Abulia, also known as aboulia, is a state of diminished motivation. In general, abulia refers to a type of apathy that develops as a result of disease, specifically disease that affects the brain. Some people who have abulia are aware of the change in level of motivation, but it is particularly noticeable and upsetting for friends and loved ones.

An individual who experiences abulia may show symptoms that range from subtle to overwhelming in levels of severity, with mutism (not speaking) being the most extreme form.

Abulia is most commonly associated with neurologic or psychiatric conditions. It is estimated that about 20-30% of stroke survivors experience apathy or abulia.

When abulia results from a sudden event, such as a stroke, it may become apparent during or after stroke recovery. When abulia results from a progressive disease, such as Alzheimer’s disease or Parkinson’s disease, it may worsen over time.

Symptoms

There are a number of symptoms of abulia.

Typical symptoms may include any combination of the following:

• Apathy- lack of interest or motivation in getting things started or in joining activities. Not enthusiastic about getting things done. Difficulty initiating or completing projects or important tasks.
• Disinterest in things that are going on or in participating in activities or events.
• Passivity
• Lack of opinion or lack of expression of opinion about preferences
• Asocial- lack of interest in other people, lack of interaction with others, limited communication with others, avoiding others.
• Extreme quiet or muteness

• Physical slowness of movement
• Lack of spontaneity
• Emotionally remote
• Difficulty in making decisions or plans, indecisiveness
• Chewing food for long periods of time without swallowing

Causes

Brain damage or dementia can interfere with normal functioning in the brain, resulting in abulia.

Damage to the nerve circuits of the frontal lobes of the brain that impact the dopaminergic system, is thought to be the cause of abulia. The dopaminergic system describes the system of chemicals produced in the brain that provide positive feelings of happiness and satisfaction. Thus, it is possible that once positive feedback is disrupted, there is little incentive to try to attain things that make a person ‘happy.’

Most people who experience and show symptoms of abulia have experienced one of the following conditions:

• Stroke
• Huntington’s disease
• Schizophrenia
• Acquired brain injury- from trauma, cancer or infection
• Alzheimer’s disease
• Vascular dementia
• Lewy body dementia
• Parkinson’s disease
• Frontotemporal dementia

Difference From Depression

While they share some features in common, abulia and depression are not the same. Abulia is clinically distinct from depression in that people living with abulia typically do not exhibit signs of sadness or negative thoughts. Instead, they exhibit a lack of concern about their condition or about the world around them.

Establishing the difference between the two conditions and getting an accurate diagnosis is important because abulia does not improve with antidepressant medications, while people who have depression should generally expect to experience improvement of symptoms with antidepressants.

Diagnosis

You might be wondering whether you have abulia or depression or whether your friend, coworker or loved one has abulia or depression. You should start by seeking medical attention so that the symptoms and signs can be carefully evaluated.

The diagnosis of abulia may take some time. Abulia is diagnosed through a medical history that details the feelings and actions of the person who might have abulia, as well as a history of the observations make by friends and loved ones. Your doctor may ask further questions and make clinical observations during the office visit. In some cases of abulia, diagnostic imaging with a Brain CT scan or Brain MRI scan can reveal localized brain lesions such as stroke, one of the main causes of abulia.

Treatment

There are some medical treatments available for the treatment and management of abulia. Medications that have an effect on the body’s dopaminergic system, which is disrupted in abulia, have shown positive results when it comes to objective symptoms of abulia.

Cognitive rehabilitation can help in optimizing thinking skills, which may improve abulia. Physical therapy can help with initiating physical activity, possibly increasing motivation in people who are affected with this condition. Counseling and family counseling can improve communication and help in dealing with abulia.

CAUSES:

Whiplash occurs when the muscles in your neck suffer a strain because of a rapid movement backward and then forward. The sudden motion causes your neck’s tendons and ligaments to stretch and tear, resulting in whiplash.

Symptoms:

What does whiplash feel like?

How is whiplash diagnosed?

Treatment for whiplash:

Complications associated with whiplash

By the time you sign up for back surgery, your doctor will probably have tried a number of treatments to ease your back pain. While there are no guarantees the operation will provide relief, there are lots of options. Learn as much as you can about back surgery ahead of time. The more you know, the better the choice you’ll make.

What Are the Benefits?

Often, the result is more than just a drop in pain. You may find:

• You can move around better.
• You’re more physically fit.
• Your mood improves.
• You don’t need to take as much pain medicine.
• You can go back to work.
• You’re more productive at work

Risks:

That said, any operation will have some degree of risk, including:

• Reaction to anesthesia or other drugs
• Bleeding
• Infection
• Blood clots, for instance in your legs or lungs
• Heart attack
• Stroke
• Herniated disk
• Nerve damage, which can lead to weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control

The odds that something could go wrong go up for people with certain health conditions. They also vary by type of surgery. Part of your surgeon’s job is to identify potential problems. So talk it over before you head to the OR.

Each type comes with its own risks and benefits.

Spinal fusion. This is the most common surgery for back pain. The doctor will join spinal bones, called vertebrae, together. This limits the motion between them and how far your nerves can stretch. But it probably won’t limit your activity. It’s rare, but the bones don’t always fuse completely. Smoking can make this more likely. If it happens, you may need another operation to fix it.

Laminectomy. In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in your back. This relieves pressure on spinal nerves and can ease pain or weakness. It can make your spine less stable. If that happens, you’ll probably need a spinal fusion. Doctors sometimes do the two procedures together.

Foraminotomy. The surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. So the surgeon may do a spinal fusion at the same time. That’ll increase the amount of time you need for recovery.

Diskectomy. Sometimes a disk, the cushion that separates your vertebrae, can slip out of place, press on a spinal nerve, and cause back pain. In a diskectomy, the surgeon removes all or part of the disk. He may have to make a big cut in your back, or he may be able to do it through a small one. Sometimes it’s part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion.

Disk replacement. A surgeon removes the damaged spinal disk and inserts an artificial one between your vertebrae. Unlike fusion, this lets you continue to move your spine. Recovery time may be shorter than for a spinal fusion, too. But there is a slight chance the new disk could slip or fall out of place and require repair.

Interlaminar implant. The surgeon implants a U-shaped device between two vertebrae in your lower back. It helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. Unlike spinal fusion, the implant provides stability and lets you move your back almost like normal. You may not be able to bend backward as easily in that area.

List of Hospitals which is giving treatments for International Patients under Global Treatments Services P. Ltd., Bangalore are given below:

 

Dumping syndrome is common after gastric surgery. It is a group of symptoms that may result from having part of your stomachremoved or from other surgery involving the stomach. The symptoms range from mild to severe and often subside with time. Although you may find dumping syndrome alarming at first, it is not life threatening. You can control it by making changes in what and how you eat. By controlling dumping syndrome, you will also be avoiding the foods that tend to make you gain weight.

Causes of Dumping Syndrome

After gastric surgery, it can be more difficult to regulate movement of food, which dumps too quickly into the small intestine. Eating certain foods makes dumping syndrome more likely. For example, refined sugars rapidly absorb water from the body, causing symptoms. Symptoms may also happen after eating dairy products and certain fats or fried foods.

Dumping Syndrome: Symptoms of the Early Phase

An early dumping phase may happen about 30 to 60 minutes after you eat. Symptoms can last about an hour and may include:

• A feeling of fullness, even after eating just a small amount
• Abdominal cramping or pain
• Nausea or vomiting
• Severe diarrhea
• Sweating, flushing, or light-headedness
• Rapid heartbeat

 

 

Dumping Syndrome: Causes of the Early Phase

Symptoms of an early phase happen because food is rapidly “dumping” into the small intestine. This may be due to factors such as these:

• The small intestine stretches.
• Water pulled out of the bloodstream moves into the small intestine.
• Hormones released from the small intestine into the bloodstream affect blood pressure.

Dumping Syndrome: Symptoms of the Late Phase

A late dumping phase may happen about 1 to 3 hours after eating. Symptoms may include:

• Fatigue or weakness
• Flushing or sweating
• Shakiness, dizziness, fainting, or passing out
• Loss of concentration or mental confusion
• Feelings of hunger
• Rapid heartbeat

Dumping Syndrome: Causes of the Late Phase

The symptoms of this late phase may happen due to a rapid rise and fall in blood sugar levels. The cause of this rapid swing in blood sugar may be worse when eating sweets or other simple carbohydrates.

If you have not already been diagnosed with the dumping syndrome, and you have confusion, dizziness, rapid heartbeat, or fainting, get immediate medical help.

Dumping Syndrome Treatment

Many people find that taking steps like these greatly reduces symptoms of dumping syndrome.

Foods to avoid. Avoid eating sugar and other sweets such as:

• Candy
• Sweet drinks
• Cakes
• Cookies
• Pastries
• Sweetened breads

Also avoid dairy products and alcohol. And avoid eating solids and drinking liquids during the same meal. In fact, don’t drink 30 minutes before and 30 minutes after meals.

Foods to eat. To help with symptoms, also try these tips:

• Use fiber supplements, such as psyllium (Metamucil or Konsyl), methylcellulose (Citrucel), or guar gum (Benefiber).
• Use sugar replacements, such as Splenda, Equal, or Sweet’N Low, instead of sugar.
• Go for complex carbohydrates, such as vegetables and whole-wheat bread, instead of simple carbohydrates, such as sweet rolls and ice cream.
• To prevent dehydration, drink more than 4 cups of water or other sugar-free, decaffeinated, noncarbonated beverages throughout the day.

How to eat. Here are some other ways to lessen symptoms of dumping syndrome:

• Eat five or six small meals or snacks a day.
• Keep portions small, such as 1 ounce of meat or 1/4 cup of vegetables.
• Cut food into very small pieces. Chew well before swallowing.
• Combine proteins or fats along with fruits or starches. (For example, combine fruit with cottage cheese.)
• Stop eating when you first begin to feel full.
• Drink liquids 30 to 45 minutes after meals.
• Reclining after eating may help prevent light-headedness.

When to Call the Doctor About Dumping Syndrome

It is important to manage dumping syndrome so you stay well-nourished and don’t lose too much weight. Talk to your health care provider about any symptoms you have and what else you can do. In some cases, medication or surgery may be needed to help correct the symptoms of dumping syndrome.

If you’ve received the news that your lung contains something “suspicious,” this may be a source of great distress. The first thing that may come to mind is a dreaded word: cancer. In many cases, though, a lung nodule turns out to be benign. This means that it isn’t cancer. A hard part is waiting and not knowing. Here’s information that may make your wait just a little bit easier.

What Are Benign Lung Nodules and Benign Lung Tumors?

A nodule is a “spot on the lung,” seen on an X-ray or computed tomography (CT) scan. In fact, a nodule shows up on about one in every 500 chest X-rays. Normal lung tissue surrounds this small round or oval solid overgrowth of tissue. It may be a single or solitary pulmonary nodule. Or, you may have multiple nodules.

Your lung nodule is more likely to be benign if:

• You are younger than age 40.
• You are a nonsmoker.
• There is calcium in the nodule.
• The nodule is small.

A benign lung tumor is an abnormal growth of tissue that serves no purpose and is found not to be cancerous. Benign lung tumors may grow from many different structures in the lung.

Determining whether a nodule is a benign tumor or an early stage of cancer is very important. That’s because early detection and treatment of lung cancer can greatly enhance your survival.

What Are the Symptoms of Benign Lung Nodules and Tumors?

Benign lung nodules and tumors usually cause no symptoms. This is why they are almost always found accidentally on a chest X-ray or CT scan. However, they may lead to symptoms like these:

• wheezing
• Coughing that lasts or coughing up blood
• Shortness of breath
• Fever, especially if pneumonia is present

What Are the Causes of Benign Lung Nodules and Tumors?

The causes of benign lung tumors and nodules are poorly understood. But in general, they often result from problems like these:

Inflammation from infections such as:

• An infectious fungus (histoplasmosis, coccidioidomycosis, cryptococcosis, or aspergillosis, for example)
• Tuberculosis (TB)
• A lung abscess
• Round pneumonia (rare in adults)

Inflammation from noninfectious causes such as:

• Rheumatoid arthritis
• Wegener granulomatosis
• Sarcoidosis

• Birth defects such as a lung cyst or other lung malformation.

  These are some of the more common types of benign lung tumors:

  • Hamartomas are the most common type of benign lung tumor and the third most common cause of solitary pulmonary nodules. These firm marble-like tumors are made up of tissue from the lung’s lining as well as tissue such as fat and cartilage. They are usually located in the periphery of the lung.
  • Bronchial adenomas make up about half of all benign lung tumors. They are a diverse group of tumors that arise from mucous glands and ducts of the windpipe or large airways of the lung. A mucous gland adenoma is an example of a true benign bronchial adenoma.
  • Rare neoplasms may include chondromas, fibromas, or lipomas — benign tumors made up of connective tissue or fatty tissue.

 

 

A pleural effusion is an unusualamount of fluid around the lung.There are many medicalconditions that can lead to  it. Soeventhough your pleural effusionmay have to be drained, yourdoctor likely will target thetreatment at whatever  caused it.

The pleura is a thin membranethat lines the surface of the lungsand the inside of the chest walloutside the lungs. In pleuraleffusions, fluid builds up in thespace between the layers of pleura.

Normally, only teaspoons of watery fluid are in the pleural space, allowingthe lungs to move smoothly within the chest cavity during breathing.

Causes

A wide range of things can cause a pleural effusion. Some of the morecommon ones are:

• Leakage from other organs: This is usually from congestive heartfailure (when your heart doesn’t pump blood to your body properly).But it can also come from liver or kidney disease when fluid builds up inyour body and leaks into the pleural space.
• Cancer: Usually lung cancer is the problem, but other cancers that havespread to the lung or pleura can cause it, too.
• Infections: Examples are pneumonia or tuberculosis.
• Autoimmune conditions: Examples are lupus or rheumatoid arthritis.
• Pulmonary embolism: This is a blockage in an artery in one of yourlungs.

Symptoms

You might not have any. You’re more likely to have symptoms when a pleuraleffusion is moderate or large-sized, or if inflammation is present.

If you do have symptoms, they may include:

• Shortness of breath
• Chest pain, especially on breathing in deeply (pleurisy, or pleuritic pain)
• Fever
• Cough

Types

Doctors use the terms “transudative” and “exudative” to describe the two main types of pleural effusions:

Transudative: This pleural effusion fluid is similar to the fluid you normally have in your pleural space. It forms from liquid leaking across normal pleura. This type of pleural effusion rarely needs to be drained unless they are very large. Congestive heart failure is the most common cause of this type of effusion.

Exudative: This effusion forms from excess liquid, protein, blood, inflammatory cells or sometimes bacteria leaking across damaged blood vessels into the pleura. It may need to be drained, depending on its size and how much inflammation is involved. Among its causes are pneumonia and lung cancer.

Treatment

Your doctor may need to treat only the medical condition that caused the pleural effusion. You would get antibiotics for pneumonia, for instance, or diuretics for congestive heart failure.

Large, infected, or inflamed pleural effusions often need to be drained to help you feel better and to prevent more problems. Procedures for treating pleural effusions include:

• Thoracentesis: If the effusion is large, your doctor may take more fluid than she needs for testing, just to ease your symptoms.
• Tube thoracostomy (chest tube): The doctor makes a small cut in your chest wall, and inserts a plastic tube into your pleural space for several days.
• Pleural drain: For pleural effusions that keep coming back, you may get a long-term catheter inserted through your skin into the pleural space. You can drain the pleural effusion at home. Your doctor will tell you how and when to do that.
• Pleurodesis: Your doctor injects an irritating substance (such as talc or doxycycline) through a chest tube into the pleural space. The substance inflames the pleura and chest wall, which then bind tightly to each other as they heal. Pleurodesis can prevent pleural effusions from coming back, in many cases.
• Pleural decortication: Surgeons can operate inside the pleural space, removing potentially dangerous inflammation and unhealthy tissue. To do this, your surgeon may make small cuts (thoracoscopy) or a large one (thoracotomy).

 

 

A cold or the flu runs its course in a couple weeks, if you’re lucky. After that, you’re back to normal. But sometimes you may get bronchitis, too.

That’s when your bronchial tubes, which carry air to your lungs, get infected and swollen. You end up with a nagging cough and a lot more mucus.

You can get bronchitis in other ways, too, and there are actually two types of it:

• Acute bronchitis: This is the more common one. Symptoms last for a few weeks, but it doesn’t usually cause any problems past that.
• Chronic bronchitis: This one is more serious, in that it keeps coming back or doesn’t go away at all. It’s one of the conditions that makes up what’s called chronic obstructive pulmonary disease (COPD).

 

What causes toxic megacolon?

How is toxic megacolon treated?