and some other B complex vitamins results in bright scarlet or beefy red tongue.
g) Anaemia:-
It is the decrease in haemoglobin percentage of the blood.In severe anaemia tongue becomes pale.
4) Coating on the tongue:-
a) Bad breath:-
The main cause for bad breath is formation of a pasty coating(bio film) on the tongue which lodges thousands of anaerobic bacteria resulting in the production of offenssive gases.Those who complain about bad breath may have thick coating on the posterior part of the tongue.
b) Typhoid fever:-
In typhoid fever tongue becomes white coared like a fur.
c) Candidiasis;-
It is a fungal infection which affects the mucus surfaces of the body.On the tongue there will be sloughing white lesions.
d) In diabetes and hypoadrenalism there will be sloughing white lesions.
e) Secondary syphilis:-
Syphilis is a sexually transmitted diseased caused by trepenoma pallidum infection.In secondary stage of this disease we can see mucous patches which are painless,smooth white glystening opalescent plaques which can not be scraped off easily.
f) Leokoplakia:-
Here white keratotic patches are seen on the tongue and oral cavity.This is a precancerous condition.
g) AIDS:-
In these patients hairy leukoplakia is seen.
h) Peritonitis:-
It is the inflammation of the peritonium(inner covering of abdominal cavity which also covers the intestines and keep them in position) in this condition there is white furring of the tongue.
i) Acute illness:-
Furring is also seen in some acute diseases.
5) Papillae:-
These are small projections on the rongue associated with taste.There are different type of papillae on the healthy tongue.In some diseases there are some abnormal changes which are following.
a) Hairy tongue:-
This condition is due to elongation of filiform papillae seen in poor oral hygeine ,general debility and indigestion.
b) Geographic tongue:-
Here irregular red and white patches appear on the tongue.These lesions looks like a geographic map.The excact cause is not known.
c) Median rhomboid glossitis:-
In this condition there is smooth nodular red area in the posterior mid line of the tongue.This is a congenital condition.
d) Nutritional deficiency:-
In nutrional deficiency there is glossitis(inflammation of tongue) leading to papillary hypertrophy followed by atrophy.
e) Benign migratory glossitis:-
It is an inflamatory condition of the tongue where multiple annular areas of desquamation of papillae appear on the tongue which shift from area to area in few days.
f) Thiamine and riboflavin deficiency:-
Deficiency of these vitamins cause hypertrophied filiform and fungiform papillae.
g) Niacin and iron deficiency:-
In this condition there is atrophy of papillae.Smooth tongue is encountered in iron deficiency.
h) Vitamin A deficiency:-
This causes furrowed tongue.
i) In nutritional megaloblastic anaemia tongue becomes smooth.
j) Folic acid deficiency:-
Here macrocytic megaloblastic anaemia with glossitis is seen.
k) Cyano coblamine deficiency:-
Here glossitis with macrocytic megaloblastic anaemia and peripheral neuropathy is encountered.
l) Scarlet fever;-
In this streptococcal infection there is bright red papillae standing out of a thick white fur ,later the white coat disappear leaving enlarged papillae on the bright red surface and is called strawberry tongue.
6) Ulcers on the tongue:–
a) Apthous ulcer:-
These are round painful ulcers appear in stressed individuals frequently. May be associated with food allergy.Usual sites are tongue,lips,oral mucosa and ect.
b) Herpes simplex:-
It is an acute vesicular eruptions produced by herpes simplex virus.When these vesicles rupture it forms ulcers.
c) Ulcer in cancer:-
Cancerous ulcers are having everted edges with hard base.Bleeding is also seen.Cancer of the tongue is common in tobacco chewers.
d) Syphilitic ulcers:-
Syphilitic fissures are longitudinal in direction.In primary syphilis extra genital chancre is seen on the tongue.In secondary syphilis multiple shallow ulcers are seen on the under surface and sides of the tongue.In tertiary syphilis gumma may be seen on the midline of the dorsum of the tongue.
e) Dental ulcers:-
These ulcers are produced by sharp edges of carious teeth.