Dementia

Dementia Memory Loss

4 Medicines That Can Delay The Effects Of Dementia

As we age, we encounter different types of health-related issues. Diseases related to memory loss are often associated with getting older.

But the fact is that people in their 40’s and 50’s can also develop dementia. Certain diseases can cause temporary dementia in children and teenagers too. Needless to say, memory loss and cognitive impairment can make life difficult for patients and loved ones alike.

Dementia can slowly and gradually affect a person’s ability to recognize things including events, people, sights, and sounds, and associate objects with meaning. Patients often have trouble expressing themselves and communicating with people, planning their schedule, and all the other routine chores of life.

Generally, it is dementia that is to be blamed for memory loss, worsening of higher-level cognitive functions and challenges in language and expressing emotions. Dementia has many types, but the most common type of dementia is Alzheimer’s, Vascular Dementia which is caused by strokes, and Lewy Body disease.

No medication has yet been created that could completely cure dementia, but there are several that could stop or at the least delay its advancement.Some of these drugs may work only for a very short period of time for example for about 6 to 12 months.

All of the below are only to be taken on the doctor’s prescription.

Drug # 1.Memantine

Memantine is a drug that is suggested to patients with dementia. To some extent, this drug delays the deterioration of mental abilities and prolongs independence in patients. It is generally well tolerated, but has certain side effects like nausea, loss of appetite, vomiting, joint pain, swelling in hands or feet, etc.

Drug# 2 Cholinesterase inhibitors

This medication is used to treat dementia symptoms in their early or moderate stage. Cholinesterase inhibitors are given to treat symptoms related to language, thinking, memory and other mental processes. This drug is known to delay the worsening of dementia symptoms for at least 6 to 12 months. Side effects include nausea, loss of appetite, vomiting, etc.

Drug #3 Anti-anxiety medications

Anti-anxiety medications are also (typically to treat anxiety disorders) given to patients with dementia to help treat restlessness and agitation. At times, doctors also prescribe antidepressants to eradicate symptoms of depression.

Drug # 4 Donepezil

Just like other medicines, this drug also can not completely cure dementia, but it can slow down the advancement of its symptoms. Gauging the current health condition of the patient, including liver and heart functioning, and blood pressure is essential before prescribing donepezil.

This medicine is generally well tolerated with side effects like a headache, diarrhea, loss of appetite and abdominal discomfort.

Although drugs play their limited roles in treating the symptoms, a lot can be done through healthy lifestyle and home remedies. Those who look after the patients of dementia should try the following suggestions.

 

  1. Encourage patient to exercise

Exercise is an activity that benefits everyone, including people living with dementia. With exercise, you can improve cardiovascular health and overall body strength. A regular exercise routine, combined with a healthy diet can protect the brain from dementia.

 

  1. Enhance Communication

One of the ways dementia impacts people is that it makes them lose interest in life and other people around them.Therefore, it becomes all the more important to bridge the communication gap. When talking with your loved one with dementia, maintain eye contact, speak gently with clear and simple words. Show them how important they are in your life.

 

  1. Establish a night time ritual

Caregivers notice achange in behaviour, especially at night. Make their bedtime calm and pleasant. Their rooms should ideally not be close to the lounge and away from thenoise of thetelevision. Make sure to leave nightlights on to avoid any untoward incident.

 

  1. Encourage them to keep a calendar

Keep them busy and occupied by providing them with a calendar of upcoming events, medication schedule and daily activities of life.

 

 

  1. Stay positive and enjoy small moments

Try to see the good in everything, and make sure your patient does too. Try to see their mind as half-present. With good care, love and support, people with dementia can enjoy the beauty of life in everyday things, and the small family moments even if they are at the final stage of the disease.

 

Conclusion

It can be very devastating to receive the diagnosis of dementia. It is not just a life changing experience for the one diagnosed, but also for the patient’s loved ones.

Dementia is a difficult medical condition to live with. When life’s challenges us with memory loss, or dementia, our priorities, relationships and perceptions take a180-degree turn.

There is a general understanding that practicing life’s daily routine does not test the brain enough to keep it active and sharp. It couldn’t be further from the truth.

For dementia patients, it is very healthy to stay involved with different interesting activities, be it cooking, cleaning, gardening or listening to favorite pieces of music.

We often hear this old piece of wisdom; ‘care is better than cure’. In order to prevent dementia from taking root in the first place, it would be best to make sure that you are challenging yourselfmentally, and taking good care of your body by exercising and healthful eating.


Essential Oils

Essential Oils

The 7 Essential Oils that Calm Stress and Anxiety

According to different studies, specific scents can have enormous effects on your moods and emotions. It is believed that essential oils have a direct effect on parts of the human brain that handles stress, depression, and anxiety through their aromatic molecules that are capable of going past the blood barrier in the brain.

While these essential oils cannot cure cases of stress and anxiety on their own, they have been passed to help in calming stress and anxiety levels among individuals. Currently, there is a claim for a countless number of oils that do the trick, but in this article, we shall highlight 7 of the best as referenced by millions of users across the globe. Dr. Oz made a powerful revelation regarding Garcinia cambogia as a weight loss remedy, and today it is one of the household names in weight loss solutions. The same way, the following essential oils (EOs) have become popular with users who want to have relaxed minds.

#1. Lavender – It is one of the most popular oils trusted for its magical aroma that helps ease the mind of stress and anxiety. It is an extraction from the famous lavender flowers through a careful distillation process and is made up of more than 150 components necessary for the calming effect. Buyers looking to purchase original lavender oil are advised to beware of counterfeits that usually contain high amounts of cineol and low in esters.

#2. Roman chamomile – Chamomile has several uses to humans, a good reason why it has been in use for more than 2 centuries. Most people have used or at least heard about chamomile tea, but they might not know how powerful it is as an essential oil for calming the effects of depression. Its sweet fruity aroma makes it distinguishable among other popular scents, and can be used to ease cases of insomnia and muscle tension.

#3. Rose geranium – It has a lovely scent that is loved by most people in the world, and has been proven to help improve hormonal balance among individuals, and at the same time create a relaxed mood. Smelling it also helps soothe the central nervous system, thus making you feel better all day.

#4. Bergamot – This is an essential oil extracted from raw citrus fruit, and just like other listed oils can be used to good effect in relaxing the mind. An exclusive study showed that bergamot helps in minimizing corticosterone responses to stress and also corrects the HPA axis activity.

#5. Sandalwood – A unique oil with a woodsy aroma that does more than just calming stress and depression. Its magical aroma has been used in terminal illnesses effectively to help with insomnia.

#6. Clary sage – This is another powerful substance that has immense effects on stressed individuals. According to a study carried out in a Korean University, students taking a stress test using a combination of clary sage and other essential oils recorded less anxiety cases.

#7. Jasmine – Jasmine should be one of the most powerful essential oils to ever be used for calming anxiety. Some scholars have even equated it to the popular drug Valium that helps patients in calming nerves. Jasmine naturally boosts the GABA activity in the brain to regulate over-excitement, stress, and patient anxiety.

How to use these essential oils to good effect

There are several ways that you use to attain the desired results from your essential oils. You can choose to inhale, defuse, massage, add to your bath water, or even apply on your pillow. Ideally, all you want is to have that fragrance of your magical essential oil all around you. People have used it in their cars, offices, and their bedrooms, provided it doesn’t cause any bad effect to the immediate environment.


Callus

10 Ways Natural to remove Callus

Callus Feet

Corns and calluses, here is an example of the typical hassles that affect the plant or toes. How to take care of them in a natural way? Some traditional remedies can certainly help us. The first care must, however, turn to shoes. May be too tight or have soles unsuitable.

If corns and calluses recur often, try to look for a pair of new shoes from softer and comfortable. Meanwhile, here are some natural remedies that might be useful. After the foot baths or compresses, which will softens corns and calluses. You can gently rub the areas affected by the problem with the pumice stone.

1) Bread and vinegar   Everyday Roots suggest a home remedy for corns and calluses with bread and vinegar. Dip a slice of bread in a bowl with vinegar or apple, until the crumb will not be well soaked. Use it to apply a compress on corns and calluses. Bandaged with gauze and let stand for long. Or apply a single piece of bread and a light bandage to cushion the pain while walking.

2) Olive oil and lemon In a glass mix 2 tablespoons of lemon juice and 2 tablespoons of olive oil. Gradually add the baking soda and stir until it forms a creamy mixture. Apply to affected areas when needed, with a small band or with a plaster. Oil and lemon juice soften the hardened skin. The baking soda helps to exfoliate the skin.

 3) Essential Oils Among the essential oils suitable for the treatment of corns are the essential oil of lavender and geranium essential oil. They are suitable to be applied to the skin already softened, after a hot bath or foot bath. Rub a few drops of essential oils on the affected areas. Then you can wipe gently using the pumice stone. You can also pour a few drops of essential oil directly into the footbath.

4) Bicarbonate To soften the skin in case of corns and calluses dedicate a foot bath with baking soda. This treatment helps to eliminate dead cells and facilitates healing. Pour into a bowl of warm water 3 tablespoons of baking soda to the foot bath or massaged on corns and calluses a compound formed by 3 teaspoons of baking soda and 1 teaspoon of water.

5) Chamomile A grandmother remedy very useful to soften the skin and to facilitate healing of corns and calluses is the foot bath with chamomile. Prepare a regular infusion of chamomile, let cool and pour it in a bowl with hot water. It is also a useful remedy for excessive sweating of the feet.

6) Corn starch The cornstarch (or cornstarch) is useful both to prevent corns and calluses, both to relieve the discomfort. You can apply as if it’s talcum powder on the soles of the feet and between the toes. The cornstarch absorbs moisture and prevents cracking. You can create a starch scented pouring the cornstarch in a glass jar with a few drops of essential oil of lavender or geranium.

7)  Vinegar To spend a night treatment for corns and calluses, Moisten cotton ball with vinegar and let it stick to the area in which it has the problem, with the help of a patch. Let sit overnight and in the morning wipe the skin with a pumice stone.

8) Ice If corns and calluses are accompanied by severe pain and swelling, apply on the affected part an ice cube wrapped in a handkerchief, or a small bag of ice for an analgesic action that will help alleviate the discomfort.

9) Lemon juice Create a compound spread on the skin by mixing 1 or 2 teaspoons of rice flour with a few drops of lemon juice freshly squeezed. Applied to the skin and wrap with gauze then let stand overnight to soften corns and calluses.

10) SALT that is always a remedy available to everyone to soften corns and calluses.

This is the common salt present in every kitchen. Pour two tablespoons of salt in hot water for the foot bath and let your feet soak for 15-20 minutes. The sea salt or Epsom salts is suitable. When the skin is softened, you can rub with pumice stone.

 


Arthritis

Arthritis

If you know someone who has trouble moving around or feeling pain and stiffness in his body, that person could have arthritis. In most cases, arthritis causes pain and swelling in the joints which eventually results to severe damage. Arthritis is not a single disease. This covers over hundreds of different medical conditions which can affect a wide range of age groups. It is the main cause of disability among elderly in industrialized countries.

Arthritis came from the Greek work arthron- which means joint and Latin–itis which means inflammation. It is therefore defined as inflammation of one or more joints. There are many forms of arthritis. Osteoarthritis, a degenerative joint disease,is the most common form of arthritis which normally affects the elderly. Other forms include rheumatoid arthritis, autoimmune diseases, septic arthritis, psoriatic arthritis.

Causes

For you to better understand what is going on with patients suffering from arthritis, you should understand first how joint works. A joint is a point where two bones meet allowing body movements. Ligaments are fibrous connective tissue keeping the bones in place. Cartilage covers the bone surface to prevent two bones from rubbing directly against each other allowing the joint to work smoothly and painlessly. Surrounding the joint is the capsule. The joint cavity which is the space inside the joint has synovial fluid. Synovial fluid is produced by the synovium which nourishes the joint and the cartilage.

Depending on the type of arthritis you have, different factors could have contributed to joint damage. It could be daily tear and wear of the joint, a lack of fluid, autoimmunity, infection, genetic makeup, trauma or physical injury, muscle strains, obesity, allergic reactions or a combination of many factors.

Signs and Symptoms

The major complaint by individuals who have arthritis is joint pain and stiffness, which typically worsen with age. Pain is usually constant and may be localized to the joint affected. Other signs and symptoms include swelling, redness and decreased range of motion. Some types of arthritis like rheumatoid arthritis and lupus can affect other organs in the body leading to variety of symptoms which include body malaise, fatigue, loss of appetite, poor sleep and stiffness.

Extra-articular features include lymphadenopathy, ocular inflammation, cutaneous nodules, edema, cutaneous vasculitis lesions, diarrhea, bursitis, tenosynovitis, urethritis and orogenital ulceration.

Risk Factors

Risk factors include family history, age, obesity, previous trauma, and gender. Women are more likely than men to develop rheumatoid arthritis while men are more prone to have gout.

Osteoarthritis

This is the most common type of arthritis, often called “wear and tear” arthritis. In osteoarthritis, there is erosion of the cartilage resulting to bone rubbing directly on bone which causes severe pain and restriction of movements. OA is most commonly found in the knees (because they are primarily weight-bearing joints), hips, hands and fingers and spine. Heberden’s nodes are small bony swellings that develop on the distal (end) joints of the fingers. Bouchard’s nodes are small bony outgrowths that appear on the proximal(middle) joints of the fingers or toes.Other areas like the wrists, elbows, shoulders and ankles are less frequently affected by OA. When OA is found in these areas, there may have been a history of stress or trauma to that joint.

Generally, this wear and tear arthritis comes on slowly, or it can be hastened by a joint injury or an infection. The most common sign is joint pain after physical work or exercise. As the disease progresses, one or combinations of these signs and symptoms will be noted: swelling and redness of one or more joints, stiffness after periods of inactivity (i.e. sleeping), flare ups of pain and inflammation after use of the affected area and crepitus (crunching feeling or sound of bone rubbing on bone when the joint is used).

The exact cause of OA is unknown. Joint damage can be due to repetitive movement or can be as a result of direct injury. Some of the factors that may increase the risk of developing OA include age (strongest risk factor), gender, obesity, hereditary, joint alignment and sports. OA affects both men and women. However, before age 45, OA occurs more frequently in men while after age 45, OA is more common in women. Individuals with joints that don’t move or fit together correctly (i.e. dislocated hips, bowlegs) are more prone to develop OA.

The diagnosis of OA is usually clinical. There is no definitive test to diagnose OA. Your physician will ask you about your symptoms and examine your joints to help determine if you have the condition. OA is suspected if you are 45 years of age or older, joint pain that gets worse the more you use your joints, no pain and stiffness in the morning, or stiffness that lasts less than 30 minutes. Diagnostic exams like x-rays are usually not necessary, however they may be used to rule out other possible causes of your symptoms such as a fractured bone. A series of x-rays obtained over time can show the progression of joint damage. X-rays of the affected joints can show, bone damage, cartilage loss, and bone spurs (extra bone growth that develop on the surface of normal bones).

It is important to understand that there is no way to reverse the cartilage loss in OA. However, treatment options are available to help you alleviate the symptoms. The main treatments for OA include lifestyle modifications, medications and supportive therapies. In severe cases, where conservative measures have not been helpful, surgery to repair and strengthen or replace the damaged joints may also be considered.

Lifestyle modifications include diet, losing weight and exercise. Being overweight often makes OA worse as it can add weights on your joints. If you are overweight, try to lose weight by eating a low fat diet rich in vegetables, fruits and lean proteins and do regular exercise. If your condition causes you pain and stiffness, you may think that exercise will make your symptoms worse. But on contrary, regular exercise keeps you active and mobile, building up muscles thereby strengthening the joints thus improving symptoms. Aerobic exercises such as walking, riding a bicycle, dancing, swimming will keep your heart healthy while controlling your weight. Strength-training exercises such as weight lifting strengthen the muscles for better support of the joints. Stretching exercises increase flexibility and relieve stiff joints. All these exercises improve your posture and relieve your stress, all of which will relieve the symptoms.

Sometimes, medications are needed to control the symptoms. Analgesics can be given to help reduce pain. Examples are acetaminophen (i.e. Tylenol), tramadol and oxycodone. If pain is not controlled by taking paracetamol alone, your physician might add a stronger pain killer such as non-steroidal anti-inflammatory drugs (NSAIDS). These agents work by reducing inflammation. There are two types of NSAIDS. The traditional NSAIDS such as naproxen, ibuprofen and diclofenac and the COX-2 inhibitors such as celecoxib. If pain is so severe and cannot be controlled by both lifestyle modifications and oral medications, intra-articular injections of corticosteroids is also an option.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory, systemic disorder that normally affects the small joints in your hands and feet. Autoimmune disease is when your immune system doesn’t recognize your own body and targets your own body’s tissues. Patients with autoimmune diseases have antibodies and immune cells in their blood that attacks their own body tissues. This could be associated with inflammation. The inflammation around the joints is a characteristic feature of rheumatoid arthritis. However, the disease can also cause inflammation and injury to other organs of the body such as the skin, lungs, eyes, and blood vessels, hence, rheumatoid arthritis is sometimes called rheumatoid disease. While RA can occur at any age, it usually begins after age 40 and is more common in women than in men. Rheumatoid arthritis that begins below age of 16 is referred to as Juvenile Idiopathic Arthritis or Juvenile Rheumatoid Arthritis.

In contrast with the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of the joints (synovium) leading to a painful swelling that can result in bone erosion, joint deformity and loss of function.The tendons and ligaments that hold the joints together weaken and stretch losing its shape and its alignment gradually. The exact cause of RA is still not completely understood. There is no evidence that physical and emotional stress could trigger the disease. The process involves inflammatory, fibrosis and erosions of the capsule around the joints, underlying bone and cartilage. It can produce diffuse inflammation of the lungs, membrane of the lungs and heart and the whites of the eyes. RA can also cause nodular lesions on the skin.

More than half of the risk for RA is believed to be hereditary. It is strongly linked with the inherited tissue type major histocompatibility complex or MHC antigen HLA-DRB1 (most specifically the shared epitope alleles, including *0401 and *0404), and the genes PTPN22 and PADI4. RA is also three times more common in smokers than non-smokers. Moderate alcoholic drinkers may be protective. No infectious agent has been consistently linked with RA. However, epidemiological studies have confirmed a potential association between RA and Epstein-Barr virus and Human Herpes Virus 6. Patients with RA are more likely to show an abnormal immune response to EBV and have higher levels of anti-EBV antibodies.

The hallmark of RA is joint inflammation. This helps distinguish from the non-inflammatory form of arthritis, osteoarthritis. This is associated with redness, warmth, stiffness, pain and swelling of the joint/s affected, particularly following a prolonged inactivity. Morning stiffness is a prominent feature of RA and typically lasts for more than an hour. In non-inflammatory type of osteoarthritis, inflammation and early morning stiffness is less prominent, generally lasts less than an hour and movements aggravate pain. Generally, small joints are affected, however, any joint can be affected with RA: wrists, knees, shoulders, neck, feet, hips, cervical spine. Joints affected are usually in a symmetrical pattern, which means the same joint on both sides of the body, although this can present as asymmetrical at the beginning of the disease. As the disease progresses, multiple joints can be affected (polyarthritis).

With time, the inflammation around the joints leads to tethering and erosions of the tendons and destruction of the joint surface resulting to limitation of movement and joint deformity. Fingers deformities include swan neck deformity; “Z-deformity”- hyperextension of interphalangeal joint fixed flexion and sublaxation of the metacarpophalangeal joint; ulnar deviation; and boutonniere deformity. In severe cases, mutilating deformities of the joints occur, known as arthritis mutilans.

Not only the joints of the fingers, but other areas of the body can also be affected by RA which are all results of general process of inflammation, leading to ta a variety of symptoms which include body malaise, fatigue, loss of appetite, and muscle aches, which sometimes can be mistaken as flu, although they are usually less intense and lasts longer. Involvement of multiple areas of the body is more common with moderate to severe RA.

A feature most characteristic of RA is rheumatoid nodule, a type of inflammatory reaction known as “necrotizing granuloma”. The typical rheumatoid nodule is a few millimeters to a few centimeters in diameter, sometimes painful, and is usually found over bony prominences, such as the elbow, the knuckles, the heel, or any other areas that is susceptible to repeated mechanical stress. These nodules are associated with a positive rheumatoid factor titer and severe erosive arthritis.

Many forms of vasculitis occur in RA. Microinfarcts are benign forms of vasculitis seen around the nailfolds. Erythematous to purplish discoloration of the skin is a more severe form of vasculitis known as livedoreticularis which are caused by the presence of an obliterative cutaneous capillaropathy. The lungs, heart, eyes, kidneys, liver, and blood can also be affected by RA. They can be presented as shortness of breath, chest pain, episcleritis, renal amyloidosis, anemia and atherosclerosis leading to myocardial infarct.

Rheumatoid arthritis is a clinical diagnosis. There is no single test that can clearly identify RA. The American College of Rheumatology uses the following criteria for the diagnosis of RA. Presence of four or more factors is diagnostic. The first four factors should be present for at least six weeks.

  1. Morning stiffness for at least an hour.
  2. Swelling or presence of fluid around three or more joints simultaneously.
  3. At least one swollen area in the finger, wrist, or hand.
  4. Symmetrical
  5. Presence of rheumatoid nodules.
  6. Positive rheumatoid factor (RF)
  7. X-ray changes in the hands and wrists typical of RA, associated with destruction of bone around the involved joints.

The goals of treatment for RA are to reduce inflammation, relieve symptoms, improve physical function and overall well-being, to prevent joint and organ damage and to reduce long term complications. There is no cure for RA. However, medications can help reduce inflammation in order to alleviate pain and slow down joint damage. Occupational and physical therapy can teach you how to protect your joints. For patients with permanent damage that limits daily function, surgical treatment is an option.

There are two classes of drugs used in the treatment of RA. The first-line drugs or fast-acting drugs and the second-line drugs or slow-acting drugs. First-line drugs are used to reduce pain and inflammation. Drugs such as NSAIDS (e.g. ibuprofen, ketoprofen, naproxen sodium, and celecoxib) and costicosteroids (e.g. prednisone, prednisolone, methylprednisolone) are considered to be first-line drugs. Second-line drugs are used to slow down or stop the course of the disease and structural damage. These drugs includedisease-modifying antirheumatic drugs or DMARDS (e.g. methotrexate, hydroxycholorquine, sulfasalazine, cyclophosphamide, azathioprine, leflunomide); JAK inhibitors such as Tofacitinib block the Janus kinase or JAK pathways which are involved in the body’s immune response; biologics (e.g. abatacept, adalimumab, anakinra, infliximab, certolizumabpegol, etanercept, golimumab and rituximab) which block a specific step in the inflammation process. Abatacept blocks the activation of T cells. Rituximab blocks B cells. Tocilizumab blocks a cytokine called interleukin-6 (IL-6). Since these drugs work by targeting specific steps, they don’t wipe out the entire immune response. These can be given as infusion or injected.

If your joints are severely damaged by RA, joint replacement therapy can help reduce pain and restore function. The procedure involves replacing damaged part of a joint with metal or plastic parts. Hip and knee replacements are most common.

Gouty Arthritis

Gout is an inflammatory condition usually characterized by sudden, recurrent, severe attacks of redness, sharp pain, stiffness and swollen joints, often affecting the metatarsal-phalangeal joint at the base of the big toe. You can also get gout attacks in your foot, ankle, knees or other joints. It is a complex form of arthritis which is caused by elevated uric acids in the blood. The uric acid crystalizes, and these crystals deposit in the joints and surrounding tissues. Some people with high blood uric acid levels never get gout. But when the levels are too high, uric acid may form hard crystals in your joints causing pain. Long standing elevated uric acid levels may also result in tophi, a hard, painless deposits or uric acid crystals. Extensive tophi may lead to chronic arthritis due to bone erosion. It may also be presented as kidney stones or urate nephropathy.

Although men and postmenopausal women are usually affected, this condition can affect anyone. The hallmark of gout is a nightmare attack of redness, swelling, tenderness and burning pain in your big toe (most common), ankle, knees or other joints. The attack is so painful often wakening you up in the middle of the night. The reason for attacks at night is due to lower body temperature. The attacks can last a few days or weeks before the pain goes away. Another attack may not occur for months or years.

Normally, our body produces uric acid when it breaks down purines. Purines are substances that are present normally in our body, as well as in certain foods, such as organ meats, sea foods and steaks. Alcoholic beverages, especially beer, and sweetened fruit sugar also promote high levels of uric acid. Under normal conditions, uric acid dissolves in our blood and passes through the kidneys to be eliminated through urine. Uric acid builds up if your body produces too much uric acid or your kidneys excrete too little uric acid forming sharp, needle-like crystals in a joint or surrounding tissue that causes pain, swelling and inflammation.

Your risks of getting gout is higher if you are fond of eating meat and fish that are high in purine and drinks too much alcohol. Some drugs also increase uric acid concentration, such as aspirin and diuretics. Major illness or certain medical conditions such as high blood pressure, rapid weight loss, obesity, diabetes, metabolic syndrome and surgery also increase blood uric acid levels. People born with rare conditions such as Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome have a partial or complete deficiency in an enzyme that helps to control uric acid levels.

Hyperuricemia is a classic feature of gout. However, gout can occur without hyperuricemiaand individuals with high uric acid levels do not have the signs and symptoms of gout. Hence, blood testing can sometimes be misleading. Hyperuricemia is defined as plasma urate level greater than 7.0 mg/dl or 420 μmol/l in males and 6.0 mg/dl or 360 μmol/l in females. Other tests include joint fluid test, x-ray imaging, ultrasound and dual energy CT scan.

The goals of treatment are to settle the symptoms of acute attack and prevention of future gout attacks and long term complications. Options for acute treatment include NSAIDS, steroids and colchicine. Some evidence shows support on application of ice for 20-30 minutes several times a day reduces pain. Allopurinol and Febuxostat block uric acid production, limiting the amount of uric acid your makes, thus lowering your blood uric acid levels. Probenecid improves uric acid removal through the kidneys thus reducing your risk of gout. However, uric acid levels in your urine is elevated.


Save

Appendix

Appendix

Appendicitis:  What To Expect & How To Recover

For a world so highly driven by research and technology, the appendix has largely remained an enigma for doctors. A thin tube, located in the lower abdomen and attached to the large intestine, the functions of the appendix are still open to speculation.  Some research suggests it helps our body store good bacteria to help recover from digestive illness. There are also theories about the organ being a reminder from our evolution journey from ape to man. Although the organ looks and sounds pretty trivial, any disorder related to it can have serious implications.

The most common complication related to appendix is its inflammation or infection called appendicitis. In most cases it results in emergency surgical removal of the appendix known as Appendectomy, more commonly referred to as “appendix removal”. In rare cases if left untreated, an infected appendix may also prove to be fatal.

Causes

The exact cause of Appendicitis is relatively unknown. Research suggests that people having a rich fiber diet have relatively less probability of suffering from it.

Symptoms

  • Sharp pain starting near the belly button and moving to the lower right abdomen
  • A mild fever
  • Nausea and Vomiting
  • Swelling near the lower abdomen
  • Gas build up and loss of appetite
  • Abdominal cramps and painful urination
  • Some individual may also experience constipation or diarrhea

Diagnosis

In most cases the doctors will perform a physical examination by applying gentle pressure on the affected areas. Sometimes a rectal examination may also be performed. The other tests required are:

  • A blood test checking the white blood cell count to detect an infection
  • A urine test to rule out the possibility of a Urinary Tract Infection (UTI) or a kidney stone , which may also cause similar pain

Based on the results of the above, the doctor may also recommend a CT scan to confirm the exact cause of the pain.

Treatment

Since the appendix does not have a known important function, in most cases doctors recommend surgical removal of the organ. A minor infection can be cured through antibiotics and medication. However an untimely rupture of the appendix can prove to be fatal. Therefore in most cases surgery is viewed as the safest option.

Pre operative procedure

Appendix removal is usually an emergency surgery, however standard pre operative procedure is recommended.

The patient is advised not to eat or drink anything. If the patient experiences severe cramping, nausea, vomiting etc, related medication may be started along with IV antibiotics.

Surgical Procedure

The procedure can be performed through a direct incision or a laparoscopy; both require the patient to be given general anesthesia.

The affected area is usually shaved and disinfected.

If the patient has developed an abscess, a direct incision is required.  A 3-4 inch incision is made in the lower right side of the abdomen. The abscess is drained of pus and fluid and the abdominal cavity is cleaned.

If the doctor uses laparoscopy smaller incision is made and the doctor inserts small surgical tools and a camera to view and remove the appendix.

In some cases the appendix may also rupture causing bacteria and fluid to spread into the abdomen leading to serious infection peritonitis. In this situation the doctor may advise draining the fluid by placing a tube and controlling the infection first. An appendectomy may be performed only after the infection is completely cured.

A standard surgery may last around 2-3 hours and sometimes longer in case of complications.

Post Operative Care

All vital signs of the patient like temperature, breathing, heart rate etc are monitored till the anesthesia wears off, typically 6-8 hours after surgery.

Within 12 hours after surgery the patient is offered clear fluids only for some time. Solid food is introduced gradually. After the patient begins eating normally and bowel movements look fine, IV is removed and light physical activity is allowed.

Antibiotics and pain relieving medication may be administered as per the instructions from doctor. The patient is monitored typically for 2-3 hours before being discharged.

Recovery and Home Care:

The patient is given appropriate medication to be continued at home. Also the incision area must be kept clean and dry. Although normal routine can be resumed within a couple of days, heavy lifting, exercising or any strenuous activity should be avoided. However walking and limited movement are good for full recovery, typically within 4-6 weeks from surgery.

The doctor may also advise a follow up visit/check up after 2-3 weeks of surgery. The follow up visit may include a physical examination and removal of stitches/ staples from the incision area.

However it is important to contact your doctor immediately in case you experience any of the below:

  • Swelling ,oozing or persistent pain around the incision area
  • Fever of more than 101 degrees Fahrenheit or more
  • Irregular bowel movement or loss of appetite for more than 2 days
  • Vomiting , Nausea or Dizziness
  • Blood in urine or vomit

Risks & Complications

Although the probability of complications is very low, it is important to be aware of the risks and take proper post operative care.

The most common complication post operation is Wound Infection. It can be prevented easily by keeping the wound clean and dry.

In rare cases an abscess may also get formed in the incision area. Another uncommon complication is Stump Appendicitis. In this condition the patient may experience inflammation of the residual appendix.

Also in some cases patients develop cases of hernia or bowel obstruction in the long term. However maintaining a healthy diet and following your doctor’s advice may prevent all of the above. To find the list of hospitals and treatment cost of appendix removal surgery in major Indian cities you may refer to www.healthprice.in.

 


Save