We all at some point of time feel uncomfortable with our eyes. To our surprise, many common eye disorders disappear without the need for treatment or can be self-managed by oneself. Various products which are available over the counter (OTC) are artificial tears, ointments and ocular decongestants.  These products can help to combat dryness, itchiness, and excessive watering of the eye. However, a word of caution…In some cases, what seems to be like a minor eye problem may cause severe, potentially blinding conditions. So, always consult with your doctor for any persisting eye condition.

There are many OTC products which are safe and effective for mild eye disorders and are available for self-treatment. Two important factors to keep in mind when opting for self-treatment are:

if the problem appears in the eyeball itself, you need to consult a physician immediately; and

Use an OTC eye care product for 72 hours and check to see the improvement if the symptoms persist or the condition worsens, you should always see a doctor immediately. If there is blurry vision, double vision, visual loss or eye pain are your symptoms, then seek the help of an ophthalmologist (MD) immediately.

Ophthalmologists and optometrists both provide routine eye checkups. Ophthalmologists are physicians (MDs) who are specialized in diagnosing and treating diseases of the eyes and medically. Ophthalmology is the branch of science which deals with the eye. Optometrists are healthcare providers who provide eye care and diagnosis. An optician is a technician who does the job of fitting eyeglasses, it’s framed, and providing contact lenses.

What an Eye Examination Consists of:

Examining the structure of the eye;

 knowing the causes of the symptoms or disorder;

Treating ocular symptoms and eye disorders which are safe to self-treat and those which need the help of should an eye doctor; and the types of OTC eye care products available and their usefulness in the treatment of disorders.

Are Common Disorders Of The Eye Self-Treatable? Blepharitis, Lice, and Dermatitis

Blepharitis

It is a common eye condition which causes inflammation of the eyelid. Blepharitis results in red, thickened and scaly eyelids that typically sometimes causes loss of the eyelashes. This condition can be due to bacterial infection with Staphylococcus epidermidis or Staphylococcus aureus, or a mixture of the two or seborrheic dermatitis (a type of skin inflammation without known cause), it can sometimes occur because of rosacea of the face.

 The most common symptoms of blepharitis are

• itching,
• the flakiness of the lids, and
• A burning sensation of the eyes.

Treatment for Blepharitis

 Blepharitis can be initially treated by the use of hot compresses on the affected lids, which can be followed by an eyelid scrub. If the condition does not resolve, you should see the doctor immediately. He may prescribe you with antibiotic eye drops, eye ointments, or certain oral medication for the treatment of the condition.

Lice

This condition, eyelids become infested with one or two different lice, the crab louse (also called Phthirus pubis) or the head louse (called Pediculus humanus capitis).

Lice of the eyelids show symptoms and signs which are similar to that of blepharitis

• redness
• scaliness
• thickened eyelids, with some loss of the eyelashes.

Lice are common in young school going, children. Sometimes movements of the adult lice can be seen at the base of the lashes.

Treatment for Lice

Petrolatum or a non-medicated ointment is used and applied on the eyelid which suffocates the lice eggs. Some of the preparations like RID, NIX, A-2000, or any other hair preparation which are designed for radiation of lice in the hair should never be used near the eyes.

Contact Dermatitis

Contact dermatitis causes inflammation of the skin that results in redness, swelling, or scaling of the eyelid with intense urge to itch. This condition can be triggered by the topical use of any irritant product which can be soap or make up or exposure to a foreign substance. Sometimes the upper and lower eyelids are affected, and this causes inflammation which is likely to be an allergic reaction. Even if you use foreign substances for many years without any reaction, it can result in allergy.

Treatment for Contact Dermatitis

Antihistamines are the oral medication that can be taken by mouth which is used to treat contact dermatitis of the eyelid. To avoid the recurrence, Discontinue the use of the offending agent.

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Similar Names:

1. Dinitrogen monoxide;
2. laughing gas;
3. Hyponitrous acid anhydride;
4. factitious air.

How Does It Appear?

1. It is a colourless gas with a slightly sweet taste as well as odour.
2. It exists in the form of crystals and also liquid form.
3. It is found abundant in the atmosphere.
4. It produces from the decomposition of organic nitrogen compounds in soil.

What Are The Uses Of Nitrous Oxide

1. It is used as an analgesic in dental and obstetric surgery.
2. It can also be used as an anaesthetic in combination with other agents.
3. Nitrous oxide is used as the foaming agent in whipped cream, as an oxidant in organic compounds, to make nitrates in alkali metals.
4. It is also used in some rocket fuel combinations.
5. Whipped cream found in the can have been reported to release up to 1.5L of nitrous oxide.
   
   

   Nitrous Oxide

Mechanism Of Action

1. This gas acts as a central nervous system depressant.
2. It can cause asphyxiation by oxygen displacement.
3. It inactivates the biological activity of vitamin B12 and oxidizes cobalt which results in deprivation of vitamin B12.
4. Naloxone has been found to partially reverse the activity of nitrous oxide-induced analgesia.

Indications

• Uses as General Anaesthesia:- It is used in combination with other anaesthetics
  1. Nitrous oxide is used as a weak inhalational anaesthetic. It has a very low amount of alveolar concentration, that is the reason it can’t be used alone in general anaesthesia. So, it is combined with other potential inhalational anaesthetics for general anaesthesia.
  2. Nitrous oxide is most commonly used in mask induction of general anaesthesia in children. It is combined with oxygen and potent inhalational anaesthetic like sevoflurane which is delivered via mask inhalation.
• In Dentistry
  1. Nitrous oxide helps to decrease the pain and anxiety associated with dental procedures. It is delivered in combination with oxygen by nasal passage or mask. These nasal masks are specially designed to fully cover the nose which allows the mixture to flow while allowing the dental procedures through the mouth of the patient.
  2. It is commonly used by paediatric dentists to assist in procedures like amnesia, analgesia, as well as relaxation and cooperation in younger patients.
  3. Nitrous oxide uses in adult dental patients include lower pain tolerance, anxiety, mental retardation or any underlying psychiatric disorder.
• Other Indications include:
  1. Additional uses include colonoscopy, sigmoidoscopy, ophthalmic procedures, laser procedures, obstetrical labour pain, ambulance transport and medical procedures including joint injections.
  2. Nitrous oxide is less commonly self-administered in case of chronic pain because of terminal illness and in case of pain associated with cancer treatment.
  3. In the case of paediatric patients, it’s used is indicated in lumbar puncture, venous cannulation, or dressing changes has helped in a significant reduction in pain levels which allows shorter recovery time.
  4. A study has shown that nitrous oxide in combination with oxygen. When administered to the patients for three minutes displayed less anxiety and distress and it was effective in reducing pain in children.
  5. Nitrous oxide also used successfully in minor surgeries of children such as cyst surgery and abscess drainage

What Are The Side Effects Of The Gas?

1. The solubility of nitrous oxide increases by 35 times in blood than nitrogen.
2. When we inhale it, it increases the air-containing spaces such as bowel in size, while non-air containing spaces such as eustachian tube increases in pressure. This increase in pressure and size leads to bowel distention and rupture of the tympanic membrane.
3. It has been reported that Nitrous oxide may cause mild hypertension when given as anaesthetic.
4. It can also cause cardiac arrhythmias which may also result from hypoxia.
5. Nausea and vomiting may also occur
6. It causes intoxication which results in acute neuralgia due to asphyxia.
7. Side effects of inhalations also include a headache, dizziness, and excitation that results in CNS depression, seizures, and death.
8. The respiratory disturbance may also occur.
9. It may also cause interstitial emphysema and pneumomediastinum because of inhalation of gas from whipped cream cans.
10. Based on the research it has been evaluated that it is a potential carcinogen.

Toxicity

It Causes:

1. Increased muscle tone
2. Respiratory depression
3. hypertension
4. cardiovascular failure
5. Mydriasis
6. Prolonged usage can lead to bone marrow depression, polyneuropathy, megaloblastic changes, and death can also occur.
7. Impotence also occurs due to nitrous oxide-induced myeloneuropathy.
8. Neurological and hematopoietic effects are also reported and it may result in selective inactivation of vitamin B12.

Fatal Dose

1. When a person is exposed to 50-70% of nitrous oxide for 3 hrs it can cause aplastic anaemia and sometimes death.
2. If 40% of nitrous oxide is inhaled in the air can cause confusion and sedation while 80% level can lead to unconsciousness in most people.

Treatment

1. The way to treat a cough or difficulty in breathing, respiratory tract irritation, hypoxia, bronchitis or pneumonitis is to remove from the source of exposure.
2. If cerebral oedema and ICP (elevated intracranial pressure)  administer mannitol and elevate the head of the individual.
3. Hyperventilation is recommended if the impending herniation occurs.
4. Usage of folinic acid, IV is recommended for bone marrow abnormalities.
5. For neurologic damage, methionine supplements are recommended.

Supportive Measures Include:

1. Control the relapse of seizures
2. Treatment of hypoxia
3. Continuous monitoring of arrhythmias
4. Treatment of respiratory irritation.

References:-
https://emedicine.medscape.com/article/1413427-overview
https://www.britannica.com/science/nonmetal
https://www.healthline.com/health/nitrous-oxide-side-effects

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Hypogonadism is a condition where your sex glands do not function properly. Your sex glands might produce too little or no sex hormones. The sex glands in men are called as testes and in females, they are called ovaries. They can also be named as gonads. The main function of sex hormones is to develop secondary sexual characters such as testicular development in men and breast development in women. These hormones play an important role in menstrual cycles and also the production of sperm.

Hypogonadism- Types, Causes, Symptoms, Diagnosis, Treatment

Hypogonadism is also known as gonads deficiency. In males, it is referred to as low serum testosterone or andropause.

This condition can be treated with appropriate medical treatment.

Types of Hypogonadism

They are two types of hypogonadism. Let’s have a look at both types of hypogonadism:

• Primary Hypogonadism:- It is also known as a primary testicular failure. Because the problem originated from the testicles. The main causes of primary hypogonadism are Klinefelter syndrome- in this condition they are a congenital abnormality of the sex chromosomes, undescended testicles, mumps orchitis, hemochromatosis, injury to the testicles and cancer treatment.
• Secondary Hypogonadism:- In this condition, the problem is with the pituitary glands or hypothalamus which do not function properly. Hypothalamus produces a hormone called gonadotropin-releasing hormones. This hormone signals the brain to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones signal the testes to produce male sex hormone called testosterone. Common causes of secondary hypogonadism are Kallmann’s syndrome, pituitary disorders, inflammatory diseases, HIV/AIDS, certain medications, obesity and the normal ageing process.

Causes of Hypogonadism:-

The following are the causes of primary Hypogonadism:-

• Autoimmune disorders which are addison’s diseases and hypoparathyroidism.
• Severe infections which involve mumps in your testicles as well.
• Kidney and liver diseases
• Exposure to radiations
• Hemochromatosis which due to more absorption of iron in the body
• Sexual organ surgery
• Genetic disorders

Causes of Central or Secondary Hypogonadism

• Genetic disorders which includes kallmann’s syndrome
• Infections
• Pituitary disorders
• Inflammatory diseases
• Obesity
• Frequent Weight fluctuations
• Brain surgery
• Exposure to radiations
• Any injury to pituitary gland

Symptoms of Hypogonadism

The following are the symptoms of hypogonadism seen in women:-

• No menstrual cycle
• No growth of breast or slow growth
• Hot flashes
• Less hair growth in the body
• Low or Absence of sex drive
• Milky discharge from breasts

The Following are the Symptoms of Hypogonadism seen in Men:-

• Muscle loss
• Loss of body hair is seen
• Abnormal growth of the breast
• Reduction in the growth of penis and testicles
• Erectile dysfunction
• Osteoporosis
• Low or Absence of sex drive
• Fatigue
• Infertility
• Hot flashes
• Difficulty in concentration
  
  

  Hypogonadism

How to Diagnose Hypogonadism?

Your doctor will conduct a physical exam in order to assess the growth of secondary sexual characteristics. The doctor will also look for the levels of testosterone in the body. The following are the tests performed to confirm hypogonadism:

• Hormonal testing
• Analysis of the semen
• Pituitary imaging
• Genetics study
• Testicular biopsy

Treatment for Hypogonadism

Treatment options available for females are as follows:-

• Increasing the number of female sex hormones
• Estrogen supplementation is done when hysterectomy is performed.
• But in normal cases, the combination of estrogen and progesterone is given because there is a risk of developing endometrial cancer. If the increased levels of estrogen are alone is given.

Treatment in Male as Follows:-

1. Testosterone replacement therapy is widely used in hypogonadism. You can get
   • Injection
   • Patch
   • Gel
   • Lozenge

Take a Note:-

Hypogonadism is a chronic condition which requires life-long treatment. Your sex hormones may decrease if you stop treatment. You will need support from groups and through therapy which can help you before, during and after the treatment.

References:
https://www.healthline.com/health/hypogonadism#outlook
https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/diagnosis-treatment/drc-20354886

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Breast cancer is a type of cancer that starts within the tissues of the breast. It is the common type of cancer affecting many American women who are second to lung cancer that is the cause of cancer death. Breast cancer cam is diagnosed in the median age between the ages of 60 and 65 years. The incidence rate of breast cancer is also high in middle age woman. Statistics reveal that 1 in 8 women are susceptible to developing breast cancer in their lifetime.

How to Reduce Breast Cancer

Types of Breast Cancer

Below are the main types of cancer

Ductal Carcinoma:

It starts in the ductal tubes that regulate milk from the breast tissues to the nipples. This is the most common type of breast cancer.

Lobular carcinoma:

It starts in the milk-producing parts of the breast called lobules. This type of cancer is least reported.

Invasive carcinoma:

• Most of the breast cancers are of adenocarcinomas which are classified on the basis of the microscopic appearance of ducts and lobules.
• Invasive ductal carcinoma frequently affects bone, liver, lung or brain, whereas infiltrating lobular carcinoma tends to affect GI tract, reproductive organs, leptomeninges, peritoneal surfaces and other unusual sites.

Non-invasive carcinoma:

DCIS is commonly diagnosed than lobular carcinoma in the situation (LCIS).

Who Are More Susceptible

Breast cancer not only affects female but it also affects males. This type of cancer in males is of the rare type. It is the largest cause of death in American women after lung cancer.

Causes and Risk Factors

They are a variety of things which cause breast cancer

Endocrine factors:

• Marriages at the late age after 30s and first childbirth after 30 as well as nulliparity increases the risk of developing breast cancer.
• Prolonged usage of HRT (Hormone replacement therapy) and longer use of progestins are the contributable factors of breast cancer.
• Environmental and lifestyle changes also contribute to developing breast cancer in women.

Genomic factors:

BRCA1, include BRCA2, in chromosome 13 as well as 17. Other genes identified are associated with hereditary breast cancer includes TP53, CHK2, ATM and PTEN.

Signs and symptoms

General symptoms

They will be no symptoms visible in the asymptomatic patients until the screening of mammary gland is done.

Local signs and symptoms

There is the presence of a painless palpable lump in the breast is the most common symptom.
Nipple discharge retraction or dimpling oedema of the skin with redness or warmth is a less common symptom.
Palpable lymph nodes are local regional symptom also present.

Systemic metastases signs and symptoms

This symptom depends on the site of metastases, it includes bone pain, breathing difficulty, pain in the abdomen or enlargement of it, mental disturbance, jaundice.

How Breast cancer can be diagnosed

It can be diagnosed through following laboratory and diagnostic tests

Lab tests include :

Tumour markers are used to test cancer antigens or carcinoembryonic antigen.

Liver function tests or alkaline phosphatase are used in the evaluation of metastatic disease.

Diagnostic tests include :

Mammogram (it can be done with or without MR scan of the breast)

Biopsy for pathological review and determination of tumour receptors which include estrogen/progesterone status and HER2 status.

Chest x-ray, chest CT scan, abdominal CT scan or

Ultrasound or MRI scan.

Invasive carcinoma:

• Most of the breast cancers are of adenocarcinomas which are classified on the basis of the microscopic appearance of ducts and lobules.
• Invasive ductal carcinoma frequently affects bone, liver, lung or brain, whereas infiltrating lobular carcinoma tends to affect GI tract, reproductive organs, leptomeninges, peritoneal surfaces and other unusual sites.
• Non-invasive carcinoma: DCIS is commonly diagnosed than lobular carcinoma in the situation (LCIS).

Treatment

Stage 1 and stage 2

Breast-conserving therapy involves removal of part of the breast, evaluation of the axillary lymph node, radiation therapy of the breast lump.

Treatment

Systemic adjuvant therapy includes the administration of systemic therapy followed by definitive local therapy (radiation, surgery, or a combination of these). These therapies are followed if there is no evidence of metastatic disease.

Adjuvant Chemotherapy

This therapy can be used alone or in a combination with adjuvant therapy in breast cancer. The medications which are used are fluorouracil, paclitaxel, doxorubicin, epirubicin, cyclophosphamide, paclitaxel, vincristine and vinorelbine.

Stage 3 (Locally advanced breast cancer)

• This type of cancer refers to breast carcinomas with significant primary tumour and nodal disease, but in which distant metastases cannot be documented.
• The NCCN guidelines addressing the management of locally advanced disease recommend starting chemotherapy with either anthracycline or taxane containing drugs.
• Many patients have successful BCT response to chemotherapy is seen. Adjuvant therapy is prescribed to advanced cancer patients to minimize local recurrences, regardless of the type of surgery used for the individual patient.

Stage 4 (Metastatic breast cancer)

Treatment of this stage includes cytotoxic, biological or endocrine therapy often results in regression of disease as well as improves the quality of life of the patients. If the patient responds to the therapy, the duration of survival is also increased. The most important factor which determines response to endocrine therapy is the presence of estrogen and progesterone in the primary tumour tissue. 50-60% patients with ER-positive tumours and 70-80% of patients with ER and PR-positive response to the hormonal therapy successfully whereas ER-negative tumours respond less than 10% to the therapy.

Pharmacogenetic approach

Skincare

• Follow proper hygiene and keep skin clean and dry.
• Keep skin moisture to prevent chapping of the skin.
• Follow proper hygiene of the nails by not cutting the cuticles.
• Do not expose skin to the harmful radiation of the sun, if moving outwears sunscreen.
• Do not perform activities like washing dishes, gardening, using detergents, or working with any other tools without wearing gloves.
• If any minor injury occurs on the skin, clean it with soap and apply antibiotics ointment to avoid the spread of infection.

Lifestyle Changes

• Follow the proper diet and maintain the duration and intensity of the exercise.
• Take rest while performing an exercise which allows the limb to recover.
• Maintain a healthy weight.
• Garments
• Wear non-constricting garments and it should be well-fitted.
• For air, travelling wear well-supported garments

Additional safety measures

• Avoid standing for a long duration of time
• Avoid sitting crossed legs and sitting for a prolonged time.
• Wear clean and hygienic footwear and hosiery.
• Support at-risk limb with well-fitted garment while performing strenuous activity.

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Cardiac arrhythmias occur because of abnormalities of impulse formation or propagation. Abnormal impulse formation

Abnormal Automaticity

Automaticity is another term for pacemaker activity, a characteristic possessed by all cells of the specialised cardiac conduction system during health and, potentially, by other cardiac myocytes during certain disease states. The rate of firing of a pacemaker cell is largely determined by the duration of the phase 4 diastolic interval This in turn is determined by (i) the maximum diastolic potential following depolarization of the preceding action potential, (ii) the slope of diastolic depolarisation due to pacemaker currents and (iii) the threshold potential for generation of a new action potential. In the healthy state, there is a hierarchy of firing rates within the specialised conduction system with the highest rate in the sinus node followed by the AV node and then the His–Purkinje system.

Arrhythmias

Abnormal Impulse Propagation

Re-entry

Many clinically important arrhythmias are due to reentry, in which an activation wavefront rotates continuously around a circuit. Re-entry depends upon a trigger in the form of a premature beat, and a substrate, that is, the reentry circuit itself.

Signs And Symptoms of Arrhythmias

Patients with a cardiac arrhythmia may present with a number of symptoms:

The most common symptom is palpitation, an awareness of an abnormal heartbeat, although some patients with clearly documented arrhythmia have no palpitation. Arrhythmias start suddenly and, therefore, if the patient clearly describes palpitation of sudden onset (‘like flicking a switch’), this is a useful pointer to an arrhythmia rather than heightened awareness of sinus tachycardia, which has a less sudden onset.

The heart is designed to work most efficiently in sinus rhythm. Any arrhythmia compromises cardiac function. Classical symptoms that arise due to reduced cardiac output include reduced exercise capacity, breathlessness and fatigue.

Angina may accompany tachycardia, even in the absence of coronary artery disease. Tachycardia increases the metabolic rate of cardiac muscle and hence its demand for blood flow. Myocardial perfusion occurs predominantly during diastole and during tachycardia proportionately less time is spent in diastole and so myocardial demand for blood can exceed supply, resulting in angina.

A sudden drop in cardiac output may accompany either bradycardia or tachycardia, causing episodes of dizziness (presyncope), loss of consciousness (syncope) or, in extreme cases, sudden death from cardiac arrest.

Atrial tachyarrhythmias such as atrial flutter and atrial fibrillation may be complicated by the development of intracardiac thrombus, usually within the left atrial appendage. This thrombus may embolize to any part of the body but the most common clinical presentation is with a transient ischaemic attack or stroke. Arrhythmias may aggravate heart failure in two ways: (i) the haemodynamic effect of the arrhythmia may precipitate heart failure or aggravate existing heart failure and (ii) prolonged tachycardia of any type may lead to tachycardia-induced cardiomyopathy

Diagnosis of Arrhythmias

It includes a 12-lead ECG and an echocardiogram to detect structural heart disease. Other investigations for structural and ischaemic heart disease may be indicated at this stage with the aim of detecting any underlying structural heart disease. If the history does not include sinister features such as syncope or a family history of sudden unexpected death at a young age, and the resting 12-lead ECG and echocardiogram are normal, then the patient can be reassured that they are extremely unlikely to have a serious heart rhythm disturbance. The extent of further investigation will be dictated by how troublesome the symptoms are.

Treatment for Arrhythmias

Management

Cardiac arrhythmias associated with unstable angina, heart failure or hypotension requires emergency treatment. In most cases, the treatment of choice is d.c. cardioversion.

Concerns about thromboembolism as the heart returns to sinus rhythm are valid but should not delay emergency treatment. Immediate d.c. cardioversion is appropriate when the onset of arrhythmias is clearly identified as within 48 h of presentation or when the patient is already taking warfarin and has had a therapeutic INR for at least 4 weeks.

If facilities permit, a transesophageal echocardiogram may be performed in patients not already on warfarin in order to exclude intracardiac thrombus. Heparin should then be given immediately and continued until the INR is within the therapeutic range.

Anticoagulant therapy should be continued for at least 3 months following cardioversion. Long-term stroke prophylaxis is guided thereafter by the CHADS2 score.

If d.c. cardioversion is deemed inappropriate, rapid ventricular rate control may be achieved with intravenous ß-blockers, verapamil or digoxin.

Drug Therapy for Arrhythmias

Antiarrhythmic drug therapy is used to control the frequency and severity of arrhythmias, with the aim of maintaining sinus rhythm where possible. Although antiarrhythmic drug treatment has been the mainstay of arrhythmia treatment, many of these drugs have limited efficacy and important toxicity. Many arrhythmias are now curable by catheter ablation. Implantable devices such as permanent pacemakers and ICDs have assumed an increasingly important role in the treatment of arrhythmias and, in many cases, antiarrhythmic drugs have an adjunctive role.

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The liver weighs up to 1500g in adults and as such is one of the largest organs in the body. The main functions of the liver include protein synthesis, storage, and metabolism of fats and carbohydrates, detoxification of drugs and other toxins, excretion of bilirubin and metabolism of hormones,

Liver Disease

Acute Liver Disease

It is a self-limiting episode of hepatocyte damage which in most cases resolves spontaneously without clinical sequelae. This is a rare condition in which there is a rapid deterioration in liver function with associated encephalopathy (altered mentation) and coagulopathy. It may result in Acute liver failure which carries a significant morbidity and mortality and may require emergency liver transplantation.

The Chronic Liver Disease

It occurs when permanent structural changes within the liver develop secondary to long-standing cell damage, with the consequent loss of normal liver architecture. In many cases, this progresses to cirrhosis, where fibrous scars divide the liver cells into areas of regenerative tissue called nodules. The conventional wisdom is that this process is irreversible, but therapeutic intervention in hepatitis B and hemochromatosis has now repeatedly documented cases of reversal of cirrhosis. Once the patient reaches this stage they are at risk of developing liver failure, portal hypertension or hepatocellular carcinoma.

Symptoms of Liver Disease

The common symptoms of liver disease are the weakness, increased fatigue, and general malaise. Weight loss and anorexia are more commonly seen in chronic liver disease and loss of muscle bulk is a characteristic of the very advanced disease. Abdominal discomfort may be seen in patients with an enlarged liver or spleen while distension with ascites is usually the cause of more advanced disease. Abdominal pain is common in hepatobiliary disease, frequently localized to the right upper quadrant. This mostly results in rapid or gross enlargement of the liver when the pain is thought to be a consequence of capsular stretching. There is Tenderness over the liver in case of acute hepatitis, hepatic abscess or hepatic malignancy.

liver

Causes of Liver Disease

Viral Infections

Viruses are the common causative agents which the affect liver, resulting in a transient and innocuous hepatitis.Five human viruses have been well described to date, including hepatitis A (HAV), B (HBV), C (HCV), D (HDV) and E (HEV). Each type of viral hepatitis causes similar symptoms with acute inflammation of the liver.

Alcohol:

Alcohol is the single most significant cause of liver disease throughout the Western world accounting for between 40% and 60% of cases of cirrhosis in different countries. About 20% of alcohol abusers develop progressive liver fibrosis, which can eventually lead to alcoholic cirrhosis, typically after a period of 10–20 years of heavy indulgence

Non-Alcohol Related Fatty Liver Disease:

Liver pathology that is very similar to alcohol-induced disease is now well recognized in a number of settings including obesity, diabetes mellitus, and the metabolic syndrome.

Immune Disorder:

Autoimmune disease can affect the hepatocyte or bile duct and is characterized by the presence of autoantibodies and raised immunoglobulin levels. It includes Autoimmune Hepatitis (AIH), Primary biliary cirrhosis (PBC), Primary sclerosing cholangitis (PSC).

Vascular Abnormalities:

The Budd–Chiari syndrome (BCS) is a rare, heterogeneous and potentially fatal condition related to the obstruction of the hepatic venous outflow tract.

Metabolic and Genetic Disorders:

There are various inherited metabolic disorders that can affect the functioning of the liver. Hemochromatosis, Wilson’s disease, α1-Antitrypsin deficiency, Glycogen storage disease, Gilbert’s syndrome.

Drugs:

Drugs are an important cause of abnormal liver function tests and acute liver injury, including ALF (DILI drug induced liver injury).

Diagnosis of Liver Disease

All patients with liver disease must undergo a comprehensive and thorough assessment to ascertain the underlying etiology. Although causes of acute and chronic liver disease may differ, a similar approach is used to investigate both patient groups to ensure no primary cause or cofactor is overlooked.

• Biochemical tests
• Imaging Techniques
• Liver Biopsy
• Lab Investigation Of Aetiology

Treatment for Liver Disease

Several pharmacological agents are available for the emergency control of variceal bleeding. Most act by lowering portal venous pressure. They are generally used to control bleeding in addition to balloon tamponade and emergency endoscopic techniques.

• Vasopressin was the first vasoconstrictor used to reduce portal pressure in patients with actively bleeding varices. However, its associated systemic vasoconstrictive adverse effects limited its use.
• The synthetic vasopressin analog, terlipressin, is highly effective in controlling bleeding and in reducing mortality. It can be administered in bolus doses every 4–6h and has a longer biological activity and a more favorable side effect profile.
• Once a diagnosis of variceal bleeding has been established, a vasoactive drug infusion (usually terlipressin) should be started without further delay and continued for 2–5 days. Somatostatin and the somatostatin analog, octreotide, are reported to cause selective splanchnic vasoconstriction and reduce portal pressure.
• Although they are reported to cause less adverse effects on the systemic circulation, terlipressin remains the agent of choice.

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Home Remedies For Removing Lice From Hair

The most common signs of lice are itching on the head and red bumps on the scalp. Lice reproduces very quickly so it is very important to tame them as soon as possible. Combing them out with a very thin rooted comb is the most common remedy but it is tiring and it leaves behind the chances of not extracting lice eggs from the hair.

Let’s take a look at some of the home remedies that treats and removes lice from the scalp in an effective way.

1# Use Garlic

Strong smell of garlic helps in killing lice
The strong smell of garlic kills the lice by suffocating them. For this, you need to take 10 garlic cloves and crush them into a fine paste and mix two to three tsp of lemon juice in it. Apply this mixture on your scalp for half an hour and then rinse your hair with hot water. Repeat this process once in a week for atleast a month.

Strong smell of garlic helps in killing lice

2# Olive oil

Apply olive oil on your generously before going to the bed and put on a shower cap or towel to keep oil on your head overnight. In the morning comb out lice from the scalp and they will easily come out. After that wash your hair with some herbal or anti-lice shampoo.

3# Salt

Salt also kills lice in the hair along with vinegar
Mix one quarter cup of salt with equal amount of vinegar and then spray this solution in your hair. Put a shower cap on your head and let it cover for two hours. Then wash off your hair with a mild shampoo. Repeat this process every three days to get rid of lice from your hair and scalp.

Salt also kills lice in the hair along with vinegar

4# Coconut oil

The lubricating power of coconut oil will stop the lice from moving freely and prevents it from multiplying as well. Rinse your hair with apple cider vinegar and then apply generous amount of coconut oil to your scalp at night. Cover your head with a towel or shower cap for 7-8 hours. In the morning, comb your hair and lice will come out easily.

5# Mayonnaise

Mayonnnaise suffocates and kills lice
It has lot of oil in it and has viscosity properties as well that suffocates and kills lice. Apply it in your hair overnight and cover your hair with a shower cap. In the morning wash off your hair with shampoo and brush out your hair to take out remaining lice if any.

Mayonnnaise suffocates and kills lice

6# Sesame Seed oil

This oil has anti-fungal and insecticide properties which is why it helps in solving the problem of lice. Mix 1/4 cup of sesame oil, 1/8th cup of neem oil, 1 tsp of tea tree oil, one and half tsp of eucalyptus and rosemary oil and 10 drops of lavender oil. First rinse your hair with apple cider vinegar and then let them dry. Apply this oil solution to your hair and leave it overnight. In the morning, comb your hair to remove lice from the scalp.

7# Neem Oil

Neem is a natural pesticide and it kills lice within few hours
Neem has natural insecticide and it helps in getting rid of the lice in an effective way. Either use a neem oil shampoo or apply neem oil to your scalp for few hours to get rid of lice.

Neem is a natural pesticide and it kills lice within few hours

8# White Vinegar

Vinegar has acetic acid that helps in killing lice infested in the scalp. Just mix some white vinegar with equal amount of water to dilute it. Pour it on your scalp and immediately wrap a towel around your head for one to two hours. You can also dip a comb in white vinegar and comb your hair with that or rinse your hair with the same for immediate results.

9# Hot Oil

Applying hot oil will also remove lice from the hair
Use either coconut or neem oil for this as this will help in removing lice in an easy way. The staunch of neem oil and hotness of oil will make lice slide down easily from the scalp and out of your hair. Wash your head after this and once again comb your hair with thin tooth comb to take out any remaining lice.

Applying hot oil will also remove lice from the hair

10# Thyme Leaves

Strong herbal infusion of thyme treats lice in an effective way
Prepare a strong herbal infusion using either fresh or dried thyme leaves and flowers. Use this preparation as a rinse or spray onto hair while combing with a nit comb multiple times a day.

Strong herbal infusion of thyme treats lice in an effective way

This will help in removing lice from the scalp and the hair effectively.

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Anorexia Nervosa

Furthermore, ladies and men who experience the ill effects of anorexia nervosa epitomize an obsession with a thin figure and irregular eating habits. Anorexia nervosa is compatible with the term anorexia, which alludes to self-starvation and absence of hunger.

Main Types of Anorexia

Majorly, There are two basic types of anorexia, which are as per the following:

Purge Anorexia Nervosa Type– The individual experiencing this type of anorexia nervosa, will purge when he or she eats. This is normally a consequence of the unwelcoming sentiments of guilt a sufferer would involvement in connection to eating; they remunerate by vomiting, mishandling laxatives, abusing diuretics or excessively working out.
Anorexia Nervosa Of Restrictive Type – In this type of anorexia nervosa, the individual will restrain the amount of food devoured, naturally ingesting a negligible sum that is well underneath their body’s caloric needs, viably gradually starving him or herself.

Though above two types of anorexia are different types but the signs and symptoms for both occur the same.

Causes Of Anorexia

Anorexia is not a simple disorder but it is a result of many symptoms and irregular eating patterns which make it the complex issue. This complex condition might occur due to multiple factors including environmental and biological factors.

Environmental Factors

The following are the environmental factors which are responsible for anorexia nervosa:

The impacts of the slenderness culture in media, that always strengthen thin individuals as perfect generalizations
Callings and professions that advance being slim and weight reduction, for example, artful dance and displaying
Family and youth traumas: adolescence sexual abuse, serious injury
Peer weight among companions and colleagues to be thin or be provocative.

Biological factors

The following are the biological factors which contribute to anorexia nervosa.

Hormonal imbalance

Hereditary character (the tie amongst anorexia and one’s qualities is as yet being intensely researched, however, we realize that hereditary character is a part of the story).

Nutritious inadequacies

Signs and Symptoms of Anorexia Nervosa

Living with anorexia means you’re always concealing your habits. This makes it hard at first for loved ones to recognize the notice signs. Whenever went up against, you may attempt to clarify away your disordered eating and wave away concerns. Yet, as anorexia advances, individuals near you won’t have the capacity to deny their senses that something isn’t right—and neither should you.

Symptoms Of Anorexia Due to Different Food Behaviour

Eating less regardless of being thin – Taking after an extremely limited eating regimen. Eating just certain low-calorie foods. Banning “awful” foods, for example, sugars and fats.

Fixation on calories, fat grams, and sustenance – Perusing food names measuring and measuring parcels, keeping a food journal, perusing diet books.

Pretending to eat or lying about eating – Concealing, playing with, or discarding food to abstain from eating.

Weird or shrouded food habits – Declining to eat around others or in broad daylight places. Eating in unbending, ceremonial ways (e.g. cutting food “just so,” biting food and spitting it out, utilizing a particular plate).

Anorexic appearance and self-perception signs and manifestations

Sensational weight reduction – Fast, extreme weight reduction with no restorative cause.

Feeling fat, notwithstanding being underweight – You may feel overweight by and large or just “excessively fat” in specific spots, for example, the stomach, hips, or thighs.

Obsession with self-perception – Fixated on weight, body shape, or apparel estimate. Visit measure ins and worry over little changes in weight.

Brutally condemning of appearance – Investing a ton of energy before the reflect checking for blemishes. There’s continually something to condemn. You’re never sufficiently thin.

Signs And Symptoms Of Purging type of anorexia

Utilizing diet pills, purgatives, or diuretics – Mishandling water pills, herbal craving suppressants, remedy stimulants, ipecac syrup, and different medications for weight reduction.

Vomiting After eating – Often disappearing after dinners or heading off to the washroom. May run the water to mask hints of heaving or reappear possessing a scent reminiscent of mouthwash or mints.

Habitual working out – Taking after a rebuffing exercise regimen went for blazing calories. Practicing through wounds, disease, and terrible climate. Working out additional hard subsequent to gorging or eating something “awful.”

Treatment

Given the complexities of anorexia nervosa, an expert treatment group including therapeutic specialists, dietitians, and advisors is fundamental for the recuperation from this eating disorder. Compelling, all-encompassing eating disorder treatment for anorexia includes three vital parts:

Therapeutic: The most noteworthy need in the treatment of anorexia nervosa is tending to any genuine medical problems that may have come about because of ailing health, for example, improper heartbeat.

Dietary: This segment incorporates weight reclamation, usage and supervision of a custom fitted dinner plan, and training about ordinary eating designs.

Treatment: The objective of this a portion of treatment is to perceive fundamental issues connected with the eating disorder, address and recuperate from traumatic life occasions, learn more beneficial adapting aptitudes and further build up the ability to express and manage feelings.

Home Remedies For Anorexia:

The best home remedy for the treatment of an anorexic patient is a use of the following foods:

Home Remedies For Anorexia

• Garlic
• Ginger
• Oranges
• Mint

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Back pain is a very common health issue. Mostly it affects middle-aged and older people. Pain is usually around the hips and in the back. Young people may also suffer from the back pain. A backache may cause difficulty in sitting, standing and sleeping.

The pain is usually aching in character and limits the flexibility. It is usually very uncomfortable condition and makes you unable to concentrate on your work. Almost every one of us suffers from back pain at some point in our life.

Home Remedies to Relieve Back Pain

Causes of Back Pain May be Followed:

1. Muscle tension.
2. Sedentary lifestyle.
3. Lifting heavy weight.
4. Physical exertion.
5. Poor sitting position.
6. The poor quality of the mattress.
7. Pregnancy.
8. Increased weight.
9. Stress.
10 Travelling.

Causes of back pain

The doctor may prescribe you pain killers that may provide temporary relief. In this article, we will discuss home remedies to relieve back pain.

Top Remedies to Relieve Back Pain:

1.Holy basil leaves- Basil leaves have anti-inflammatory properties. It acts as a natural painkiller.
How to use:

• Take few basil leaves.
• Add it to a pan of water.
• Heat it till the water remains half.
• Now add one pinch of salt to it.
• Cool the mixture.
• Strains it and drink it.
• Drink this preparation once a day if the pain in mild.
• In the case of pain is severe drink this concoction 2 times a day.

2.Epsom Salt-

Magnesium sulfate or Epsom salt has the property to relieve joint and muscle pain. It also wards off the body toxins and improves the function of joints and muscles.

How to use:

• Take 2 tablespoons of Epsom salt
• Add it to the bath tub filled with water
• Immerse yourself in the bathtub for about half an hour.
• This is an effective and inexpensive way to relieve a backache.

Epsom Salt Remedies to Relieve Back Pain

3. An Ice pack to relieve a backache- Ice reduces swelling, makes affected area numb, blocks the signals of the pain and relieves a backache. How to use:

• Wrap a piece of ice in a cheese cloth.
• Apply it on the affected areas fro 15 to 20 minutes.
• Repeat this several times a day

*Alternately you can use frozen peas.
* Remember not to use ice directly on the skin or it may cause frostbite.
4. Massage- You may massage using the following ingredients:

• Camphor and coconut oil- Take 2 tablespoons of coconut oil. Mix camphor in it. Heat the mixture. Let it cool. Now massage the affected area in a circular motion with this preparation to relieve a backache.
• Tea tree oil- Mix tea tree oil with a carrier oil such as olive oil to dilute it. Now apply and massage the affected area in circular motion. Tea tree oil is an anti-inflammatory, it promotes blood circulation, decreases swelling and relieves a backache.

Massage Remedies to Relieve Back Pain

5.Eucalyptus oil bath-

Add a few drops of Eucalyptus oil to the bathtub or a bucket of warm water. Submerge yourself into the bathtub for 20 minutes or take a bath with eucalyptus oil added water. This will ward off stress and will relieve a backache.

6. Ginger tea-

Take few ginger slices and add it to one cup of water. Now heat it for about 15 minutes. Strain it and let it cool. Add a few drops of honey to this tea and drink it 2 times a day. You may also crush the ginger and form a paste. Now apply this paste on the affected area. After 15 minutes, rinse off with warm water and apply eucalyptus oil.

Ginger Tea to Relieve Back Pain

7. Chamomile tea- Add few chamomile leaves to a cup of steaming water. Let it steep for a few minutes. After 15 minutes, strain the mixture and drink it. This will relieve stress and backache.
8.Heat application- Take a clean sock. Fill rice in it. Microwave it for 60 seconds. Now check the temperature. If the temperature if the medium and comfortable apply it to the back.

9.Garlic- Galic is a natural painkiller and anti-inflammatory. You may either chew some pods of garlic or massage with garlic oil. To prepare garlic oil, add 10 pods of garlic to 2 tablespoon coconut oil. Heat it at low temperature for 10 minutes. Now cool it to a comfortable temperature. Strain it. Apply this preparation on your back and massage gently. After 20 minutes take warm water bath

Garlic to Relieve Back Pain

10.Wheat- Soak a handful of wheat in water for 10 hours. It is better if you soak them at night. In the morning add cuscus grass, coriander and a cup of milk to it. Boil the mixture and drink it 2 times daily. This preparation works an analgesic and relieves a backache.
11.Milk and turmeric- Add a half teaspoon of turmeric in a glass of warm milk. You may also add half teaspoon honey to it. Turmeric is a natural analgesic as well as anti-inflammatory. You will be relieved in a few days.

12.Poppy seeds-

This is a wonder remedy to relieve a backache. Grind 100 grams of poppy seeds and add rock candy to it. Eat 1 tablespoon of this mixture daily 2 times. This is followed by drinking a glass of milk.

Poppy Seeds remedies to relieve back pain

This is all home remedies, we know to relieve a backache. If you know some more home remedies to treat a backache please share with us.

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