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.