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Dengue Fever

Understanding Dengue

Dengue fever is an Arboviral disease meaning it is an infection caused by a group of viruses that are spread by the bite-infected mosquitoes and ticks. The Aedes genus of mosquitoes, found in the tropical and subtropical regions of the world, is responsible for the transmission of dengue fever. You will notice such diseases more in the warmer seasons as these insects are more active. Dengue is a viral disease caused by any of the four related viruses: dengue virus 1, 2, 3, and 4.

The Different Types of Dengue Fever

 Dengue virus triggers your immune system and causes fever.There are 4 distinct serotypes of the dengue virus: DENV-1, DENV-2, DENV-3, and DENV-4. They are all RNA viruses belonging to the Flavivirus family/genus. All these subtypes can cause severe infections. However, research has shown specific serotypes to be more harmful, especially DENV-1 or DENV-2.

Dengue fever is classified into three types, depending upon its severity:

  • Dengue Fever – the primary infection, which is usually benign
  • Dengue Haemorrhagic Fever (DHF)
  • Dengue Shock Syndrome (DSS).

Based on your clinical signs, your doctor can diagnose which type of dengue fever you are affected by.

Symptoms of Dengue Fever

Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include

  • Sudden, high fever
  • Severe headaches
  • Pain behind the eyes
  • Severe joint and muscle pain
  • Fatigue
  • Nausea
  • Vomiting
  • Skin rash, which appears two to five days after the onset of fever
  • Mild bleeding (such a nose bleed, bleeding gums, or easy bruising)

Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults. However, serious problems can develop. These include dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death. This is called dengue shock syndrome (DSS).

People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing dengue hemorrhagic fever.

Diagnosing Dengue Fever

Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after traveling to a tropical area, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection.

Treatment for Dengue Fever

There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.

Is Platelet count very important?

Contrary to the popular public opinion, platelet counts are not important for the child’s treatment. Platelet tends to decrease during infection and increase during recovery. Administering platelets doesn’t hasten recovery. However, rarely doctor might order platelets when there is visible bleeding.

It is not the drop in platelet count, but the drop in blood pressure which can be fatal.

It makes more sense to follow up marker of leakage called hematocrit rather than platelet count. Further level of platelet count doesn’t predict if the child is going to be sick. It is best to prevent paranoia around platelet count and running around blood banks for get platelets.

For people with severe dengue, hospitalization is often needed.

Preventing Dengue Fever

 The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or traveling to a tropical area. This involves protecting yourself and making efforts to keep the mosquito population down. Eat some fruits like pomegranate, papaya, kiwi fruit etc for increasing blood platelet count.

  • Kiwi fruit, fig, Pomogranates, papaya etc( these will increase the blood count )
  • Juice made from young leaves of papaya.(daily have one time 5ml or 3ml- continue for 3-5 days).



Mangosteen – Uses, Benefits and more..

What is Mangosteen?

Mangosteen Aka Garcinia mangostana is a plant that grows in Southeast Asia. A Queen of fruits .The fruit is dark purple or red, the juicy inner flesh is bright white and the fruit pulp is slightly sour and sweet. Mangosteen contains chemicals that might act as antioxidants and fight infections. Mangosteen is relatively low in calories yet provides many essential nutrients .


People use mangosteen for

  • Serious gum infections
  • Obesity
  • Muscle strength
  •  Diarrhea, and many other conditions,
  • Supports diabetes control.

Health Benefits

  • Rich in  antioxidants and anti inflamatory  properties, highly beneficial to skin.

It has very rich and high anti oxidant and anti inflammatory profile. Antioxidants are compounds that can neutralize the damaging effects of potentially harmful molecules called free radicals, which are linked to various chronic diseases.

  • consumption of this fruit reduces visible signs of aging

It contains lots of nutrition helps in reducing aging and gives a  radiant glowing skin.

  • Enhances the skin radiance

consumption of mangosteen  brings natural glow and healthy supple skin

  • protects skin from free radicals
  • Boosts immunity

It contains vitamin C which supports immune system by boosting it.

  • Improves digestion

It improves digestion and gut health.

  • Helps lower cholesterol levels

It helps  in maintaining cholesterol  levels

  • Improves mental Health


Mangosteen is easy to prepare and eat — though it may be difficult to find depending on where you live. The fruit’s season is relatively short, which often limits its availability.

Your best bet is to look for it at specialty Asian markets, but be aware that fresh mangosteen can be quite expensive. Frozen or canned forms may be cheaper and easier to find — but be mindful that canned versions often contain added sugar.

The fruit can also be found in juice form or as a powdered supplement.

If you happen to score a fresh supply, choose fruits with a smooth, dark purple outer rind. The rind is inedible but can be easily removed with a serrated knife.

The inner flesh is white and very juicy when ripe. This part of the fruit can be eaten raw or added to smoothies or tropical fruit salads for a delicious boost of flavour.


Elephantiasis/ Lymphatic filariasis


Elephantiasis is a condition characterized by gross enlargement of an area of the body, especially the limbs. Other areas commonly affected include the external genitals. Elephantiasis is caused by obstruction of the lymphatic system, which results in the accumulation of a fluid called lymph in the affected areas.  Elephantiasis is a painful and profoundly disfiguring disease, caused by infection with parasites classified as nematodes (roundworms) of the family Filariodidea that are transmitted through the bites of infected mosquitos. Mosquito-transmitted larvae are deposited on the skin from where they can enter the body. The larvae then migrate to the lymphatic vessels where they develop into adult worms, thus continuing a cycle of transmission. The affected skin can thicken and harden to look something like an elephant’s skin.

It’s more common in tropical or subtropical areas. In endemic countries, lymphatic filariasis has a major social and economic impact. causing temporary or permanent disability. Lymphatic filariasis affects over 120 million people in 72 countries throughout the tropics and sub-tropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America.


Elephantiasis is caused by parasitic worms that are spread by mosquitoes. It starts when mosquitoes infected with the roundworm larvae bite you. The tiny larvae survive in your bloodstream and grow. They finish maturing in your lymph system. They can live there for years and cause a lot of damage to your lymph system.


  • Mild Edema
  • Huge swelling
  • pain in affected swollen area.
  • Thickened, nonelastic saggy skin
  • chills and fever

Elephantiasis may also affect the male and female external genital organs. In a male, there may be enlargement of the scrotum, and the penis may be retracted under skin which has become thickened, nonelastic, hot and painful. The spermatic cords may thicken. Affected individuals may experience pain and a burning sensation.

A detailed patient history and identification of characteristic symptoms. They also will have blood tests done to see if roundworms are in your bloodstream. These tests need to be done at night, because that’s when these parasites are active.


Treatment of elephantiasis always involves treating the underlying condition. Lymphatic filariasis is a chronic lymphedema, which should be treated in the early stages with good compression therapy and garments to prevent elephantiasis.

There are some things you can do on your own to ease them:

  • Wash and dry the swollen areas daily.
  • Use moisturizers.
  • Check for wounds and use medicated cream on any sore spots.
  • Exercise, and walk when possible.
  • If your arms or legs are swollen, keep them elevated when you’re lying down or seated.

However, in the majority cases, medical therapy alone is not enough and surgery may be necessary as a last option. In cases where the male genitals have been affected, reconstructive surgery on the penis and scrotum has been successful. Anti-streptococcal antibiotics are used to relieve secondary infection. Lymphatic tissue may be removed by surgery or radiation therapy.

Elephantiasis can be disabling. Sometimes it’s hard to move the affected body parts, which means it could be difficult to work. It might even be hard to get around in your home.

You might also worry about how your condition looks to other people. This can cause anxiety and depression. If you have elephantiasis and want information about support groups, ask your doctor. You can also go online to find resources that might help.

Non alcoholic steatohepatitis


The liver is part of the digestive system and the largest organ inside the body. Liver helps break down food, store energy, filter waste products, and remove toxins. Even healthy livers contain some fat, but if your liver has more than 5%  fat, you may have some form of NAFLD. If that fat is accompanied by inflammation, it is called NASH.

Fatty Liver Disease:


Also known as  Alcoholic Fatty Liver Disease, Alcoholic Steatohepatitis, NAFLD, NASH, Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis

The body can repair minor liver damage, but if the effects are severe or long-term, scar tissue eventually replaces liver tissue (a process known as fibrosis). That can lead to cirrhosis—a life-threatening condition in which irreversible damage prevents the liver from working properly.

Risks for fatty liver Disease:

The cause of nonalcoholic fatty liver disease (NAFLD) is unknown. Researchers do know that it is more common in people who:

  • Have type 2 diabetes and prediabetes
  • Have obesity
  • Are middle aged or older (although children can also get it)
  • Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
  • Have high levels of fats in the blood, such as cholesterol and triglycerides
  • Have high blood pressure
  • Take certain drugs, such as corticosteroids and some cancer drugs
  • Have certain metabolic disorders, including metabolic syndrome
  • Have rapid weight loss
  • Have certain infections, such as hepatitis C
  • Have been exposed to some toxins


NAFLD is the most common chronic liver disease. Most people with NAFLD have a fatty liver without inflammation. However, 20% of population with NAFLD develop NASH—liver inflammation that can seriously harm the organ. NASH is most common among people who are obese and/or have Type 2 diabetes. As these conditions become more prevalent, so does NASH.


  • An immune system reaction to excessive fatty liver tissue
  • The release of toxic inflammatory chemicals (cytokines) by liver cells or fat cells
  • Self-destruction (apoptosis) of liver cells
  • Oxidative stress, the effect of unstable molecules called free radicals

Genetics, metabolic changes, and changes to the microbiome (the microorganisms that are part of a healthy gut) might contribute to NASH.


Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.


Since there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use:

  • Your medical history
  • A physical exam
  • Various tests, including blood and imaging tests, and sometimes a biopsy.


Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.


diet  Some lifestyle changes that can help with fatty liver disease

Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains

Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.

Get regular exercise, which can help you lose weight and reduce fat in the liver

Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.




Liposuction is a type of cosmetic surgery that breaks up and “sucks” fat from the body. Liposuction is not an overall weight-loss method. Liposuction may work for you if you have a lot of body fat in specific places but otherwise have a stable body weight. Also called lipoplasty, liposculpture suction, lipectomy, or lipo.


People who undergo liposuction usually have a stable body weight but would like to remove undesirable deposits of body fat in specific parts of the body.The procedure does not remove cellulite, dimples, or stretch marks. The aim is esthetic. It suits those who wish to change and enhance the contour of their body.Liposuction permanently removes fat cells, altering the shape of the body. However, if the patient does not lead a healthy lifestyle after the operation, there is a risk that the remaining fat cells will grow bigger.

Liposuction is normally advised only if lifestyle changes have not achieved the desired results. It can treat areas of fat that are resistant to exercise and diet.When an individual gains weight, each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas.


The following body areas are commonly targeted for liposuction treatment:

  • abdomen
  • back
  • buttocks
  • chest
  • inner knees
  • hips
  • flanks (love handles)
  • neckline and the area under the chin
  • thighs, both “saddlebags,” or outer thighs, and inner thighs
  • upper arms


Liposuction is normally done for cosmetic purposes, but it is sometimes used to treat certain conditions.

These include:

  • Lymphedema: A chronic, or long-term, condition in which excess fluid known as lymph collects in tissues, causing edema, or swelling. The edema commonly occurs in the arms or legs. Liposuction is sometimes used to reduce swelling, discomfort, and pain.
  • Gynecomastia: Sometimes fat accumulates under a man’s breasts.
  • Lipodystrophy syndrome: Fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient’s appearance by providing a more natural looking body fat distribution.
  • Extreme weight loss after obesity: A person with morbid obesity who loses at least 40 percent of their BMI may need treatment to remove excess skin and other abnormalities.
  • Lipomas: These are benign, fatty tumors. 


After liposuction, swelling typically goes away within a few weeks. By this time, the treated area should look less bulky. Within several months, expect the treated area to look slimmer.Skin loses some firmness as people age, but liposuction results usually last a long time if you maintain your weight. If you gain weight after liposuction, your fat levels may change. For example, you may gain fat around your abdomen no matter what areas were originally treated.

Liposuction works best for people with good skin tone and elasticity, where the skin molds itself into new contours.People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done.

The person needs to be over 18 years of age and in good health. Those with circulation or blood flow problems, such as coronary artery disease, diabetes, or a weakened immune systems should not undergo liposuction.

People should discuss the pros and cons of liposuction with their doctor before deciding on whether to proceed. Liposuction should only be carried out after careful consideration.After liposuction, swelling typically goes away within a few weeks. By this time, the treated area should look less bulky. Within several months, expect the treated area to look slimmer.Skin loses some firmness as people age, but liposuction results usually last a long time if you maintain your weight. If you gain weight after liposuction, your fat levels may change. For example, you may gain fat around your abdomen no matter what areas were originally treated.


The risk of complications is usually associated with how large the procedure is, as well as the surgeon’s skills and specific training.

The following risks, unpleasant side effects, or complications are possible:

  • Severe bruising: This can last for several weeks.
  • Inflammation: The swelling may take up to 6 months to settle, and fluid may continue to ooze from the incisions.
  • Thrombophlebitis: A blood clot forms in a vein, causing inflammation and further complications.
  • Contour irregularities: If there is poor skin elasticity, if the wound heals in an unusual way, or if fat removal has been uneven, the skin may appear withered, wavy, or bumpy.
  • Numbness: The affected area may feel numb for a while, but this is usually temporary.
  • Infections: Rarely, a skin infection may occur after liposuction surgery. Sometimes this needs to be treated surgically, with the risk of scarring.
  • Kidney or heart problems: As fluids are being injected and or suctioned, the change in the body’s fluid levels may cause kidney or heart problems.
  • Pulmonary embolism: Fat gets into the blood vessels and travels to the lungs, blocking the circulation in the lungs. This can be life-threatening.
  • Pulmonary edema: Sometimes, when fluid is injected into the body, it accumulates in the lungs.
  • Allergic reaction: The patient may be allergic to medications or materials used during surgery.
  • Skin burns: The cannula movement may cause friction burns to the skin or nerves.

Those who are most satisfied with the results tend to be the people who consider carefully the pros and cons beforehand, who are informed about what to expect, who choose a qualified and experienced surgeon, and who discuss the details carefully with their surgeon.






Cryotherapy is also called cryosurgery or cryoablation is a minimally invasive therapy. This type of treatment removes damaged or diseased tissue that comes from a variety of medical conditions. This treatment uses intense cold to freeze and destroy cancer cells and abnormal tissue. For this, liquid nitrogen or argon gas is applied. Cryotherapy is a type of local treatment. That is, it is used to treat a specific place on the body. Cryotherapy is used to treat skin tumors, as well as some tumors inside the body.


Cryotherapy is usually done without open surgery. Most people recover quickly from the procedure and with little pain. Your provider might recommend cryotherapy for:

How is cryotherapy used to treat cancer?

With cryotherapy, the tissue is frozen to destroy the treated cells.

For skin tumors, the doctor applies liquid nitrogen to the abnormal area with a swab or spray.

For tumors inside the body, an instrument called a cryoprobe is used to freeze the tumor tissue. The cryoprobe is inserted into the body during surgery or through a small incision in the skin. Using the cryoprobe, the doctor directly applies liquid nitrogen or argon gas to the tumor.


During this procedure, the doctor is guided by ultrasound or magnetic resonance imaging (MRI) to place the cryoprobe in the correct site and limit damage to healthy tissue surrounding the tumor. In some cases, more than one cryoprobe is used to freeze different parts of the tumor.

As the frozen tissue melts, the cells are destroyed. Tumors that freeze inside the body are reabsorbed. Tumors that freeze into the skin form a scale that falls off as the skin heals.

It is possible to combine cryotherapy with other cancer treatments such as hormone therapy , chemotherapy , immunotherapy , radiotherapy or conventional surgery. For example, after a primary bone tumor is removed, the remaining tissue may be treated with cryotherapy to decrease the risk of the tumor coming back.

Risks & Benefits

The risks of cryotherapy are small, but complications can occur. These complications may include:

  • Bleeding, cramping or pain after cryotherapy around the cervix.
  • Bone fractures.
  • Nerve damage resulting in loss of feeling.
  • Swelling, scarring and skin infection.

Cryotherapy has many benefits.

  • For tumors inside the body, usually only a small cut or puncture is needed to insert the cryoprobe through the skin. This avoids some problems that surgery has, such as pain and bleeding.
  • Cryotherapy is often done under local anesthesia and does not require hospitalization.
  • Because cryotherapy is a local treatment and doctors focus on treating an exact area, damage to nearby healthy tissue is limited.
  • It is possible to repeat cryotherapy without problems and use it with other cancer treatments.
  • Cryotherapy is used when surgery is not possible due to the type of tumor, age, or other health problems the person has.
  • Cryotherapy may be an option when the cancer does not respond to standard treatment .

Recovery & Outcome

Healthcare providers successfully treat many problems with cryotherapy. Most skin conditions treated with cryotherapy do not require any special care after treatment.

Some people who have internal cryotherapy need to limit their activity for a few days after the procedure. Your provider will let you know when you can return to your regular routine. You may need more than one cryotherapy treatment to remove all the abnormal tissue.

Consult your Physician :

Contact your healthcare provider if you have signs of an infection after cryotherapy. These signs may include:

  • Redness.
  • Pus.
  • Unexplained fever.

You should also see your provider if you still notice a skin issue after you heal from cryotherapy.




is a condition in which the fibrous joints between the skull bones fuse too early. These joints are known as sutures. If this occurs (usually before or at birth) it can cause an abnormal head shape, or in some cases restrict growth of the brain, which increases the pressure inside the skull.

Usually, during infancy the sutures remain flexible, allowing a baby’s skull to expand as the brain grows. In the front of the skull, the sutures meet in the large soft spot (fontanel) on top of the head. The anterior fontanel is the soft spot felt just behind a baby’s forehead. The next largest fontanel is at the back (posterior). Each side of the skull has a tiny fontanel.

Craniosynostosis usually involves premature fusion of a single cranial suture, but it can involve more than one of the sutures in a baby’s skull (multiple suture craniosynostosis). In rare cases, craniosynostosis is caused by certain genetic syndromes (syndromic craniosynostosis).

Treating craniosynostosis involves surgery to correct the shape of the head and allow for brain growth. Early diagnosis and treatment allow your baby’s brain adequate space to grow and develop.

Although neurological damage can occur in severe cases, most children develop as expected in their ability to think and reason (cognitive development) and have good cosmetic results after surgery. Early diagnosis and treatment are key.


The signs of craniosynostosis are usually noticeable at birth, but they become more apparent during the first few months of your baby’s life. Signs and severity depend on how many sutures are fused and when in brain development the fusion occurs. Signs and symptoms can include:

  • A misshapen skull, with the shape depending on which of the sutures are affected
  • Development of a raised, hard ridge along affected sutures, with a change in the shape of the head that’s not typical

Types of craniosynostosis

There are several types of craniosynostosis. Most involve the fusion of a single cranial suture. Some complex forms of craniosynostosis involve the fusion of multiple sutures. Multiple suture craniosynostosis is usually linked to genetic syndromes and is called syndromic craniosynostosis.

The term given to each type of craniosynostosis depends on what sutures are affected. Types of craniosynostosis include:


  • Sagittal (scaphocephaly).Premature fusion of the sagittal suture that runs from the front to the back at the top of the skull forces the head to grow long and narrow. This head shape is called scaphocephaly. Sagittal craniosynostosis is the most common type of craniosynostosis.
  • Premature fusion of one of the coronal sutures (unicoronal) that run from each ear to the top of the skull may cause the forehead to flatten on the affected side and bulge on the unaffected side. It also leads to turning of the nose and a raised eye socket on the affected side. When both coronal sutures fuse prematurely (bicoronal), the head has a short and wide appearance, often with the forehead tilted forward.
  • The metopic suture runs from the top of the bridge of the nose up through the midline of the forehead to the anterior fontanel and the sagittal suture. Premature fusion gives the forehead a triangular appearance and widens the back part of the head. This head shape is also called trigonocephaly.
  • Lambdoid synostosis is a rare type of craniosynostosis that involves the lambdoid suture, which runs along the back of the head. It may cause one side of a baby’s head to appear flat, one ear to be higher than the other ear and tilting of the top of the head to one side.


Often the cause of craniosynostosis is not known, but sometimes it’s related to genetic disorders.

  • Nonsyndromic craniosynostosisis the most common type of craniosynostosis. Its cause is unknown, although it’s thought to be a combination of genes and environmental factors.
  • Syndromic craniosynostosisis caused by certain genetic syndromes, such as Apert syndrome, Pfeiffer syndrome or Crouzon syndrome, which can affect a baby’s skull development. These syndromes usually also include other physical features and health problems.


Surgery for craniosynostosis is designed to correct the abnormal head shape and allow the growing brain room to expand normally.

The surgery for craniosynostosis is typically performed in the first two years of life. There are multiple types of surgery used to treat craniosynostosis, including strip craniectomy, spring-assisted craniectomy and cranial vault remodeling, amongst others. Not all patients are a candidate for all types of surgery. The surgery is performed by a team of a plastic surgeon and a neurosurgeon, working together.

What craniosynostosis surgery can treat

  • Abnormal skull shapes that result from early suture fusion
  • Raised intracranial pressure (ICP), or pressure on the brain caused by restriction of skull growth
  • Certain problems with eye position related to suture fusion

What results should I expect after craniosynostosis surgery?

The immediate results of craniosynostosis surgery will depend on the type of surgery performed. With open craniosynostosis procedures, the fused sutures are released, and the skull bones are repositioned to create a more typical head shape. The results of open procedures will be immediately apparent with a significant change in your child’s head shape from before to after surgery.


If untreated, craniosynostosis may cause, for example:

  • Permanently misshapen head and face
  • Poor self-esteem and social isolation

The risk of increased pressure inside the skull (intracranial pressure) from simple craniosynostosis is small if the suture and head shape are fixed surgically. But babies with an underlying syndrome may develop increased intracranial pressure if their skulls don’t expand enough to make room for their growing brains.

If untreated, increased intracranial pressure can cause:

  • Developmental delays
  • Cognitive impairment
  • Blindness
  • Seizures
  • Headaches

Plantar fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia.

Plantar fasciitis commonly causes stabbing pain that often occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight.



The plantar fascia is a band of tissue, called fascia,that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking.

Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the facia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.


Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worst with the first few steps after awakening, although it also can be triggered by long periods of standing or when you get up from sitting.


Plantar fasciitis is diagnosed based on your medical history and physical exam. During the exam, your health care professional will check for areas of tenderness in your foot. The location of your pain can help determine its cause.

Imaging tests

Usually no tests are needed. Your health care professional might suggest an X-ray or MRI to make sure another problem, such as a stress fracture, is not causing your pain.

Sometimes an X-ray shows a piece of bone sticking out from the heel bone. This is called a bone spur. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.

Risk factors

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

  • Plantar fasciitis is most common in people between the ages of 40 and 60.
  • Certain types of exercise.Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
  • Foot mechanics.Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you’re standing and can put added stress on the plantar fascia.
  • Excess pounds put extra stress on your plantar fascia.
  • Occupations that keep you on your feet.Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can be at increased risk of plantar fasciitis.


Most people who have plantar fasciitis recover in several months with conservative treatment, such as icing the painful area, stretching, and modifying or staying away from activities that cause pain.


Pain relievers you can buy without a prescription such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can ease the pain and inflammation of plantar fasciitis.


Physical therapy or using special devices might relieve symptoms. Treatment may include:

  • Physical therapy.A physical therapist can show you exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist also might teach you to apply athletic taping to support the bottom of your foot.
  • Night splints.Your care team might recommend that you wear a splint that holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching while you sleep.
  • Your health care professional might prescribe off-the-shelf or custom-fitted arch supports, called orthotics, to distribute the pressure on your feet more evenly.
  • Walking boot, canes or crutches.Your health care professional might suggest one of these for a brief period either to keep you from moving your foot or to keep you from placing your full weight on your foot.

Surgical or other procedures

If more-conservative measures aren’t working after several months, your health care professional might recommend:

  • Injecting steroid medicine into the tender area can provide temporary pain relief. Multiple shots aren’t recommended because they can weaken your plantar fascia and possibly cause it to rupture. Platelet-rich plasma obtained from your own blood can be injected into the tender area to promote tissue healing. Ultrasound imaging during injections can assist in precise needle placement.
  • Extracorporeal shock wave therapy.Sound waves are directed at the area of heel pain to stimulate healing. This is for chronic plantar fasciitis that hasn’t responded to more-conservative treatments. Some studies show promising results, though this therapy hasn’t been shown to be consistently effective.
  • Ultrasonic tissue repair.This minimally invasive technology uses ultrasound imaging to guide a needlelike probe into the damaged plantar fascia tissue. The probe tip then vibrates rapidly to break up the damaged tissue, which is suctioned out.
  • Few people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is serious and other treatments have failed. It can be done as an open procedure or through a small incision with local anesthesia


Ignoring plantar fasciitis can result in chronic heel pain that hinders your regular activities. You’re likely to change your walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems.