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Sarcopenia – Muscle loss with aging

Nov 20, 2024 Posted by admin Senior care 0 comments

Overview

Sarcopenia is the age-related progressive loss of muscle mass and strength. Sarcopenia is a common condition that affects 10% of adults who are over 50 years old and unfortunately, sarcopenia shortens life expectancy in those it affects, compared to individuals with normal muscle strength While it can decrease life expectancy and quality of life. A healthy diet and regular exercise can reverse sarcopenia, increasing lifespan and quality of life. Everyone loses muscle with age, typically about 3%-5% each decade after age 30. Inactive people lose the most. The loss can become more noticeable and start to speed up at around age 60. After age 80, studies suggest somewhere between 11% and 50% of people have sarcopenia. Sarcopenia can be a serious problem. Once you’ve lost a lot of muscle and strength, you may struggle to do things such as getting out of chairs, opening jars, or carrying groceries. You also can become frail and have a higher risk of falls, broken bones, disability, and death. management of sarcopenia focuses on lifestyle changes to prevent muscle loss. These usually include – excercise, nutrition and dietary supplements etc therefore, proper diet and strength training can help people with sarcopenia have a positive outlook and make improvements to the condition.

Sarcopenia Causes

Physical inactivity.
Obesity.
Chronic diseases such as chronic obstructive pulmonary disease (COPD), kidney disease, diabetes, cancer and HIV.
Rheumatoid arthritis.
Insulin resistance.
Reduction in hormone levels.
Malnutrition or inadequate protein intake.
Decrease in your ability to convert protein to energy.
Decline in the number of nerve cells that send messages from your brain to your muscles telling them to move.

Sarcopenia Symptoms

These are some of the most common symptoms of sarcopenia:

Muscle weakness
Loss of stamina, or staying power, when you are active
Slow walking
Trouble performing daily activities
Trouble climbing stairs
Loss of balance
Falling
Noticeably shrinking muscles

Risk factors

Although aging is the main cause of sarcopenia, other factors contribute to the loss of muscle mass. They include:

Living a sedentary lifestyle: Getting little or no physical activity on a regular basis puts people at an increased risk of developing sarcopenia as they age.
Poor nutrition: Poor dietary habits can also contribute to the development of sarcopenia. Although poor nutrition is possible at any age, it may affect how fast muscle mass declines in older adults.

Older adults tend to eat less, which can lead to malnutrition. Also, Eating large amounts of acid producing foods, such as grains and processed foods, and eating too few vegetables and fruits may also negatively affect muscle mass.

Diagnosis and Tests

How is sarcopenia diagnosed?

Your healthcare provider may diagnose sarcopenia after performing a physical exam and asking you about your symptoms. You may complete a questionnaire based on your self-reported symptoms called the SARC-F. SARC-F stands for:

S — Strength.
A — Assistance with walking.
R — Rising from a chair.
C — Climbing stairs.
F — Falls.

You score each factor with a number between 0 and 2. The highest maximum SARC-F score is 10. A SARC-F score of 4 or more warrants more testing. There is no single test that can diagnose sarcopenia. Your healthcare provider may recommend several tests to diagnose and then determine the severity of sarcopenia.

Muscle strength tests

Handgrip test: Handgrip strength draws a parallel to the strength in your other muscles. Providers use it to identify shortages in overall muscle strength.
Chair stand test: Providers use the chair stand test to measure your leg muscle strength, especially your quadriceps. The chair stand test measures the number of times you can stand and sit from a chair without the use of your arms in 30 seconds.
Walking speed test: The walking (gait) speed test measures the time it takes for you to travel 4 meters (about 13 feet) at your usual walking pace.
Short physical performance battery (SPPB): With the SPPB test, you take three timed tasks: chair stand test, standing balance test and walking speed test.
Timed-up and go test (TUG): The TUG test measures the time it takes for you to rise from a chair, walk 3 meters (about 10 feet) away from the chair, walk 3 meters back to the chair, and sit back down in the chair.

Sarcopenia Treatment

The primary treatments for sarcopenia are lifestyle changes, especially increases in physical activity.

Sarcopenia exercise plan

Strength training, which is also called resistance training, can help you regain strength and mobility. Your doctor may refer you to a physical therapist or suggest working with a trainer or taking a class to get started.

A typical strength training program might include working with free weights or weight machines and stretchy resistance bands. It also might include so-called bodyweight exercises, such as push-ups, lunges, and leg raises. You should do a combination of exercises that work your arms, legs, abdominal muscles, back, and chest.

Prevention

How can I prevent sarcopenia?

You may not be able to completely prevent sarcopenia since the condition happens as part of the natural aging process. But you can take steps to slow the progression of the disease. These include:

Make healthy food choices: Maintain a healthy diet that includes high-quality proteins. Aim for 20 to 35 grams of protein in each meal.
Exercise: Maintain a physically active lifestyle that includes exercises such as resistance training.
Routine physicals: See your healthcare provider regularly, and let them know about any changes in your health.

The Bottom Line

Sarcopenia, the loss of muscle mass and strength, becomes more common with age and can decrease lifespan and quality of life.Eating enough calories and high-quality protein can slow down the rate of muscle loss. Omega-3 and creatine supplements may also help fight sarcopenia.Nevertheless, exercising is the most effective way to prevent and reverse sarcopenia.Resistance exercises appear to be particularly effective, including using resistance bands, lifting weights or doing calisthenics like squats, push-ups and sit-ups.However, even simple exercises like walking can slow your rate of muscle loss. At the end of the day, the most important thing is to get active.

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Pityriasis Alba

Nov 13, 2024 Posted by admin Dermatology 0 comments

Overview
Pityriasis refers to the characteristic fine scale, and alba to its pale colour (hypopigmentation) so, Pityriasis alba is a low-grade type of eczema/dermatitis mainly seen in children and adolescents aged 3 to 16 years, but can occur in older and younger people. It affects boys and girls equally. The condition perhaps is more common, in dark skin compared to white skin. It often presents following sun exposure, perhaps because tanning of surrounding skin makes affected areas more prominent. People with pityriasis alba get round, oval, or irregularly shaped patches of pale pink or red skin. The patches are usually scaly and dry. No treatment is necessary for asymptomatic pityriasis alba but people with pityriasis alba develop red or pink patches on their skin that are usually round or oval. The patches usually clear up with moisturizing creams or go away on their own. However, they often leave pale marks on the skin after the redness has faded.

Causes
Doctors don’t know what causes pityriasis alba. It may be related to another skin condition called atopic dermatitis or eczema that causes a skin rash. People whose skin is very sensitive or who get a lot of sun may be more likely to get the condition.

Symptoms
People with pityriasis alba get round, oval, or irregularly shaped patches of pale pink or red skin. The patches are usually scaly and dry. They may appear on the:
face, which is the most common place
upper arms
neck
chest
back
Pityriasis alba evolves through several stages.

Slightly scaly pink patch or plaque with a just palpable papular surface.
Hypopigmented patch or plaque with fine surface scale.
Then post-inflammatory hypopigmented macule without scale.
Resolution.

Diagnosis

Pityriasis alba is usually a clinical diagnosis but may be confused with several other disorders that cause hypopigmentation.

To exclude these, investigations may include:

Wood lamp examination: the hypopigmentation of pityriasis alba does not enhance, and there is no fluorescence
Scrapings for mycology: microscopy and fungal culture are negative in pityriasis alba
Skin biopsy: biopsy is rarely required, but may reveal mildly spongiotic dermatitis and reduction in melanin.
Risks for pityriasis alba

Pityriasis alba is most common in children and adolescents. It occurs in approximately 2 to 5 percent of children. It’s most frequently seen in children between the ages of 6 and 12 years. It’s also very common in children with atopic dermatitis, an itchy inflammation of the skin.

Pityriasis alba often appears in children who take hot baths frequently or who are exposed to the sun without sunscreen. However, it’s unclear if these factors cause the skin condition. Pityriasis alba isn’t contagious.

Treatment

No treatment is required for pityriasis alba. The patches usually go away with time. Your doctor may prescribe a moisturizing cream or topical steroid cream such as hydrocortisone to treat the condition. In some cases, your doctor may prescribe a nonsteroid cream, such as pimecrolimus. Both types of creams can help reduce skin discoloration and relieve any dryness, scaling, or itchiness. Even if you’ve had treatment, the patches can return in the future. You may need to use the creams again. In most cases, however, pityriasis alba goes away by adulthood. The development or prominence of pityriasis alba can be reduced with sunscreen use to minimise sun tanning.

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Allergies

Nov 5, 2024 Posted by admin Uncategorized 0 comments

Overview

Allergy is a condition in which the immune system reacts abnormally to a foreign substance. Allergies are one of the most common chronic diseases. A chronic disease lasts a long time or occurs often. An allergy occurs when the body’s immune system sees a substance as harmful and overreacts to it. The substances that cause allergic reactions are allergens. When someone has allergies, their immune system makes an antibody called immunoglobulin E (IgE). These antibodies respond to allergens. The symptoms that result are an allergic reaction. Avoiding allergens is an important treatment approach. However, it often doesn’t completely end allergic reactions.

Symptoms

Common allergy symptoms may include:

rashes, such as hives
nausea
vomiting
fever
wheezing
difficulty breathing
congestion
runny nose
sneezing
coughing
fatigue
headaches

Causes of allergies

It’s still unclear why the immune system causes an allergic reaction when a normally harmless foreign substance enters the body.

However, researchers have identified several factors that may contribute to allergies, including:

Older age
Genetics
Hormonal changes, especially in people assigned female at birth
Immunological factors, such as weakened immune system
Gut microbiome changes
Having other allergies, such as atopic dermatitis

Several common allergens have also been identified, including foods, medications, and environmental irritants. The cause of allergies may depend on how you come into contact with it:

Ingestion: Foods like nuts, cow’s milk, sesame, fish, tree nuts, and shellfish may cause allergies. Some oral medications like penicillin may also trigger a reaction.
Inhaling: Several environmental irritants, such as pollution, pet dander, mold, pollen, and dust mites, can trigger allergies.
Direct contact: Some allergies are caused by direct contact with allergens, such as insect stings, the sun, certain plants, latex, and certain metals.

Diagnosis

A doctor will first ask about your symptoms and perform a physical exam.

They may ask about anything unusual you may have eaten recently and any substances you may have come in contact with. For example, if you have a rash on your hands, they may ask if you put on latex gloves recently.

To confirm an allergy, they may order several tests, including:

Blood test: This can help detect the presence of IgE, which are cells that react to allergens.
Skin prick test: Small amounts of an allergen are pricked, brushed, or scratched against your skin to see if there’s an allergic reaction.

Types of allergies

There are several types of allergies These include:

food allergies
hayfever (allergic rhinitis)
asthma
atopic dermatitis (eczema)
skin allergies
medication allergies
insect bite allergies

Treatment and Management

Avoiding the allergen that triggers the reaction is the best way to prevent allergies. If that’s not possible, there are treatment options available.

Medication

Allergy treatment usually includes over-the-counter or prescription medications, which are available as nasal sprays, pills, liquids, and topical ointments.

Some allergy medications may include:

antihistamines, such as diphenhydramine (Benadryl), loratadine (Claritin), and cetirizine (Zyrtec)
corticosteroids
decongestants (Afrin, Suphedrine PE, Sudafed)
mast cell stabilizers, which stop mast cells from releasing histamine

It’s important to work with a healthcare professional to develop the best management plan for your allergies.

Immunotherapy

Immunotherapy is a treatment that involves administering small doses of an allergen to help your body become used to it over time.

There are two types of immunotherapy:

Injections: This involves several injections over a few years. It’s most helpful for allergens like pollen, pet dander, insect stings, and asthma.
Sublingual immunotherapy (SLIT): This involves placing small doses of allergens under your tongue. It’s best for asthma and nasal allergies, such as dust mites, ragweed, and grass.

Successful immunotherapy can prevent allergy symptoms from returning. The best way to prevent allergies is to avoid allergens. You can also take antihistamines or other medications daily to help control your symptoms and reduce your allergic reaction. If you have animal allergies, avoid petting, hugging or kissing animals. Don’t allow them in your bedroom or on your furniture. Regularly vacuuming rugs, carpets and other surfaces helps remove dust, animal dander, pollen and other allergens.

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Allergic Asthma

Oct 25, 2024 Posted by admin Pulmonology 0 comments

Overview

Allergic asthma is a chronic inflammatory condition. When you inhale an allergen, such as pollen, mold, or dust mites, your lungs become inflamed, and your airways tighten. This type of asthma is very common in both children and adults. Symptoms of allergic asthma can include shortness of breath, coughing, wheezing, stuffy nose, itchy eyes and a rash.

When you have allergies, your body creates a response to something it thinks is a threat — the allergen. Your immune system fires up all of its defenses to try and fight off this danger. Your immune system releases various chemicals that cause inflammation, or swelling, and squeezing of your airways upon exposure to an allergen. You might need to use fast-acting rescue medicines, long-term treatments, or both, further your doctor may recommend a nebulizer. This machine changes asthma medications from a liquid to a mist so it’s easier to get the medicine into your lungs.

If you or a loved one has allergic asthma, it’s important to understand what your triggers are. Once you figure that out, you can take steps to avoid them. As a result, you’ll have fewer and less severe asthma attacks.

Symptoms and Causes

If you have allergic asthma, you may have many of the same symptoms you’d experience with other types of asthma. These symptoms can include:

Feeling short of breath.
Coughing frequently, especially at night.
Wheezing (a whistling noise during breathing).
Experiencing chest tightness (feeling like something is pressing on your chest).

Allergen exposure can also trigger other symptoms, including:

A stuffy nose/Congestion
Nasal drainage
Itchy or watery eyes.
A rash or hives.
Flaky skin

Diagnosis and Tests

Specific types of lung function tests include:

Spirometry. This measures the amount of air you inhale and exhale and how fast you can exhale. You’ll blow into a mouthpiece connected to a device or computer that looks for narrowing in the bronchial tubes of your lungs.
Peak flow. A simple test of lung function, you’ll breathe into a small handheld device that measures air pressure as you breathe out. The test can’t diagnose asthma, but it can be used in the lab or at home to keep track of your condition.
FeNO test. Also known as exhaled nitric oxide testing. You’ll blow into a device that measures the amount of nitric oxide in your airways. Your lungs produce this gas when they become inflamed due to asthma.
Provocation (trigger) test. This test tells doctors how sensitive your lungs are to certain triggers and is used to help confirm an asthma diagnosis. You may get it if you have asthma symptoms that can’t be diagnosed with other tests. Your doctor will ask you to you inhale a potential asthma allergen and then take a breathing test to measure your response.
During a skin test, the healthcare provider puts small drops of liquid containing various allergens on your skin. Then, they gently scratch your skin to allow allergens to enter the top layer. If you’re allergic to the substance, your skin will react by swelling or you may develop tiny, raised bumps.In certain cases, a blood test can identify allergic triggers. Allergy blood tests can miss a small percentage of allergies compared to skin testing.

Management and Treatment

Treatment can involve avoiding the allergen or making lifestyle changes, and medications.

Avoiding the allergen

Your provider will help you figure out what’s triggering your asthma and find ways to either avoid or manage these allergens. Often, these triggers are in your environment. Once you know what they are, you can manage your interactions with them. This might mean hiring someone to cut your grass if you know that pollen is a trigger for your asthma, or avoiding places with a lot of animals if dander is a trigger for you.

Depending on what triggers your asthma, other steps you can take include:

Cleaning your house frequently. This could include frequent mopping and dusting and washing your bedding and pillows in hot water every week.
Using dust and allergen-proof sheets and pillows on your bed.
Keeping house and car windows closed during peak pollen season. You can also avoid being outside when pollen counts are highest or wear glasses, face masks or other protective equipment when outdoors.
Using high-quality filters in your home air conditioning units or running an air purifier.
Developing an action plan. It’s important to have a plan in place that helps you know when to take certain medications, what to do if the medications aren’t working and who to call in those situations. The plan should include what to do during an asthma attack.

Medical treatment

Medications for allergy-induced asthma may include:

Leukotriene modifiers: This is the name for a group of medications that treat both allergies and asthma. Montelukast (Singulair®) is one of the most common leukotriene modifiers.
Allergy shots: Also called immunotherapy, allergy shots can reduce how your immune system reacts to an allergen. It involves getting regular injections (shots) of the allergen to build up your tolerance over time.
Rescue inhalers: These offer fast relief for asthma symptoms by opening up your airways so you can breathe better.
Antihistamines: This type of medication reduces mild to moderate allergy symptoms like itching skin or watery eyes. Your provider may suggest taking an antihistamine as part of your treatment plan.
Corticosteroids: Both oral and inhaled corticosteroids can help prevent allergy-induced asthma symptoms by reducing inflammation in your airways.
Biologics: These are small proteins that your provider injects to help treat the underlying cause of asthma. This treatment is for moderate or severe allergic asthma.

Conclusion

There isn’t a cure for allergic asthma, but you can reduce your risk of an allergic asthma attack by understanding and avoiding triggers and ensuring you’re using the best medical treatment to manage your asthma.

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Understanding Pulmonary Embolism (PE)

Oct 23, 2024 Posted by admin Pulmonology 0 comments

Overview

When your blood goes from your heart to your lungs through your pulmonary artery. In the lungs, the blood is supplied with oxygen and then goes back to the heart, which pumps the oxygen-rich blood to the rest of your body.A pulmonary embolism (PE) happens when a blood clot suddenly blocks an artery that supplies blood to your lungs.

This blockage can cause serious problems such as damage to your lungs and low oxygen levels in your blood. The lack of oxygen can harm other organs in your body, too. If the artery is clogged by a big clot or many smaller clots, it can cause a deadly pulmonary embolism.

If you think you may have deep vein thrombosis (DVT), the best thing you can do is call your doctor as soon as possible. There are several ways that they can figure out likeUltrasound, MRI,Pulmonary angiogram etc. Some people with DVT might need to take blood thinners for the rest of their lives. Your doctor will make this decision based on how likely you are to have another blood clot. They’ll also consider your risk of bleeding when they suggest longer treatment with blood thinners.

Therefore, pulmonary embolism condition is a medical emergency requiring quick treatment, a pulmonary embolism can cause heart or lung damage and even death. With timely diagnosis and treatment, a PE is seldom fatal.

Symptoms and Causes

Sudden shortness of breath — whether you’ve been active or at rest.
Fast breathing.
Wheezing.
Unexplained sharp pain in your chest, arm, back, shoulder, neck or jaw. The pain may be similar to symptoms of a heart attack and can get worse when you take a breath.
Cough with or without bloody mucus.
Pale, clammy or bluish skin.
Rapid heartbeat (pulse).
Excessive sweating.
In some cases, feeling anxious, lightheaded, faint or passing out.

What causes a pulmonary embolism?

Pulmonary embolism causes include:

Blood collecting or “pooling” in a certain part of your body (usually an arm or leg). Blood usually pools after long periods of inactivity, like after surgery, bed rest or a long flight or plane ride.
Injury to a vein, like from a fracture or surgery (especially in your pelvis, hip, knee or leg).
Another medical condition, like cardiovascular disease (including congestive heart failure, atrial fibrillation, heart attack or stroke).
An increase or decrease in your blood’s clotting factors. Elevated clotting factors can occur with some types of cancer or in some people taking hormone replacement therapy or birth control pills. Abnormal or low clotting factors may also happen as a result of blood clotting disorders.

People at risk of developing a PE include those who:

Have a blood clot in their leg, or deep vein thrombosis (DVT).
Are inactive for long periods of time while traveling via motor vehicle, train or plane (such as a long, cross-country car ride).
Have recently had trauma or injury to a vein, possibly from surgery, a fracture or varicose veins.
Are using hormonal-based contraception (like birth control pills, patches or rings) or hormone replacement therapy.
Have a blood clotting disorder.
Have a family history of blood clots.
Currently smoke.
Have diabetes.
Have cancer.
Are older than 60.
Have a history of heart failure, heart attack or stroke.
Have overweight (a body mass index or BMI greater than 25) or obesity (a BMI greater than 30).
Are pregnant or have given birth in the previous six weeks.
Received a central venous catheter through their arm or leg.

If you have any of these risk factors and you’ve had a blood clot, talk with your healthcare provider so they can take steps to reduce your risk of PE.

Diagnosis and Tests

After looking at your symptoms and risk factors, a provider will use the following tests to make a PE diagnosis:

Blood tests (including the D-dimer test).
Computed tomography (CT) angiogram.
Ultrasound of your leg. (This helps identify blood clots in people’s legs, or deep vein thrombosis, which can move to the lungs, become a PE and cause more damage.)
A VQ scan, if you’re unable to get contrast for a CT scan. (This is a nuclear scan that can detect clots in your lung.)
A pulse oximeter (pulse ox) that attaches to your fingertip to check your oxygen level.
Echocardiogram.

Other tests your provider may order include:

Pulmonary angiogram.
Chest X-ray.

Classification of PE

PE severity is commonly classified three main categories based on easily obtainable clinical variables. High-risk PE is defined as presenting with hypotension, a systolic arterial pressure less than 90 mm Hg or drop of more than 40 mm Hg for at least 15 minutes and the need for vasopressor support. Intermediate-risk PE is defined by a patient being normotensive with evidence of RV dysfunction or myocardial ischemia. Low risk PE are patients that do not meet the criteria for intermediate-risk.

Management and Treatment

The length of your pulmonary embolism treatment and hospital stay will vary, depending on the severity of the clot. Some people may not need to stay overnight.

The main treatment for a pulmonary embolism is an anticoagulant (blood thinner).

Depending on the severity of your clot and its effect on your other organs such as your heart, you may also undergo thrombolytic therapy, surgery or interventional procedures to improve blood flow in your pulmonary arteries.

In most cases, treatment consists of anticoagulant medications (blood thinners). Anticoagulants decrease your blood’s ability to clot. This prevents future blood clots.

Compression stockings

Compression stockings (support hose) improve blood flow in your legs. People with deep vein thrombosis often use them. You should use them as your provider prescribes. The stockings are usually knee-high length and compress your legs to prevent your blood from pooling.

Thrombolytic therapy

Thrombolytic medications (“clot busters”), including tissue plasminogen activator (TPA), dissolve the clot. You’ll always receive thrombolytics in the emergency department or intensive care unit (ICU) of a hospital where a provider can monitor you. You may receive this type of medication if you have a special situation, like low blood pressure or an unstable condition because of the pulmonary embolism.

Can a pulmonary embolism be prevented?

Yes, you may be able to prevent it. Ways to prevent a pulmonary embolism include:

Getting regular physical activity. If you can’t walk around, move your arms, legs and feet for a few minutes every hour. If you know you’ll need to sit or stand for long periods, wear compression stockings to encourage blood flow.
Drinking plenty of fluids, but limiting alcohol and caffeine.
Not using tobacco products.
Avoiding crossing your legs.
Not wearing tight-fitting clothing.
Getting to a weight that’s healthy for you.
Elevating your feet for 30 minutes twice a day.
Talking to your provider about reducing your risk factors, especially if you or any of your family members have had a blood clot.
Talking to your provider about a vena cava filter.

Conclusion

It can take months or years for a pulmonary embolism to go away completely. Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic manifestation of PEs that keep coming back.You’ll need to take a blood thinner for three to six months or longer. Don’t stop taking it unless your provider instructs you to. If you’re taking a blood thinner, don’t do things that put you at risk of an injury that could make you bleed.

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Multiple myeloma – A rare blood cancer

Oct 15, 2024 Posted by admin Oncology 0 comments

Overview

Multiple myeloma is a rare blood cancer that affects plasma cells in the bone marrow. it is a blood cancer related to lymphoma and leukemia.

Multiple myeloma happens when healthy cells turn into abnormal cells that multiply and produce abnormal antibodies called M proteins. This change starts a cascade of medical issues and conditions that can affect your bones, your kidneys and your body’s ability to make healthy white and red blood cells and platelets. As multiple myeloma gets worse, those plasma cells begin to spill out of your bone marrow and spread through your body.

Some people have multiple myeloma without symptoms but blood tests show signs of conditions that may become multiple myeloma. In this case, healthcare providers may recommend watchful waiting or monitoring your overall health rather than starting treatment. Healthcare providers can’t cure multiple myeloma, but they can treat related conditions and symptoms and slow its progress.

Causes

Multiple myeloma symptoms develop over time and may resemble other medical conditions or diseases. Here are some of the conditions linked to multiple myeloma and their causes:

Anemia: You don’t have enough red blood cells because multiplying abnormal plasma cells don’t leave room for your red blood cells.
Bacterial infection, particularly pneumonia: Like red blood cells, abnormal plasma cells are multiplying and crowding healthy white blood cells that fight infection.
Thrombocytopenia: You don’t have enough platelets — the cells that help your blood to clot — because abnormal plasma cells crowd out those platelets and keep your bone marrow from making enough platelets.
Bone pain/bone fracture: Bone pain and/or fracture can happen if abnormal plasma cells destroy bone tissue, causing a soft spot in your bone. These are osteolytic lesions.
Kidney problems/failure: Your kidneys filter waste and toxins. Abnormal plasma cells make M proteins that block the filtering process and damage your kidneys.
Amyloidosis: This disease happens when abnormal proteins (amyloid proteins) build up in your organs.
Hypercalcemia: This condition happens when damaged or weakened bones release too much calcium into your bloodstream.
Hyperviscosity syndrome: M proteins — proteins made by abnormal plasma cells — thicken your blood. Your heart has to work harder to pump blood through your body.
Cryoglobulinemia: Multiple myeloma can make proteins in your blood clump together when it’s cold.

Symptoms

Multiple myeloma causes many symptoms, but bone pain often is the first symptom people notice. Other symptoms include:

Weakness in your arms and legs and/or a sensation of numbness in your arms and legs. Multiple myeloma can affect the bones in your spine, causing them to collapse and press on your spinal cord.
Having fatigue — feeling so tired you can’t manage daily activities — and feeling weak. These are signs of anemia.
Nausea and vomiting. This may be a sign of hypercalcemia.
Not having an appetite and/or feeling thirstier than usual. These may be signs of hypercalcemia.
Unexplained weight loss.
Unexplained fever. This may be a symptom of a bacterial infection.
Bruising or bleeding more easily. This may be a sign abnormal plasma cells prevent your body from producing enough platelets. Platelets help your blood to clot.
Feeling confused or “foggy.”

Multiple Myeloma Diagnosis

To confirm a diagnosis, you might have blood tests including:

Complete blood count (CBC): This test measures your red and white blood cell numbers, the amount of hemoglobin in your red blood cells and your red blood cell concentration level.
Blood chemistry test: This test shows your creatine levels (how well your kidneys work), albumin levels (this is a protein), calcium levels and lactic dehydrogenase levels (LDH). LDH is a tumor marker. A tumor marker is a substance in cancerous cells or healthy cells responding to cancer.
Quantitative immunoglobulin test: This blood test measures the levels of certain antibodies in your blood.
Electrophoresis: This test looks for M proteins in your blood.
Urine tests: Healthcare providers may ask you to collect your urine at home over a 24-hour period so they can test for Bence Jones protein, another sign of multiple myeloma.
X-rays: Healthcare providers use X-rays to look for bones damaged by multiple myeloma.
Computed tomography (CT) scan: This is another way to look for bone damage.
Magnetic resonance imaging (MRI): This test uses radio waves and strong magnets to create detailed images of your bones and spine. Healthcare providers may use this test to look for plasmacytomas. These are single groups of abnormal plasma cells.
Positron emission tomography (PET) scan: This is another test for plasmacytomas.
Bone marrow biopsies: Healthcare providers may do bone marrow biopsies to analyze the percentage of normal and abnormal plasma cells in your bone marrow. They may also test your bone marrow sample for changes in your DNA that may drive cancer growth.

Multiple Myeloma Complications

Multiple myeloma can cause problems including:

Bone problems. Your bones can become weaker, leading to fractures.
Blood problems. You might get anemia, which means your body doesn’t have enough red blood cells. This can make you tired and pale and cause heart problems. You might also have too few platelets, which makes it harder for your blood to clot.
Infections. When you have myeloma, your body produces a lot of weak antibodies that crowd out healthy ones, making it harder for you to fight infection. A lack of white blood cells can also weaken your immune system.
Kidney damage. Myeloma can clog your kidneys so they don’t filter the way they should. This might lead to kidney failure.

The staging process for multiple myeloma starts with placing the condition in one of four classifications:

MGUS: Blood tests show small amounts of M protein. About 1 % to 2% of people with MGUS develop multiple myeloma.
Solitary or isolated plasmacytomas: These are single groups of abnormal plasma cells.
SMM: This is a pre-cancerous form of multiple myeloma. People who have SMM may have mild symptoms along with tests showing small amounts of M protein in their blood and an increased number of plasma cells in their bone marrow.
Multiple myeloma: This classification means tests show multiple groups of abnormal plasma cells, high M protein levels in blood or urine and a high percentage of abnormal plasma cells in bone marrow. People in this classification often have anemia, hypercalcemia, kidney failure and osteolytic lesions.

Healthcare providers use the Revised International Staging System (R-ISS) to stage multiple myeloma. The RISS system is based in part on blood tests that show the levels of albumin, beta-2 microglobulin and lactate dehydrogenase. Healthcare providers also consider tests for specific gene abnormalities.

Management and Treatment

Some treatments healthcare providers may use if you have symptoms caused by multiple myeloma include:

Pain medications:People often have significant bone pain.
Antibiotics:A weakened immune system can lead to more infections. Your doctor may prescribe antibiotics to clear up these infections.
Steroids: High doses of steroids can kill cancer cells and reduce inflammation.
Chemotherapy: Healthcare providers use chemotherapy to reduce the number of abnormal plasma cells.
Immunotherapy:This treatment stimulates your immune system so it develops more cancer-fighting cells.
Radiation therapy: This treatment kills cancer cells and reduces bone tumors.
Stem cell transplants: Stem cells are specialized cells in your bone marrow or blood that can help produce healthy new plasma cells. Healthcare providers typically recommend autologous stem cell transplants. This treatment replaces damaged or unhealthy stem cells with healthy stem cells from your body. Rarely, you may receive healthy plasma stem cells from a donor. This is an allogenic stem cell transplant.

Conclusion

Multiple myeloma happens when healthy plasma cells become abnormal cells that multiply and produce abnormal antibodies. People live 10 years or more with multiple myeloma. As with most types of cancer, early diagnosis and treatment help people live longer. While there is no cure for multiple myeloma, it can treat related conditions and symptoms and slow its progression.

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Cervical myelopathy

Oct 11, 2024 Posted by admin Neurology 0 comments

Overview

Any space-occupying lesion within the cervical spine with the potential to compress the spinal cord can cause cervical myelopathy. The most common type is cervical spondylotic myelopathy, which happens after natural changes to your body as you age. It can cause neck pain, muscle weakness and numbness, among other symptoms. Surgery treats cervical myelopathy.

Once the disorder is diagnosed, complete remission to normality never occurs and spontaneous temporary remission is uncommon. In 75% of the patients, episodic worsening with neurological deterioration occurs, 20% have slow steady progression, and 5% experience rapid onset and progression.

Symptoms and Causes

The symptoms of cervical myelopathy and cervical spondylotic myelopathy include:

Neck pain or stiffness.
Numbness or tingling in your hands and arms.
Muscle weakness in your hands and arms.
Loss of balance and difficulty walking.
Difficulty with fine motor skills (like buttoning a shirt or holding silverware).

Common causes of compression include:

Bone spurs.
Herniated disk.
Narrow cervical canal (birth defect).
Rheumatoid arthritis.
Spondylolisthesis.
Spinal degeneration.
Spinal stenosis.
Traumatic injury.
Tumor.

Cervical spondylotic myelopathy happens due to age-related changes that affect the structure and function of parts of your spine in your neck (spinal degeneration). These changes narrow the spinal canal (the opening where your spinal cord sits), which puts pressure on your spinal cord. Degenerative changes are a natural part of getting older.

Risk factors for cervical myelopathy..

Cervical myelopathy can affect anyone at any age. Studies show it’s more common among people of Asian descent older than 30 years.

Cervical spondylotic myelopathy can affect anyone as well, but it’s more common among men and people assigned male at birth and adults after age 40. The average age of a diagnosis is 64.

If left untreated, cervical myelopathy symptoms may get worse. This might cause:

Severe pain.
Bowel and bladder dysfunction.
Nerve damage.
Difficulty walking (instability, high risk of falls).
Limited use of your fingers, hands and arms.
Paralysis.

Diagnosis and Tests

A healthcare provider will diagnose cervical myelopathy after a physical exam, a neurological exam and other testing. During the exams, your provider will review your symptoms and medical history. They may also test your balance, reflexes and dexterity, and observe you walking (if possible) to better understand how symptoms affect you.

Your provider may order imaging tests to look at your spine. Imaging tests may include:

X-ray.
MRI.
CT scan.
Myelogram.

Management and Treatment

There isn’t a cure available for all causes of cervical myelopathy. Surgery can decrease symptoms and prevent complications. Even after treatment, age-related changes may affect more than one area of your spine.

Nonsurgical cervical myelopathy management

A healthcare provider may recommend nonsurgical options to help you manage mild cervical myelopathy. They may include:

Wearing a neck brace.
Participating in physical therapy.
Taking medications.

Surgical cervical myelopathy treatment

You may be a candidate for surgery if you have:

Severe pain.
Muscle weakness.
Numbness.
Balance and walking challenges.
Difficulty with fine motor skills.

The procedure that a surgeon recommends can vary based on your symptoms, general health and your age. It may include one or a combination of the following:

Diskectomy.
Disk replacement.
Laminectomy.
Laminoplasty.
Spinal fusion.

surgeon will explain the possible risks before the procedure so you can make an informed decision about your health, also post surgery specific instructions on how to take care of yourself and when you should see them for a follow-up visit.

Prevention

You can’t prevent all causes of cervical myelopathy. Spinal cord compression related to cervical spondylotic myelopathy happens due to natural changes to your body as you age, which you can’t prevent. But you can reduce your risk of injury by taking safety precautions and avoiding high-risk or dangerous activities.

Conclusion

Your spinal cord has an important job in your body. Unpredictable things, like an accident or natural changes that happen as you age, can put pressure on your spinal cord. Like a bridge in a busy town, wear and tear is unavoidable. Your body needs maintenance and care in the same way a city’s infrastructure does to make sure vital parts have the support they need to function. This is especially important with cervical myelopathy.

A healthcare provider can help you manage symptoms and relieve pressure on your spinal cord. This may require surgery. While a procedure on your neck may be scary to think about, your care team will take extra precautions to make sure you’re safe and avoid complications.

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Sore Throat

Oct 2, 2024 Posted by admin General Health 0 comments

Sore throat presents as pain ,itching sensation or irritation in the throat, usually hurts more when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. Most sore throats are caused by infections, or by environmental factors like dry air. Although a sore throat can be uncomfortable, it will usually go away on its own.

Causes of sore throat

Viral infection
Bacterial infection
Allergy to pollens, molds and smoke
Poor Oro dental hygiene
Acid reflux

Sore throats are divided into types,

Based on the part of the throat they affect:

Pharyngitis causes swelling and soreness in the throat.
Tonsillitis is swelling and redness of the tonsils, the soft tissue in the back of the mouth.
Laryngitis is swelling and redness of the voice box, or larynx.

Sore throat risk factors

Though anyone can get a sore throat, there are several factors that can increaseTrusted Source your risk.

Some common risk factors include:

Age: Children are more susceptibleTrusted Source to certain conditions that can cause a sore throat, including strep throat.
Time of year: Some types of infection are more commonTrusted Source during certain seasons, including winter.
Exposure to irritants: Several irritants, such as cigarette smoke or pollution, can cause a sore throat.
Personal hygiene: Infrequent hand washing could increase your risk of infection.
Certain settings: Some settings, such as schools and daycares, can increase the spread of infections that could cause a sore throat.
Vocal strain: People who regularly talk loudly, yell, or sing for long periods can strain their vocal cords more easily, leading to a sore throat.

Treatment includes

You can treat most sore throats at home. Get plenty of rest to give your immune a chance to fight the infection.

To relieve the pain of a sore throat:

Gargle with a mixture of warm water and 1/2 to 1 teaspoon of salt.
Drink warm liquids that feel soothing to the throat, such as hot tea with honey, soup broth, or warm water with lemon. Herbal teas can beTrusted Source especially soothing to a sore throat.
Cool your throat by eating a cold treat like a popsicle or ice cream.
Suck on a piece of hard candy or a lozenge.
Turn on a cool mist humidifier to add moisture to the air.
Rest your voice until your throat feels better.

Otherwise,

You can take medications to relieve the pain of a sore throat, or to treat the underlying cause.

Over-the-counter medications that relieve throat pain.

You can also use one or more of these treatments, which work directly on the pain of a sore throat:

a sore throat spray that contains a numbing antiseptic like phenol, or a cooling ingredient like menthol or eucalyptus
throat lozenges
cough syrup

How to prevent a sore throat

While a sore throat cannot always be avoided, there are several steps you can take to help prevent it.

Some ways you may be able to prevent a sore throat includeTrusted Source:

clean your hands regularly
limit close contact with others who have respiratory infections, sore throats, and colds
if you smoke, consider quitting
avoid exposure to secondhand smoke as much as possible

Conclusion:

Viral and bacterial infections, as well as irritants and injuries, cause the majority of sore throats. Most sore throats get better in a few days without treatment.

Rest, warm liquids, saltwater gargles, and over-the-counter pain relievers can help soothe the pain of a sore throat at home.

Strep throat and other bacterial infections are treated with antibiotics. A doctor can use a swab test to find out if you have strep.

See a doctor for more severe symptoms, like trouble breathing or swallowing, a high fever, or a stiff neck.

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Pilonidal Cyst – An unusual pocket in the skin

Sep 25, 2024 Posted by admin Uncategorized 0 comments

Overview

A pilonidal cyst is an unusual pocket in the skin that usually contains hair, dirt and skin debris. The cyst is almost always near the tailbone at the top of the buttocks. When a pilonidal sinus becomes infected it can turn into an abscess or cyst. It can cause severe pain and may ooze pus and blood and have a strong odor.

A pilonidal sinus infection mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.

You may not have any noticeable symptoms at first other than a small, dimple-like depression on the surface of your skin. However, once the depression becomes infected, it will quickly develop into a cyst (a closed sac filled with fluid) or an abscess (a swollen and inflamed tissue where pus collects).

Your doctor may prescribe antibiotics if the skin around your pilonidal cyst is inflamed, but antibiotics will not heal the cyst or make it go away.

This is the preferred method for your first pilonidal cyst. Your doctor makes a cut into the cyst and drains it. They remove any hair follicles and leave the wound open, packing the space with gauze.

It’s a simple procedure done under local anesthesia, meaning the doctor numbs just the area around the cyst. You have to change the gauze often until the cyst heals, which may take up to 3 weeks.

Symptoms

A pilonidal cyst may not cause symptoms. But if it’s infected, the skin around the cyst may be swollen and painful. Symptoms of an infected pilonidal cyst include:

A pit near the top of the buttocks crease.
Pain.
Inflamed, swollen skin.
Pus or blood leaking from an opening in the skin.
An odor from draining pus.

What are the causes of a pilonidal sinus infection?

The exact cause of an infected pilonidal sinus isn’t known, but it’s believed to be a combination of changing hormones hair growth, and friction from clothes or from spending a long time sitting.

Activities that cause friction, like sitting, can force the hair growing in the area to burrow back under the skin. The body considers this hair foreign and launches an immune response against it, similar to how it would react when dealing with a splinter.

This immune response forms the cyst around your hair. Sometimes a person may have multiple sinuses that connect under the skin.

The signs of an infection include:

pain when sitting or standing
swelling of the cyst
reddened, sore skin around the area
pus or blood draining from the abscess, causing a foul odor
hair protruding from the lesion
formation of more than one sinus tract, or holes in the skin

You may also experience a low-grade fever, but this is much less common.

Pilonidal Cyst Treatments

Can a pilonidal cyst go away on its own?

Sometimes, your cyst may open and drain on its own. If it does drain on its own, be sure to keep the area around it dry and clean.

Pilonidal cyst antibiotics

Your doctor may prescribe antibiotics if the skin around your pilonidal cyst is inflamed, but antibiotics will not heal the cyst or make it go away.

Phenol injection

For this type of treatment, your doctor will first give you a local anesthetic. They will then inject phenol, a chemical compound used as an antiseptic, into the cyst. This procedure may need to be repeated several times. Eventually, this treatment will cause the lesion to harden and close.

This treatment has a very high recurrence rate. Therefore, it’s uncommon in the United States. Doctors turn to surgery as the treatment of choice in some cases.

Laser therapy

Laser therapy won’t cure your current pilonidal cyst, but it can remove hair to prevent it from becoming ingrown. This could help keep further cysts from developing.

Pilonidal cyst surgery

If your pilonidal cyst is chronic or keeps returning, you may need surgery. You also may need surgery if the cyst worsens and creates a hole under your skin. Some forms of surgery include:

Marsupialization. In this procedure, your doctor makes a cut and drains the cyst, removing pus and any hair inside. Then, they sew the edges of the cut to the wound edges to make a pouch.

Advantages — This is outpatient surgery under local anesthesia. It also lets your doctor make a smaller, shallower cut so that you don’t need to repack gauze daily.
Disadvantages — It takes about 6 weeks to heal, and you need a doctor specially trained in the technique.

Incision, drainage, closing of wound. In this technique, the doctor drains the cyst, but it’s not left open.

Advantage — You don’t need to pack gauze because your doctor fully closes the wound after surgery.
Disadvantages — You’re more likely to have problems with the cyst in the future. It’s harder to remove the entire cyst with this method. It’s usually done in an operating room with a specially trained surgeon.

Risk factors

Factors that might increase your risk of a pilonidal cyst include:

Being a young adult white male.
Being overweight.
Having an inactive lifestyle.
Sitting for long periods at a time.
Having thick, stiff body hair.

Pilonidal Cyst Complications

If your pilonidal cyst is not treated or keeps returning, you could develop what’s called sinus cavities (empty spaces under the skin) and pockets of infection.

Infected pilonidal cyst

An infected pilonidal cyst can be painful and is referred to as an abscess.

If your cyst is infected, the pus may smell bad, and you may get a fever and feel nauseated.

If your infected cyst worsens, the infection could spread throughout your body, which might be life-threatening.

Pilonidal cyst recurrence

Even with medical treatment, you may develop chronic pilonidal disease, which means your cysts keep coming back.

Prevention

To help prevent pilonidal cysts, try to:

Wash regularly.
Achieve or maintain a healthy weight.
Avoid prolonged sitting.

If you’ve had pilonidal cysts in the past, you might want to regularly shave the affected area or use hair removal products to reduce the risk of a new cyst.

Takeaways/Conclusion

Pilonidal cysts are small fluid-filled sacs or bumps that appear along the crease or top of your buttocks. If the cyst isn’t painful, you can try treating it yourself. However, if the pain worsens or appears to get infected, you should see your doctor. Your doctor can treat the pilonidal cyst or surgically remove it. It’s important to know the signs of pilonidal cysts since they can come back after treatment.

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Leptospirosis

Sep 22, 2024 Posted by admin General Health 0 comments

Overview

Leptospirosis, also called Weil disease, is the most common zoonotic infection in the world. One can get leptospirosis after getting water or soil contaminated by animal pee (urine) in your nose, your mouth, your eyes or a break in your skin. Leptospirosis risk often increases after a hurricane or flood when people have contact with contaminated water or soil. leptospirosis in people can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, trouble breathing, and even death.

You can get leptospirosis no matter where you live, but it’s most common in tropical areas and warmer climates with lots of rainfall each year. You’re at an increased risk for leptospirosis if you live in or travel to these areas.

It generally takes 2-30 days to get sick after having contact with the bacteria that cause leptospirosis. The disease may occur in two phases:

In the first phase, people may have fever, chills, headache, muscle aches, vomiting, or diarrhea. The person may feel better for a while but become ill again.

Some people may suffer a more severe second phase with kidney or liver failure, or inflammation of the membrane around the brain and spinal cord (meningitis).

The illness can last from a few days to several weeks. Without treatment, getting better may take several months.

Weil’s syndrome is often deadly if not treated or if you delay treatment. But if treated promptly, it’s very likely you’ll recover.

Signs and symptoms

In people, leptospirosis can cause a wide range of symptoms, including:

Fever
Headache
Chills
Body or muscle aches
Vomiting or nausea
Yellowed skin and eyes (jaundice)
Red eyes
Stomach pain
Diarrhea
Rash

Many of these symptoms can be mistaken for other diseases. Some people have no symptoms.

Phases of leptospirosis

Leptospirosis consists of two phases: the leptospiremic (acute) phase and the immune (delayed) phase.

Leptospiremic phase

During the leptospirosis phase (also called the septicemic phase) you may experience a sudden onset of flu-like symptoms. This usually starts within two to 14 days after a Leptospira infection. It lasts between three and 10 days.

In this phase, bacteria are in your bloodstream and moving to your organs. Blood tests will show signs of infection.

Immune phase

In the immune phase, Leptospira bacteria has moved from your blood to your organs. The bacteria is most concentrated in your kidneys, which make pee (urine). Urine tests will show signs of the bacteria and you’ll have antibodies to Leptospira in your blood.

A small number of people will get very sick with Weil’s syndrome in this phase. Weil’s syndrome causes internal bleeding, kidney damage and severe yellowing of your skin and eyes (jaundice).

Diagnosis and Tests

Your healthcare provider diagnoses leptospirosis with a physical exam, blood tests and urine tests.

Blood or urine tests: A blood sample or a urine sample under the lab investigation will help diagnose Leptospirosis.
Imaging. If you are showing signs of severe leptospirosis, you may use a chest X-ray, CT scan or other imaging. They’ll use a machine to take pictures of the inside of your body to look for damage to your organs.

Treatment and Prevention

If you have severe leptospirosis, you’ll stay in the hospital. Your provider will give you antibiotics directly through an IV. Depending on which of your organs are affected, you may need additional medications or procedures.

Antibiotics. Types of antibiotics that treat leptospirosis include doxycycline, amoxicillin, ampicillin, penicillin-G and ceftriaxone. Your provider will decide which to use based on how sick you are and your medical history.
Mechanical ventilation. If your lungs are infected with bacteria, you may have a hard time breathing and need the help of a machine to breathe for you. Your provider will give you medication to keep you asleep while you’re connected to the machine.
Plasmapheresis. Also called plasma exchange, plasmapheresis might help you if you’re at risk for organ damage from leptospirosis. During this procedure, your provider removes your blood using a tube attached to a vein. A machine separates your plasma from your blood and replaces it with a plasma substitute. Your blood is then returned to your body through another tube.

The best way to prevent leptospirosis is by not swimming or wading in water that might have animal pee in it. This includes floodwaters. Other ways you can reduce your risk include:

Taking preventative medication. If you’re traveling and at high risk for leptospirosis, ask your provider about taking medication to keep from getting sick.
Avoiding animals that could have leptospirosis.
Wearing protective clothing and shoes if you work with or around animals.
Wearing protective shoes and clothing if you have to be in contact with water or soil that might be contaminated with bacteria.
Avoiding water sports and swimming in lakes and rivers after floods.
Drinking only treated water. Don’t drink water from lakes, rivers and canals without boiling it first.
Wearing gloves if you have to touch dead animals. Don’t touch them with your bare hands and wash your hands thoroughly afterwards.
Covering open cuts or wounds with waterproof dressing.

Can humans survive leptospirosis?

Yes, you can survive leptospirosis. Most cases of leptospirosis have no symptoms or have very mild symptoms that go away on their own. Weil’s syndrome is often deadly if not treated or if you delay treatment. But if treated promptly, it’s very likely you’ll recover.

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