FOOD ALLERGIES

DOC I HAVE FOOD ALLERGIES One of the most common types of the allergy is food allergy. Your immune system believes that food proteins which you enter in your body are harmful, so it reacts with attack. Your immune system make mistake so it recognizes substances of the food as harmful. Immune system makes amounts of the antibodies which try to fight these substances. The causes of Food Allergy are: Every food may cause allergy, but the most foods that are cause of allergy are: 1.tree nuts, peanut,and hazelnut 2.milk, 3.Eggs are rare food allergy, but this food may trigger anaphylaxis 4.fish,seafood like shellfish, prawns, crabs,lobsters or squids 5.duck 6.soy, wheat . Majority of people outgrow their food allergies, but there are people who are allergic on certain food for whole life. In that case the best solution is to avoid these foods. So, before you have to eat something, it is recommended to read all ingredients in the food. If you find that food contain ingredients on which you are allergic, you shouldn't eat it The symptoms of Food Allergy are: Food allergy symptoms may vary from mild to total collapse of the body, followed in the worst cases with the death. These severe symptoms of food allergy are known as anaphylaxis. Anaphylaxis is followed with violent allergic reaction from certain types of the food. Most common symptoms of the food allergy are:   1.Feeling of tingling in the mouth   2.Tongue and throat swelling   3.Problem with breathing, difficult breathing   4.Hives   5.Vomiting   6.Cramps in the stomach   7.Diarrhea   8.Low Blood pressure   9.In the worst cases death Usually these symptoms appear within minutes to two hours after you have entered certain food to which you are allergic. The Treatment of Food Allergy is: Medical treatment may be urgent in severe cases of food allergy. 1. One of the medical treatment is also known as epinephrine or also known as adrenaline. This medication is only for most severe cases. 2.Antihistamines are used to counter the histamine in the food causing the allergy 3.Corticosteroids may be given to counter the immune reactions from the food allergy Prevention of food allergy is by: If you are allergic on certain food, it doesn't mean that you should stop with eating food on which you are not allergic. It is recommended to write a food diary and make a list of the food on which you are allergic. If you got some reaction to certain food, you need to write in your diary the food that cause allergy. This food diary will help the doctor  know which food you are allergic to.

PANIC ATTACKS

DOC I HAVE A PANIC ATTACK

Panic attacks are sudden feelings of terror occuring without warning.
These episodes can occur at any time even while asleep

Most people with panic attacks may experience:
1.Fast heart beats
2.Feeling weak, giddy or faint
3.Tingling or numbness in the hands and fingers
4.Sense of terror of impending doom or death
5.Having cold sweats
6.Chest pains
7.Breathing difficulties
8.Feeling loss of control

Panic attacks are generally short lasting less than ten minutes

People with one panic attack are at greater risk for having another panic attacks than those who never had a panic attack.

Panic Disorder is when the attacks occur repeatedly .

The causes of Panic attacks are:

A.Panic attacks may be symptoms of an anxiety disorder.


Panic attacks occur twice as often for women than men.


The peak age of a person's first panic attack (onset) is 15-19 years.

Unlike other anxiety forms, panic attacks are very sudden and often unexpected, unprovoked, and are often disabling.

B.Panic attacks can also occur in:
1.posttraumatic stress disorder (PTSD),
2.schizophrenia,
3.intoxication (alcohol or drugs)
4.thyroid abnormalities
5.anemia,
6.certain medications such as:
a.stimulants like methylphenidate (Ritalin),
b.diabetes medications like metformin and insulin,
c.antimalarial medications like quinine,
d.food additives like aspartame
7.withdrawal from certain drugs of abuse.
8.corticosteroid withdrawal, such as withdrawal from dexamethasone (Decadron).

The types of Panic attacks are:

During a panic attack he or she may develop irrational fears called phobias,
At this stage, the person is said to have panic disorder with agoraphobia.

The  symptoms and signs of Panic Attacks are:
The symptoms of a panic attack appear suddenly, without any apparent cause.
1.racing or pounding heartbeat (palpitations);
2.chest pains;
3.stomach upset;
4.dizziness, lightheadedness, nausea;
5.difficulty breathing, a sense of feeling smothered;
6.tingling or numbness in the hands;
7.hot flashes or chills;
8.trembling and shaking;
9.dreamlike sensations or perceptual distortions;
10.terror, a sense that something unimaginably horrible is about to occur and one is powerless to prevent it;
11.a need to escape;
12.nervousness about the possibility of losing control and doing something embarrassing;
13.fear of dying.

The duration of a panic attack typically lasts for more than 10 minutes,

The Complications from a Panic Attack are:
individuals with panic disorder seem to be at higher risk of having a heart valve abnormality called mitral valve prolapse (MVP)which needs special precautions to be taken when treated for any dental problem.

Anxiety attacks while asleep called nocturnal panic attacks affect about 40%-70% of those who suffer from daytime panic attacks.
People who suffer from panic symptoms while sleeping tend to
1.have more respiratory distress associated with their panic.
2.experience more symptoms of depression and other psychiatric disorders
3.to wake suddenly from sleep in a state of sudden fear or dread for no apparent reason.

The duration of nocturnal panic attacks tends to be less than 10 minutes.

Treatment of Panic Attacks:
1.Reassurance from Doctors that it is not dangerous.ECG is done to exclude heart conditions.

2.Rest


3.Psychotherapy and counseling


4.Mild tranquilliser may be given if necessary


5.Avoid drinking alcohol, smoking, and stimulant drugs

Panic attacks in children may result
1.in the child's grades declining,
2.avoiding school and other separations from parents,
3.substance abuse,
4.depression, and
5.suicidal thoughts, plans, and actions.

AGING

DOC I AM AGING

Aging is the process where the human body accumulate damage to its cells. tissues and organs as it grows older.

This accumulated damage is believed to be the result of oxidation damage to the cell contents from free radicals.

Average and maximum lifespans:
The maximum life span for humans is currently maximized at approximately 120 years
Average lifespan in a population is lowered:
1.infant and child mortality is frequently linked to infectious diseases or nutrition problems.

2.accidents and age-related chronic disease such as cancer or cardiovascular disease play an increasing role in mortality.

 Extension of lifespan can often be achieved by:
1.improved medical care,
2.vaccinations,
3.good diet,
4.exercise
5.avoidance of bad habits such as smoking.

Maximum lifespan is determined by
1.the rate of aging inherent in its genes and by environmental factors.
2.calorie restriction.
3.breeding from only older members.

Anti-aging medicine is the study of slowing down or reversing the processes of aging to extend both the maximum and average lifespan.

In Theory extension of maximum lifespan could be achieved by
1. reducing the rate of aging damage,
2. periodic replacement of damaged tissues,
3. molecular repair or rejuvenation of deteriorated cells and tissues
4. enhancement of telomerase enzyme activity.

 Diets and supplements
1.nutrition—diets or supplements—as a means to extend lifespan
2.antioxidant supplements, such as Vitamin C, Vitamin E, Q10, lipoic acid, carnosine, and N-acetylcysteine, may extend life if the free radical theory of extending life is to be believed
3.oxytocin, insulin, human chorionic gonadotropin (hCG), and erythropoietin (EPO).
4.Resveratrol is a sirtuin stimulant that appears to extend lifespan in simple organisms

Hormone treatments
1.low-dose GH treatment for adults with GH deficiency changes the body composition by
a.increasing muscle mass, decreasing fat mass,
b.increasing bone density and muscle strength,
c.improves cardiovascular parameters (i.e. decrease of LDL cholesterol)
d.affects the quality of life without significant side effects.

Nanotechnology
nanomedicine could give rise to life extension through the repair of many processes thought to be responsible for aging.

Cloning and body part replacement
therapeutic cloning and stem cell research could one day provide a way to generate cells, body parts, or even entire bodies  that would be genetically identical to a prospective patient.

Cryonics
1.storing the body at low temperatures after death may provide an entry into a future in which advanced medical technologies may allow resuscitation and repair.
2.cryogenic temperatures will minimize changes in biological tissue for many years, giving the medical community ample time to cure all disease, rejuvenate the aged and repair any damage that is caused by the cryopreservation process.

Strategies for Engineered Negligible Senescence (SENS)
combine existing and predicted future biochemical and genetic techniques to a cure for cancer, stem cell treatments, addition of new enzymes to the human body and moving mitochondrial DNA to the cellular nucleus.

Genetic modification
artificial genes are integrated with an organism to replace mutated or otherwise deficient genes,
Targeting catalase to the mitochondria resulted in a 20% lifespan increase in mice, and improved performance in therapeutically infected mice.

Fooling genes
an approach to life-extension that involves fooling genes into thinking the body is young
The basic idea is that our bodies are composed of genes that activate throughout our lifetimes, some when we are young, and others when we are older.
These genes are activated by environmental factors and the changes caused by these genes activating can be fatal.

PREGNANCY TRIMESTERS

DOC I AM PREGNANT 2

Pregnancy is typically broken into three periods, or trimesters, each of about three months.
First Trimester:
The first 12 weeks of pregnancy are considered to make up the first trimester.
The first two weeks are the two weeks before conception.
The third week is the week in which fertilization occurs.
In the 4th week, the fertilized egg reaches the uterus and burrows into its wall which provides it with the nutrients it needs. At this point it is called an embryo which connects via the umbilical cord to the placenta in the wall of the womb.
The 5th week marks the start of the development of the embryo.
This is the time when the embryo's brain, spinal cord, heart and other organs begin to form.

At this point the embryo is made up of three layers,
1.the top one (called the ectoderm) will give to the embryo's layer of skin, central and peripheral nervous systems, eyes, inner ear, and many connective tissues
2.the middle layer (the mesoderm) will give rise to the heart and the beginning of the circulatory system as well as the bones, muscles and kidneys.
3.the inner layer (the endoderm) will give rise to the development of the lungs, intestine and bladder.

In the 6th week, the embryo will be developing basic facial features
Its arms and legs also start to grow.
In the 7th week, the brain, face and arms and legs quickly develop.
In the 8th week, the embryo starts moving
In the next 3 weeks, the embryo's toes, neck and genitals develop as well.
By the end of the first trimester, the fetus will be about 3 inches (76 mm) long and will weigh approximately 1 ounce(28g).

Second trimester
Weeks 13 to 28 of the pregnancy are called the second trimester.
Most women feel more energetic in this period, starting to put on weight as the symptoms of morning sickness fade away.
The movement of the fetus, often referred to as "quickening", typically happens in the fourth month, and can be felt in the 20th to 21st week, or earlier if the woman has been pregnant before.
The placenta fully functions at this time and the fetus makes insulin and urinates.
The reproductive organs differentiate the fetus as male or female.

Third trimester
Final weight gain takes place from the 29 to 40 weeks of pregnancy.
The fetus will be growing the most rapidly gaining up to 28 g per day.
The woman's belly will transform in shape as the belly drops due to the fetus turning in a downward position ready for birth.
Fetal movement can become quite strong and can be uncomfortable to the woman.
This period of her pregnancy can be uncomfortable, causing symptoms like weak bladder control and backache.
Movement of the fetus becomes stronger and more frequent.
There is head engagement ( the fetal head descends into the pelvic cavity) so that only a small part  can be felt abdominally.
The perenium and cervix are further flattened and the head may be felt vaginally.
Because the head engagement severely reduces bladder capacity, increases pressure on the pelvic floor and the rectum,the
mother may experience the perpetual sensation that the fetus will "fall out" at any moment.

Childbirth
This is the process whereby an infant is born.
It is considered to be the beginning of the infant's life.
A woman is considered to be in labour when she begins experiencing regular uterine contractions, accompanied by changes of her cervix — primarily effacement and dilation. There may be waterbag bursting or blood(show)
Most childbirth is widely regarded as painful, some women do report painless labours
Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a cesarean section.

During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through the release of oxytocin, a hormone also released during breastfeeding.

PREGNANCY

DOC I AM PREGNANT
Pregnancy is the carrying of a fetus or embryo in the womb of a woman. 

The term embryo is used to describe the developing offspring during the first 8 weeks following conception while the term fetus is used from about 2 months of development until birth.

Human pregnancy is divided into three trimester periods:
1.The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus).
2.The second trimester, the development of the fetus can be more easily monitored and diagnosed.
3.The third trimester often approximates the ability of the fetus to survive outside of the uterus.

 Fertilization
The process leading to pregnancy occurs earlier usually in the fallopian tube when the female egg is penetrated by the male spermatozoon following the act of sexual intercourse.
This process is referred to as fertilization or conception.
The fertilized egg then travel down the fallopian and implants itself into the inner lining of the womb or uterus.
Once implanted in the uterus the embryo will grow to become a fetus at 2 months before coming out of a normal pregnant mother's womb at 38 weeks from conception to become a newborn baby.
After implantation into the lining of the womb, the embryo secretes a hormone named human chorionic gonadotropin which in turn stimulates the corpus luteum in the woman's ovary to produce progesterone.
The progesterone act to maintain the lining of the uterus so that the embryo will continue to be nourished by the glands in the lining of the uterus.
The capillaries will be stimulated to grow from the wall of the uterus to form the placenta which allow the embryo to receive vital nutrients from the woman's blood supply.The umbilical cord is the connecting cord from the embryo or fetus to the placenta and allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply.

The expected date of delivery is 40 weeks counting from the first day of the last menstrual period and birth usually occurs between 38 and 42 weeks.Even though pregnancy begins at conception, it is more convenient to date from the first day of a woman's last menstrual period.

Diagnosis of pregnancy:
The beginning of pregnancy may be detected by a pregnant woman without medical testing through a number of symptoms of pregnancy:
1. nausea and vomiting,
2. excessive tiredness and fatigue,
3. cravings for certain foods
4. frequent urination particularly during the night.

Signs of pregnancy include:
1.the presence of human chorionic gonadotropin (hCG) in the blood and urine can be detected as early as 12 days after implantation
2.missed menstrual period,
3.implantation bleeding during the third or fourth week after last menstrual period,
4.increased basal body temperature sustained for over 2 weeks after ovulation,
5.Chadwick's sign (darkening of the cervix, vagina, and vulva),
6.Goodell's sign (softening of the vaginal portion of the cervix),
7.Hegar's sign (softening of the uterus isthmus),
8.pigmentation of linea alba – darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around the 22nd week of pregnancy
9.Breast tenderness and darkening of the nipples is common
10.an early obstetric ultrasonography can determine the age of the pregnancy fairly accurately based on the last menstrual period.

LASIK SURGERY

DOC I HAVE LASIK SURGERY

LASIK (an acronym for laser-assisted in situ keratomileusis) is a type of refractive surgery done by ophthalmologists for correcting myopia, hyperopia, and astigmatism using excimer laser.

The LASIK technique use of the laser was to change the surface shape of the cornea first done in 1991.

The operation itself involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser.
The flap is repositioned and the eye is left to heal in the postoperative period.

Preoperative:
Patients who are wearing soft contact lenses are instructed to stop wearing them 5 to 21 days before operation.

The patient's corneas are examined with a pachymeter to determine their thickness and to measure their surface contour.

This process also discover astigmatism and other irregularities in the shape of the cornea.

With this information the eye surgeon calculates the amount and the locations of corneal tissue to be removed during the operation.

The patient typically is given a course of antibiotic beforehand to minimize the risk of infection.

Operation:
The operation is performed when the patient is awake and mobile although he/she is sometimes given a mild sedative (such as Valium) and anesthetic eye drops.

LASIK is performed in three steps.
A corneal suction ring is applied to the eye, holding the eye in place.
1.create a flap of corneal tissue.

Once the eye is immobilized, the flap is created with a mechanical microkeratome using a metal blade, or a femtosecond laser microkeratome that creates a series of tiny closely arranged bubbles within the cornea.
A hinge is left at one end of this flap.
The flap is folded back, revealing the stroma, the middle section of the cornea.

2.remodeling of the cornea underneath the flap with the laser.
An excimer laser (193 nm) is used to remodel the corneal stroma.
The laser vaporizes tissue in a finely controlled manner without damaging the adjacent stroma.

3.the flap is repositioned.
After the laser has reshaped the stromal layer, the LASIK flap is carefully repositioned over the treatment area by the surgeon and checked for the presence of air bubbles, debris, and proper fit on the eye.
This flap stays in position by natural adhesion until healing is completed.

Postoperative care:
Patients are usually given a course of antibiotic and anti-inflammatory eye drops.
Patients are usually told to sleep much more and are also given a darkened pair of shields to protect their eyes from bright lights and protective goggles to prevent rubbing of the eyes when asleep and to reduce dry eyes.
They also are required to moisturize the eyes with preservative-free tears.
Proper post-operative care is important to prevent the risk of complications.

LASIK surgery results:
The surveys determining patient satisfaction with LASIK have found most patients satisfied, with satisfaction range being 92–98 percent.

Complications:
Intraoperative complications
1.flap complications
2.slipped flap (a corneal flap that detaches from the rest of the cornea) is one of the most common complications.
3.Flap interface particles

Early postoperative complications
1.dry eye symptoms at 6 months period post surgery.
2.diffuse lamellar keratitis (DLK),
3.infection responsive to treatment.Infection under the corneal flap is possible.

Late postoperative complications
1.A subconjunctival hemorrhage
2.Surgery induced dry eyes or in severe cases chronic dry eye.Due to 70% of corneal nerves that are severed during the Lasik operation , the lubrication system of the eye is affected and nerves may never recover to pre-operative condition.
3.Overcorrection or undercorrection
4.Vitamin D deficiency from Sun sensitivity
5.Visual acuity fluctuation
6.Halos or starbursts around light sources at night
7.Light sensitivity
8.Ghost images or double vision
9.Wrinkles in flap (striae)
10.Decentered ablation
11.Debris or growth under flap
12.Thin or buttonhole flap
13.Induced astigmatism
14.Corneal Ectasia -decrease in the number of corneal keratocytes (fibroblasts) after LASIK.
15.Floaters
16.Epithelium erosion
17.Posterior vitreous detachment
18.Macular hole.
19.flap dislocations have been reported 1–7 years post-LASIK.
20.intraocular pressure, essential in glaucoma screening and treatment.
21.retinal detachment
22.choroidal neovascularization
23.uveitis
24.keratomileusis effected at a later age increases the incidence of corneal higher-order wavefront aberrations.
25.Microfolding -an almost unavoidable complication of LASIK usually negligible
26.Blepharitis,  with crusting of the eyelashes can lead to infection or inflammation of the cornea after LASIK.

Newer methods like Femtosecond laser intrastromal vision correction via all-femtosecond correction (like Femtosecond Lenticule Extraction, FLIVC, or IntraCOR), or other techniques that avoid permanently weakening the cornea with incisions and deliver less energy to surrounding tissues will replace LASIK Surgery.

CONGESTIVE HEART FAILURE

DOC I HAVE CONGESTIVE HEART FAILURE

Congestive Heart failure occurs when the heart can not pump enough blood to the rest of the body.

This condition may affect either the right side or the left side of the heart. Often both sides of the heart are involved.

The Causes of Congestive Heart failure are:

When the heart is unable to pump enough oxygen-rich blood out to the rest of the body, blood may back up in other areas of the body.

Fluid builds up in the lungs, liver, gastrointestinal tract, and the arms and legs.

This is called congestive heart failure.

The main causes are:
1.coronary artery disease (CAD) a narrowing of the small blood vessels that supply blood and oxygen to the heart.

2.cardiomyopathy-Heart failure can also occur when an infection weakens the heart muscle and the heart muscle enlarges to compensate.

3.Congenital heart disease -defects in the heart of the newborn affects the pumping action of the heart

4.Heart valve disease - abnormal valves affects the blood flow through the heart

5.Some types of abnormal heart rhythms(arrhythmias) affects efficiency of blood flow through the heart

6.Emphysema - chronic lung disease affect the heart lung circulation

7.Overactive thyroid - fast heart beat affects the heart pumping action

8.Severe anemia -insufficient blood affects the blood flow in the heart

9.Underactive thyroid - slow heart beats also affects the heart

Symptoms:

Symptoms of heart failure usually begin slowly.
1.breathing problems occurs even while resting.

2.Cough worse at night

3.Fatigue, weakness, faintness

4.Loss of appetite

5.Need to urinate at night

6.Pulse that is fast or irregular, or palpitations(feeling of fast heart beats)

7.Shortness of breath when active or lying down

8.Swollen (enlarged) liver or abdomen

9.Swollen feet and ankles

10.Waking up from sleep as a result of shortness of breath

11.Weight gain

Heart failure symptoms can also begin suddenly; for example, after a heart attack or other heart problem.

Signs

1.Fast or difficult breathing

2.Irregular or fast heartbeat and abnormal heart sounds

3.Leg swelling (edema)

4.Neck veins that stick out (distended)

5.Sounds (creps) from fluid buildup in lower parts of the lungs

6.Swelling of the liver or abdomen

Diagnosis:
An echocardiogram (ultrasound) is the best test to diagnose, find the cause of, and monitor the heart failure because it can check on the blood flow through the heart.

Imaging tests are useful:
1.Cardiac stress tests
2.Heart catheterization
3.MRI of the heart
4.Nuclear heart scans

Laboratory tests are done to check on:
1. kidneys condition (BUN, creatinine, creatinine clearance, urinalysis)

2.low blood count or anemia -- full blood count (FBC)

3.Test for brain natriuretic peptide (BNP)

4.sodium and potassium levels in your blood

Treatment:

MONITORING

1.Follow-up appointments to check the heart function.

2.Knowledge of symptoms indicating heart failure is getting worse
a.changes in your heart rate,
b.pulse rhythm
c.blood pressure,
d.weight.

3.Weight gain within a day or two may be a sign of extra fluid in the body and the heart failure is getting worse.

4.reduce the salt eaten and limit the fluid taken during the day.

5.Avoid alcohol

6.Avoid smoking

7.Keep active walking or riding a stationary bicycle. Avoid exercise on days when there is increased fluid or weight.

8.Lose weight if overweight.

9.Lower your cholesterol by diet

10.Rest is needed for the heart .

MEDICATIONS

Medicines treat the symptoms, prevent the heart failure from getting worse, and prolong life

Medicines like diuretics,aspirin and digoxin will:
1.Help the heart muscle pump better

2.Keep the blood from clotting

3.Lower the blood pressure

4.Open up the blood vessels or slow the heart rate

5.Replace potassium

6.Rid your body of excess fluid and salt (sodium)

Surgery:
1.Coronary bypass surgery (CABG) and angioplasty may help improve blood flow to the damaged or weakened heart muscle.

2.Heart valve surgery may be done if damages to the heart valve are causing heart failure.

3.A pacemaker can help treat slow heart rates or help both sides of the heart contract at the same time.

4.A defibrillator sends an electrical pulse to stop life threatening abnormal heart rhythms.

SEVERE HEART FAILURE
Severe heart failure occurs when treatments no longer work.
Certain treatments may be used when a person is waiting for a heart transplant:
1.Intra-aortic balloon pump (IABP)
2.Left ventricular assist device (LVAD)

Prognosis:

Very often the heart failure can be controlled by taking medicine, changing to a healthy lifestyle, and treating the underlying condition.

Heart failure can suddenly get worse due to:
1.Angina
2.Eating high-salt foods
3.Heart attack
4.Infections or other illnesses
5.Not taking medicines correctly

Heart failure is usually a chronic illness, which may get worse over time.
Some people develop severe heart failure, in which medicines, other treatments, and surgery no longer help.

ANTIOXIDANTS

DOC WHAT ARE ANTIOXIDANTS

Antioxidants are substances that may protect the  cells in the body against the effects of free radicals.

Free radicals are molecules produced by:

1. Oxidation—one of the body's natural chemical processes—can produce free radicals which are highly unstable molecules that can damage cells.

Free radicals are produced when the body breaks down foods like carbohydrates, proteins and fats for use as glucose, amino acids or fatty acids or storage in the body

2.environmental exposures like tobacco smoke, radiation, and environmental contaminants can produce free radicals from chemical reactions in the environment .

These free radicals can start  chain reactions which can occur in a cell resulting in  damage or death to the cell.

Free radicals can damage  the cells in the body and therefore may play a role in Alzheimer's disease, cancer, eye disease, heart disease, Parkinson's disease, and rheumatoid arthritis.

Antioxidants are found in many foods.

1.fruits and vegetables, nuts, grains

2. meats, poultry and fish.

Antioxidants are substances that may protect the cells  of the body from potentially disease-producing cell damage that can result from natural bodily processes and from exposure to certain chemicals.

The body can produce its own antioxidants and also obtain them from food.

Antioxidants are abundant in vegetables and fruits and are also found in grain cereals, teas, legumes, and nuts.

Antioxidant substances include anthocyanins, beta-carotene, catechins, coenzyme Q10, flavonoids, lipoic acid, lutein, lycopene, selenium, and vitamins C and E

People take antioxidant supplements in an effort to improve their health and to prevent various diseases

Systematic reviews of the research literature have concluded that there is not enough evidence to support the use of antioxidant supplements for preventing cancer, cardiovascular disease, and eye disease, and reducing overall mortality in healthy people and people with various diseases

One exception is the combination of antioxidants and zinc reduced the risk of developing advanced stages of age-related macular degeneration (AMD) by 25 percent in people who had intermediate AMD or advanced AMD in only one eye. Antioxidant supplements used alone reduced the risk by about 17 percent.

Safety of Antioxidants

Antioxidants in foods are generally considered safe.
However beta-carotene supplements have been found to increase the risk of lung cancer in smokers.
vitamin E supplements may increase the risk of bleeding in certain people.

Use of Antioxidants

Do not use antioxidant supplements:

1.as a replacement for a healthful diet

2.as conventional medical care,

3.to postpone seeing a doctor about a medical problem.

SCHIZOPHRENIA

DOC I HAVE SCHIZOPHRENIA

Schizophrenia is a complex mental disorder characterized by symptoms involving:
1.personality
2.Thinking non logically
3.emotionally unstable responses,
4.Behaving abnormally in social situations
5.tendency to withdraw from reality to a private personal world

Schizophrenia is a complex illness.
The cause is yet unknown.
1.genetic factors - schizophrenia has a history of
a family member with the disease.
2.environmental events may trigger schizophrenia in people who are genetically more at risk for it.
3.Schizophrenia affects both men and women equally.
4.It usually starts in the teen years or young adulthood, but may start later in life.
It usually begin later in women, and is milder.
5.Childhood-onset schizophrenia begins after age 5. Childhood schizophrenia is rare.

Schizophrenia symptoms develop slowly over months or years.
1.difficulty keeping friends and working.
2.anxiety,
3.depression,
4.suicidal thoughts or behaviors.

Early symptoms are:
1.Irritable or tense feeling
2.Difficulty sleeping
3.Problem concentrating
4.problems with thinking, emotions and behavior develop, including:
a. Lack of emotion (flat affect)
b. Strongly held beliefs not based in reality (delusions)
c. Hearing or seeing things that are not there (hallucinations)
d. Problems paying attention
e. Thoughts jump between unrelated topics ( loose associations)
f. Bizarre behaviors
g. Social isolation

Paranoid schizophrenia symptoms include:
1.Anxiety
2.Anger or argumentative
3.False believes that people are trying to harm him(paranoia).

Disorganized schizophrenia symptoms include:
1.Difficulty with thinking and expressing ideas clearly
2.Childlike behavior
3.Showing little emotion

Catatonic schizophrenia symptoms include:
1.Lack of activity
2.Muscles and posture rigidity
3.Grimaces or odd expressions on the face
4.No response to other people

Chronic:
All types of Schizophrenia tend to have the following:
1.blunting of affect or emotion
2.incoherant thought
3.delusions
4.hallucinations
5.apathy or withdrawl from society

Diagnosis
1.thorough interview of the person and family

members:
a.length of the symptoms
b.ability to function whether it has changed
c.Developmental background
d.Genetic and family history
2.Brain scans (such as CT or MRI) and blood tests to rule out other disorders

Complications
Having schizophrenia increases the risk for:
1.alcohol or drugs abuse:
Using alcohol or other drugs increases the risks of recurrence.
2.Physical illness:
People with schizophrenia may become physically sick due to an inactive lifestyle and side effects
from medication.
3.Suicide

TOOTHACHE

DOC I HAVE TOOTHACHE

Toothache is the pain around the teeth or jaws usually following a tooth problem.

Toothache can be very severe and may cause the sufferer many sleepless nights.

The causes of Toothache are:

Tooth Problems such as :
1.Dental caries which is caused by the action of the bacteria that lives in plague, a sticky coating of saliva and food debris that forms on the surface of the teeth.

2.a broken tooth

3.an exposed tooth root

4.dental abscess

5.gum disease

Disorders of the temporo-mandibular joints such as:
1.temporomandibular joint arthritis

2.injuries to the jaw or joint

The Symptoms of Toothache is basically pain.
However the pain can be mild to severe or excruciating and chronic.
The toothache may be made worse by chewing on hard food or cold or even heat.

The symptom of toothache and its causes can only be determined by a  professional dental examination which includes X-rays .

the most common cause of toothache is

1.the dental caries and abscess,
a.sensitivity of the tooth to hot/ cold foods and drinks.
b.Pain occurs when the dentin is damaged.
c.Visible pits or holes appear on the enamel

2.Gum disease is the second most cause ot toothache.
Gingivitis or infection of the gums can cause the erosion of gum and bone tissue that surrounds and keep the tooth in place.
As a result of the gum infection and destruction of the bone of the tooth, the nerve of the tooth is affected and send pain signals to indicated the severity of the gum and tooth infection.

3.Tooth roots that are exposed are no longer protected by the gums aand bone of the tooth. The exposed tooth roots can be become very sensitive to cold hot or sour foods.

4.Broken tooth means a fracture of the bone of the tooth. Biting on the bone fracture can severe excruciating pain.

5.Impacted tooth such as wisdom tooth can cause pain if the tooth is pressing against the gums and the nerve surrounding the gums.

6.Temporo-mandibular joints inflammation caused by habitual clenching of teeth
or grinding of teech can caused irritation of the temporo-mandibular joints resulting in spasm of muscles and jaw pain.

Treatment of Toothache:
1.scrape the teeth to remove plague
A flouride gel may be applied to protect the teeth from plague

2.If a cavity is present, the dental surgeon may fill the tooth with fillings made of dental amalgam in molars and premolars and composite resins for the front teeth.

3.in the case of a large cavity or a broken tooth, the dentist will drill the decayed portion of the tooth, fill the cavity and cover the tooth with an artificial crown.

4.root canal treatment involves removal of the tooth’s pulp and replacing it with an inert material.

5.The entire tooth is taken out if the decay is very advanced

6. Brufen or other NSAID pain killers are given for temporo-mandibular joints inflammation and also to relieve toothache in general.

7.Local anesthetic cream or clove oil has been used to apply to tooth with relief of pain

Preventing Decay
Tips for preventing caries include:
1.diet low in sugar
2.good oral hygiene:

a.Brushing teeth twice a day with fluoride toothpaste.
b.Cleaning between teeth daily with floss.

3.regular dental visits and assessment.

4.a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.

BIRTH CONTROL METHODS

DOC I NEED BIRTH CONTROL METHODS

Hormonal Methods:

1.Birth control pills

Birth control pills is taken daily.

Effects are reversible;

lessens menstrual cramps; makes the periods regular; reduces acne; reduces risks of developing ovarian and endometrial cancer;

no protection against STIs; may interfere with other medications

2.Hormonal Injections:

Depo-Provera is an injection that costs a little bit more than the pill but may prevent pregnancy
for 3 months.

Lunelle injection is a monthly progesterone injection but  can only prevent pregnancy for up to one month.

Effects are reversible;

only 4 times a year;

reduces the risk of developing endometrial cancer   

 May cause irregular bleeding or spotting;

no protection against STIs.

3.The Nuva Ring

The Nuva Ring or vaginal ring is a flexible ring that is inserted into the vagina for three weeks
before removal .
The ring contains chemicals such as estrogen and progesterone that releases this into the body.


The birth control patch releases hormones into the body like the the oral pill.

Other methods of birth control are:

1.The Intra Uterine Device

The Intrauterine Device or IUD is a small plastic device that contains hormones and copper.
It thickens the cervical mucus to decrease the chances of an egg from fertilizing as well
physically prevent the sperms from entering the uterus easily.
The device is long-lasting (up to 5 years); no interruption to intercourse;may cause irregular
bleeding or spotting; no protection against STIs; IUD rarely may fall out; a physician is required to insert and remove the IUD

2.Withdrawal Method

The withdrawal method is removal of the male penis out of the girl’s vagina before ejaculation. Effectiveness is 80%.no protection against STIs

3.Sterilization of women and Male reproductive tubes

Sterilization or tubal ligation closes the fallopian tubes permanently and prevent the sperms
from entering the fallopian tube to fertilize the egg.
Men can also have their spermatic duct ligated.
This is called a vasectomy.
Effectiveness is 99.5%;No interference with intercourse;Usually Irreversible; surgery risks; no
protection against STIs

4.Rhythm Method

Natural family planning is using the Rhythm method when sexual intercourse is avoided during the fertile period. Effectiveness is 70-80%; no protection against STIs


5.Abstinence

Abstinence is not engaging in sexual intercourse at all .Effectiveness is 100%.NO STIs.

How to choose your birth control method:

Factors such as  
1.age,
2.frequency of sexual activity,
3.family history regarding genetic disease
4.comfort level when using a particular method,
5.level of desire to be pregnant in the future
are important when choosing an appropriate birth control method.

The usage of a condom has the advantage of  protection against most STIs while hormonal method
is more effective as birth control.

BIRTH CONTROL

DOC I NEED BIRTH CONTROL

Birth Control or Contraception is a term used to prevent pregnancy and control births.

There are different ways of preventing pregnancy:
1.men - includes:
a.condoms
b.withdrawal before ejaculation
c.abstinence during the fertile period
d.vasectomy

2.women - includes:
a.female condom
b.diaphragm
c.cervical cap
d.contraceptic sponge
e.spermicides
f.oral contraceptives
g.birth control patch
h.Progesterone injections
i.Nuva ring
j.IUD
k.sterilization by tubal ligation
l.Rhythm method

Basically there are two major methods of birth control :
1. barrier
2. hormonal.

Other birth control methods include
1.sterilization otherwise known as surgery,
2.withdrawal,
3.natural family planning
4.abstinence which is the simplest method.

In the barrier method , the male or the female uses

1.the condom to prevent the sperm from ever entering the female’s uterus.
The male condom comes in many brands, color and flavors and is usually made of latex rubber.
The condom is placed over the penis when it is erect prior to intercourse.

The female condom on the other hand is made of polyurethane and is seven inches long.
This protect the cervix, vaginal canal and the  areas surrounding the vagina.
The female condom is inserted into the woman’s vagina also prior to intercourse.
Effectiveness is 95%;Protection against certain STIs;May break or slip; makes noises during
intercourse

2. Another barrier method is to use spermicides which is a chemical designed to kill sperm.
The spermicide is available as foam, jelly, foaming tablet or vaginal suppository.
Effectiveness 82% is greatly increased when it is used with a condom, diaphragm or cervical cap;May provide lubrication; can be used by women who breastfeed or smoke;No protection against STIs; may cause allergic reactions in some people

3.the diaphragm that is a soft rubber dome which stretches over a flexible ring that contains
spermicides in the form or cream or jelly.This is inserted inside the woman’s vagina and
placed over the cervix.
The diaphragm should not stay inside the vagina for more than 3 hours prior to intercourse.
Effectiveness 94%;Protection against certain STIs;  Proper insertion is required; may dislodge during intercourse; may cause allergic reactions in some people (due to the spermicide used)

4.The cervical cap is a small cup made of polyurethane just like the condom.
The cup is filled with spermicidal cream and inserted into the girl’s vagina and placed over the
cervix.Effectiveness is 91% (for women who have not given birth) 74% (for women who have given birth before)     Protection against certain STIs; can be fitted 24 hours before intercourse;Proper insertion is required; may dislodge during intercourse; may cause allergic reactions in some people (due to the spermicide used); may cause vaginal discharge and odour

5.the contraceptive sponge is a soft saucer shaped device made from polyurethane like the female
condom.

Besides the above Barrier methods, there are the hormonal birth control methods.

1.Hormonal birth control method can be in the form of an implant, patch, pill or injection.
The purpose is to a.prevent the woman’s ovaries from releasing an egg monthly
b.thicken  the cervical mucus so the sperm will have a difficult time penetrating the egg

c.thin the lining of the uterus so that the chances of a fertilized egg implanting on the uterus wall
is reduced.
d.effectiveness is 98-99%

BIPOLAR DISORDERS TREATMENT

DOC I NEED TREATMENT FOR BIPOLAR DISORDER

Treatment of Bipolar Disorders:

The main goals of treatment are to:
1.Avoid moving from one phase to another
2.Avoid the necessity for a hospital stay
3.Assist the patient function as well as possible between episodes
4.Prevent self injury and suicide by patient
5.Make the periods of manic and depressive phases less frequent and severe

The Doctor may also look for any triggers which may cause the bipolar condition and any medical or emotional problems that might affect treatment.

The  medicines used to stabilize moods are :
1.Carbamazepine
2.Lamotrigine
3.Lithium
4.Valproate (valproic acid) and other antiseizure drugs

Other drugs used to treat bipolar disorder include:
1.Antipsychotic drugs and anti-anxiety drugs (benzodiazepines) for mood problems
2.Antidepressant medications may be added to treat depression.
Some people with bipolar disorders are more likely to have manic or hypomanic episodes if they are put on antidepressants.
Because of this, antidepressants are used  only in people who also take a mood stabilizer.
3.Electroconvulsive therapy (ECT) can be used to treat the manic or depressive phase of bipolar disorder if it does not respond to medication.
ECT uses an electrical current to cause a brief seizure in the patient while the patient is under general anesthesia.
ECT is still the most effective treatment for depression not relieved with medications.
4.Transcranial magnetic stimulation (TMS) uses high-frequency magnetic pulses to target affected areas of the brain. It is used second after ECT.

Patients who are in the middle of manic or depressive episodes may be required to stay in a hospital until their mood is stable and their behavior is under control.

Complications of Bipolar Disorders:

Stopping medical treatment or taking it the wrong way may cause the symptoms to return and lead to the following complications:
1.Alcohol and/or drug abuse
2.Difficulties with relationships, work, and finances
3.Suicidal thoughts and behaviors

Prognosis of Bipolar Disorders:
1.Mood-stabilizing medication can help control the symptoms of bipolar disorder.It is important to help and support the patients to take medicine properly and to make sure that mania and depression are treated as early as possible.

2.Some patients stop taking the medication as soon as they feel better or because the mania feels good. However any stoppage of medication can cause serious problems.

3.Suicide is a very real risk during both mania and depression. People with bipolar disorder who think or talk about suicide need immediate emergency attention.

Prevention of Bipolar Disorders:

1.Support and education about bipolar disorder (psychoeducation) may help families cope and reduce the odds of symptoms returning.
2.Programs that offer outreach and community support services can help people who do not have family and social support.

Important support skills taught include:
1.Coping with symptoms which are present despite taking medications
2.Learning a healthy lifestyle especially getting enough sleep , eating well and staying away from recreational drugs
3.Learning to take medications properly and how to control side effects
4.Learning to look for the return of symptoms, and knowing what to do if they return
5.Family members and caregivers are very important in the treatment of bipolar disorder.
They can provide the right support services for patients and make sure the patient takes medication correctly.
6.Getting enough sleep is very important in bipolar disorder.
Lack of sleep can trigger a manic episode.
7.Treatment is always helpful during the depressive phase.
8.Bipolar disorder patients cannot always tell the doctor about their condition.Patients often cannot recognize their own manic symptoms.
9.Changes in mood with bipolar disorder are unpredictable. It is difficult to tell whether a patient is responding to treatment or naturally coming out of a bipolar phase.

Bipolar Disorders is difficult to treat and patients, their friends, and family must know the risks of death if bipolar disorder is not treated properly.

BIPOLAR DISORDERS

DOC I HAVE BIPOLAR DISORDER

Bipolar disorder is a condition in which people swings between periods of a very good or irritable mood and depression.

The exact cause is unknown, but it can occur in families of people with bipolar disorder.
Bipolar disorder affects both men and women equally.
It usually begins between ages 15 - 25.

The Types of bipolar disorder:
1.bipolar disorder type I have had at least one manic episode and periods of major depression.

2.bipolar disorder type II have never had full mania.
There are periods where there is high energy levels and impulsiveness but that is not as extreme as mania (called hypomania).
This hypomania episodes alternate with periods of depression.

3.mild form of bipolar disorder called cycloymia involves less severe mood swings alternating between hypomania and mild depression.

Triggers of a manic episode in people with bipolar disorder:
1.Life changes such as births
2.Medications such as antidepressants or corticosteroids
3.Periods of insomnia
4.Recreational drug usage

Symptoms
A.Manic phase -last from days to months:
1. Distracted easily
2.Little or no need for sleep
3.Poor judgement
4.Poor control of temper
5.Reckless behavior and poor self control
6.Binge eating, drinking, and/or drug usage
7.Sex with multiple partners (promiscuity)
8.Spending sprees
9.Very elevated mood
10.Hyperactivity
11.Increased physical energy
12.Over Talking
13.Very high self-esteem (false beliefs about self or abilities)
14.Very involved in activities
15.Upset easily (agitated or irritated)

These symptoms of mania occur usually with bipolar disorder I or Manic depression.
With bipolar disorder II, the symptoms of mania are similar but less intense.

B.Depressed phase of both types of bipolar disorder:
1.Daily poor mood or sadness
2.Problems in concentrating, remembering, or making decisions
3.Eating disorders
4.Loss of appetite and weight
5.Overeating and weight gain
6.Tiredness or lack of energy
7.Feels worthless, hopeless, or guilty
8.Loss of pleasure in activities once enjoyable
9.Loss of personal self-esteem
10.Thinking of death and suicide
11.Problem getting to sleep or sleeping too much
12.Avoiding friends or activities that were once enjoyable

There is a high tendency of suicide with bipolar disorder.
Abuse of alcohol or other substances  can make the symptoms and suicide risk worse.

Sometimes the two phases of manic attack and depression may overlap.
Manic and depressive symptoms can occur together or quickly one after the other in what is called a mixed state.

Diagnosis can be obtained from:

1.family medical history of bipolar disorder
2.history of recent mood swings and the length of time of mood swings
3.thorough examination to look for illnesses that may cause the symptoms
4.laboratory tests to check for thyroid problems or drug levels
5.consultation of family members regarding patient's behavior
6. medical history of any medical problems and  medications taken
7.Observation of behavior and mood

Note that drug usage may cause some symptoms but does not rule out bipolar affective disorder.
Drug abuse may be a symptom of bipolar disorder.

VITAMIN K DEFICIENCY

DOC I HAVE VITAMIN K DEFICIENCY

Vitamin K Deficiency is a medical condition caused by the deficiency of the human body of Vitamin K as a result of inadequate dietary intake or impaired absorption.

Vitamin K is present in all living human tissues as an important cofactor in the synthesis of prothrombin and clotting factors VII, IX, and X(the Vitamin K dependant clotting factors) in the liver.

There are 3 types of Vitamin K:
1.Vitamin K1- Phytomenadione
2.Vitamin K2- Menaquinone
3.Vitamin K3- Menadione
They help in forming the clotting factors in the liver.

Vitamin K is found primarily in
1.animal sources - liver.
2.vegetable sources: Vitamin K is found in fresh green and yellow vegetables, fruits and potatoes.

Optimal requirements of Vitamin K are:
1.adults and children above puberty: 20 mg to 50 mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 10 mg to 20 mg daily

Functions of Vitamin K:
1.Vitamin K together is essential for the formation and maintenance of prothrombin and clotting factors in the liver.

2.Vitamin K is synthesized in the intestine of the human host by intestinal bacteria.

Causes of Vitamin K Deficiency:
Vitamin K Deficiency occurs
1.when there is Vitamin K deficiencies due to
a.diet - lactating mothers should take more Vitamin K
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
c.Inadequate absorption resulting from abnormal intestinal bacterial flora (in hemorrhagic disease of newborns or after some antibiotics)

2.Severity of Vitamin K deficiency is inversely related to age.
It is more common in elderly people.

Symptoms of Vitamin K Deficiency:
1.Vitamin K Deficiency is a silent disease.
People with Vitamin K Deficiency often do not know that they have the condition.

2.Hemorrhagic tendercies and hemorrhages in many organ such as brain, muscles and intestines.

3.Body function-weakness and fatique

4.Mental-Brain dysfunction may occur in children with Vitamin K deficiciency because of bleeding.

Diagnosis of Vitamin K Deficiency:
1.Blood Vitamin K levels are low

Treatment of Vitamin K Deficiency:
The goal of Vitamin K Deficiency treatment is the prevention of increased fragility of red blood cells and low Vitamin K.

Therefore, prevention of Vitamin K Deficiency is as important as treatment. Vitamin K Deficiency treatment and prevention measures are:

Medications:
Vitamin K supplements
1.Vitamin K is given at 10 mg to 50 mg per day orally in mild bleeding until the response is adequate.

2.Vitamin K 10mg to 20 mg is also given intramuscularly or intravenously in slow or moderate bleeding

3.Vitamin K 25 mg to 50 mg intramuscularly or intravenously in  cirrhotic patients with severe gastrointestinal bleeding

4.1mg of Vitamin K is given to newborns as a single dose intramuscularly or subcutaneously as prevention from bleeding.

5.Vitamin K is also used for reversal of bleeding due to coumarin or inandione anticoagulant overdosage.

6.Vitamin K is also given in hypoprothrombinemia in liver disease or intestinal malabsorption,antibiotic treatment, salicylates
Side effects are:
1.Vitamin K may cause hemolytic anemia and kernictus in infants.

Prognosis of Vitamin K Deficiency:
1.good response to treatment in Vitamin K deficiciency.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin K Deficiency.

Prevention of Vitamin K Deficiency:
take more liver,diary products,potatoes and vegetables.

VITAMIN B7 DEFICIENCY

DOC I HAVE VITAMIN B7 DEFICIENCY
Vitamin B7(biotin) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B7 as a result of inadequate dietary intake or impaired absorption.
Functions of Vitamin B7:
1.Essential for energy production and the metabolism of fats and protein.
2.Required for healthy skin and hair.
Vitamin B7 works with the other B vitamins in helping to sustain a healthy nervous system.
Vitamin B7 is found primarily in
1.Egg yolk,eggs, organ meats,
2.brewer’s yeast, legumes, nuts, onions, cucumbers, yogurt, and molasses 
Optimal requirements of Vitamin B7 are:
1.adults and children above puberty: 30 mcg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 15 mcg daily
Causes:
Vitamin B7 Deficiency occurs
1.when there is Vitamin B7 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B7
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
 
2.Severity of Vitamin B7 deficiency is inversely related to age.
It is more common in elderly people.
Symptoms:
1.Vitamin B7 Deficiency is a silent disease in the early stages.
People with Vitamin B7 Deficiency often do not know that they have the condition.
2.change in appearance of the hair including hair loss
the texture and gloss of the hair may change from healthy and shiny to dull and somewhat lifeless.
3.dry, scaly patches of skin on the arms, legs, and in the groin area. If left untreated, the texture of the skin may become exceedingly rough and easily irritated.
3.Vitamin B7 works with the other B vitamins in helping to sustain a healthy nervous system.
4.tingling in the hands, numbness, paresthesia
5.depression,
6.personality changes,sleep disturbances
7.fatigue
Diagnosis:
1.Blood Vitamin B7 levels are low
Treatment:
The goal of Vitamin B7 Deficiency treatment is the prevention of peripheral neuropathy and skin amd hair lesions.
Therefore, prevention of Vitamin B7 Deficiency is as important as treatment. Vitamin B7 Deficiency treatment and prevention measures are:
Medications:
Vitamin B7 supplements
1.Vitamin B7 is given at 30 mcg per day orally until the response is adequate.
2.It is most effective when taken with the B group vitamins, Vitamin A, vitamin C and Vitamin E.
Side effects are:
1.Vitamin B7 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested
2.No side effects have been reported on dosage exceeding 10 g a day.
Prognosis:
1.good response to treatment in Vitamin B7 deficiency in early stages.
2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B7 Deficiency.
Prevention:
take more liver, egg yolks, cereals and fresh green vegetables.

VITAMIN B5 DEFICIENCY

DOC I HAVE VITAMIN B5 DEFICIENCY

Vitamin B5(Pantothenic acid) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B5 as a result of inadequate dietary intake or impaired absorption.

Functions of Vitamin B5:
1.Vitamin B5 plays an important role in the secretion of hormones, such as cortisone because of the role it plays in supporting the adrenal gland.
These hormones assist the metabolism:
2.It is essential for metabolism of fats,carbohydrates and protein 
to make fatty acids and cholesterol.
3.It help to fight allergies
4.It assists in the the maintenance of healthy skin, muscles and nerves.
5.It is used in the creation of lipids, neurotransmitters, steroid hormones and hemoglobin.
6.pantothenic acid is also helpful to fight wrinkles as well as graying of the hair.

Vitamin B5 is found primarily in
1.Beef,  eggs, organ meats. kidney,  liver,  pork,  saltwater fish,
2.fresh vegetables, legumes,mushrooms, nuts, torula yeast, whole rye flour, Whole grains,royal jelly,brewer’s yeast,

Optimal requirements of Vitamin B5 are:
1.adults and children above puberty: 5 mg to 10mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 5 mg daily

Causes:
Vitamin B5 Deficiency occurs
1.when there is Vitamin B5 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B5
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
2.Vitamin B5 can be lost in cooking -
a.particularly with roasting or milling,
b.when exposed to acids like vinegar,
c.alkali such as baking soda.
d.It is also destroyed to a large degree in canning.
3.People under stress,
4.prone to allergies,
5.consuming alcohol 
6.eating too many refined foods can develop a shortage of this vitamin.

Severity of Vitamin B5 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B5 Deficiency is a silent disease in the early stages.
People with Vitamin B5 Deficiency often do not know that they have the condition.

2.fatigue,

3.headaches,

4.nausea,

5.tingling in the hands, numbness, paresthesia (abnormal sensation such as "burning feet" syndrome)

6.depression,

7.personality changes,sleep disturbances

8.cardiac instability .

9.Frequent infection,

10.muscle weakness and cramps

Diagnosis:

1.Blood Vitamin B5 levels are low
2.lowered blood cholesterol,
3.decreased serum potassium, 
4.failure of adrenocorticotropin to induce eosinopenia.
5.increased insulin sensitivity,

Treatment:
The goal of Vitamin B5 Deficiency treatment is the prevention of peripheral neuropathy and skin lesions.

Therefore, prevention of Vitamin B5 Deficiency is as important as treatment. Vitamin B5 Deficiency treatment and prevention measures are:

Medications:
Vitamin B5 supplements
1.Vitamin B5 is given at 10-20 mg per day orally until the response is adequate.

2.It is most effective when taken with the B group vitamins, Vitamin A, vitamin C and Vitamin E.

Side effects are:
1.Vitamin B5 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested

2. diarrhea, digestive disturbances and water retention have been reported on dosage exceeding 10 g a day.

Prognosis:
1.good response to treatment in Vitamin B5 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B5 Deficiency.

Prevention:
take more red meat, liver, egg yolks, cereals and fresh green vegetables.

VITAMIN B3 DEFICIENCY

DOC I HAVE VITAMIN B3 DEFICIENCY

Vitamin B3(Niacin) Deficiency is a medical condition caused by the deficiency of the human

body of Vitamin B3 as a result of inadequate dietary intake or impaired absorption.

Vitamin B3 is present in all living human tissues as an important anti-oxidant and enzymes in the metabolism of food

Functions of Vitamin B3:
1.It helps the body make various sex and stress-related hormones in the adrenal glands and
other parts of the body.

2.It has a role in improving circulation and reducing cholesterol levels in the blood.
Niacin has been used to lower LDL or bad cholesterol and triglycerides in the blood.
It also increase the HDL or good cholesterol.

In fact it is even better than many branded cholesterol lowering medicines.

3.Because of its effect on the cholesterol and fats, it has been given to help prevent atherosclerosis. However niacin can also increase homocysteine levels in the blood which is associated with an increased risk of heart disease.

4.Osteoarthritis-it has been suggested that niacinamide can help relief arthritis and improve joint mobility and symptoms

5.Azheimer's Disease -studies show that people with higher niacin levels in the diet has lower risk of Alzeimer's disease.

6.Skin conditions - topical forms of niacin has been used as treatment foe acne, aging skin and
prevention of skin cancer.

7.All B vitamins help the body to metabolize food (carbohydrates, proteins, fats) into fuel (glucose, amino acids, cholesterol) and therefore improve energy.

Vitamin B3 is found primarily in
1.animal sources - beef liver, beef kidney, fish, salmon, swordfish, tuna
Foods that contain tryptophan, an amino acid the body converts into niacin, include poultry, red
meat, eggs, and dairy products.

2.vegetable sources: Vitamin B2 is found in fresh green and yellow vegetables, yeast, cereals,sunflower seeds,and peanuts

Optimal requirements of Vitamin B3 are:
1.adults and children above puberty: 14 mg to 16 mg daily
Pregnant mother and elderly may need double the amount.


2.Infants and children before puberty: 2 mg to 12 mg daily

Causes of Vitamin B3 Deficiency:
Vitamin B3 Deficiency occurs
1.when there is Vitamin B3 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B3
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis

2.Severity of Vitamin B32 deficiency is inversely related to age.
It is more common in elderly people.

3.It is rare for any person in the developed world to have vitamin B3 deficiency.
The main cause in the developed world is alcoholism.

Symptoms of Vitamin B3 Deficiency:
1.Vitamin B3 Deficiency is a silent disease in the early stages.
People with Vitamin B3 Deficiency often do not know that they have the condition.
They may have:
2.indigestion
3.fatigue
4.depression

In severe Vitamin B3 deficiency, a condition called pellegra develops with the following symptoms(the 3 D):
1.dermatitis -cracked scaly skin

2.dementia - mental confusion

3.diarrhea - loose stools

Other symptoms are burning sensation in the mouth and a swollen red bright red tongue.

Diagnosis of Vitamin B3 Deficiency:
1.Blood Vitamin B3 levels are low

Treatment of Vitamin B3 Deficiency:
The goal of Vitamin B3 Deficiency treatment is the prevention of pellegra.
Therefore, prevention of Vitamin B3 Deficiency is as important as treatment. Vitamin B3 Deficiency treatment and prevention measures are:

Medications:
Vitamin B3 supplements- 3 types are available:
niacin, niacinamide or inositol hexaniacinate
Vitamin B3 is given at 100 mg per day orally until the response is adequate.
Side effects are:
1.Vitamin B3 in high doses can give rise to side effects sucha s flushing of the face, stomach
upset, headache, giddiness and blurring of vision.

2. There is also a danger of liver damage.
It can interact with cholesterol lowering drugs, aspirin,blood pressure and diabetes medicines

Prognosis of Vitamin B3 Deficiency:
1.good response to treatment in Vitamin B3 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B3 Deficiency.

Prevention of Vitamin B3 Deficiency:
1.take more liver, egg yolks, cereals and fresh green vegetables.

2.avoid alcohol.

A Family Doctor's Tale - VITAMIN B12 DEFICIENCY

DOC I HAVE VITAMIN B12 DEFICIENCY

Vitamin B12 (cyanocobalamin) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B12 as a result of inadequate dietary intake or impaired absorption.

Vitamin B12 is present in all living human tissues as an important  ingredient in the production of red blood cells.

Functions of Vitamin B12:
1.It is important in metabolism of labile methyl groups example biosynthesis of choline and methionine

2.It maintains glutathione in reduced state

3.It is important in the maturation of erythrocytes, neurologic function and growth.

Vitamin B12 is found primarily in
1.animal sources - red meat, liver, milk, egg yolks
2.vegetable sources: Vitamin B12 is found in fresh green and yellow vegetables, cereals

Optimal requirements of Vitamin B12 are:
1.adults and children above puberty: 1 mcg to 2 mcg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 0.5 mcg to 1 mcg daily

Causes:
Vitamin B12 Deficiency occurs
1.when there is Vitamin B12 deficiencies due to
a.diet - starvation, vegetarians

b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis


c.intestinal parasites such as diphyllobothrium latum


d.pernicious anemia when the gastric mucosa  cannot produce the intrinsic factor necessary for vitamin B12 absorption

2.Severity of Vitamin B12 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B12 Deficiency is a silent disease in the early stages.
People with Vitamin B12 Deficiency often do not know that they have the condition.

2.Blood - anemia with pallor, shortness of breath and weakness


3.Brain -subacute combined degeneration of spinal cord and brain

  - numbness of hands and feet

                 -giddiness

                 -developmental delays and failure to thrive in children

4.Mental -depression, fatigue, mental confusion

Diagnosis:
1.Blood Vitamin B12 levels are low

Complications:

Serious complications of vitamin B12 deficiency include:

1.anemia

2.nerve damage

3.abnormalities in growth and development

4.brain dysfunction including depression and dementia

Treatment:
The goal of Vitamin B12 Deficiency treatment is the prevention of pernicious anemia and peripheral neuropathy.

Therefore, prevention of Vitamin B12 Deficiency is as important as treatment. Vitamin B12 Deficiency treatment and prevention measures are:

Medications:
Vitamin B12 supplements
1.Vitamin B12 is given at 100 mcg per day by injection which may be a life long treatment in cases when the body cannot absorb oral Vitamin B12


2.Oral Vitamin B12 tablets can be given in people who can absorb the vitamin in the stomach.

 It can also be given sublingually or through the nasal route.

3.treat the underlying causes such as gastric problems and gastrectomy, malabsorption, decreased intake in the case of vegetarians

Side effects of Vitamin B12 are:
1.Vitamin B12 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested

Prognosis:
1.good response to treatment in Vitamin B12 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B12 Deficiency.

Prevention:
take more red meat, liver, egg yolks, cereals and fresh green vegetables.

Vegetarians should take Vitamin B12 supplements.

A Family Doctor's Tale - VITAMIN B6 DEFICIENCY

DOC I HAVE Vitamin B6 Deficiency

Vitamin B6(pyridoxine) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B6 as a result of inadequate dietary intake or impaired absorption.

Vitamin B6 is present in all living human tissues as an important  enzymes in amino acid metabolism

Functions of Vitamin B6:
1.It is converted to pyridoxal phosphate a co-enzyme of a seies of enzymes that atalyze tramination, decarboxylation and deamination of amin acids.

Vitamin B6 is found primarily in
1.animal sources - red meat, liver, milk, egg yolks
2.vegetable sources: Vitamin B6 is found in fresh green and yellow vegetables, cereals

It is rare as a isolated Vitamin B6 deficiency.

Optimal requirements of Vitamin B6 are:
1.adults and children above puberty: 1 mg to 2 mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 0.5 mg to 1 mg daily

Causes:
Vitamin B6 Deficiency occurs
1.when there is Vitamin B6 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B6
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
c.alcoholism
d.medications such as isoniazid, hydralazine, cycloserine and penicillamine

2.Severity of Vitamin B6 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B6 Deficiency is a silent disease in the early stages.
People with Vitamin B6 Deficiency often do not know that they have the condition.

2.Skin changes - seborrheic dermatitis of nose, mouth

3.Mucosal changes -oral erosions of the buccal lining

3.peripheral neuropathy

Diagnosis:
1.Blood Vitamin B6 levels are low

Treatment:
The goal of Vitamin B6 Deficiency treatment is the prevention of peripheral neuropathy and skin lesions.

Therefore, prevention of Vitamin B6 Deficiency is as important as treatment. Vitamin B6 Deficiency treatment and prevention measures are:

Medications:
Vitamin B6 supplements
1.Vitamin B6 is given at 5 mg per day orally until the response is adequate.

2.prevention of Vitamin B6 deficiency in people taking isoniazid, hydralazine, cycloserine and penicillinamine

3.Patients with homocystinuria
Side effects are:
1.Vitamin B6 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested

2.It should not be given in patients taking levodopa because it antagonizes the effects of the drug.
Prognosis:
1.good response to treatment in Vitamin B6 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B6 Deficiency.

Prevention:
take more red meat, liver, egg yolks, cereals and fresh green vegetables.