MULTIPLE SCLEROSIS

DOC I HAVE MULTIPLE SCLEROSIS

What is Multiple Sclerosis?

Multiple Sclerosis is a progressive degenerative disease of the central nervous system with recurrent episodes of neurologic

dysfunction disconnected in time and space and associated with evidence of demyelination of the central nervous system.

It affects the patient in different areas of the nervous system at various points in time.

What causes Multiple Sclerosis?

The cause is unknown but believed to be related to an auto immune disease resulting from a viral infection.

Multiple sclerosis results in destruction of the myelin surrounding the nerves of the CNS. The destruction is thought to be

caused by the body's immune system attacking the myelin sheath disrupting the transmission of information in the CNS and

lead to the symptoms seen in multiple sclerosis.


1.In Multiple Sclerosis, there is multiple scattered greying well defined lesions from few small mm size to few cm in size

present in the white matter and extending to the grey matter of the brain.

2.The lesions vary from partial to complete destruction of the myelin sheath with relative sparing of the axon , glia and

other structure.

Who is at risk of Multiple Sclerosis?

Multiple Sclerosis occurs between 20 to 50 years old.

It is more common in Northern Europeans.

Women are affected 2 times more than men.

Triggers that can cause the onset of MS are:
infections
trauma
surgery
emotional upset,
stress
pregnancy

What are the symptoms of Multiple Sclerosis?

The typical symptoms of Multiple Sclerosis are multiple and variable which explains its name.
There may be mild cases which may not need treatment or severe cases which need confinement to wheelchairs.

There is a typical course of exacerbations and remissions over a peroid of years and increased residual neurological deficit

1.impairment of vision is usually an early sign of MS
2.diplopia can occur with optic neuritis
3.unsteady gait due to the effect of the disease on the cerebellum which control balance and co-ordination
4.paresthesia or tingling sensation in the fingers and toes
5.weakness of the muscles leading to hemiplegia
6.facial paresis, vertigo and hearing loss
7.seizures when foci in the brain are over stimulated
8.Constipation and urinary incontinence may also occur as a result of the weakened muscles
9.one peculiar trait is that higher temperatures aggravate the symptoms in MS patients. Nerve conduction at higher

temperature such as a hot shower cause the slowing in the transmission of messages in nerves that have already lost myelin.

How is the diagnosis of Multiple Sclerosis made?

The diagnosis of  Multiple Sclerosis is difficult and involve
1.History of a multiple symptoms involving the nervous system
2.physical and neurological examinations for peripheral neurological deficit.
3.blood count and chemistry, urine analysis are all routine laboratory tests used to rule out other diagnoses
4.Cerebral spinal fluid evaluation may show mild mononuclear pleocytosis (less than 40 cells per cubic meter, protein normal

or increased and high gamma globulin IgG.
5.MRI can search for changes within the brain or spinal cord that are particular to multiple sclerosis.

What are the complications for Multiple Sclerosis ?

1.Weakness of the muscles leading to hemiplegia

2.spasticity of the muscles with rigidity and cramps

3.Poor co-ordination and imbalance

4.urinary and bladder problems

5.visual loss and pain suggesting optic neuritis , an inflammation of the eyeball

What is the treatment for Multiple Sclerosis?

Multiple Sclerosis cannot be cured but can be suppressed:

Supportive measures
1.Bed rest
2.Proper diet and nutrition to strengthen the muscles of the body
3.physiotherapy to strengthen muscles
4.occupational therapy to help stimulate the mind
5.Speech therapy for speech and awallowing
6.social support
7.Avoid triggers

Medications:
1.Glatiramer acetate is able to reduce the relapse rates of multiple sclerosis by about one-third and appears to reduce the

overall progression of multiple sclerosis

2.Natalizumab is a monoclonal antibody that binds to white blood cells which are thought to play a role in causing the

nervous system damage in multiple sclerosis. It also reduces the rates of relapses of MS by two thirds.

3.Fingolimod is a daily oral medication to treat MS by reducing the number of lymphocytes which is believe to cause

inflammation in MS.

4.Interferon which are anti-viral agents has found to reduce relapses of MS by one third.
What is the prognosis of Multiple Sclerosis?

5.Previous treatment used to be ACTH injections and corticosteroids. These are are seldom used.

What is the prognosis of Multiple Sclerosis?
MS is unfortunately still not curable at this time.
Most patients about 65 % with the relapsing and remitting form may improve to a stage where relapses are very much reduced.

Unfortunately they continue to have more disabling symptoms or secondary progressive multiple sclerosis.
15% become worse with progressive relapses.
10% has primary progressive MS with no remissions in between.
Death usually results from pneumonia and heart trouble.

HUNTINGTON'S CHOREA

DOC I HAVE HUNTINGTON'S CHOREA


What is Huntington's Chorea?

Huntington's Chorea is a progressive degenrative disease affecting basal ganglia characterized by choeiform movements (movements such as writhing, twisting, and turning in a constant, uncontrollable dancing motion) and mental deterioration.

What causes Huntington's Chorea?

The cause is believed to be genetic with autosomal dominance transmission from parent to offspring with full penetrance.

In Huntington's Chorea, there is widespread degeneration changes with cell loss and reactive gliosis mainly in the cerebral cortex (thinking and perception), basal ganglia (balance) and caudate nucleus (co-ordination).

There is the belief that the deficiency of gamma-aminobutyric acid (GABA) in the cells may have contribute to the impairment of the nerve cells.

Who is at risk of Huntington's Chorea?

Huntington's Chorea affects sexes in equal numbers.

It is an inherited condition. On average 50 per cent of children of the sufferers will be affected.

What are the symptoms of Huntington's Chorea?

The typical course of Huntington's Chorea usually appear between 30 to 45 years but may be earlier or later.

1.choreiform movements (movements such as writhing, twisting, and turning in a constant, uncontrollable dancing motion )

2.emotional disturbance with mental changes

3.cognitive impairment

4.mood swings with inertia followed by irritability

5.apathy

6.anger

7.depression

8.delusion and hallucinations

9.The speech can become  slurred and vital functions, such as eating, speaking, swallowing and especially walking, begin to decline.

10.All the above may occur to varying degree but rate of progression is  generally parallel.

How is the diagnosis of Huntington's Chorea made?

The diagnosis of  Huntington's Chorea involve:
1.Typical history of choreiform movements,emotional and mental impairment with family history.

2.physical and neurological examinations for brain neurological deficit.

3.CT scan or MRI may show selective atrophy of the caudate nucleus and putamen. In addition there are enlargement of fluid-filled cavities within the brain called ventricles. These tests do not completely differentiate Huntingson's Chorea from other conditions such as dementia but they will together with the choreiform movements,emotional and mental impairment point towards Huntingdon's chorea.

What are the complications for Huntington's Chorea ?

1.Progression of nerve involvement to whole body with paralysis

2.Dementia may gradually result from mental impairment

What is the treatment for Huntington's Chorea?

The is no cure for Huntington's Chorea but symptomatic control of choreiform movements and delusions with haliperidol or clonazepam may help.

Proper nutrition , fluids and exercise will help the patient to stay healthy and fit.

As the condition progress hospitalization or institutional care (such as nursing homes) is usually indicated.

Genetic counseling is important for treatment and prevention of  
Huntington's Chorea.

What is the prognosis of Huntington's Chorea?

Except for a few cases there is a relentless progression to death.
Death usually occurs in 10 to 15 years although the course may more acute or prolonged.

MOTOR NEURONE DISEASES

DOC I HAVE A MOTOR NEURONE DISEASE

What are Motor Neurone Diseases?

Motor Neurone Diseases is a group of progressive degenerative diseases affecting motor neurones with varying corticospinal involvement.

The diseases destroy cells that control important muscle activity such as speaking, walking, breathing, and swallowing. The damaged nerve cells are unable to send signals to the muscles to do their activity resulting in weakness, wasting and tremors of the muscles.

The Motor Neurone Diseases includes conditions such as Amyotrophic Lateral Sclerosis (ALS), progressive bulbar palsy, primary lateral sclerosis, and progressive muscular atrophy.

What causes Motor Neurone Diseases?

The cause is unknown but environmental, toxic, viral, or genetic factors have found to play a part in its formation.

1.In all Motor Neurone Diseases, there is loss of nerve cells in the anterior horn of spinal cord and motor nuclei of brain stem.

2.In Primary Lateral Sclerosis there is corticospinal tract degeneration most evident in the lower spinal cord but traceable to internal capsule and corona radiata.

Who is at risk of Motor Neurone Diseases?

Motor Neurone Diseases occurs in middle age 40-60 years old and are more common in males.

It occurs as endemic in Guam where there is high familial incidence in association with Parkinson dementia complex.

What are the symptoms of Motor Neurone Disease?

The typical course of Motor Neurone Diseases except for primary lateral sclerosis is 2 to 6 years resulting in death.

1.acute onset of asymmetrical muscle tremors, weakness and wasting in both lower limbs with ascending progression of the weakness upwards to the arms and face .

2.the lower cranial nerves can also be affected leading to bulbar weakness, (dysphagia or difficulty with swallowing), facial weakness and respiratory difficulties. If this happens , hospitalization is a must.

3.spasticity of the muscles

4.hyperreflexia

5.mental function is usually not affected

How is the diagnosis of Motor Neurone Disease made?

The diagnosis of  Motor Neurone Disease involve
1.History of a rapid onset and progression of motor weakness, wasting, tremors, hyperreflexia and the absence of fever.

2.physical and neurological examinations for peripheral neurological deficit.

What are the complications for Motor Neurone Disease ?

1.Progression of nerve involvement to whole body

2.Paralysis of respiratory muscles and swallowing can be life threatening

What is the treatment for Motor Neurone Disease?

Treatment for Motor Neurone Disease may be urgent especially in cases of respiratory distress:

1.Hospitalization and early intubation with a respirator on standby in case of difficulty in respiration

2.treatment of the condition is supportive only as there is no cure for the disease

a.physiotherapy to strengthen muscles

b.Speech therapy for speech and swallowing

3.The drug riluzole approved to treat ALS, prolongs life by 2-3 months but does not relieve symptoms. 

4.Symptoms such as spasticity  can be treated with muscle relaxants.

Anticonvulsants and pain killers can help to relieve pain.

5.A healthy and balanced diet is necessary to maintain strength in the muscles and mind

What is the prognosis of Motor Neurone Disease?

Most Motor Neurone Diseases except for primary lateral sclerosis (which is usually not fatal) are relentless diseases with  progression to death.

DUCHENNE MUSCULAR DYSTROPHY

DOC I HAVE DUCHENNE MUSCULAR DYSTROPHY

What is Duchenne muscular dystrophy?

Duchenne muscular dystrophy is a genetic disease which causes rapid weakness and wasting of muscles.

What is the cause of Duchenne muscular dystrophy?

Duchenne muscular dystrophy is believed to occur as a result of a defective gene for dystrophin (a protein in the muscles).

In Duchenne muscular dystrophy males are more likely to develop symptoms than are women.

Inheritance is usually sex-linked and recessive. The sons of women who are carriers of the disease have a 50% chance of having the disease while the daughters have a 50% chance of being carriers.

Duchenne muscular dystrophy occurs in 0.3 per cent of male infants in the population.

What are the symptoms of Duchenne muscular dystrophy?

Symptoms may appear as early as infancy and include:

1.Fatigue
2.Muscle weakness which is worse in the legs

3.waddling gait

4.use of hands to raise self from floor
4.Difficulty in running, jumping
5.Frequent falling

6,climbing stairs difficult

7.Pseudohypertrophy of the infraspinatus, deltoids , triceps and calf muscles


8.Atrophy of muscles occurs with contractures and deformity

9.Progressive difficulty in walking with ability to walk lost by 12 years of age
10.Most patients at age 12 are confined to a wheelchair.

Signs :

A complete physical examination may show:

1.Abnormal heart muscle (cardiomyopathy)
2.Congestive heart failure
3.Deformities of the chest and back (scoliosis)
4.Enlarged calf muscles which are later replaced by fat and connective tissue (pseudohypertrophy)
5.Loss of muscle mass (wasting)
6.Muscle deformities in the heels and legs
7.Respiratory difficulty due to weakness of lung muscles

Investigations:

1.Electromyography (EMG)
2.Genetic tests
3.Muscle biopsy

What is the Treatment of Duchenne muscular dystrophy?

Treatment of Duchenne muscular dystrophy are usually symptomatic to improve the quality of life as there is no cure for the disease.

Gene therapy may be able to cure by removing the defective gene in the future.

1.Physical activity is helpful to maintain muscle strength and function.
Inactivity may worsen the muscle disease.

2.massage and electrical stimulation of muscles
2.Orthopedic appliances (such as braces and wheelchairs) may increase the ability for self help.

What is the prognosis of Duchenne muscular dystrophy?

Duchenne muscular dystrophy usually leads to rapidly worsening muscular condition.
Death can occurs by age 25 typically from respiratory conditions such as pneumonia.

What are the complications of Duchenne muscular dystrophy?

1.heart disease such as cardiopathy and heart failure
2.muscle deformities such as scoliosis
3.mental impairment which is rare
4.permanent, progressive disability
5.pneumonia or other respiratory infections
6.death from respiratory failure

What is the preventive measures of Duchenne muscular dystrophy?

Duchenne muscular dystrophy can be detected with about 95% accuracy by genetic studies performed during pregnancy.
Genetic couseling will therefore be a great help to prevent the disease.

PURPURA

DOC I HAVE PURPURA

Purpura is a physical sign of escape of red blood cells through the endometrial wall of the dermal capillaries resulting in purplish blotches under the skin.

What is the cause of Purpura?

It is usually due to vacular wall defect, low platelets, infections or injury:

Vascular wall defect may be caused by:
1.Scurvy or lack of vitamin C
2.Fragilty of vascular wall due to age(senile purpura, anemia, diabetes or steroid therapy
3.Autoimmune disease such as Henoch Schonlein purpura
4.Blood cancer such as multiple myeloma

Infections:
1.Dengue fever - cause low platelets
2.Subacute bacterial endocarditis - cause low platelets
3.Typhoid fever
4.Rocky mountain fever

Low Platelets:
1.Aplastic anemia - low production of red blood cells, white blood cells and platelets from marrow
2.Megaloblastic anemia
3.Leukemia
4.Exposure to toxic drugs (chemotherapy) or radiation
5.Splenomegaly
6.Idiopathic thrombocytopenic purpura
7.Lymphoma
8.Neonatal thromocytopenia
9.Drug induced thrombocytopenia

Others:
1.Injury
2.Trauma
3.Burns
4.Dialysis
5.Blood thinners such as aspirin, warfarin, plavix
3.alcohol

What are the symptoms of Purpura?

Symptoms:

1.typical purple blotches under the skin
2.fever with purpura is a medical emergency
3.fundoscopic bleeding
4.abdominal pain may be a recurring symptom
5.splenomegaly
6.low platelets
7.bleeding time prolonged

How do you made the diagnosis of Purpura?

Diagnosis of Purpura is often based on
1. history of Purpura
2. history of drug allergy
3. history of blood thinners
4. Full blood count
5. Bone marrow biopsy

What are the complications of Purpura?

The complications of Purpura are:

1. Anemia

2. damage to liver , spleen and nerves

What is the treatment of Purpura?

Treat the underlying cause:
1.Blood transfusion of platelets in severe cases

2.Antibiotics for infections

3.Avoid causative agents especially drugs, vitamin deficiency,renal disease,radiation

4.corticosteroids is useful in idiopathic thrombocytopenic purpura

5.Splenectomy may be helpful

What is the prognosis of Purpura?

Prognosis depends on the cause of Purpura.
Patients with blood cancer has a poorer prognosis compared to injury.

WEIGHT LOSS 3

DOC HOW DO I LOSE WEIGHT?

Control Diet

15.)Grocery store shop at outer aisles

There is one common thread in all grocery store designs: the healthy foods are on the perimeter aisles. Think about it, when you go into the grocery all of the healthy stuff, fruits, vegetables, meats, and dairy products are arranged around the stores walls whereas the center aisle areas in those few stores that stock butter and cheese in the center near the frozen foods. .

Train yourself to start on one end of the outer aisle and work your way around. You will be able to fill your basket with healthy items if you do so.

16.)Get good cook books

Get a good cookbook. Not all recipes in a cookbook are low-carbohydrate fare. However you will be surprised at the number of low-carbohydrate friendly recipes you can find in a standard Betty Crocker Cookbook.

Cookbooks often contain handy tips on purchasing cuts of meat and preparing meats, fruits and vegetables in new and exciting ways. New low-carbohydrate cookbooks are hitting the shelves all the time. Try to take advantage of these resources to eat something new, different and nutritious.

17.)Take a good multivitamin as supplement to your diet The most conscientious food combiner may miss some healthy vitamins, minerals and trace elements in their diets. To help supplement your diet, consider taking a good multivitamin. If you are an otherwise healthy individual, your body will do its part. Keep to the low-carbohydrate diet plan that is right for you with some variety to your meals to help you on the path to good health and weight loss goals.

18.) Reward Yourself

Once in a while reward yourself. You will be less likely to cheat on your new diet if you grant yourself small rewards. If you are a chocolate lover, treat yourself to a small square of chocolate  each evening.

BURN YOUR CALORIES

1.) Work Out with Weights

Beside the diet control the other way is to burn up the fat. One way is to add a weight exercise program and routine work out. Weight training will not only tone your muscles but will strengthen your body and improve your general health. Lifting weights will also help to burn calories and fat more quickly than ordinary exercise.It will also boost your blood circulation and metabolism.

2.) Avoid Marathon Work Outs

Some people feel that the best way to burn fat and lose weight is to have one long, extensive work out. That is not true because it will exhaust all your energy leaving less energy for the next exercise. Break up your work out plan into small manageable sessions throughout the day. For example take a brisk walk in the morning, enjoy a work out at lunch, and then exercise more in the evening. This will keep you active all day long and will better maintain your metabolism.

3.) Mix It Up

Being active in different quality exercises will keep your interest and help you to maintain your goal of burning fat. Changing exercises such as to swim laps one day, jog another, and riding a bicycle the next will not only allow you to experience a variety of physical activities, it will also allow you to better tone your body.

Finally a positive and cheerful optimism will help a long way to reduce your weight. If you can control your diet and burn your calories you will definitely lose weight! Do not doubt that!

WEIGHT LOSS 2

DOC HOW DO I LOSE WEIGHT?

Control Diet

7.)Avoid meal replacements

Every day new meal replacement shakes and bars are sold on the market.They may claim to be healthy, but almost all of them contain hydrogenated oil and sweeteners.

Low carbohydrate doughnuts and muffins can be found at your neighborhood grocery store . While low-carbohydrate pastries may be tempting to buy, unfortunately they still contain all of the usual carbohydrate suspects: sugar and flour.

They may be healthier than your typical muffin as an occasional treat but not for long term eating.

8.) Low Glycemic Index Diet

A low Glycemic Index(sugar index) diet is a good way of burning fat quickly. This diet allows people to take large amounts of foods with low rankings on the Glycemic Index. These foods have enough nutrition and will help your body to burn fats and calories faster. The diet includes many of your favorite fruits, vegetable, meats, dairy, and grain products.

9.)Get fresh fruits not squeezed

Fruit juice can be very tempting as a replacement for soda but most commercial fruit juice has very little actual fruit juice.

Instead you will find lots of sugar water and other ingredients. Skip the juice altogether and eat a fresh piece of fruit instead. Not only does fresh fruit contain less sugar than juice. Fresh fruit also has fiber which is good for you and will help you feel fuller longer.

10.)Cooking your own food:

Many food in restaurents claims to have low carbohydrate and calories but most of them are not ideal low-carbohydrate fare. There are many recipes for good nutritional and easily prepared meals that you can cook yourself at home.

If you cook your own foods, you will be able to know exactly the contents of the food and you will have better control for hidden sugar and otherwise processed foods.

The other benefit is the significant cost per meal as opposed to eating at restaurants and fast food establishments.

It is also easier to control your diet with your favorite fresh food selections available at your kitchen.

11.) Eat slowly and enjoy your food

You will feel full and more satisfied if you take the time eat slowly by chewing it and savouring your food. Do not eat while standing . Sit down and chew.

Eating slower will help you enjoy your food more, notice what it is you are actually eating and get a better knowledge of when you are actually full.

12.) Cut Calories Wisely

It is tempting to drastically cut your calorie intake when you start on a healthy lifestyle. By reducing calories too quickly, your body will be too rapidly burning all available calories, which will slow down your metabolism.
Instead use a step method when cutting your calorie intake to minimize risk.Furthermore, you are more likely to maintain your healthy lifestyle through this step method.

13.) Skip Happy Hour

Avoid alcohol. Alcohol is rich in sugars and carbohydrates, and therefore a high calorie substance. These calories can add up quickly and take away from essemtial nutrients that should be included in your daily diet. Besides this alcohol acts as an inhibitor for burning fat allowing your body to store the fat faster.

14.)Having your food storage containers

Using your food storage containers of various sizes will make it so much easier for you to plan your meals. You can buy and store nuts, fruits and vegetables in bulk for easy use later.

Fix your own lunch and snacks and bring them in containers with you to work.

WEIGHT LOSS 1

DOC HOW DO I LOSE WEIGHT?

A Simple Guide to your weight loss program involve 2 main components:
1.Control Diet
2.Burn up Calories

Control Diet
1.) Drink More Water

Drinking water 8 to 10 times each day to stay hydrated and healthy. Once you get started, you will begin to crave water.

Start with a glass of water first thing in the morning before you eat. If you really do not like the taste of water, try adding a few drops of lemon or lime to your water but no sugar or sweetener! Ice also helps.

One of the best weight loss secrets is to avoid the sweet drinks and the sodas which are all calorie laden. Instead grab a refreshing glass of water.

Besides flushing toxins and waste material out of your system, drinking water encourages you to build muscle.

Drinking a glass of water after very meaal will help you get in your 8 to 10 glasses of water each day but it can also have other benefits.If you feel hungry after a smaller meal, try drinking water after the meal. The water will help you feel full and prevent further eating.

2.) Eat More Small Meals

Do not skip breakfast each morning even if you will have to go bed earlier 20 mins each night to wake up for a proper breaskfast! Breakfast is the most important meal of the day and will contribute to your good health and to weight control.

Eating breakfast is not only good for overall weight loss, it will help you control your diet the rest of the day. You will less likely to eat something sweet and in the bread group if you skip breakfast.

Keep a couple of hard-boiled eggs in the fridge or some high-fiber, low starch fruit around to take for breakfast. Breakfast is the best time to take fruits.

You will feel better and lose weight quicker if you eat a large breakfast and eat a smaller dinner. Try and eat the majority of your carbohydrates earlier in the day, leaving a salad and lean meat protein for dinner.

By eating larger meals during the part of the day when you are most active will help you to feel less hungry throughout the day and stop cravings for unhealthy snacks.

Traditional three-large-meals-a-day plan will not help your body to burn up large meals and any excess will be turned into fat. Many nutritionist believe you should eat six small meals a day. You should cut back on your food consumption at each meal, or else you will be doubling your intake of calories!

Just like eating breakfast will increase your metabolism, so will eating small meals more often. This will also help you reduce the total carbohydrate intake by making sure that your meals are planned and occur regularly throughout the day.

3.) Consider eating a salmon or fish during breakfast

This is one way to work in Omega-3 fatty acids that are good for you and add some variety to your daily diet. After a time you may tire of eating eggs and bacon for breakfast. Eating a salmon or fish will give you the protein and healthy fish oils you need.

4.)Avoid White Foods

Anything which is made from sugar, flour, potatoes, rice or corn - just avoid. Always look for colorful fruits and veggies to substitute for the white foods. Buy broccoli, lettuce, bell peppers, green beans and peas, brown rice in moderation, leafy greens like kale and spinach, apples, melons, oranges and grapes.

Fruits and vegetables are not only colorful but they are also high in fiber, nutrients and important antioxidants. Eating colorful fruits and vegetables will give your diet variety as well as healthy benefits with their fresh vitamins, minerals and fiber. Most people will find some vegetables that they enjoy eating. Vegetarians have food that looks and taste as good as meat .They are actually made out of soya bean and flour.

5.) Choose Protein

Choose protein-laden foods for boosting your metabolism and enabling your body to burn fat rapidly. In addition to burning fat, consuming a protein-enriched diet will help you rebuild muscle after work outs and maintain leanness of that muscle. Wisely choose proteins for your diet. Take great care to pick proteins low in fat so you do not consume extra calories.

6.)Eat more protein at every meal

Eating protein helps you burn more calories. This iss because protein is made up mainly of amino acids, which are harder to breakdown in your body so you burn more calories getting rid of them.

Eating a protein rich snack can help you to lose weight.

Eating protein will also help you feel full so that you have less craving for unhealthy snacks.

BRISTOL STOOL SCALE

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DOC HOW DO I KNOW WHETHER MY STOOL IS NORMAL

Actually many people do not know the definition of diarrhea.

They define the word diarrhea as watery stools where in fact the word diarrhea means any stools which are softer or more frequent than normal.

The researchers at the Bristol University have come out with a scale which is called the Bristol Stool Scale.

According to the Bristol Stool Scale, the seven types of stools
are:
1.Type 1: Separate hard lumps like nuts
2.Type 2: Sausage shaped but lumpy
3.Type 3: like a Sausage but with cracks on its surface
4.Type 4: like a Sausage or snake, smooth and soft
5.Type 5: soft blobs with clear cut edges
6.Type 6: Fluffy pieces with ragged edges, a mushy stool
7.Type 7: Watery, no solid pieces. Entirely liquid.

Type 1 and 2 indicate constipation while type 5-7 indicate diarrhea. Type 3 and 4 are considered ideal stools because they are the easiest to pass.

Avoidance of constipation include:

1. Increase in daily fiber intake to at least 15gm (eg. 1 bowl of bran cereal for breakfast),
fruits and vegetables).
Fibre increases the bulk of the stool allowing easy passage of stools through the large
intestine.

2. Drink at least 8 glasses of water a day (2 liters). Water reduces the hardness of stools.

3. Regular exercises at least 2-3 times a day especially after meals. Exercise will enhance
intestinal movement.

4. Allow a distraction free period of 15 min a day for bowel movement. The strongest
intestinal movement occurs after breakfast.

5. Do not ignore or suppress the urge to pass bowel movement. This may impair the
sensation to detect initiation of bowel movement leading to constipation.

Avoidance of  diarrhea include:

1.washing your hands thoroughly for 20 seconds after using the bathroom or changing diapers

2.washing your hands thoroughly for 20 seconds before eating

3.disinfecting contaminated surfaces such as counter tops and baby changing stations

4.Avoid eating or drinking foods or liquids that might be contaminated

5.Avoid rapid intestinal movement from stress, irritable bowel syndrome

Please read my blogs on constipation and diarrhea

BIRD FLU

DOC I HAVE BIRD FLU

Bird Flu or more correctly, avian flu is new strain of influenza virus H5N1 which can infect humans.

It has been around for 1987 and was expected to be the next big pandemic to hit the world.

Millions of birds and poultry has been culled all these countries especially in Thailand and China.

Just in December 2011 there has been a few cases found in Hong Kong where culling of poultry has been done .

The number of cases of avian flu in humans in the current outbreak is very small, and almost all have come about by direct contact with infected or dead birds or poultry.

The first outbreak of bird flu occurred in 1987 . Since then the bird flu have claimed at least 306 human lives in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Laos, Nigeria, Pakistan, Thailand, Turkey, and Vietnam.

Just as recent as December 2011 one woman in Shenzhen which is in southern China died of bird flu(H5N1).

On January 7th 2012 another person also died of Bird flu in Indonesia.

Central to the problem of dealing with bird flu is diagnosis.
A number of upper respiratory infections have similar symptoms—at least at the onset of the illness, including the common cold, seasonal influenza, and bird flu.

Seasonal flu and bird flu have almost identical symptoms:
1.fever,
2.cough,
3.malaise (feeling unwell),
4.nausea,
5.vomiting,
6.diarrhea.

The Multiplexed Respiratory Test, discriminates influenza A from influenza B and identifies the H5-subtype of influenza A (bird flu is “H5N1”) from all other H subtypes.
In addition, it can identify almost all the other common—and some uncommon—viruses that cause influenza-like illnesses.

Preparation to treat a bird flu epidemic:
1. The single most important thing for an epidemic such as avian bird flu is to have well-prepared local health care systems.

2. Regular hand washing, and other beneficial cleanliness custom may save more lives than all other medicines combined.

3. The proper recognition and prizes should be given to those who have come up with effective vaccines for the avian bird flu disease. On the same note, vaccine makers should be given the freedom to make use of state materials needed for the vaccines.

4. Relevant drugs and vaccines for the avian bird flu disease should be bought and sold at fair prices.

5. Make preparations to ensure the continuity of food and power supplies.

6. It is therefore appropriate to have local health authorities ready to be used when the situation calls for it.

7. Encourage the formation of prediction markets about the avian bird flu epidemic.

8. There should be useful information about the progress of avian flu.

This will be especially useful in some Asian countries where the avian bird flu epidemic is expected to be rampant.

9. The World Health Organization should be prepared for such a bird flu epidemic.

During an avian bird flu epidemic, there are also things that should not be done:
1. Tamiflu and vaccine stockpiling have their useful roles.

In addition to the medical limitations of these investments(Tamiflu is losing its effect on most influenza because of their frequent use especially in Hong Kong), other institutional factors, such as transportation, will restrict the ability to allocate these supplies promptly to the persons needing them(healthcare and emergency staff)

2. Quarantines and mass isolations are useless in a bird flu epidemic.

3. In an avian bird flu epidemic  the health authorities must be in full control of the situation

4. It is pointless to block off or isolate the pandemic in its country of origin.It may have spread abroad already. Besides birds are migratory.

5.Public places such as schools and marketplaces should be closed immediately to be on the safe side.

5. People should not obsess over avian bird flu at the expense of other medical issues.

BED BUGS

DOC I HAVE BEEN BITTEN BY BED BUGS

What are Bed Bugs?

A Bed Bug is an insect called Cimex lectularius which is a small living insect that one can hardly see with the naked eye.

Bed bugs can be found in schools, hotels, apartments and houses. They can usually crawl and hide themselves in clothes, quilts, bed covers, pillow, furniture, cracks and crevices in the home.

Bed bugs are usually active at night. They mostly bite at exposed skin area such as face, neck, arms, hands feet etc. leaving swelling and redness at those bitten areas.

Their bites are characterized by itchiness and secondary skin infections.

Bed bugs are very flexible and tough insects because after they eat once in their life  they can spend their whole life span on that single meal.

The Life span of bed bugs is only one year.

Bedbugs can survive as long as up to one year without sucking blood.

The female bug can lay lay eggs three times in their life. and 300 eggs at one time. The eggs hatch in 6-10 days into adult bed bugs.

What are the Symptoms of Bed Bugs?

1.itching which is worse at night

2.rashes and abrasions on the skin due to scratching and secondary infections.

Rashes typically are present on legs and arms, sometimes on the body , seldom on the face. Rarely it may be present on the scalp.

Bedbug bites can not be felt immediately because of a sedative present in the saliva of the bedbug that keeps the blood from clotting and immunes the body for some time.

The process of sucking blood of a host lasts for 4-5 minutes.

The only good thing about these bugs is that they don not carry germs or bacteria that may cause harmful diseases to human body.

How do you confirm the diagnosis of Bed Bugs?

Skin scrapings can be examined microscopically for the Bed Bugs bites.

What is the Treatment of Bed Bugs?

Wash the infected area with an antibacterial liquid and apply calamine lotion afterward.

Pesticides (chemicals to treat Bed Bugs) actually contain mild insecticide :

Benzyl benzoate lotion

Malathion lotion

Gamma benzene hexachloride cream

Permethrin cream

Bathing is followed by application of the insecticide to the whole body from the neck to soles, left for 24 hours.

Treatment of contacts may be required if there is obvious signs of Bed Bugs.

While the Bed Bugs cannot live off the human skin for longer than 24 hours, each treatment with pesticide should be accompanied by washing, in hot water, of bedsheets, pillow cases and any clothes worn over the previous week.

Most people improve within a few days of treatment but it may take 4-6 weeks for the itch and rash of Bed Bugs to go away completely.

Prevention:
Keep your house clean and spray an effective pest control formula to eradicate these bugs completely.


 

ANGER MANAGEMENT

DOC HOW DO I MANAGE MY ANGER

Anger is an emotion which is experienced by kids and adults alike as a normal response to interference by others in a negative manner.
Anger is a normal response to such a situation.

Anger can be classed as a mild or intense irritation.
It depends on the individual, the circumstance and their emotions.
1.Some people tend to keep their anger to themselves, bottling up their negative emotions and hurt.
2.Others lash out or become extremely defensive and even abusive.

Anger may be a healthy, normal emotion.
Regular episodes of angry or reckless behavior in a person can a problem, one that needs to be dealt with.
Anger can be also intense to the point of violence.
However when the anger takes over an individual's life, it can making them destructive to themselves and everyone around them. 

Controlling anger is considered anger management.
1.Most important to controlling anger is to admit there is a problem.
2.people who have major anger issues cannot see it.
3.They will continue down a path where they are constantly angry
4.Anger prevents them from seeking the help they require
5.The angry individual will likely experience loss of their family, their job and their own identity.
 
Anger management is designed to :
1.help the individual work out their problems,
2.help them figure out why they become so angry.
3.teach the person techniques which prevent them from getting angry as often or for very long.
4.help them have a better quality of life and live a healthy, normal life..

Anger management strategies are programs created specifically to help those with anger issues.
These programs address different people, kids, teens, adults, couples and families.
These programs are there to teach or help people to work on their anger.
Teaching people strategies to work out their problems and control their anger is important in anger management.
Every program is intended to help people who are hot-tempered and frequently have fits of rage.
Anger management strategies are designed to help an individual return to a healthy, normal existence.

1.Taking a time-out is considered a healthy management strategy.
Removing oneself from a situation or person that makes a person angry is practicing time-out.
This anger management strategy might simply require a ride in the car or a walk on the beach.
Playing sports or working out will help an individual to use up some of the extra energy without involving
Some other suggestions for time-out are reading, listening to music or sitting alone in silence.
Each of these activities are healthy anger management strategies.

2.A second example of a healthy anger management strategy is owning up to the anger.
Although the anger is usually brought on by an irritating situation or a confrontation with another individual, the anger actually belongs to the troubled person.
Only the person who's experiencing the anger issues can control their fits of rage.
He mustlearn anger management strategies and how to deal with his emotions in a healthy way.
When an individual becomes mad or upset he or she need to try to disclose the reasons for the anger whether it is hurt, fear, frustration sadness, confusion , jealousy or whatever seems to bring unleash the rage.

3.Another healthy anger management strategy is to look back on those situations that upset an individual and try to find ways to make changes.
Learning the cause of the anger may help the individual to avoid those situations.
Not only might the person learn to avoid these incidents but they might also choose to take what they've learned and attempt to deal with the situation without bursting into a frenzy.

4.A fourth suggestion regarding healthy management strategies is to confront the situation or person.
Talk to the person or people involved, calmly of course, to try to determine the root of the problem.
The angry individual might actually discover that the whole thing was a mix-up, a misunderstanding.
The individual might also try asking the person or people in the situation to think about their behavior and perhaps even change it.
It may be surprising what people would be willing to do to help the person who is attempting to deal with their problems with anger.
Hopefully everything will work out for the best.
If not there has to be room for acceptance.
Sometimes a person must simply accept the situations and people they cannot change and either deal with it or walk away.

Learning healthy anger management strategies should be considered by those with anger problems.

VEGETARIAN

DOC I AM A VEGETARIAN

A Vegetarian Diet is important for those people who opt for Optimal Personal and Environmental Health.

It’s been well documented through the years that vegetarians are healthier than people who eat meat.

Vegetarians are less likely to :
1.be obese
2.have high blood pressure,
3.diabetes,
4.rheumatoid arthritis
5.colon cancer
6.less likely to die from heart disease.

Vegetarians have lower blood pressure even when they eat the same amount of salt as meat eaters and exercise less.

Many studies show that vegetarians have less instances of colon cancer, due in large part to the differences in the bacterial flora that is present in the colon.

There are many factors in the vegetarian diet that contribute to better health.
1.Vegetarians consume two to three times as much fiber as do meat-eaters, which has been shown to reduce cholesterol and blood glucose levels, and protect against colon cancer.

2.They also consume more antioxidants, which are found in a wide variety of plant foods and protect cells from oxygen-induced damage and reduce the risk for heart disease, arthritis, cancer, and other diseases.

3.Vegetarians eat more isoflavones than do meat eaters. These compounds, found mostly in soy foods, are a type of phytochemical. Research shows that isoflavones may reduce the risk for prostate cancer and may improve bone health.

4.Vegetarians also consume much less saturated fat and cholesterol than do meat eaters, resulting in significantly lower levels of blood cholesterol, decreased instances of heart disease and possibly for diabetes and cancer.

5.And, since vegetarians do not eat meat, they are not exposed to heme iron, a type of iron found in meat that may increase the risk of heart disease and cancer.

6.Lastly, being a vegetarian is not only optimally healthy for your body, but also for your your environment and the planet’s animals.

It allows you to live more harmoniously with the world around you, which improves mental and emotional health accordingly.

MASSAGE THERAPY

DOC WHAT IS MASSAGE THERAPY?

What is Massage Therapy?

Massage therapy is a form of therapy that a licenced massage therapist or physiotherapist does massage of painful muscles or the body to improve blood circulation in a patient.

Besides being able to help relieve sore muscles, massaging a body needs a massage therapist who know what are the risks, if there are any side effects and how it supplements conventional medicine for stress and improving blood flow in the body.

Types of Massage Therapy include:

1.reflexology,

2.shiatsu,

3.back massage,

4.hot stone,

4.deep tissue,

5.aromatherapy

6.Swedish.

7.Thai

Risks with  massage therapy  can be avoided if you take the proper precautions.

The best thing to do will be to consult with your doctor to see if it is safe for you to see a masseuse.

Patients who have the following conditions should not undergo massage therapy. These include 1.deep vein thrombosis that happens to be a blood clot in a deep vein, usually in the legs,

2.bleeding disorder or taking blood-thinning drugs such as warfarin,

3.damaged blood vessels

4.weakened bones from osteoporosis,

5. recent fracture,

6.cancer.


7.fever, 

8.open injury,

9.damaged nerves, 

10.an infection or acute inflammation.

Certain conditions could also be dangerous if you decide to have a massage. These include 1.pregnancy,

2.cancer,

3.fragile skin,

4. dermatomyositis

5.heart problems,

Side effects associated with massage therapy include:

1.temporary pain or discomfort,

2.bruising,

3.swelling

4.sensitivity or allergy to massage oils.

Massage therapy should not be used a substitute for regular medical care.

If your doctor tells you that you can see a massage therapist, do some research about the person.

You should check on their credentials or licenses, years of experience and training.

If you need massage therapy to help cure medical condition, find out beforehand if they have specialized training in this field.

It would not hurt to also ask if they use other practices aside from massage therapy to help their patients.

Some examples of these include the use of herbs and requiring the patient to go on a special diet.

Some people may even ask for a free ten minute test to see how well they perform.

The best part about massage therapy is that it can provide relief without the need to ingest pain killing drugs and knowing some facts about it is good so you know what you are getting yourself into once you visit the place.

As long as there is no dangers or side effects, going for a session of massage therapy by a licenced massage therapist to relieve some stress or pain may be beneficial for your health

PHYSIOTHERAPY

DOC WHAT IS PHYSIOTHERAPY

Physiotherapy is also known as physical therapy of medical conditions. That answers the question of what is physiotherapy for many people.

As a supplementary type of health care, physiotherapy concerns itself with providing physical healing methods for many different kinds of injuries and illnesses.

Therapy at a Physiotherapy Clinic:

When a patient is referred to the physiotherapy clinic, he or she will be evaluated by a physiotherapist.

After this initial evaluation, he or she will be scheduled for treatments like ultrasound or acupuncture etc as recommended by the doctors in conjunction with the physiotherapists.

They will be assigned exercises to do at the clinic. A good physiotherapist will begin treatment right away.

The different types of Physiotherapy:

1.massage or manipulation (hands-on) of the musculo-skeletal system when the muscles and tissues are injured.

2.Traction of the skeletal system to lengthen the spaces between bones so that nerves or tendons are pressed on by the bones

3.Strengthening of the muscular system helps the patient to recover from surgery as well as prevention of tightening of the muscles and tendons and making them more flexible.

4.Heat (heat pads, infra-red light, shortwave diathermy) help the blood circulating after injuries and help earlier recovery

5.ice (cold compress) help to reduce swelling and tissue damage

6.ultrasound treatment, radiofrequency waves , are all useful to relieve pain and stiffness.

7.Hyperbarbaric treatment: Increase in oxygen pressure can improve the faster healing of injuries and recovery from surgery.

All these methods tend to promote better health, both physical and psychological.

The importance of physiotherapy equipment:

Equipment for helping patients regain their strength and mobility are a part of what is physiotherapy. This equipment may allow a person who is partially paralyzed to get the most exercise possible. This is crucial in maintaining the integrity of their spines and muscles.

The importance of Education in Physiotherapy:

Besides the methods used in Physiotherapy, education is a part of what is physiotherapy. A physiotherapist will teach a patient how to care for their injuries. He will teach exercises to do at home so that therapy can continue beyond the walls of the clinic or hospital. He will teach ways to overcome difficulties that cannot be cured.

Rehabilitation is another part of Physiotherapy treatment:

Patients have injuries from sports, car accidents, or assault. These injuries can be treated through physiotherapy. Given the right treatments and an injury that will respond to treatment, much progress can be made. Full functioning may be regained. It may even be possible for them to go back to work rather than being laid up at home.

Physiotherapy is a carefully planned and executed treatment strategy.

It is based upon assessments of the conditions that patients suffer. If all goes well, the patient will return to their original condition. If this is not possible, the goal is for the patient to reach a goal that is the best movement and lack of pain that is possible.

The preventative side of the field of physiotherapy is very important in the overall holistic treatment of a patient.

It is a part of the work of practitioners of physiotherapy to encourage exercises and postures that will help patients avoid physical injuries and conditions requiring their services.

An excellent physiotherapist will have fewer return patients, but the flow of people needing physiotherapy continues.

YOGA

DOC WHAT ARE THE HEALTH BENEFITS OF YOGA

Yoga is a physical, mental, and spiritual discipline, originating in ancient India,whose goal is the attainment of a state of perfect spiritual insight and tranquility.

The goals of yoga are varied and range from improving health to achieving Moksha which is liberation from all worldly suffering and the cycle of birth and death .

The more technical sense of the term "yoga", describing a system of meditation or contemplation with the aim of the cessation of mental activity and the attaining of a "supreme state" .

"Ashtanga Yoga" ("Eight-Limbed Yoga").

The Eight Limbs are:
1. Yama (The five "abstentions"):
non-violence,
non-lying,
non-covetousness,
non-sensuality,
non-possessiveness.

2. Niyama (The five "observances"):
purity,
contentment,
austerity,
study,
surrender to god.

3. Asana: means "seat", and refers to the seated position used for meditation.

4. Pranayama ("Suspending Breath"):
interpreted as control of the life force.

5. Pratyahara ("Abstraction"):
Withdrawal of the sense organs from external objects.

6. Dharana ("Concentration"):
Fixing the attention on a single object.

7. Dhyana ("Meditation"):
Intense contemplation of the nature of the object of meditation.

8. Samadhi ("Liberation"):
merging consciousness with the object of meditation.

Types of Yoga are:
1. Raja Yoga: the first yoga the path of meditation
2. Karma yoga: The yoga of action.
3. Bhakti yoga: The yoga of devotion,
4. Jnana yoga: The yoga of knowledge.
5. Hatha Yoga: the purification of the physical body as leading to the purification of the mind.

The Hatha Yoga is generally the yoga accepted by the western world as the yoga which they practiced .

Health benefits of yoga:
Yoga came to the attention of an educated western public in the mid 19th century as a form of purely physical system of health exercises :
1.meditation
2.breathing
3.concentration

Yoga is used for treatment of cancer patients :
1.to decrease depression,
2.reduce insomnia,
3.relieve pain, and fatigue
4.control anxiety.

stress.
Treatment with yoga reported significantly :
1.less mood disturbance and
2.reduced stress
3.positive effects on sleep anxiety,
4.better quality of life,

Schizophrenia:
Yoga's ability to
1.improve cognitive functions
2.reduce stress
makes it appealing in the treatment of schizophrenia because of its association with cognitive deficits and stress related relapse.

Heart disease.
studies of the effects of yoga on heart disease suggest:
1. yoga may help reduce high blood pressure,
2.improve symptoms of heart failure,
3.enhance cardiac rehabilitation,
4.lower cardiovascular risk factors.

Other health benefits:
1. musculoskeletal and mental health improvements,
2.reduced symptoms of asthma in asthmatics.
3.improve mood and anxiety more than other exercises, such as jogging or walking.

MEDITATION

DOC WHAT IS MEDITATION?

Meditation is a method to make the mind calmer and more focused.

Meditation can also help to understand body and mind interaction.

Meditation can help to transform the mind:
1.from negative to positive,
2.from disturbed to peaceful,
3.from unhappy to happy.

Overcoming negative minds and cultivating constructive thoughts is the purpose of the transforming meditations found in the Buddhist tradition.

There is the need for Meditation because:
1.many people feel stressed and over-worked as the result of the hectic pace and stress of modern life
2.there appears to be insufficient time in the day to get everything done.
3.The stress and tiredness make people unhappy, impatient and frustrated.
4.Loss of self confidence in achievements can cause despondency or irritation.

The Purpose of Meditation is:
1.The purpose of meditation is to make the mind calm and peaceful.
2.If the mind is peaceful, there will no worries and mental discomfort and true happiness will be achieved
3.Meditation training will help the mind to gradually become more and more peaceful and a purer form of happiness will be obtained.
4.Eventually the person will be able to stay happy all the time even during the most difficult circumstances.
5.Training in meditation creates an inner space and clarity that enables the person to control our mind regardless of the external circumstances.
6.Gradually the person develop mental equilibrium, a balanced mind that is happy all the time.
7.In this way the person will come to experience a permanent inner peace known as nirvana where day and night in life after life there will be only peace and happiness.

The Benefits of Meditation are:
1.Meditation will remove all distracting thoughts and there will a sense of inner peace and relaxation.
2.When the otherwise incessant flow of distracting thoughts is calmed through concentrating on the breath, the mind becomes unusually lucid and clear.
3.The mind will feel lucid and clear and the body will feel refreshed.  
4.It is possible to experience inner peace and contentment just by controlling the mind without having to depend at all upon external conditions.
5.Much of the stress and tension comes from our mind
6.When the turbulence of distracting thoughts subsides and their mind becomes still, a deep happiness and contentment naturally arises from within.
7.This feeling of contentment and well-being helps the mind to cope with the busyness and difficulties of daily life.
8.Many of the problems in life including ill health are caused or aggravated by this stress and can be overcome with meditation.
9.Difficult situations will become easier to deal with.
10.The mind will naturally feel warm and well disposed towards other people, and the relationships with others will gradually improve.

A Simple Breathing Meditation

1.The first stage of meditation is to stop distractions and make the mind clearer and more lucid. This can be accomplished by practising a simple breathing meditation.
2. Choose a quiet place to meditate and sit in a comfortable position.
The most important thing is to keep the back straight to prevent the mind from becoming sluggish or sleepy.
3.First stop distractions and make the mind clearer and more lucid.
4.Sit with our eyes partially closed and turn the attention to the breathing.Breathe naturally, preferably through the nostrils, without attempting to control the breath.Be aware of the sensation of the breath as it enters and leaves the nostrils.
5.remain focused single-pointedly on the sensation of the breath
6.Slowly by focusing on the breathing, the mind becomes relaxed and that is the essence of meditation .

TINNITUS TREATMENT

DOC I NEED TINNITUS TREATMENT

Treatment depends on the type of hearing loss and degree of tinnitus.
A.Medicines and others
1.antianxiety or antidepressant medication

2.relaxation techniques help when stress is a factor.

3.Avoiding caffeine which may worsen symptoms.

4.Biofeedback may  diminish tinnitus in some patients.

5.Avoid aspirin  in large quantities

6.protection of hearing and avoiding loud noises

B.Non-invasive.
The treatment can be in the form of
1.hearing aid,
Hearing Aid  may have dual functions. It helps to improve hearing acuity, clearer speech understanding as well as to cover the tinnitus effect. However, it may be unsuitable for people with a reduced sound tolerance level, and sensitivity to loud, unpleasant sounds .

2.Tinnitus Retraining Therapy (TRT),
Tinnitus Retraining Therapy (TRT) has been widely used for many years.
The approach is to desensitize the tinnitus via a broadband tinnitus masker (such as the sound of a fan, radio, or white noise machine) along with a specific course of counselling to retrain the brain of sufferers until they are habituated to the tinnitus and it is no longer disturbing.

The therapy may be long-term and time-consuming.

3.Neuromonics tinnitus treatment -very successful in ‘desensitizing’ patients towards their tinnitus.
The sound stimulus is transmitted at specific intervals coordinated with embedded music  2-3 hours a day when the tinnitus is most disturbing.
The idea is to desensitize the brain’s limbic system until patients becomes used to it and get relief.
The treatment can occur while reading, relaxing, doing house chores, computer work or before going to bed. During the treatment process, patients are guided through an interactive and progressive programme of care with the audiologist, as they adjust to each stage of treatment. The audiologist will then assess the patients’ progress.

It is a 6 months program involving the following stages:
1.Pre-conditioning stage (first 2 months) – use of special shower sound to interact with the tinnitus.
2.Active stage (subsequent 4 months) – constant interaction with the tinnitus.

At the end of 6 months program, the sufferer enters the maintenance stage when he/ she can manage without clinical support.
Generally, the treatment involves stimulating the hearing pathways affected by tinnitus or hearing loss with a customized music therapy.

Over 90% reported:
a.A relief from their tinnitus
b.Ability to sleep well
c.A sense of control over their tinnitus
d.A decreased sound disturbance from tinnitus

4.Counselling & Educational Support
If the tinnitus is not serious, the patients can see a counsellor or a psychologist for direct counselling program, and educational support. The purpose is to provide :
a.advice and information about tinnitus;
b.explain what self-help strategies are available for patients and how they work;
c.current medical treatment and management,
d.availability of group support and facilities.

C.Surgery
Surgery of the acoustic nerve to block the tinnitus only for individuals who're becoming or definitely deaf.

Other surgeries may be used when the tinnitus is caused by a tumor across the ear,  the tumor is usually eliminated.

Prognosis:
Depending on the type of tinnitus, symptoms will tend to recur over time.
Stress level, diet, and  noise exposure can worsen tinnitus.
Many people find their tinnitus annoying but can learn to adapt without difficulty.

Prevention:
1.Protect your hearing at work.
2.When around any noise that bothers your ears (a concert,  hunting), wear hearing protection or reduce noise levels.
3.Everyday noises such as blow drying the hair or using a lawnmower can require noise protection.Keep ear plugs or earmuffs handy for these activities.

TINNITUS

DOC I HAVE TINNITUS

Tinnitus is the symptom of perception of sound in the human ear or head in the absence of external sounds.
It is not a illness.
The sound is sometimes accompanied by hearing loss and dizziness in a syndrome known as Meniere's diseas

It affects a large proportion of adult population.
Almost 12 percent of men who are 65 to 74 years of age are affected by tinnitus.
1.Construction site workers
2.MP3 player users
3.Rock concert goers
4.Gun and rifle users

The causes of Tinnitus are:
1.hearing loss is the most common cause.
Age or trauma to the ear (through noise, drugs, or chemicals)cause the damage of the portion of the ear for hearing (the cochlea) becomes damaged.
Because the cochlea do not send the normal signals to the brain, the brain becomes confused and essentially develops its own sound (the tinnitus) to make up for the lack of normal sound signals.

2.ear trauma is usually noticed in both ears, because both ears are usually exposed

3.the harmful effects of excessively loud noise from firearms, high intensity music, or other sources is a very common cause of tinnitus because of  hearing damage

4.ear infection or excess wax in the ear can affect  the ear.

5.drugs such as aspirin (if overused), aminoglycoside antibiotics and quinine may damage the hearing nerve.

6.brain tumor known as an acoustic neuroma which grow on the nerve that supplies hearing can cause tinnitus.
This tinnitus usually affects one ear unlike  the hearing loss  seen in both ears.

Signs & Symptoms
The sound that they perceive in the ear or head has been described as:
1.ringing,
2.whistling,
3.vacuuming,
4.hammering,
5.buzzing
6.humming sounds.

About 2% of tinnitus sufferers have:
1.Disturbed sleeping patterns.
2.Anxiety and depression.
3.Inability to relax and concentrate.
4.Sensitivity to loud sounds and noises.
5.A negative impact on work, family and social life.

An ENT doctor may be consulted for tinnitus:

1.When medical and/or surgical contraindications are not present.
2.family members are worried or concerned about the “non-stop” tinnitus.
3.Your sleep, concentration and general health is affected.

Exams and Tests
1.complete history and physical examination of the head and neck
2.A complete hearing test (audiogram)
3.auditory brainstem response
4.brain scan such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be required.
5.blood tests for hyperthyroidism may be taken.
6.spinal tap may be rarely performed to measure the fluid pressure in the skull and spinal cord.

EATING DISORDERS

DOC I HAVE EATING DISORDERS

Eating disorders is defined as the persistent refusal of a person to eat resulting in marked loss of weight.


It is a psychological problem with patient becoming obsessed with his or her so called obesity with intent to lose weight as a result  


This condition is more prevalent in women than in men.


Onset usually occur in puberty.

Eating disorders include:
1.anorexia nervosa - refusal to eat or eating very minimally
2.bulimia - eating followed by vomiting
3.binged eating with induced vomiting

The most common cause is obstensible fear of obesity resulting in excessive dieting.

There is this distorted image of the body size related to social norms and psychosexual conflicts.

Other causes are:
1.anxiety


2.depression


3.low self esteem


4.troubled family and personal relationships


5.history of physical or sexual abuse


6.cultural and social norms that value people on basis of physical appearance and not inner qualities and strength


7.sometimes may be hereditary - It may run in families

Symptoms of eating disorders are:
1.progressive and excessive weight loss


2.loss of muscle mass (thin stick like)


3.loss of bone mass with osteopenia, osteoporosis , possible fractures,


4.Damage to esophagus, lining of stomach, gastritis, bloating from gas


5.Associated induced endocrine changes (amenorrhea, hirsutism)


6.Stunted growth due to  insufficient growth hormones as a result of  malnutrition


7.Weakened immune system with icy hand and excess hairs on the skin (body too cold)


8.Anemia and Induced vitamin deficiency due to poor nutrition


9.Fainting spells, sleep disruptions, mental confusion, seizures due to insufficient nutrients to the brain


10.Low blood sugar with chills, giddiness, shaking and restlessness from insufficient absorption of sugars


11.Disruption of body fluid mineral balance especially potassium can affect the heart with irregular heart beat , cardiac arrest and death


12.general organ failure resulting in kidney and liver damage from insufficient nutrients to the body's organs


13.Constipation, urinary and anal incontinence, resulting from weakened perineal muscles of the pelvis

14.Mental development and psychological development may be affected from the lack of nutrients to the brain

Treatment of eating disorders:
1.Hospitalization is necessary when the condition becomes life threatening


2.Weight restoration to improve mood and health of patient

3.Correction of nutrition and metabolic deficiency in patient


4.Psychotherapy and counseling of individual to develop healthy ways of controlling one's life


5.Use of antidepressant and serotonin blockers and other newer medications for depression and anxiety


6.Support groups to help family and nutritional counseling

Prognosis of eating disorders:
1.Good in mild cases


2.Poor in severe cases,may be fatal