Tuesday, March 11, 2014

HEADACHE-MIGRAINE

Migraine is not just a severe headache, but it’s a result of specific physiologic changes in the brain. Beside the headache there are many associated symptoms such as: sensitivity to light, sound and smells, nausea, vomiting. Usually the pain is unilateral on the one side of the head.
Migraine with aura is a term for migraine with specific warning symptoms. These symptoms can be blind spot in one eye, flashing lights or numbness of the one side of the body.  The aura lasts until the headache begins or may last until the end of the headache.
 It’s thought that the main reasons  for migraine are the changes of some neurotransmitters (hormone like substances that send messages between brain cells). There are many triggers for this condition such as normal hormone fluctuations( regular menstrual cycles, oral contraceptive(birth pills) ), some food such as red wine, chocolate, aged cheese, stress, oversleeping, changes in barometric pressure can lead to migraine.
The treatment depends of the type of migraine. The usually drugs are: ibuprofen, acetaminophen, triptans (sumatriptan, almotriptan, eletriptan can be very effective). Very important for the therapy are: the age, sex, blood pressure of the patients. In the therapy may be included antidepressant medications, anti-seizure medications, blood pressure medications and magnesium, butterbur, riboflavin. Some patients with very frequent headaches( more than 15 per month) might benefit from botox injections.

Thursday, February 13, 2014

OVARIAN CYSTS


The ovaries are reproductive female glands . The functions of the ovaries are producing eggs (ova) and female hormones estrogen and progesterone. On the other side the function of the female hormones are development of female body characteristics (breasts, body hair, body shape), regulation of menstrual cycle and pregnancy. Ovarian cysts are closed sac-like structures that are filled with liquid or other content.
The reasons for ovarian cysts are various. So we have many types of ovarian cysts. The most common are follicular cysts, which are formed from a follicle. A follicle is a sac that contains an egg and is filled with fluid. During the menstrual cycle the follicle opens to realize the egg. When this is not happened the follicle grows larger than normal and follicle cyst is formed.
Luteum cysts are also frequent cysts . The corpus luteum  is a tissue in the ovary that is formed from the follicles, after releasing the egg. If the egg is not fertilized (pregnancy doesn’t occur), the corpus luteum disappears. But also may fill with fluid or blood and persist as a cyst on the ovary.
The bigger part from the ovarian cysts are asymptomatic (the women never realize that she has ovarian cyst). The most common symptom is abdominal or pelvic pain. This pain is caused from: torsion of the cyst (twisting of the cyst around its blood vessels), bleeding or rupture of the cyst.
The other symptoms are caused by pressing of the cyst to the saround tissue. These symptoms can include: urinary urgency, pain with sexual intercourse, feeling an urge to defecate, feeling full after eating only a small amount of food etc.

Most of the follicular or luteum cysts disappear without therapy in one to three months. The therapy is used only for compound cysts and the treatment depends from the woman’s age and the size of the cyst. This cyst are treated surgically. 

Wednesday, February 5, 2014

WRINKLES

Although it may sound strange to you the wrinkles are common for older people and newborn. But what really concern us are wrinkles associated with aging. On the market there are many products that do little or nothing to wrinkles. The most important factor for skin aging is the sun exposure. Sun causes many skin changes as dryness, liver spots, sagginess and wrinkles, so the wrinkles are appeared on the parts of the skin where the sun exposure is greatest, like neck, face, the back of the hands. There are two categories of wrinkles:
 -Fine surface
 -Deep furrows
What we can really do with wrinkles is to remove them or prevent it. The approach depends of the wrinkle type. Fine surface are treated with topical agents, while for deeper furrows we need filer injections or plastic surgery. There are many factors that promote wrinkles:
 - Heredity
 -Sun exposure
 -Pigmentation degree more pigment is better
 -Smoking
There are many medical treatments and procedures for wrinkles: vitamin A Acid, alpha hydroxyl acids, antioxidants.

Thursday, January 16, 2014

CHEMICAL BURNS

The rule of the skin for out homeostasis is very important. Skin participates in protection from microorganisms and fluid and temperature regulation of the body. We have three layers of skin : 
 -Epidermis –the outer layer
 -Dermis –the middle tissue made up of collagen and elastic fibers. Here we have hair follicles reside, sweat glands, blod vessels and nerves.
 -Hypodermis where larger blood vessels and nerves are found and which is most important in temperature regulation.
The burns are categorized in three degrees :
 -First degree-superficial burn that causes local inflammation
 -Second degree-deeper burn with more pain, redness and inflammation
 -Third degree- all three layers of the skin are involved .this type of burn is white, leathery and painless because the nerves and blood vessels are damaged.
Chemical burns are classified as:
 -Acids- chemicals  with pH less than 7, like acetic acid, sulfuric acid and hydrochloric acid.
 -Bases – pH grater than 7, ex. Ammonia
When you have major burs firs that you should do is to:
 1.Remove the victim from burning area
 2.Remove all burning materials from the victim
 3.Call 911
 4.Keep the patient warm and still. If it’s available wrap the injured areas with clan sheet. Do not use cold water because this may cause hypothermia (droping of the body temperature).
If the burn is minor than you should:
 1.Clean the wound gently with lukewarm water
 2.Remove all potentially constricting objects (rings, bracelets) because the burn areas are swelling.
 3.You can use topical antibiotics as silvadene, bacitracin or neosprin.
In case of chemical burns it’s very important to identify what had cause the burn.



Tuesday, January 7, 2014

HAIR LOSS


Normal hair loss is up to 100-150 hairs per day. This condition usually is not associated with systemic or internal disease. There are many risk factors that include genetic factors, aging process. Thinning of hair in the age of thirty is often normal. A reversible hair loss is usually caused by stress, hormonal changes(pregnancy, puberty, menopause) and nutritional changes. Also some health conditions such as thyroid disease and iron deficiency anemia can cause hair loss. Hair loss is also seen as side effect of some medications as cancer and immune suppression medications. 
The hair loss is classified as diffuse and pitchy. Diffuse hair loss is when large areas or the hole scalp is affected. The localized hair loss is called pitchy. Ne the other hand pitch hair loss is classified as:
 -Traction alopecia (caused by tight braids or ponytails)
 -Alopecia areata (small circular or coin size baldness; usually the hair grows back within months)
 -Tinea capitis (baldness caused by fungal infection)
 -Trichotillomania (caused by twisting r pulling hair out)
Alopecia areata is considered as autoimmune condition (the body attacks his own hair follicles). Frequently stress is blamed for alopecia areata, but also alopecia areata can cause stress. Small smut of steroids is usually injected into affected patches to stimulate hair growth. Other treatments  are oral steroids, immunosupressives and ultraviolet light.
Tinea capitis is more common in African or afro-american peoples. It’s contagious from sharing hats, and  combs. After treatment with oral antifungals, the hair grows back.
Diffuse hair loss can be :
 -Telogen effluvium (rapid shedding after childbirth, fever or sudden weight loss)
 -Androgenetic f androgenic hair loss
Normally scalp hairs live about three years (called anagen/growing phase). After thaht during three months the hair root shrivels up into a small white “club” and the hair falls out, usually during shampooing (telogen/resting phase). Normally, about  10% of scalp hairs are in the telogen phase. Sometimes as a result of some circumstances 30%-40% of the hairs can enter into telongen. Three month later, hairs come ut on a massive shedding especially near the front of the scalp. These can be cause by: stress, sudden weight loss, childbirth, high fever, surgery, severe illness. The more dramatic the hair loss is, that better the prognosis is. No special treatment is needed for this condition (telogen effluvium).
Androgenetic/androgenic alopecia is shown in female and male. The name implies that hormones and genetic are both included.

Tuesday, December 24, 2013

IRON STORAGE DISORDERS

The amount of iron stored by the body is measured indirectly with measuring the ferritin levels. Ferritin is a body protein that is used to store iron. There are some tests that help us to evaluate the body’s iron stores such as ferritin test, iron binding capacity test ect.
Normal results for a ferritn test are 12-300 nanograms per milliliter of blood for males and 12-150 ng/ml for females.
High levels of ferritin can be indicative for hemochromatosis. This is genetic disorder in which there is excessive accumulation of iron in the body. There is  problem is with the absorption of iron from the intestines which is greater than the amount needed to replace losses. Normaly the body cannot increase iron excretion there for the absorbed iron accumulates in the body. The excess iron deposits in the heart, joints, testicles, liver and causes damage to these organs. So the sign and symptoms of hemochromatosis came from these organs. Women develop sign and symptoms 10 years later then man, because they lose the iron thanks to menstruation. Sign and symptoms of hemochromatosis are: fatigue, joint pains, heart failure, diabetes mellitus, liver cirrhosis, sexual dysfunction and  darkening of skin. Also some chronic inflammatory conditions such as liver disease rheumatoid arthritis or some types o f cancer can be caused  from high ferritin levels.

When  the levels of ferritin are low we have iron deficiency. In these condition the body cannot produce sufficient  levels of hemoglobin (component of red cells that carries the oxygen)  and we have anemia. Sign and symptoms of anemia are: fast heartbeat, dizziness, fatigue, shortness of breath and pale skin.

Sunday, December 15, 2013

ASPERGER’s SYNDROME

This is neuro-developmental  disordes that effects individual’s behavior such as communication  and pattern of social interactions. Formerly this disorder was characterized as distinct autism spectrum disorder. It’s still disc as Asperger’s syndrome is separate clinical entity or high-functioning form of autism.  People with asperger’s syndrome normal to above-average intelligence but typically have difficulties with social interactions and often have pervasive, absorbing interests in special areas.
Dr. Hans Asperger first described this condition. Because the obsessive interests in and knowledge of particular subjects of this patients, he called them little professors. 
Positive characteristics of people with Asperger syndrome are:
 -The ability to work independently
 -The increased  ability to focus on details
 -Intensity and original way of thinking 
To give the diagnosis of asperger’s syndrome is impossible without direct testing and observation. It’s suggested that Thomas Jefferson, Mozart, Benjamin Franklin, Albert Einstein had Asperger’s syndrome.
Symptoms of Asperger’s syndrome are:
 -Lack of interest in socializing/making friends
 -Avoiding eye contact 
 -Lack  of use of gestures
 -Lack of changing facial expression
 -Failure to respect interpersonal boundaries
 -Unusually sensitive to noises, touch, odors, tastes.
 -Repetitive motor patterns such as hand flapping or arm waving
The children with this syndrome have normal language development in contrast to other autistic conditions. However there is alteration in language skills such:
 -Changes in voice and speaking
 -They have difficulties with understanding the subtle use of language, such as irony or sarcasm.
 -Disorganized or not relevant to the discussion speech.
In some cases there is psychiatric and behavior disorders  like:
 -Anxiety disorder
 -Depression  or other mood disorders.
There should be multidisciplinary approach in treating this patients. Medical therapy is not effective but in some cases selective serotonin reuptake inhibitor medications are used for relief of anxiety or depression. There are a lot of behavioral and educational interventions that can be useful. The type of intervention depends of individual’s age and needs.