What is malaria?

Malaria is an infection of the blood that is carried from person to person by mosquitoes. The disease has been recognized for thousands of years and once was found almost everywhere except in the most northern areas of the world.  However, it remains a serious problem in much of the tropical and subtropical world.

Millions of people continue to be infected every year and close to one million of them die.

Malaria symptoms

With malaria you develop a high fever, which comes and goes every other day or few days. How often a fever returns varies with each species of malaria.

• Many infections do not show this classic pattern of returning fevers at all. In many people the infection will seem more like flu with high fever and body aches.
• People also will complain of headache, nausea, shaking chills (rigors),sweating and weakness.
• As the infection progresses the fevers get less severe and you seem to recover. However, the infection can remain in many people for several years, particularly for those with a long history of exposure to malaria.
• These people can develop some immunity and may be infected for many years while only rarely having symptoms.

The different types of malaria each bring on their own complications.

• P falciparum: You can develop severe haemolytic anaemia (the red blood cells actually break down), kidney failure, coma and death. Treatment is a medical emergency. Drug resistance has become widespread. Current information on disease patterns, prevention for travellers and drug resistance can always be found through a travel health clinic or your GP surgery.
• P ovale: This species also can cause anaemia, but this infection is rarely life threatening.
• P vivax: You can develop anaemia and rupture of the spleen, which can become life threatening. People with P vivax or P ovale may relapse several months after the initial illness because of the persistence of dormant forms (called hypnozoites) remaining in the liver. These should be eradicated with medical treatment.
• P malariae: This infection is rarely life threatening, but a long-standing disease can lead to kidney failure. If untreated, this infection can last throughout your life.

Malaria causes

Malaria is caused by protozoan of the genus Plasmodium.

• Infection begins with a bite from an infected mosquito.
• The parasite travels from the mosquito to your liver, where the parasite begins to reproduce.
• The parasite leaves the liver and travels to the bloodstream, where it infects red blood cells. The parasite reproduces in the red blood cells, which destroys the cells and releases more parasites into the bloodstream.
• If another mosquito bites an infected person, that mosquito can then carry the infection to someone else.

There are four species of Plasmodium that infect humans:

• P vivax – Most common in India and Central and South America but found worldwide. It has an incubation period of 8-13 days. Infections can sometimes lead to life-threatening rupture of the spleen. In people treated only with chloroquine, this type of malaria can hide in the liver and return later.
• P ovale – Rarely found outside Africa. This form of malaria has an incubation period of 8-17 days and can hide in the liver of partially treated people and return later.
• P malariae – Found worldwide but less common than the other forms. This form of malaria has an incubation of 2-4 weeks. If untreated, the infection can last many years.
• P falciparum – Common worldwide, this is the most life-threatening form of malaria. This parasite has an incubation period of 5-12 days. Resistance to many of the medicines used to treat or prevent malaria is increasing.
• Although most people acquire malaria through mosquito bites, in some foreign countries the disease can have other sources.
  • Every year a handful of people are infected through blood transfusions or organ transplants.
  • IV drug users can develop malaria from sharing needles.
  • Each year a few babies are born to mothers who did not know they were infected. The babies then develop malaria.

When to seek medical care

People who recently have traveled to a country in which malaria exists and who develop a high fever or other symptoms that may be malaria should seek immediate medical attention at the GP’s surgery or at a hospital.

Examinations and tests

A healthcare professional will perform blood tests to determine if you have malaria and, if so, which type.

Malaria treatment

• Your doctor will prescribe a medicine or a combination of medicines straight away, depending on the type of strain and where you were infected.
• In much of the world, malaria is treated at home with oral medication and fluids. Severe infections require IV drug therapy.
• The most important aspect of home care is to make sure you drink lots of fluids and not to become dehydrated.

Next steps follow-up

• People infected with P vivax or P ovale will need to take chloroquine for several weeks after being treated in order to kill the parasites hiding in the liver.
• Report any recurrent fever or symptoms to your doctor because treatment failures are fairly common, and additional treatment will be indicated.
• Do not donate blood for several years after having been exposed to malaria.

Prevention

• For people travelling to areas where malaria exists, prevention is perhaps the most important aspect of managing the disease. Seek advice well before you travel, because some medications need to be started before you travel. DEET, or diethyltoluamide, is one of the most commonly used repellents that the NHS says is effective in sprays, roll-ons, sticks and creams. However, London School of Hygiene and Tropical Medicine researchers have found mosquitoes are able to ignore the smell of one of the most popular insect repellent ingredients a few hours after first being exposed to it, highlighting the importance of taking additional precautions such as the use of mosquito nets.
• Several medications are used to prevent infections during foreign travel. The pattern of resistance to these medications is constantly changing.
• In some parts of the world, P falciparum is resistant to all these medications.

What Causes Diabetes?

Your pancreas makes a hormone called insulin. It’s what lets your cells turn glucose from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don’t use it as well as they should. Doctors call this insulin resistance.

At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can’t keep up, and the sugar builds up in your blood instead.

Usually a combination of things cause type 2 diabetes, including:

Genes. Scientists have found different bits of DNA that affect how your body makes insulin.

Extra weight. Being overweight or obese can cause insulin resistance, especially if you carry your extra pounds around the middle. Now type 2 diabetes affects kids and teens as well as adults, mainly because of childhood obesity.

Metabolic syndrome. People with insulin resistance often have a group of conditions including high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides.

Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and usually the liver will slow down and store its glucose for later. But some people’s livers don’t. They keep cranking out sugar.

Bad communication between cells. Sometimes cells send the wrong signals or don’t pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reaction can lead to diabetes.

Broken beta cells. If the cells that make the insulin send out the wrong amount of insulin at the wrong time, your blood sugar gets thrown off. High blood glucose can damage these cells, too.

Risk Factors and Prevention

While certain things make getting diabetes more likely, they won’t give you the disease. But the more that apply to you, the higher your chances of getting it are.

Some things you can’t control.

• Age: 45 or older
• Family: A parent, sister, or brother with diabetes

Some things are related to your health and medical history. Your doctor may be able to help.

• Prediabetes
• Heart and blood vessel disease
• High blood pressure, even if it’s treated and under control
• Low HDL (“good”) cholesterol
• High triglycerides
• Being overweight or obese
• Having a baby that weighed more than 9 pounds
• Having gestational diabetes while you were pregnant
• Polycystic ovary syndrome (PCOS)
• Acanthosis nigricans, a skin condition with dark rashes around your neck or armpits
• Depression

Other risk factors have to do with your daily habits and lifestyle. These are the ones you can really do something about.

• Getting little or no exercise
• Smoking
• Stress
• Sleeping too little or too much

Because you can’t change what happened in the past, focus on what you can do now and going forward. Take medications and follow your doctor’s suggestions to be healthy. Simple changes at home can make a big difference, too.

Lose weight. Dropping just 7% to 10% of your weight can cut your risk of type 2 diabetes in half.Get active. Moving muscles use insulin. Thirty minutes of brisk walking a day will cut your risk by almost a third.Eat right. Avoid highly processed carbs, sugary drinks, and trans and saturated fats. Limit red and processed meats.Quit smoking. Work with your doctor to avoid gaining weight, so you don’t create one problem by solving another.

Symptoms

The symptoms of type 2 diabetes can be so mild you don’t notice them. In fact, about 8 million people who have it don’t know it.

• Being very thirsty
• Peeing a lot
• Blurry vision
• Being irritable
• Tingling or numbness in your hands or feet
• Feeling worn out
• Wounds that don’t heal
• Yeast infections that keep coming back

Long-Term Effects

Over time, high blood sugar can damage and cause problems with your:

• Heart and blood vessels
• Kidneys
• Eyes
• Nerves, which can lead to trouble with digestion, the feeling in your feet, and your sexual response
• Wound healing
• Pregnancy

The best way to avoid these complications is to manage your diabetes well.

• Take your diabetes medications or insulin on time.
• Check your blood glucose.
• Eat right, and don’t skip meals.
• See your doctor regularly to check for early signs of trouble.

What Is Fabry Disease?

Fabry disease runs in families. It can have lots of different symptoms, including pain in the hands and feet and a specific kind of rash.

When you have Fabry disease, a certain type of fatty substance builds up in your body. It narrows your blood vessels, which can hurt your skin, kidneys, heart, brain, and nervous system.

Your doctor may call Fabry disease a “storage disorder.” It usually starts in childhood and is much more common in men than women.

There are treatments that can make a difference in how you feel, day-to-day. Getting support from your family and friends is key, too.

Causes

You get Fabry disease from your parents. It’s passed down through genes.

The problem is that your body can’t make an enzyme called alpha-galactosidase A, which you need to break down fatty substances like oils, waxes, and fatty acids. When you have Fabry disease, you either were born without that enzyme or it doesn’t work right.

Symptoms

You may notice things like:

• Pain and burning in your hands and feet that get worse with exercise, fever, and hot weather or when you are tired
• Small, dark red spots usually found between your belly button and knees
• Cloudy vision
• Hearing loss
• Ringing in the ears
• Sweating less than normal
• Stomach pain, bowel movements right after eating

Fabry disease can lead to more serious problems, especially in men. These can include:

• Higher chance of heart attack or stroke
• Serious kidney problems, including kidney failure
• High blood pressure
• Heart failure
• Enlarged heart
• Osteoporosis

Treatment

Your doctor will probably recommend enzyme replacement therapy (ERT). It replaces the enzyme that is missing or not working correctly so that your body can break down fatty substances the way it should.

ERT is the only FDA-approved treatment for Fabry disease. It will help ease the pain and other symptoms that Fabry disease causes.

You will probably visit an outpatient center every few weeks to get the enzyme injected into a vein.

Your doctor may recommend that you also take:

• Drugs to relieve pain (prescription or nonprescription)
• Medicine for stomach problems
• Blood thinners or other drugs for irregular heartbeat or other heart problems
• Blood pressure medicine, which also helps protect your kidneys

You may need dialysis or a kidney transplant if Fabry disease has caused serious kidney damage.

You can also expect to get regular tests to keep track of how you’re doing. These may include:

• Blood, urine, and thyroidtests
• EKG (electrocardiogram). A nurse or other medical professional will attach soft, sticky patches to different parts of your body. These patches measure electrical signals from your heart and can tell how fast your heart is beating and if it has a healthy rhythm.
• Echocardiogram. This is an ultrasound of your heart. It can show if all the parts of your heart are healthy and if it’s pumping well.
• Brain MRI. An MRI, or magnetic resonance imaging, makes pictures of organs and structures inside your body.
• CT of your head. CT, or computed tomography, is a powerful X-ray that makes detailed pictures of the inside of your body.
• Hearing and eye exams
• Lung function test to see how much air you breathe in and out, and how much oxygen is getting to your blood

Taking Care of Yourself

Be good to yourself. Do things that you enjoy, spend time with people who are good company, and save your energy for the things that really matter to you. Part of that may involve saying “no” more often, and letting people know what would help you. That’s OK to do!

Nephropathic cystinosis is a rare disease that usually appears in infants and children at a young age.

It is a life-long condition, but available treatments, such as cysteamine therapy and kidney transplantation, have allowed people with the disease to live longer.

Cystinosis is a disease caused by an abnormal buildup of a certain amino acid called cystine. It is a rare, but serious disease with a lifelong impact, and can affect many parts of the body.

Cystinosis is an inherited disease, meaning that it is passed down through families. A faulty gene for the protein cystinosin leads to problems with the way cystine is stored in the body. Cystinosis is a recessive genetic disorder and patients must receive an abnormal copy of the cystinosin gene from each parent in order to develop the disease. In people with cystinosis, a buildup of cystine can lead to the formation of crystals. Cystinosis can impact many parts of the body, including the eyes, muscles, brain, heart, white blood cells, thyroid, and pancreas. Cystinosis can also cause serious problems with the kidneys.

There are three types of cystinosis, depending on when symptoms first appear (known as onset): Infantile (early-onset) cystinosis; later childhood or adolescent (late-onset) cystinosis; or adult cystinosis. About 95% of patients with cystinosis have the infantile/early-onset form, making it the most common variant of this disease, and most patients develop kidney problems.

Signs and Symptoms of Cytsinosis

Generally, early-onset cystinosis is the most serious form. Symptoms, complications, and timing of cystinosis can vary, depending on the type of disease.

Infantile (early-onset) Cystinosis

Infants with cystinosis might have no noticeable symptoms at first. However, by 6 – 12 months of age, problems start to appear, including below-average growth, feeding intolerance (picky eating and/or fussiness), frequent urination, and periods of dehydration (constant thirst). One of the first organs affected by cystinosis is the thyroid gland and patients may need to be given thyroid hormone. Walking can also be delayed.

Infantile (early-onset) cystinosis is also called “nephropathic cystinosis,” which is a term used because people with cystinosis can have serious problems with their kidneys. Infants with nephropathic cystinosis can develop a condition called “Fanconi syndrome,” meaning their kidneys cannot absorb nutrients and minerals, such as sodium and potassium. As a result, these essential nutrients are lost in the urine. When infants become children, they are at high risk of developing worsening kidney disease, and eventually kidney failure, meaning the kidneys can no longer work. At that stage, dialysis or a kidney transplant is needed to survive. Without appropriate treatment, children with cystinosis can develop kidney failure by around 10 – 12 years of age.

Cystinosis can also cause other problems, including difficulty swallowing, muscle wasting, and weaker bones. People with cystinosis are also at higher risk for diabetes (high blood sugar).

Cystinosis can also impact the brain and nervous system. As a result, children and teenagers can also have problems with attention, memory, movement, and coordination.

Late-Childhood or Adolescent (late-onset) Cystinosis

Signs and symptoms appear at a later age. If left untreated, kidney failure can develop by the late teenage years or early adulthood. People with late-onset cystinosis can accumulate cysteine in their eyes and have problems with their vision and photophobia, meaning they are sensitive to light.

Adult cystinosis

People with the adult – onset form of this disease mainly have problems with their eyes and/or light sensitivity (photophobia), which is why it can also be called ocular cystinosis. People with adult-onset cystinosis usually do not have problems with the kidneys.

Cystinosis Diagnosis

Cystinosis is diagnosed using different methods, including a physical exam to look for signs of the disease. The eyes will be examined to see if cystine crystals are present (signs of eye problems appear after two years of age). Personal and family medical histories will also be checked. A genetic test can also be used to help confirm a diagnosis.

Measuring the amount of cystine in white blood cells is one of the major tests for cystinosis. There are two tests that can be used to measure how well the kidneys are working. Blood and urine tests and radiology tests are also used to check how other organs are working.

Treatment of Cystinosis

Infants and young children with cystinosis might need to receive fluid and electrolytes, such as sodium and potassium. Vitamin D and phosphate salts might also be given for problems with weaker bones. Diabetes is usually managed with a low-sugar diet, insulin, or other medicines that help control sugar in the blood.

Infants and younger children with cystinosis might eventually need a kidney transplant if their kidneys are no longer working. People with a kidney transplant will need to take certain medicines, and do other important things to maintain their health.

There are also certain medications that can help lower the amount of cystine in the body, called “cystine-depleting” medicines. They can improve symptoms and help delay problems with the kidneys and other parts of the body. All people with cystinosis will need to take this medicine throughout their lives. There are new formulations of the medicine that can be given twice a day and that have less of a bad taste. Measuring the amount of cystine in white blood cells is used to find out how well these medicines are working.

With kidney transplantation, cystine therapy, and other medications, people with cystinosis today live longer into adulthood, provided they are treated early and appropriately. However, this disease has a lifelong impact, so it is important for people with cystinosis to keep up with their medical appointments and treatments. They also need to keep taking medications and stay with the treatment plan, as recommended by their healthcare provider.

Lupus

What it is: Lupus (also called SLE or systemic lupuserythematosus) is an autoimmune disease. It can affect many organs in your body.

 

Lupus, also known as systemic lupus erythematosus, is a chronic autoimmune disease which can affect many body parts, including the joints, skin, kidneys, heart, lungs, blood vessels, or brain. When lupus occurs, the immune system of the body malfunctions, meaning, though it is responsible for fighting off viruses, bacteria, and germs and protecting the body, it suddenly starts to attack your body’s healthy tissues. In this disease, the immune system becomes overactive as opposed to the condition of HIV when it becomes underactive. This condition can range from mild to life-threatening.

How does lupus occur?

The immune system in our bodies is responsible for producing antibodies that fight against antigens (intruders that sneak into our bodies to cause harm) and protect the body against any infections. Lupus occurs when the immune system of the body malfunctions and is unable to differentiate between antigens and healthy tissue. In this condition, the immune system in fact directs antibodies against the healthy tissue in our bodies, along with the antigens, causing swelling, pain, and tissue damage.

There are various types of lupus such as:

• Lupus nephritis: is inflammation of the kidney that is caused by systemic lupus erythematosus (SLE).
• Neonatal lupus: which affects newborn babies.
• Subacute cutaneous lupus erythematosus: which causes skin sores on areas of the body exposed to the sun.
• Discoid lupus erythematosus: which causes a skin rash that doesn’t easily disappear.
• Drug-induced lupus: which can be caused by certain medicines.

Who is prone to lupus?

The chances of developing lupus are higher in people who:

• are women
• are of black ancestry
• are between the ages of 15 and 45
• have a family history of lupus
• take medicines that are associated with drug-induced systemic lupus

What are the causes of lupus?

The cause of lupus in most cases, is as yet unknown. A few potential triggers include:

• Genetics: A family history of lupus may make you more susceptible to this disease.
• Infections: Contracting an infection can initiate lupus or cause a relapse.
• Sunlight:  Exposure to sunlight can trigger a response in susceptible people. Skin lesions may appear.
• Hormones: Both men and women produce estrogen, however, its production is much greater in females. Many women experience symptoms of lupus before menstrual periods and/or during pregnancy when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus, however, researchers have not yet found any connection between estrogen, or any other hormone, and lupus.
• Medications:  Certain medicines such as anti-seizure medications and antibiotics, can cause lupus can be triggered by certain types of blood pressure medications. These patients usually get better after they stop taking the medicines.

What are the complications of lupus?

Some major complications of lupus include:

• anemia
• risk of bleeding or blood clotting
• inflammation of blood vessels
• kidney damage or kidney failure
• inflammation of chest cavity lining (pleurisy)
• headaches
• dizziness
• behaviour changes
• hallucinations
• strokes or seizures.
• inflammation of the heart muscle
• increased risk of cardiovascular diseases and heart attacks

What are the symptoms of lupus? How is lupus diagnosed?

The most common symptoms of lupus include:

• fatigue and fever
• joint pain, stiffness and swelling
• butterfly-shaped rash on the face that covers the cheeks and bridge of the nose
• skin lesions that occur due to exposure to the sun
• fingers and toes that turn white or blue when exposed to cold or during stressful periods
• shortness of breath
• chest pain
• dry eyes
• headaches
• confusion
• memory loss

Diagnosis

Lupus can produce different and often confusing symptoms in the body, so it may take some time for a physician to diagnose it. In fact, this disease is known as ‘the great imitator’ as its symptoms mimic many other illnesses.Usually, a general physician can diagnose lupus. Depending on the severity of your condition he may refer you to other specialists such as a dermatologist, cardiologist, nephrologist, neurologist, gastroenterologist, pulmonologist, or a perinatologist.

For diagnosing lupus your doctor will look for your current symptoms such as pain, heat, redness, swelling, and loss of function at a particular place in the body. He will also enquire about your complete medical history, and if you have a family history of lupus.

There is no single diagnostic test for systemic lupus, however, the test usually suggested by doctors for lupus is called the antinuclear antibody (ANA) test. This is not a test specifically for lupus, but this test along with many other laboratory tests can build up a picture providing more information to your doctor and finally confirm if it is lupus.Other tests include:

• blood test (for complete blood count)
• kidney and liver assessment
• urinalysis
• chest X-Ray
• echocardiogram
• skin biopsy

What is the treatment of lupus?

Medical Treatment for Lupus

Depending on the severity of your condition, your doctor may prescribe medicines to suppress the immune system, reduce inflammation, and treat pain, swelling and fever associated with lupus.

Exercise

Research shows that lupus patients who exercise build stronger muscles, prevent joint stiffness, control fatigue, and avoid weight gain.Before deciding on an exercise regimen, make sure to consult your doctor to find out what type of exercises suit you the best since some movements can be harmful if you have swollen joints or muscle pain.

Some exercises that you can consider are yoga, pilates, Tai Chi, dancing, swimming, and bicycling.

Hemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. Straining, exertion, pregnancy, and other activities can lead to bleeding, pain, itching and swelling of hemorrhoids.  Sometimes hemorrhoids make it difficult to get clean after a bowel movement and can lead to rashes and irritation around the anal area.  More severe hemorrhoids cause obstruction and stricture of the anal area making the process of having a bowel movement even harder and more discomforting.  Once hemorrhoids have become enlarged producing symptoms the patient often will need an intervention to “shrink” or remove the hemorrhoids before they can obtain relief.

Hemorrhoid treatment options

There are three major methods of treating hemorrhoids in the office; Infrared coagulation (Laser), Rubber band ligation, and Sclerotherapy.  All methods are essentially “painless” when performed by an appropriate physician.  Office treatments require no down time, can be performed during a normal office visit, require no special preparation, no anesthesia, and no medication.  These procedures can be done and you can go right back to work.  A surgeon trained in rectal surgery can determine which treatment method will produce the best results for your condition.

1. Infrared coagulation (Laser)- Using a small probe, a burst of infrared energy is applied to the hemorrhoid’s surface in an area where there is typically no sensation.  This removes a couple millimeters of tissue and requires repeat applications to produce results.  This can be effective for hemorrhoids that do not prolapse (bulge with bowel movements out of the anal canal).
2. Rubber band ligation - One of the most permanent in office procedures for the removal of symptomatic hemorrhoids. A small band is placed around the base of the hemorrhoid, above the area where there is sensation.  The band effectively will remove a large portion of the hemorrhoid, essentially leaving a smaller hemorrhoidal cushion.  This typically can begin to produce relief after the first application.  One band is placed per visit to decrease the chances of having any discomfort and bleeding.  Having multiple bandings performed can be as effective as a full, inpatient surgery for removal of a patient’s hemorrhoids.  This treatment when done right will not produce pain and will produce immediate results.
3. Sclerotherapy- An effective treatment for reducing bleeding internal hemorrhoids.  While in the office a small injection is made into the hemorrhoidal vessels which are above the area of normal sensation.  Over a period of time the hemorrhoid “hardens” and shrinks due to minor interruption of the blood supply.  Can be very effective for patients on blood thinning medication who bleed with bowel movements.
4. Hemorrhoidectomy – For the most severe of cases, your surgeon may recommend a hemorrhoidectomy which is a surgery performed in the hospital under general sedation.  Typically this has been regarded as a painful surgery, but recently has been improved through the use of a tool called the harmonic scalpel.  A harmonic scalpel hemorrhoidectomy uses ultrasound generated energy to gently remove the hemorrhoid, minimizing damage to underlying, sensitive tissue.  This both decreases bleeding after the surgery as well as any “collateral” damage through traditional surgery with electrocautery and sutures.  For most cases a surgery performed in this manner can be done on an “outpatient” basis without the need for an overnight hospital stay.

What is body odor?

When a body gives off a scent others may find unpleasant, it is known as body odor.

Body odor usually becomes evident if measures are not taken when a human reaches puberty. People who are obese, those who regularly eat spicy foods, as well as individuals with certain medical conditions, such as diabetes, are more susceptible to having body odor.

People who sweat too much, such as those with hyperhidrosis, may also be susceptible to body odor. However, often the salt level of their sweat is too high for the bacteria to break down. It depends on where the excess sweating is occurring and which type of sweat glands are involved.

Sweat itself is virtually odorless to humans. It is the rapid multiplication of bacteria in the presence of sweat and their breaking down of sweat into acids that eventually causes the unpleasant smell.

Body odor is most likely to occur in the following places:

• feet
• groin
• armpits
• genitals
• pubic hair and other hair
• belly button
• anus
• behind the ears
• the rest of the skin, to a lesser extent

Body odor can have a pleasant and specific smell to the individual and can be used to identify people, especially by dogs and other animals. Each person’s unique body odor can be influenced by diet, gender, health, and medication.

Causes

Body odor is caused by bacteria breaking down sweat and is largely linked to the apocrine glands. Most body odor comes from these.

These glands are found in the breasts, genital area, eyelids, armpits, and ear. In the breasts, they secrete fat droplets into breast milk. In the ear, they help form earwax. Apocrine glands in the skin and the eyelids are sweat glands.

Most of the apocrine glands in the skin are located in the groin, armpits, and around the nipples. In the skin, they usually have an odor. They are scent glands.

The apocrine glands are mainly responsible for body odor because the sweat they produce is high in protein, which bacteria can break down easily.

What causes foot odor?

Most of us wear shoes and socks, making it much more difficult for the sweat to evaporate, giving the bacteria more sweat to break down into smelly substances. Moist feet also raise the risk of fungi developing, which can also give off unpleasant smells.

Prevention

A large concentration of apocrine glands is present in the armpits, making that area susceptible to the rapid development of body odor.

The following steps may help control armpit odor:

1) Keep the armpits clean: Wash them regularly using anti-bacterial soap, and the number of bacteria will be kept low, resulting in less body odor.

2) Hair: When armpits have hair, it slows down the evaporation of sweat, giving the bacteria more time to break it down into smelly substances. Shaving the armpits regularly has been found to help body odor control in that area. Reusable razors are available to purchase online.

3) Deodorant or antiperspirant: Deodorants make the skin more acidic, making it more difficult for bacteria to thrive. An antiperspirant blocks the sweating action of the glands, resulting in less sweating. Some studies, however, have indicated that antiperspirants may be linked to breast cancer or prostate cancer risk.

This study suggests that current research is inconclusive on the risks of antiperspirant sprays.

Deodorants and antiperspirants with natural ingredients are available to purchase online.

Tips on preventing foot odor

Smelly feet are less of a problem socially than underarm B.O. because the unpleasant odor is usually contained by shoes and socks.

However, the smell may become obvious if the person with smelly feet visits a home where shoes are taken off before entering, as is the custom in various countries and homes.

The following steps may help control foot odor:

1) Wash your feet at least once a day: Warm water is better at killing bacteria than cold water. Make sure you dry your feet thoroughly afterward, including in between your toes.

2) Socks: They must allow the sweat to evaporate. The best socks are those made of a combination of man-made fibers and wool. Wear a clean pair of socks each day.

3) Shoes: If you wear trainers or shoes with plastic linings make sure it is not for long. A leather lining is better for sweat evaporation. If you have a problem with sweaty feet, do not wear the same pair of shoes two days in a row. Shoes do not completely dry overnight.

4) Pumice stone: Bacteria thrive on dead skin. If the soles of your feet have patches of dead skin remove them with a pumice stone. These are available to buy online.

5) Deodorants and antiperspirants: Ask your pharmacist for special foot deodorants and antiperspirants. If you have athlete’s foot, you should not use deodorants or antiperspirants. Treat the fungal infection with appropriate medication.

6) Walk around barefoot: Whenever you can, walk around barefoot, or at least slip out of your shoes regularly.

First, you’ll have what’s called a cardiac catheterization. Medication will be given to relax you, then the doctor will numb where the catheter will go with anesthesia.

Next, a thin plastic tube called a sheath is inserted into an artery — sometimes in your groin, sometimes in your arm. A long, narrow, hollow tube called a catheter is passed through the sheath and guided up a bloodvessel to the arteries surrounding the heart.

A small amount of contrast liquid is put into your blood vessel through the catheter. It’s photographed with an X-ray as it moves through your heart’s chambers, valves, and major vessels. From those pictures, doctors can tell if your coronary arteries are narrowed and, in some cases, whether the heart valves are working correctly.

If the doctor decides to perform angioplasty, he will move the catheter into the artery that’s blocked. He’ll then do one of the procedures described below.

The whole thing lasts from 1 to 3 hours, but the preparation and recovery can add much more time. You may stay in the hospital overnight for observation.

What Types of Procedures Are Used in Angioplasty?

There are several your doctor will choose from. They include:

Balloon: A catheter with a small balloon tip is guided to the narrowing in your artery. Once in place, the balloon is inflated to push the plaque and stretch the artery open to boost blood flow to the heart.

Stent: This is a small tube that acts as a scaffold to support the inside your coronary artery. A balloon catheter, placed over a guide wire, puts the stent into your narrowed coronary artery. Once in place, the balloon is inflated, and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed while the stent stays in place. Over several weeks, your artery heals around the stent.

These are often placed during angioplasty to help keep the coronary artery open. The stent is usually made of metal and is permanent. It can also be made of a material that the body absorbs over time.

Some stents contain medicine and are designed to reduce the risk of the artery getting blocked again (your doctor may call that restenosis). The doctor will decide if this is the right stent for your blockage.

Rotablation: A special catheter, with an acorn-shaped, diamond-coated tip, is guided to the point of the narrowing in your coronary artery. The tip spins at a high speed and grinds away the plaque on your artery walls. The microscopic particles are washed away in your bloodstream. This process is repeated as needed to improve blood flow.

This is rarely used because balloon angioplasty and stenting have much better results. They’re also easier for the cardiologist to perform.

Atherectomy: The catheter used here has a hollow cylinder on the tip with an open window on one side and a balloon on the other. When the catheter is put into the narrowed artery, the balloon is inflated, pushing the window against the plaque. A blade in the cylinder rotates and shaves off any plaque that protrudes into the window. The shavings are caught in the catheter chamber and removed. This process is repeated as needed to allow for better blood flow.

Like rotablation, this procedure isn’t used much.

Cutting balloon: This catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then the balloon presses the plaque against the artery wall.

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn’t improve with rest.

This condition is also known as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME). Sometimes it’s abbreviated as ME/CFS.

The cause of chronic fatigue syndrome is unknown, although there are many theories — ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors.

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for chronic fatigue syndrome focuses on symptom relief.

Symptoms

Signs and symptoms may include:

• Fatigue
• Loss of memory or concentration
• Sore throat
• Enlarged lymph nodes in your neck or armpits
• Unexplained muscle or joint pain
• Headaches
• Unrefreshing sleep
• Extreme exhaustion lasting more than 24 hours after physical or mental exercise

When to see a doctor

Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.

Causes:

People who have chronic fatigue syndrome appear to be hypersensitive to even normal amounts of exercise and activity.

Why this occurs in some people and not others is still unknown. Some people may be born with a predisposition for the disorder, which is then triggered by a combination of factors. Potential triggers include:

• Viral infections. Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder. Suspicious viruses include Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.
• Immune system problems. The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it’s unclear if this impairment is enough to actually cause the disorder
• Hormonal imbalances. People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.

Diagnosis:

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. Because the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis.

Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:

• Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.
• Medical problems. Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.
• Heart and lung impairments. Problems with your heart or lungs can make you feel more fatigued. An exercise stress test can assess your heart and lung function.
• Mental health issues. Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counselor can help determine if one of these problems is causing your fatigue.

Treatment:

There is no cure for chronic fatigue syndrome. Treatment focuses on symptom relief.

Medications

Many people who have chronic fatigue syndrome are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants also can help improve sleep and relieve pain.

Therapy

The most effective treatment for chronic fatigue syndrome appears to be a two-pronged approach that combines cognitive training with a gentle exercise program.

• Cognitive training. Talking with a counselor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically.
• Graded exercise. A physical therapist can help determine what exercises are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. Gradually increasing the intensity of your exercise over time may help reduce your hypersensitivity to exercise, just like allergy shots gradually reduce a person’s hypersensitivity to a particular allergen.

Risk factors

Factors that may increase your risk of chronic fatigue syndrome include:

• Age. Chronic fatigue syndrome can occur at any age, but it most commonly affects people in their 40s and 50s.
• Sex. Women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.
• Stress. Difficulty managing stress may contribute to the development of chronic fatigue syndrome.

Complications:

Possible complications of chronic fatigue syndrome include:

• Depression
• Social isolation
• Lifestyle restrictions
• Increased work absences